胃癌组织中PDCD4基因的表达和甲基化水平及其临床意义

目的 观察胃癌组织中抑癌基因PDCD4启动子区甲基化状态及其对PDCD4表达水平的影响并探讨其临床意义。方法 通过免疫组织化学、Western blot法检测胃癌组织中PDCD4蛋白的表达；RT-PCR法检测PDCD4 mRNA的表达；甲基化特异性PCR（MSP）法检测PDCD4启动子区甲基化水平。分析PDCD4表达水平以及启动子甲基化水平与胃癌患者临床病理特征之间的相关性。结果 胃癌组织中PDCD4蛋白及mRNA表达水平均显著降低（P<0.05），甲基化作用显著增强（P<0.05）。PDCD4蛋白表达缺失与胃癌的分化、临床分期以及淋巴结转移密切相关（P<0.05）；PDCD4高甲基化与胃癌的淋巴结转移、临床分期密切相关（P<0.05）。PDCD4甲基化水平与PDCD4蛋白以及mRNA表达水平均呈负相关（P<0.05）。结论 胃癌组织中PDCD4表达水平显著降低，并与胃癌发展相关，启动子区高甲基化可能是PDCD4表达缺失的原因。     

Neoadjuvant Crizotinib in Resectable Locally Advanced Non–Small Cell Lung Cancer with ALK Rearrangement

Background

Locally advanced NSCLC is one of the most heterogeneous conditions, with multidimensional treatments involved. Neoadjuvant therapy had been commonly considered an optimal management strategy for patients with operable locally advanced. However, as targeted therapy has been widely applied in advanced NSCLC, neoadjuvant targeted therapy has remained poorly explored in locally advanced disease.

1470 nm激光在解剖性切除非肌层浸润性膀胱癌中的临床应用

目的探讨1470 nm激光在解剖性切除非肌层浸润性膀胱癌中的临床疗效。方法回顾性分析2018年1月至2019年12月于本院泌尿外科行1470 nm激光解剖性切除浅表性膀胱肿瘤患者60例的临床资料,所有患者均通过膀胱镜检查和CT或MRI检查,术前诊断为非肌层浸润性膀胱癌。分析1470 nm激光在解剖性切除非肌层浸润性膀胱癌中的应用效果。结果所有患者均顺利完成手术,无中转开放手术,并且术中无并发症,手术时间为10~30 min,平均(15.3±4.9)min,术后冲洗液无色或淡粉色,未见血块,术后1周拔除导尿管。结论1470 nm激光应用于解剖性切除浅表性膀胱肿瘤中效果显著,具有无瘤原则,利于肿瘤分期,可减少闭孔反射。     

头皮银屑病的中西医结合治疗进展

头皮银屑病是隶属银屑病的特殊类型,因其发病部位的特殊性,给治疗带来了诸多挑战。目前,临床主要以糖皮质激素、抗真菌制剂、维生素D3衍生物、紫外线等外治为主。但单纯的西医治疗效果局限。通过结合中医药辨证分型、外清内调综合施治,取得了一系列骄人的成果。研究表明,中西医结合疗法在增效、降费、减轻副作用、提高依从性等方面具有独特的优势。本文主要从中西医结合疗法应用于头皮银屑病治疗相关机理、效用性的角度进行综述,以期推动中西医结合治疗头皮银屑病共识的形成。     

阿莫西林与替硝唑治疗急性肠胃炎的效果观察

目的观察阿莫西林与替硝唑治疗急性肠胃炎的效果。方法以本院2018年4月—2019年4月收治的60例急性肠胃炎患者作为研究对象,借助双盲随机抽样法分为对照、试验组,每组列入30例,对照组给予阿莫西林治疗,试验组予以阿莫西林与替硝唑联合治疗,评定两组患者的临床效果、肠胃炎症状积分。结果治疗前,两组患者的肠胃炎症状积分无显著差异,P>0.05(t=0.0752,P=0.9403);治疗后,试验组相较于对照组患者的肠胃炎症状积分较低,P<0.05(t=14.5841,P=0.0000);试验组(96.67%)较对照组(76.67%)临床效果较高,P<0.05(χ²=5.1923,P=0.0226)。结论急性肠胃炎患者予以阿莫西林与替硝唑联合治疗具有积极意义,值得临床研究。     

颈内动脉钙化积分与缺血性中风急性期中医证型的相关性研究

目的:探讨颈内动脉Agatston钙化积分与缺血性中风急性期中医证型的相关性。方法:将400例缺血性中风急性期患者按照中医辨证分为风痰火亢、风火上扰、痰热腑实、风痰瘀阻、痰湿蒙神、气虚血瘀、阴虚风动等7个证型;所有病例均行Siemens双源头颈CT检查,计算颈内动脉Agatston钙化积分,并根据积分划分为0分、1~199分、200~399分、400~599分及≥600分5个等级;比较缺血性中风急性期各中医证型患者的颈内动脉钙化积分情况。结果:缺血性中风急性期各中医证型患者在年龄、性别方面比较,差异无统计学意义(P0.05)。共有328例患者存在颈内动脉钙化,各证型患者所占例数从多到少依次为:风痰瘀阻证气虚血瘀证阴虚风动证痰热腑实证风火上扰证风痰火亢证痰湿蒙神证。各中医证型患者颈内动脉钙化积分比较,差异有统计学意义(P0.05);各证型的颈内动脉钙化积分级比较,差异无统计学意义(P0.05)。结论:缺血性中风急性期中医证型中分布风痰瘀阻证及气虚血瘀证占比较多;各中医证型颈内动脉钙化积分存在一定差异,以气虚血瘀证积分最高、风痰瘀阻证次之,此可为缺血性中风急性期中医辨证分型的研究提供参考。     

Resilience and Depression Influence Clinical Outcomes Following Primary Total Joint Arthroplasty

BackgroundResilience and depression may impact clinical outcomes following primary total joint arthroplasty (TJA). This study aimed to quantify baseline resilience and depression prevalence in patients undergoing primary TJA and evaluate their influence on patient-reported clinical outcomes.MethodsWe prospectively enrolled 98 patients undergoing primary TJA. Exclusion criteria included patients under 18 years of age, undergoing surgery for fracture, or who underwent additional surgery during the study period. Patients completed the Brief Resilience Scale to measure resilience, Patient Health Questionnaire-9 to measure depression, and Patient-Reported Outcomes Measurement Information System-10 to measure global physical and mental health preoperatively and 1 year postoperatively.ResultsPreoperatively, 22% and 15% of patients demonstrated major and mild depression, respectively. High resilience was identified in 34% of patients, normal resilience in 55%, and low resilience in 11%. Preoperative depression correlated with lower resilience, global physical health, and global mental health scores preoperatively as well as at 1 year after surgery (P < .001). Higher levels of preoperative resilience correlated with higher global physical and mental health scores preoperatively and at 1 year postoperatively (P < .001).ConclusionDepression symptoms are common among patients undergoing primary TJA and are associated with worse patient-reported outcomes. Patients with higher levels of resilience have higher global physical and mental health scores before and after TJA. Psychological traits and depression impact clinical outcomes following TJA.     

分化型甲状腺癌患者口服131I后体内活度变化及剂量水平

目的 研究¹³¹I治疗分化型甲状腺癌（DTC）患者体内放射性活度及外部剂量水平的变化规律，分析二者之间的关系，并估算400 MBq患者剂量当量率的修正因子。方法 研究对象为43例甲状腺全切术后，首次行¹³¹I"清甲"治疗的DTC患者，服药量为1 850~3 700 MBq，平均服药量（2 405±777）MBq。分别于口服¹³¹I后2、6、20、22、24、27、30、44、46、48、54、68及72 h，测定患者的体内剩余放射性活度以及患者前部0.3、1及3 m处的剂量当量率。结果 患者服¹³¹I后的体内剩余放射性活度随时间变化函数为A=A₀（1.033 16e^{-0.062 4t}+0.017 17）。可估算出"清甲"治疗的DTC患者有效半减期为12.19 h，体内放射性活度降至400 MBq仅需26.4~38.9 h。患者服用¹³¹I后距其0.3、1及3 m的标准化剂量当量率随时间变化函数分别为：Ḣ_0.3=127.220 7e^{-0.054 8t}+3.765 71、Ḣ₁=30.225 8e^{-0.064 4t}+0.824 67、Ḣ₃=4.161 9e^{-0.061 5t}+0.167 97。患者服¹³¹I后体内剩余放射性活度与1 m处剂量当量率呈正相关（r=0.982，P<0.05），函数为Ḣ₁=0.025A+1.245。DTC患者体内剩余活度分别为1 000、700和400 MBq时，距患者1 m处对应的剂量当量率分为26.2、18.7和11.2 μSv/h。估算活度为400 MBq的患者0.3、1及3 m处剂量当量率的修正因子分别为0.25、0.49及0.70。结论 服用¹³¹I活度在3 700 MBq以下的DTC患者仅需住院2日便可达到出院标准。当DTC患者体内活度降至400 MBq时，其1 m处的剂量当量率远小于25 μSv/h。单纯利用点源公式估算患者周围剂量当量率会造成高估的情况，因此对于公式估算患者周围辐射水平时使用的修正因子还需进一步研究，使模型估算结果更贴合实际情况。     

Association of Physical Activity,Screen Time and Sleep with Depressive Symptoms in Adolescents

Little is known on the association between movement behaviors including physical activity (PA), screen time (ST) and sleep (SLP) with depression in adolescents. This study aimed to explore the associations of PA, ST and SLP with depressive symptoms in adolescents. A total of 1,331 middle school students participated in this survey and provided valid data pertaining to the study variables. Self-reported questionnaires were used to collect information on participants’ sociodemographic parameters. The Health Behavior in School-aged Children Questionnaire was used to assess the PA (days for moderate to vigorous PA), ST (daily hours of ST) and SLP (daily hours of SLP). Study participants’ depressive symptoms were assessed using the Children’s Depression Inventory. Generalized linear models were used to estimate the associations of PA, ST and SLP with depressive symptoms. Of all the 1331 study participants, boys accounted for 51.31% and percentage of 7^th, 8^th and 9^th graders were 52.44%, 23.22% and 24.34%, respectively. After controlling for sex, body mass index, grade, ethnicity, residence, siblings, perceived family affluence, father and mother educational level, only ST was positively associated with depressive symptoms (beta = 0.17, p = 0.005). This study suggests that excessive ST would be detrimental to depressive symptoms in adolescents. It may be effective to reduce ST for depression intervention or prevention. Future studies are encouraged to use an improved study design to confirm or negate this study’s research findings.