TPN治疗对老年腹部外科患者血黏度的影响

目的 :探讨完全胃肠外营养 (TPN)对腹部外科老年患者的全血及血浆黏度的影响。方法 :6 1例不能经口进食≥ 7d的腹部外科老年患者随机分为TPN组和常规输液组 ,用旋转黏度计测定TPN治疗前及治疗 7d后的全血黏度及血浆黏度 ,作自身对照 ,并与常规输液组作比较。结果 :TPN组在TPN前切变率为 2 0 0s-1、5s-1时的全血黏度 (mPa·s)和切变率为 10 0 -1S 时的血浆黏度(mPa·s)分别为 3.4 9± 0 .6 7,7.2 6± 1.2 7,1.4 8± 0 .13;在TPN后切变率为 2 0 0 -1S 、5 -1S 时的全血黏度 (mPa·S)和切变率为 10 0 -1S时的血浆黏度 (mPa·S)分别为 3.83± 0 .86 ,7.5 1± 1.4 1,1.5 2± 0 .12 ;常规输液组治疗后切变率为 2 0 0 -1S 、5 -1S 时的全血黏度 (mPa·S)和切变率为 10 0 -1S 时的血浆黏度 (mPa·S)分别为 3.6 0± 0 .6 2 ,8.0 7± 1.17,1.5 0± 0 .12。经t检验 ,TPN前后不同切变率的全血和血浆黏度均无显著差异 (均P >0 .0 5 ) ;TPN治疗后与常规输液组治疗后不同切变率的全血和血浆黏度也均无显著差异 (均P >0 .0 5 )。结论 :腹部外科老年患者用TPN治疗 7d ,不引起全血及血浆黏度的明显变化     

Monitoring Treatment Response and Metastatic Relapse in Advanced Bladder Cancer by Liquid Biopsy Analysis

Of the patients undergoing radical cystectomy, 20–80% experience relapse. Minimally invasive methods for early detection of metastatic relapse after cystectomy and for monitoring ongoing therapy are urgently needed to improve individualised follow-up and treatment. Therefore, we evaluated the use of circulating tumour DNA (ctDNA) in plasma and urine to detect metastatic relapse after cystectomy and measure treatment efficacy. We exome sequenced tumour and germline DNA from patients with muscle-invasive bladder cancer and monitored ctDNA in 370 liquid biopsies throughout the disease courses by 84 personalised digital droplet polymerase chain reaction assays targeting 61 genes. Patients were prospectively recruited between 2013 and 2017. Patients with metastatic relapse had significantly higher ctDNA levels compared with disease-free patients (p < 0.001). The median positive lead time between ctDNA detection in plasma and diagnosis of relapse was 101 d after cystectomy (range 0–932 d). Early detection of metastatic relapse and treatment response using liquid biopsies represents a novel, highly sensitive tool for monitoring patients, supporting clinicians, and guiding treatment decisions.

精浆弹性硬蛋白酶与精子 DNA 完整性及精液参数的影响分析

目的：探讨男性不育患者精浆弹性硬蛋白酶水平与精子 DNA完整性及精液质量之间的关系。方法选择148例男性不育患者根据精浆弹性硬蛋白酶的检测结果将所有患者分为 A、B、C3组。 A组为精浆弹性硬蛋白酶含量＜290 ng／mL;B组为精浆弹性硬蛋白酶含量290～1000 ng／mL;C 组为精浆弹性硬蛋白酶含量＞1000ng／mL。用酶联免疫吸附试验（ ELISA）检测精浆中弹性硬蛋白酶,精子 DNA完整性检测用精子染色质扩散法（ SCD）,精液参数用计算机辅助精子分析系统检测。结果 A组与 C 组相比精子存活率与前向运动精子百分率（PR）均升高、精子DNA碎片指数（DFI）明显降低,差异均具有统计学意义（ P＜0．05）。 B组的上述指标与A组相比,差异均无统计学意义（ P ＞0．05）。结论精浆弹性硬蛋白酶与精子DNA完整性及精液质量密切相关,生殖道感染是影响男性精液质量的一个重要原因。     

No strict requirement for eosinophils for bone marrow plasma cell survival

Lasting antibody responses are maintained by long‐lived plasma cells, which are thought to lodge in the BM in specialized survival niches. Eosinophils have been reported to function as a critical component of the BM survival niche where they are thought to provide pro‐survival signals to nearby plasma cells. Recent study shows that many BM plasma cells are recently generated and chiefly short‐lived cells, raising the possibility that rare plasma cell–eosinophil interactions are a rate‐limiting step needed to establish lasting humoral immunity. To address these issues, we examined the impact of eosinophil depletion on short‐ and long‐lived BM plasma cells in the context of antibody responses induced by both T‐cell dependent and T‐cell independent antigens. Surprisingly, our results failed to support a role for eosinophils in either plasma cell generation or survival. These studies included examination of plasma cell frequencies in mice lacking eosinophils either after antibody‐mediated depletion, or due to mutation of the GATA1 locus.     

General overview of blood products in vitro quality: Processing and storage lesions

Blood products are issued from blood collection. Collected blood is immediately mixed with anticoagulant solutions that immediately induce chemical and/or biochemical modifications. Collected blood is then transformed into different blood products according to various steps of fabrication. All these steps induce either reversible or irreversible “preparation-related” lesions that combine with “storage-related” lesions. This short paper aims to provide an overview of the alterations that are induced by the “non-physiological” processes used to prepare blood products that are used in clinical practice.     

Platelet—Rich—Plasma Injections in Treating Lateral Epicondylosis: a Review of the Recent Evidence

Lateral epicondylosis is common, with various treatment modalities. Platelet—rich—plasma injections from autologous blood have recently been used in centres worldwide for the treatment of tennis elbow. We review and present the recent published evidence on the effectiveness of PRP injections for lateral epicondylosis. Nine studies met our inclusion criteria including 6 RCT’s for the purpose of analysis. PRP injections have an important and effective role in the treatment of this debilitating pathology, in cases where physiotherapy has been unsuccessful.     

结外NK/T细胞淋巴瘤鼻型患者B症状与EBV‐DNA及细胞因子预后价值分析

目的 探讨结外NK/T细胞淋巴瘤鼻型（ENKTL）患者治疗前B症状与血浆EBV‐DNA拷贝数和血清细胞因子水平的相关关系,并分析其机制和预后价值。方法 回顾性分析资料齐全的173例患者,其中男性116例,女性57例,中位年龄43岁（4~71岁）。Ann Arbor分期Ⅰ‐Ⅱ期126例,Ⅲ‐Ⅳ期47例。肿瘤原发部位包括鼻腔（100例）、非鼻腔上呼吸消化道（34例）和上呼吸消化道以外（39例）。治疗前有和无B症状者分别为91例和82例。按照血浆EBV‐DNA拷贝数的高低分为阴性组36例、低载量（<10⁴ copies/ml）组73例和高载量（≥10⁴ copies/ml）组64例。检测的血清细胞因子包括IFN‐γ、IL‐2、IL‐4、IL‐6、IL‐10和TNF‐α。相关性分析采用Cochran‐Armitage趋势检验和Spearman相关性分析,采用Cox回归风险模型进行单因素分析评估预后影响因素并用Kaplan‐Meier法绘制生存曲线。结果 B症状及发热的发生与血浆EBV‐DNA拷贝水平的增加呈显著一致的趋势,发生B症状的患者其血清IFN‐γ、IL‐6和IL‐10的水平均高于无B症状组（P均<0.001）。血清IFN‐γ、IL‐6和IL‐10水平也均与血浆EBV‐DNA拷贝数呈正相关。B症状的发生与ENKTL患者的高危临床特征相关,包括晚期、原发肿瘤局部侵犯、区域淋巴结累及和治疗前LDH升高。单因素生存分析显示,Ann Arbor分期、B症状、血浆EBV‐DNA及上述血清细胞因子均为OS和PFS的影响因素（P均<0.05）。然而,多因素分析并未显示B症状对生存的独立预后价值。结论 ENKTL患者B症状的发生与EBV‐DNA拷贝水平和细胞因子的增高有关,这些指标也是影响ENKTL患者预后的重要因素。