糖尿病足溃疡病人D型人格、心理弹性与其抑郁的相关性研究

目的:探讨糖尿病足溃疡病人抑郁、D型人格、心理弹性现状及其相关性。方法:选取2020年8月—2021年1月青岛市某三级甲等医院门诊219例糖尿病足溃疡病人为研究对象,采用一般情况调查表、D型人格量表、心理弹性量表及抑郁自评量表对其进行问卷调查。结果:糖尿病足溃疡病人抑郁自评量表得分为(58.88±10.07)分,心理弹性得分为(53.56±11.67)分,有104例病人具有D型人格特质,占47.49%(104/219)。糖尿病足溃疡病人D型人格负面情感和社交抑制维度得分与抑郁得分呈正相关(r=0.457,0.426;P<0.001),心理弹性得分与抑郁得分呈负相关(r=-0.510,P<0.001)。D型人格对抑郁存在正向预测作用(β=0.794,P=0.046),心理弹性对抑郁存在负向预测作用(β=-0.044,P=0.009)。结论:糖尿病足溃疡病人抑郁症状高发,且与其D型人格特质及心理弹性水平密切相关,医务人员应注意识别病人的D型人格特质,改善其心理弹性水平,以减少其抑郁的发生。     

湖北省中药饮片GMP认证中存在主要问题及建议

摘 要为全面理解中药饮片的生产质量管理规范（GMP）认证相关标准,提高企业对中药饮片GMP的认识,逐步统一检查员的检查尺度,本文对2017年湖北省中药饮片检查缺陷进行统计分析,对GMP认证过程中缺陷项目进行分类描述,提出相应的改进建议,以期为企业和检查员理解GMP标准提供参考。     

Establishing Decision Trees for Predicting Successful Postpyloric Nasoenteric Tube Placement in Critically Ill Patients

Background

Despite the use of prokinetic agents, the overall success rate for postpyloric placement via a self‐propelled spiral nasoenteric tube is quite low.

Methods

This retrospective study was conducted in the intensive care units of 11 university hospitals from 2006 to 2016 among adult patients who underwent self‐propelled spiral nasoenteric tube insertion. Success was defined as postpyloric nasoenteric tube placement confirmed by abdominal x‐ray scan 24 hours after tube insertion. Chi‐square automatic interaction detection (CHAID), simple classification and regression trees (SimpleCart), and J48 methodologies were used to develop decision tree models, and multiple logistic regression (LR) methodology was used to develop an LR model for predicting successful postpyloric nasoenteric tube placement. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of these models.

Results

Successful postpyloric nasoenteric tube placement was confirmed in 427 of 939 patients enrolled. For predicting successful postpyloric nasoenteric tube placement, the performance of the 3 decision trees was similar in terms of the AUCs: 0.715 for the CHAID model, 0.682 for the SimpleCart model, and 0.671 for the J48 model. The AUC of the LR model was 0.729, which outperformed the J48 model.

Conclusion

Both the CHAID and LR models achieved an acceptable discrimination for predicting successful postpyloric nasoenteric tube placement and were useful for intensivists in the setting of self‐propelled spiral nasoenteric tube insertion.     

湖北省原料药GMP认证中发现的主要缺陷及建议

目的：为全面理解原料药GMP认证相关标准,提高生产企业对原料药生产规范的认识和检查员的检查水平。方法：对2016年至2017年湖北省原料药现场检查中主要缺陷进行统计分析,对GMP认证中主要缺陷项目进行分类总结。结果与结论：通过共性问题,结合原料药产品的本身特点,建议加强各岗位操作人员培训,落实培训效果;合理设计厂房,加强硬件系统的改造;严格把关物料,做好溶剂回收工作;注重细节,有针对性做好确认与验证工作;文件管理系统化,记录填写规范化;引入风险管理,贯彻执行生产全过程管理;重视变更和偏差管理,提高质量意识;建立职业化检查员队伍。     

A visible fluorescent nanovaccine based on functional genipin crosslinked ovalbumin protein nanoparticles

Accurate and efficient antigen delivery is crucial for inducing a strong and long-term immune response. A visible protein nanovaccine made from antigen could provide a novel and promising technology for secure and efficient delivery of the antigen with imaging visualization. In this study, a functional nanovaccine based on genipin crosslinked ovalbumin (OVA) fluorescent nanoparticles with chitosan (CS-OVA-NPs) was developed. The nanovaccine can carry abundant antigens by self-crosslinking without additional carriers. The fluorescence imaging technique was applied to monitor and reveal the process of antigen delivery in vivo based on the fluorescence of genipin with a non-invasive and real-time manner. This functional OVA nanovaccine can enhance the uptake of OVA in Dendritic Cells (DCs) and further promote DCs to maturate in vitro. In vivo study further indicated CS-OVA-NPs could trigger antigen-specific immune responses, which demonstrated that this fluorescent nanovaccine provided a novel design approach for accurate and efficient vaccine delivery.     

MAT2B mediates invasion and metastasis by regulating EGFR signaling pathway in hepatocellular carcinoma

Clinical and Experimental Medicine - The poor prognosis of hepatocellular carcinoma (HCC) patients is mainly due to cancer metastasis. Methionine adenosyltransferase 2β (MAT2B) encodes a...     

Biomarkers to diagnose metastatic breast carcinoma to the pancreas: A case report and update

The patient is a 72‐year‐old female who presents with new onset jaundice. The patient has a past medical history significant for right‐sided estrogen receptor (ER)‐positive and left‐sided ER‐negative breast cancers in 2005 and 2009, respectively, and recent 1‐year history of ER‐positive right‐sided breast cancer with bone and brain metastases. CT scan and endoscopic ultrasound (EUS) revealed a new 2 cm mass in the head of the pancreas, leading to EUS‐guided fine‐needle aspiration of the lesion. Pathologic workup revealed adenocarcinoma with signet‐ring cells, representing either metastatic breast or primary pancreatic cancer. Immunohistochemistry and molecular diagnostic workup identified positive GATA‐binding protein 3 (GATA3) immunoreactivity and a mutation in Erb‐B2 receptor tyrosine kinase 2 (ERBB2), also known as human epidermal growth factor receptor 2 (HER2). Here, we review the diagnostic markers commonly used to differentiate metastatic breast vs primary pancreatic adenocarcinoma, and discuss the challenges of utilizing GATA3 immunoreactivity and ERBB2 mutations for diagnosis.