Candidate microRNA biomarkers in human colorectal cancer: systematic review profiling studies and experimental validation

Colorectal cancer (CRC) is a major cause of cancer mortality worldwide. There is an urgent need to search for specific and sensitive biomarkers for early diagnosis of CRC. We carried out a comprehensive systematic review of published studies that compared the miRNA expression profiles between CRC tissue and paired neighboring noncancerous colorectal tissue to determine candidate miRNA biomarkers for CRC. A miRNA ranking system that takes the number of comparisons in agreement, total study sizes and direction of differential expression into the consideration was devised and used. One of the most up-regulated miRNAs, miRNA-106a, was consistently reported to be differentially expressed in six studies and the five most down-regulated miRNAs, miR-30a-3p, miR-139, miR-145, miR-125a and miR-133a, were consistently reported to be differentially expressed in four studies. Moreover, we further validated five miRNAs in a clinical setting using qRT-PCR, which demonstrated that miR-106a expression was increased, whereas the expression of miR-30a-3p, miR-145, miR-125a and miR-133a was decreased in the CRC tissues. Therefore, these miRNAs may be the candidates to develop a panel of biomarkers with sufficient sensitivity and specificity for the diagnosis of CRC in a clinical setting.     

CD8+ T cells in fetal membranes display a unique phenotype,and their activation is involved in the pathophysiology of spontaneous preterm birth

Preterm labor/birth is the leading cause of perinatal mortality and morbidity worldwide. Previous studies demonstrated that T cells were crucial for maintaining maternal–fetal immune tolerance during the first trimester of pregnancy; however, their phenotypes and functions in labor and delivery remain largely unknown. We recruited three cohorts of women at delivery for T-cell immunophenotyping in the placentas, fetal membranes, umbilical cord blood, and maternal peripheral blood. Our data showed a differential enrichment of T cells during the third trimester of human pregnancy, with CD4⁺ T cells being more observable within the umbilical cord blood, whereas CD8⁺ T cells became relatively more abundant in fetal membranes. CD4⁺ and CD8⁺ T cells derived from fetal membranes were dominated by effector memory T cells and exhibited extensive expression of activation markers but decreased expression of homing receptor. In comparison with term births, fetal membrane CD8⁺ T cells, especially the central memory subset, were significantly increased in frequency and showed more profound activation in spontaneous preterm birth patients. Finally, using an allogeneic mouse model, we found that T-cell-activation-induced preterm birth could be alleviated by the depletion of CD8⁺ T but not CD4⁺ T cells in vivo. Collectively, we showed that CD8⁺ T cells in fetal membranes displayed a unique phenotype, and their activation was involved in the pathophysiology of spontaneous preterm birth, which provides novel insights into the immune mechanisms of preterm birth and potential targets for the prevention of this syndrome. © 2023 The Pathological Society of Great Britain and Ireland.     

医联体模式下上海远郊医疗资源整合现状分析与发展对策

2012年上海市政府通过启动实施"5+3+1"工程,加快郊区三级医院建设,推动全市优质医疗资源布局更加均衡.作为工程项目的 上海某三甲医院分院区通过医联体建设,积极发挥优质医疗资源辐射作用,推动远郊医疗资源整合.2021年按照市政府部署,该院启动一体化建设,并计划建设区域紧密型医联体,推进区域医疗资源整合.本课题在梳理...     

急性心肌梗死患者经皮冠状动脉介入术后早期经胸冠状动脉血流成像预测左心室收缩功能的价值

目的探讨经胸冠状动脉血流成像（TCFDI）在急性心肌梗死患者冠状动脉介入术（PCI）后早期预测左心室收缩功能恢复的应用价值。方法对急性前壁、前间壁心肌梗死PCI术成功再通前降支患者30例，术后24～48h采用TCFDI获取冠状动脉前降支中远端血流频谱，测量舒张期血流峰值速度（Vp）、平均速度（Vm）、速度时间积分（VTI）、血流减速时间（DDT）及舒张期血流速度达峰时间（T）。观测左心室室壁运动计分指数（WMSI）和射血分数（EF），然后行心肌声学造影，评价微循环再灌注。术后1个月随访，根据PCI术后1个月随访时左心室EF值将患者分为EF〈50％组和EF≥50％组，分析两组间冠状动脉血流频谱各项指标间有无差异，及冠状动脉血流频谱各项指标与PCI术后1个月左心室EF及左心室WMSI的相关性。结果左心室EF〈50％组DDT小于EF≥50％组DDT（P〈0．01），其余指标两组间差异无统计学意义。DDT与1个月时左心室EF、WMSI均呈显著相关（r=0．581，r=-0．634，P均〈0．01）。以DDT≤391ms为截断值时，预测左心室EF〈50％的敏感性为87．5％，特异性86．4％。结论TCFDI技术可以于急性前壁、前间壁心肌梗死患者成功PCI术后早期预测左心室收缩功能恢复情况。     

Endoscopic biliary stenting for irretrievable common bile duct stones: Indications, advantages, disadvantages, and follow-up results

BackgroundThe advantages of endoscopic retrograde cholangiopancreatography (ERCP) over open surgery have made it the predominant method of treating patients with choledocholithiasis. After sphincterotomy, however, 10%–15% of common bile duct (CBD) stones cannot be removed with a basket or balloon. Methods for managing “irretrievable stones” include surgery; mechanical, intraductal shock wave, and extracorporeal shock wave lithotripsy; chemical dissolution; and biliary stenting. Endoscopic biliary stent insertion, which is frequently used in specific situations, has both advantages and disadvantages. To maximize the advantages and minimize the complications of biliary endoprosthesis, it is important to recognize its proper indications and to apply the technique in proper situations.Data sourcesWe reviewed all publications cited in Pubmed and published through July 2011 on biliary endoprosthesis in patients with irretrievable CBD stones. We analyzed the indications, advantages, disadvantages, and long-term follow-up results of this technique.ResultsDespite the occurrence of related complications, such as cholangitis, endoscopic placement of an endoprosthesis may reduce stone size, allowing later clearance of unextractable stones. Permanent biliary stenting may be a definitive treatment in selected elderly patients who are poor candidates for surgery.ConclusionEndoscopic biliary stenting remains a simple and safe method for patients with stones difficult to manage by conventional endoscopic methods and those patients unfit for surgery or at high surgical risks.     

基于精准医疗探讨缺血性脑血管病的中医药防治

以精准医疗理念为基础,提出中医药防治缺血性脑血管病的研究思路:首先,在中医药理论的指导下,以辨证论治为基础,辨识患者不同体质和易感基因,对缺血性脑血管病患者进行准确分型分层,精准诊断;然后,借助基因组学、代谢组学、转录组学等方法和手段,制定个体化诊疗方案;最后,运用中医药进行多靶点、多环节、多途径、多层次的整体精准调节,提高中医药防治缺血性脑血管病的水平。主要从治未病与精准预防、治已病与精准治疗之间的对应关系进行论述。