胃癌患者根治术后腹腔灌洗液中CEA mRNA表达的临床意义

目的：探讨胃癌患者根治术后腹腔冲洗液中CEA mRNA表达情况及其临床意义。方法: 回顾性分析了2013 年1 月至2017 年12 月在南京大学医学院附属鼓楼医院接受胃癌根治切除术后进行腹腔灌洗液CEA mRNA检测的139 名患者的病历资料，并进行术后常规随访。用RT-PCR检测139 胃癌患者根治术后腹腔灌洗液中CEA mRNA表达情况。卡方检验分析腹腔灌洗液中CEA mRNA表达与临床基本特征、组织病理学资料、血液学指标及复发方式之间的关系。采用Logistic 单因素及多因素回归分析筛查影响CEA mRNA表达水平的因素。结果：139 名患者中44 名（31.7%）患者腹腔灌洗液CEA mRNA阳性。分析显示，胃癌患者腹腔灌洗液CEA mRNA阳性表达与性别、年龄、病理分级、Lauren 分型和HER2、EGFR、VEGFR等标记物间均没有明显的关联（均P>0.05），与病理类型、脉管是否侵犯、局部浸润深度、淋巴结转移程度和临床AJCC 分期有明显的关联（均P<0.05）。CEA mRNA阳性患者腹膜复发率明显高于阴性患者（P=0.012）。Logistic 单因素回归分析显示，印戒细胞癌（P=0.04，HR=2.810，95% CI: 1.050~7.520）、T 分期（P=0.016，HR=6.329，95% CI: 1.417~28.264）、N 分期（P=0.022，HR=3.068，95% CI: 1.172~8.027）、AJCC分期（P=0.016 ，HR=3.971 ，95% CI: 1.295~12.173 ）、神经侵犯（P=0.002 ，HR=6.738，95% CI: 1.995~22.757）、脉管侵犯（P<0.001，HR=16.36，95% CI: 3.85~69.512）为胃癌患者腹腔灌洗液CEA mRNA阳性表达的危险因素。Logistic 多因素回归分析显示，经过对其他因素的校正，脉管侵犯（P<0.001，HR=21.314，95% CI: 4.21~107.907）为胃癌患者腹腔灌洗液CEA mRNA阳性表达的独立危险因素。结论：胃癌腹腔灌洗CEA mRNA阳性的患者腹膜复发转移风险高且预后不良，应考虑包括腹腔局部治疗在内的更加积极的抗肿瘤治疗。     

乙肝孕妇血清标志物模式与HBV-DNA载量及肝功能关系研究

目的探讨乙肝孕妇血清标志物模式、HBV-DNA载量及肝功能三者之间的关系,为孕期乙肝病毒感染情况的监控和乙肝病毒母婴传播的预防提供参考。方法选取2019年1月-11月在我院产检的767例乙肝表面抗原阳性孕妇的乙肝血清标志物模式、肝功能指标的丙氨酸氨基转移酶(alamine aminotransferase,ALT)及HBVDNA载量进行研究,探讨三者间的关系。结果HBsAg、HBeAg、HBcAb阳性组孕妇HBV-DNA阳性率及病毒载量均高于其余两组(P<0.05);ALT升高程度与HBV-DNA载量具有一定相关性(r=0.255,χ^2=80.150,P=0.000);HBeAg阳性组和HBeAg阴性组间HBV-DNA阳性率、ALT异常率差异均有统计学意义。结论HBV-M、HBV-DNA与肝功能之间有一定的相关性,大三阳孕妇中高病毒载量比例高,应加强乙肝孕妇孕期各项指标的监测,必要时进行干预治疗。     

蒜氨酸抗菌机制研究

目的 检测蒜氨酸最低抑菌浓度（MIC）与最低杀菌浓度（MBC），探讨蒜氨酸体内外抗菌机制。方法 体外微量稀释法检测蒜氨酸MIC和MBC，荧光显微镜观察菌体表面蒜氨酸，探讨蒜氨酸抗菌机制。体内蒜氨酸和青霉素分别治疗金葡菌感染家兔脓肿，检测脓汁标本中细菌存活情况，探讨体内蒜氨酸抗菌作用。结果 蒜氨酸对大肠杆菌、伤寒杆菌、金黄色葡萄球菌、白色葡萄球菌的MIC分别为3.047 μg·mL^-1、6.094 μg·mL^-1、0.386 μg·mL^-1、0.386 μg·mL^-1，蒜氨酸体外无杀菌活性。浓汁标本：死菌率蒜氨酸治疗组显著高于阴性对照组（P < 0.01），与青霉素治疗组无明显差异（P > 0.05）；活菌率蒜氨酸治疗组显著低于阴性对照组（P < 0.01），与青霉素治疗组无明显差异（P > 0.05）。结论 蒜氨酸与菌体蛋白、细菌酶蛋白结合阻断细菌与环境物质交换，抑制细菌生命活动，具有较强的抑菌作用，无杀菌活性；蒜氨酸体内代谢成大蒜素，具有较强杀菌作用。     

丹青胶囊联合他扎罗汀倍他米松治疗银屑病的临床研究

目的 探讨丹青胶囊联合他扎罗汀倍他米松治疗银屑病的临床疗效.方法 选取2019年6月—2021年6月在天津市职业病防治院门诊皮肤科就诊治疗的114例银屑病患者,根据随机数字法分为对照组和治疗组,每组各57例.对照组患者给予他扎罗汀倍他米松乳膏,洗净患处,待皮肤干爽后,将适量本品均匀涂抹于患处,1次/d.治疗组患者在对照组治疗基础上口服丹青胶囊,4粒/次,3次/d.两组患者均连续治疗7 d.观察两组患者的临床疗效和临床症状好转时间,比较两组治疗前与治疗1、4、8周的皮损面积和严重程度指数(PASI)评分和血清炎性因子水平.结果 治疗后,治疗组总有效率是98.25％,显著高于对照组的82.46％(P<0.05).治疗后,治疗组患者皮损暗红、皮损肥厚、皮肤瘙痒、皮肤疼痛等症状好转时间均显著短于对照组(P<0.05).治疗后,两组PASI评分均较治疗前显著降低(P<0.05);治疗1、4、8周治疗组PASI评分显著低于对照组(P<0.05).治疗后,两组患者血清炎性因子白细胞介素6(IL-6)、白细胞介素17(IL-17)、肿瘤坏死因子α(TNF-α)、干扰素-γ(IFN-γ)水平均较治疗前显著降低(P<0.05);治疗后,治疗组血清炎性因子水平显著低于对照组(P<0.05).结论 丹青胶囊联合他扎罗汀倍他米松治疗银屑病效果明显,能显著降低炎性因子水平,并有助于改善皮损情况,值得临床推广应用.     

Development of an IgG-Fc fusion COVID-19 subunit vaccine,AKS-452

AKS-452 is a biologically-engineered vaccine comprising an Fc fusion protein of the SARS-CoV-2 viral spike protein receptor binding domain antigen (Ag) and human IgG1 Fc (SP/RBD-Fc) in clinical development for the induction and augmentation of neutralizing IgG titers against SARS-CoV-2 viral infection to address the COVID-19 pandemic. The Fc moiety is designed to enhance immunogenicity by increasing uptake via Fc-receptors (FcγR) on Ag-presenting cells (APCs) and prolonging exposure due to neonatal Fc receptor (FcRn) recycling. AKS-452 induced approximately 20-fold greater neutralizing IgG titers in mice relative to those induced by SP/RBD without the Fc moiety and induced comparable long-term neutralizing titers with a single dose vs. two doses. To further enhance immunogenicity, AKS-452 was evaluated in formulations containing a panel of adjuvants in which the water-in-oil adjuvant, Montanide™ ISA 720, enhanced neutralizing IgG titers by approximately 7-fold after one and two doses in mice, including the neutralization of live SARS-CoV-2 virus infection of VERO-E6 cells. Furthermore, ISA 720-adjuvanted AKS-452 was immunogenic in rabbits and non-human primates (NHPs) and protected from infection and clinical symptoms with live SARS-CoV-2 virus in NHPs (USA-WA1/2020 viral strain) and the K18 human ACE2-trangenic (K18-huACE2-Tg) mouse (South African B.1.351 viral variant). These preclinical studies support the initiation of Phase I clinical studies with adjuvanted AKS-452 with the expectation that this room-temperature stable, Fc-fusion subunit vaccine can be rapidly and inexpensively manufactured to provide billions of doses per year especially in regions where the cold-chain is difficult to maintain.     

Investigation of the mechanisms of Genkwa Flos hepatotoxicity by a cell metabolomics strategy combined with serum pharmacology in HL-7702 liver cells

1. To investigate Genkwa Flos hepatotoxicity, a cell metabolomics strategy combined with serum pharmacology was performed on human HL-7702 liver cells in this study.

2. Firstly, cell viability and biochemical indicators were determined and the cell morphology was observed to confirm the cell injury and develop a cell hepatotoxicity model. Then, with the help of cell metabolomics based on UPLC-MS, the Genkwa Flos group samples were completely separated from the blank group samples in the score plots and seven upregulated as well as two down-regulated putative biomarkers in the loading plot were identified and confirmed. Besides, two signal molecules and four enzymes involved in biosynthesis pathway of lysophosphatidylcholine and the sphingosine kinase/sphingosine-1-phosphate pathway were determined to investigate the relationship between Genkwa Flos hepatotoxicity and these two classic pathways. Finally, the metabolic pathways related to specific biomarkers and two classic metabolic pathways were analyzed to explain the possible mechanism of Genkwa Flos hepatotoxicity.

3. Based on the results, lipid peroxidation and oxidative stress, phospholipase A₂/lysophosphatidylcholine pathway, the disturbance of sphingosine-1-phosphate metabolic profile centered on sphingosine kinase/sphingosine-1-phosphate pathway and fatty acid metabolism might be critical participators in the progression of liver injury induced by Genkwa Flos.     

血清窖蛋白-1在慢性阻塞性肺疾病相关肺动脉高压患者中的表达及意义

目的 研究血清窖蛋白-1 （Cav-1） 在慢性阻塞性肺疾病 （COPD） 相关肺动脉高压 （PAH） 患者中的表达及其意义。方法 选取稳定期COPD患者65例， 根据是否合并PAH分成COPD组 ［肺动脉收缩压 （PASP） ＜40 mmHg， 35例］ 及COPD-PAH组 （PASP ≥40 mmHg， 30例）。另选取在本院健康体检的志愿者30例作为对照组。对比各组基线资料、 动脉血气分析、 肺功能指标， 以及血清Cav-1、 白细胞介素 （IL） -6和肿瘤坏死因子-α （TNF-α） 的表达水平。绘制受试者工作特征 （ROC） 曲线， 评价Cav-1对COPD合并PAH的诊断价值。结果 COPD-PAH组与COPD组第一秒用力呼吸容积 （FEV1） /用力肺活量 （FVC）、 FEV1占预计值百分比 （FEV1%） 及氧分压 ［p （O2 ）］ 低于对照组， 而二氧化碳分压 ［p （CO2 ）］、 PASP均高于对照组 （P＜0.01）。COPD-PAH组p （O2 ） 低于COPD组， p （CO2 ）、 PASP均高于COPD 组 （P＜0.01）。对照组、 COPD组及COPD-PAH组Cav-1表达水平呈逐渐降低趋势， 而IL-6、 TNF-α表达水平呈逐渐升高趋势 （P＜0.01）。血清Cav-1诊断COPD合并PAH的ROC曲线下面积为0.902 （0.821～0.955）， 最佳截断值为 6.66 μg/L， 此时诊断敏感度为76.7%， 特异度为85.7%， 与多普勒超声诊断仪测量PASP结果比较一致性较好 （Kappa 值=0.627）。结论 血清Cav-1在COPD相关PAH患者表达明显下调， 可以作为预测COPD相关PAH的新型血清标志物。     

Assessing the impact of blood alcohol concentration on the rate of in-hospital mortality following traumatic motor vehicle crash injury: A matched analysis of the National Trauma Data Bank

Background

The purpose of this study was to compare the outcomes of trauma patients who were injured in a motor vehicle crash and tested positive for alcohol upon hospital arrival versus those who tested negative.

The increase in bone mineral density by bisphosphonate with active vitamin D analog is associated with the serum calcium level within the reference interval in postmenopausal osteoporosis

Objectives: To examine the factors associated with increase in lumbar spine bone mineral density (LS-BMD) by bisphosphonates (BPs) with active vitamin D analog (aVD).

Methods: Two independent postmenopausal osteoporotic patients treated by BPs with aVD for 24 months (Study 1: n?=?93, Study 2: n?=?99) were retrospectively analyzed.

Results: In Study 1, LS-BMD of the patients significantly increased for 24 m (5.4%, p?r²: 0.088, p?=?.02). While average sCa of the patients was 9.2?mg/dL before treatment, it increased time-dependently to 9.6?mg/dL for 24 m by treatment. As each patient had their LS-BMD five times during the study, there were four instances of %LS-BMD in each patient, resulting in 372 instances of %LS-BMD in Study 1. The smallest Akaike’s information criterion value for the most appropriate cut-off levels of sCa for %LS-BMD by treatment every 6 m was 9.3?mg/dL. The %LS-BMD by treatment for 6 m during 24 m period in patients with sCa ≥9.3?mg/dL (1.5%) was significantly higher than that in patients with sCa <9.3?mg/dL (0.8%, p?=?.038). The results of Study 2 were similar to those of Study 1, confirming the phenomena observed.

Conclusion: sCa was associated with an increased LS-BMD by BPs with aVD.     

LC-MS/MS法测定人血浆中布康唑浓度的不确定度评定

目的：评定LC-MS/MS法测定人血浆中布康唑浓度的不确定度。方法：分析测定过程中不确定度的来源，包括对照品的称量、仪器误差、标准溶液的配制、含药血浆样品的配制、血浆样品的处理、标准曲线的拟合、基质效应、重复性等，评定各来源分量的不确定度，计算合成不确定度和扩展不确定度。结果：人血浆中低（60.0 pg·mL^-1）、中（600.0 pg·mL^-1）、高（6 400.0 pg·mL^-1）浓度布康唑的扩展不确定度分别为5.62，63.90，626.26 pg·mL^-1（k=2，P=95%）。结论：LC-MS/MS法测定人血浆中布康唑浓度的不确定度主要由基质效应、血浆样品的处理（提取回收率），仪器误差、重复性（精密度）引入。