结直肠癌与自然杀伤细胞的相关性探讨北大核心

目的:研究结直肠癌及其配对的癌旁组织的自然杀伤(nature killer,NK)细胞数量及分布情况。方法:结直肠癌及其配对的癌旁组织各40例,以SP免疫组化法检测NK细胞。结果:结直肠癌及其配对的癌旁组织中均未检测到NK细胞的浸润。结论:结直肠癌及其配对的癌旁组织中缺乏NK细胞浸润可能与肿瘤微环境、生理微环境、未知的NK细胞亚型相关,结直肠癌患者可能不适用NK细胞进行免疫治疗。     

A Case of Refractory Childhood Glaucoma Secondary to Weill-Marchesani Syndrome: Management with Combined CO2 Laser-Assisted Sclerectomy Surgery and Trabeculectomy

A 2-year-old girl was diagnosed as Weill-Marchesani syndrome with typical systemic features of short stature, short and stubby hands and feet, language disorders and mental retardation. He developed bilateral angle closure glaucoma, ectopia lentis and suffered visual loss from the ocular features of Weill-Marchesani syndrome. The child was successfully treated by combined CO₂ laser-assisted sclerectomy surgery and trabeculectomy.     

微创超声乳化手术前后角膜前后表面及不同区域范围角膜参数的变化

目的：比较白内障微创超声乳化手术前后角膜前表面屈光力(ASF)、角膜真实净屈光力(TNP)和总角膜屈光力(TCRP)分布特点及角膜前后表面曲率半径比(B/F ratio)差异。

方法：前瞻性研究。收集2020-12/2021-05就诊于潍坊眼科医院行2.2mm微切口超声乳化白内障吸除联合人工晶状体植入术的年龄相关性白内障患者156例156眼。术前及术后3mo行Pentacam眼前节生物测量仪检查，收集以角膜顶点和以瞳孔为中心2、4、6mm环上和区域内ASF、TNP和TCRP，以及手术前后B/F ratio。

结果：术后3mo，以角膜顶点为中心2mm直径环上和区域内ASF值较术前均无差异(均P>0.05)，而4、6mm直径环上和区域内ASF值较术前均有差异(均P<0.05)； 以瞳孔为中心2mm直径环上及区域内ASF值较术前均无差异(均P>0.05)。以角膜顶点为中心和以瞳孔为中心2、4、6mm直径环上和区域内TNP、TCRP值较术前均有差异(均P<0.05)。术前以角膜顶点为中心和瞳孔为中心在2mm与6mm之间环上和4mm与6mm之间环上TCRP值均有差异(均P<0.0167)； 在2mm与6mm区域内TCRP值均有差异(均P<0.0167)； 术后3mo，以角膜顶点为中心和瞳孔为中心环上TCRP值在2mm与6mm之间、4mm与6mm之间均有差异(均P<0.0167)，而以角膜顶点为中心和瞳孔为中心区域内TCRP值仅在2mm与6mm直径范围内有差异(P<0.0167)。B/F ratio术前为81.79%±1.87%，术后3mo为80.68%±2.23%(P<0.001)。

结论：白内障手术前后以角膜顶点和以瞳孔为中心的不同直径环上及区域内各项角膜屈光力参数会有一定的变化和差异，人工晶状体度数计算的K值选择及基于角膜特性的人工晶状体个体化选择时应予以考虑。     

急性ST段抬高型心肌梗死患者进门-球囊扩张时间及其各时间点的分析

目的分析急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)进门-球囊扩张时间(DTB)及其各时间点的特征。方法收集2018年1月—2020年12月行急诊PCI的180例STEMI患者的DTB及其各时间点(急诊停留时间、转运时间和介入时间)数据。将患者依据不同标准分为DTB达标组和DTB非达标组,工作时间组和非工作时间组,自费组和非自费组,2018年组和2020年组。比较各组的相关指标。结果 180例STEMI患者平均DTB为(115.0±51.9) min;急诊停留时间为(71.4±50.3) min,其中进门至呼叫心内科时间为(10.9±6.1) min,呼叫心内科至签署知情同意书时间为(31.4±30.4) min,签署知情同意后至离开急诊室时间为(39.5±31.6) min;转运时间为(4.4±1.3) min;介入时间为(35.2±13.1) min。DTB达标组的DTB、急诊停留时间均短于DTB未达标组,差异有统计学意义(P 0.05)。工作时间组与非工作时间组DTB、急诊停留时间、签署同意书至离开急诊时间比较,差异均有统计学意义(P 0.05)。自费组和非自费组DTB及各时间点情况比较,差异均无统计学意义(P0.05)。2020年组的DTB、急诊停留时间均短于2018年组,差异有统计学意义(P 0.05)。结论获取知情同意、介入导管室准备是急诊STEMI患者DTB延长的主要因素,建立院前、院内的无缝衔接的规范流程,可有效缩短DTB。     

Clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis: A protocol for systematic review and meta-analysis

Background:Dental pain can have a detrimental effect on quality of life. Symptomatic apical periodontitis is the most common cause of dental pain and arise from an inflamed or necrotic dental pulp. There is growing evidence to support the effectiveness of probiotics in combination with antibiotics on periodontitis. We therefor will conduct this study to evaluate the clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis.Methods:We will systematically search the following databases: PubMed, the Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), and WanFang database. A grey literature search will be conducted using ZETOC Conference Proceedings and Open Grey. Only randomized controlled trials (RCTs) related to research on probiotics in combination with antibiotics to treatment patients with periodontitis will be included. All sources have to be searched from their inception to October 2020. Two authors will independently select studies, extract study data, and evaluate the quality of the included studies. We will use Review Manager Software (RevMan 5.3) to analyze data.Results:This study will systematically evaluate the clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis.Conclusions:This study will generate evidence for a better clinical decision of patients with periodontitis.Registration number:DOI 10.17605/OSF.IO/QZ6SB (https://osf.io/qz6sb/).     

不同剂量羟考酮PCEA与PCIA用于前列腺术后镇痛效果比较

【摘要】 目的 探讨不同剂量羟考酮通过患者硬膜外自控镇痛（PCEA）与患者静脉自控镇痛（PCIA）用于前列腺术后的镇痛效果。 方法 选取在2018年1月~2020年1月期间于我院行前列腺术的210例患者，采用随机数字表法将患者分成A1、A2、A3、B1、B2、B3 6组，每组各35例。其中A1、A2、A3组术后镇痛采用PCIA方案，分别使用0.6mg/kg、0.8mg/kg、1.0mg/kg的羟考酮+托烷司琼10mg+0.9%氯化钠溶液至100mL；B1、B2、B3术后镇痛采取PCEA方案，分别使用0.6mg/kg、0.8mg/kg、1.0mg/kg的羟考酮+托烷司琼10mg+0.9%氯化钠溶液至100mL。比较手术前（T0）、术后6h(T1)、术后12h(T2)、术后24h(T3)及术后48h(T4)6组患者的生命体征、视觉疼痛模拟评分（VAS）及不良反应的发生情况。 结果 各组患者在不同时间点的MAP、HR及SPO2的水平比较差异无统计学意义（P＞0.05）。B1、B2、B3组患者分别在T1、T2、T3、T4时间的VAS评分显著低于A1、A2、A3组（均P＜0.05），A2、A3组患者分别在T1、T2、T3、T4时间的VAS评分显著低于A1组（均P＜0.05），B2、B3组患者分别在T1、T2、T3、T4时间的VAS评分显著低于B1组（均P＜0.05）。B1、B2、B3不良反应的发生率分别显著低于A1、A2、A3组（均P＜0.05）。B1、B2不良反应的发生率显著低于A2、A3组（P＜0.05），且A3组不良反应的发生率显著高于A1、A2，B3组的不良反应的发生率显著高于B1、B2组（均P＜0.05）。 结论 对前列腺手术患者术后，不同剂量羟考酮PCEA的镇痛效果及不良反应发生率均显著优于不同剂量羟考酮的PCIA，且当羟考酮的剂量为0.8mg/kg时，效果最佳。     

A Perioperative Care Display for Understanding High Acuity Patients

Background  The data visualization literature asserts that the details of the optimal data display must be tailored to the specific task, the background of the user, and the characteristics of the data. The general organizing principle of a concept-oriented display is known to be useful for many tasks and data types. Objectives  In this project, we used general principles of data visualization and a co-design process to produce a clinical display tailored to a specific cognitive task, chosen from the anesthesia domain, but with clear generalizability to other clinical tasks. To support the work of the anesthesia-in-charge (AIC) our task was, for a given day, to depict the acuity level and complexity of each patient in the collection of those that will be operated on the following day. The AIC uses this information to optimally allocate anesthesia staff and providers across operating rooms. Methods  We used a co-design process to collaborate with participants who work in the AIC role. We conducted two in-depth interviews with AICs and engaged them in subsequent input on iterative design solutions. Results  Through a co-design process, we found (1) the need to carefully match the level of detail in the display to the level required by the clinical task, (2) the impedance caused by irrelevant information on the screen such as icons relevant only to other tasks, and (3) the desire for a specific but optional trajectory of increasingly detailed textual summaries. Conclusion  This study reports a real-world clinical informatics development project that engaged users as co-designers. Our process led to the user-preferred design of a single binary flag to identify the subset of patients needing further investigation, and then a trajectory of increasingly detailed, text-based abstractions for each patient that can be displayed when more information is needed.