Effects of Wenyang Zhenshuai Granules on the Expression of Key Mitochondrial Autophagy Proteins in the Doxorubicin-Induced Model of H9c2 Cardiomyocyte Injury

Bulletin of Experimental Biology and Medicine - This study aimed to explore the effects of Wenyang Zhenshuai granules (WZG) on the morphology of cardiomyocytes, cell viability, and the expression...     

Hepatotoxicity of cantharidin is associated with the altered bile acid metabolism

Cantharidin (CTD) is an effective antitumor agent. However, it exhibits significant hepatotoxicity, the mechanism of which remains unclear. In this study, biochemical and histopathological analyses complemented with ultra-high-performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS)-based targeted metabolomic analysis of bile acids (BAs) were employed to investigate CTD-induced hepatotoxicity in rats. Sixteen male and female Sprague–Dawley rats were randomly divided into two groups: control and CTD (1.0 mg/kg) groups. Serum and liver samples were collected after 28 days of intervention. Biochemical, histopathological, and BA metabolomic analyses were performed for all samples. Further, the key biomarkers of CTD-induced hepatotoxicity were identified via multivariate and metabolic pathway analyses. In addition, metabolite–gene–enzyme network and Kyoto Encyclopedia of Genes and Genomes pathway analyses were used to identify the signaling pathways related to CTD-induced hepatotoxicity. The results revealed significantly increased levels of biochemical indices (alanine aminotransferase, aspartate aminotransferase, and total bile acid). Histopathological analysis revealed that the hepatocytes were damaged. Further, 20 endogenous BAs were quantitated via UHPLC-MS/MS, and multivariate and metabolic pathway analyses of BAs revealed that hyocholic acid, cholic acid, and chenodeoxycholic acid were the key biomarkers of CTD-induced hepatotoxicity. Meanwhile, primary and secondary BA biosynthesis and taurine and hypotaurine metabolism were found to be associated with the mechanism by which CTD induced hepatotoxicity in rats. This study provides useful insights for research on the mechanism of CTD-induced hepatotoxicity.     

呼吸机自动测量气道阻断压与标准测量方法的一致性

目的 验证呼吸机自动测量的气道阻断压(airway occlusion pressure,P0.1)与标准测量方法的一致性,以及不同触发形式对自动测量结果的影响。方法 选择采用非阻断自动测量P0.1的呼吸机,分别进行模拟肺和临床试验。调节全自动自主呼吸模拟肺,模拟具有不同呼吸努力和呼吸力学特征的48种状态,应用待检测呼吸机,以压力支持通气模式为模拟肺进行通气。临床研究部分纳入15例接受压力支持通气的成年患者。两部分研究均随机交叉应用压力和流量触发,采集呼吸机自动监测的P0.1后,采用标准呼气末气道阻断法进行P0.1测量,作为标准参考值。采用Bland-Altman检验分析P0.1呼吸机监测值与标准参考值的一致性,计算残差(呼吸机监测值-标准参考值)和95%一致性区间,比较不同触发形式对残差的影响。结果 在模拟肺验证中,P0.1呼吸机监测值与标准参考值之间的残差(95%一致性区间)在压力和流量触发下分别为0.04(－0.63~0.70)和－0.54(－1.44~0.36)cmH₂O(1 cmH₂O=0.098 kPa),两者相比差异具有统计学意义(P<0.001)。临床观察获得了相似的结果,压力和流量触发时的残差(95%一致性区间)分别为－0.11(－0.73~0.52)和－0.54(－1.50~0.59)cmH₂O,差异无统计学意义(P>0.05),表明呼吸机监测值与标准参考值间存在一致性。结论 压力触发时,呼吸机非阻断法自动测量的P0.1与标准方法具有良好的一致性。而流量触发明显低估P0.1,建议自动监测时切换到压力触发。     

毛细胞型星形细胞瘤的MRI诊断与病理分析

目的:回顾性分析颅内毛细胞型星形细胞瘤（pilocytic astrocytoma，PA）的MRI表现，并与病理结果对照研究，以提高该病的影像学诊断。方法:分析本院2014年至2017年经病理证实的10例该病患者的临床及影像学资料。结果:10例毛细胞星型细胞瘤中，5例呈囊实性改变，4例呈实性改变，1例呈囊性伴壁结节改变且结节明显强化。术后病理显示，镜下可见疏松区与致密区双极性分布，且比例各不相同，部分可见血管增生及嗜酸性小体。结论:毛细胞型星形细胞瘤在影像学上有一定的特征性，肿瘤多为囊性壁结节型或实性肿块，不同类型的肿瘤镜下显示疏松区与致密区比例不同，强化程度与其毛细血管通透性密切有关，熟悉影像学表现及鉴别诊断，并与相关病理联系，可为临床手术方案的制订提供重要的参考价值。     

多层次学员“一体化”临床思维培训与评价

随着“5+3”医学人才培养模式的推行，临床教学中更需注重对医学生临床思维的培养，然而现有的培训模式存在不足；如教学模式不完善，教师带教意识不够，学生难以适应角色转变，形成固有思维定势，依赖辅助检查等。通过梳理临床思维的内涵，并根据多层次学员不同的培训目标，从专业整体思维框架的建立、专题讲座、启发式查房、多点思路扩展实操训练、“传-帮-带”小组的自主互动学习、病例讨论等方面，探索并构建了多层次学员“一体化”临床思维培训及评价模式；且经过小范围应用后，得到了师生的广泛认可。     

多细胞过继性免疫治疗治疗晚期恶性肿瘤的近期疗效及安全性分析

目的:初步观察DC、CIK、γδT、CD3AK及NK细胞多细胞过继性免疫治疗对晚期恶性肿瘤患者的近期临床疗效及安全性分析。方法:对我院在2014年10月至2015年10月收治的162例次晚期恶性肿瘤患者进行多细胞过继性细胞免疫治疗，血细胞分离机单采自体外周血单个核细胞（peripheral blood mononuclear cells，PBMC)，体外培养扩增DC、CIK、γδT、CD3AK及NK细胞，采用FCM法检测各细胞表型，并按计划序贯回输给患者进行治疗。结果:69例（43%）患者临床症状有不同程度改善，尤其是精神、食欲及睡眠质量改善最为明显，安全性分析显示主要不良反应为发热，占15%，28例完成3疗程免疫治疗患者瘤体变化为部分缓解（partial remission，PR）2例，疾病稳定（stable disease，SD）16例，疾病控制率（disease control rate，DCR）为64%。结论:DC、CIK、γδT、CD3AK及NK细胞过继性免疫治疗对晚期恶性肿瘤安全有效，可明显改善其生活质量，具有一定的临床应用前景。     

The ONE‐MIND Study: Rationale and protocol for assessing the effects of ONlinE MINDfulness‐based cancer recovery for the prevention of fatigue and other common side effects during chemotherapy

Cancer patients often experience poor quality of life (QoL) during chemotherapy (CT) treatments due to side effects including fatigue, insomnia, pain and nausea/vomiting. Mindfulness‐based cancer recovery (MBCR) is an evidence‐based intervention for treating such symptoms, but has not been investigated as an adjunctive treatment during CT. This study aims to determine the efficacy of an online group MBCR programme delivered during CT in 12 real‐time interactive weekly sessions for managing fatigue (primary outcome). Secondary outcomes include sleep disturbance, pain, nausea/vomiting, mood, stress and QoL. Exploratory outcomes include cognitive function, white blood cell counts and return to work. The study is a two‐armed randomised controlled waitlist trial with 2:1 allocation to treatment (online group MBCR during CT) or control (waitlist usual care; online MBCR following CT completion) with a target sample size of N = 178. Participants are breast or colorectal cancer patients undergoing common CT regimens in Calgary, Canada. Online assessments using validated self‐reported instruments will take place at baseline, post‐MBCR, post‐CT and 12 months’ post‐baseline. If online MBCR delivered during CT significantly reduces fatigue in cancer patients’ post‐CT and also impacts secondary symptoms, this would provide evidence for including mindfulness training as an adjunctive symptom management therapy during CT.     

构建自我信心、动机和权威建议影响儿童安全座椅使用的分析模型

目的 建立自我信心、动机和权威建议影响儿童安全座椅使用的模型，并通过结构方程模型进行验证，为推动儿童安全座椅使用宣传倡导工作提供科学依据。方法 采用多阶段整群随机抽样方法，在上海市和深圳市调查9 112位拥有≥ 1辆私家轿车且有0~6岁儿童家庭的儿童监护人关于儿童安全座椅使用的情况，构建自我信心、动机和权威建议影响儿童安全座椅使用的模型，通过结构方程模型对理论模型进行验证和量化分析。结果 整体模型符合预期理论模型，且拟合情况较好，指标均达到标准。RMSEA=0.03，CFI=0.97。各路径标准化系数均有统计学意义（P<0.05）。权威建议和动机对自我信心的影响标准化系数分别为0.45和0.30，自我信心对儿童安全座椅使用的影响标准化系数为0.40。权威建议对动机的影响标准化系数为0.61。结论 在儿童安全座椅宣传倡导工作中应重视使用来源于专业权威、具备较好公信力和公益性的专家及机构组织的建议，应将儿童道路交通安全现况和安全座椅作用机制作为宣传重点之一。