单孔胸腔镜下肺癌术后胸腔引流时间的影响因素分析北大核心

目的:探讨单孔胸腔镜下肺癌手术术后胸腔引流时间的影响因素。方法:本研究采用回顾性分析方法,回顾我院2018年01月至2019年12月原发性肺癌患者经单孔胸腔镜手术治疗的病例199例。按照术后胸腔引流时间分为两组,Ⅰ组(术后胸腔引流时间<5天)和Ⅱ组(术后胸腔引流时间≥5天)。对于影响术后胸腔引流时间的可能因素在两组间先采用单因素分析的方法筛选,再将筛选出来的对术后胸腔引流时间可能有意义的影响因素进行二项Logistic多因素回归分析。结果:经单因素分析及二项Logistic多因素回归分析结果显示:年龄≥60岁、手术部位、肺段切除术、胸膜粘连、手术时间≥180 min、术后早期下床活动是术后胸腔引流时间的独立影响因素(P<0.05)。结论:对于具有多个延长术后胸腔引流时间的独立影响因素的患者,应制定个体化管理方案,尽可能减少术后胸腔引流时间,减少住院天数,加快患者康复。     

Expression of retinoblastoma protein in human growth hormone-secreting pituitary adenomas

The retinoblastoma gene (RB1) is a tumor-suppressor gene in chromosomal region 13q14.2. Its role in the pathogenesis of pituitary tumors has not been fully clarified. Some studies have shown that losses in this chromosomal region are related to aggressive tumor behavior, although the retinoblastoma protein (pRB) is still expressed. Conversely, lack of expression of pRB was observed in one fourth of GH-secreting pituitary adenomas (GH-tumors). In order to further study the expression of pRB in GH-tumors, we evaluated this protein in 49 tumors from patients with acromegaly (20 noninvasive, 25 invasive, and 4 with no information) and 8 normal pituitaries using immunohistochemistry (IHC). Nuclear staining for pRB ranged from 0 to 90% (median 40%) in the tumors and from 40 to 80% (median 58%) in normal pituitaries. In 10 tumors (20% of total) the adenomatous cells were negative (5 cases) or had very low labeling (5 cases) for pRB. Sixty three percent (31/49) of the tumors showed staining in 10–80% of the cells and in 16% (8/49) of the cases >80% of the adenomatous cells were positive for pRB. The expression of pRB was not different in invasive and noninvasive tumors. In conclusion, pRB is underexpressed in a subgroup of GH-tumors, and this may represent an early event in the pathogenesis of this tumor subtype.     

Two new mutations and three novel polymorphisms in the<Emphasis Type="Italic"> RB1</Emphasis> gene in Ecuadorian patients

RB1 is the gene responsible for retinoblastoma, the most common malignant intraocular tumor of infancy and early childhood. There are no reports about this gene in Ecuadorian populations, and only a few studies have been published in Latin America about this subject. There is a spectrum of more than 370 mutations described in the RB1 gene mutation database (http://www.d-lohmann.de/Rb/mutations.html), and alterations have been found in 25 of the 27 exons. During the exon-by-exon analysis of 31 tumor and blood samples from Ecuadorian patients, we found two new mutations and three novel polymorphisms. One of the polymorphisms is located in intron 26 where no alterations of the gene have been described previously. The polymorphisms were found in all of the patients tumor samples, but not in normal population, suggesting there might be a relationship between these polymorphisms and the development of retinoblastoma in the Ecuadorian population.The nucleotide sequence data reported are available in the GenBank database under the accession numbers: AY243567, AY260472, AY260473, AY273783     

Alteration of cell cycle regulators correlates with survival in epithelial ovarian cancer patients

The p16-cyclinD1/CDK4-pRb pathway (RB pathway) and p14ARF-MDM2-p53 pathway (p53 pathway) work at the G1-S checkpoint, and the ATM-chk2-CDC25-cyclinB1/cdk1 pathway works at the G2-M checkpoint. The disruption of these pathways is thought to be related to the prognosis of human cancer. In this study, we analyzed the status of these pathways in 107 epithelial ovarian cancer (EOC) patients by immunohistochemistry and evaluated the relationship of these results with chemotherapy response and the prognosis. Altered RB, p53, and G2 pathways were detected in 50.5% (54/107), 51.4% (55/107), and 33.6% (36/107) of cases, respectively. The overall survival (OS) of 77.3% for patients with a normal RB pathway was significantly higher than the OS of 50.0% for patients with an altered RB pathway (by Kaplan-Meier analysis, P = 0.0021). The OS of 66.2% for patients with a normal G2 pathway was significantly higher than the OS of 58.3% for patients with an altered G2 pathway (P = 0.0416). However, the status of the p53 pathway was not related to OS. By univariate and multivariate analyses, advanced stage, high histological grade, altered RB pathway, and altered G2 pathway were significant predictors of poor OS. However, there was no significant relationship between pathway status and chemotherapy response. The status of the RB pathway and of the G2 pathway were independent prognostic factors of EOC.     

护理专业医学生医患沟通技能及其心理影响因素研究

目的 了解职业技术类院校护理及助产专业医学生的心理对其医患沟通技能的影响作用,为职业技术类院校的医学生医患沟通技能提升提供指导。 方法 利用成熟的医学生医患沟通态度、技能以及心理学相关量表设计调查问卷,采用全部抽样的方式,对忻州职业技术学院护理专业学生进行调研,并最终获得264份有效问卷用于逐步进入法的多元线性回归分析。 结果 分析结果表明,医学生学习医患沟通技能的积极态度（r=0.39,P<0.001）、情绪疏泄能力（r=0.29,P<0.001）、观点采择意识（r=0.20,P<0.001）对其医患沟通技能水平的作用具有统计学意义。 结论 职业技术类院校在培养医学生的医患沟通技能时,应重点关注学生的积极学习态度、情绪疏泄能力和观点采择意识。     

用体外器官培养方法研究EDCs对新生小鼠睾丸的影响

目的 通过已建立的小鼠睾丸体外培养系统,研究四种内分泌干扰物（Endocrine Disrupting Chemicals,EDCs）对男性内分泌系统的影响。 方法 将新生小鼠的睾丸组织在体外环境中培养24h,而后在培养基中分别加入浓度为0.1μM, 1μM, 10μM and 100μM的四种（DEHP、MEHP、NP、p, p’-DDE）内分泌干扰物并培养72h,同时设置对照组;培养结束后进行组织学观察,测定冻存培养基中睾酮和抑制素βB (INH-βB)的分泌水平,同时测定细胞色素P450侧链裂解酶(P450Scc)、3β-羟基类固醇脱氢酶(3β-HSD)、细胞色素P45017α-羟化酶(P450C17)和波形蛋白（vimentin）的基因表达情况。 结果 所有剂量组中睾酮的分泌水平均发生改变;P450Scc、3β-HSD、P450C17和INH-βB蛋白质的表达及mRNA水平均受到四种内分泌干扰物的影响（P<0.05）;DEHP和MEHP降低了波形蛋白的mRNA水平（P<0.05）,而NP和p, p’-DDE对波形蛋白没有显著影响（P>0.05）。 结论 本研究建立的体外培养新生小鼠睾丸模型中,所选的四种已知EDCs改变了两种睾丸激素水平,三种类固醇合成酶以及与支持细胞功能相关的波形蛋白的表达。     

同位素稀释-气相色谱串联质谱法测定啤酒中4种亚硝胺类化合物

目的 建立啤酒中4种N-亚硝胺类化合物（N-亚硝基二甲胺、N-亚硝基二乙胺、N-亚硝基二丙胺、N-亚硝基二苯胺）的同位素稀释固相萃取-气相色谱串联质谱测定方法。 方法 样品经活性炭固相萃取小柱富集、二氯甲烷洗脱,洗脱液经氮吹浓缩定容后,采用INNOWAX毛细管色谱柱分离,多反应监测（MRM）模式检测,同位素稀释内标法定量。 结果 各物质在5 μg/L~200 μg/L范围内线性关系良好,相关系数均大于0.9995。方法的检出限为0.03-0.10 μg/L,定量限为0.10~0.33 μg/L。不同水平的加标回收率为72.1%~100.3%,相对标准偏差为1.5%~9.5%（n=6）。 结论 该方法操作简单,灵敏度和准确度高,适用于啤酒中4种N-亚硝胺类化合物的测定。     

云南省跨境婚姻家庭艾滋病、梅毒和乙肝检测现状分析

目的 了解云南省中-缅、中-老、中-越跨境婚姻家庭艾滋病、梅毒和乙肝检测情况,为完善跨境婚姻家庭预防母婴传播相关服务政策提供科学依据。 方法 对目前居住在云南省边境地区的中国籍和跨境婚姻家庭进行调查和访谈,收集一般人口学特征、最近一次怀孕期间三病检测情况等信息。经整理后,使用构成比和率对指标进行计算,使用卡方检验、秩和检验比较中国籍和跨境婚姻家庭各项检测服务状况。 结果 外籍媳妇主要以农民、文盲/小学、无经济收入的少数民族为主。配偶检测率,老挝籍低于当地中国籍媳妇（〖XC五号.EPS;P〗=7.87,P=0.005）,缅甸籍、越南籍与当地中国籍没有差异;缅甸籍高于老挝籍和越南籍（〖XC五号.EPS;P〗=41.84,P＜0.001）。三病检测点知晓率,缅甸籍媳妇低于当地中国籍媳妇（〖XC五号.EPS;P〗=6.11,P＜0.03）,越南籍、老挝籍与当地中国籍没有差异;老挝籍高于缅甸籍和越南籍（〖XC五号.EPS;P〗=44.03,P＜0.001）。获得预防母婴传播相关知识比例,三个外籍媳妇均低于当地中国籍（〖XC五号.EPS;P〗=19.84,P＜0.001;〖XC五号.EPS;P〗=7.52,P=0.006;〖XC五号.EPS;P〗=4.38,P=0.036）。 结论 边境地区针对跨境婚姻家庭开展艾滋病、梅毒和乙肝预防母婴传播相关工作取得实效,三病检测情况与当地中国籍基本一致,但在其他服务利用上仍存在一定差距,外籍媳妇孕早期三病检测率及其配偶检测率、相关预防母婴传播知识获取还有待提升,需要运用更加有效的服务管理模式来促进三病检测可及性的进一步提高。     

Tumor suppressor genes,growth factor genes,and oncogenes in hepatitis B virus-associated hepatocellular carcinoma

A series of changes in the genes that control hepatocyte growth, or interference with the protein products of these genes, appears to have an important role in the etiology of hepatocellular carcinoma (HCC). Mutations of the p53 tumor suppressor gene have been identified in 30-50% of HCC patients in some geographic areas. Abnormalities of the RB tumor suppressor gene have been found in 20-25% of HCCs, including 80-86% of HCCs with p53 mutations. Overexpression of transforming growth factor α (TGF-a), insulin-like growth factor II (IGF-II), and the oncogenes N-ras, c-myc, and c-fos have been found in high percentages of HCC patients. The cumulative effect of these changes may be more important than the order in which they occur. Some of these changes may explain the mechanism(s) by which the hepatitis B virus participates in the development of HCC. © 1994 Wiley-Liss, Inc.     

EDWARD COTLIER AND ROBERT WEINREB, EDITORS Retinoblastoma in Transgenic Mice: Models of Hereditary Retinoblastoma

Retinoblastoma, the most common intraocular malignancy in childhood, has served as a paradigm for the study of genetic mechanisms of oncogenesis. The retinoblastoma susceptibility gene RB1 was the first tumor suppressor gene to be cloned, and genetic and molecular biologic studies of this tumor have greatly expanded the understanding of the mechanics of tumorigenesis. Human retinoblastoma has essentially no naturally occurring animal counterpart. The development of transgenic murine models of retinoblastoma have created an experimental tool for manipulation of a tumor gene system in vivo. These models have also enabled studies of new therapeutic modalities. This review outlines the development of the transgenic murine models of retinoblastoma, together with the genetic mechanisms of retinoblastoma origin. Current therapeutic innovations developed by means of the transgenic models are described.