经口腔前庭腔镜甲状腺癌根治术的临床实践及与开放性手术比较

目的 经口腔前庭腔镜甲状腺癌根治术的临床实践及与开放性手术进行比较。方法 回顾性收集并比较分析自2019年3月至2019年12月中国科学院大学宁波华美医院甲状腺外科行经口腔前庭腔镜甲状腺切除术和传统开放性甲状腺切除术的甲状腺肿瘤患者各45例临床资料（行经传统开放术式患者样本量较大,随机抽样选择45例）,比较分析两组在性别、年龄、BMI、病理类型,清扫淋巴结数量以及手术时长,术后引流量,术后出现相关并发症,远期预后等指标。结果 两种术式患者术前术后相关临床资料无明显统计学差异,术中指标如出血量,淋巴清扫方面两组亦无统计学差异,但术中手术时间较开放组延长（P<0.05）,手术费用较开放组更多,住院时长较开放组更短。结论 选择合适的患者,行经口腔前庭入路腔镜甲状腺癌根治术安全可行,在美容效果上有优势。     

Pulmonary Hypertension in HIV

Human immunodeficiency virus–associated pulmonary arterial hypertension (HIV-PAH) is important to recognize given its association with significant morbidity and mortality. With the introduction of antiretroviral therapy, the focus of disease management has largely shifted from treating immunodeficiency-related opportunistic infections to managing chronic cardiopulmonary complications. Symptoms are nonspecific, and a high index of clinical suspicion is needed to avoid significant delay in the diagnosis of HIV-PAH. Although several viral proteins have been implicated in the pathogenesis of HIV-PAH, the exact mechanism remains uncertain. Further studies are needed to elucidate precise pathogenic mechanisms, early diagnostic tools, and novel therapeutic targets to improve prognosis of this severe complication.     

东北苦菜UPLC指纹图谱建立及化学模式识别

目的建立东北苦菜Ixeris vesicolor DC.UPLC指纹图谱,并进行化学模式识别。方法东北苦菜甲醇提取物的分析采用CORTECS C18色谱柱(2.1 mm×150 mm,1.6μm);流动相0.1%磷酸水⁃乙腈,梯度洗脱;体积流量0.1 mL/min;检测波长(1~15 min,327 nm;15~50 min,360 nm);柱温35℃;进样量2μL。采用相似度分析和化学模式识别技术相结合的方法对其进行质量评价。结果10批样品指纹图谱中有19个共有峰,相似度均大于0.953。通过聚类分析将样品分成2类,主成分分析结果支持聚类分析结果,采用正交偏最小二乘法⁃判别分析筛选出了导致不同批次药材质量差异的3个共有峰,指认出2号峰(绿原酸)和12号峰(木犀草素)。结论该方法稳定可靠,可系统、全面地评价东北苦菜的药材质量。     

不同产地当归藤HPLC指纹图谱

目的建立不同产地当归藤HPLC指纹图谱。方法当归藤85%甲醇提取物的分析采用Phenomenex C18色谱柱(4.6 mm×250 mm,5μm);流动相乙腈⁃0.1%磷酸水,梯度洗脱;体积流量0.8 mL/min;柱温30℃;检测波长225 nm。对结果进行聚类分析和主成分分析。结果12批样品指纹图谱中有12个共有峰,相似度均大于0.940,并指认了没食子酸,儿茶素;聚类分析将12批样品分为2类。结论该方法准确稳定,重复性好,可用于当归藤药材的质量控制。     

南北柴胡HPLC-ELSD指纹图谱的研究

目的:采用HPLC-ELSD法分别建立南、北柴胡的指纹图谱,并进行真伪鉴别。方法:样品的甲醇提取液采用TOSOH TSKgel ODS-100V C18(4.6mm×15cm,5μm)色谱柱分析,乙腈-水梯度洗脱,流速:1.0 mL/min柱温:25℃,检测器为蒸发光散射检测器(ELSD)。并对结果进行相似度评价和主成分分析。结果:建立了含有11个共有峰的北柴胡HPLC-ELSD指纹图谱和含有14个共有峰的南柴胡HPLC-ELSD指纹图谱。伪品的相似度低,可以通过指纹图谱进行真伪鉴别。结论:该方法能快速可靠的鉴别和区分南、北柴胡,可以用于柴胡的质量控制。     

症状前期进行性肌营养不良患儿24例病例系列报告

背景：进行性肌营养不良（PMD）中Duchenne型肌营养不良(DMD)和Becker型肌营养不良(BMD)的临床表现、治疗和预后差异明显，目前国内外对症状前期PMD患儿的诊断尚无共识。 目的：探讨婴幼儿时期症状前期PMD患儿的临床特征和实验室检查特点，并探讨血清肌酶水平在DMD和BMD分型诊断中的价值。 设计：病例系列报告。 方法：收集2016年1月至2020年7月江西省儿童医院确诊的症状前期PMD患儿，分析临床特征和实验室检查特点，并以基因检测结果为诊断标准分为DMD组和BMD组，血清肌酶通过ROC曲线分析以约登指数最大值时的取值作为诊断界值，比较不同肌酶的诊断准确性。 主要结局指标：PMD患儿的临床表现、基因结果、血清酶水平（AST、ALT、LTH、CK、CK-MB）。 结果：24例PMD患儿纳入分析，其中DMD组18例，BMD组6例。22例（91.7%）因发现转氨酶升高就诊，2例（8.3%）因亲戚确诊前来就医。PMD患儿CK-MB、CK、LDH、AST和ALT水平均明显升高，DMD组均高于BMD组（除AST外，P均<0.05）。当ALT>224.5 U·L-1、CK>11 069 IU·L-1、CK-Mb>204 IU·L-1、LDH>1 349.5 IU·L-1时为DMD的可能性更高，尤其是LDH>1 349.5 IU·L-1具有高度特异性。 结论：血清肌酶水平增高为 PMD 患儿症状前期的主要表现。LDH＞1 349.5 IU·L-1对诊断DMD具有高度特异性。     

The STING activator c-di-AMP exerts superior adjuvant properties than the formulation poly(I:C)/CpG after subcutaneous vaccination with soluble protein antigen or DEC-205-mediated antigen targeting to dendritic cells

Vaccination is the most efficient strategy to protect from infectious diseases and the induction of a protective immune response not only depends on the nature of the antigen, but is also influenced by the vaccination strategy and the co-administration of adjuvants. Therefore, the precise monitoring of adjuvant candidates and their immune modulatory properties is a crucial step in vaccine development. Here, one central aspect is the induction of appropriate humoral and cellular effector mechanisms.In our study we performed a direct comparison of two promising candidates in adjuvant development, the STING activator bis-(3,5)-cyclic dimeric adenosine monophosphate (c-di-AMP) and the Toll-like receptor ligand formulation poly(I:C)/CpG. These were evaluated in C57BL/6 mice using the model antigen ovalbumin (OVA) in subcutaneous vaccination with soluble protein as well as in a dendritic cell (DC) targeting approach (αDEC-OVA). Strikingly, c-di-AMP as compared to poly(I:C)/CpG resulted in significantly higher antigen-specific IgG antibody levels when used in immunization with soluble OVA as well as in antigen targeting to DC. In vaccination with soluble OVA, c-di-AMP induced a significantly stronger CTL, Th1 and IFNγ-producing CD8⁺ memory T cell response than poly(I:C)/CpG. The response was CTL and Th1 cell dominated, a profile shared by both adjuvants. In the context of targeting OVA to DC, c-di-AMP induced significantly increased Th1 and Th2 cell responses as compared to poly(I:C)/CpG. Interestingly, the Th1 response dominated the overall T cell response only when c-di-AMP was used, indicating a distinct modulatory property of c-di-AMP when the DC targeting immunization approach was exploited.Taken together, we describe superior properties of c-di-AMP as compared to poly(I:C)/CpG in subcutaneous vaccination with soluble antigen as well as antigen targeting to DC. This indicates exceptionally effective adjuvant properties for c-di-AMP and provides compelling evidence of its potential for further adjuvant development, especially also when using DC targeting approaches.