粪便中miRNA-424在结直肠癌诊断和筛查中的应用

目的研究miRNA(miR-150,miR-424,miR-29b,miR-96)在结直肠癌组织和粪便中的表达情况。方法纳入77例结直肠癌患者以及43名正常志愿者。运用实时定量PCR技术,对miRNA在结直肠癌患者与正常人群的粪便中的表达情况进行检测,并比较二者的差异。结果 miR-150在正常人群和结直肠癌患者粪便中表达有显著差异(P<0.05);miR-424在正常组中的表达量显著低于肿瘤组(P<0.05)。miR-29b和miR-96在两种人群粪便中的表达量无显著差异(P>0.05)。miR-424的曲线下面积为0.756,而miR-150的曲线下面积为0.661。结论 miR-424在结直肠癌患者和正常人群的粪便中表达存在明显差异。     

脑胶质瘤恶性进展关键miRNA表达的研究

目的寻找影响胶质瘤恶性进展的关键微小RNA(miRNA)。方法使用miRNA表达谱芯片检测198例不同级别胶质瘤组织标本miRNA的表达情况,挑选代表性差异表达miRNA,采用荧光定量PCR方法进行验证。在人胶质瘤细胞系,通过MTT试验、平板克隆形成试验、细胞周期试验,探讨关键miRNA对肿瘤细胞增殖能力的影响。结果相对于Ⅱ级胶质瘤组织,Ⅲ级胶质瘤组织中miR-374a、miR-590-3p、miR-374b、miR-29c、miR-153表达上调,而let-7c、miR-544、let-7a、miR-132、miR-7d等表达下调。对miR-374a、miR-544表达水平进行验证,结果与芯片方法一致。人胶质瘤H4细胞转染miR-374amimics后,细胞生长率明显增高,细胞克隆数量明显增加。H4细胞转染miR-544mimics后,细胞生长率明显降低,细胞克隆数量明显减少。与Ⅱ级或Ⅲ级胶质瘤组织相比,miR-196b在Ⅳ级胶质母细胞瘤组织中表达水平明显增高,转染miR-196b可明显增加U251细胞的生长率,S期细胞比例增加。结论在不同级别胶质瘤中差异表达的miR-374a、miR-544、miR-196b,可能是通过影响细胞增殖能力推动胶质瘤恶性进程。     

乳房浸润性导管癌组织miR-10b和miR-195表达及意义

目的探讨miRNA 10b（miR-10b）、miRNA 195（miR-195）在乳腺浸润性导管癌组织表达及其意义。方法收集40例乳癌病人癌组织及癌旁组织标本,应用逆转录PCR法测定组织中miR-10b、miR-195表达,并分析其与临床病理特征的关系。结果乳腺浸润性导管癌组织miR-10b、miR-195表达明显低于癌旁组织（t=4.35、5.71,P〈0.05）。miR-195表达与肿瘤的大小、有无淋巴结转移及间质脉管癌栓等有关（U=-2.127--2.083,P〈0.05）,miR-10b、miR-195表达与肿瘤TNM分期、雌激素受体（ER）、孕激素受体（PR）及人表皮生长因子受体-2（Her-2）表达水平无明显相关性（P〉0.05）。结论乳房组织中miR-10b、miR-195表达可能为筛查和诊断乳房肿瘤的潜在生物学指标。     

5种血清miRNA的检测在前列腺癌诊断中的价值评估

目的 检测miR-141,miR-16,miR-103,miR-574,miR-34b等五种前列腺癌相关的miRNA在前列腺癌患者血清中的含量,评价其在前列腺癌诊断中的价值.方法 收集临床血清样本,将其分为前列腺癌、前列腺增生、PSA升高等三组,提取血清中miRNA.应用荧光定量PCR方法检测相应miRNA的含量,用GraphPad Prism软件进行统计学分析.结果 miRNA-103和miR-34b在前列腺癌患者、前列腺增生患者和PSA增高人群血清中的含量普遍较正常人增高,其中miRNA-34b平均增高2.2×104倍,在所有PSA升高的样本中均增高.其余3种miRNA的水平相对于正常人未呈现显著差异.结论 miR-34b的诊断价值与PSA相当,是一个潜在的前列腺癌诊断性血清标志物.     

miR-181b与肿瘤

microRNA(miRNA)是一类在转录后水平调控基因表达的单链非编码小分子RNA。miRNA能够调控机体多种生理和病理过程,如细胞增殖、分化、发育、凋亡、激素分泌和肿瘤形成等。在肿瘤中miR-181b与靶基因结合,作用相关信号通路,促进或抑制肿瘤生长,可作为判断某些肿瘤的生物标志物。对miR-181b与恶性肿瘤的发生、发展机制的研究具有重要意义,可为恶性肿瘤的诊断与治疗提供新的思路。     

miR-10b介导乳腺癌转移的机制与靶向治疗

乳腺癌是女性常见的恶性肿瘤之一,它的局部浸润和远处转移是目前治疗的难点。微小RNA(miRNA)在癌症中的功能研究,为肿瘤的发生及侵袭转移机制提供了新的思路。目前已研究发现miRNA家族中的miRNA-10b(miR-10b)通过三条通路介导乳腺癌的侵袭和转移。随着miR-10b的分子靶向药物如miR-10b阻断剂、CCN5激活剂、NSAID舒林酸(SS)的不断发现,miR-10b可能成为治疗乳腺癌转移的新靶点。该文就miR-10b在乳腺癌转移中的机制与靶向治疗作一综述。     

精液中miR-34b、miR-122、miR-429联合检测对男性不育症的诊断价值

目的 探讨男性不育症患者精液中miRNA表达水平的差异,分析相关miRNA的表达水平对男性不育症的诊断价值。方法 纳入2019年4月至2021年4月该院收治的168例男性不育症患者,其中20例通过高通量测序分析其精液中miRNA表达水平,另外148例作为研究组;同时纳入168例男性健康志愿者,其中20例通过高通量测序分析其精液中miRNA表达水平,另外148例作为对照组。检测并比较两组受试者精液中miR-34b、miR-122、miR-429的相对表达量。采用受试者工作特征(ROC)曲线分析精液中miR-34b、miR-122、miR-429检测对男性不育症的诊断价值。结果 高通量测序发现,20例健康志愿者与20例男性不育症患者精液中多种miRNA的表达水平具有差异,其中表达上调的miRNA有58个,表达下调的miRNA有22个。选取表达差异最大的3个miRNA(miR-34b、miR-122、miR-429)进行表达水平的验证和诊断价值的分析。实时荧光定量PCR发现,两组精液中miR-34b、miR-122、miR-429的相对表达量比较,差异均有统计学意义(P<0.05)。R...     

全反式维甲酸和三氧化二砷诱导急性早幼粒细胞白血病细胞分化前后微小RNA表达变化

目的 研究急性早幼粒细胞白血病(APL)细胞分化前后微小RNA(miRNA,miR)表达变化.方法 采用全反式维甲酸(ATRA)和三氧化二砷(As2O3)诱导APL细胞系NB4 细胞分化,瑞氏-姬姆萨染色观察细胞形态,流式细胞术检测细胞表面标志CD11b的表达,用实时定量RT-PCR检测miRNA表达谱miR-15b、miR-16、miR-34a、miR-107、miR-124a、miR-146、miR-155、miR-181a、miR-223、miR-342、let7c等miRNA的表达水平,用2-△△Ct法计算miRNA相对表达水平.收集15例APL初诊和15例APL缓解期患者骨髓单个核细胞(MNC),用RT-PCR检测MNC miRNA 的表达水平,用2-△Ct法计算miRNA表达水平.结果 ATRA作用NB4细胞96 h,miR-15b、miR-16、miR-107、miR-223、miR-342表达水平均显著上调,分别为对照组的3.40、4.22、5.41、20.03和5.29倍,As2O3作用NB4细胞96 h,miR-15b、miR-16、miR-107、miR-223、miR-342表达水平也显著上调,分别为对照组的3.62、2.49、2.58、4.27和1.94倍,除miR-15b外,ATRA处理组miR-16、miR-107、miR-223和miR-342表达水平上调程度均高于As2O3处理组,其中尤以miR-223为甚.ATRA和As2O3治疗后缓解期APL患者miR-15b、miR-16、miR-107、miR-181a、miR-223和miR-342表达水平(2-△Ct值)分别为0.4137、0.6367、0.1260、0.0522、0.6611和0.0280,而APL初诊患者miR-15b、miR-16、miR-107、miR-181a、miR-223、miR-342表达水平分别为0.0751、0.2022、0.0425、0.3064、0.1733和0.0090,APL缓解期miR-15b、miR-16、miR-107、miR-223和miR-342表达水平高于APL初诊者(P值均<0.05),而APL缓解期miR-181a表达水平低于APL初诊者(P<0.05).结论 特定miRNA参与APL细胞分化过程.     

21-三体综合征胎儿中孕期母体血清microRNA的表达谱

目的探讨21-三体综合征(DS)胎儿的中孕期母体血清与正常妊娠的中孕期母体血清中的mircoRNA(miRNA)的差异性表达。方法收集DS胎儿(均经羊水细胞G显带核型确认)母体及正常妊娠母体的血清标本各10例,分别等量混合后作为DS组和健康对照组。用低密度芯片技术(TLDA)分析674种已知的人类miRNA在两组血清中的表达,建立两组标本的miRNA表达谱。结果 DS组高丰度(Ct≤25)miRNA表达的有16种,中丰度(2533)miRNA。健康对照组高、中、低丰度表达的miRNA分别为19、69、66种。两组中表达量最高的19种miRNA均为miR-223、miR-16、miR-24、miR-126、miR-17、miR-191、miR-106a、miR-92a、miR-19b、miR-146a、miR-484、miR-320、miR-20a、miR-150、miR-222、miR-30c、miR-135a*、miR-93、miR-126*,且表达量无显著差异(ΔΔCt<2)。与健康对照组比较,DS组miR-125b、miR-99a、miR-100、miR-194、miR-365、miR-215、miR-574-3p、miR-193b、miR192、miR-885-5p和miR-122表达下调;miR-221、miR-15b和miR-199a-3p表达上调(ΔΔCt>2)。结论 DS组与健康对照组血清之间存在明显的miRNA差异表达。     

探讨miRNA标记物在骨髓间充质干细胞对成骨诱导分化过程中的调控机制

目的 探讨miRNA标记物在骨髓间充质干细胞对成骨细胞诱导分化过程中的调控机制。方法 选取2016年6月—2018年1月该院收治的40例脊柱结核患者作为研究对象,将体外培养的人骨髓间充质干细胞（BMSCs）通过转化生长因子-β1(TGF-β1)对骨髓间充质干细胞向成骨细胞分化进行诱导,通过基因芯片技术对诱导分化期间miRNA进行检测,最后通过实时荧光定量PCR进行验证。结果 骨髓间充质干细胞向成骨细胞分化期间筛选出差异表达miRNA,其中miR-130b、miR-193b为表达上调miRNA,miR-135、miR-424为表达下调miRNA。于原样本中实施实时荧光定量PCR验证,验证结果同基因芯片筛选结果存在高度一致性（Kappa=0.913,P<0.05）。结论 高表达的miR-130b、miR-193b及低表达的miR-135、miR-424均有可能够调控骨髓间充质干细胞对成骨细胞的诱导分化过程。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.