Toll样受体4、肝细胞生长因子水平对肝细胞癌患者切除术后预后的影响

目的 探讨术前血清Toll样受体4(TLR4)、肝细胞生长因子(HGF)表达水平对肝细胞癌患者切除术后预后的影响.方法 选取78例肝细胞癌患者作为研究对象,均接受肝细胞癌切除术治疗并随访1年,依据随访1年时预后情况(带瘤生存或无瘤生存)将患者分为预后不良组与预后良好组.记录并比较2组患者的基线资料,术前检测患者的血清TLR4、HGF水平,并分析术前血清TLR4、HGF水平对肝细胞癌患者肝细胞癌切除术后预后的影响.结果 随访1年时,预后不良患者16例,占20.51％ (16/78);预后不良组患者血清甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)、TLR4、HGF水平均高于预后良好组,差异有统计学意义(P＜0.05);2组基线资料及其他实验室指标水平比较,差异无统计学意义(P＞0.05).多因素Logistic回归分析结果显示,术前血清AFP、AFU、TLR4和HGF高水平是肝细胞癌患者术后预后不良的危险因素(OR＞1,P＜0.05);受试者工作特征曲线显示,术前血清TLR4、HGF水平单独及联合检测预测肝细胞癌患者术后预后的曲线下面积均＞0.70,具有一定的预测价值;TLR4、HGF的cut-off值分别取13.629、0.608 ng/mL时,可获得最佳预测价值.结论 肝细胞癌患者肝细胞癌切除术后预后可能受术前血清TLR4、HGF水平的影响.     

Rac1基因在肝细胞癌中的过表达与转移侵袭的关系

[目的]探讨rac1基因mRNA及其蛋白在肝细胞癌(HCC)中的表达规律及其与转移侵袭的关系.[方法]应用逆转录聚合酶链反应(RT-PCR)和免疫组织化学(S-P)法检测48例HCC及癌旁肝组织中Rac1基因mRNA及蛋白的表达情况,结合患者的临床病理资料分析Rac1基因与HCC转移侵袭的关系.[结果]HCC组织中Rac1基因mRNA及蛋白的表达水平明显高于癌旁肝组织的表达水平其差异均有显著性(P＜0.05),且Rac1基因蛋白的表达与患者的性别、肿瘤的大小、甲胎蛋白(AFP)、HBsAg以及有无肝硬化无关(P＞0.05),而与肿瘤的分化程度、有无包膜及有无门静脉癌栓有关(P＜0.05).[结论]Rac1基因在HCC的表达与其分化程度、有无包膜及有无门静脉癌栓密切相关,其表达水平可能成为判断HCC转移、侵袭能力重要分子生物学指标.     

血清中肝细胞生长因子的检测与肝硬化发病相关性分析

肝细胞生长因子 (HGF)在肝硬化和肝肿瘤发生、发展和转移均起着重要作用[1 3 ] 。我们采用酶联免疫吸附法(ELISA)检测肝细胞癌 (HCC)、肝硬化 (LC)和慢性肝炎 (CH)患者血清中的HGF水平 ,并对其与HCC、LC和CH的关系进行评价。一、对象和方法1 对象 :所有病例来自我院 2 0 0 1年 7～ 12月住院患者。HCC患者 110例 ,其中男 92例 ,女 18例 ,年龄 2 5～ 6 8岁 ,平均年龄 5 3岁 ,均经临床及影像学检查 (B超、CT)及术后病理切片证实为HCC ,术前采静脉血。LC患者 81例 ,其中男 6 2例 ,女 19例 ,年龄 2 4～ 6 1岁 ,平均年龄 5 4岁 ,依…     

磷脂酰肌醇蛋白多糖-3在肝细胞肝癌的表达及其与术后复发的相关性

目的探讨磷脂酰肌醇蛋白多糖-3（GPC-3）mRNA在肝细胞癌（HCC）癌组织及癌旁组织的表达及其与术后复发的相关性。方法用逆转录聚合酶链反应测定60例HCC癌组织及癌旁组织中GPC-3 mRNA的表达。PCR产物经凝胶电泳,比较HCC组织及癌旁组织中GPC-3与-βactin条带的灰度值之比,半定量分析GPC-3 mRNA的表达水平,分析术后3年不易复发HCC患者的癌组织GPC-3 mRNA的表达水平。结果 GPC-3 mRNA在HCC癌组织中高度表达,阳性率为68.3%,癌旁组织中低表达或未见表达,术后3年内未复发的HCC患者癌组织中GPC-3 mRNA呈现低表达水平,GPC-3 mRNA表达与肿瘤大小、肿瘤数目、有无包膜、门静脉癌栓、HBsAg及AFP水平无明显相关。结论 GPC-3 mRNA在HCC癌组织中的表达明显高于癌旁组织,可能是HCC的一种新的潜在的肿瘤特异标志物;癌组织中GPC-3mRNA低表达的HCC患者不易复发,可能是判断HCC进展和评价预后的一个潜在重要指标。     

肝细胞癌组织中miR-218的表达及其临床意义

[目的]研究miR-218在肝细胞癌(Hepatocellular carcinoma,HCC)组织中的表达并探讨其临床意义.[方法]收集HCC手术组织标本54例,30例癌旁正常组织作为对照,采用实时荧光定量PCR(qRT-PCR)检测HCC组织及对照组织中miR-218的表达情况,分析miR-218表达水平与HCC临床病理参数之间的关系.[结果]与癌旁对照组织相比,miR-218在HCC组织表达普遍下调,差异具有统计学意义(P＜0.01),癌旁对照组织中miR-218平均表达量约为HCC的2.90倍;miR-218下调表达程度与HCC恶性程度、肿瘤分化程度、肝内和肝外转移及门静脉癌栓有关,miR-218的表达水平与HCC患者年龄、性别、饮酒史、HBsAg、肿瘤大小、是否合并肝硬化等无关.[结论]miR-218与HCC的发生、临床进展密切相关,其可能成为HCC新的潜在的治疗靶点及诊断和预后的分子标志物.     

肝细胞肝癌组织ICAM-1及血清sICAM-1水平变化的临床意义

目的：研究细胞间黏附分子-1（ICAM-1）在肝细胞肝癌（HCC）中表达的临床意义。方法：应用免疫组化方法结合全自动图像检测40例HCC组织及其癌旁组织和28例肝硬化组织中ICAM-1的表达，以酶联免疫吸附实验（ELISA）法测定42例HCC、26例肝硬化患者和22例正常健康者血清中可溶性细胞间黏附分子-1（sICAM-1）的水平，并与甲胎蛋白（AFP）进行同步分析。结果：40例HCC组织ICAM-1表达阳性率为80．0％，高于癌旁和肝硬化组织（P〈0．05），阳性率与组织学分类相关。HCC组织中ICAM-1含量高于癌旁及肝硬化组织（P〈0．05），转移组HCC中ICAM-1的含量也高于非转移组（P〈0．05），而癌旁及肝硬化组织中含量差异无显著性（P〉0．05）。HCC患者血清sICAM-1水平高于肝硬化及正常健康组（P〈0.05），HCC伴转移组患者血清中sICAM-1无转移组（P〈0.05），AFP阴性组与阳性组sICAM-1水平差异无显著性（P〉0.05）。结论：HCC组织中高度表达ICAM-1和血清中高水平的sICAM-1，在一定程度上可以反映HCC发展程度及转移状态，ICAM-1有可能作为HCC的一个新的诊断指标。     

肝细胞肝癌中核RNA输出因子3的表达及其意义

目的：探讨核RNA输出因子3（nuclear RNA export factor 3,NXF3）在肝细胞肝癌（HCC）患者中的表达及意义.方法：采用免疫组织化学法检测96例HCC患者的癌组织及癌旁组织中NXF3的表达.采用Cox比例风险模型与Kaplan-Meier法分析NXF3与患者的临床和病理特征及生存期的关系.结果：NXF3在HCC患者癌组织中的表达显著高于癌旁组织（P＜0.001）,且在合并有肝硬化的HCC患者中显著高表达[比值比（odds ratio,OR）为0.018,95％可信区间（confidence interral,CI）为1.2～10.9].与癌组织中NXF3低表达HCC患者相比,NXF3高表达HCC患者总体生存率与无瘤生存率均较低（P=0.022和P=0.014）.采用Cox比例风险模型对影响HCC患者预后的临床和病理特征进行单因素与多因素分析,结果均表明,NXF3为HCC患者的独立危险因素.与癌组织中NXF3低表达的患者相比,NXF3高表达的患者的病死率和复发率更高（OR=3.2,P=0.006;OR=2.5,P=0.008）.结论：NXF3在HCC患者癌组织中呈高表达,并与HCC患者的总体生存率以及肿瘤复发有关,可以作为判断HCC患者肝切除术后的预后指标.     

原发性肝细胞癌患者 TACE治疗前后血清血小板源性生长因子 -BB水平变化及其临床意义

目的　探讨原发性肝细胞癌（HCC）患者经皮肝动脉化疗栓塞（TACE）治疗前后血清血小板源性生长因子 （PDGF）-BB 的变化情况及其与近期疗效的关系。方法　选取2016 年1 月~2018 年10 月采用TACE 治疗的172 例 HCC 患者为观察组,另选取同期80 例健康体检者作为对照组,采用酶联免疫吸附试验法（ELISA）检测血清中PDGFBB 水平。结果　观察组患者术前、术后1 天、1 周和1 月的血清PDGF-BB 水平均显著高于对照组,差异均具有统计 学意义(P ＜ 0.01)。TACE 术前观察组患者的血清PDGF-BB 水平与肿瘤数目、肿瘤大小和有无癌栓相关(P ＜ 0.05)。 TACE 术后观察组患者的疗效与肿瘤数目、肿瘤大小、有无癌栓、术前血清AFP 水平和术后1 周血清PDGF-BB 水平显 著相关( 均P ＜ 0.05)。Logistic 多因素分析结果显示术后1 周血清PDGF-BB(OR=2.665, 95%CI: 1.231~5.769, P =0.000) 和肿瘤数目(OR=1.904, 95%CI: 1.023~3.544, P =0.005) 均是影响TACE 术后疗效的因素。结论　血清中PDGF-BB 水平与 TACE 术后HCC 患者的短期疗效密切相关。     

PRPF3和CHEK1在肝细胞肝癌中的表达水平及临床意义

目的 研究肝细胞肝癌(HCC)患者组织中前mRNA加工因子3(PRPF3)和检查点激酶1(CHEK1)的表达水平,探讨两者的临床意义。方法 应用R语言分析癌症基因组图谱数据库中HCC癌组织和癌旁组织中PRPF3和CHEK1 mRNA表达水平的差异。利用免疫组化检测该院诊治的86例HCC患者的癌组织和癌旁组织中PRPF3和CHEK1的蛋白表达水平。Spearman秩相关分析癌组织中PRPF3和CHEK1表达水平的相关性。统计学分析癌组织中PRPF3、CHEK1表达水平与临床病理特征的关系。Kaplan-Meier生存分析(Log-rank检验)分析PRPF3、CHEK1表达水平与生存预后的关系。单因素及多因素COX回归分析影响HCC患者生存预后的危险因素。结果 TCGA数据库及免疫组化结果,HCC癌组织中PRPF3、CHEK1 mRNA及蛋白表达水平明显高于正常肝组织,差异有统计学意义(均P<0.05)。癌组织中PRPF3与CHEK1蛋白表达水平呈显著正相关(r=0.607,P<0.001)。不同肿瘤TNM分期、病理分级及肝内转移患者癌组织中PRPF3、CHEK1蛋白表达水平...     

SIPA1基因对原发性肝细胞癌转移复发的影响

[目的]研究SIPA1基因在肝细胞癌( HCC) 中的表达情况及其临床意义.[方法]采用免疫组织化学S-P法检测86例HCC组织及其癌旁肝组织和8例正常肝组织中SIPA1的表达情况,研究其与HCC 临床病理学资料及预后的关系.[结果]86 例HCC 中,SIPA1在癌组织的阳性表达率和癌旁组织中阳性表达率分别为43.0%(37/86)和87.2%(75/86),前者明显低于后者(P＜0.01).有静脉侵袭的肝癌标本癌旁表达SIPA1低(P＜0.05).SIPA1蛋白在癌旁组织中表达存在个体差异,低表达组术后复发率更高(P＜0.01),生存期更短(P＜0.01).[结论]SIPA1在HCC中发挥肿瘤抑制基因的作用,且对抑制HCC的复发转移有重要作用.     

现代残疾康复理念、政策与社区康复体系研究

本研究分析了当代残疾康复的理念和理论架构,构建了以国际公约、决议和政策、国内法律和政策以及操作性工具3个层次的康复理论体系;运用包容性发展,分析探讨了当代社区康复的体系和特点;就发展康复事业、为残疾人提供全面系统的康复服务提出相关的政策建议。     

我院文职护士管理和培训的实践与体会

目的构建文职护士培训、使用及管理的科学方法。方法通过规范管理、科学施训、作为骨干大胆任用等多种管理方式,使文职护士得到充分的发展。结果文职护士群体成长为医院优秀骨干,首批满3年的文职护士顺利通过续聘考核。结论科学的管理培训是文职护士成长的重要基石,对医院护理管理有着重要作用。     

国内外唇腭裂专科护理发展现状的文献研究及分析

目的了解和分析国内唇腭裂专科护理工作发展的现状。方法检索并分析万方医学网、中国知网、Springer Link及PubMed英文数据库近6年有关唇腭裂手术的围术期护理、患儿的喂养、手术安全管理、围术期疼痛研究以及心理护理的相关文献。结果共检索出国内文献89篇(核心期刊20篇)、国外文献22篇,其中围术期护理38篇、患儿的喂养16篇、手术安全管理10篇、围术期疼痛研究10篇、心理护理15篇。结论与国外文献相比,国内论文总结和回顾性居多,应增加研究探讨性论文,从而促进唇腭裂临床护理工作专科化的发展。     

城乡学童个性行为特征调查

目的探讨农村与城市儿童的个性行为特征。方法将97名农村学龄儿童设为农村组,97名城市学龄儿童设为城市组,采用艾森克个性问卷一儿童版和Achenbach’s 行为量表一儿童版进行评定分析。结果两组学龄儿童艾森克个性问卷各维度评分均无显著性差异（P均〉0．05）,且与全国常模相一致（P均〉0．05）;农村组男学童Achenbach’s行为量表违纪行为、攻击行为及外向型因子分均显著高于城市组,女学童退缩、社交问题因子分均显著高于城市组（P〈0．05或0．01）,其他因子分均无显著性差异（P均〉0．05）。结论农村与城市儿童个性无显著差异,而农村儿童存在较多的行为问题,可能与其所受教养和生活方式有关。     

Comparison of short-term and long-term protocols for stabilization and preservation of RNA and DNA of Leishmania, Trypanosoma, and Plasmodium

Molecular tools continue to be important in the prevention and control of parasitic diseases. However, using these techniques directly in the field remains a major challenge. Therefore, the preservation of clinical samples collected from endemic field areas for later analysis remains an important preanalytical process. This study aimed at identifying a suitable protocol for stabilization and preservation of RNA and DNA in bioclinical specimens for Trypanosoma, Leishmania, and Plasmodium research. Both spiked and unspiked blood samples were preserved in 7 protocols (different media; storage temperatures). Samples were evaluated for possible degradation of DNA and RNA along the storage duration up to the 10th week. Nucleic acid targets were assessed as follows: (i) Trypanosoma and Plasmodium RNA analysis was done using real-time nucleic acid sequence-based amplification (RT-NASBA) for 18S rRNA and for stage-specific Pfs25 mRNA, respectively; (ii) Trypanosoma DNA assessment analysis was conducted by using a conventional PCR for 18S rDNA; (iii) Leishmania RNA analysis was performed with a quantitative NASBA for 18S rRNA and Leishmania DNA assessment with an RT-PCR for 18S rDNA. Findings suggested that a newly developed L3™ buffer proved to be reliable and suitable for both short- and long-term preservation of parasite nucleic acid material. This buffer is envisaged to be suitable for utilization in field situations where resources are limited.     

History of violence and subjective health of mother and child

Objective: To study the self-reported prevalence of experienced violence among a cohort of women about two years after giving birth, their health during pregnancy, pregnancy outcomes and their experience of their child’s health.

Setting and subjects: In 2011, a total of 657 women participated in phase III of the Childbirth and Health Cohort Study in Icelandic Primary Health Care, 18 to 24 months after delivery. The women had previously participated in phase I around pregnancy week 16 and phase II 5–6 months after delivery. Data were collected by postal questionnaires.

Main outcome measures: Women’s reported history of experienced violence, sociodemographic and obstetric background, self-perceived health, the use of medications and their child’s perceived health.

Results: In phase III, 16% of women reported experiencing violence. These women felt less support from their current partner (p?p?p?p?p?p?=?0.008).

Conclusions: Our study confirms that a history of violence is common among women. A history of violence is associated with various maternal health problems during and after pregnancy, a higher rate of caesarean sections and maternal reports of health problems in their child 18–24 months after birth.

• KEY POINTS

• Violence is a major concern worldwide. Understanding the impact of violence on human health and developing effective preventive measures are important elements of any public health agenda.

• ??The reported prevalence of experiencing violence was 16% among women attending antenatal care in the primary health care setting in Iceland.

• ??Women with a history of violence reported worse health in general during pregnancy and delivered more often by caesarean section, compared to women with no such history.

• ??Mothers with a history of violence also evaluated the general health of their child as worse than women with no such history.

• ??The findings of this study support the importance of recognizing and addressing experienced violence among women in primary care.

     

Rates and risks of transmission of smallpox and mechanisms of prevention

In 1980, the World Health Organization declared smallpox eradicated from the world; the last known natural case had occurred in Somalia in 1977, and the United States had stopped routinely vaccinating its citizens in 1972. However, with increasing concerns regarding domestic and international terrorism, smallpox has resurfaced as a potential threat to global health. We review the direct and indirect modes of smallpox transmission and how patterns of transmission vary substantially, depending on the severity of circulating disease, vaccination status, environmental and socioeconomic factors, and the setting of an outbreak. We examine mechanisms for controlling outbreaks of disease and preventing further transmission in the event of an outbreak, with an emphasis on smallpox vaccination.     

通用设计原则与产品研发策略

本文介绍了通用设计的概念和设计原则,并阐述了根据此原则实施通用设计的产品研发策略。通用设计惠及的不仅是残疾人,也惠及了包括普通公众在内的广泛人群,以及企业。应将通用设计的原理应融入政府相关政策和未来发展的规划中,为残疾人以及更多人群提供合理便利的通用设计产品。     

胃癌DNA含量与E-cad、EGFR表达的关系及其意义

目的　探讨胃癌组织DNA含量与E cad、EGFR表达的关系 ,评价其在浸润、转移潜能及预后判断中的作用。方法　应用图像分析仪及SP免疫组化法检测 30例正常胃黏膜上皮、30例不典型增生和 5 0例胃癌组织DNA含量与E cad、EGFR蛋白表达情况。结果　①正常胃黏膜上皮、Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌组的DI、PI、S %、>5c %逐渐增高 ,与胃癌分期、淋巴结转移显著相关 (P <0 0 1)。②E cad在正常胃黏膜上皮阳性表达率 10 0 % ,EGFR呈阴性表达 ;Ⅰ、Ⅱ、Ⅲ级不典型增生及胃癌E cad阳性表达率逐渐降低 ,EGFR的阳性表达率逐渐升高 ,且差异显著 (P <0 0 5 ) ;E cad表达减弱、EGFR表达升高与胃癌分化差、淋巴结转移显著相关 (P <0 0 1)。③E cad表达阴性的胃癌DNA指数及EGFR表达水平显著高于E cad阳性 (P <0 0 1)。结论　检测DNA含量及E cad、EGFR蛋白表达有助于胃癌的早期诊断及转移潜能和预后的判断。     

Quality and suitability of antimicrobial discs: theoretical and practical sources of error and variability

ABSTRACT

Introduction: The use of antimicrobial discs remains one of the main methods for assessing antibiotic activity. Most discs are made to one of three main standards (FDA, WHO, DIN); these all describe an assay method for assessing the quality of discs using a linear method. Theory predicts a curved relationship, and this is backed up in many cases in practice. In such cases, the assays are potentially invalid. Other sources of uncertainty arising from the manufacturing processes employed are also discussed.

Areas covered: This includes error arising from applying FDA, WHO, and DIN standards, the manufacturing techniques employed, and variation in the materials used in production. The need for a specification that relates directly to the use of the discs is also discussed.

Expert opinion: Manufactured discs, some of which may be out of specification due to curvature and other sources of error, have been used to establish quality zone sizes. Quality zone sizes have then been used to measure the quality of discs. This circular quality system where there is no quantitative check is potentially unsafe. In the many decades of their use, there has been no comprehensive check on the quality of manufactured discs using quantitative, validated assays.