经肛门内镜显微手术前预防性应用抗生素的临床价值

目的  探讨术前预防性使用抗生素在经肛门内镜显微手术（TEM）中的临床价值。方法 选取30例于该院行TEM手术治疗直肠肿瘤的患者作为研究对象,随机分为抗生素组和对照组,抗生素组为术前和术后均应用抗生素,对照组为仅术后应用抗生素。评估患者术前和术后血沉（ESR）、C-反应蛋白（CRP）、降钙素原（PCT）、白细胞计数（WBC）、中性粒细胞（NE%）和体温（T）等指标的变化。结果  抗生素组患者术后第1天和第3天ESR、CRP、WBC、NE%和T均明显低于对照组（P <0.05）,并且WBC、NE%和T在术后第3天较术后第1天有明显的下降趋势。对于PCT,在术后第1天两组比较差异有统计学意义,抗生素组低于对照组（P <0.05）,但在术后第3天,两者之间差异无统计学意义（P >0.05）。结论  术前预防性应用抗生素对TEM微创手术引起的炎症减轻和感染预防可能有一定的临床价值,但最终结论仍需要扩大病例数进一步研究。

     

RNA Interference-Mediated Knockdown of Bombyx mori Haemocyte-Specific Cathepsin L (Cat L)-Like Cysteine Protease Gene Increases Bacillus thuringiensis kurstaki Toxicity and Reproduction in Insect Cadavers

The silkworm’s Cat L-like gene, which encodes a lysosomal cathepsin L-like cysteine protease, is thought to be part of the insect’s innate immunity via an as-yet-undetermined mechanism. Assuming that the primary function of Cat L-like is microbial degradation in mature phagosomes, we hypothesise that the suppression of the Cat L-like gene expression would increase Bacillus thuringiensis (Bt) bacteraemia and toxicity in knockdown insects. Here, we performed a functional analysis of Cat L-like in larvae that were fed mulberry leaves contaminated with a commercial biopesticide formulation based on Bt kurstaki (Btk) (i.e., Dipel) to investigate its role in insect defence against a known entomopathogen. Exposure to sublethal doses of Dipel resulted in overexpression of the Cat L-like gene in insect haemolymph 24 and 48 h after exposure. RNA interference (RNAi)-mediated suppression of Cat L-like expression significantly increased the toxicity of Dipel to exposed larvae. Moreover, Btk replication was higher in RNAi insects, suggesting that Cat L-like cathepsin may be involved in a bacterial killing mechanism of haemocytes. Finally, our results confirm that Cat L-like protease is part of the antimicrobial defence of insects and suggest that it could be used as a target to increase the insecticidal efficacy of Bt-based biopesticides.     

Expansion of CD3+CD8+PD1+ T lymphocytes and TCR repertoire diversity predict clinical responses to adoptive cell therapy in advanced gastric cancer

The adoptive cell therapy (ACT) and delivery of ex vivo activated cellular products, such as dendritic cells (DCs), NK cells, and T cells, have shown promise for the treatment of gastric cancer (GC). However, it is unknown which cells can improve patient survival. This study was focused on the antitumour activity of a subset of these cellular products and their relationships with clinical outcomes. Nineteen patients were enrolled at the Capital Medical University Cancer Center, Beijing Shijitan Hospital, from June 1, 2013, to May 30, 2016. CD8⁺PD1⁺ T-cell sorting was carried out using flow cytometry, and the T-cell receptor (TCR) repertoire during ex vivo expansion for 15 days was analyzed by next-generation sequencing. After 15 days of culture, the number of CD8⁺ T cells had increased significantly, and the number of CD4⁺ T cells had increased correspondingly. After ex vivo expansion, CD8⁺ T cells exhibited significantly enhanced expression of PD-1, LAG-3, and TIM-3 but not 4-1BB. Survival analysis showed that patients with a pro/pre value of CD8⁺PD-1⁺ T cells >2.4 had significantly favorable overall survival (OS) (median OS time, 248 days versus 96 days, P=0.02) and progression-free survival (PFS) (median PFS time, 183 days vs. 77 days, P=0.002). The sorted CD8⁺PD-1⁺ T cells displayed enhanced antitumor activity and increased IFN-γ secretion after coculture with autologous tumor cell lines. TCR repertoire diversity was decreased after ex vivo expansion, which decreased the Shannon index and increased the clonality value. The prognosis of patients was significantly improved and was associated with the extent of CD8⁺PD-1⁺ T-cell expansion. In summary, this study showed that after ex vivo expansion for 15 days, CD8⁺PD-1⁺ T cells could be identified as tumor-reactive cells in patients treated for GC. Changing TCR species can predict the extent of CD3⁺CD8⁺PD1⁺ T-cell growth and the effect of ACT treatment.     

Does losing money truly hurt? The shared neural bases of monetary loss and pain

Both monetary loss and pain have been studied for decades, but evidence supporting the relationship between them is still lacking. We conducted a meta‐analysis to explore the overlapping brain regions between monetary loss and pain, including physical pain and social pain. Regardless of the type of pain experienced, activation of the anterior insula was a shared neural representation of monetary loss and pain. The network representation pattern of monetary loss was more similar to that of social pain than that of physical pain. In conclusion, our research provided evidence of the common neural correlates of monetary loss and pain.     

Emerging pro-drug and nano-drug strategies for gemcitabine-based cancer therapy

Gemcitabine has been extensively applied in treating various solid tumors. Nonetheless,the clinical performance of gemcitabine is severely restricted by its unsatisfactory pharmacokinetic parameters and easy deactivation mainly because of its rapid deamination, deficiencies in deoxycytidine kinase (DCK), and alterations in nucleoside transporter. On this account, repeated injections with a high concentration of gemcitabine are adopted, leading to severe systemic toxicity to healthy cells. Accord...     

四生汤减轻放射反应的作用机制研究

为进一步研究四生汤减轻放射反应的作用机制,分别以＾１３７Ｇｓ－γ射线全身一次性照射造成小鼠急性辐射损伤模型及人骨髓细胞为研究对象,观察四生汤对模型动物和人骨髓细胞增殖的影响。结果表明四生汤明显提高模型动物Ｇ－ＣＦＵ和ＣＦＵ－Ｓ数量,对人骨髓Ｇ－ＣＦＵ产率也有明显的促进作用。四生汤内可能含有促进骨髓造血干细胞增殖和分化的成分。     

热缺血对兔肾表面微循环的影响

作者用10只家兔.观察了不同时限热缺血对兔肾表面微循环的影响。将动物分四组。A组为手术对照,不阻断肾动脉。其余B、C、D组分别阻断左肾血流10min、30min和60min。在阻断前和恢复血流10min后,分别用显微镜观察肾表面微循环。行右肾切除。动物观察14天。结果表明,10min缺血组动物仅有轻度毛细血管收缩。30min以上热缺血.不仅引起更明显的微血管收缩,还可引起不同程度的血管扩张和血流淤滞现象。微循环紊乱尤其是血流淤滞的程度.与术后肾功能及组织学检查结果一致。提示缺血后肾皮质微循环状况与肾功能恢复密切相关。肾保存时,保存液中加入适当保护剂保护肾脏微循环,对于移植后肾功能的恢复具有重要意义。     

单针超滤浓缩回输术治疗肝硬化顽固性腹水180例分析

目的探讨单针腹水超滤浓缩回输术治疗肝硬化顽固性腹水的疗效。方法180例均为我院收治的患者,经内科保守治疗效果不佳者。其中男142例,女38例。本次出现腹水2个月至3年不等,伴有肝肾综合征82例,原发性腹膜炎27例,胆道感染16例,肠道感染10例,胸水或胸水感染者6例,消化道出血者12例,应用日本东丽血液净化机、国产负压吸引器及一次性血路管、中空纤维滤器及带有侧孔平头空心套管针对患者实行超滤浓缩术,一次可超滤腹水3000～13000ml,迅速改善多种临床症状及体征。结果腹水缓解并维持3个月以上视为显效。腹水缓解其后再次出现,但使用利尿剂重新敏感视为有效。近期腹水回到原来水平视为无效。结果:显效60例(33.3%),有效90例(50%),无效30例(16.6%),总有效率为83.3%。操作过程中患者仅有3例出现一过性血压下降,2例腹部轻微疼痛,9例腹部针刺部位瘀癍,3例穿刺部位有渗出。结论单针腹水超滤浓缩术操作简便易行,副反应小,能迅速缓解顽固性腹水患者的痛苦,是治疗肝硬化顽固性腹水的一种安全有效的方法。     

Effects of Kangdaxin on myocardial fibrosis in heart failure with preserved ejection fraction rats

BackgroundThis study aimed to explore the effects of Kangdaxin oral liquid on myocardial fibrosis in heart failure with preserved ejection fraction (HFpEF) rats.MethodsA total of 30 Sprague Dawley (SD) rats were randomly divided into 3 groups Sham operation group (Sham), HFpEF group (HFpEF), and HFpEF with drug intervention group (HFpEF + I). Rats in HFpEF + I group were given Kangdaxin oral liquid at a dose of 2.7 mL/(kg·d). After modeling or treatment, the value of E/A and E/e'' in each group of rats were measured by echocardiography. The N-terminal pro b-type natriuretic peptide (NT-proBNP) level was determined by enzyme-linked immunosorbent assay (ELISA). Heart weight/body mass index (Hw/W) and left ventricular weight/body mass index (LVw/W) were calculated after the rats were sacrificed; the transforming growth factor-β1 (TGF-β1) protein expression level in cardiac tissue was detected by western blot.ResultsCompared with sham group, the values of diastolic function item (E/A) and mitral annular early diastolic velocity (E/e'') in HFpEF group were significantly decreased, and the level of NT-proBNP was significantly increased (P<0.05). Compared with HFpEF group, the value of E/A and E/e'' in HF + I group were significantly increased, and the level of NT-proBNP was significantly decreased (P<0.05). Compared with sham group, the expression of TGF-β1 protein in heart tissue of HFpEF group were significantly increased (P<0.05). Compared with HFpEF group, the expression of TGF-β1 protein in HFpEF + I group were significantly decreased (P<0.05).ConclusionsKangdaxin oral liquid has protective effect on heart in HFpEF rats, which can reduce the protein expression of TGF-β1 in the heart tissue of HFpEF rats. This may be a possible mechanism to inhibit myocardial fibrosis and improve cardiac diastolic function.