19例 CRT（CRT－D）植入术患者的围手术期护理配合

探讨CRT(CRT-D)植入术患者的围手术期护理配合。收集心内科19例CRT(CRT-D)植入术患者的基本资料及术前、术中、术后的护理资料,强调心理护理、个性化护理、专科护理特点。19例CRT(CRT-D)植入术患者顺利度过围手术期,为我们以后的护理提供了宝贵的经验。通过本次研究,积累了关于双室再同步化治疗后的护理经验,提高患者及护理安全。     

丹皮酚的药理作用及机制

丹皮酚是从牡丹根皮中提取的有效活性成分,近年来的研究表明,其不仅对呼吸系统、循环系统、内分泌系统的多种疾病具有治疗作用,同时具有明显的抗肿瘤作用。因此对其主要药理作用及相关作用机制进行了综述。     

非肥胖型与肥胖型非酒精性脂肪性肝病患者代谢特征和肝脂肪变程度比较

目的 比较非肥胖型与肥胖型非酒精性脂肪性肝病(NAFLD)患者代谢特征和肝脂肪变程度差异。方法 2015年1月～2021年6月我院诊治NAFLD患者274例,根据体质指数(BMI)=25 kg/m²,将其分为非肥胖型66例和肥胖型208例。计算胰岛素抵抗指数(HOMA-IR),行磁共振仪检查,应用仪器自带软件计算肝脏脂肪含量(LFC)和腹部皮下脂肪厚度(ASFT),使用FibroTouch测量肝脏受控衰减参数(CAP),使用多普勒超声诊断仪检测颈动脉内膜中层厚度(CIMT),将肝脂肪变分为Ⅰ级、Ⅱ级和Ⅲ级。结果 非肥胖型NAFLD患者BMI为(23.4±1.4)kg/m²、血清丙氨酸氨基转移酶水平为24.2(19.6,35.8)U/L,天冬氨酸氨基转移水平为25.0(18.7,32.3)U/L,甘油三酯为(1.9±0.4)mmol/L,高密度脂蛋白为(1.3±0.4)mmol/L,空腹血糖为(5.0±0.7)mmol/L,空腹胰岛素为7.0(4.8,9.4)μU/mL,HOMA-IR为1.6(1.1,2.3),尿酸为376.5(294.3,4...     

Prevalence and risk factors for postinfectious cough in discharged patients with coronavirus disease 2019 (COVID-19)

BackgroundCough is one of the most common symptoms of coronavirus disease 2019 (COVID-19). However, the prevalence of persistent cough in recovered patients with COVID-19 during a longer follow-up remained unknown. This study aims to investigate the prevalence, and risk factors for postinfectious cough in COVID-19 patients after discharge.MethodsWe conducted a follow-up study for 129 discharged patients with laboratory-confirmed COVID-19 in two large hospitals located in Hubei Province, China from January 2020 to December 2020. Baseline demographics, comorbidities and smoking history were extracted from the medical record. Current symptoms and severity were recorded by a uniform questionnaire. Spirometry, diffuse function and chest computed tomography (CT) were performed on part of patients who were able to return to the outpatient department at follow-up.ResultsThe median (interquartile range) follow-up time was 8.1 (7.9–8.5) months after discharge. The mean (standard deviation) age was 51.5 (14.9) years and 57 (44.2%) were male. A total of 27 (20.9%) patients had postinfectious cough (>3 weeks), 6 patients (4.7%) had persistent cough by the end of follow-up, including 3 patients with previous chronic respiratory diseases or current smoking. Other symptoms included dyspnea (6, 4.7%), sputum (4, 3.1%), fatigue (4, 3.1%), and anorexia (4, 3.1%) by the end of follow-up. Thirty-six of 41 (87.8%) patients showed impaired lung function or diffuse function, and 39 of 50 (78.0%) patients showed abnormal CT imaging. Patients with postinfectious cough demonstrated more severe and more frequent cough during hospitalization (P<0.001), and more chronic respiratory diseases (P=0.01). In multivariate logistic regression analysis, digestive symptoms during hospitalization [odds ratio (OR) 2.95, 95% confidence interval (CI): 1.10–7.92] and current smoking (OR 6.95, 95% CI: 1.46–33.14) were significantly associated with postinfectious cough of COVID-19.ConclusionsA small part of patients developed postinfectious cough after recovery from COVID-19, few patients developed chronic cough in spite of a higher proportion of impaired lung function and abnormal lung CT image. Current smoking and digestive symptoms during hospitalization were risk factors for postinfectious cough in COVID-19.     

The role of toll-like receptors (TLRs) in pan-cancer

BackgroundToll-like receptors (TLRs) are important components of the innate and adaptive immune systems, and abnormal TLR expression has been linked to a variety of cancers. However, there was a lack of clarity on the association of TLR stimulation with the carcinogenesis of cancer. The study''s goal was to analyse the clinical importance of TLRs expression at the mRNA level in pan-cancer datasets, as well as the link between TLR expression and carcinogenesis, progression, and clinical prognosis.MethodsThe expression profile of TLRs derived from UCSC pan-cancer data was analysed in multiple dimensions, including clinical analysis, immunological subtype analysis, tumour microenvironment (TME) analysis, tumour stem cell correlation analysis, and drug sensitivity analysis. Additionally, we analyse protein-protein interactions, functional enrichment, and chromatin accessibility, as well as TLR expression in single-cell sequencing data.ResultsOur multi-omics analysis results imply that TLRs may operate as a biological marker for carcinogenesis and progression, a potential target for anti-tumour therapy, and a prognostic biomarker, laying the theoretical groundwork for future translational medicine research.ConclusionTLRs are involved in the formation of malignancies and can be explored in further detail as potential prognostic indicators.

Key Messages

• Toll-like receptors (TLRs) are key factors in the process of the innate and adaptive immune response, and their aberrant expression of TLRs have been widely reported in various cancer. However, the association between TLRs stimulation and tumorigenesis of cancer has not been well clarified.
• In this study, in the pan-cancer data, integrated TLR family gene expression analysis, clinical correlation analysis, immune subtype correlation analysis, tumour microenvironment correlation analysis, tumour stem cell correlation analysis, and drug sensitivity correlation analysis were performed.
• TLRs play an important role in the development of tumours and can be studied in depth as potential prognostic markers.

     

试论中医阴阳平衡法治疗恶性肿瘤

阴阳失衡,机体内环境稳态的破坏是恶性肿瘤发生、进展的重要原因;调整阴阳的动态平衡是中医治疗肿瘤的重要法则。     

杨运宽调神意守针法

调神意守针法是将针法守神法和道家意守法结合起来,促使针刺得气后循经感传甚至气至病所,激发患者潜在的调整功能。杨运宽教授常运用此针法治疗某些痛证、神经系统疾病及慢性难治性疾病,可获得较一般针法更好的疗效。本文详细介绍了这一针法的操作方法和临床应用。     

Global Pattern and Trends in Penile Cancer Incidence: Population-Based Study

BackgroundPenile cancer is a relatively rare genital malignancy whose incidence and mortality are rising in many countries.ObjectiveThis study aims to assess the recent incidence and mortality patterns and incidence trends of penile cancer.MethodsThe age-standardized incidence and mortality rates (ASIR and ASMR, respectively) of penile cancer in 2020 were estimated from the Global Cancer Registries (GLOBOCAN) database. Incidence trends of penile cancer from 1973 to 2012 were assessed in 44 populations from 43 countries using the Cancer Incidence in Five Continents plus (CI5plus) and the Nordic Cancer Registries (NORDCAN) databases. Average annual percentage change was calculated to quantify trends in ASIR using joinpoint regression.ResultsGlobally, the estimated ASIR and ASMR of penile cancer were 0.80 (per 100,000) and 0.29 (per 100,000) in 2020, equating to 36,068 new cases and 13,211 deaths in 2020, respectively. There was no significant correlation between the ASIR (P=.05) or ASMR (P=.90) and Human Development Index. In addition, 15 countries saw increasing ASIR for penile cancer, 13 of which were from Europe (United Kingdom, Lithuania, Norway, Estonia, Finland, Sweden, Cyprus, Netherlands, Italy, Croatia, Slovakia, Russia, and the Czech), and 2 from Asia (China and Israel).ConclusionsAlthough the developing countries still bear the higher incidence and mortality of penile cancer, the incidence is on the rise in most European countries. To mitigate the disease burden resulting from penile cancer, measures to lower the risk for penile cancers, including improving penile hygiene and male human papillomavirus vaccination, may be warranted.     

c-myc脱氧核酶对白血病细胞端粒酶活性的抑制作用

目的:探讨c-myc脱氧核酶的切割作用及对白血病细胞端粒酶活性的影响.方法:合成针对c-myc mRNA的"10～23"型脱氧核酶DzMycI及其类似物DzMycI'提取总RNA在细胞外切割c-myc mRNA;转染白血病细胞系HL-60后,用RT-PCR扩增c-myc基因片段和端粒酶蛋白亚基hTERT的片段,用PCR-ELISA法测定端粒酶活性.结果:脱氧核酶DzMyel在细胞外和细胞内均能够有效地切割c-myc mRNA;在转染HL-60后,DzMycI显著抑制白血病细胞生长(P<0.05),下调端粒酶蛋白亚基hTERT的表达,显著降低HL-60细胞端粒酶活性(P<0.05).DzMycI催化中心的一个碱基被替换后形成的脱氧寡核苷酸DzMycI'在胞外和胞内均不表现对c-myc mRNA的切割作用.结论:脱氧核酶DzMycI确实能够高效特异地切割c-myc mRNA,降低白血病细胞端粒酶活性,抑制白血病细胞生长,有可能作为c-myc抑制剂用于白血病的基因治疗领域中.     

新生儿暂时性呼吸困难的肺部超声表现

目的 观察新生儿暂时性呼吸困难的肺部超声特点。方法 选取2018年7月至2019年6月扬州大学医学院附属淮安市妇幼保健院收治的60例暂时性呼吸困难患儿作为观察组,选取同期60例胎龄相近的健康新生儿作为对照组。观察组患儿分别在出生后6 h内和72 h后进行肺部超声检查,对照组患儿仅在出生后6 h内进行肺部超声检查,分析其肺部超声特点。结果 超声检查发现,所有患儿均无实变发生。出生后6 h内,观察组患儿胸膜线异常、A-线消失、存在B-线、肺泡间质综合征、双肺点和胸腔积液的发生率高于对照组,差异有统计学意义（P<0.05）。观察组出生后72 h后患儿胸膜线异常、A-线消失、存在B-线、肺泡间质综合征、双肺点和胸腔积液的发生率低于出生后6 h内超声检查结果,差异有统计学意义（P<0.05）。结论 暂时性呼吸困难患儿具有胸膜线异常、A-线消失、存在B-线、肺泡间质综合征、双肺点、无实变发生和胸腔积液等特点,肺部超声对新生儿暂时性呼吸困难的早期诊断和病情监测具有重要价值。