2013年-2017年我国血站收入的结构变动情况分析△

目的：对我国不同类型血站的收入状况进行问卷调查和深度访谈,分析近年来我国血站收入结构变动情况及特征,找到影响血站收入结构变动的主要项目,合理优化血站收入结构。方法：2018 年8月采用普查的方法对全国353家（32 家血液中心、321 家中心血站）的收入状况进行问卷调查,同时选取山东省6地市中心血站的负责人进行深度访谈。对收集的血站收入数据,运用结构变动方法进行分析。 结果：2013年-2017年公益一类血站收入的结构变动度为24.22%,财政补助收入、事业收入是构成公益一类血站收入变动的主要来源,其中财政补助收入的贡献率53.20%;2013年-2017年我国公益二类血站收入的结构变动度为16.79%,财政补助收入、事业收入是构成公益二类血站收入变动的主要来源,其中贡献率最大的是事业收入49.99%。结论：财政补助收入、事业收入是影响血站收入结构变动的主要项目,两类血站的日常运营与建设对财政补助收入高度依赖,公益二类经营收入增幅不明显,发展不足。     

夜间最低血氧饱和度联合睡眠相关量表筛查儿童阻塞性睡眠呼吸暂停的应用

目的 评价夜间最低血氧饱和度(LSaO₂)联合OSA-18量表和针对儿童的改良版Epworth嗜睡量表(ESS-CHAD)初筛儿童阻塞性睡眠呼吸暂停(OSA)的准确性,以探讨更简便、快捷、可行的基层医院初筛疑似儿童OSA的方法。方法 纳入2020年8月13日—2021年2月8日就诊于本院耳鼻咽喉头颈外科睡眠监测中心完成整夜多导睡眠监测的儿童139例作回顾性分析研究,其家长在医生协助下完成OSA-18量表和ESS-CHAD。分析LSaO₂和两种量表及三者联合早期初筛疑似儿童OSA的诊断价值。结果 LSaO₂预测儿童是否患OSA的最佳界值为90.5%(P<0.00, AUC=0.82)。OSA-18和ESS-CHAD依据不同界值分别诊断儿童OSA的灵敏度最高,分别为74.8%、22.7%。LSaO₂/OSA-18,LSaO₂/ESS-CHAD、OSA-18/ESS-CHAD诊断儿童OSA的灵敏度最高,分别为88.2%、68.1%、77.3%。 结论 LSaO₂有诊断儿童OSA的临床价值,OSA-18量表较ESS-CHAD初筛疑似儿童OSA有更高的灵敏度,但特异度低,LSaO₂联合OSA-18量表诊断儿童OSA的灵敏度、特异度均较其他联合诊断方式高。在无法进行睡眠监测的基层医院可考虑应用LSaO₂ 与OSA-18量表结合的方式初步筛查儿童OSA。     

困难气管内插管的预测和处理

目的 探讨对困难气管内插管的预测及处理方法。方法 随机选取各类需行气管内插管麻醉下择期手术患者50例,术前测量IG、Slux,TM,HENE,HFNF、气道分类及声门分级等各项指标,并分析它们在气管插管难度之间的关系。结果 50例患者中,气道分类Ⅳ类者7例,声门分级Ⅲ级者17例,Ⅳ级者1例。17例声门Ⅲ级者以EtCO2引导下口腔盲插法插管成功,1例声门Ⅳ级者以气囊充气鼻腔盲控气管内插管法插管成功。结论 术前评价气管插管难易程度应综合考察各项测量指标,这些指标中又以声门分级最为可靠。     

Incidence of hospital‐acquired pressure injury: A cohort study of adults admitted to public and private hospitals in Sao Paulo,Brazil

This study aimed to estimate the incidence of hospital‐acquired pressure injury (PI) and its risk factors in inpatient and intensive care units of five hospitals (two public and three private) in the city of Sao Paulo, Brazil. A 6‐month follow‐up prospective cohort study (n = 1937) was conducted from April to September 2013. Baseline and follow‐up measurements included demographic and care information, as well as risk assessments for both undernutrition (NRS‐2002) and PI (Braden scale). Poisson regression with robust variance was used for data analysis. A total of 633 patients (32.60%) showed risk for PI. The incidence rate of PI was of 5.9% (9.9% in public hospitals vs 4.1% in private hospitals) and was higher in intensive care units, compared to inpatient care units (10% vs 5.7%, respectively). Risk for PI increased with age (RR = 1.05; 95% CI 1.04‐1.07); was higher in in public hospitals, compared to private hospitals (RR = 4.39; 95% CI 2.92‐6.61); in patients admitted for non‐surgical reasons compared to those admitted for surgical reasons (RR = 1.91; 95% CI 1.12‐3.27); in patients with longer hospital stays (RR = 1.04; 95% CI 1.03‐1.06); high blood pressure (RR = 1.76; 95% CI 1.17‐2.64); or had a risk for undernutrition (RR = 3.51; 95% CI 1.71‐7.24). Higher scores in the Braden scale was associated with a decreased risk of PI (RR = 0.79; 95% CI 0.75‐0.83). The results of our study indicate that 5.9% of all patients developed PI and that the most important factors that nurses should consider are: patient age, care setting, length of hospitalization, comorbidities, reason for admission and nutrition when planning and implementing PI‐preventative actions.     

Pseudoangiosarcomatous squamous cell carcinoma: first case report on penis

Pseudoangiosarcomatous squamous cell carcinoma, also called pseudovascular, pseudoangiomatoid or adenoid pseudovascular carcinoma, is an uncommon and highly aggressive variant of squamous cell carcinoma. Histologically, it is characterized by proliferation of atypical keratinocytes with acantholysis and formation of pseudovascular spaces, forming anastomosed channels lined with neoplastic cells that invade the dermis. These cells are positive for cytokeratin and negative for vascular markers such as CD31 and CD34. There are few reports of this variant in the literature. Skin, breast, lung and vulva involvement have been described, but to the best of our knowledge, no cases involving the penis has been described. This study aims to describe the first case of angiosarcomatous squamous cell carcinoma of the penis. The patient presented with a painful lesion in the penis associated with urinary retention. Macroscopic findings exhibited an ulcerative vegetating lesion that involving the entire glans and part of the penile body, as well as infiltration of penile structures and scrotal skin. Microscopy shows atypical proliferation of sarcomatous keratinocyte pattern mimicking vascular spaces. Human papilloma virus (HPV) biomarkers and polymerase chain reaction (PCR) were all negative. Advanced penile squamous cell carcinoma with aggressive lymph node metastasis. This report presents the first case of penile pseudoangiosarcomatous squamous cell carcinoma, as an important differential diagnosis.     

Vaccination with chimeric protein induces protection in murine model against ascariasis

An estimated 400 million people are infected by parasites of the genus Ascaris and the existing control measures are inefficient. Vaccine development using B cell antigens is a promising strategy for increased protection against this parasite. The present study aimed at developing a chimeric protein capable of conferring protection against infection by Ascaris sp. For this purpose, we performed B-cell epitope predictions on previously described vaccine candidate proteins from Ascaris suum and the corresponding peptides were used to construct a chimeric protein. Female BALB / c mice were immunized subcutaneously in three doses at 10 day intervals with a vaccine formulation comprised of the chimeric protein together with monophosphoryl lipid A (MPLA). Control groups included protein alone, MPLA, or PBS. After challenge infection, animals vaccinated with chimeric protein plus MPLA showed a reduction of 73.54% of larval load in the lung compared to control group animals. Animals immunized with chimeric protein plus MPLA also display higher IgG response and a reduction in lung inflammation. Our study highlights how chimeric proteins containing more than one B cell epitope can enhance immune protection against helminthic infection and offer new approaches to the development of Ascaris vaccines.     

基于特征的深度学习预测化合物-蛋白质相互作用的研究进展

药物研发过程中,化合物-蛋白质相互作用（compound-protein interaction,CPI）预测是发现苗头化合物、药物重定位等研究的关键技术手段。近年来,深度学习被广泛应用于CPI研究,加速了药物发现中CPI预测的发展。本文重点讨论基于特征的 CPI 预测模型,首先,介绍了CPI预测中常见的数据库、化合物和蛋白质的典型特征表示方法。根据建模中的关键问题,从多模态和注意力机制两个方面,对基于特征的CPI预测模型展开论述。在此基础上,选取其中12个模型,在3个经典数据集上评估了模型在分类任务和回归任务中的性能。本文总结当前该领域面临的挑战,对未来的发展方向进行展望,为CPI预测方法进一步研究提供思路。     

Expression of HLA-DR antigen in hepatocellular carcinoma and its up-regulation by interferon

Objective: To observe the expression of human leukocytic antigen DR (HLA-DR) in primary hepatocellular carcinoma (HCC) and its up-regulation by interferon (IFN). Methods: The expression of HLA-DR in 46 specimens of human HCC tissues, 4 human HCC cell lines (SMMC-7721, HCC-9204, BEL-7402 and HHCC) and a human hepatocyte cell line QZG was respectively detected by immunohistochemical ABC staining and flow cytometry. The expression of HLA-DR in the 5 cell lines was detected by ELISA before and after the cells were treated with IFN-γ or IFN-α. Results:Eighteen out of 46 HCC tissues (39.1%) expressed HLA-DR, whereas all the normal liver tissues immediately adjacent to HCC tissues were HLA-DR-negative. No obvious HLA-DR-positive staining was found in all the 5 cell lines. The expression of HLA-DR was up-regulated in all the 5 cell lines after IFN-γ or IFN-α treatment. The up-regulation of HI A-DR in QZG cells was less obvious than that in HCC cell lines. The effect of IFN-γ was more significant than that of IFN-α. Conclusion: HCC tissues can express HLA-DR to some extent, but HCC cell lines do not express detectable HLA-DR. IFN can up-regulate HLA-DR expression in HCC cells.     

道诺霉素抑制视网膜色素上皮细胞炎前因子的表达

目的　观察道诺霉素对视网膜色素上皮细胞细胞(RPE)炎前因子表达的影响 .方法　培养的人 RPE经 IL- 1β(10μg· L- 1 )刺激以及不同浓度的道诺霉素作用后 ,用EL ISA、免疫组化和原位杂交等方法 ,检测培养的人 RPE炎前因子 m RNA和蛋白质的表达 .结果　 EL ISA显示对照组培养 RPE在 IL- 1β刺激 8h后 ,上清中 IL- 6与 IL- 8分别为2 0 0 0 pg· m L- 1· 10 - 6 cells和 5 0 0 0 pg· m L- 1· 10 - 6 cells.使用 10 0 μg·L- 1 道诺霉素作用于培养的 RPE后 IL- 6与 IL-8分别为 180 pg· m L- 1 · 10 - 6 cells (P <0 .0 1)和 32 0pg· m L- 1· 10 - 6 cells(P<0 .0 1) .免疫组化和原位杂交亦显示不同浓度道诺霉素可以不同程度地抑制 RPE内炎前因子蛋白质与 m RNA的表达 .结论　道诺霉素能有效地抑制 IL -1β诱导的培养的 RPE IL - 6和 IL - 8的表达     

HIV-1感染者外周血单个核细胞缺损病毒基因的研究

目的:研究HIV-1感染者缺损HIV-1 DNA的特性.方法:用长片段PCR法(LD-PCR)研究分析HIV-1感染者外周血单个核细胞(peripheral blood mononuclear, PBMCs)和体外培养感染淋巴细胞中HIV-1基因特征,使用位于HIV-1 DNA链两端的LTR(U5)、LTR(R)为引物,插入有全长HIV-1基因片段的大肠杆菌质粒PNL4-3等为标准对照,并对部分标本克隆测序.结果:经扩增9.1 kb是LD-PCR的主要产物,但在10例HIV-1感染者中有9例PBMCs检测出大小不一、范围较广的缺失HIV-1基因片段,经用基因探针杂交,发现近HIV-1基因中心部位缺失频率增加,缺失结合点常存在3～4个核苷酸短片段直接重复,体外培养中HIV-1基因缺损量减少,完整和缺失基因的存在与培养中病毒分离的时间密切相关.结论:HIV-1感染者PBMCs中存在大量HIV-1基因重组和缺损片段.