压电免疫传感器两种抗体固定方法的比较研究

目的比较压电免疫传感器两种抗体固定方法的优劣,选择压电免疫传感器抗体敏感膜固定的最佳方法. 方法分别采用巯基化方法和蛋白A(SPA)固定法将抗人胰岛素单克隆抗体固定在压电免疫传感器金膜电极表面,比较不同抗体工作浓度、不同浓度标准溶液反应条件下抗体固定量、一致性以及传感器响应能力如频率变化、反应时间、检测线性范围以及反应非特异性等. 结果两种固定方法制备的压电免疫传感器其检测灵敏度、反应时间相当,但巯基化固定方法抗体固定量大、一致性好、检测线性范围较宽、非特异反应低. 结论抗体巯基化法制备的压电免疫传感器具有检测范围宽、非特异反应低等优点,是免疫传感器抗体敏感膜制备的理想方法.     

右雷佐生联合磷酸肌酸钠对蒽环类药物致乳腺癌患者心脏损伤的保护作用

目的： 分析右雷佐生联合磷酸肌酸钠对蒽环类药物致乳腺癌患者心脏损伤的预防作用及安全性。方法：收集200例女性乳腺癌患者,随机分为对照组、A组、B组、C组,每组各50例。对照组给予标准剂量的AC或EC方案化疗,A组在对照组基础上给予注射用右雷佐生,B组在对照组基础上给予注射用磷酸肌酸钠,C组在对照组基础上给予右雷佐生及磷酸肌酸钠,3周为1个化疗周期。比较各组化疗后心脏损伤发生率,分析蒽环类药物致心脏毒性的危险因素,并观察化疗前及化疗3个周期后患者心电图、心肌酶、血清B型利钠肽（BNP）和心肌肌钙蛋白I（cTnI）水平、左室射血分数（LVEF）,以及不良反应发生率情况。结果：200例乳腺癌患者中,发生心脏损伤49例（24.5%）。4组之间的心脏损伤发生率具有显著差异（P < 0.05）,心脏损伤发生率排序为对照组（50.00%） > B组（24.00%） > A组（16.00%） > C组（8.00%）。多因素Logistic回归分析结果显示,心脏保护方案的使用、化疗周期数 ＞ 3、蒽环类药物累积剂量 ＞ 400 mg与心脏损伤的发生相关（P < 0.05）。化疗周期数 > 3、蒽环类药物累积剂量 > 400 mg是蒽环类药物致心脏毒性的独立危险因素,而使用心脏保护剂则是保护因素。对照组化疗后心电图异常发生率高于A、B、C组（P < 0.05）。化疗前各组患者心肌酶、BNP、cTnI、LVEF比较,差异无统计学意义（P > 0.05）;化疗后对照组BNP、cTnI水平高于A、B、C组（P < 0.05）。4组化疗期间不良反应发生率差异无统计学意义（P > 0.05）。结论：右雷佐生联合磷酸肌酸钠用于蒽环类药物致乳腺癌患者心脏损伤有良好的效果且安全性较好。     

脑卒中患者吞咽障碍恢复不良影响因素的Meta分析

目的 系统分析脑卒中患者吞咽障碍恢复不良的影响因素。方法 系统检索中国知 网、万方数据库、维普网、中国生物医学文献数据库、PubMed、Cochrane Library、Embase 数据库,收集 建库至 2022 年 12 月发表的脑卒中患者吞咽障碍恢复不良影响因素相关研究,使用 RevMan 5.4.1 软件 对纳入文献进行Meta分析。结果 共纳入 22 篇文献,4 248 例患者。Meta分析结果显示,年龄≥ 70 岁 （OR=1.53,95%CI：1.29～1.80）、美国国立卫生研究院卒中量表（NIHSS）评分≥ 8 分（OR=2.36,95%CI： 1.53～3.63）、改 良 Rankin 量 表（mRS）评 分 ＞ 0 分（OR=1.71,95%CI：1.40～2.09）、双 侧 卒 中（OR=4.85, 95%CI：2.62～8.97）、低密度脂蛋白（LDL）水平≥3 mg/L（OR=3.70,95%CI：2.46～5.56）、认知障碍（OR=6.23, 95%CI：0.98～39.58）、误吸（OR=4.47,95%CI：3.28～6.11）、气管插管（OR=2.70,95%CI：1.58～4.63）是脑 卒中患者吞咽功能恢复不良的危险因素（P＜ 0.05）;体重指数＞ 18.5 kg/m2 （OR=0.76,95%CI：0.67～0.86）、 Barthel 指数（BI）＞ 60 分（OR=0.37,95%CI：0.22～0.62）、功能独立性测评（FIM）评分＞ 20 分（OR=0.96, 95%CI：0.94～0.99）是脑卒中患者吞咽功能恢复不良的保护因素（P＜0.05）。结论 高龄、高NIHSS评分、 双侧卒中、低体重指数、高 mRS 评分、低 BI、低 FIM 评分、高 LDL 水平、合并认知障碍、误吸、气管插管是 脑卒中患者吞咽障碍恢复不良的危险因素,临床可结合影响因素完善吞咽障碍患者的管理措施。     

Simplified Chinese Version of the Spinal Instability Neoplastic Score in Evaluating Patients with Metastatic Spinal Tumor: A Cross‐Cultural Adaptation and Validation

ObjectiveTo translate the original English version of the Spinal Instability Neoplastic Score (SINS) into simplified Chinese, adapt it cross‐culturally, validate its psychometric properties in measuring spinal instability in patients with metastatic spinal tumors in the Chinese mainland, examine the reliability and validity to demonstrate its accuracy and applicability in clinical practice.MethodsPatients diagnosed with metastatic spinal disease between January 2016 and January 2020 were recruited. The number of participants was advised to be at least 50 for appropriate analysis of reliability, construct validity, as well as ceiling or floor effects, and recruitment of 100 patients was advised for internal consistency analysis. The study was conducted in two phases: first, the SINS was translated into simplified Chinese; second, the factor structure, internal consistency, test–retest reliability, validity, and floor and ceiling effects of the SC‐SINS were assessed. The internationally recognized cross‐cultural adaptation guidelines were followed. Internal consistency was evaluated with Cronbach''s alpha. Test–retest reliability was examined among the patients with a 4‐week interval. The validity of the Chinese version of SINS (SC‐SINS) was assessed by examining its relationship with Kostuik classification. Principal component analysis was conducted to confirm the factor structure of each subscale.ResultsA total of 160 participants (88 males and 72 females) were enrolled. No major difficulties occurred in the forward and backward translations of SINS. The internal consistency of SC‐SINS was excellent (Cronbach''s α =0.857, ranging from 0.68 to 0.85). Test–retest reliability was also excellent with a value of 0.89, ranging from 0.86 to 0.95. Validity analyses indicated that the SC‐SINS was positively and significantly correlated with Kostuik classification. The correlation between “Posterolateral Involvement of Spinal Elements” and “1‐2 Partial Damage” was the highest with a correlation value of 0.792. The correlation between “Pain” and “1–2 Partial Damage” was the lowest with a value of 0.341. All items showed principal component coefficients greater than 0.4. The values of Factor 1 ranged from 0.523 to 0.681; Factor 2 ranged from 0.591 to 0.731; Factor 3 ranged from 0.613 to 0.754; Factor 4 ranged from 0.461 to 0.711; Factor 5 ranged from 0.513 to 0.701; and Factor 6 ranged from 0.501 to 0.668. In addition, neither floor nor ceiling effects were seen in the SC‐SINS.ConclusionThe SC‐SINS demonstrated high internal consistency and test–retest reliability, which has been proven valid and reliable to measure spinal stability in patients from the Chinese mainland with metastatic spinal tumor.     

医疗器械生物学评价——实验动物保护要求

2006版“医疗器械生物学评价-动物保护要求“国际标准规定了在用于评价医疗器械的材料或医疗器械本身的生物相容性的动物试验中,爱护动物和使用动物的最基本要求.目的在于:为进行医疗器械生物学评价的委托者,设计者以及进行试验或从动物试验进行推测、评价的科研人员,提供尊重生命的通用性要求;也推荐并提供以下指南:促进今后进一步“减少(reduction)“应用动物全部的数量;“精致(refinement)“在动物中减少或除去痛苦或苦恼的试验方法;以及其他的合乎科学、有效的不需要动物的方法来“代替(replacement)“动物试验.该标准适用于在除人类之外的脊椎动物体上进行医疗器械或材料的生物相容性试验.     

A novel robust nomogram based on peripheral monocyte counts for predicting lymph node metastasis of prostate cancer

Accurate methods for identifying pelvic lymph node metastasis(LNM)of prostate cancer(PCa)prior to surgery are still lacking.We aimed to investigate the predicti...     

乙型肝炎病毒血清标志物全阳性模式一例分析及随访

目的 为了揭示临床实验室乙型肝炎病毒血清标志物少(罕)见模式客观存在的规律,探讨和分析了乙型肝炎病毒血清标志物全阳性模式病例的临床转归情况以及血清标志物的动态变化趋势.方法 以慢性乙型病毒性肝炎患者为对象,用荧光定量PCR和酶联免疫吸附试验同步检测不同时段血清HBVDNA和HBsAg、HBsAb、HBeAg、HBeAb、HBcAb五项血清学标志物,并进行血清肝功能酶学指标的动态跟踪.结果 在长达3个月的时间段内,HBVM持续稳定在全阳性模式不变,用重组人干扰素α2b(安福隆)进行抗病毒治疗的早期应答虽不明显,但治疗至5个月后,随着病毒的阴转,HBeAg和HBeAb也逐步阴转,肝功能酶学指标逐步恢复正常,但HBsAg与HBsAb仍同时保留阳性.结论 HBVM在慢性乙型肝炎患者不同病程中可呈现不同模式的组合,而不能简单的用"大三阳"、"小三阳"或15阳性等模式进行解释,应动态观察乙肝两对半组合模式以及编码的变化,有利于对乙型肝炎的诊治和疗效评估.     

以鱼鳞病样皮损为首发表现的蕈样肉芽肿

报告1例以鱼鳞病样皮损为首发表现的蕈样肉芽肿。患者女,28岁。全身泛发灰褐色色素沉着,四肢伸侧可见大小不等的深褐色菱形或多角形鳞状斑片,表现轻度萎缩,伴糖皮样脱屑。皮损组织病理学改变符合蕈样肉芽肿。     

Evaluation of physician experience in achieving non-perfused volume ratio of high-intensity focused ultrasound ablation for uterine fibroids: a multicentre study

ObjectiveTo evaluate the effect of different levels of physician experience on the high-intensity focused ultrasound (HIFU) ablation of uterine fibroids and to provide a reference for the use of non-perfused volume ratio (NPVR) standards during training.MethodsThis prospective multicentre study enrolled patients with uterine fibroids. The effect of the physician’s level of experience on the outcomes under different NPVR standards and the learning curve of six centres without HIFU experience were analysed. The impact of patient demographic and clinical characteristics were also evaluated.ResultsA total of 1352 patients from 20 centres were included in the study. The median NPVRs were 92.00%, 88.10% and 92.86% in the no experience group, inexperienced group and experienced group, respectively. Posterior wall fibroids, lateral wall fibroids and fundus fibroids were inversely correlated with NPVR, while experienced physicians were positively correlated with NPVR. With NPVR ≥ 70% and NPVR ≥ 80% standards, physicians in the no experience group completed the learning curve on the 11th and 16th procedure, respectively. Physicians under a standard of an NPVR ≥ 90% did not complete the learning curve.ConclusionsNPVR ≥ 80% is a standard that is worth using for HIFU treatment of uterine fibroids.     

The altering in sensory sensitivity: a current issue of female breast surgery

Breast surgery is an important treatment for women with malignant breast diseases. In addition to breast appearance, the integrity of breast function is increasing in patients with breast diseases. As the basis of breast physiological function, breast skin sensitivity is important to the quality of life of patients after surgery. Breast skin sensitivity gives the patient a “real” breast feeling. The sensory recovery after breast surgery has also become one of the important goals of breast surgery. In this review, we aim to discuss the research progress on recovery of breast skin sensitivity after different treatment modalities for breast disease.