脑积水分流术后感染因素与预后相关性分析

目的 分析脑积水分流术后感染的相关因素及预后.方法 回顾性分析403例脑积水分流术后患者的临床资料,其中术后感染64例,并对性别比例、年龄层次、病因学及感染时期的差异与预后的关系进行Logistic回归分析.结果 403例接受脑积水分流术患者中有64例发生感染（15.9％）,其中脑膜炎47例（73.5％）、腹膜炎10例（15.6％）、切口感染7例（10.9％）.单因素Logistic回归分析结果显示,性别、特发性脑积水、脑出血等与脑积水分流术后感染无明显关联（均P＞0.05）;而年龄、先天性脑积水、颅内肿瘤、感染时间等则为脑积水分流术后感染发生的相关因素（均P ＜0.05）.相关分析表明年龄与GOS呈负相关（r=-0.478,P＜0.05）.结论 年龄、脑积水病因及术后感染时间等是感染的危险因素;患者年龄越小,预后越好.     

Overcoming EMT-associated resistance to anti-cancer drugs via Src/FAK pathway inhibition

Epithelial to mesenchymal transition (EMT) is a key process in embryonic development and has been associated with cancer metastasis and drug resistance. For example, in EGFR mutated non-small cell lung cancers (NSCLC), EMT has been associated with acquired resistance to the EGFR inhibitor erlotinib. Moreover, “EGFR-addicted” cancer cell lines induced to undergo EMT become erlotinib-resistant in vitro. To identify potential therapeutic vulnerabilities specifically within these mesenchymal, erlotinib-resistant cells, we performed a small molecule screen of ~200 established anti-cancer agents using the EGFR mutant NSCLC HCC827 cell line and a corresponding mesenchymal derivative line. The mesenchymal cells were more resistant to most tested agents; however, a small number of agents showed selective growth inhibitory activity against the mesenchymal cells, with the most potent being the Abl/Src inhibitor, dasatinib. Analysis of the tyrosine phospho-proteome revealed several Src/FAK pathway kinases that were differentially phosphorylated in the mesenchymal cells, and RNAi depletion of the core Src/FAK pathway components in these mesenchymal cells caused apoptosis. These findings reveal a novel role for Src/FAK pathway kinases in drug resistance and identify dasatinib as a potential therapeutic for treatment of erlotinib resistance associated with EMT.     

中青年人群非酒精性脂肪肝发生风险预测模型的建立

目的建立非酒精性脂肪肝(NAFLD)的发生风险预测模型,为NAFLD的预防及发生提供管理策略。方法选取2015年1月至2018年7月大连医科大学附属第二医院健康管理中心年度体检数据库中18~59岁、至少有2次连续体检记录、基线未发生NAFLD且无重要指标缺失者的数据,观察结局为NAFLD。收集基本信息、体格检查、实验室检查和腹部超声检查资料,将所有研究对象随机分为建模组和验证组。采用SPSS 23.0进行χ²检验、t检验、秩和检验、单因素Cox回归分析。利用建模组资料进行多因素Cox回归分析选取预测指标,用RStudio软件绘制线图,构建NAFLD发生风险预测模型。通过一致性指数(C指数)和校正曲线对建模组和验证组模型的预测效果进行验证。结果本研究共纳入2377名研究对象,其中建模组1585人,验证组792人。本研究共有467人发生NAFLD(累积发病率为19.6%),平均随访时间为(27.06±8.02)个月。其中,建模组NAFLD发病人数为310人(发病率为19.6%),验证组NAFLD发病人数为157人(累积发病率为19.8%)。多因素Cox回归分析结果显示,高密度脂蛋白胆固醇水平(HR=0.334,95%CI:0.209~0.534)为NAFLD发病的独立保护因素,而体质指数(HR=1.220,95%CI:1.172~1.271)、甘油三酯(HR=1.114,95%CI:1.052~1.180)、低密度脂蛋白胆固醇(HR=1.252,95%CI:1.054~1.487)、丙氨酸氨基转移酶(HR=1.013,95%CI:1.005~1.021)、血尿酸(HR=1.003,95%CI:1.001~1.004)为NAFLD发病的独立危险因素(P<0.05,P<0.01)。利用上述影响因素成功构建NAFLD发生风险预测模型。建模组和验证组的C指数分别为0.789(95%CI:0.766~0.812)、0.777(95%CI:0.742~0.812),校正曲线显示模型预测结果与实际观察结果吻合良好。结论本研究构建的NAFLD发生风险预测模型可以准确地预测NAFLD的发生概率,为早期识别NAFLD高危人群提供新思路。     

A Comparison of Classical and Anatomical Total Knee Alignment Methods in Robotic Total Knee Arthroplasty : Classical and Anatomical Knee Alignment Methods in TKA

The purpose of this study was to compare the clinical and radiological outcomes achieved using classical and anatomical alignment methods in primary total knee arthroplasty (TKA). One hundred and seventeen patients were randomly assigned to undergo robotic-assisted TKA using either the classical (56 patients) or the anatomical alignment method (61 patients). Clinical outcomes including varus and valgus laxities, ROM, HSS and WOMAC scores and radiological outcomes were evaluated after a minimum follow-up of 2 years. Varus and valgus laxity assessments showed no significant inter-group differences (P > 0.05). Moreover, no significant differences were observed in ROM, HSS and WOMAC scores (P > 0.05). We could not find any significant difference in mechanical alignment of the lower limb. The results of this study show that two alignment methods provide comparable clinical and radiological outcomes after primary TKA.     

比较种植体支抗和J钩临床效果的Meta分析

背景:正畸治疗常用的有面弓形口外弓和J钩,两者都能很好地增强支抗,但临床效果可能有差异。目的:比较种植体支抗和J钩在临床治疗效果及牙根吸收方面的差异。方法:计算机检索PubMed(1950-01/2010-08)、Embase(1966-01/2010-08)、Cochrane library(2010年第2期)、中文科技期刊数据库(VIP)(1989-01/2010-08)、中国生物医学文献数据库(CBM)(1978-01/2010-08)、中国期刊全文数据库(CNKI)(1979-01/2010-08)。手工检索并辅以文章追溯的方法收集国内、国外学者10年内公开发表的有关比较种植体支抗和J钩效果的文献。运用Meta分析对头影测量结果进行定量分析。采用RevMan5.0版统计软件进行统计分析。采用卡方检验对纳入研究进行异质性检验。采用固定效应模型及随机效应模型,计算合并加权均数差及其95%CI。结果及结论:共纳入4篇文献,87例受试者。Meta分析结果显示:种植体组比J钩组在覆合、覆盖减少量和上中切牙切缘至腭平面的垂直距离减少量3项指标变化上差异有显著性意义。单个研究结果:相对于J钩,种植支抗引起牙根吸收量较少,结果有显著性差异。在支抗控制方面,种植体支抗可以很好的替代J钩。但是尚需要更多高质量,大样本的RCT进一步验证两者的差异。     

Study on College Students' Implicit AI truism with Different Experiment Material

目的 考察大学生内隐利他倾向的存在性及其与外显利他的关系.方法 采用自行修订的Rushton编制的《利他精神自陈量表》及图片—词汇联结和词汇—词汇联结的内隐联想测验进行研究.结果 ①内隐图片—词汇联结实验的相容反应时与不相容反应时差异显著(t=-12.55),内隐词汇一词汇联结实验的结果也存在显著差异(t=-10.04);②内隐利他与外显利他行为无相关,不同实验材料的内隐实验IAT效应值存在显著相关(r=0.43,P＜0.01)；③内隐利他和外显利他在性别上差异均不显著.结论 利他行为内隐倾向存在且稳定;利他行为的内隐倾向与外显行为相分高,并且男女生的利他行为不存在显著差异.     

链霉素缓释复合降解膜植入损伤肌腱局部腱周结缔组织的变化

背景:国内外学者曾用生物、非生物及药物等方法,诸如生物膜、透明质酸钠、纤维素密封胶等材料进行大量肌腱修复防粘连研究,但到目前为止尚未取得突破性进展。目的:观察肌腱损伤局部植入链霉素复合降解膜后腱周结缔组织的增生。方法:切断SD大鼠跟腱后,随机数字表法分为3组,分别在肌腱断端缝合处植入链霉素复合缓释降解膜、维生素C复合缓释降解膜、空白缓释降解膜。术后90d行肌腱损伤局部组织学观察、羟脯氨酸含量和生物力学指标检测。结果与结论:链霉素复合缓释降解膜组肌腱缝合处内部的成纤维细胞、胶原纤维均较其腱周围、维生素C复合缓释降解膜组、空白缓释降解膜组多;腱缝合处肌腱周围多为正常结构的疏松结缔组织,很少有增生的结缔组织长入肌腱内部;肌腱与周围组织分界清晰,最大抗拉强度、羟脯氨酸含量明显优于其他两组。表明链霉素复合缓释降解膜通过抑制腱周结缔组织增生,防止腱周结缔组织增生长入腱内,从而减轻或防止粘连形成。     

Comparative Evaluation of Two Hemagglutinating Encephalomyelitis Coronavirus Vaccine Candidates in Mice

Porcine hemagglutinating encephalomyelitis (PHE) is caused by the coronavirus hemagglutinating encephalomyelitis virus (PHE-CoV), and the recent, rapid spread of PHE-CoV in piglets from many countries emphasizes the urgent need for a PHE-CoV vaccine. Here we use a murine model for evaluation of the induction of humoral and cellular immune responses by inactivated and PHE-CoV DNA vaccines in order to define the immune correlates for protection against PHE-CoV. The inactivated vaccine was composed of purified PHE-CoV and aluminum hydroxide gel (alum), which was chosen as an adjuvant because of its long history of safety for human use. The PHE-CoV DNA vaccine was constructed by subcloning the S1 gene of PHE-CoV into the pVAX1 vector to create the recombinant plasmid pV-S1. Our results showed that the inactivated PHE-CoV vaccine (IPV) elicited a high level of humoral immunity, resulting in good protection efficacy against PHE-CoV challenge. The IPV induced the IgG1 subclass of serum antibodies and expression of the cytokine interleukin-4 (IL-4), suggesting that the IPV generated a predominantly Th2-type immune response. The DNA vaccine was found to mediate primarily a cellular immune response with high levels of IgG2a and the cytokines IL-2 and gamma interferon (IFN-γ). However, mice that were vaccinated twice with the DNA vaccine and boosted with the IPV could mount a sufficient neutralizing antibody response against live PHE-CoV, with little variation in IgG1 and IgG2a levels, and showed high levels of IL-2 and IL-4. This response may activate both B and T cells to mount a specific humoral and cellular immune response that could, in turn, elicit a phagocyte-mediated defense against PHE-CoV infections to achieve viral clearance.