The prognostic role of tumour‐infiltrating lymphocytes in oral squamous cell carcinoma: A meta‐analysis

It has been suggested that tumour‐infiltrating lymphocytes (TILs) are associated with the progression of oral squamous cell carcinoma (OSCC). However, the prognostic value of TILs is inconclusive due to the heterogeneity of immune cells within the tumour microenvironment. In this meta‐analysis, we aimed to assess the prognostic value of TILs in OSCC. The PubMed, Cochrane, Embase, Scopus and Web of Science databases were searched up to April 20, 2019, and 33 studies were ultimately included in this meta‐analysis. Our pooled meta‐analysis showed that high infiltration of CD8⁺ TILs, CD45RO⁺ TILs and CD57⁺ TILs favoured better overall survival (OS). However, high infiltration of CD68⁺ macrophages and CD163⁺ macrophages was associated with poor prognosis in OSCC. These findings suggest that CD8⁺ TILs, CD45RO⁺ TILs, CD57⁺ TILs, CD68⁺ macrophages and CD163⁺ macrophages might serve as novel prognostic factors and therapeutic targets in OSCC.     

骨形成蛋白2基因修饰的老年大鼠骨髓间充质干细胞成骨分化能力的研究

目的观察年龄因素对骨髓间充质干细胞(marrow mesenchymal stem cells, MSCs)成骨分化能力的影响;了解基因治疗对老年大鼠MSCs成骨分化能力的影响. 方法 1月龄(幼年组)、9月龄(成年组)及24月龄(老年组)雄性Wistar大鼠各6只,取MSCs经体外分离、培养及携带骨形成蛋白2(bone morphogenetic protein 2,BMP-2)基因的腺病毒载体(Ad-BMP-2)转染后,定量检测BMP-2、碱性磷酸酶(alkaline phosphate,ALP)表达,以及成骨细胞标志性蛋白:Ⅰ型胶原、骨涎蛋白(bone sialoprotein,BSP)和骨桥素(osteopontin, OPN)的表达.将转染的各组MSCs分别与磷酸三钙(tricalcium phosphate, TCP)复合后植入裸鼠体内,3周后取材,比较各组诱导异位成骨能力. 结果 ELISA检测表明BMP-2基因修饰的MSCs可以有效表达BMP-2,且表达量在各年龄组间差异无统计学意义(P>0.05);各组ALP于诱导后第9天达高峰,但组间差异均无统计学意义(P＞0.05);诱导后第7天,RT-PCR半定量检测示各组均有成骨细胞特征性蛋白,即:Ⅰ型胶原、OPN及BSP的明显表达,表达量在各组间差异无统计学意义(P>0.05);BMP-2基因转染的MSCs与TCP复合后可诱导裸鼠体内异位成骨,各组成骨量差异无统计学意义(P>0.05). 结论 BMP-2基因修饰的老年大鼠MSCs可以恢复成骨分化能力,基因治疗可能为老年性骨骼疾病提供一种新的治疗途径.     

肾移植术后严重肺部感染患者血液滤过的护理

对10例肾移植术后合并急性呼吸窘迫综合征(ARDS)的严重肺部感染患者实行连续性高容量血液滤过(CHVHF)治疗.结果4例痊愈出院,6例存活时间超过15 d(15 d后5例死亡,1例放弃治疗);CHVHF治疗过程中,患者血压、心率平稳,APACHEⅡ评分48 h后显著改善(P＜0.05,P＜0.01).提示肾移植术后合并ARDS的严重肺部感染患者应用CHVHF治疗是一种安全有效的方法,加强护理评估与监测,保持体外循环通畅,做好心理护理是使治疗顺利进行,取得满意疗效的重要保障.     

渐进性活动训练预防膀胱全切、尿流改道术后患者小肠梗阻的对照研究

目的研究渐进性活动训练对膀胱全切、尿流改道术后患者肠功能恢复的影响.方法2003年1月～2005年8月,将138例行膀胱全切、尿流改道术的患者随机分为2组,训练组在常规护理方法的基础上,同时实施渐进性活动训练,对照组采取常规护理方法.结果2组患者小肠梗阻的发生比较,差异有显著意义(P＜0.01).结论渐进性活动训练可降低膀胱全切、尿流改道术后患者小肠梗阻的发生.     

Prognostic factors for surgical resection in patients with multidrug-resistant tuberculosis.

Although surgical lung resection could improve prognosis in some patients with multidrug-resistant tuberculosis (MDR-TB), there are no reports on the optimal candidates for this surgery. The aim of the present study was to elucidate the prognostic factors for surgery in patients with MDR-TB. Patients who underwent lung resection for the treatment of MDR-TB between March 1993 and December 2004 were included in the present study. Treatment failure was defined as greater than or equal to two of the five cultures recorded in the final 12 months of treatment being positive, any one of the final three cultures being positive, or the patient having died during treatment. The variables that affected treatment outcomes were identified through univariate and multivariate logistic regression analysis. In total, 79 patients with MDR-TB were included in the present study. The treatment outcomes of 22 (27.8%) patients were classified as failure. A body mass index <18.5 kg x m(-2), primary resistance, resistance to ofloxacin and the presence of a cavitary lesion beyond the range of the surgical resection were associated with treatment failure. Low body mass index, primary resistance, resistance to ofloxacin and cavitary lesions beyond the range of resection are possible poor prognostic factors for surgical lung resection in multidrug-resistant tuberculosis patients.     

Neprilysin基因在大鼠体外培养骨髓基质细胞中的表达

目的探讨人Neprilysin基因在小鼠MSCs中的表达情况。方法分离培养小鼠MSCs，采用分子克隆技术构建Neprilysin—pEGFP重组质粒，将此Neprilysin—pEGFP重组质粒用脂质体转染进MSCs中，在荧光倒置显微镜下观察该基因在MSCs中的表达效率。结果经酶切鉴定得到系列正确的重组Neprilysin—pEGFP。Neprilysin可在MSCs中表达且通过脂质体传染的效率是20％。结论获得了表达Neprilysin基因的骨髓基质细胞，为进一步探讨将该细胞用于阿尔茨海默病基因治疗的可能性研究提供了技术基础。     

代孕技术中的伦理道德及法律问题

新近发展的代孕技术给众多不孕夫妇带来为人父母的喜悦之时,也对人们传统的生殖伦理观念形成冲击并挑战现存法律制度.人们不仅要肯定代孕技术的合理性,也要警惕其所产生的潜在的破坏性影响.合理利用该技术和制定相应的法规是避免出现伦理和社会混乱的有效途径.     

创伤性休克的液体超负荷分析

目的 探讨创伤性休克患者发生液体超负荷的原因和治疗方法。方法 总结存活时间超过24h的286例创伤性休克患者，对休克纠正后出现全身性水肿患者进行分析，比较存活与死亡患者在伤后第1～8天的液体出入量。结果 286例创伤性休克患者中，出现水肿者262例（91．6％），存活232例（88．5％），死亡30例（11．5％）。死亡组的液体入量明显多于存活组（P〈0．05），液体出量则显著少于存活组（P〈0．05或P〈0．01）。存活组在伤后第4、5天出现液体负平衡即液体出量大于液体入量600～700mL（P〈0．05），而死亡组未出现液体负平衡现象。结论 创伤性休克的抢救过程中容易造成液体超负荷，液体出量增加甚至出现液体负平衡现象，预示着病情好转，此时只要生命体征稳定即可，不宜过分强调出入量平衡而大量补充液体。     

逍遥散治疗经前期综合征69例

逍遥散出自《太平惠民和剂局方》，由当归、白芍药、柴胡、茯苓、白术、炙甘草、薄荷、煨姜组成。经前期综合征为临床常见的妇科病症，笔者近年来采用逍遥散加减治疗经前期综合征69例，疗效满意，现报道如下。     

脑梗塞合并精神障碍病人的分型及护理

脑梗塞是由于脑动脉粥样硬化和血栓形成使管腔闭塞，导致急性脑供血不足和脑组织局部坏死的临床症候群。其主要临床表现为偏瘫和失语。其中部分病人还可合并精神障碍。脑梗塞在我国十分常见，据文献报道：我国每年约有150余万人发生脑梗塞，因此认为做好脑梗塞病人的治疗和护理，尽快恢复其肢体和脑功能，具有十分重要的临床意义和社会意义。