Prognostic impact of acquisition of cytogenetic abnormalities during the course of chronic myelomonocytic leukemia

Karyotypic abnormalities are detected in 20–40% of chronic myelomonocytic leukemia (CMML) patients at initial diagnosis and have been shown to correlate with patients' outcome. The significance of acquisition of cytogenetic abnormalities (ACA) during the course of CMML, however, is largely unknown. In a cohort of 314 CMML patients, karyotypic abnormalities were detected in 106 (34%) patients at the time of diagnosis; and ACA were detected in 80 (25%) patients after a median interval of 17 months (range, 2–117 months). The most frequently observed ACA were a complex karyotype, followed by +21, ?7/del(7q), del(20q), i(17q), and ?17/del(17p). ACA appeared to occur more frequently in patients with a normal or lower risk karyotype. Progression to AML was seen in 44 of 80 (55%) patients with ACA versus 67 of 234 (29%) patients without ACA (P < 0.0001). Presence of ACA predicted an inferior leukemia‐free survival (LFS) by univariate (P = 0.0435) and multivariate analysis (HR = 1.892, P = 0.006). While acquisition of a complex karyotype was positively correlated with AML progression (P = 0.0086), del(20q) was associated with a stable disease (P = 0.0198). We conclude that ACA occur in ～20–30% of CMML patients during the course of disease, and are significantly associated with AML progression and a shorter LFS. Karyotypic abnormalities, either present at diagnosis or acquired during the course of disease, have prognostic implication in CMML patients. Am. J. Hematol. 90:882–887, 2015. © 2015 Wiley Periodicals, Inc.     

超级软衬热凝树脂在颌骨囊肿塞治器中的应用

采用超级软衬热凝树脂制作塞治器,对59例颌骨囊性病变进行开窗减压治疗,术后佩戴塞治器.术后3、6、12个月行曲面体层片及锥形束CT检查;结果显示59例颌骨囊性病变内骨密度逐渐增高,囊腔体积变小;其中32例新成骨超过50％,17例患者囊腔消失,无需行二期刮切手术.     

A comparative analysis of lung cancer patients treated with lobectomy via three-dimensional video-assisted thoracoscopic surgery versus two-dimensional resection

Background

Three-dimensional (3D) vision systems are now available for thoracic surgery. It is unclear whether 3D video-assisted thoracic surgery (VATS) is superior to 2D VATS systems. This study aimed to compare the operative and perioperative data between 2D and 3D VATS lobectomy (VTL) and to identify the actual role of 3D VTL in thoracic surgery.

Methods

A two-institutional comparative study was conducted from November 2013 to November 2014 at Liaoning Cancer Hospital & Institute and the First Affiliated Hospital of Guangzhou Medical University, China, of 300 patients with resectable non-small cell lung cancer (NSCLC). Patients were assigned to receive either the 3D VATS (n=150) or 2D VATS (n=150) lobectomy. The operative and perioperative data between 2D VATS and 3D VATS were compared.

Results

Although there was no significant difference between the two groups regarding the incidence of each single complication, a significantly less operative time was found in the 3D VATS group (145 min) than in the 2D VATS group (176 min) (P=0.006). Postoperative mortality rates in 3D VATS and 2D VATS groups were both 0%.No significant difference was found between groups for estimated blood loss (P=0.893), chest drainage tube placement time (P=0.397), length of hospital stay (P=0.199), number of lymph nodes resected (P=0.397), postoperative complications (P=0.882) and cost of care (P=0.913).

Conclusions

Early results of this study demonstrate that the 3D VATS lobectomy procedure can be performed with less operative time. 3D VATS and 2D VATS lobectomy are both safe procedures in first-line surgical treatment of NSCLC.     

IS6110-限制性片段长度多态性DNA分型在结核分子流行病学研究中的应用

目的 建立宁夏、北京和上海等地结核分支杆菌发离株IS6110－RFLP DNA指纹图谱，观察其流行病学特征。方法 提取结核分支杆菌基因组DNA，经限制性内切酶PvuⅡ切割、琼脂糖凝胶电泳和Southern转印后，用荧光标记的IS6110DNA序列中245bp探针杂交，以核酸化学发光试剂盒探测荧光信号，比较各菌株指 IS6110拷贝数和带型，分析不同地理区域流行菌株的特点。结果 103例结核患的临床分离株，经245bp探针杂交后的指纹图谱显示大部分菌株含8－21个IS6110拷贝，在宁夏和北京地区流行的结核分支杆菌带型具有共同特点，并有成簇分布的现象，在上海分离株中发现1株零拷贝株和1株单拷贝株。结论 IS6110－RFLP DNA分型方法可用于我国流行的结核分支杆菌分子流行病学研究；宁夏分离株与北京分离株在基因上亲缘关系较相近。     

SLC7A11基因表达沉默的肝癌细胞株的构建及筛选

目的:构建并筛选出SLC7A11基因表达沉默的肝癌LM3细胞株,为研究SLC7A11基因的表达沉默对肝癌发生发展的影响奠定基础。方法:针对SLC7A11基因的不同部位合成3个siRNA的寡核苷酸片段,分别将其克隆到真核表达载体p GPU6/GFP/Neo中。利用脂质体转染法分别将质粒导入肝癌LM3细胞,24小时后观察细胞内GFP表达情况,并通过real-time PCR及Western blot的方法比较各组细胞SLC7A11基因mRNA和蛋白的表达水平,然后用G418对转染细胞进行筛选培养。结果:经酶切分析及测序验证,成功构建了靶向沉默SLC7A11基因的真核表达质粒p GPU6-SLC7A11-siRNA;通过real-time PCR及Western blot的方法验证,成功筛选出SLC7A11基因表达沉默的肝癌LM3细胞株。结论:成功构建并筛选出SLC7A11基因表达沉默的肝癌细胞株,为进一步研究SLC7A11基因表达沉默对肝癌细胞发生发展的影响奠定了基础。     

临床护理路径在髋关节置换术护理中的应用

目的：探讨临床护理路径对髋关节置换术患者的影响。方法将80例髋关节置换术患者分为观察组和对照组,观察组患者实施临床护理路径护理,对照组采用传统的护理模式护理。结果观察组患者功能锻炼知识掌握程度由62．5％上升到100％,而并发症由25％减少到2．5％。结论实施临床护理路径能使患者更好掌握功能锻炼,减少并发症的发生。     

Enhanced gas selectivity induced by surface active oxygen in SnO/SnO2 heterojunction structures at different temperatures

The development of heterojunction structures has been considered as an important step for sensing materials. In this report, 3D hierarchical SnO–SnO₂ heterojunction structures were synthesized and developed via simple one-pot hydrothermal synthesis without any extra processes. The prepared 3D samples exhibit high sensitivity, benefiting from the synergistic effects of SnO and SnO₂. Interestingly, SnO–SnO₂ hybrid structures exhibited distinctly different sensitivities at 180 and 280 °C, and the sensitivity can achieve values of 47.69 and 41.56 toward ethanol and acetone, respectively, at concentrations of 100 ppm. A mechanistic analysis of the sensitivity and concentration-dependence revealed that the oxygen species on the surface were O⁻ and O²⁻ at different temperatures. Therefore, the temperature selectivity of the sample may be due to the different activities of the active oxygen species. Moreover, the composition also shows excellent stability at operating temperatures. The high sensing sensitivity and selectivity is promising for practical VOC gas detection; this also offers a new perspective for the design of multifunctional sensing materials.

The development of heterojunction structures has been considered as an important step for sensing materials.     

骨科责任护士工作流程单的设计与应用

目的 探讨优质护理服务过程中斯型护理管理模式,提高护理质量和患者满意度.方法 成立责任护士工作流程单(下称流程单)设计小组,制定患者由入院到出院护理过程的5类流程单,责任护士根据工作流程单进行日常护理工作.实施4个月后评价效果.结果 流程单应用后护理质控检查评分显著高于应用前(均P＜0.01);患者满意率相对提高,但差异无统计学意义(P＞0.05).结论 流程单的应用有利于提高护理质量,确保护理安全.     

红景天苷保护砷中毒大鼠左心功能:二维斑点追踪成像观察

目的 以二维斑点追踪成像（2D-STE）评估红景天苷保护砷中毒大鼠左心功能的价值。方法 将40只大鼠随机分为红景天苷高剂量组（S30组）、红景天苷低剂量组（S15组）、模型组、无毒干预组（Sal组）及对照组,每组8只。于每晨9时对S30组、S15组及模型组以As₂O₃（5 mg/kg体质量）灌胃,Sal组及对照组以无菌水灌胃,持续30天;之后对S30组以红景天苷30 mg/kg体质量、S15组及Sal组以红景天苷15 mg/kg体质量、对照组和模型组以无菌水连续灌胃7天;比较组间超声参数和血清心肌标志物差异,观察心肌组织病理改变,评价分层应变参数与血清心肌标志物的关系。结果 S30组、S15组及模型组血清肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、心肌丙二醛均高于对照组（P均<0.05）,而心肌超氧化物歧化酶、左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）、各层心肌整体圆周应变（GCS）及心内膜下心肌各节段圆周应变均低于对照组（P均<0.05）;上述3组大鼠心肌细胞肿胀、坏死,细胞间隙增宽,核深染,以模型组最为明显,S30组及S15组程度相对较轻。Sal组与对照组各指标差异均无统计学意义（P均>0.05）。各组心内膜下/中层/心外膜下GCS与CK-MB （r＝－0.926、－0.813、－0.738,P均<0.05）及LDH （r＝－0.908、－0.803、－0.737,P均<0.05）均呈负相关。结论 2D-STE可用于评估红景天苷对砷中毒大鼠左心功能的保护作用。