基于加权基因共表达网络的膀胱尿路上皮癌预后及疗效相关基因筛选

目的构建加权基因共表达网络分析（weighed gene co-expression network analysis,WGCNA）,鉴定出膀胱尿路上皮癌（bladder urothelial carcinoma,BLCA）中与预后及治疗效果相关的基因,并分析其在肿瘤相关通路中的活性。方法在癌症基因组图谱数据库获取膀胱尿路上皮癌的转录组测序及相应临床数据;选择年龄、性别、身高、体重、人种、生存时间、吸烟年数、治疗效果、病理分级、TNM分期及淋巴结浸润为临床表型进行加权基因共表达网络分析;利用R语言进行生存分析;利用GSCALite工具进行肿瘤相关的通路活性分析;利用基因表达汇编数据库中的GSE13507和GSE3167数据集进行验证。结果本研究鉴定出与预后及治疗效果均显著相关的基因模块及模块关键基因GPHN、CPSF2、PRMT5、EIF2S1、KLC1、SLC39A9、SRP54及CNIH,上述8个基因在肿瘤相关通路中有一定活性。结论GPHN、CPSF2、PRMT5、EIF2S1、KLC1、SLC39A9、SRP54及CNIH基因在BLCA中与预后及治疗效果均显著相关,并且参与了肿瘤相关通路,可能成为BLCA的生物标志物或潜在治疗靶点。     

应用距下关节镜诊治跗骨窦综合征

目的分析跗骨窦综合征在关节镜下的特征,评价应用关节镜治疗的临床效果。方法回顾性分析2012年1月至2014年1月,本院收治的15例诊断为跗骨窦综合征的病例。其中男6例,女9例;平均33.4岁（19~48岁）。其中,踝扭伤后11例,跟骨骨折后2例,胫腓骨骨折后1例,强直性脊柱炎1例。均应用距下关节镜检并行镜下手术。术前后应用直观模拟量表（VAS）评估术后疼痛改善情况,应用美国骨科足踝外科（AOFAS）踝-后足评分评估恢复效果,并记录相关并发症。结果关节镜下发现11例患者有不同程度的滑膜充血增生、脂肪纤维化、疤痕形成,有3例患者伴距跟骨间韧带的局部撕裂,1例伴腓骨肌腱损伤,1例伴距跟关节面软骨损伤;有2例患者镜下未见明显异常。针对不同病变,行跗骨窦区的增生滑膜、疤痕及脂肪组织清除,射频电极止血。术后平均随访16个月（6~28个月）,疼痛消失及明显缓解者13例,2例缓解不明显,其中,诊断强直性脊柱炎1例患者缓解3月后再发疼痛,经抗炎治疗缓解。AOFAS踝-后足评分均较术前明显改善,疼痛症状明显缓解,平均VAS评分从术前的7.7分下降到2.1分,优良率86.7%（13/15）。结论跗骨窦综合征在关节镜下常有明确的滑膜充血或增生等病理表现,通过关节镜手术可取得较优良的疗效。     

组织学前列腺炎对经尿道前列腺剜除术的影响及临床意义

目的分析组织学前列腺炎对经尿道前列腺剜除术（PKEP）的影响程度和临床意义。方法通过经尿道前列腺剜除术对231例前列腺增生（BPH）患者行手术治疗。所有患者根据手术标本病理检查结果进行分组：138例BPH伴组织学前列腺炎患者（炎症组）和93例单纯BPH患者（对照组）,分析两组患者的增生腺体剥离时间,出血量,并发症发生情况以及术后排尿情况。结果两组患者的年龄差异无统计学意义（P〉0．05）,两组患者前列腺体积差异无统计学意义（P〉0．05）。PSA、IPSS评分以及尿流率差异均有统计学意义（P〈0．05）。炎症组与对照组剥离时间分别为：（55±20）min和（37±11）min,差异有统计学意义（P〈0．05）。炎症组5例发生前列腺包膜穿孔,对照组无穿孔发生,差异有统计学意义（P〈0．05）。两组术中出血量分别为：（310±90）ml和（105±55）ml,差异有统计学意义（P〈0．05）。炎症组8例需术中输血,对照组无输血,差异有统计学意义（P〈0．05）。炎症组与对照组术后发生暂时性尿失禁分别为63例和19例,差异有统计学意义（P〈0．05）。两组患者术后3个月尿流率差异无统计学意义（P〉0．05）。结论组织学前列腺炎是导致PKEP手术时间延长,增加术中出血量以及术后并发症发生的重要因素。     

Markov模型在艾滋病研究领域中的应用

Markov 模型是生物医学上常用的一种随机过程模型。随机过程X＝﹛X（t）,t∈T﹜是一组依赖于t的随机变量,即对于每一个t,Xt是一个随机变量,称为过程在t时刻的状态。     

Characteristics of Toxic Metal Accumulation in Farmland in Relation to Long-Term Chicken Manure Application: A Case Study in the Yangtze River Delta Region,China

Characteristics of toxic metal accumulation in farmland in relation to intensive chicken manure application on a regional scale was studied in this paper. Concentrations of Zn, As and Cu in manure exceeded the related standard in 66.7 %, 14.3 % and 16.7 % of samples, respectively. Among chicken feed samples, concentrations of Zn, Cr and As exceeded the National Standard limits in 74.3 %, 56.3 % and 34.3 % of samples, respectively. The accumulation of metals in soils from long-term chicken manure application has led to increasing uptake in above-ground shoots of wheat. The maximum contents of all metals present in the soil are currently below the threshold values of National Grade II criteria. At present, the farmland soil is safe for agricultural production, but more attention should be given to the potential environmental risk of metal accumulation in chicken manure and soils.     

Hippocampal Glycogen Synthase Kinase 3β is Critical for the Antidepressant Effect of Cyclin-Dependent Kinase 5 Inhibitor in Rats

Cdk5 is a member of cyclin-dependent kinase (Cdk), a proline-directed serine/threonine kinase, and plays a key role in normal neural development and function. Evidence of previous study showed that chronic inhibition of Cdk5 in hippocampal dentate gyrus (DG) blocked the development of depressive-like symptoms, suggesting that Cdk5 plays a role in development of depression. Forced swim test, novelty-suppressed feeding test, and learned helplessness were used to evaluate the cellular and molecular mechanisms underlying the behavioral regulation of Cdk5 inhibitors in rats. Two Cdk5 inhibitors butyrolactone and roscovitine were used to investigate the possible antidepressant-like actions of Cdk5 blockade and the potential mechanisms. Systemic administration of butyrolactone (200 mg/kg, IP) or roscovitine (100 mg/kg, IP) produced effective antidepressant-like actions. Moreover, infusion (5 mM) of GSK3β activator LY294002 into DG abolished the antidepressant-like actions of butyrolactone and roscovitine, suggesting that inhibition of GSK3β might be involved in the antidepressant effect of Cdk5 inhibitors. Moreover, pretreatment of LY294002 (5 mM) blocked the antidepressant-like effect of butyrolactone and roscovitine in learned helplessness. Additionally, inescapable footshock induced a significant increase of GSK3β activity, while butyrolactone and roscovitine decreased GSK3β activity. In contrast, pretreatment of LY294002 prevented the inhibitory effects of butyrolactone and roscovitine on GSK3β activation. Finally, a specific GSK3β inhibitor, SB216763 (1 ng, DG), demonstrated an effective antidepressant-like action. These findings demonstrate that systemic administration of Cdk5 inhibitors produced antidepressant-like actions and that inhibition of GSK3β is involved in behavioral response of Cdk5 inhibitors.     

Functional connectivity‐based parcellation of the human sensorimotor cortex

Task‐based functional magnetic resonance imaging (fMRI) has been successfully employed to obtain somatotopic maps of the human sensorimotor cortex. Here, we showed through direct comparison that a similar functional map can be obtained, independently of a task, by performing a connectivity‐based parcellation of the sensorimotor cortex based on resting‐state fMRI. Cortex corresponding to two adjacent Brodmann areas (BA 3 and BA 4) was selected as the sensorimotor area. Parcellation was obtained along a medial–lateral axis, which was confirmed to be somatotopic (corresponding roughly to an upper, middle and lower limb, respectively) by comparing it with maps obtained using motoric task‐based fMRI in the same participants. Interestingly, the resting‐state parcellation map demonstrated higher correspondence to the task‐based divisions after individuals performed the motor task. Using the resting‐state fMRI data, we also observed higher functional correlations between the centrally located hand region and the other two regions, than between the foot and tongue. The functional relevance of these somatosensory parcellation results indicates the feasibility of a wide range of potential applications to brain mapping.     

癌症患者同伴支持量表的汉化及信效度检验

目的 汉化癌症患者同伴支持量表,并检验其信效度。方法 通过正译、回译、文化调试和预调查对原量表进行汉化,形成中文版癌症患者同伴支持量表。于2021年3月—6月选取长沙市2所三级甲等医院的128例青年癌症患者进行问卷调查,分析量表的信效度;2021年7月—2022年3月选取该2所医院招募的241例患者进行问卷调查,用于验证性因子分析。结果 中文版癌症患者同伴支持量表包括3个维度、11个条目。量表水平的内容效度指数为0.948,条目水平的内容效度指数为0.714～1.000。探索性因子分析提取出3个公因子,各条目因子载荷为0.535～0.872,累计方差贡献率为69.64%,方程拟合良好。量表总的Cronbach’s α系数为0.923,折半信度为0.860。验证性因子分析结果 显示,模型拟合度良好。结论 中文版癌症患者同伴支持量表的信效度良好,适用于青年癌症患者同伴支持感的评估。     

TST加外切缝合术治疗环状混合痔的临床观察

为探讨选择性痔上黏膜切除术（TST）加外切缝合术治疗环状混合痔的效果,将50例环状混合痔患者随机分为观察组和对照组各25例,观察组采用TST加外切缝合术治疗,对照组采用PPH治疗。跟踪随访、观察记录术后疗效及并发症。结果显示,两组疗效差异无统计学意义（P〉0．05）;在术后并发症等方面观察组优于对照组（P〈0．05）。结果表明,TS＇I’加外切缝合术治疗环状混合痔安全性高,治疗效果显著。     

根治性膀胱全切后改良MainzⅡ式膀胱术96例临床分析

目的:探讨根治性膀胱全切后改良MainzⅡ式膀胱术的术后临床效果。方法:采用改良MainzⅡ膀胱术治疗膀胱癌患者96例,通过监测肾功能和尿控情况,观察有无逆行感染及切口感染、肾积水、肠瘘等并发症,并做生活质量评分(QOL),从而判断手术疗效。结果:96例患者手术均获得成功,手术时间3~10h,平均6h;出血量200~1 000ml,平均400ml。随访6~36个月,96例患者均无尿失禁;排尿次数1次/2~5h,平均1次/3h,每次尿量100~500ml,平均300ml;5例逆行感染,12例切口感染,9侧肾积水,其中3例双侧肾积水,25例轻度高氯性酸中毒,2例肠瘘,1例术前肾积水术后肾萎缩,肿瘤复发转移5例,4例死亡。QOL为0~5分,平均2.5分(介于满意和大致满意之间)。结论:改良MainzⅡ式膀胱术具有操作简单、手术时间短、复发率低、并发症少等优点,可作为一种可控性尿流改道的术式选择。