化疗致肺癌患者严重粒细胞减少相关危险因素研究

摘 要 目的：探讨化疗致肺癌患者严重粒细胞减少的相关危险因素,为临床用药提供参考。方法: 回顾性分析肺癌患者临床资料,统计分析找出与严重粒细胞减少有关的危险因素。结果: 单因素分析显示严重粒细胞减少与放疗史、化疗周期和粒细胞集落因子使用时机具有相关性。Logistic回归分析显示,放疗史、粒细胞集落因子使用时机是肺癌患者严重粒细胞减少的危险因素。结论:对于有放疗史的患者,可选用细胞毒性小的化疗方案,或降低药物剂量,或预防使用集落刺激因子;合理应用粒细胞集落刺激因子可减轻肺癌化疗引起的严重粒细胞减少。     

中西医结合治疗慢性病毒性肝炎降低内毒素水平的临床观察

目的:观察中西医结合治疗降低慢性病毒性肝炎患者内毒素水平的临床疗效.方法:将92例患者随机分两组:治疗组和对照组,运用鲎试剂定量检测技术对病例内毒素水平采血检测.结果:治疗组内毒素水平1.64±0.46Eu/ml,至第七周恢复正常者占50%;对照组内毒素水平2.10±0.51Eu/ml,至第七周恢复正常者占30.6%;两组间疗效有显著性差异(P＜0.05).结论:中西结合治疗对降低内毒素水平有较好的疗效.     

PF4通过NF-κB上调巨噬细胞MMP-9表达

目的观察血小板因子4(PF4)是否通过核因子κB(NF-κB)上调THP-1单核源性巨噬细胞基质金属蛋白酶9(MMP-9)表达。方法佛玻酯诱导THP-1细胞分化成巨噬细胞。巨噬细胞分别在NF-κB抑制剂(PDTC)缺乏或存在情况下与溶媒或PF4(100μg/L)孵育一定时间,RT-PCR检测MMP-9 mRNA水平;同时,巨噬细胞与PF4(25~200μg/L)单独或结合Toll样受体4(TLR4)阻断剂(抗体HTA125,anti-TLR4)孵育,ELISA法检测NF-κB含量。结果 PF4较对照组上调巨噬细胞MMP-9 mRNA水平。而NF-κB抑制剂抑制PF4诱导的巨噬细胞MMP-9表达上调。PF4呈浓度依赖性增加巨噬细胞的NF-κB含量,最大效应浓度为100μg/L。TLR4阻断剂逆转PF4诱导的巨噬细胞NF-κB含量增加。结论 PF4可能通过NF-κB上调巨噬细胞MMP-9的表达。TLR4可能是PF4-NF-κB通路中NF-κB的上游信号分子。     

静脉输注免疫球蛋白对呼吸机相关肺炎疗效的系统评价

目的 系统评价免疫球蛋白(IVIG)治疗呼吸机相关性肺炎(VAP)相关研究,分析其有效性,为临床治疗策略提供依据。方法 系统检索CNKI、万方、CBM、Pubmed、Embase、ISI及Cochrane数据库中相关文献,采用Cochrane标准评价纳入研究偏倚风险,Meta分析结合描述性分析研究数据。结果 ①纳入6个随机对照研究,435例低体质量儿、早产儿及婴儿VAP患者,质量一般。②Meta分析结果显示IVIG组死亡率低于非IVIG组[RR=0.33,95%CI(0.18~0.60),P=0.0002];IVIG组血液免疫球蛋白浓度比对照组高3.19 mg/L [MD=3.19,95%CI(3.02~3.37),P<0.05];③IVIG组败血症[RR=0.14,95%CI(0.04~0.51),P=0.003]和多器官功能衰竭发生率[RR=0.51,95%CI(0.30~0.88),P=0.02]低于对照。结论 IVIG主要用于早产儿及低体质量儿VAP患者,可能提高体液免疫,降低败血症和多器官功能衰竭发生率,减少患者病死率,改善预后。     

Sedentary behavior is associated with chronic obstructive pulmonary disease: A generalized propensity score-weighted analysis

Chronic obstructive pulmonary disease (COPD) is the fourth and third leading cause of death worldwide and in China, respectively. Sedentary behavior has been shown to increase the risk of respiratory disease, such as asthma. However, the relationship between sedentary behavior and COPD is unclear. This study aimed to investigate the association between sedentary behavior and COPD.Data was extracted from the 2018 a large-scale cross-sectional study of Chronic Disease and Lifestyle Population Survey in Sichuan Province of China, in which sedentary behavior and chronic diseases were self-reported according to medical records. The association between sedentary behavior on risk of COPD was estimated using multivariable regression model in non-matching cohorts and generalized propensity score-weighted (GPSW)cohorts, respectively, controlling for potential confounders.Individuals who remained sedentary for more than 7 hours per day were more likely to have COPD than the control group (<3 hours) both in conventional multivariate logistic regression analysis (OR = 2.020, 95%CI: 1.575–2.585, P < .001) and GPSW analysis (OR = 2.381, 95%CI: 1.778–3.188, P < .001). After GPSW and the sensitivity analysis using refined smoking variable further found a dose-effect between sedentary behavior and COPD, with 1.242 (95%CI: 1.006–1.532, P < .05) times risk of COPD in those sedentary behavior of more than 5 hours per day (GPSW) and 1.377 (95%CI: 1.092–1.736, P < .05) times risk in those sedentary behavior above 5 hours per day (sensitivity analysis), comparing with the control group.Sedentary behavior is independently associated with increased risk of COPD, adjusting for other confounders. The findings of this study have important implications for future research and public health guidance. Reducing sedentary time may have a significant role in COPD prevention.     

Fabrication and photocatalytic property of magnetic SrTiO3/NiFe2O4 heterojunction nanocomposites

Novel multifunctional SrTiO₃/NiFe₂O₄ nanocomposites were successfully fabricated via a two-step route. The as-prepared samples were characterized by using X-ray diffraction (XRD), field-emission scanning electron microscopy (FESEM), energy dispersive spectroscopy (EDS), field-emission transmission electron microscopy (TEM), UV-visible diffuse reflectance spectroscopy (DRS), X-ray photoelectron spectroscopy (XPS), photoluminescence (PL) spectroscopy and vibrating sample magnetometry (VSM). The results indicate that the SrTiO₃/NiFe₂O₄ heterostructures are composed of SrTiO₃ spheroidal nanoparticles adhered to NiFe₂O₄ polyhedra. The heterojunction established in the composite material accelerates the process of electron–hole pair separation and boosts the photo-Fenton reaction. Among the samples, 15 wt% SrTiO₃/NiFe₂O₄ nanocomposites exhibit a powerful light response and excellent room temperature ferromagnetism. Subsequently, the photocatalytic degradation of RhB over the as-prepared samples was investigated and optimized, revealing that the 15 wt% SrTiO₃/NiFe₂O₄ nanocomposites exhibit the best photocatalytic activity and stability under simulated solar light irradiation. Furthermore, according to experimental results, the possible mechanism of improved photocatalytic activity was also proposed.

Photocatalytic degradation of RhB for all samples under simulated solar light illumination and absorption spectra of RhB over 15 wt% SrTiO₃/NiFe₂O₄ nanocomposites.     

Superlattice-like structure and enhanced ferroelectric properties of intergrowth Aurivillius oxides

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties. In this work, Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ and Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ compounds were successfully synthetised using a simple solid-state reaction method. X-Ray diffraction patterns and scanning transmission electron microscopy high angle annular dark field (STEM-HAADF) images confirm the 2–3 and the 3–4 intergrowth structures in Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ compounds, respectively. A superlattice-like distortion in these oxides was proposed resulting from the combination of sub-lattices with different a and b parameters, which was validated by XRD refinements and Raman spectra. Polarization-electric field tests and pulsed polarization positive-up negative-down measurements demonstrate that such superlattice-like structures can effectively enhance the intrinsic ferroelectric polarization and coercive field of these oxides, especially when compared with their component oxides Bi₃TiNbO₉, Bi₃LaTiNbFeO₁₂ and Bi₅Ti₃FeO₁₅. Simultaneously, ferroelectric Curie temperatures of Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ oxides are lowered because of the internal stress in the superlattice-like structure. Nevertheless, the paramagnetism of the samples is hardly influenced by their structure, while mainly related to their iron content, in which iron has a similar effective magnetic moment around 3.4–3.9.

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties.     

Desired vancomycin trough concentration to achieve an AUC0‐24/MIC ≥400 in Chinese children with complicated infectious diseases

A vancomycin steady‐state trough concentration (C_min) of 15‐20 mg/L is recommended for achieving a ratio of the 24‐hour area under the curve to the minimum inhibitory concentration (AUC_0‐24/MIC) of ≥400 in adults. Since few paediatric data are available, our objectives were to (a) measure the pharmacokinetic indices of vancomycin and (b) determine the correlation between C_min and AUC_0‐24/MIC in paediatric patients. Population‐based pharmacokinetic modelling was performed for paediatric patients to estimate the individual parameters. The relationship between C_min and the calculated AUC_0‐24/MIC was explored using linear regression and a probabilistic framework. A sensitivity analysis was also conducted using Monte Carlo simulations. Body‐weight significantly influenced the pharmacokinetics of vancomycin. Based on real data and simulations, C_min ranges of 5.0‐5.9 and 9.0‐12.9 mg/L were associated with AUC_0‐24/MIC ≥400 for MIC values of ≤0.5 and ≤1 mg/L, respectively. Vancomycin regimens of 10 and 15 mg/kg every 6 hours achieved a C_min of 5.0‐5.9 mg/L and AUC_0‐24/MIC ≥400 in >90% of the children when MIC was ≤0.5 mg/L. At a MIC of ≤1 mg/L, vancomycin at 15 mg/kg every 6 hours achieved C_min of 9.0‐12.9 mg/L and AUC_0‐24/MIC ≥400 in 2.0‐ and 1.6‐fold as many children compared to a dose of 10 mg/kg every 6 hours, respectively. Vancomycin C_min values of 5.0‐12.9 mg/L were strongly predictive of achieving AUC_0‐24/MIC ≥400, and rational dosing regimens of 10‐15 mg/kg q6h were required in paediatric patients, depending on the pathogen.