Frequency of collateral blood flow in the infarct-related coronary artery in rupture of the ventricular septum after acute myocardial infarction

Patients with postinfarction ventricular septal rupture have poor residual or collateral blood flow in the infarct artery and do not benefit from ischemic preconditioning. This suggests that rupture of the ventricular septum occurs on an unprotected and unprepared myocardium.     

广西微小按蚊卵巢营养细胞多线染色体的观察

对广西微小按蚊卵巢营养细胞多线染色体进行观察并绘制了模式图。染色体由5臂组成,X染色体最短,具端着丝粒:Ⅱ号染色体最长,具亚中着丝粒;Ⅲ号染色体具中着丝粒。主要特征区有6区,7A、B,19C,20区,28A,30A、B,37D,38A、B,46D。观察700多张标本,染色体全部呈纯合状态。采用卵巢营养细胞制备的多线染色体带型清晰,伸展良好,染色体的两臂往往相连,易于确定臂间关系。     

Diagnosis and surgical treatments of hepatocellular carcinoma with tumor thrombosis in bile duct： Experience of 34 patients

AIM: Hepatocellular carcinoma (HCC) with bile duct tumor thrombosis (BDT) is a rare event. The prognosis of this type of patients is very dismal. The aim of this study was to share the experience in the diagnosis and treatment of HCC with BDT, to further improve the prognosis of these patients.METHODS: Thirty-four patients of HCC with BDT received surgical treatment in authors‘ institute from July 1987 to January 2003 were reviewed retrospectively. The experience in the diagnosis and treatment, and the outcome of this type of HCC patients were summarized.RESULTS: Thirty of the 34 patients (88.2%) were positive for alpha-fetoprotein (AFP) (>20 μg/L), and 12 patients (35.3%) were found having obstructive jaundice before operation, 18 cases were suspected of “obstruction of bile duct“ preoperatively. The primary tumors were frequently located at the left medial (13 cases) or right anterior lobe(14 cases). Thirty-one patients received liver resections and removal of BDT, while the other 3 patients received removal of BDT combined with hepatic artery ligation and cannulation(HAL+HAI), or only removal of BDT because their liver function reservation and general condition could not tolerate the primary tumor resection. The 1-year survival rate was 71.4%(20/28). The longest disease-free survival was over 15 years. The intrahepatic tumor recurrence within 1 year after operation was found in 14 patients (14/28, 50.0%).CONCLUSION: Surgical removal of primary tumors and BDT is safe and beneficial to the HCC patients with BDT. Early detection, diagnosis, and surgical treatment are the key points to prolong the survival time of patients.     

在娱乐场所服务小姐中开展艾滋病预防干预试点研究

目的 了解娱乐场所服务小姐中艾滋病的有关知识、态度和行为,探索在该人群中开展预防艾滋病宣传教育的措施和评价方法。方法 采用快速评估,现场访谈和咨询、免费发放艾滋病预防宣传折页、安全套和同伴教育等方法进行干预,运用问卷调查和定性访谈方法评价干预效果。结果 基线调查124名服务小姐,干预后调查135名,干预后性病和艾滋病预防知识知晓率等均有显著性提高,但态度及行为干预前后无显著性差异。85.0％的人愿意使用安全套,但实际只有42.1％的人每次都使用安全套。结论 干预活动中不仅要提供性病艾滋病的防治知识,还要提供改变高危行为的技能。定性访谈资料可信性较高,可做为定量资料的补充和评价,但如何把定量与定性资料有机的结合起来还有待进一步探讨。     

Lentiviral-mediated miRNA against osteopontin suppresses tumor growth and metastasis of human hepatocellular carcinoma

In our previous study, osteopontin (OPN) was identified as one of the leading genes that promote the metastasis of hepatocellular carcinoma (HCC). However, the mechanism by which OPN promotes metastasis of HCC is not understood. In this study, RNA interference mediated by viral vectors-which could induce a long-lasting down-regulation in gene expression-was applied to analyze the role of OPN in metastasis of HCC. Three lentiviral vectors encoding microRNA against OPN, Lenti.OPNi-1, Lenti.OPNi-2, and Lenti.OPNi-3, were constructed and found to down-regulate the OPN level by 62%, 78%, and 95%, respectively, in HCCLM3 cells which had an overexpression of OPN and a higher metastatic potential. Consequently, both Lenti.OPNi-2 and Lenti.OPNi-3 induced a significant decrease in matrix metalloproteinase (MMP)-2 and urokinase plasminogen activator expression, and led to an obvious inhibition of both in vitro invasion and in vivo lung metastasis of HCCLM3 cells (P < 0.001). Moreover, Lenti.OPNi-3, rather than Lenti.OPNi-2, could also suppress in vitro proliferation and in vivo tumor growth of HCCLM3. Smaller detectable tumors were found in only 50% of mice after implantation of Lenti.OPNi-3-transfected HCCLM3 cells (341 +/- 502.6 mm(3) versus >3500 mm(3) in controls; P < 0.001). Lenti.OPNi-3, not Lenti.OPNi-2, significantly suppressed the MEK/ERK1/2 pathway in HCCLM3 cells. Recombinant OPN was found to induce translocation of p65 into the nucleus of HCC cells and activation of MMP-2 and MEK/ERK/1/2, which were suppressed by the nuclear factor kappaB (NF-kappaB) inhibitor pyrrolidine dithiocarbamate. Conclusion: OPN plays an important role in metastasis as well as tumor growth of HCC, in which different minimum threshold levels of OPN are needed. These effects may occur through activation of the mitogen-activated protein kinase and NF-kappaB pathways, and MMP-2. OPN could be a hopeful target for the control of HCC.     

糖尿病足溃疡病原菌分布及耐药性分析

目的分析糖尿病足溃疡病原菌分布及耐药性。方法选择2015年12月-2019年1月于青岛大学医学院附属威海医院/威海市立第二医院治疗的糖尿病足溃疡患者200例,对溃疡部位的分泌物进行分离,测定其菌株及耐药性。结果 200例患者中培养出病原菌株的患者180例,培养出菌株215株,其中革兰阳性球菌120株,革兰阴性杆菌76株,真菌19株;对培养出的菌株进行耐药性分析,革兰阳性球菌及革兰阴性杆菌对头孢类抗菌药物、阿莫西林、四环素等有一定耐药性,对莫西沙星、庆大霉素的敏感性较好。结论糖尿病足溃疡病原菌以革兰阳性球菌为主,且具有一定的耐药性,临床应配合耐药性监测结果选择抗生素治疗。     

药师对本院中成药重复使用的干预效果

目的:探讨药师干预对中成药重复使用的效果,促进中成药的合理使用。方法:选取我院2018年6—12月使用中成药的患者299例为对照组,2019年1—6月使用中成药的患者301例为干预组。对照组采用常规的处方点评,干预组通过完善中成药重复用药点评细则、规范培训点评中药师、加大临床监测力度和中成药合理用药宣教等药学干预手段进行点评,对比干预前后中成药重复使用率。结果:与对照组比较,干预后我院中成药重复使用率由干预前46.15%(138/299)下降至13.95%(42/301),差异有统计学意义(P<0.05);干预前本院中成药重复使用排名前10位的组合中,9组的重复使用率在药师干预后明显下降,仅参芪扶正注射液和复方黄芪益气口服液组合的重复使用率由干预前的1.34%(4/299)上升至3.99%(12/301)。结论:药师干预有效降低我院中成药的重复使用率,促进中成药的合理使用,但仍存在重复用药情况,还需干预。     

miR‐30b‐5p up‐regulation related to the dismal prognosis for patients with renal cell cancer

The diagnosis of renal cell carcinoma (RCC) is often made late since there is no early symptom, which thus results in dismal patient prognosis. As a result, new biomarkers are urgently needed and efforts should be made to identify their functions in predicting RCC prognosis. microRNAs (miRNAs) are a class of small noncoding RNAs that are about 20‐22 nucleotides in length, and they have been demonstrated to function as prognostic markers in numerous tumors. This study aimed to assess the role of miR‐30b‐5p in predicting the prognosis of RCC postoperatively. In this study, RNA was extracted from 284 formalin‐fixed and paraffin‐embedded kidney cancer tissue samples. After cDNA synthesis, real‐time quantitative PCR (RT‐qPCR) was adopted for detecting the relative miR‐30b‐5p level. Then, the Kaplan‐Meier method, Cox regression analysis, and the receiver operating characteristic curve analysis were applied in analyzing the miR‐30b‐5p effect on the prognosis for patients. Our findings indicated that, following adjustment for age, gender, tumor stage, and tumor size, patients with low miR‐30b‐5p expression had remarkably longer overall survival. Thus, the miR‐30b‐5p level might be related to RCC prognosis.     

Ferritin as a key risk factor for nonalcoholic fatty liver disease in children with obesity

BackgroundThe association between serum ferritin and nonalcoholic fatty liver disease (NAFLD) in children with obesity is not clear. This study was designed to investigate whether serum ferritin can be an independent predictor for NAFLD.MethodsAccording to the hepatic ultrasound results, a total of 347 children with obesity were enrolled in this study. Among them, 95 patients with NAFLD and 95 without NAFLD were matched for gender, age, blood pressure and body mass index, the odds ratios (OR) and 95% confidence intervals (CI) for the association of ferritin and the risk of NAFLD were analyzed.ResultsAfter propensity score matching, ferritin values of the patients with NAFLD were significantly higher than those without NAFLD group. Alanine aminotransferase and ferritin were strongly associated with NAFLD in multivariate stepwise logistic regression analysis. The medium and high levels of ferritin increased risk of NAFLD, and the adjusted ORs were 3.298 (95% CI:1.326‐8.204), 7.322 (95% CI:2.725‐19.574) across the ferritin concentration tertiles after adjustment for confounders. Ferritin was shown to be the best predictor for NAFLD with sensitivity and specificity of 60.0% and 77.9%, respectively, area under the curve was 0.733.ConclusionThe results show that serum ferritin can usefully be considered as a predictor of NAFLD in children with obesity.