老龄大鼠膀胱生理特性改变的实验研究

目的:探讨老龄大鼠膀胱生理特性的改变及其可能机制.方法:雌性Wistar大鼠分为年轻成年组(6月龄)和老龄组(24月龄),通过在体充盈期膀胱测压,判定逼尿肌不稳定的发生率,比较两组最大膀胱容量和漏尿点压的差异;在水浴条件下,分别测量两组新鲜逼尿肌条的自发收缩频率、应力作用下的反应张力、对电刺激的反应强度等指标,并对实验结果进行统计学分析.结果:与年轻成年组相比,老龄大鼠表现为更易出现逼尿肌不稳定;麻醉条件下最大膀胱容量显著增加(P＜0.01),漏尿点压无明显差异;自发收缩频率显著增高(P＜0.05).老龄大鼠逼尿肌条在应力增加时,张力上升缓慢;应力降低时,张力下降迅速.应力改变时电刺激诱发收缩表现为与单纯应力改变时的张力改变相似,张力增加值在两组间元差异.结论:老龄膀胱功能的改变与自身逼尿肌兴奋性增加、高顺应性、弹性降低有关,肌源性改变是其主要因素.     

Different classes of antibiotics exhibit disparate negative impacts on the therapeutic efficacy of immune checkpoint inhibitors in advanced non-small cell lung cancer patients

It has been reported that antibiotics (ATBs) have adverse effect on the efficacy of treatment with immune checkpoint inhibitors (ICIs) in cancer patients. Since different classes of ATBs have different antibacterial spectrum, we aimed to study whether all ATBs had similar or different negative effects on the clinical outcomes of ICIs in patients with advanced non-small cell lung cancer (NSCLC). Patients with advanced NSCLC who received ICIs were included in this retrospective study and grouped by the class of ATBs they had used around the ICIs treatment time. The overall survival (OS) and the progression free survival (PFS) of patients among these groups were compared using Kaplan-Meier method and Cox proportional hazards model. A total of 148 eligible patients were enrolled, and 80 patients used ATBs. The results indicated that quinolones had no significant negative consequence on the clinical outcomes, while β-lactams significantly shortened the OS and PFS of patients. Furthermore, patients exposed to the combination of β-lactams and quinolones suffered the worst OS and PFS. Moreover, the subgroup analysis of β-lactams revealed that only penicillins, but not carbapenems and cephalosporins, markedly reduced both OS and PFS. In addition to the class of ATBs used, the time frame of ATBs used also affected the clinical outcomes of ICIs therapy. Patients receiving ATBs within 60 days prior to and 30 days after the initiation of ICI treatment had significantly shorter OS and PFS compared with those who did not use ATBs. This study demonstrated that different classes of ATBs had disparate negative impacts on the clinical outcomes, and the use of β-lactams, especially penicillins, should be avoided in advanced NSCLC patients who are receiving or scheduled to receive ICIs within 60 days.     

利用微信公众号宣传平台提升门诊服务质量的实践探讨

为深入贯彻落实"互联网+医疗健康"便民惠民活动,不断优化门诊服务流程,提高服务效率与质量,门诊管理者积极探索,创新服务模式,以微信公众号建设为突破口,主动宣传国家医改新政策,落实分级诊疗,提升服务水平。通过线上服务模式,加强与患者的沟通,提供贯穿诊前、诊中、诊后全流程的信息化便民服务,有效缓解了门诊"三长一短"的现象,实现了患者有序就医,患者满意度提高。尤其在疫情防控期间,对于减少人员聚集、保障就医安全等方面起到了积极的作用。     

Two important factors affecting the prognosis of patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma

ObjectiveTo investigate the effects of hand–foot syndrome (HFS) and fatigue on disease progression and survival in patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma.MethodsA retrospective analysis of patients with advanced hepatocellular carcinoma treated with sorafenib in our hospital from 1 October 2018 to 31 October 2021 was performed, and clinical and pathological data and follow-up results were obtained. Patients were divided into groups according to the severity of HFS and fatigue. Survival analysis among the groups was performed using the Kaplan–Meier method, continuous variables were analyzed using the t-test, and factors associated with survival were evaluated using multivariate Cox regression analysis.ResultsThe study included 150 men and 23 women with a mean age of 60.77 years (range: 40–85 years). The median overall survival (OS), progression-free survival (PFS), and time to tumor progression (TTP) increased with increasing severity of HFS. Conversely, the median OS, PFS, and TTP decreased with increasing severity of fatigueConclusionHFS and fatigue were independent risk factors affecting TTP, PFS, and OS among patients treated with sorafenib followed by regorafenib for advanced hepatocellular carcinoma.     

基于转录组学膀胱癌临床预后模型的构建

目的：筛选膀胱癌预后相关基因，建立膀胱癌预后评分模型。方法：通过UCSC Xena平台下载癌症基因组图谱（TCGA）数据库、基因型和基因表达量关联数据库（GTEx）中406例膀胱癌患者的临床信息和膀胱癌组织RNA测序数据，以及28名健康对照者正常膀胱组织RNA测序数据。采用加权基因共表达网络分析（WGCNA）、单因素Cox回归分析、LASSO回归分析和多因素Cox回归分析筛选膀胱癌预后相关基因并建立预后模型，结合Kaplan-Meier生存曲线、受试者操作特征曲线（ROC曲线）验证模型的准确性。结果：分析得到膀胱癌相关差异表达基因共2308个。WGCNA拟合得到6个基因模块，筛选出对膀胱癌预后有显著作用的基因829个。运用单因素Cox回归与LASSO回归分析筛选出24个与膀胱癌患者预后相关的基因，多因素Cox回归分析训练集数据得到9个作为独立预测因子的基因，分别是 ADCY9、 MAFG_DT、 EMP1、 CAST、 PCOLCE2、 LTBP1、 CSPG4、 NXPH4、 SLC1A6，以此建立膀胱癌患者预后预测模型。训练集中高风险组和低风险组3年存活率分别为31.814%和59.821%，测试集中高风险组和低风险组3年存活率分别为32.745%和68.932%，模型预测训练集和测试集患者预后的ROC曲线下面积均在0.7以上。 结论：本研究建立的模型对膀胱癌高风险和低风险人群的生存情况具有较好的预测能力。     

Supplement to the published paper "Theory-guided interventions for Chinese patients to adapt to heart failure:A quasi-experimental study"

We appreciate the question raised in a discussion with a reader and the editor about an instrument for outcome measure of the quality of life among people with ...     

四种补肾中药对去卵巢大鼠骨质疏松骨形态的作用

目的 比较骨碎补、锁阳、淫羊藿和狗脊４种补肾中药对去卵巢（ＯＶＸ）大鼠骨质疏松的作用。方法 将５４只３月龄雌性Ｗｉｓｔａｒ大鼠随机分成模型组和中药治疗组。模型组包括非手术组、假手术组和去卵巢组,每组１０只;中药组包括骨碎补组、锁阳组、淫羊藿组和狗脊组,每组６只。去卵巢手术后１周,中药组分别用上述４种中药喂养,８周后放血外死全部小鼠,用骨形态主坦学方法比较４种中药对ＯＶＸ大鼠骨质疏松的防治作用。结果     

Intimate partner violence (IPV) and preeclampsia among Peruvian women

OBJECTIVE: Mounting evidence supports the view that intimate partner violence (IPV) is an important cause of maternal mortality. Some, but not all, prior studies suggest that IPV is associated with increased risks of maternal medical conditions such as hypertensive disorders of pregnancy which are leading causes of maternal mortality worldwide. We assessed the relation between IPV and risk of preeclampsia among Peruvian women. STUDY DESIGN: We conducted a case-control study at two large hospitals in Lima, Peru. Preeclampsia cases were 339 women with pregnancy-induced hypertension and proteinuria (i.e., preeclampsia). Controls were 337 normotensive women. Information concerning women's exposure to physical and emotional violence during pregnancy was collected during in-person interviews conducted after delivery and while patients were in hospital. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from logistic regression models. RESULTS: The prevalence of IPV was 43.1% among cases and 24.3% among controls. Compared with those reporting never exposure to IPV during pregnancy, women reporting any exposure had a 2.4-fold increased risk of preeclampsia (OR=2.4; 95% CI: 1.7-3.3). The association was strengthened slightly after adjusting for maternal age, parity and pre-pregnancy adiposity (OR=2.7; 95% CI: 1.9-3.9). Emotional abuse in the absence of physical violence was associated with a 3.2-fold (95% CI: 2.1-4.9) increased risk of preeclampsia. Emotional and physical abuse during pregnancy was associated with a 1.9-fold increased risk of preeclampsia (95% CI: 1.1-3.5). CONCLUSIONS: IPV among pregnant women is common and is associated with an increased risk of preeclampsia. These data support recent calls for coordinated global health efforts to prevent violence against women.