纳米活性炭吸附氟尿嘧啶在胃癌荷瘤裸鼠体内释放及抑瘤作用的观察

目的:观察自制的5-氟尿嘧啶(5-FU)-纳米活性炭(ACNP)在胃癌荷瘤裸鼠体内的释放和抑瘤效果。方法:在BALB/c/nu裸鼠腹腔内移植人胃癌细胞系SGC7901,建立转移模型并随机分组。A组:腹腔内注入5-FU;B组:5-FU-AC-NP;C组:纯生理盐水。1)于不同时间点内眦静脉采血,高效液相色谱检测血浆中5-FU浓度;2)观察各组小鼠的存活状况,比较各组腹腔内瘤结节的质量和大小。结果:5-FU-ACNP组与5-FU组比较,前者血中的5-FU吸收、消除半衰期延长,峰浓度减低且变化平稳,P<0.05;裸鼠腹腔内瘤结节较轻、较少,P<0.05,裸鼠的中位存活时间延长,P≤0.01。结论:自制的ACNP结合5-FU经腹腔给药后,药物入血缓慢,血浆中的浓度低,半衰期延长,毒副反应减轻,对裸鼠腹腔移植瘤有较强抑制作用。     

孤啡肽与孕期并发症的交互作用对产后抑郁症影响

目的 探讨血清孤啡肽（orphanin FQ,OFQ）与孕期并发症及其交互作用对产后抑郁症（postpartum depression,PPD）影响。 方法 收集银川市与中卫市两所医院200名待产孕妇,应用酶联免疫分析法（enzyme-linked immuno sorbent assay,ELISA）测定血清OFQ水平,采用自行设计的问卷调查家庭因素及孕期并发症,采用爱丁堡产后抑郁量表（Edinburg postnatal depression scale,EPDS）评估产后42 d抑郁状况。 结果 产后抑郁症组血清OFQ水平48.52（37.56,57.13）pg/ml高于对照组18.37（16.63,25.35）pg/ml,差异有统计学意义（Z=-6.761,P< 0.001）。婆媳关系较差（P=0.014）、有孕期并发症（χ²=6.505,P=0.011）的产妇抑郁检出率高。非条件Logistic回归分析模型分析显示,血清OFQ（OR=21.464,95% CI：6.859~67.167,P< 0.001）与孕期并发症（OR=3.600,95% CI：1.013~12.794,P=0.048）为PPD的危险因素,交互作用模型分析显示血清OFQ与孕期并发症之间存在交互作用（OR=2.229,P=0.021）。 结论 血清OFQ与孕期并发症是PPD的危险因素,两者同时存在时可增加PPD发生的危险性。     

超声成像在急性下肢深静脉血栓机械性清除治疗中应用价值

目的 探讨超声在急性下肢深静脉血栓(DVT)机械性血栓清除(PMT)治疗中应用的有效性和安全性。方法 132例急性期DVT患者置入滤器后分为82例超声组和50例造影组进行PMT及导管溶栓治疗,术后评估并比较两组静脉通畅情况、患肢周径差、血生化指标、手术时间、并发症及疗效随访。结果 超声组、造影组术后静脉通畅率较高,分别为82%、77.7%,术后两组静脉通畅情况组间对比差异均无统计学意义( P均＞0.05) 。平均手术时间超声组(1.08±0.32h)少于造影组(2.36±0.25h)(P=0.000)。并发症发生率超声组(12.2%)低于造影组(26%)(P=0.016)。术后血红蛋白含量超声组(125.66±15.48g/L)高于造影组(91.53±11.73g/L)(P=0.004)。两组术后患肢周径差、D-二聚体浓度、Villalta评分及VEINES-QOL评分组间对比差异均无统计学意义( P均＞0.05)。 结论 超声监测对急性DVT行PMT治疗安全有效,与传统静脉造影模式相比具有无辐射、手术时间短及并发症低的优点。     

白藜芦醇保护缺血再灌注大鼠心肌作用与miR-21的相关性

目的 观察白藜芦醇预处理后大鼠心肌微小RNA(miRNA)的表达变化,分析白藜芦醇介导的心肌保护作用与miR-21之间有否关系.方法 通过miRNA芯片微阵列方法和qRT-PCR检测并验证白藜芦醇灌胃预处理后的大鼠心肌miRNA表达谱；建立大鼠心肌缺血再灌注损伤模型,检测各组心肌梗死面积、心肌细胞凋亡率以及miR-21的表达水平.结果 白藜芦醇预处理后,大鼠心肌的miR-21表达水平约为对照组的2.5倍;miR-21阻逼剂对白藜芦醇预处理引起的miR-21高表达产生了明显的抑制作用；过表达的miR-21显著降低了心肌细胞凋亡率,心肌组织梗死面积明显缩小.结论 白藜芦醇可以调控心肌多种miRNA的表达水平,通过促进miR-21的表达,白藜芦醇能够抑制心肌细胞的凋亡,从而减轻缺血再灌注对心肌的损伤.     

Percutaneous ultrasound and endoscopic ultrasound-guided biopsy of solid pancreatic lesions: An analysis of 1074 lesions

Backgrounds: Percutaneous ultrasound (US) and endoscopic ultrasound (EUS)-guided pancreatic biopsies are widely accepted in the diagnosis of pancreatic diseases. Studies comparing the diagnostic performance of US- and EUS-guided pancreatic biopsies are lacking. This study aimed to evaluate and compare the diagnostic yields of US- and EUS-guided pancreatic biopsies and identify the risk factors for inconclusive biopsies. Methods: Of the 1074 solid pancreatic lesions diagnosed from January 2017 to February 2021 in our center, 275 underwent EUS-guided fine needle aspiration (EUS-FNA), and 799 underwent US-guided core needle biopsy (US-CNB/FNA). The outcomes were inconclusive pathological biopsy, diagnostic accuracy and the need for repeat biopsy. All of the included factors and diagnostic performances of both US-CNB/FNA and EUS-FNA were compared, and the independent predictors for the study outcomes were identified. Results: The diagnostic accuracy was 89.8% for EUS-FNA and 95.2% for US-CNB/FNA ( P = 0.001). Biopsy under EUS guidance [odds ratio (OR) = 1.808, 95% confidence interval (CI): 1.083-3.019; P = 0.024], lesion size < 2 cm (OR = 2.069, 95% CI: 1.145-3.737; P = 0.016), hypoechoic appearance (OR = 0.274, 95% CI: 0.097-0.775; P = 0.015) and non-pancreatic ductal adenocarcinoma carcinoma (PDAC) diagnosis (OR = 2.637, 95% CI: 1.563-4.449; P < 0.001) were identified as factors associated with inconclusive pathological biopsy. Hypoechoic appearance (OR = 0.236, 95% CI: 0.064-0.869; P = 0.030), lesions in the uncinate process of the pancreas (OR = 3.506, 95% CI: 1.831-6.713; P < 0.001) and non-PDAC diagnosis (OR = 2.622, 95% CI: 1.278-5.377; P = 0.009) were independent predictors for repeat biopsy. Biopsy under EUS guidance (OR = 2.024, 95% CI: 1.195-3.429; P = 0.009), lesions in the uncinate process of the pancreas (OR = 1.776, 95% CI: 1.014-3.108; P = 0.044) and hypoechoic appearance (OR = 0.127, 95% CI: 0.047-0.347; P < 0.001) were associated with diagnostic accuracy. Conclusions: Both percutaneous US- and EUS-guided biopsies of solid pancreatic lesions are safe and effective; though the diagnostic accuracy of EUS-FNA is inferior to US-CNB/FNA. A tailored pancreatic biopsy should be considered a part of the management algorithm for the diagnosis of solid pancreatic disease.