患者肿瘤组织来源的胶质母细胞瘤类器官的制备方法

目的：探讨胶质母细胞瘤（GBM）患者肿瘤组织来源的GBM类器官（GBO）模型的制备方法。方法：选取2021年广东三九脑科医院新诊断经病理确诊的8例GBM患者的新鲜肿瘤组织标本,将其剪成0.5～1 mm大小的组织碎片并用特制的培养基进行培养,待其成球且直径达到1 mm时剪小传代,同时选取培养2周以上的GBO进行石蜡包埋、切片,后进行H-E染色和免疫组化染色检测,并与亲本GBM组织进行组织学与细胞学的比较。结果：成功培养2例可传代冻存的GBO,并建立GBO生物库。H-E染色结果显示,GBO保留了与亲本GBM组织相似的组织结构和细胞形态;免疫组化实验结果显示,GBO与GBM组织中GFAP、OLIG2、Ki67和ATRX分子的表达情况一致。结论：将患者来源的GBM组织在体外剪小并用特制培养基培养,可构建与GBM患者肿瘤组织在组织和细胞层面一致的GBO。     

The Effect of Enteral Immunonutrition in the Intensive Care Unit: Does It Impact on Outcomes?

Background: The present research aimed to evaluate the effect on outcomes of immunonutrition (IMN) enteral formulas during the intensive care unit (ICU) stay. Methods: A multicenter prospective observational study was performed. Patient characteristics, disease severity, nutritional status, type of nutritional therapy and outcomes, and laboratory parameters were collected in a database. Statistical differences were analyzed according to the administration of IMN or other types of enteral formulas. Results: In total, 406 patients were included in the analysis, of whom 15.02% (61) received IMN. Univariate analysis showed that patients treated with IMN formulas received higher mean caloric and protein intake, and better 28-day survival (85.2% vs. 73.3%; p = 0.014. Unadjusted Hazard Ratio (HR): 0.15; 95% CI (Confidence Interval): 0.06–0.36; p < 0.001). Once adjusted for confounding factors, multivariate analysis showed a lower need for vasopressor support (OR: 0.49; 95% CI: 0.26–0.91; p = 0.023) and continuous renal replacement therapies (OR: 0.13; 95% CI: 0.01–0.65; p = 0.049) in those patients who received IMN formulas, independently of the severity of the disease. IMN use was also associated with higher protein intake during the administration of nutritional therapy (OR: 6.23; 95% CI: 2.59–15.54; p < 0.001), regardless of the type of patient. No differences were found in the laboratory parameters, except for a trend toward lower triglyceride levels (HR: 0.97; 95% CI: 0.95–0.99; p = 0.045). Conclusion: The use of IMN formulas may be associated with better outcomes (i.e., lower need for vasopressors and continuous renal replacement), together with a trend toward higher protein enteral delivery during the ICU stay. These findings may ultimately be related to their modulating effect on the inflammatory response in the critically ill. NCT Registry: 03634943.     

Experimental Study on Self-Centering Performance of the SMA Fiber Reinforced ECC Composite Beam

The combination of superelastic shape memory alloy fibers and ECC materials can form a new SMA fiber reinforced ECC composite material (SMAF-ECC) with good self-centering performance. In order to study the self-centering performance of the new composite material, 6 groups of pre-notch beam specimens were made for three-point bending cyclic loading tests, and the failure phenomenon, hysteresis curve, self-centering effect and influencing factors of the specimens were analyzed. The research results show that when the SMA fibers are effectively anchored in the ECC matrix, the SMA fibers can exert the superelastic properties to provide the ECC beams with recoverying force, and realize the crack self-closure and deflection self-recovery function for the beams, with the minimum residual crack width and deflection is only 0.9 mm and 1.3 mm respectively. Increasing fiber content can cause a small increase in the self-centering ability of the beams. However, only when the fiber diameter is appropriate, better self-centering effect can be achieved, but the difference caused by fiber diameter in the test was only 5%. SMA Fiber end forms have significant influence on self-centering performance. The knotted end beam can get a more than 70% self-centering ratio, while the straight end beams and bended end beams have no self-centering ability. The research results provide important reference for the research and application of this new self-centering materials and their structures.     

胃癌组织中OPN和MMP-2蛋白的表达及意义

目的 探讨骨桥蛋白（osteopontin,OPN）和基质金属蛋白酶-2（maXtrix metalloproteinase-2,MMP-2）在胃癌侵袭转移中的作用.方法 应用免疫组织化学sp方法检测80例胃癌组织中OPN和MMP-2的表达.结果 80例胃癌组织中OPN和MMP-2表达的阳性率分别为80%（64/80）和75%（60/80）,OPN和MMP-2的表达均与胃癌病理进展程度、组织学分化程度、临床分期、淋巴结转移相关.结论 OPN高表达可能对肿瘤的浸润、转移有促进作用,OPN与MMP-2的表达在胃癌的进展中可能起协同作用.     

危重病人院内安全转运探讨

目的 探讨危重病人院内安全转运的管理措施,提高抢救成功率,减少并发症发生.方法 回顾性分析307例危重病人院内转运、检查、治疗过程中出现的并发症,并提出安全转运管理措施.结果 307例患者安全转运306例,转运成功率为99.67%.途中出现与转运有关的并发症25例(8.14%),经相应抢救处理后,病情稳定,成功转运24...     

早产胎膜早破的影响因素分析

目的探讨早产胎膜早破的影响因素,为预防早产提供理论基础。方法采用病例对照的方法,研究影响早产胎膜早破的因素。结果在孕期增重上正常足月组明显高于早产胎膜早破组（P〈0．05）。在早产胎膜早破组和正常足月组中,无系统产检（OR=2．29,95％CI：1．02～5．14）、无吸烟或被动吸烟（OR=0．43,95％CI：0．19～0．98）、人工流产（OR=3．30,95％CI：1．44～7．59）、绒毛膜羊膜炎（OR=4．12,95％CI：1．06—16．05）、孕期阴道流血史（OR=9．60,95％CI：1．15～80．04）是影响早产胎膜早破的独立性因素。结论为预防早产,提高孕产妇和围产儿的健康水平,需要对影响早产胎膜早破的因素进行干预。     

复方调脂胶囊辅助治疗肾病综合征40例疗效观察

目的:观察复方调脂胶囊辅助治疗肾病综合征的临床疗效。方法:79例病例随机分为两组,其中对照组39例,治疗组40例。所有病例均按原发性肾病综合征的措施治疗,治疗组在此基础上加用复方调脂胶囊口服,观察两组病例治疗后的疗效。结果:两组病例治疗后总有效率比较差异有统计学意义(P0.05);治疗组血脂水平与治疗前比较,差异有统计学意义(P0.05,P0.01)。结论:复方调脂胶囊能有效降低血脂,对提高肾病综合征的治疗有积极意义。     

阻塞性睡眠呼吸暂停低通气综合征与心血管结构改变关系分析

目的:通过超声心动图及血管彩色多普勒观察阻塞性睡眠呼吸暂停综合征(OSAHS)患者心脏及血管结构的改变情况,探讨OSAHS严重程度对心血管结构的影响。方法:将经多导睡眠图检测的100例受试对象,根据呼吸暂停低通气指数分为对照组40例、OSAHS轻中度组40例、OSAHS重度组20例,应用超声心动图及血管彩色多普勒超声显像仪观察心脏结构及颈动脉内膜中层厚度。结果:OSAHS组室间隔厚度、左心室舒张期内径(LVDd)、舒张末期左心室后壁厚度(LVPWTD)、左心房内径(LAD)、主动脉内径、主动脉血流速度、颈动脉内膜中层厚度比对照组增大(P<0.05),且LVDd、LVPWTD、LAD的增大与OSAHS的严重程度相关(P<0.05)。重度OSAHS组左心室射血分数较对照组下降(P<0.05),轻中度组下降不明显。结论:OSAHS导致心脏及血管内膜的结构改变,随着OSAHS的程度加重心脏及血管内膜结构改变加重,超声心动图及血管彩色多普勒超声检查可作为治疗OSAHS疗效的观察方法。