结核病患者外周血γ干扰素释放试验假阴性的相关因素分析

目的 分析影响结核病患者外周血γ干扰素释放试验(interferon-gamma release assay,IGRA)检测假阴性的影响因素。方法 回顾性分析2018年1月至2020年3月解放军总医院第八医学中心结核四科收治的资料完整、外周血IGRA检测阴性和阳性的结核病患者,分别作为IGRA假阴性组(38例)和IGRA阳性组(119例),收集其一般情况、病史特点、血清生化指标和外周血淋巴细胞亚群,采用单因素和多因素logistic回归分析导致IGRA检测结果假阴性的影响因素。结果 IGRA假阴性组淋巴细胞计数、T细胞计数、CD4⁺T细胞计数、CD8⁺T细胞计数、NKT细胞计数M(Q₁,Q₃)分别为1.15(0.77,1.58)×10⁹个/L、867.50(508.75,1135.50)个/μl、493.00(256.00,673.75)个/μl、254.50(170.25,429.25)个/μl、38.50(16.50,88.25)个/μl,均明显低于IGRA阳性组[分别为1.46(0.99,1.88)×10⁹个/L、1013.00(667.00,1394.00)个/μl、590.00(386.00,850.00)个/μl、335.00(232.00,561.00)个/μl、57.00(30.00,121.00)个/μl,差异均有统计学意义(Z值分别为-2.512、-2.143、-2.092、-2.303、-2.338,P值分别为0.012、0.032、0.036、0.021、0.019)。logistic回归分析结果显示,NKT细胞计数低于正常值(<40个/μl)的患者,IGRA检测出现假阴性的风险是NKT细胞计数正常者的2.440倍(95%CI:1.159~5.134)。结论 NKT细胞计数的减少可能导致外周血IGRA出现假阴性。     

甲磺酸阿帕替尼片用于标准治疗失败后卵巢癌治疗的有效性和安全性

目的:观察甲磺酸阿帕替尼用于标准治疗失败后卵巢癌的有效性和安全性，为多线耐药的卵巢癌患者提供一种治疗方式。方法:选取2015年6月至2018年3月二线及二线后化疗失败的晚期卵巢癌患者26例，口服甲磺酸阿帕替尼后观察疗效及毒副反应。结果:1例患者CR，17例患者PR,2例患者SD,6例患者PD，客观有效率69%，疾病控制率77%，中位PFS达4.3个月。患者总体耐受性良好，常见的不良反应为1-3级的胃肠道反应，包括腹痛、恶心及呕吐，其中以腹痛最为常见。结论:对于经标准治疗失败后的晚期卵巢癌患者，阿帕替尼具有良好的疗效和安全性。     

NLRP3炎性小体在蛛网膜下腔出血中的研究进展

蛛网膜下腔出血（SAH）是一种急性脑血管疾病，近年来炎性反应被认为在SAH及其并发 症中起着重要作用，而NLRP3 炎性小体在炎性反应中起关键作用，但其具体作用机制有待进一步阐明。 现针对NLRP3 炎性小体在SAH中的作用及相关研究作一综述，旨在为SAH的临床研究和治疗策略提供 相关线索。     

职业病网络报告系统用户权限管理现状及对策

目的分析职业病网络报告系统用户权限管理现状和问题,为进一步加强权限管理提出建议。方法将截至2018年4月底在"中国疾病预防控制信息系统"的用户身份认证管理系统——"用户认证与授权管理系统"注册的、与职业病网络报告工作相关的系统管理员、业务管理员、本级用户、直报用户,使用SPSS 23.0软件对数据进行处理,对用户分布、用户所在机构设置的用户数、用户权限情况等进行分析。结果职业病与职业卫生信息监测系统共有各级各类用户35 144个,其中直报用户最多(24 788个,占70.53%),业务管理员用户最少(2 138个,占6.08%)。直报用户均设为县区级,绝大部分分布在卫生院(11 208个,占45.22%)和医院(8 435个,占34.03%),88.74%的直报机构仅有1个直报账户,3.06%的直报机构有3个及以上直报账户,个别机构直报用户数甚至超过10个。本级用户分布在3 140家职业病报告业务管理机构中,个别地市级和县区级职业病业务管理机构具有5个以上的本级用户。各类机构中大部分用户设置的角色数在5个以内;有15 022个(占60.60%)直报用户使用了"所有报告卡直报角色",主要分布在卫生院。存在的主要问题:基层尤其是县区级职业病防治机构、职业病报告业务管理机构能力不足;部分基层机构用户数设置过多;部分用户权限设置不合理,业务管理员管理欠规范。结论加强基层职业病报告业务管理机构的能力,进一步规范各级各类机构用户和权限管理,业务管理员严格授权,国家出台细化的用户和权限管理规范等措施来进一步加强权限管理工作。     

Growth‐promoting effects of low‐level butyl benzyl phthalate exposure on human neuroblastoma SH‐SY5Y cells

The purpose of present study was to investigate the impact of butyl benzyl phthalate (BBP) on SH‐SY5Y neuroblastoma cells in vitro. The cell counting kit‐8 was used to measure cell proliferation and flow cytometry was utilized to study cell cycle phases and apoptosis. Western blotting and quantitative real‐time polymerase chain reaction were used to detect levels of aromatase, estrogen receptors (ERs) and some apoptosis and cell cycle‐related genes. Results showed BBP‐stimulated SH‐SY5Y cells in a dose‐dependent manner and produced a reverted U‐shaped dose‐response curve. BBP at lower concentrations (0.01 and 0.1 μm ) significantly induced cell proliferation while inhibited cell growth at 300 μm . The promoting effect of estradiol could be entirely blocked by administration of ICI182 780, a pure antagonist of ERs, while the effect of BBP could be partly blocked. Additionally, we confirmed 0.1 μm BBP‐induced cell proliferation caused the arrest of cells in S phase and inhibited apoptosis, which might be partially explained by the decreased expression of p53, the increased expression of proliferating cell nuclear antigen, Bcl‐2 and cell cycle regulator cyclin‐D1, and the activation of aromatase. The addition of ICI182 780 had no effect on BBP‐induced ERβ mRNA expression, whereas ICI182 780 could effectively counteract the effect of estradiol. Moreover, pretreatment with ICI182 780 could block the induction of aromatase protein expression and activity by BBP, showing an involvement of ERs. Except for the ER pathway, these results showed there might be other pathways involved in promoting the effects of low‐level BBP on SH‐SY5Y cells, which require further investigation.     

Effect of Force of Microneedle Insertion on the Permeability of Insulin in Skin

Many experiments conducted in the literature have investigated the effect of microneedles (MNs) on insulin permeation across skin. There are also a number of articles that deal with the effect of MN insertion force in skin. However, there is little known on quantifying the relationship between the effect of MN insertion force and the amount of insulin permeated for given MNs. This issue is addressed in this article. MNs of 1100 µm and 1400 µm are used to conduct in vitro permeability experiments on porcine skin, using insulin. Histological images of MN treated skin are obtained from a microtome and the viscoelastic properties of the skin sample are measured using a rheometer. An in-house insertion force device is utilized that can reproducibly apply a specified force on MNs for a set period of time using compressed air. It is deduced that when porcine skin was pretreated with an applied force of 60.5 N and 69.1 N, the resultant amount of insulin permeated was approximately 3 µg and 25 µg over a 4-hour period for the MNs used. The amount of MN force applied to porcine skin was shown to be related to the amount of insulin permeated. An increase in insertion force increase the amount of insulin permeated. It was also demonstrated that using insufficient force may have reduced or prevented the amount of insulin passing through the skin, regardless of the geometry of the MNs.