p16与Rb基因在喉癌中的表达及其临床意义

目的：探讨抑癌基因ｐ１６和Ｒｂ在喉肿瘤中的表达及其相互关系。方法：用免疫组织化学方法观察４０例喉鳞状细胞癌ｐ１６和Ｒｂ基因的表达。结果：喉癌标本中ｐ１６和Ｒｂ阳性表达率分别为４２．５％和５７．５％,其中７例肿瘤组织（１７．５％）ｐ１６和Ｒｂ基因均阳性表达,未见同一肿瘤组织中两者均缺失。在喉癌的临床类型、分期及组织分化程度方面ｐ１６和Ｒｂ基因的阳性表达率差异有显著性（Ｐ〈０．０５）。结论：ｐ１６和Ｒ     

甘肃省慢性病患者健康素养水平及其影响因素分析

目的了解甘肃省慢性病患者健康素养水平及其影响因素,为慢性病患者的健康宣教工作提供科学依据。方法以甘肃省2017年健康素养监测数据库中5 416名慢性病患者为研究对象,采用χ2检验和多因素logistic回归,探索慢性病患者健康素养的影响因素。结果甘肃省慢性病患者的总体健康素养水平为6.91%。3个方面健康素养中,基本知识和理念素养具备率最高为15.18%,健康生活方式与行为素养具备率最低为8.42%;6类健康问题中,科学的健康观素养具备率最高为30.52%,慢性病防治素养具备率最低仅为10.32%;多因素logistic回归分析提示:是否慢性病"共病"(是:OR=0.716,95%CI:0.516~0.993)、民族(汉族:OR=2.794,95%CI:1.652~4.725)、文化程度(高中/中专:OR=2.547,95%CI:1.648~3.936;大专及以上:OR=2.039,95%CI:1.478~2.794)、自评健康状况(好:OR=1.477,95%CI:1.057~2.065)和职业(事业单位职工:OR=3.477,95%CI:2.226~5.432;学生:OR=3.267,95%CI:1.203~8.871;工人:OR=1.718,95%CI:1.064~2.774)是慢性病患者健康素养的影响因素。结论甘肃省慢性病患者健康素养水平仍较低,尤其是"共病"患者、少数民族居民、初中及以下学历人群、自评健康差者和农民,他们是健康教育与促进的工作重点。     

老年血液系统恶性肿瘤合并贫血患者EPO和sTfR水平的测定及意义

目的 测定老年血液系统恶性肿瘤合并贫血患者红细胞生成素(EPO)、可溶性转铁蛋白受体(sTfR)的水平并对其临床意义进行研究.方法 选取贫血患者142例,根据疾病类型不同将患者分为血液肿瘤贫血组(n=41)、实体肿瘤贫血组(n=51)、缺铁性贫血组(n=50).比较3组患者的血清EPO、sTfR水平,并对EPO、sTfR与血红蛋白(Hb)的相关性进行分析.结果 3组患者的Hb水平比较,差异无统计学意义(P>0.05);血液肿瘤贫血组和缺铁性贫血组患者的EPO水平比较,差异无统计学意义(P>0.05);血液肿瘤贫血组和缺铁性贫血组患者的EPO水平均高于实体肿瘤贫血组(P<0.05);血液肿瘤贫血组和实体肿瘤贫血组患者的sTfR水平均低于缺铁性贫血组(P<0.05);缺铁性贫血组患者的Hb与EPO、sTfR均呈负相关(r=-0.861、-0.546,P<0.01).结论 血液肿瘤患者的贫血机制可能并非源于EPO生成不足,而是由于骨髓红系造血功能受到抑制.     

困难甲状腺手术中喉返神经解剖的研究

目的：探讨困难甲状腺手术中喉返神经解剖的方法,以最大限度减少损伤,提高手术的安全性。方法：回顾性分析52例巨大结节性甲状腺肿、胸骨后结节性甲状腺肿、位于甲状腺下极的结节性甲状腺肿、甲状腺癌以及甲状旁腺肿瘤等困难甲状腺手术中喉返神经的解剖过程和方法,了解病变累及喉返神经的状况以及避免喉返神经损伤的措施。结果：52例患者中,除2例甲状腺癌一侧喉返神经受侵予以切除外,其余50例喉返神经均解剖成功。50例喉返神经解剖成功者中,3例喉返神经拉长者术后无声嘶,2例喉返神经局部压为扁平者术后也无声嘶,3例术后轻微声嘶者经营养神经治疗1~3个月后恢复正常。1例喉不返神经,2例胸骨劈开,2例术后行气管切开。术后无并发症发生。结论：困难甲状腺手术中喉返神经的解剖大多需要游离腺叶和肿瘤并将其翻向内前上方,再以气管食管沟、甲状腺下动脉和（或）甲状软骨下角为标志进行解剖,实践证明该方法可行。     

Effect of number density on optimal design of gold nanoshells for plasmonic photothermal therapy

Despite much research efforts being devoted to the design optimization of metallic nanoshells, no account is taken of the fact that the number of the nanoshells that can be delivered to a given cancerous site vary with their size. In this paper, we study the effect of the nanoshell number density on the absorption and scattering properties of a gold-nanoshell ensemble exposed to a broadband near-infrared radiation, and optimize the nanoshells’ dimensions for efficient cancer treatment by analyzing a wide range of human tissues. We first consider the general situation in which the number of the delivered nanoshells decreases with their mean radius R as ∝ R^−β, and demonstrate that the optimal design of nanoshells required to treat cancer most efficiently depends critically on β. In the case of β = 2, the maximal energy absorbed (scattered) by the ensemble is achieved for the same dimensions that maximize the absorption (scattering) efficiency of a single nanoshell. We thoroughly study this special case by the example of gold nanoshells with silica core. To ensure that minimal thermal injury is caused to the healthy tissue surrounding a cancerous site, we estimate the optimal dimensions that minimize scattering by the nanoshells for a desired value of the absorption efficiency. The comparison of gold nanoshells with different cores shows that hollow nanoshells exhibiting relatively low absorption efficiency are less harmful to the healthy tissue and, hence, are preferred over the strongly absorbing nanoshells. For each of the cases analyzed, we provide approximate analytical expressions for the optimal nanoshell dimensions, which may be used as design guidelines by experimentalists, in order to optimize the synthesis of gold nanoshells for treating different types of human cancer at their various growth stages.OCIS codes: (170.0170) Medical optics and biotechnology, (160.4236) Nanomaterials, (250.5403) Plasmonics, (350.5340) Photothermal effects     

Wearable Mixed-Reality Holographic Navigation Guiding the Management of Penetrating Intracranial Injury Caused by a Nail

Penetrating brain injury caused by a nail is an extremely rare neurosurgical emergency that poses a challenge for neurosurgeons. Nail entering the brain from the orbit and lodging within the cranial cavity is even more unusual. A 53-year-old male was found unconscious at a construction site, and brain CT revealed not only the presence of a nail beneath the inner table of the parietal bone, but also traumatic intracerebral hematoma. Consequently, accurate localization of the nail and hematoma was mandatory for surgical plan. During surgical planning, computational model reconstruction and trajectory calculation were completed using preoperative CT in 3D Slicer. Under the guidance of a head-mounted mixed-reality holographic computer, the neurosurgeon was able to visualize and interact with the hologram of the surgical plan, and intraoperative findings demonstrated that our low-cost portable wearable mixed-reality holographic navigation assisted precise localization of the nail and intracerebral hematoma, assuring less injury to the already compromised brain. After the surgery, the patient could obey commands, and postoperative imaging ruled out the possibility of brain abscess during follow-up. To the best of our knowledge, this is the first report on using a low-cost wearable mixed-reality holographic navigation to guide the management of penetrating intracranial injury caused by a nail.     

斑蝥酸钠对体外培养肺癌患者淋巴细胞免疫应答的影响

目的 探讨斑蝥酸钠对体外培养肺癌患者淋巴细胞免疫应答的影响.方法 病理诊断为非小细胞肺癌的患者20例,体外进行人外周血淋巴细胞培养,应用四甲基偶氮唑盐法检测不同浓度斑蝥酸钠维生素B6作用下淋巴细胞的增殖影响情况,应用流式细胞仪分析不同浓度斑蝥酸钠对CD4+ CD25+T细胞、CD25+ FOXP3+T细胞、CD4+和CD8+T细胞的影响.结果 当斑蝥酸钠维生素B6注射液浓度＜10 μg/ml时,浓度升高能刺激外周血淋巴细胞的增殖.斑蝥酸钠维生素B6浓度＞lOμg/ml,随着浓度的升高,斑蝥酸钠对淋巴细胞增殖的刺激作用减弱.当斑蝥酸钠维生素B6注射液浓度＜10 μg/ml时,随着实验组浓度的升高,与对照组相比,CD4 +/CD8+比值明显升高(t=2.171,P=0.032;t=2.103,P=0.041;t=3.662,P =0.002;t =3.201,P=0.003;t =3.233,P =0.003),CD4+ CD25 +/CD4+和CD25+ FOXP3+T明显降低,差异有统计学意义;但当斑蝥酸钠维生素B6注射液浓度高于10 μg/ml时,斑蝥酸钠10、15、20 μg/ml组CD4 +/CD8+比值、CD4+ CD25 +/CD4+和CD25+ FOXP3+T变化均不大.结论 斑蝥酸钠维生素B6在一定范围内能促进体外培养肺癌患者淋巴细胞的增殖,并提高其细胞免疫能力.     

大鼠Meynert基底核注入海人藻酸后c-fos原癌基因蛋白在脑纹状体边缘区及边缘系统内的表达

为研究Meynert基底核与纹状体边缘区以及脑内其他跟学习记忆有关的边缘系统结构间的关系,将海人藻酸注射于大鼠Meynert基底核后,观察c－fos原癌基因蛋白在脑内的表达。海人藻酸注射4h后,脑内只有少量c－fos阳性表达：海人藻酸注射8h后,脑内c－fos原癌基因蛋白表达增至最高峰。在海马、齿状回、中央杏仁核、纹状体、边缘区中有大量密集的c－foc阳性表达。在终纹床核、丘脑网状核、外侧隔核、丘脑下部视上核、室旁核、前下托及嗅内皮质等处可见较多c－foc阳性表达。在伏隔核、视前区、丘脑底核、黑质外侧部等部位可见少量c－fos阳性表达。海人藻酸注射Meynert基底核16h后,除海马、齿状回、中央杏仁核、纹状体及边缘区中有较多表达外,其余部位阳性标记基本消失。但脑腹侧的梨状前皮质、嗅结节、杏仁皮质核及前嗅核等部位出现大量的c－fos阳性表达。大脑皮质也可见较多c－fos阳性表达。海人藻酸注射48h后,脑内各部位的c－fos阳性反应均消失。本研究结果提示Meynert基底核和纹状体边缘区以及跟脑内其它与学习记忆有关的边缘系统结构间有密切的功能联系。     

天津市1999-2015年宫颈癌死亡率和过早死亡损失寿命年变化趋势分析

目的 分析天津市宫颈癌死亡长期趋势,为开展相关研究和预防工作提供参考。方法 计算1999-2015年天津市宫颈癌的死亡率、标化死亡率、累积死亡率（0~74岁）、截缩死亡率（35~64岁）和过早死亡损失寿命年（YLL）,应用Joinpoint回归分析宫颈癌死亡率、YLL率的趋势和年度变化百分比（APC）,并分析不同年龄组变化趋势。结果 1999-2015年天津市户籍居民因宫颈癌死亡1 741人,平均粗死亡率为2.15/10万,中国人口标化率为1.47/10万,世界人口标化率为1.50/10万,平均每年YLL为3 347.97人年。宫颈癌死亡者中,0~34岁占3.10%,35~64岁占57.84%,≥ 65岁占39.06%;城市宫颈癌死亡率高于农村,城乡比为1.37：1。1999-2015年宫颈癌年龄别死亡率随年龄的增加而上升。2014-2015年年龄别死亡率呈现双峰分布的特征,50岁为第一个高峰,75岁为第二个高峰;1999-2011年天津市女性宫颈癌死亡率呈稳定状态（APC=-0.2%,P=0.80）,2011-2015年呈快速上升趋势（APC=21.6%,P<0.01）;20~49岁组1999-2015年呈上升趋势（APC=6.9%,P<0.01）;50~69岁组1999-2007年呈下降趋势（APC=-9.2%,P<0.01）,2007-2015年呈上升趋势（APC=14.5%,P<0.01）;≥ 70岁组1999-2009年呈下降趋势（APC=-10.2%,P<0.01）,2009-2015年变化差异无统计学意义（APC=7.8%,P=0.10）。自2008年开始,50~70岁组宫颈癌的YLL率超过≥ 70岁组,并且差距逐渐扩大。结论 自2011年天津市地区宫颈癌死亡率呈快速上升趋势,50~70岁人群将是宫颈癌寿命损失的主要群体。