Design of ZIF-based hybrid nanoparticles with hyaluronic acid-augmented ROS behavior for dual-modality PA/NIR-II FL imaging

Photoacoustic (PA) imaging has emerged as a promising bio-imaging technique due to its non-invasive visualization of lesions at great penetration depths. Fluorescence (FL) imaging in the second near-infrared window (NIR-II, 1000–1700 nm) achieves a higher imaging resolution and lower background signals compared to NIR-I. However, the single imaging method possesses its own disadvantages. Thus, we have demonstrated ZIF-8–IR820–MnPc–HA nanoparticles (ZIMH NPs) that can achieve visualization and localization of tumors in mice models with the help of a dual-modality PA/NIR-II FL imaging performance. Meanwhile, these excellent nanoparticles also induce the efficient generation of singlet oxygen (¹O₂) upon 808 nm laser illumination, and display excellent photodynamic therapy efficacy in cells, further indicating their potential application for in vivo PDT. In ZIMH NPs, hyaluronic acid (HA) impressively acts as a “sponge”, enhancing the generation of ¹O₂ and facilitating the cellular therapeutic effects. We believe that ZIF-8–IR820–MnPc–HA NPs present a brand-new strategy for the exploration of efficient PDT photosensitizers with dual-modality imaging performance for use in various biomedical applications.

We have obtained ZIF-8–IR820–MnPc–HA nanoparticles with hyaluronic acid-augmented ROS behavior for dual-modality PA/NIR-II FL imaging in vivo.     

肾静脉栓塞的彩色多普勒超声征象及其诊断价值

目的通过与增强CT对比分析,探讨彩色多普勒超声在肾静脉栓塞疾病中的诊断价值。 方法选取2014年1月至2017年9月在北京协和医院就诊的经手术病理或随访证实的40例45侧肾静脉栓塞患者,其中,15例20侧肾静脉血栓及25例25侧肾静脉癌栓,均行彩色多普勒超声及增强CT检查,总结肾静脉栓塞的超声表现,包括栓塞病灶的位置、受累静脉管腔及管壁特点、侧支形成情况及彩色多普勒表现。超声与增强CT诊断肾静脉血栓及癌栓的准确率比较采用χ²检验。 结果彩色多普勒超声对肾静脉血栓及癌栓的诊断准确性分别为85%、84%,CT增强扫描的诊断准确性依次分别为100%、96%,差异均无统计学意义（P均>0.05）。肾静脉栓塞的主要超声征象有：（1）肾静脉管腔扩张伴实性成分填充;（2）主干内血流中断或充盈缺损;（3）肾内无明显静脉血流信号或血流信号分布稀疏。 结论彩色多普勒超声与增强CT在诊断肾静脉栓塞上有较好的一致性,超声可作为评估肾静脉栓塞的重要影像学方式,结合病史能为肾静脉栓塞提供较为可靠的诊断依据。     

2种长度切口MSICS联合IOL植入术的角膜地形图分析

目的探讨2种长度切口对手法小切口白内障摘除联合人工晶状体植入术（manual small incisioncataract surgery with intra-ocular lens implantation,MSICS＋IOL）后角膜地形图的影响。方法将拟行MSICS＋IOL的患者89例89只眼（核硬度Ⅳ~Ⅴ级）分为2组,A组45只眼核硬度Ⅳ级,B组44只眼核硬度Ⅴ级,分别行5.5 mm、6.5 mm巩膜隧道切口的MSICS＋IOL,用角膜地形图仪观察手术前、手术后1周及1个月时的角膜形态变化。结果术后1周及1个月时,B组角膜表面散光值（cylinder,CYL）、平均角膜曲率（average cornealpower,ACP）值均大于A组,差异有统计学意义（P〈0.05）;术后1周,B组角膜表面非对称指数（surface asym-metry index,SAI）较A组增加,差异有统计学意义（P〈0.05）,术后1个月时则与A组大致相同（P〉0.05）;2组术后1周、1个月的角膜表面规则指数（surface regularity index,SRI）差异无统计学意义（P〉0.05）。结论切口长度为5.5 mm的MSICS＋IOL手术较6.5 mm对术后早期角膜散光影响小;切口长度为5.5 mm的MSICS＋IOL手术和6.5 mm长度切口者对术后早期角膜的规则性影响相似。     

A retrospective study of breast cancer subtypes: the risk of relapse and the relations with treatments

Immunohistochemical markers are often used to classify breast cancer into subtypes that are biologically distinct and behave differently. The aim of this study was to estimate relapse for patients with the major subtypes of breast cancer as classified using immunohistochemical assay and to investigate the patterns of benefit from the therapies over the past years. The study population included primary, operable 2,118 breast cancer patients, all non-specific infiltrative ductal carcinoma, with the median age of 53.2 years. All patients underwent local and/or systemic treatments. The clinicopathological characteristics and clinical outcomes were retrospectively reviewed. The expression of estrogen receptor (ER), progesterone receptor, human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR), and cytokeratin 5/6 were analyzed by immunohistochemistry. All patients were classified into the following categories: luminal A, luminal B, HER2 overexpressing, basal-like, and unclassified subtypes. Ki-67 was detected in luminal A subtype. The median follow-up time was 67.9 months. Luminal A tumors had the lowest rate of relapse (12.7%, P < 0.001), while luminal B, HER2 overexpression, and basal-like subtypes were associated with an increased risk of relapse (15.7, 19.1, 20.9%). Molecular subtypes retained independent prognostic significance (P < 0.001). In luminal A subtype, adjunctive radiotherapy could decrease the risk of relapse (P = 0.005), Ki67 positive was a high-risk factor for relapse (P < 0.001), and adjuvant chemotherapies could reduce the relapse for the patients with risk factors (P < 0.001). Adjuvant hormone therapy was an effective treatment for ER-positive tumors (P < 0.001). Molecular subtypes of breast cancer could robustly identify the risk of recurrence and were significant in therapeutic decision making. The model combined subtype and clinical pathology was a significant improvement. Luminal A tumors might represent two distinct subsets which demonstrated distinct prognosis and therapy response.     

早期先兆流产保胎治疗后妊娠结局观察

目的 探讨早期先兆流产保胎治疗继续妊娠的结局.方法 对早期先兆流产保胎治疗后继续妊娠的孕妇144例与同期内无早期先兆流产征象的孕妇150例进行观察,比较两组的妊娠结局.结果 两组在子痫前期、产后出血、早产、新生儿不良结局方面无显著差异(P>0.05),而胎盘粘连、前置胎盘的发生两组有显著差异(P<0.05).结论 早期先兆流产经保胎治疗后继续妊娠,对妊娠结局无严重不良影响.但是出血时间长及有多次自然流产史的患者胚胎缺陷可能性大,需慎重.     

Protection against multiple influenza A virus subtypes by intranasal administration of recombinant nucleoprotein

Vaccination is a cost-effective way to control the influenza epidemic. Vaccines based on highly conserved antigens can provide protection against different influenza A strains and subtypes. In this study, the recombinant nucleoprotein (rNP) of the A/PR/8/34 (H1N1) influenza virus strain was effectively expressed using a prokaryotic expression system and then purified with a nickel-charged Sepharose affinity column as a candidate component for an influenza vaccine. The rNP was administered intranasally three times at 3-week intervals to female BALB/c mice in combination with an adjuvant (cholera toxin B subunit containing 0.2% of the whole toxin). Twenty-one days after the last immunization, the mice were challenged with homologous or heterologous influenza viruses at a lethal dose. The results showed that intranasal immunization of 10 μg rNP with adjuvant completely protected the immunized mice against the homologous influenza virus, and immunization with 100 μg rNP in combination with adjuvant provided good cross-protection against heterologous H5N1 and H9N2 avian influenza viruses. The results indicate that such a vaccine administered intranasally can induce mucosal and cell-mediated immunity, thus having the potential to control epidemics caused by new emerging influenza viruses.     

脐带间充质干细胞经肝动脉移植治疗失代偿期肝硬化的临床研究

目的探讨人脐带间充质干细胞（UC-MSC）经肝动脉途径移植治疗失代偿期肝硬化的临床疗效及安全性。方法 15例失代偿期肝硬化患者采用人UC-MSC经肝动脉途径移植治疗,治疗后定期观察患者血清转氨酶（ALT、AST）、总胆红素（TBil）、白蛋白（ALB）、凝血酶原时间（PT）和纤维蛋白原（FIB）水平变化,并观察患者临床症状及体征的改善情况及不良反应。结果 UC-MSC移植治疗后2周,各项肝功能指标与治疗前比较无显著性差异;治疗后4周,除ALT和AST有所改善外（P均〈0.05）,其余指标无明显改善;治疗后8周各项肝功能指标均有改善（P均〈0.05）,12周有显著性改善（P均〈0.01）。治疗后4周大多数患者的临床症状有明显改善;12周后患者总体生存率为93%,1例患者在UC-MSC静脉移植后8周因为肝性昏迷而死亡。患者均未发生与细胞移植相关的不良反应。结论 UC-MSC经肝动脉途径移植是治疗失代偿期肝硬化的一种安全有效的方法,短期内可以改善失代偿期肝硬化患者肝功能及临床症状,是一种值得推荐的治疗方法。     

CT引导经皮穿刺微波消融肺部恶性肿瘤的临床观察

目的 探讨CT引导经皮穿刺微波消融（PMAT）治疗肺部恶性肿瘤的临床疗效及应用价值。方法 2010年3月至2012年10月我科收治的23例周围型肺癌患者行CT引导经皮肺穿刺微波消融治疗,共31个病灶。微波频率2450MHz、功率50～70W,根据肿瘤大小、形状选择1点或2点加热。结果 23例患者均完成治疗,手术时间为5～12 min,平均8min。微波消融后即刻CT表现为病灶密度减低及CT值降低,由术前的均数52.60Hu降低为26.12Hu。获完全缓解6例,部分缓解12例,稳定3例,进展2例,有效率为78.3％。3例气胸,2例胸腔积液,15例发热,无1例针道转移。随访至2012年12月,17例患者存活,1年局部控制率为65.2％,中位无进展生存时间为14.6个月,1年、2年生存率分别为91.3％、82.6％。结论 CT引导下PMAT治疗肺肿瘤微创、安全、有效,可以提高患者的生活质量并延长生存时间。     

不同性别COPD患者对诊断和治疗方面的认知

目的 研究不同性别对COPD患者的认知以及诊疗行为的影响.方法 收集2007年1月至12月北京大学第三医院呼吸内科门诊就诊的稳定期COPD患者,采用横断面研究方法,所有入选患者由研究者面对面进行“COPD患者对疾病认知程度的问卷调查”,运用SPSS 22.0软件对数据进行处理.结果 共177例患者入选,其中男性126例(71.2％),女性51例(28.8％).男女患者年龄、BMI和收入等差异无统计学意义(P＞0.05).与男性患者相比,女性患者中,从不吸烟者比例很高(62.7％ vs 12.7％,P＜0.01),戒烟者比例较低(27.5％ vs65.9％,P＜0.01),吸烟包年明显低于男性患者[0 (0～7.5) vs30 (10～45),P＜0.01].女性患者中小学以下文化程度者(21.6％ vs6.3％,P＜0.01)和无工作者的比例(29.4％ vs 11.9％,P＜0.01)较男性患者大.在肺功能方面,女性COPD患者FEV1/FVC[(58.7±9.8)％vs(55.0±10.9)％,P＜0.05]稍比男性好,VC则低于男性患者[(69.6±19.6)％ vs (78.8±19.5)％,P＜0.01].女性患者合并脑血管病的比例较男性患者更低(0.0％ vs 10.3％,P＜0.05).女性患者知晓肺功能结果的比例较男性患者稍高(17.6％ vs7.9％,P=0.059).结论 女性患者对COPD的认知及诊疗中的行为与男性患者存在一定的差异,临床医师需要对女性患者给予关注.     

TLR4受体与银屑病及过敏性紫癜皮肤病的研究进展

国内外研究表明TLR4在银屑病和过敏性紫癜患者中的体内表达上调。TLRs信号过度活化时,激活机体内炎症反应,导致炎性细胞大量浸润及细胞因子过度释放,可使体内Th1/Th2免疫应答失衡,干扰机体自身免疫耐受机制,导致免疫功能紊乱。本文对银屑病和过敏性紫癜的与TLR4介导的免疫研究进展进行了综述。