前列腺剜除术联合小切口膀胱切开术治疗大体积前列腺增生并膀胱结石的疗效观察

目的:探讨"半微创技术"即经尿道2μm激光前列腺剜除术联合小切口膀胱切开术,治疗大体积良性前列腺增生(BPH)合并大体积或多发膀胱结石的疗效。方法:对21例大体积BPH合并膀胱结石患者,采用经尿道2μm激光剜除前列腺,后经耻骨上正中切口显露膀胱,将所剜除腺体及结石取出。结果:21例手术均成功,手术时间明显缩短,患者均未输血。术后4~6d拔除尿管。术前与术后6个月Qmax分别为(6.1±2.6)ml/s和(20.5±4.3)ml/s;剩余尿分别为(125.7±61.5)ml与(19.0±5.8)ml;国际前列腺症状评分(IPSS)分别为(21.6±5.2)分与(5.4±3.0)分;生活质量评分(QOL)分别为(4.3±0.5)分与(1.9±0.8)分。四项指标手术前后比较差异均有统计学意义(P0.01)。术后随访3~6个月,2例出现暂时性尿失禁,全部患者无尿瘘、切口感染等手术并发症。结论:经尿道2μm激光前列腺剜除术结合小切口膀胱切开术,一次性治疗大体积BPH合并多发膀胱结石能明显减少手术时间,具有安全、高效的优点,对于大体积BPH合并膀胱多发结石或质硬、直径3cm结石的高龄患者值得推荐应用。     

Protection to Fasciola hepatica in the gut mucosa of immune rats is associated with infiltrates of eosinophils,IgG1 and IgG2a antibodies around the parasites

We investigated the immune effector mechanisms that underlie protection against F. hepatica in the gut wall of immune rats, using (immuno)histochemistry. In the lamina propria of immune Wistar rats, four weeks after oral infection, frequencies of IgE-positive cells, eosinophils and mucosal mast cells were significantly increased, compared with naïve rats. These factors represent the traditional effector mechanisms against helminths. No significant differences were detected between the two groups in frequencies of IgM-, IgG2a-, IgG1- and IgA- positive cells, CD4- and CD8-positive cells, NK cells, macrophages, neutrophils or goblet cells. Upon challenge of immune rats with F. hepatica in an ex vivo gut segment, NEJs that migrated through the (sub)mucosa were coated with IgG1 and IgG2a antibodies and surrounded by eosinophils. No IgE or IgA antibodies were detected on the parasites. The onset of these immune effector responses, two h after challenge, was related to the expression of protection. These results suggest that NEJs are killed by an eosinophil-mediated cytotoxic response involving IgG antibodies. These antibodies were not produced in the intestine, but infiltrated the gut upon challenge. The observed immune effector responses were not restricted to the site where the primary infection is located, namely the small intestine, but were also detected in the large intestine. The presence of the protective immune mechanisms in two other rat strains demonstrates the pivotal importance of these responses, irrespective the genetic background of the host.     

应用健康教育护理路径延续院外癌痛规范化治疗的研究

目的探讨健康教育路径延续院外癌痛规范化治疗的应用效果。方法将100例癌痛患者随机分为实验组和对照组,每组50例。对照组实施常规健康教育,实验组应用健康教育护理路径。比较两组癌痛知识的掌握情况、治疗的依从性、疼痛控制情况和生活质量。结果实验组的癌痛知识掌握情况优于对照组,院外规范化治疗的依从性高于对照组,院外1个月时的NRS评分低于对照组,出院后的生活质量优于对照组,差异均有统计学意义(P<0.05)。结论对癌痛患者应用健康教育护理路径实施健康教育,可以提高患者对癌痛知识的正确认识及掌握和治疗依从性,有效控制疼痛,提高患者生活质量。     

苦黄注射液联合复方蛋氨酸胆碱治疗酒精性脂肪肝的疗效及对肝纤维化的影响研究

目的 探究复方蛋氨酸胆碱结合苦黄注射液在酒精性脂肪肝治疗中的疗效及对肝纤维化的影响。方法 按照随机数字表法将2019年1月至2021年12月海安市人民医院收治并确诊的104例酒精性脂肪肝患者分为对照组和观察组,各52例。对照组给予复方蛋氨酸胆碱治疗,观察组苦黄注射液联合复方蛋氨酸胆碱治疗。两组患者均连续治疗1个月。采用全自动生化分析仪检测两组患者治疗前后血清丙氨酸转移酶（alanine transferase,ALT）、天冬氨酸转氨酶（aspartate aminotransferase,AST）、总胆固醇（total cholesterol ,TC）、三酰甘油（triacylglycerol,TG）、总胆红素（total bilirubin,TBil）水平;采用放射免疫法检测两组患者治疗前后血清层粘连蛋白（laminin,LN）、透明质酸（hyaluronic acid,HA）、Ⅲ型前胶原N端肽（type III procollagen N-terminal peptide,PC Ⅲ）及Ⅳ型胶原（type IV collagen,Ⅳ-C）水平。比较两组患者的临床症状改善情况、临床疗效、肝功能指标及肝纤维化指标。结果 观察组治疗后的腹胀、肝区不适、黄疸、痞满等症状消失时间分别为（3.9±0.1） d、（9.8±0.2） d、（11.5±0.7）d、（3.8±0.2） d,均短于对照组分别为（7.5±0.3） d、（14.3±0.4） d、（15.6±0.8） d、（7.4±0.3） d（均P<0.05）。观察组临床总有效率高于对照组（94.2% vs 78.9%）（χ2=5.283,P=0.022）。观察组ALT、AST、TC、TG、TBil水平分别为（31.5±5.3） IU/L、（36.4±3.4） IU/L、（4.1±0.2） mmol/L、（1.4±0.3） mmol/L、（12.6±3.1） μmol/L,低于对照组[分别为（57.4±5.6） IU/L、（54.7±3.5） IU/L、（6.4±0.4） mmol/L、（2.6±0.5） mmol/L、（21.2±5.3） μmol/L]（均P<0.05）。观察组治疗后LN、HA、PC Ⅲ、Ⅳ-C水平分别为（51.6±9.4） μg/L、（32.5±7.4） μg/L、（7.5±1.8） ng/mL、（32.3±4.2） μg/L,均低于对照组[分别为（80.5±10.3） μg/L、（58.7±12.2） μg/L、（16.5±3.6） ng/mL、（71.2±8.6） μg/L]（均P<0.05）。对照组和观察组不良反应发生率分别为7.68%、3.84%,两组比较无明显差异（χ2=0.707,P=0.400）。结论 复方蛋氨酸胆碱结合苦黄注射液在酒精性脂肪肝患者中的治疗疗效显著,可改善患者的临床症状和肝功能,延缓肝纤维化的进程,安全性高。     

叠氮钠对SH—SYT6人神经母细胞瘤细胞膜电位和胞内β—淀粉样蛋白表达的影响

目的：观察线粒体呼吸链复合体Ⅳ抑制剂叠氮钠对SH－SY5Y细胞的细胞膜电位及胞内β－淀粉样蛋白（Aβ）表达水平的影响，以探讨用叠氮钠建立模拟Alzheimer病（AD）脑中神经细胞能量代谢障碍的细胞模型的可能性。方法：不同浓度的叠氮钠损伤细胞后，用激光共聚焦显微镜观察细胞膜膜电位；用免疫细胞化学法检测细胞内β－淀粉样蛋白前体蛋白（APP）和Aβ的表达水平。结果：叠氮钠在浓度25－100mmol/L时，与细胞共孵育，可使细胞膜电位去极化程度明显增高，并引起胞内Aβ表达显著增高，但对胞内APP表达水平影响不明显。结论：叠氮钠致神经细胞损伤模型可能是模拟AD患者及脑中与线粒体复合体Ⅳ损伤相关的病理改变的较好模型。     

连续性肾脏替代疗法对多器官功能障碍综合征患者血浆白介素6、10水平的影响

目的观察多器官功能障碍综合征(MODS)患者采用连续性肾脏替代疗法(CRRT)治疗0h,8h,24h和48h后肾功能及血浆白介素6(IL-6)、IL-10水平变化,探讨CRRT治疗MODS的可能机制。方法用CRRT方法治疗MODS患者71例,观察CRRT治疗前及治疗8h、24h和48h后患者肾功能及血浆IL-6、IL-10水平变化。结果MODS患者除尿素氮(BUN)和血肌酐(SCr)异常外,其血浆IL-6和IL-10水平均较正常对照组高(P均<0.01),CRRT治疗8h,24h和48h后MODS患者肾功能得到明显改善的同时[BUN0h/(26.15±13.60),8h/(19.45±8.63),24h/(17.22±6.11),48h/(16.36±7.86)mmol/L,与CRRT0h比较均P<0.01;SCr0h/(552.63±348.44),8h/(386.95±231.96),24h/(328.19±106.53),48h/(369.38±222.98)μmol/L,与CRRT0h比较均P<0.01)],患者血浆IL-6水平较治疗前明显降低[0h/(469.44±288.75),8h/(386.95±231.96),24h/(398.45±98.89),48h/(316.89±60.70)ng/ml,CRRT48h与0h比较P<0.05;而血浆IL-10水平较治疗前明显升高0h/(3.34±2.12),8h/(3.18±1.88),24h/(5.87±4.77),48h/(7.71±5.23)ng/ml)],CRRT24h、48h与0h比较P<0.05。结论CRRT是MODS的有效治疗方法,提示有效清除体内的代谢产物和炎性介质是CRRT治疗MODS的可能机制。     

Conserved epitopes dominate cross‐CD8+ T‐cell responses against influenza A H1N1 virus among Asian populations

Novel strains of influenza A viruses (IAVs) have emerged with high infectivity and/or pathogenicity in recent years, causing worldwide concern. T cells are correlated with protection in humans through cross‐reactive immunity against heterosubtypes of IAV. However, the different hierarchical roles of IAV‐derived epitopes with distinct levels of polymorphism in the cross‐reactive T‐cell responses against IAV remain elusive. In this study, immunodominant epitopes scattered throughout the entire proteome of 2009 pandemic influenza A H1N1 virus and seasonal IAVs were synthesized and divided into different pools depending on their conservation. The overall profile of the IAV‐specific CD8⁺ T‐cell immunity was detected by utilizing these peptide pools and also individual peptides. A dominant role of the conserved peptide‐specific T‐cell immunity was illuminated within the anti‐IAV responses, while the CD8⁺ T‐cell responses against the variable epitopes were lower than the conserved peptides. As previously demonstrated within a Caucasian population, we determined that GL9‐specific T cells, which also utilize Vβ 17 TCR (BV19), play a pivotal role in IAV‐specific T‐cell immunity within an HLA‐A2⁺ Asian population. Our study objectively reveals the different predominant roles of T‐cell epitopes among IAV‐specific cross‐reactive cellular immunity. This may guide the development of vaccines with cross‐T‐cell immunogenicity against heterosubtypes of IAV.     

Cedrus atlantica Extract Suppress Glioblastoma Growth through Promotion of Genotoxicity and Apoptosis: In Vitro and In Vivo Studies

Glioblastoma (GBM) is the most common malignant primary brain tumor in humans, exhibiting highly infiltrative growth and drug resistance to conventional chemotherapy. Cedrus atlantica (CAt) extract has been shown to decrease postoperative pain and inhibit the growth of K562 leukemia cells. The aim of this study was to assess the anti-GBM activity and molecular mechanism of CAt extract in vitro and in vivo. The results showed that CAt extract greatly suppressed GBM cells both in vitro and in vivo and enhanced the survival rate in subcutaneous and orthotopic animal models. Moreover, CAt extract increased the level of ROS and induced DNA damage, resulting in cell cycle arrest at the G₀/G₁ phase and cell apoptosis. Western blotting results indicated that CAt extract regulates p53/p21 and CDK4/cyclin D1 protein expression and activates extrinsic and intrinsic apoptosis. Furthermore, CAt extract enhanced the cytotoxicity of Temozolomide and decreased AKT/mTOR signaling by combination treatment. In toxicity assays, CAt extract exhibited low cytotoxicity toward normal cells or organs in vitro and in vivo. CAt extract suppresses the growth of GBM by induction of genotoxicity and activation of apoptosis. The results of this study suggest that CAt extract can be developed as a therapeutic agent or adjuvant for GBM treatment in the future.     

Origami-based “Book” shaped three-dimensional electrochemical paper microdevice for sample-to-answer detection of pathogens

Herein, an ease-of-use and highly sensitive origami-based “book” shaped three-dimensional electrochemical paper microdevice based on nucleic acid testing (NAT) methodology was developed for sample-to-answer detection of pathogens from whole blood and food samples. The whole steps of NAT, including sample preparation, amplification and detection, were performed by alternately folding the panels of the microdevice, just like flipping a book. The screen-printing electrodes were combined with wax-printing technology to construct a paper-based electrochemical unit to monitor Loop-mediated isothermal amplification (LAMP) reaction with an electrochemical strategy. After nucleic acid extraction and purification with the glass fiber, the LAMP reaction was performed for 45 min to amplify the extracted nucleic acid sequence, followed by the execution of the electrochemical interrogation reaction based on methylene blue (MB) and double-stranded LAMP amplicons. Starting with whole blood and food samples spiked with Salmonella typhimurium, this microdevice was successfully applied to identify pathogens from biological samples with satisfactory sensitivity and specificity. Therefore, the proposed origami-based “book” shaped three-dimensional paper microdevice has great potential for disease diagnosis, food safety analysis applications in the future.

Herein, an ease-of-use and highly sensitive origami-based “book” shaped three-dimensional electrochemical paper microdevice based on nucleic acid testing (NAT) methodology was developed for sample-to-answer detection of pathogens from whole blood and food samples.