伏立康唑联合卡泊芬净治疗儿童白血病合并侵袭性真菌病疗效分析

目的:研究伏立康唑和卡泊芬净联合治疗儿童白血病化疗期间侵袭性真菌病(IFD)的临床疗效和安全性。方法:选取2015-2018年在我院接受抗侵袭性真菌感染治疗的41例白血病患儿,分为联合治疗组22例和伏立康唑组19例,其中联合治疗组患儿采用卡泊芬净联合伏立康唑治疗,伏立康唑组采用伏立康唑单独治疗,比较两组患儿用药后的治疗效果、感染死亡的风险因素和不良反应发生率。结果:联合治疗组与伏立康唑组临床有效率分别为77.3% 和36.9%,差异有统计学意义(P<0.05);联合治疗组死于感染相关因素的患儿少于伏立康唑组(P<0.05),治疗方式是IFD致死的风险因素(P<0.05);联合治疗组患儿出现肾功能和消化系统损伤的概率小于伏立康唑组(P<0.05)。结论:泊芬净和伏立康唑联合治疗儿童白血病合并侵袭性真菌感染的临床效果较好,可降低病死率和不良反应发生率。     

荧光成像技术在神经定位中的研究进展

术中神经定位困难常可增大神经损伤的风险,从而导致患者神经功能障碍。因此,如何在涉及神经的手术(如复发性腮腺肿瘤、前列腺等手术)中准确定位神经成为手术成功的关键因素之一。术中实时定位神经的方法众多,其中荧光成像技术具有高灵敏、易使用、低成本、无辐射的独特优势,因此受到越来越多研究者的关注。该文就荧光成像技术在神经定位中的相关研究成果进行综述。     

Correlation analysis of N-terminal pro-brain natriuretic peptide in maintenance hemodialysis patients

Objective To analysis the distribution and influence factors of N-terminal pro-brain natriuretic peptide (NT-pro BNP), and also its clinical significance though a cross-sectional survey of NT-pro BNP in maintenance hemodialysis patients in Zhongshan Hospital, Fudan University. Methods A total of 207 stable hemodialysis patients were enrolled. The clinical parameters, plasma NT-proBNP levels and echocardiographic parameters were analyzed. Results Level of plasma NT-proBNP in patients with left ventricular hypertrophy (LVH) were significantly higher than those without LVH[M(1/4, 3/4): 3 104(1 626, 7 843) ng/L vs 1 291(772, 1 845) ng/L, P﹤0.01]. After logarithmic transformation for skewed variables NT-proBNP, log[NT-proBNP] was negatively correlated with hemoglobin (r=-0.212, P=0.004) and left ventricular ejection fraction (LVEF)(r=-0.202, P=0.003), and was positively correlated with left ventricular mass index (LVMI)(r=0.370, P=0.001), interdialysic weight gain (IDWG) rate (r=0.233, P=0.001), predialysis systolic blood pressure (r=0.345, P=0.001), predialysis diastolic blood pressure (r=0.152, P=0.032). The areas under curve(AUC) of NT-proBNP for diagnosing LVH and IDWG﹥4% were 0.786(95%CI 0.689-0.883, P﹤0.01) and 0.738(95%CI 0.667-0.810, P﹤0.01). When the threshold of NT-proBNP was set at 1 917 ng/L to diagnosis LVH, the sensitivity and specificity were 0.676 and 0.824. When the threshold of NT-proBNP was set at 2 872 ng/L to diagnosis IDWG﹥4%, the sensitivity and specificity were 0.704 and 0.758. Conclusions NT-proBNP levels are significantly abnormality in hemodialysis patients, mainly related with LVH, the high rate of IDWG, and the poorly controlled predialysis blood pressure. Proper dry weight assessment and strict control of IDWG may be effective way to intervene NT-proBNP.     

基于数字组织病理图像的肿瘤与微环境相互作用风险模型在口咽癌症中的预后研究

数字组织病理学全幅图像为计算机化的定量分析提供新的机遇。越来越多的研究表明,肿瘤微环境中的免疫细胞与癌变细胞的相互作用是一项重要的预后指标。HPV+口咽癌症是头颈部常见的恶性肿瘤,目前对其没有很好的预后指标。利用计算机图像处理和模式识别技术,从数字组织病理学全幅图像中定量提取细胞核形态,并利用其特征去度量肿瘤微环境与癌变区域相互作用的程度,构建口咽癌症复发风险模型。实验数据来自华盛顿大学医学中心的病理学档案,是连续回顾性收集的234名口咽癌患者手术切除的组织病理学切片及其相应的跟踪数据。研究发现:利用图像定量分析构建口咽癌症复发风险模型,能够显著地区分复发与非复发病患,其100次5折交叉验证的分类结果的平均AUC达到0.67±0.02;对病患分别进行单变量(HR(95%CI)=1.76(0.99～3.13),P=0.0352)及多变量生存分析((HR(95%CI)=3.27(1.12～5.46),P=0.039)),结果说明肿瘤微环境与癌变区域相互作用高的口咽癌症病患相比于相互作用低的病患,有更低的复发风险及更长的生存期。研究揭示计算机定量度量的肿瘤微环境中的免疫细胞与癌变细胞的相互作用,有望作为一个独立的预后指标来指导口咽癌症病患的治疗疗程。     

siRNA干扰Notch1抑制肺癌干细胞脊柱转移瘤的生长

目的研究Notch受体1(Notch receptor 1,Notch1)在肺癌脊柱转移瘤中的表达,并探讨Notch1 siRNA对肺癌干细胞(lung cancer stem cells,LCSCs)迁移能力和脊柱转移瘤生长的影响。方法通过Western blotting法检测Sox2、Oct4和Notch1蛋白在肺癌脊柱转移瘤组织中的表达水平。通过lipofectamine 2000将Notch1 siRNA转染到肺癌干细胞(A549-CSC),Transwell法检测Notch1 siRNA对A549-CSC迁移能力的影响;将BALB/C裸鼠分为两组:control siRNA组和Notch1 siRNA组,分别通过左心室注射control siRNA和Notch1 siRNA转染的A549-CSC,通过Mic-CT检测小鼠脊柱转移瘤的生长。结果Western blot检测结果显示,Sox2、Oct4和Notch1蛋白在脊柱转移瘤组织中的表达显着高于癌旁对照组(P<0.01);Transwell结果显示,与control siRNA组比较,Notch1 siRNA组细胞迁移率显著降低(P<0.01);Mic-CT结果显示,与control siRNA组比较,Notch1 siRNA组小鼠脊柱转移瘤生长显著降低。结论siRNA干扰Notch1能够抑制LCSCs迁移能力,抑制小鼠肺癌脊柱转移瘤的生长。     

Lycopene ameliorates renal function in rats with streptozotocin-induced diabetes

Aim: To study the effect of lycopene on ameliorating renal function of diabetic nephropathy. Methods: Sixty male SD rats were divided into four groups: normal untreated (NC-U), normal treatment (NC-L), diabetes untreated (DM-U) and diabetes treatment (DM-L). DM was prepared by a single injection of STZ (70 mg/kg, intraperitoneally) dissolved in 0.1 M citrate buffer (pH 4.5). DM-U and NC-U rats received control diet; DM-L and NC-L rats received lycopene. After treated with lycopene for 8 weeks, blood was obtained for analyzing plasma lipid profiles, glucose and renal function. The kidneys were used to determine SOD activity, malondialdehyde (MDA) level, processed for histological examination and western blot. Results: Treatment of diabetic rats with lycopene decreased the values of blood urea nitrogen, 24 h urea protein and creatinine. The serum lipids like TC, TG, and LDL were decreased and HDL was increased in DM-L rats when compared with those of diabetic rats. Administration of lycopene decreased the levels of MDA content and expression of CTGF, increased Akt/PKB phosphorylation and SOD activity in diabetic renal tissues. Conclusions: Lycopene protects against development of diabetic nephropathy and ameliorates renal function via improving oxidative status and regulating p-Akt and CTGF.     

Impact of p73 gene polymorphism on cancer susceptibility: a meta analysis

Previous studies examining the association between p73 G4A and gastric cancer risk have produced inconsistent results. The objective of this study was to clarify whether p73 G4A plays a major role in the development of gastric cancer. Studies that had examined the association between p73 G4A and gastric cancer risk were identified through PubMed, Science Direct, and CNKI. We selected eligible studies based on inclusion criteria. Odds ratios were estimated using distinct genetic models, and the heterogeneity between studies was explored using Cochran’s Q statistic along with the I² statistic. Overall, we found no evidence of a significant association between p73 G4A and risk of gastric cancer. A same trend was also indicated in subgroup analysis by ethnicity. The heterogeneity tests revealed that there was no significant heterogeneity across studies. Our meta-analysis indicates that p73 G4A might not have a major effect on risk of gastric cancer. A much larger study is required to validate our findings.     

早孕期基于头臀径建立孕龄计算公式的研究方法学分析

正妊娠期准确评估孕龄(gestational age,GA)对于预测分娩日期、评估新生儿成熟度十分必要~([1-3])。早孕期准确核对GA可提高早孕期筛查染色体异常的准确性~([4]),减少被诊断为早产~([5])和过期妊娠~([6])的孕妇的数量。既往常通过末次月经日期(last menstrual period,LMP)计算GA,但30%的孕妇不确定LMP或月经周期不规律。在孕9～13周,     

科研反哺教学在预防医学专业的探索

教学和科研是高校工作非常重要的两个部分,对于人才培养起着相互支撑、相辅相成的作用.面对高校人才培养中出现的教学和科研发展失衡、实践环节逐渐弱化的现状,中国医科大学公共卫生学院依托仪器共享平台的资源优势,积极开展科研反哺教学工作的探索.将教师的科研成果融入课堂,并借助仪器共享平台丰富的资源优势深化课程教学改革,提高教学质...     

Reassembling of albumin-bound paclitaxel mitigates myelosuppression and improves its antitumoral efficacy via neutrophil-mediated targeting drug delivery

Albumin-bound paclitaxel (abPTX) has been widely used in cancer treatment. However, dose-related side effects, such as myelosuppression, restrict its clinical application. Cell-based targeting drug delivery is a promising way to mitigate systematic side-effects and improve antitumoral efficacy. In this study, we demonstrated that reassembled abPTX could be engulfed by neutrophils in vivo and delivered to tumor site, thus improving therapeutic efficacy and mitigating myelosuppression. First, in vitro analysis confirmed that reassembling of abPTX formed uniform and stable serum albumin nanoparticles (NP-abPTX) with size of 107.5 ± 2.29 nm and reserved the ability to kill tumor cells. Second, we found that NP-abPTX could be engulfed by activated neutrophil in vitro and in vivo but do not affect neutrophils’ function, such as chemotaxis and activation. In a murine tumor model, we further proved that local radiotherapy (RT) induced inflammation activated peripheral neutrophils to capture venous infused NP-abPTX and carry them into tumor tissue. As compared to abPTX, infusion of NP-abPTX dramatically enhanced inhibition of tumor growth treated by local RT and mitigated hematotoxicity. Therefore, our study demonstrated a novel strategy to mitigate side-effects and to improve tumor killing efficacy of abPTX through neutrophil-mediated targeting drug delivery.