Neoadjuvant combination of pazopanib or axitinib and programmed cell death protein-1-activated dendritic cell-cytokine-induced killer cells immunotherapy may facilitate surgery in patients with renal cell carcinoma

BackgroundRadical/cytoreductive nephrectomy or nephron-sparing surgery may be thought to be not safe or unfeasible in some renal cell carcinoma (RCC) patients in which tumor is locally advanced or highly complicated. Neoadjuvant therapy may reduce the volume of the tumor, thus facilitates surgery. The aim the study is to evaluate the efficacy and safety of neoadjuvant combination of pazopanib or axitinib and PD-1-activated dendritic cell-cytokine-induced killer (PD-1/DC-CIK) cell immunotherapy in those patients.MethodsData from 16 RCC patients who received neoadjuvant pazopanib (Group P, n=9) or axitinib (Group A, n=7) plus PD-1/DC-CIK cells immunotherapy were reviewed retrospectively. A total of 9 participants that were potential candidates for radical/cytoreductive nephrectomy (RN/CN) had locally advanced tumor and 5 participants with partial nephrectomy (PN) absolute indications had highly complicated tumors. The efficacy outcomes were based on volume changes of the primary tumor, lymph nodes, and tumor thrombus in 13 participants with complete computed tomography (CT) imaging. The treatment-related toxicities and surgical complications were also reported.ResultsWith a median of 2.1 months treatment, the overall volume of the tumors decreased by a median of 42.30% [interquartile range (IQR): 19.37–66.78%]. Specifically, the median reduction of tumor volume was 88.77 and 15.50 cm³ in group P and group A, respectively (P=0.014). However, participants in Group P were more likely to experience grade 3 or 4 treatment-related adverse events (AEs) than those in Group A (44.4% vs. 0). Finally, all participants were candidates for appropriate surgery after neoadjuvant therapy (as assessed by the surgeon), and 10 participants accepted surgery, including 5 PN, 4 RN/CN, and 1 lymph node dissection. A solitary participant had Clavien grade IV acute renal failure required dialysis and another had grade II lymphatic leakage.ConclusionsNeoadjuvant combination of pazopanib or axitinib and PD-1/DC-CIK cells immunotherapy was well-tolerated and could effectively reduce the volume of tumors in locally advanced or highly complicated RCC patients.     

不同年龄组正常人群影响最大胸椎后凸角的相关因素分析

目的：本研究通过对不同年龄组正常人群矢状位参数进行分析,旨在报道正常人群脊柱骨盆参数参考值范围,并探索不同年龄段引起最大胸椎后凸角改变的影响因素。 方法：本研究纳入自2015年1月至2018年月于两所医院健康体检中心的正常人群,收集人口统计学参数以及矢状位影像学参数。通过将人群分为≤40岁组与＞40岁组,对比分析不同年龄组人群的矢状位参数,并对不同年龄组影响最大胸椎后凸角max TK的因素进行相关性分析。结果：本研究共计纳入191例正常人群,其中≤40岁组94人,平均年龄为28.5±6.4岁;＞40岁组97人,平均年龄为53.9±8.3岁。不同年龄组人群在胸1椎体矢状位倾斜角T1 Tilt（18.6±6.5 vs. 20.6±5.5, P=0.023）, 胸椎后凸下端椎倾斜角TVA（15.3±5.3 vs. 17.5±6.6, P=0.013）,max TK（33.9±8.3 vs. 38.0±9.4, P<0.001）,max LL- max TK（14.9±8.9 vs. 12.3±9.4, P=0.048）及矢状面躯干偏移SVA（-2.5±21.8 vs. 6.1±20.9, P=0.006）上存在显著差异。在年龄≤40岁的人群中,T1 Tilt、TVA、max LL及骶骨倾斜角SS与max TK显著相关,而在年龄＞40岁的人群中,年龄、T1 Tilt、TVA、max LL及骨盆入射角PI与max TK显著相关。结论：max TK随着年龄增长呈现上下均匀增长趋势,在＞40岁的人群中,max TK与年龄呈现正相关关系。此外,不同年龄阶段,骨盆对于max TK改变的代偿呈现出不同的模式。     

功能性消化不良患者胃排空功能与症状分型的关系

目的　通过 99m Tc植酸钠固体餐检测胃排空 ,了解功能性消化不良 (functional dyspepsia,FD)患者各临床亚型胃运动的情况 .方法　 99m Tc植酸钠标记固体餐 ,对 30例 FD患者 (其中溃疡样型 10例 ,动力障碍型 10例 ,非特异型 10例 )及 10名健康对照者进行了核素检测分析 .结果　运动障碍样型及非特异型 FD患者胃半排空时间延迟 (87± 2 8min,89± 2 6 min vs6 1± 9min,P<0 .0 5 ) ,2 h胃排空率明显减少(6 3.0± 11.5 % ,5 7.7± 15 .5 % vs87.0± 10 .3% ,P<0 .0 1) ,而溃疡样型 FD与正常人比无差异 (P>0 .0 5 ) .结论　胃排空延迟在运动障碍样型及非特异型 FD病因中占重要地位 ,FD三个临床亚型之间发病机制既相同又略有不同 ;FD患者中有症状与胃排空之间存在不一致现象 ,所以核素胃排空检查在 FD胃运动功能的判定及指导治疗上有重要意义 .     

孕妇及新生儿巨细胞病毒感染的分子生物学诊断

目的 :建立套式聚合酶链反应 ( n PCR)检测人巨细胞病毒 ( HCMV)。方法 :建立套式 PCR检测 HCMV DNA,同时结合病毒分离检测临床标本。结果 :在 2 3例新生儿肝炎综合征患儿中 ,10例病毒分离及套式 PCR均阳性 ;1例病毒分离阴性 ,但套式 PCR阳性。对 58例妊娠早期孕妇血标本进行检测 ,套式 PCR阳性率为 9% ,病毒分离阳性率则为 7%。结论 :套式 PCR是一种临床检测HCMV的快速有效手段。     

医源性桡神经损伤

总结３１例医源性桡神经损伤的经验教训。方法手术治疗２５例,非手术治疗６例,手术行端端鞘膜法缝合１３例,束膜法缝合５例,神经移植４例,粘连松解３例,结果按朱家恺标准评价,优者２４例,良者６例,可者１例。随访时间最长者１０年,最短者１年。;结论熟知桡神经和肱骨干及桡骨小头的密切解剖关系和细致的手术操作加强医生的责任心,医源性桡神经损伤是安全可以避免的。手术应尽量进行,不能考虑骨折愈合与否。     

CD23单克隆抗体的研制及其鉴定

目的：制备高度特异性和高纯度的抗ＣＤ２３单克隆抗体（ＣＤ２３ＭｃＡｂ）。方法：用ＥＢＶ感染的人Ｂ淋巴细胞（ＲＰＭＩ－８８６６）免疫ＢＡＬＢ／Ｃ小鼠,采用杂交瘤技术,细胞ＥＬＩＳＡ和Ｗｅｓｔｅｒｎ－ｂｌｏｔｉｎｇ等方法制备、纯化和鉴定了ＣＤ２３ＭｃＡｂ。结果：筛选出了强分泌抗Ｂ细胞膜ＣＤ２３分子的单克隆抗体的杂交瘤细胞株（２Ｂ６）。结论：该单抗对Ｍｒ４５×１０３的ＣＤ２３分子反应具有高度特异性。     

超声心动图检测模拟失重大鼠左心室的结构与功能

目的验证模拟失重４ｗｋ大鼠心脏工室的结构与功能 否出现类似航天员飞行后的变化,方法 应用超声心动图技术检测模拟失重大鼠心脏左室的结构与功能。结果 模拟失重４ｗｋ大鼠左室舒张末与收缩末短径显著减小;左室壁厚度亦减小,但差别未达显著程度。左室舒张末与收缩末容积,每搏量及其相应的体重归一化指数皆显著减少,左室估计质量及其指料显著减少。     

酒精、乙醛对星形胶质细胞膜脂质流动性的影响

应用荧光偏振技术探讨酒精及其代谢产物乙醛对与神经细胞发育分化相关的星形胶质细胞膜脂质荧光偏振度（Ｐｒ）和流动度（ＬＦＵ）的影响。结果表明低剂量酒精、乙醛并不影响星形胶质细胞膜脂荧光偏振度和流动度,而在中剂量以上均可影响星形胶质细胞的Ｐｒ值,导致荧光偏振度降低,而细胞膜脂质流动度增高,均与酒精、乙醛剂量显著相关。同剂量酒精、乙醛对星形胶质细胞作用和流动度增加无显著性差异。但酒精、乙醛均可导致星形胶质细胞膜脂质流动性增加,致使细胞膜的结构改变。     

某市自来水有机提取物对小鼠精子及血清睾酮含量影响的研究

为探讨饮用水中有机提取物的生殖毒性,研究了某市自来水有机提取物对小鼠精子和血清睾酮含量的影响。结果表明：染毒后１０天,有机提取物致使精子活性降低畸开 子数增加,梁毒后３５天,精子活性、血清睾酮含量均显著下降。说明该自来水有机提取物通过血－睾屏障,干扰生精细胞正常发育。