应用多层螺旋CT对耳硬化症的术前评估价值

目的:评估MDCT在术前耳硬化症诊断中的作用。方法:收集经临床证实为耳硬化症、且CT扫描采用螺旋扫描病例共18例,采集的数据传输到4.1工作站,进行多平面重建。结果:18例共36耳显示异常:单独前庭窗异常18耳,表现为前庭窗扩大或狭小,周围骨质密度降低或镫骨底板板密度增高;前庭窗及蜗窗同时受累共8耳;主要累及耳蜗周围迷路骨质10耳,表现为耳蜗骨迷路边缘不整,呈条片状密度减低或双环征。MPR交互重建充分显示了所有重要解剖结构的位置、形态:其中3耳为颈静脉球高位。结论:MDCT可以正确显示耳硬化症病灶的细微改变,提供详细的术前诊断信息;结合MPR技术可全面观察病变范围,并充分显示颞骨内重要解剖结构的位置和形态。对于手术方案的设计、防止手术并发症和提高疗效等具有重要意义。     

Epithelioid trophoblastic tumor: clinicopathological features with an emphasis on uterine cervical involvement.

We report on the clinical and histological features of five cases of epithelioid trophoblastic tumor, with an emphasis on its involvement of the uterine cervix. All five patients were of reproductive age (median age 38.4 years) and all, except one, presented with vaginal bleeding 3 to 18 years after the most recent pregnancy. One patient presented with amenorrhea. Elevation of serum human chorionic gonadotropin (hCG) was seen in four cases. Pathologically, the tumor involved endocervix in three cases and involved uterine corpus in another two. All five tumors were invasive, nodular lesions consisting of epithelioid intermediate trophoblastic cells that were mononuclear with abundant eosinophilic cytoplasm, along with zones of hyaline material and necrotic debris. In three cases of cervical involvement, the neoplastic cells focally replaced endocervical surface and glandular epithelium, simulating high-grade squamous intraepithelial lesions. Immunohistochemically, all five tumors displayed focal positivity for human placental lactogen and hCG. Positive nuclear staining of p63 was seen in all five cases. All patients received total hysterectomy and various regimes of adjuvant chemotherapy. Three patients survived the tumor with no recurrences or metastases with follow-up periods of 3, 7 and 16 years. One patient is currently alive with lung metastasis 1 month after the surgery. One patient died of tumor metastasis 8 months after the diagnosis. In summary, with its unusual ability to simulate an invasive squamous cell carcinoma and other epithelioid neoplasms, epithelioid trophoblastic tumor frequently poses a diagnostic challenge, especially when involving the uterine cervix. High index of suspicion and an awareness of elevation of serum chorionic gonadotropin are crucial in reaching a correct diagnosis.     

Reduced p21(WAF1/CIP1) expression is an early event in gallbladder carcinogenesis and is of prognostic significance for patients with carcinomas of the gallbladder

The molecular basis underlying the development and progression of gallbladder carcinoma (GBC) remains poorly understood. To evaluate the roles of p21(WAF1/CIP1) and p53 in gallbladder carcinogenesis and to assess their prognostic significance for patients with GBC, we used immunohistochemistry to examine the expression of p21(WAF1/CIP1) and p53 protein in a series of surgically resected specimens, including normal epithelia, precancerous lesions adenoma, and dysplasia, and carcinomas of the gallbladder. Reduced p21(WAF1/CIP1) expression was frequently observed in carcinomas (18 of 37 lesions; 49%), and even in precancerous lesions adenomas (3 of 7; 43%) and dysplasias (5 of 5; 100%). p53 overexpression was detected in 43% of the adenomas, 60% of the dysplasias and 57% of the carcinomas. There was an inverse relationship between p21(WAF1/CIP1) and p53 expression in GBCs (P =.01). Survival analysis indicated that reduced p21(WAF1/CIP1) expression was significantly associated with shortened disease-free and overall survival (P =.04 and.03, respectively) for patients with stages II to IV GBCs. These observations suggest that reduced p21(WAF1/CIP1) expression and p53 overexpression contribute to GBC from an early stage and that determination of p21(WAF1/CIP1) expression in surgically resected specimens would add prognostic information to conventional pathologic examinations for patients with advanced-stage GBC.     

人缺血脑组织中IP-10和IFN-γ的表达

目的：探讨趋化因子IP-10和细胞因子IFN-γ是否参与人缺血脑损伤过程。方法：将21例脑梗死死亡病例按发病持续时间分为〈7天、7～14天和15～21天3组，以非缺血侧半球做对照，用HE染色法观察炎性细胞浸润情况；通过免疫组织化学方法检测缺血半球脑组织与非缺血半球脑组织中趋化因子IP-10和细胞因子IFN-γ的表达。结果：在〈7天组和7～14天组中，缺血脑组织可见大量炎性细胞浸润。在〈7天组、7～14天组和15～2l天组中，趋化因子IP-10在缺血半球脑组织中的表达高于非缺血半球（分别是1．74倍增高，P〈0．01；1．41倍增高，P〈0．05和1．52倍增高，P〈0．01）。在对细胞因子IFN-γ的检测中发现〈7天和7～14天组中，IFN-γ在缺血半球脑组织中的表达高于非缺血半球（分别是1．65倍增高，P〈0．05和1．32倍增高，P〈0．05）；在15～21天组中，IFN-γ在缺血半球与非缺血半球中的表达没有显著差异（P〉0．05）。结论：在人缺血脑组织中观察到IP-10和IFN-γ的表达，提示IP-10和IFN-γ参与了炎症反应对脑组织的损伤过程。同时也提示IP-10可能参与后期对损伤脑组织的修复。     

细胞因子对T细胞生长激素基因表达的影响

目的 探讨各种细胞因子对T细胞生长激素（GH）基因表达的影响。方法 构建含人GH调控序列的荧光素酶报告基因质粒pGL2-GH-luc，然后转染入T淋巴细胞系Jurkat E6-1细胞中，在培养液中分别加入各种细胞因子。结果 生理浓度的IL－1β，TNF－β和IFN－γ，对Jurkat细胞中荧光素酶的表达具有抑制作用（P＜0．05）。结论 细胞因子参与了调节淋巴细胞GH基因的表达。     

Impact of Dissection after Drug-Coated Balloon Treatment of De Novo Coronary Lesions: Angiographic and Clinical Outcomes

PurposeDissection after plain balloon angioplasty is required to achieve adequate luminal area; however, it is associated with a high risk of vascular events. This study aimed to examine the relationship between non-flow limiting coronary dissections and subsequent lumen loss and long-term clinical outcomes following successful drug-coated balloon (DCB) treatment of de novo coronary lesions.Materials and MethodsA total of 227 patients with good distal flow (Thrombolysis in Myocardial Infarction flow grade 3) following DCB treatment were retrospectively enrolled and stratified according to the presence or absence of a non-flow limiting dissection. The primary endpoint was late lumen loss (LLL) at 6-month angiography, and the secondary endpoint was target vessel failure (TVF, a composite of cardiac death, target vessel myocardial infarction, target vessel revascularization, and target vessel thrombosis).ResultsThe cohort consisted of 95 patients with and 132 patients without a dissection. There were no between-group differences in LLL (90.8%) returning for angiography at 6 months (0.05±0.19 mm in non-dissection and 0.05±0.30 mm in dissection group, p=0.886) or in TVF (6.8% in non-dissection and 8.4% in dissection group, p=0.799) at a median follow-up of 3.4 years. In a multivariate analysis, the presence of dissection and its severity were not associated with LLL or TVF. Almost dissections (93.9%) were completely healed, and there was no newly developed dissection at 6-month angiography.ConclusionThe presence of a dissection following successful DCB treatment of a de novo coronary lesion may not be associated with an increased risk of LLL or TVF (Impact of Drug-coated Balloon Treatment in de Novo Coronary Lesion; {"type":"clinical-trial","attrs":{"text":"NCT04619277","term_id":"NCT04619277"}}NCT04619277).     

中医药对糖尿病足溃疡相关细胞因子调控作用的研究进展

糖尿病足溃疡是糖尿病严重的破坏性并发症,致残率及致死率逐年增高,严重威胁人类身心健康。中医药治疗糖尿病足溃疡,注重辨证论治与整体观念相结合,不仅能改善中医证候,更能在加速创面愈合的同时减少创面的复发,一定程度上延缓了糖尿病足溃疡的进一步恶化,降低其致残率及致死率。现代研究发现,糖尿病足溃疡难以愈合与各种细胞因子如炎症因子、生长因子、趋化因子等分布异常密切相关;随着现代医学对中医药研究的不断深入,中药单体及复方调控细胞因子治疗糖尿病足溃疡已成为研究热点,该文通过对目前国内外研究现状进行归纳,得出以下总结：(1)芝麻酚、栀子苷、当归补血汤、紫朱软膏等调节肿瘤坏死因子-α(TNF-α)、白细胞介素（IL）-1、IL-6、IL-10等炎症因子,抑制创面炎症。(2)白芷、丹酚酸B、四效散、壮药拔毒生肌膏等调节血管内皮生长因子（VEGF）、血小板衍生生长因子（PDGF）、转化生长因子（TGF）、表皮生长因子（EGF）等生长因子,促进创面胶原沉积及血管新生。(3)芍药苷、隐丹参酮、蜂毒、回阳生肌汤等调节CXC趋化因子配体（CXCL）1、CXCL2、CC趋化因子配体（CCL）2、CCL3、基质细胞衍生...     

科技论文中通信作者和末位作者重要性的比较

【目的】 试图解决论文作者署名中通信作者与末位作者谁是最重要的作者的问题。【方法】 以Science期刊为研究对象,收集该刊论文的作者署名信息和作者贡献声明信息,提取贡献要素并进行规范化分类,结合作者贡献声明和作者署名位置、署名角色进行比较分析。【结果】 在论文作者署名位置的分布中,末位作者通常同时是通信作者。在论文研究中,通信作者往往比末位作者发挥更重要的作用。对于不是通信作者的末位作者,其对研究的贡献往往较低。【结论】 结合作者贡献声明能够合理地判断作者的重要性。学术界对于作者署名位置应该有更加统一的认识,建议在科技期刊中推行作者贡献声明政策,完善学术期刊作者贡献声明规范。     

PCOS患者AMH水平与性激素及胰岛素抵抗的相关性研究

目的 探讨多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)水平与性激素及胰岛素抵抗(IR)的相关性.方法 选取2019年1月至12月在西安交通大学第一附属医院妇科内分泌门诊及西北工业大学医院妇科确诊的PCOS患者109例,测定患者血清AM H、性激素水平,应用稳态模型评估胰岛素抵抗指数(HOMA-IR),分析PCOS患者不同AM H水平的性激素及IR值的差异,以及性激素、IR对AM H的影响.结果 对PCOS患者,根据血清AM H检测值按百分位(<25％,25％ ～75％,>75％)进行分层,随着AMH百分位逐渐升高,体质量指数(BMI)、HOMA-IR值均降低(F值分别为3.354、3.712,P<0.05),同时黄体生成素(LH)、睾酮(T)值均升高(F值分别为3.355、3.317,P<0.05).相关性分析显示,血清AMH水平与BMI、HOMA-IR均呈显著负相关(r分别为-0.228、-0.214,P<0.05),与L H、T均呈显著正相关(r分别为0.344、0.327,P<0.01).进一步多元回归分析显示,在控制BMI后,LH及T对AMH存在显著正向影响(β=0.258,P<0.05;β=0.291,P<0.01).结论 PCOS患者血清AMH水平与LH、T均呈正相关,其与HOMA-IR的负相关关系可以由BMI解释.