乳腺癌Ki-67和CyclinD1在预测及评估新辅助化疗疗效中的价值

目的 探讨乳腺癌Ki-67和CyclinD1在预测及评估新辅助化疗疗效中的价值。方法 选取2019年7月~2020年12月我院的60例临床Ⅱ-Ⅲ期的乳腺癌患者,以Miller-Payne系统评价新辅助化疗疗效,通过免疫组化检测化疗前后Ki-67、CyclinD1的表达,分析化疗前后Ki-67、CyclinD1表达的改变及与化疗疗效的关系。结果 病理缓解组化疗前Ki-67的表达水平高于非病理缓解组,差异有统计学意义（P<0.05）;化疗后Ki-67的表达水平较化疗前下降,差异有统计学意义（P<0.05）;化疗后Ki-67的明显下降与病理缓解具有相关性（r=0.392,P<0.05）。病理缓解组化疗前CyclinD1的表达水平与非病理缓解组无明显差异（P>0.05）,化疗后CyclinD1的表达水平与化疗前无明显差异（P>0.05）。化疗前CyclinD1的表达与Ki-67呈正相关（r=0.334,P<0.05）。结论 Ki-67具有预测及评估乳腺癌新辅助化疗疗效的作用。CyclinD1的表达与新辅助化疗疗效无明显关系。     

Construction and evaluation of detachable bone-targeting MOF carriers for the delivery of proteasome inhibitors

Tumor bone metastasis is an important cause of tumor recurrence and death. Although bone-targeting nanoparticles decorated with targeting ligands have shown good affinity for bone tissues with the properties of adhesion to the bone matrix, it is not easy to detach from the surface of the bone matrix in the tumor-bone microenvironment, attributed to the robust coordination force between the targeting ligands, such as bisphosphates with bone-deposited calcium. This may hinder the transport of nanoparticles from bone tissue to bone metastatic tumors. In this research, we designed a bone-targeting nanocarrier with detachable bone-targeting character for the therapy of bone metastases. The nanoparticles were constructed by using ZIF-8 and bone-targeting and MMP enzyme sensitive polypeptide-modified hyaluronic acid as a carrier and proteasome inhibitor Bortezomib (BTZ) as cargo. The results show that the constructed D8-M3-HA-ZIF8@BTZ nanoparticles possessed several favorable properties such as good colloidal stability, acid-sensitive drug release, D8 peptide mediated bone targeting and MMP enzyme-responsive desorption. Besides, nanoparticle endocytosis and cytotoxicity were enhanced through HA-mediated targeting to CD44 over-expressing tumor cells. Altogether, this study provides a potential cascade targeting strategy for improving the delivery effects of bone targeted nanoparticles for the delivery of proteasome inhibitors.

Tumor bone metastasis is an important cause of tumor recurrence and death.     

脾动脉瘤的临床特征与腔内治疗：附30例报告

背景与目的:脾动脉瘤(SAA)是一类少见、具有潜在致命破裂风险的内脏动脉瘤疾病。SAA的传统手术方式为开腹切除动脉瘤及脾脏。近年来,随着介入技术和材料的发展,SAA的腔内治疗越来越普及。相比于开放手术,腔内治疗具有微创、简便、术后快速康复的优势。本文探讨SAA腔内治疗的有效性和安全性。方法:回顾性分析2012年1月—2019年12月在中南大学湘雅医院血管外科治疗的30例SAA患者资料,并介绍了我科治疗SAA的3种介入手术方式。结果:患者30例均行腹部CTA明确SAA诊断,其中近脾门型17例,中间型9例,远脾门型4例;囊状动脉瘤19例,梭形动脉瘤11例。30例均采取腔内治疗方法,其中21例行SAA栓塞术,6例行脾动脉支架置入术,3例行脾动脉裸支架置入+栓塞术。患者术后平均住院时间4 d,平均住院费用5万元,术后发生腹痛、呕吐、发热等症状10例,症状均在3 d以内缓解,无后遗症发生。发生穿刺点出血1例,保守治疗好转后出院。住院期间无急性脾梗死发生,没有发生需再次手术的并发症。22例患者术后随访3～6个月,CT复查示动脉瘤完全血栓化,未见造影剂进入;出现无症状局灶性脾梗死5例。结论:介入腔内手术可在保留脾脏的情况下治疗SAA,治疗效果确切,且创伤小,术后恢复快,并发症发生概率低,住院时间短,费用相比开放手术无明显增加。腔内治疗可作为绝大部分SAA的首选治疗,具体手术方式需根据术前CTA显示的SAA形态及位置来决定。     

脂肪间充质干细胞治疗下肢缺血患者疗效分析及人成骨细胞特异因子-2基因表达

目的探讨分析人脂肪间充质干细胞(ADSC)治疗下肢缺血患者疗效分析及人成骨细胞特异因子-2(periostin,POSTN)基因表达状况。方法选取2015年1月至12月收治住院的下肢缺血患者56例,常规治疗的基础上给予ADSC治疗,对比治疗前后的各项临床症状、体征、检测指标的变化及人成骨细胞特异因子-2的表达。结果患者静息痛、冷感与间歇性跛行状况经治疗后均显著由于治疗前,治疗后需要止疼药物或保温措施干预的患者显著减少,行走有疼痛的患者也显著减少,差异有统计学意义(P<0.05);患者经治疗后皮温、踝臂指数、经皮氧分压显著优于治疗前,POSTN表达显著低于治疗前,差异有统计学意义(P<0.05);患者经治疗后生理职能、生理机能、一般健康状况、躯体疼痛、社会功能、精力、精神健康和情感职能8个不同的方面的SF-36评分显著优于治疗前,差异有统计学意义(P<0.05)。结论 ADSC治疗下肢缺血疗效较佳,POSTN在ADSC治疗前的下肢缺血患者血浆中呈现为高表达,治疗后显著降低,POSTN表达或可用于评价下肢缺血患者临床疗效。     

一测多评法测定左归丸中3种环烯醚萜苷类成分的含量

目的：建立以马钱苷为内参物,同时测定左归丸中莫诺苷、马钱苷和山茱萸新苷含量的一测多评法（QAMS）。方法：采用高效液相色谱法,Phenomenex C18（250 mm×4.6 mm,5 μm）硅胶色谱柱;流动相：乙腈（A）-0.3%磷酸水溶液（B）梯度洗脱;柱温35℃;检测波长（0~65 min,240 nm,检测莫诺苷和马钱苷;66~80 min,218 nm,检测山茱萸新苷）。以马钱苷为内参物,建立其与莫诺苷、山茱萸新苷的相对校正因子（RCFS）,并进行含量计算,实现一测多评;同时采用外标法（ESM）测定左归丸中3种有效成分的含量,比较一测多评法计算值与外标法实测值的差异。结果：在一定线性范围内,马钱苷与莫诺苷、山茱萸新苷的相对校正因子分别为1.048、1.390。建立的相对校正因子重现性良好,7批左归丸中3种成分的计算值与实测值间无显著差异。结论：采用本研究建立的“一测多评”法控制左归丸的质量是可行的。     

Mini-CEX在中医儿科学临床教学中的应用与效果评价

目的:评价迷你临床演练评估（mini-clinical exercise assessment,Mini-CEX）在中医儿科学临床教学中的应用效果,进一步优化具有中医儿科学特色的Mini-CEX量表,提高教师对其内涵的理解。方法:选择儿科临床实习本科生50名,随机分为Mini-CEX组和对照组,每组各25人。总共实习4...     

空肠炎性肌纤维母细胞瘤伴出血一例

1例患者间断腹部不适8年，加重伴黑便3 d入院，经胃镜、肠镜、腹部CT等检查未见出血病灶，后经胶囊内镜、双气囊小肠镜检查发现病灶，遂行“小肠肿物切除+小肠吻合术”治疗，术后组织病理确诊为（小肠）炎性肌纤维母细胞瘤，术后恢复良好。     

Risk factors of enteral feeding intolerance in severe acute pancreatitis patients: A protocol for systematic review and meta-analysis

Background:Patients with severe acute pancreatitis (SAP) have gastrointestinal dysfunction, and enteral nutrition intolerance is easy to occur during the implementation of enteral nutrition, which leads to the suspension or termination of enteral nutrition. Enteral nutrition cannot tolerate the influence of many factors. At present, there is a lack of analysis on the influencing factors of enteral nutrition intolerance in patients with SAP. Therefore, this study analyzed the factors of enteral nutrition intolerance in patients with SAP by meta-analysis, to provide a basis for the protection of enteral nutrition in patients with SAP.Methods:Databases (PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang) were searched using index words to find relevant studies published before March 2021. Meta-analyses of relative risk were performed for the identification of risk factors.Results:We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals.Conclusion:This study systematically reviewed the existing evidence and determined the incidence and predictors of enteral nutrition intolerance in patients with SAP.     

Biomarkers of joint metabolism and bone mineral density are associated with early knee osteoarthritis in premenopausal females

Clinical Rheumatology - Biomarkers of bone and cartilage metabolism were proposed as early diagnosis indicators for knee osteoarthritis (OA), however, which were influenced by disease stage, age,...     

炎性相关细胞因子和心肌梗死微循环再灌注状态的关系

目的　观察急性心肌梗死 (AMI)患者梗死相关血管 (IRA)开通前后炎性细胞因子的动态变化及其与心肌组织水平灌注状态的关系。方法　 (1)测定 8例健康人和 2 2例AMI患者急诊冠状动脉介入治疗术 (PCI)前即刻 ,术后 12、2 4h ,血浆白细胞介素 (IL) 1β、肿瘤坏死因子 (TNF)α、IL 10的变化。 (2 )按照再灌注后 2h心电图ST段回落是否 >70 % ,将 2 2例AMI患者分为 :A组 (ST回落≥ 70 % )12例和B组 (ST回落 <70 % ) 10例 ,比较两组患者IL 1β、TNFα、IL 10的变化幅度。 结果　 (1)治疗前A、B两组AMI患者血浆TNFα、IL 10略高于健康对照组 ,但差异无统计学意义 (P >0 0 5 ) ;而IL 1β显著高于健康对照组 (P <0 0 5 ) ;再灌注后 12、2 4hA、B两组血浆IL 1β和TNFα均较术前显著增高 (P <0 0 1,P <0 0 5 ) ,B组血浆IL 10较术前显著增高 (P <0 0 5 ) ,A组则无此变化 (P >0 0 5 )。 (2 )A、B两组间比较 ,治疗前TNFα、IL 1β、IL 10差异均无显著性 (P >0 0 5 ) ;成功PCI、IRA血流达TIMI 3级者 ,B组患者血浆IL 1β、TNFα、IL 10 ,在再灌注 12h显著高于A组 (P <0 0 1,P <0 0 5 ,P <0 0 5 ) ,再灌注 2 4h ,IL 1β、IL 10仍然高于A组 (P <0 0 5 )。 (3)A、B两组患者抗炎因子IL 10的升高幅度均显著低于致炎