内蒙古自治区不同生态系鼠疫自然疫源地动物鼠疫流行现状及流行风险简析

内蒙古面临着多种类型疫源地鼠疫流行和复燃的风险。蒙古旱獭疫源地虽然暂未在国内发现动物间鼠疫流行,但过去检出过阳性血清,同时蒙古旱獭种群数量持续增加且分布范围不断扩大,毗邻的蒙古国和俄罗斯联邦的蒙古旱獭疫源地动物间鼠疫持续流行;达乌尔黄鼠疫源地动物间鼠疫时隐时现;长爪沙鼠疫源地动物间鼠疫流行猛烈,并频频波及人间。由于蒙古旱獭和达乌尔黄鼠鼠疫耶尔森菌菌株毒力明显高于长爪沙鼠鼠疫耶尔森菌菌株,且在历史上曾给当地带来深重灾难,因此内蒙古自治区鼠疫防控重点应在常规鼠疫监测的基础上,进一步加强蒙古旱獭和达乌尔黄鼠疫源地流行动态的监测,警惕该两个疫源地复燃并波及人间。     

Surgical Treatment and Proposed Modified Classification for Harrington Class III Periacetabular Metastases

ObjectivesThis study aims to: (i) evaluate the outcome of patients with Harrington class III lesions who were treated according to Harrington classification; (ii) propose a modified surgical classification for Harrington class III lesions; and (iii) assess the efficiency of the proposed modified classification.MethodsThis study composes two phases. During phase 1 (2006 to 2011), the clinical data of 16 patients with Harrington class III lesions who were treated by intralesional excision followed by reconstruction of antegrade/retrograde Steinmann pins/screws with cemented total hip arthroplasty (Harrington/modified Harrington procedure) were retrospectively reviewed and further analyzed synthetically to design a modified surgical classification system. In phase 2 (2013 to 2019), 62 patients with Harrington class III lesions were classified and surgically treated according to our modified classification. Functional outcome was assessed using the Musculoskeletal Tumor Society (MSTS) 93 scoring system. The outcome of local control was described using 2‐year recurrence‐free survival (RFS). Owing to the limited sample size, we considered P < 0.1 as significant.ResultsIn phase 1, the mean surgical time was 273.1 (180 to 390) min and the mean intraoperative hemorrhage was 2425.0 (400.0 to 8000.0) mL, respectively. The mean follow‐up time was 18.5 (2 to 54) months. Recurrence was found in 4 patients and the 2‐year RFS rate was 62.4% (95% confidence interval [CI] 31.6% to 93.2%). The mean postoperative MSTS93 score was 56.5% (20% to 90%). Based on the periacetabular bone destruction, we categorized the lesions into two subgroups: with the bone destruction distal to or around the inferior border of the sacroiliac joint (IIIa) and the bone destruction extended proximal to inferior border of the sacroiliac joint (IIIb). Six patients with IIIb lesions had significant prolonged surgical time (313.3 vs 249.0 min, P = 0.022), massive intraoperative hemorrhage (3533.3 vs 1760.0 mL, P = 0.093), poor functional outcome (46.7% vs 62.3%, P = 0.093), and unfavorable local control (31.3% vs 80.0%, P = 0.037) compared to the 10 patients with IIIa lesions. We then modified the surgical strategy for two subgroup of class III lesions: Harrington/modified Harrington procedure for IIIa lesions and en bloc resection followed by modular hemipelvic endoprosthesis replacement for IIIb lesions. Using the proposed modified surgical classification, 62 patients in the phase 2 study demonstrated improved surgical time (245.3 min, P = 0.086), intraoperative hemorrhage (1466.0 mL, P = 0.092), postoperative MSTS 93 scores (65.3%, P = 0.067), and 2‐year RFS rate (91.3%, P = 0.002) during a mean follow‐up time of 19.9 (1 to 60) months compared to those in the phase 1 study.ConclusionThe Harrington surgical classification is insufficient for class III lesions. We proposed modification of the classification for Harrington class III lesions by adding two subgroups and corresponding surgical strategies according to the involvement of bone destruction. Our proposed modified classification showed significant improvement in functional outcome and local control, along with acceptable surgical complexity in surgical management for Harrington class III lesions.     

Novel glucose-lowering drugs for non-alcoholic fatty liver disease

BACKGROUNDThe efficacy of novel glucose-lowering drugs in treating non-alcoholic fatty liver disease (NAFLD) is unknown.AIMTo evaluate the efficacy of glucose-lowering drugs dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose cotransporter 2 (SGLT2) inhibitors in treating NAFLD and to perform a comparison between these treatments.METHODSElectronic databases were systematically searched. The inclusion criteria were: Randomized controlled trials comparing DPP-4 inhibitors, GLP-1 RAs, or SGLT2 inhibitors against placebo or other active glucose-lowering drugs in NAFLD patients, with outcomes of changes in liver enzyme [alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST)] from baseline.RESULTSNineteen studies were finally included in this meta-analysis. Compared with placebo or other active glucose-lowering drug treatment, treatment with DPP-4 inhibitors, GLP-1 RAs, and SGLT2 inhibitors all led to a significant decrease in ALT change and AST change from baseline. The difference between the DPP-4 inhibitor and SGLT2 inhibitor groups in ALT change was significant in favor of DPP-4 inhibitor treatment (P < 0.05). The trends of reduction in magnetic resonance imaging proton density fat fraction and visceral fat area changes were also observed in all the novel glucose-lowering agent treatment groups.CONCLUSIONTreatment with DPP-4 inhibitors, GLP-1 RAs, and SGLT2 inhibitors resulted in improvements in serum ALT and AST levels and body fat composition, indicating a beneficial effect in improving liver injury and reducing liver fat in NAFLD patients.     

南京市2015—2019年肺结核流行特征分析

目的 分析南京市肺结核的流行病学特征,为政府制定科学的控制策略提供依据。方法 采用描述性分析、季节指数法以及时空重排扫描法对南京市2015—2019年肺结核登记报告数据进行分析。结果 2015—2019年南京市共登记报告11 761例肺结核病例, 肺结核报告发病率分别为32.47/10万、29.39/10万、24.67/10万、26.30/10万、27.00/10万,总体呈现下降趋势。病例中病原学阳性5 592例（47.55%）。2015—2019年全市2月份确诊病例数较少,4月份、9月份确诊病例的较多。时空重排扫描统计发现1个一类聚集区和5个二类聚集区,主要覆盖高淳区、浦口区、江宁区、六合区、江北新区以及鼓楼区所辖的相关街道。其中,一类聚集区覆盖高淳区全部辖区范围（8个街道）,聚集时间为2015/1/1—2017/6/30 (RR = 2.32,LLR = 181.87 , P＜0.001)。结论 2015—2019年南京市肺结核病例存在明显聚集区域,可以为制定科学、精准的区域性防控策略提供参考。     

山东省潍坊东部地区精神分裂症1号染色体基因扫描研究

目的对精神分裂症患者及正常对照者的1号染色体进行扫描,查找精神分裂症的关联位点。方法在1号染色体上间隔10cM（厘摩）遗传距离,选择了31个微卫星遗传位点,用DNA混合池的方法对119例精神分裂症患者与119名正常对照者的DNA样本分别混合后进行基因组扫描。经卡方检验分析,对比患者组与对照组的等位基因峰型比率的差异。结果在D1S2878遗传位点患者组与对照组的等位基因频率差异有统计学意义,P〈0.01。结论山东省潍坊东部地区精神分裂症患者群体中存在与1号染色体的关联区域。     

Behavioral characteristics of a mouse model of cancer pain

Pain is a major symptom in cancer patients, and most cancer patients with advanced or terminal cancers suffer from chronic pain related to treatment failure and/or tumor progression. In the present study, we examined the development of cancer pain in mice. Murine hepatocarcinoma cells, HCa-1, were inoculated unilaterally into the thigh or the dorsum of the foot of male C3H/HeJ mice. Four weeks after inoculation, behavioral signs were observed for mechanical allodynia, cold allodynia, and hyperalgesia using a von Frey filament, acetone, and radiant heat, respectively. Bone invasion by the tumor commenced from 7 days after inoculation of tumor cells and was evident from 14 days after inoculation. Cold allodynia but neither mechanical allodynia nor hyperalgesia was observed in mice that received an inoculation into the thigh. On the contrary, mechanical allodynia and cold allodynia, but not hyperalgesia, were developed in mice with an inoculation into the foot. Sometimes, mirror-image pain was developed in these animals. These results suggest that carcinoma cells injected into the foot of mice may develop severe chronic pain related to cancer. This animal model of pain would be useful to elucidate the mechanisms of cancer pain in humans.     

人急性白血病淋巴细胞HSP70及 HSP70 mRNA的表达研究

目的：检测急性白血病病人血淋巴细胞热休克蛋白70（HSP70）及其mRNA的表达。方法：ELISA法检测HSP70,RT－PCR法检测HSP70 mRNA。结果：化疗前急性白血病病人淋巴细胞HSP70及mRNA明显低于正常人;而化疗后,急性白血病病人淋巴细胞HSP70及mRNA明显高于正常人（P＜0．01）,结论：HSP70与急性白血病癌细胞关系密切,对癌细胞起保护作用。     

次抑菌浓度喹诺酮类药物体外诱导人型支原体ParE基因突变的研究

目的　探讨体外诱导耐喹诺酮类药物的Mh的ParE基因突变情况。方法　以含氧氟沙星、左旋氧氟沙星、盐酸环丙沙星、司帕沙星的培养基培养Mh标准敏感株 12代后 ,将其ParE基因进行PCR扩增 ,分析其核苷酸序列。结果　氧氟沙星、左旋氧氟沙星诱导Mh发生 70位的G→A的突变 ,导致 4 2 6位的天冬氨酸转变为天冬酰胺。结论　ParE基因中 70位的突变与Mh耐喹诺酮类药物有关。     

俄歇电子发射体67Ga-EDTMP 对骨肉瘤细胞株辐射效应的形态学变化

目的　研究俄歇电子发射体67Ga-EDTMP对人骨肉瘤细胞株 (HOS - 86 0 3)的辐射效应 ,探讨67Ga作为原发肿瘤和骨转移癌内照射治疗核素的可能性。方法　用成集落实验和透射电镜研究受照细胞的形态变化。结果　发现67Ga-EDTMP对肿瘤细胞有明显的杀伤和抑制增殖作用 ,并随剂量的加大 ,抑制效率增加 ;倒置显微镜下细胞集落数量减少 ,集落偏小 ,细胞稀疏。电镜下胞浆中空泡形成 ,细胞溶解、坏死 ,细胞核固缩 ,出现典型的细胞凋亡改变 ,形成凋亡小体。结论　67Ga可能是一种有前途的骨肉瘤和骨转移癌的放射性治疗核素