罗伊适应模式在皮肤科门诊中的应用

目的:探讨罗伊适应模式在皮肤科门诊中的应用。方法:将88例皮肤科门诊患者随机分为实验组和观察组各44例,实验组进行罗伊适应模式护理,对照组实施常规护理,比较两组的满意度。结果:实验组满意度明显高于对照组。结论:实施依据罗伊适应模式制定的护理措施可以提高皮肤科门诊患者对护理质量的满意度和生活质量,值得临床推广应用。     

甘露聚糖肽预防慢性阻塞性肺疾病急性发作的单盲、随机双模拟临床研究

目的评价甘露聚糖肽预防慢性阻塞性肺疾病(COPD)急性发作的临床效果及安全性。方法采用多中心、单盲、随机对照方法,试验组给予常规治疗,如解痉、祛痰、抗感染治疗,加用甘露聚糖肽胶囊(30 mg/d),对照1组加用安慰剂(30 mg/d),对照2组加用泛福舒7 mg/d,隔日服用,疗程为3个月,随访12个月评价患者的COPD急性发作情况及机体免疫功能。结果共240例患者入选,每组各80例,甘露聚糖肽显著减少COPD急性发作感染次数、发作天数、抗生素应用天数、住院天数及圣乔治呼吸问卷评分,显著改善肺功能指标第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及CD3+、CD4+、CD4+/CD8+、IgA水平及6 min步行距离,与安慰剂比较具有统计学差异(P<0.05);与泛福舒相似,不具有统计学差异(P>0.05)。结论甘露聚糖肽可减少反复呼吸道发生COPD急性发作,提高肺功能指标及机体;免疫功能,提高患者的生活质量,不良反应轻微。     

Correlation of macrophage migration inhibitory factor gene polymorphism with the risk of early-stage cervical cancer and lymphatic metastasis

Associations of functional single nucleotide polymorphisms in MIF-173G/C with early stage cervical cancer were investigated in a hospital-based case-control study on 250 patients with cervical cancer prior to surgery (including 49 cases with and 201 cases without lymphatic metastasis) and 147 healthy controls. The polymorphism was assessed using restriction fragment length polymorphism polymerase chain reaction, and the MIF serum concentration was examined using the enzyme-linked immunosorbent assay to analyze the correlation between the polymorphism and the MIF serum concentration. Carriers of the variant C allele in MIF-173 were at a significantly higher risk of cervical cancer compared to carriers of the wild-type allele (aOR=1.508; 95% CI, 1.128-2.016, p=0.05). The GC and CC genotypes may be the causative factors for cervical cancer (aOR=1.851; 95% CI, 1.132-3.027, p=0.013). Individuals with the GC+CC genotype and C allele at the MIF-173G/C site were at a significantly higher risk of cervical cancer and lymphatic metastasis. The risk of lymphatic metastasis in early stage cervical cancer was increased more than 1.6 times in patients with the CC and GC genotypes compared with those with the GG genotype. The genotype distribution and allele frequency of MIF-173G/C were statistically significant in the well-, moderately and poorly differentiated groups (P<0.05). Compared to the GG genotype and G allele, patients with GC and CC genotypes and C allele exhibited a lower degree of differentiation and a higher degree of malignancy. A significant difference was observed in MIF serum concentrations among the various subgroups (P<0.05). The early cervical cancer, lymphatic metastasis and poorly differentiated groups exhibited higher MIF levels in serum. Moreover, patients with the CC genotype exhibited higher MIF serum concentration, which could increase the risk of early stage cervical cancer and lymphatic metastasis. The results presented in this study provide the first evidence that the genetic polymorphism MIF-173 is associated with cervical cancer in humans. Detection of MIF serum concentration and genotyping may be used as biomarkers for early diagnosis and therapy for cervical cancer.     

扩大联合脏器切除治疗T4b期胃癌的临床分析

目的探讨扩大联合脏器切除T4b期胃癌的疗效,总结手术经验。方法对2012年1月至2015年12月在哈尔滨医科大学附属第一医院手术治疗的128例T4b期胃癌临床资料进行回顾性分析。结果 85例行扩大联合脏器切除术(extended multi-organ resection,ER组),43例行姑息性手术(non-extended multi-organ resection,NER组)。随访ER组1年、2年、3年的生存率分别为65.38%、44.87%和38.46%,均高于NER组的35.13%、16.21%和5.41%,两者之间的差异均有统计学意义(P0.05)。ER组的并发症发生率为18.82%,高于NER组的4.65%,两组之间的差异有统计学意义(P0.05);ER组的围手术期病死率为2.35%,NER组为2.33%,两者之间的差异无统计学意义(P0.05)。结论扩大联合脏器切除是安全可行的,可以延长病人生存期,改善临床症状,提高生存质量。     

Characterization of a Large Novel α-Globin Gene Cluster Deletion Causing α0-Thalassemia in a Chinese Family

We report a large novel α-globin cluster deletion that we named –?–^PG (NG_000006.1: g.93628_542759del450131), in a Chinese family. This large deletion is approximately 450?kb long, spanning from upstream of the PolR3k gene at the 5′ end to the RAB11FIP3 gene at the 3′ end of chromosome 16p13.3. This deletion removes all the globin distal regulatory elements as well as the whole α-globin gene cluster. Patients with heterozygous –?–^PG/αα had red blood cell (RBC) indices consistent with α-thalassemia (α-thal) trait, but no apparent increase in a cancer tendency or mental disability, microcephaly, relative hypertelorism, unusual facies or genital anomalies.     

江西省山丘型血吸虫病传播控制地区野生动物血吸虫感染调查

目的　掌握江西省山丘型血吸虫病传播控制地区野生动物血吸虫感染情况，为实施精准防控措施及实现血吸虫病传播阻断和消除目标提供科学依据。方法　选择江西省血吸虫病疫情较重的山丘型流行区瑞昌市和彭泽县的5个流行村作为调查村。在调查村有螺环境捕捉野鼠等野生动物，收集来自调查村的野生动物肝脏，检查其血吸虫感染情况。在调查村采用间接血凝试验（IHA）筛查、粪便尼龙绢袋集卵孵化法和改良加藤厚涂片法检测人群血吸虫感染，采用粪便塑料杯顶管孵化法检测家畜血吸虫感染；采用系统抽样结合环境抽查法调查钉螺分布，采用环介导等温扩增技术（LAMP）检测钉螺血吸虫感染。结果　在调查村捕获、收购野鼠、黄鼠狼、野猪、麂子和野兔等野生动物或肝脏样本240只（份），其中捕获野鼠172只，血吸虫感染率为2.91%，其他野生动物未发现血吸虫感染；野鼠、麂子和野猪肝毛细线虫感染率分别为12.21%、1.96%和12.50%。调查村人群和家畜中均未发现血吸虫感染；各村平均钉螺密度在0.13～0.80只/0.1 m2，在1个村发现2只检测管钉螺有血吸虫阳性。结论　江西省山丘型传播控制地区野生动物在血吸虫病传播中的作用和潜在风险仍不可忽视；应继续加强监测，并采取有针对性防治措施，以巩固血吸虫病防治成果。     

Antitumor efficacy of lidamycin on hepatoma and active moiety of its molecule

AIM: To study the in vitro and in vivo antitumor effect of lidamycin (LDM) on hepatoma and the active moiety of its molecule. METHODS: MTT assay was used to determine the growth inhibition of human hepatoma BEL-7402 cells, SMMC-7721 cells and mouse hepatoma H22 cells. The in vivo therapeutic effects of lidamycin and mitomycin C were determined by transplantable hepatoma 22 (H22) in mice and human hepatoma BEL-7402 xenografts in athymic mice. RESULTS: In terms of IC50 values, the cytotoxicity of LDM was 10 000-fold more potent than that of mitomycin C (MMC) and adriamycin (ADM) in human hepatoma BEL-7402 cells and SMMC-7721 cells. LDM molecule consists of two moieties, an aproprotein (LDP) and an enediyne chromophore (LDC). In terms of IC50 values, the potency of LDC was similar to LDM. However, LDP was 105-fold less potent than LDM and LDC to hepatoma cells. For mouse hepatoma H22 cells, the IC50 value of LDM was 0.025 nmol/L. Given by single intravenous injection at doses of 0.1, 0.05 and 0.025 mg/kg, LDM markedly suppressed the growth of hepatoma 22 in mice by 84.7%, 71.6% and 61.8%, respectively. The therapeutic indexes (TI) of LDM and MMC were 15 and 2.5, respectively. By 2 iv. injections in two experiments, the growth inhibition rates by LDM at doses of 0.1, 0.05, 0.025, 0.00625 and 0.0125 mg/kg were 88.8-89.5%, 81.1-82.5%, 71.2-74.9%, 52.3-59.575%, and 33.3-48.3%, respectively. In comparison, MMC at doses of 5, 2.5, and 1.25 mg/kg inhibited tumor growth by 69.7-73.6%, 54.0-56.5%, and 31.5-52.2%, respectively. Moreover, in human hepatoma BEL-7402 xenografts, the growth inhibition rates by LDM at doses of 0.05 mg/kg ×2 and 0.025 mg/kg ×2 were 68.7% and 27.2%, respectively. However, MMC at the dose of 1.25 mg/kg ×2 showed an inhibition rate of 34.5%. The inhibition rate of tumor growth by LDM was higher than that by MMC at the tolerated dose. CONCLUSION: Both LDM and its chromophore LDC display extremely potent cytotoxicity to hepatoma cells. LDM shows a remarkable therapeutic efficacy against murine and human hepatomas in vivo.     

Cholecystectomy and the risk of colorectal cancer by tumor mismatch repair deficiency status

Purpose

Gallbladder diseases and cholecystectomy may play a role in the development of colorectal cancer (CRC). Our aim was to investigate the association between cholecystectomy and CRC risk overall and by sex, family history, anatomical location, and tumor mismatch repair (MMR) status.

Methods

This study comprised 5847 incident CRC cases recruited from population cancer registries in Australia, Canada, and the USA into the Colon Cancer Family Registry between 1997 and 2012 and 4970 controls with no personal history of CRC who were either randomly selected from the general population or were spouses of the cases. The association between cholecystectomy and CRC was estimated using logistic regression, after adjusting for confounding factors.

Results

Overall, there was no evidence for an association between cholecystectomy and CRC (odds ratio [OR] = 0.88, 95 % confidence interval 0.73, 1.08). In the stratified analyses, there was no evidence for a difference in the association between women and men (P = 0.54), between individuals with and without family history of CRC in first-degree relative (P = 0.64), between tumor anatomical locations (P = 0.45), or between MMR-proficient and MMR-deficient cases (P = 0.54).

Conclusion

Cholecystectomy is not a substantial risk factor for CRC, regardless of sex, family history, anatomical location, or tumor MMR status.