非酒精性脂肪性肝炎患者肝脏受控衰减参数的变化

目的 探讨瞬时弹性记录仪(FibroScan)检测肝脏受控衰减参数(CAP)诊断非酒精性脂肪性肝炎(NASH)的效能.方法 2016年1月～2020年1月我院收治的NASH患者142例和同期健康体检者130例,使用FibroScan检测肝脏CAP值.采用受试者工作特征曲线(ROC)并计算曲线下面积(AUC)评价CAP值...     

Phenylboronic ester-modified polymeric nanoparticles for promoting TRP2 peptide antigen delivery in cancer immunotherapy

The tremendous development of peptide-based cancer vaccine has attracted incremental interest as a powerful approach in cancer management, prevention and treatment. As successful as tumor vaccine has been, major challenges associated with achieving efficient immune response against cancer are (1) drainage to and retention in lymph nodes; (2) uptake by dendritic cells (DCs); (3) activation of DCs. In order to overcome these barriers, here we construct PBE-modified TRP2 nanovaccine, which comprises TRP2 peptide tumor antigen and diblock copolymer PEG-b-PAsp grafted with phenylboronic ester (PBE). We confirmed that this TRP2 nanovaccine can be effectively trapped into lymph node, uptake by dendritic cells and induce DC maturation, relying on increased negative charge, ROS response and pH response. Consistently, this vehicle loaded with TRP2 peptide could boost the strongest T cell immune response against melanoma in vivo and potentiate antitumor efficacy both in tumor prevention and tumor treatment without any exogenous adjuvant. Furthermore, the TRP2 nanovaccine can suppress the tumor growth and prolong animal survival time, which may result from its synergistic effect of inhibiting tumor immunosuppression and increasing cytotoxic lymphocyte (CTL) response. Hence this type of PBE-modified nanovaccine would be widely used as a simple, safe and robust platform to deliver other antigen in cancer immunotherapy.     

年龄校正Charlson合并症指数对髋部骨折病人内科并发症的预测效果分析

目的 探讨年龄校正Charlson合并症指数（age-adjusted Charlson comorbidity index,ACCI对髋部骨折病人内科并发症的预测效果。方法 回顾性分析2015年1月至2020年12月于天津医院住院治疗的1 062例髋部骨折病人的资料,其中男317例,女745例,年龄为（69.81±13.43）岁。对病人住院病历资料进行回顾性ACCI评分,计算出每个病人的ACCI总评分,将其归类为低危0～2分,中危3～5分,高危6～8分,极高危≥9分。根据病人髋部骨折后是否出现并发症分为内科并发症组（593例）和非内科并发症组（469例）。比较两组病人年龄、骨折类型、住院时间、ACCI评分、冠心病、糖尿病、脑血管疾病、心力衰竭、贫血、低蛋白血症、脑萎缩、动脉硬化性疾病的差异,对上述差异有统计学意义的变量进一步行多因素Logistic回归分析。结果 两组年龄、骨折类型、住院时间、ACCI评分、冠心病、糖尿病、脑血管疾病、心力衰竭、贫血、低蛋白血症、动脉硬化性疾病的差异有统计学意义（P<0.05）,多因素Logistic回归分析显示住院时间[OR=1.011,95%...     

A one-year follow-up study on dynamic changes of leukocyte subsets and virus-specific antibodies of patients with COVID-19 in Sichuan,China

Background: SARS-CoV-2 infection causes immune response and produces protective antibodies, and these changes may persist after patients discharged from hospital.Methods: This study conducted a one-year follow-up study on patients with COVID-19 to observe the dynamic changes of circulating leukocyte subsets and virus-specific antibodies.Results: A total of 66 patients with COVID-19 and 213 healthy patients with inactivated SARS-CoV-2 vaccination were included. The virus-specific total antibody, IgG and IgM antibody of patients after one year of recovery were higher than those of healthy vaccinated participants (94.13 vs 4.65, 2.67 vs 0.44, 0.09 vs 0.06, respectively) (P < 0.001). Neutrophil count (OR = 1.73, 95% CI: 1.10-2.70, P = 0.016) and neutrophil-to-lymphocyte ratio (OR = 1.59, 95% CI: 1.05-2.41, P = 0.030) at discharge were the influencing factors for the positivity of virus-specific IgG antibody in patients after one year of recovery. The counts of CD4+ and CD8+ T, B and NK cells increased with the time of recovery, and remained basically stable from 9 to 12 months after discharge. After 12 months, the positivity of IgG antibody was 85.3% and IgM was 11.8%, while the virus-specific antibody changed dynamically in patients within one year after discharge.Conclusions: The SARS-CoV-2 specific antibody of recovered patients showed dynamic fluctuation after discharge, while the leukocyte subsets gradually increased and basically stabilized after 9 months.     

动脉导管相关血流感染的循证研究进展

动脉留置导管常应用于重症医学科及心胸外科,作为监测患者有创血压及采集动脉血气的通道.尽管动脉留置导管具有操作简便、成本低等特点,但不良操作或维护不到位也易引发相关并发症,包括暂时性动脉闭塞、假性动脉瘤、导管相关血流感染等.本文讨论由动脉导管引起的相关血流感染,从循证的角度总结不同因素对动脉导管相关血流感染的影响,以期为...     

Prognostic and incremental value of computed tomography-based radiomics from tumor and nodal regions in esophageal squamous cell carcinoma

Objective: This study aimed to evaluate the prognostic value of preoperative radiomics and establish an integrated model for esophageal squamous cell cancer(ESCC).Methods: A total of 931 patients were retrospectively enrolled in this study(training cohort, n=624; validation cohort, n=307). Radiomics features were obtained by contrast-enhanced computed tomography(CT) before esophagectomy. A radiomics index was set based on features of tumor and reginal lymph nodes by using the least absolute shri...     

麻仁软胶囊对便秘型 IBS 大鼠模型肠黏膜 5 - HT 含量的影响

目的研究麻仁软胶囊对便秘型肠易激综合征（IBS）模型大鼠5-HT含量的影响,探讨麻仁软胶囊治疗便秘型IBS的作用机制。方法将大鼠分为中药组、西药组、模型组、正常组4组,采用冰水灌胃慢性刺激方法将前3组复制为大鼠便秘型IBS模型,观察各组大鼠粪便的数量及性状,于第14天造模成功后中药组灌中药,西药组灌西药,模型组及正常组予以正常饮食。于第28天将各组大鼠进行解剖取其部分结肠,将其做成石蜡切片,在HE染色下和SABC免疫组化染色下镜下观察各组肠组织变化及肠黏膜上5-HT的含量。结果IBS模型大鼠5-HT表达增高,出现IBS临床症状;经麻仁软胶囊干预后,大鼠5-HT表达降低。结论麻仁软胶囊可增高大鼠肠道敏感性,其作用机制与降低大鼠结肠5-HT表达、增高肠道敏感性有关。     

A case report of IgG4-related respiratory disease with pleural effusion and a literature review

Rationale:IgG4-related respiratory disease (IgG4-RRD) is a chronic autoimmune disease that affects the respiratory system and organs outside the respiratory system. This study explored the diagnosis and treatment of a case of IgG4-RRD with unilateral pleural effusion diagnosed using medical thoracoscopy, and provides an associated literature review. This report summarizes the clinical characteristics of IgG4-RRD involving the pleura to improve the diagnosis of this disease.Patient concerns:A 39-year-old man presented with a 2-week history of cough and chest tightness. Both physical examination and imaging supported the presence of left pleural effusion.Diagnosis:Medical electronic thoracoscopy was performed to obtain a pleural biopsy, which showed lymphoplasmacytic infiltration, 40 IgG4+ plasma cells per High Power Field (HPF) on microscopy, IgG4/IgG ratio >50%, phlebitis obliterans, and storiform fibrosis. The final diagnosis was IgG4-RRD.Interventions and outcomes:The patient was treated with methylprednisolone, after which his symptoms improved, and he was discharged. Oral hormone therapy was continued outside the hospital. After 4 months, the patient returned to the hospital and his condition had improved significantly.Lessons:Pleural involvement in IgG4-RRD is rare, and its diagnosis depends on pleural biopsy. Thoracoscopy usually reveals pleural thickening, pleural nodules, and milky white plaques.     

扶正解毒方治疗持续性或慢性免疫性血小板减少症气不摄血证患儿临床疗效研究

目的 研究扶正解毒方对持续性或慢性免疫性血小板减少症气不摄血证患儿的临床疗效和安全性.方法 选取2017年2月—2020年9月就诊于北京中医药大学东直门医院余惠平教授门诊的持续性或慢性免疫性血小板减少症气不摄血证患儿,共120例,按入组时间顺序编号,随机分为试验组60例和对照组60例,2组患者均服用多维片及复方芦丁片,...