A gut microbiota score predicting acute graft‐versus‐host disease following myeloablative allogeneic hematopoietic stem cell transplantation

Although studies have reported that intestinal microbiota are associated with acute graft‐versus‐host disease (aGVHD), they lacked a satisfactory method for predicting aGVHD. We collected stool and blood samples at day 15 posttransplant from 150 patients from two centers who underwent myeloablative conditioning allogeneic hematopoietic stem cell transplantation (allo‐HSCT). Stool microbiota were detected by 16S ribosomal RNA gene sequencing; inflammatory factors and T lymphocytes were detected by multiplex immunoassays and flow cytometry, respectively. A gut microbiota score (GMS) from a LASSO (least absolute shrinkage and selection operator) model was developed and validated to predict aGVHD. In the discovery cohort, the GMS could predict II‐IV aGVHD (area under the receiver operating characteristic [ROC] curve [AUC] = 0.904, P < .0001). Furthermore, the validation model was consistent with the discovery set (AUC = 0.887, P < .0001). Regulatory T/T‐helper 17 (Treg/Th17) cells ratio in the low GMS subgroup was higher compared with the high GMS (P = .012), and the validation set is consistent with the discovery set (P = .003). In addition, high cytokine levels were associated with high GMS. In conclusion, the GMS at neutrophil engraftment could predict aGVHD, and it was a potential and novel method. The GMS was associated with the inflammatory factor and Treg/Th17 balance.     

长链非编码RNA TUG1在骨肉瘤中的发生机制—系统回顾和荟萃分析

目的本研究旨在系统回顾长链非编码RNA TUG1（lncRNA TUG1）在骨肉瘤发生、发展中的机制,以及探讨TUG1在评估骨肉瘤患者预后中的价值。 方法系统检索PubMed、Embase、Web of Science、CochraneLibrary、中国知网（CNKI）和万方医学数据库,收集TUG1与骨肉瘤发生及预后的相关文献。系统回顾TUG1在骨肉瘤发生、发展中的机制,并采用Stata12软件（Stata公司,美国）对TUG1与骨肉瘤患者预后的相关性进行meta分析。 结果目前的研究表明,TUG1主要通过发挥竞争性内源RNA（competing endogenous RNA）效应调控骨肉瘤细胞增殖、凋亡和侵袭等过程,涉及通路包括AKT信号通路和Wnt/β-catenin信号通路。本研究共纳入4篇文献进行meta分析,共244例骨肉瘤患者。TUG1表达升高的骨肉瘤患者总体生存率低于TUG1表达降低的骨肉瘤患者（OR=1.921,95% CI：1.361,2.712,P=0.000）。不仅如此,骨肉瘤患者组织中TUG1表达升高往往提示肿瘤具有更大的体积（OR=4.084,95% CI：2.313,7.211,P=0.000）、较高的临床分级（OR=0.247,95% CI：0.133,0.539,P=0.000）和更早期远处转移（OR=1.943,95% CI：1.130,3.339,P=0.016）。然而,其与患者性别（OR=1.055,95% CI：0.620,1.793,P=0.844）和肿瘤发生部位（OR=0.806,95% CI：0.424,1.530,P=0.509）无显著相关性。 结论长链非编码RNATUG1与骨肉瘤发生、发展密切相关。不仅如此,TUG1表达升高提示骨肉瘤患者不良临床预后,其可能是一种评估骨肉瘤患者预后的生物学标志物。     

王国斌教授治疗癔病性麻痹验案1则

癔病性麻痹是临床上一种比较复杂的精神障碍类疾病,在对癔病性麻痹的认识方面,第五批全国老中医药专家学术经验继承工作指导老师王国斌教授主张运用西医辨病与中医辨证相结合的理念,认为癔病性麻痹属于中医情志性疾病的范畴,进而提出从心肝论治的中医诊疗思路,临床运用陈氏安定汤进行加减治疗,收效甚佳。     

临床护理路径在肋骨骨折40例中的应用

目的:对临床护理路径在肋骨骨折患者中的应用效果进行观察。方法:采用随机数字表法将80例肋骨骨折患者作分为对照组、试验组各40例。对照组采用传统的护理方法,试验组采用临床护理路径进行护理,经过10d的护理后,对患者的临床护理效果进行比较。结果:试验组的满意度、住院时间优于对照组25.00%,差异具有统计学意义(P<0.05)。结论:对肋骨骨折患者采用临床护理路径进行护理的临床效果较为明显,整体过程安全可靠,患者以及患者家属较为满意,因此值得我们在临床上进行广泛应用。