依赖NKG2D的肿瘤免疫逃避

活化性受体NKG2D(natural-killer group 2,member D)和其配基在NK、γδ+T和CD8+T细胞介导的肿瘤免疫应答中扮演了重要角色.NKG2D识别肿瘤细胞表面的配体激活效应细胞,产生有效的抗肿瘤免疫应答.但是在完全具有免疫能力的机体内,表达NKG2D配基的肿瘤仍能够生长发育,因此,在患肿瘤小鼠和肿瘤病人中一定存在着依赖NKG2D的免疫逃避机制.本文就依赖于NKG2D的免疫逃避作一详细综述,主要包括:干涉NKG2D受体的免疫逃避、干涉NKG2D配基的免疫逃避、细胞因子破坏NKG2D受体和配基的免疫逃避、抑制性细胞参与NKG2D介导的免疫逃避.这些研究为抗肿瘤治疗提供了新的途径.     

Effectiveness of novel,lower cost molecular human papillomavirus‐based tests for cervical cancer screening in rural china

This study examined the efficacy of the OncoE6? Cervical Test, careHPV? and visual inspection with acetic acid (VIA) in identifying women at risk for cervical cancer and their capability to detect incident cervical precancer and cancer at 1‐year follow‐up. In a population of 7,543 women living in rural China, women provided a self‐collected and two clinician‐collected specimens and underwent VIA. All screen positive women for any of the tests, a ～10% random sample of test‐negative women that underwent colposcopy at baseline, and an additional ～10% random sample of test‐negative women who did not undergo colposcopy at baseline (n = 3,290) were recruited. 2,904 women were rescreened 1 year later using the same tests, colposcopic referral criteria, and procedures. Sensitivities of baseline tests to detect 1‐year cumulative cervical intraepithelial neoplasia Grade 3 or cancer (CIN3+) were 96.5% and 81.6% for careHPV? on clinician‐collected and self‐collected specimens, respectively, and 54.4% for OncoE6? test. The OncoE6? test was very specific (99.1%) and had the greatest positive predictive value (PPV; 47.7%) for CIN3+. Baseline and 1‐year follow‐up cervical specimens testing HPV DNA positive was sensitive (88.0%) but poorly predictive (5.5–6.0%) of incident CIN2+, whereas testing repeat HPV16, 18 and 45 E6 positive identified only 24.0% of incident CIN2+ but had a predictive value of 33.3%. This study highlights the different utility of HPV DNA and E6 tests, the former as a screening and the latter as a diagnostic test, for detection of cervical precancer and cancer.     

2例Cornelia de Lange综合征病例报告并NIPBL基因突变研究

目的：对2例生长发育迟缓伴有特殊面容及肢体发育异常的患儿进行基因检测,实现罕见病的精准诊断,为遗传咨询提供指导。方法：应用单基因检测及全外显子组高通量测序技术对临床疑似CdLS患儿进行致病基因突变筛查,并行一代测序验证以及患儿父母的验证。结果：本研究中的2例患儿均检测到国内外尚未报道的NIPBL基因突变,c.2252 dupA、p.Asn751Lysfs以及NM-015384.4：c.6179dupA,父母均无携带,为新生变异。结论：对于发育迟缓伴特殊面容及肢体异常的患儿要考虑到Cornelia de Lang综合征可能,采用基因检测手段实现精准诊断,为患者及家属遗传咨询提供依据。     

CD166对鼻咽癌CNE-2细胞放射敏感性的影响

目的 探讨CD166对鼻咽癌CNE-2细胞放射敏感性的影响.方法 采用流式细胞术检测鼻咽癌CNE-2细胞膜CD166阳性表达率,免疫磁珠分选技术获得CNE-2-CD166(+)、CNE-2-CD166(-)细胞亚群,克隆形成实验验证其放射敏感性,CCK-8法及流式细胞术检测10 Gy剂量照射前后的细胞增殖率及细胞凋亡率.结果 CNE-2细胞膜CD166阳性表达率为(24.27±5.31)％,分选后CNE-2-CD166(+)细胞CD166阳性表达率为96.5％,CNE-2-CD166(-)细胞为0.6％.克隆形成实验结果显示,CNE-2-CD166(-)细胞相对CNE-2-CD166(+)细胞的放射增敏比(sensitization enhancement ratio,SER)为1.24.10Gy照射后24 h、48 h和72 h,CNE-2-CD166(+)细胞的存活分数分别为(76.66±3.36)％、(62.44± 1.66)％和(55.21±3.39)％,CNE-2-CD166(-)细胞为(60.34±5.13)％、(41.11±3.00)％和(35.28±4.36)％,同时段内两组细胞的存活分数比较,差异均有统计学意义(P＜0.05).10 Gy照射前,CNE-2-CD 166(+)细胞和CNE-2-CD166(-)细胞凋亡率分别为(5.87±1.14)％和(6.67±1.68)％,差异无统计学意义(P＞0.05);10 Gy照射后48 h,CNE-2-CD166(+)细胞凋亡率为(19.37±2.54)％,显著低于CNE-2-CD166(-)细胞的(28.90±4.04)％,差异有统计学意义(P=0.026).结论 CD166表达阳性的鼻咽癌CNE-2细胞对放射更具抗拒性,可能与减少细胞受照射后的凋亡率降低有关.     

继续教育对基层医务人员有关慢性阻塞性肺疾病相关认知的影响研究

目的了解基层医务人员对慢性阻塞性肺疾病的认知、过去一年继续教育情况及继续教育对慢性阻塞性肺疾病相关认知的影响。方法选取2019年10月1—31日2372名来自社区卫生服务中心(站)、乡镇卫生院和村卫生室的医务人员自愿在线填写了调查问卷,内容包括个人基本特征,对慢性阻塞性肺疾病危险因素和诊断的认知及继续教育情况。结果基层医务人员熟知吸烟、二手烟、长期呼吸道疾病史、室外空气污染和职业性粉尘等危险因素,但是对室内空气污染和遗传因素认知不足,并且仍有12.1%的基层医务人员知晓吸烟是危险因素,但正在吸烟或戒烟6个月以内。80%的调查对象知道肺功能是诊断慢性阻塞性肺疾病的金标准,但仅60.7%的调查对象能正确判读肺功能结果。过去一年中仅44.3%的基层医务人员接受了相关继续教育。继续教育对提升基层医务人员慢性阻塞性肺疾病危险因素和诊断相关认知的影响差异有显著性(OR=1.524,95%CI 1.289～1.802;OR=1.528,95%CI 1.289～1.812)。结论加大继续教育的惠及范围,有针对性地加强基层医务人员对室内空气污染和遗传因素的认知,同时在基层配备肺功能仪的前提下,开展以实操...     

Clinical Outcomes of Revision Total Knee Arthroplasty after High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Systematic Review and Meta‐Analysis

As more high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are performed, orthopaedic surgeons realize that more HTO and UKA failures will require revision to total knee arthroplasty (TKA) in the future. To systematically evaluate the clinical outcomes of TKA after HTO and TKA after UKA, the Embase, PubMed, Ovid, Web of Science, and Cochrane Library databases were searched for studies investigating revision TKA after HTO and UKA published up to June 2021. RevMan version 5.3 was used to perform the meta‐analysis. The revision TKA after HTO and revision TKA after UKA groups were compared in terms of operative time, range of motion (ROM), knee score, postoperative complications, postoperative infection, revision, and revision implants used. Nine studies were ultimately included in the meta‐analysis. Results revealed that the knee score for the revision TKA after HTO group was better than that of the revision TKA after UKA group (MD 4.50 [95% CI 0.80–8.20]; p = 0.02). The revision TKA after HTO group had a lower revision rate (OR 0.65 [95% CI 0.55–0.78]; p < 0.00001) and fewer revision implants used (OR 0.11 [95% CI 0.05–0.23]; p < 0.00001). There were no statistical differences in operation time (MD ‐2.00 [95% CI −11.22 to 7.21]; p = 0.67), ROM (MD ‐0.04 [95% CI ‐3.69–3.61]; p = 0.98), postoperative complications (OR 1.41 [95% CI 0.77–2.60]; p = 0.27), or postoperative infections (OR 0.89 [95% CI 0.61–1.29]; p = 0.53). To conclude, the revision rate of revision TKA after UKA was greater, and more revision implants were required. It is important for orthopaedic surgeons to preserve bone during primary UKA.     

血管内皮生长因子在非小细胞肺癌中的表达及其临床研究

目的 研究血管内皮生长因子(VEGF)在非小细胞肺癌(NSCLC)中的表达及其与肿瘤血管形成、临床分期、淋巴结转移的关系.方法 应用免疫组织化学方法和酶联免疫吸附试验(ELISA)检测56例NSCLC的肺癌组织和血清中VEGF的表达水平,并分析其临床意义.结果 NSCLC组织中VEGF的表达水平明显高于正常黏膜组织和癌旁组织(P<0.05),且随临床Ⅰ～Ⅳ期的顺序明显上升(P<0.05);同时有淋巴结转移组的VEGF阳性率明显高于无淋巴结转移组(P<0.05);NSCLC患者血清VEGF水平显著高于正常对照组(P<0.01),并随肺癌临床Ⅰ～Ⅳ期的顺序明显上升(P<0.05);淋巴结转移组血清VEGF水平明显高于无淋巴结转移组(P<0.05).结论 VEGF在NSCLC组织中表达明显增高,并与NSCLC的发生、发展及其淋巴结转移有关,血清VEGF是NSCLC生长、转移的重要指标.     

大黄(庶虫)虫丸对实验性子宫内膜异位症大鼠免疫功能的影响

目的:观察大黄(庶虫)虫丸对EMT大鼠免疫功能的影响.方法:采用大鼠子宫内膜异位症(EMT)动物模型,造模成功后按照异位内膜体积将大鼠随机分为大黄(庶虫)虫丸中高剂量组、大黄(庶虫)虫丸中低剂量组、西药组、模型组,并以假手术组为对照,灌胃治疗4周后检测指标.结果:①大黄(庶虫)虫丸中高剂量组、大黄(庶虫)虫丸中低剂量组、西药组对异位子宫内膜有明显抑制作用,与治疗前异位内膜体积(V1)相比,异位内膜体积(V2)明显缩小(P<0.01);②大黄(庶虫)虫丸中高剂量组能明显提高EMT大鼠胸腺、脾脏重量指数(P<0.01),降低血清肿瘤坏死因子-α(TNF-α)水平(P<0.01);③病理组织学分析显示:大黄(庶虫)虫丸中高剂量组能明显增加胸腺皮质厚度、脾小节大小及淋巴细胞数,明显降低异位内膜腺体体密度、提高腺腔值、降低淋巴结生发中心体密度(P<0.01).结论:大黄(庶虫)虫丸治疗子宫内膜异位症的部分机制可能改善子宫内膜异位症大鼠免疫功能有关.