雄黄诱导肿瘤细胞凋亡的实验研究

目的 观察中药雄黄诱导肿瘤细胞凋亡的作用。方法 以细胞凋亡和免疫功能为主要观测指标,观察中药雄黄对荷瘤小鼠的抗肿瘤作用。结果 实验表明,雄黄可诱导荷瘤（Ｌ－１２１０和Ｈ２２）小鼠的肿瘤组织凋亡,抑制荷瘤小鼠肿瘤的生长,并可延长小鼠存活时间。结论 雄黄可通过诱导肿瘤细胞凋亡,抑制细胞ＤＮＡ的合成,增强机体的细胞免疫功能等多种因素发挥抗肿瘤作用,显示出广阔的应用前景。     

Surgical and Oncologic Outcomes of Radical Abdominal Trachelectomy Versus Hysterectomy for Stage IA2-IB1 Cervical Cancer

Study Objective: To compare the surgical and oncologic outcomes between abdominal radical trachelectomy (ART) and radical hysterectomy (RH) for stage IA2-IB1 cervical cancer.Design: A retrospective cohort study (Canadian Task Force classification II-2).Setting: Shandong Cancer Hospital, Shandong, China.Patients: Three hundred twenty-nine patients with IA2-IB1 cervical cancer.Interventions: All patients underwent ART or RH.Measurements and Main Results: All patients were divided into ART (n?=?143) and RH (n?=?186) groups according to the surgical approach. Additionally, oncologic and fertility outcomes were compared for different tumor pathologies and sizes in ART patients. The ART group had similar case characteristics as the RH group, except that the ART group had a longer surgical time. During a similar follow-up period, there were 4 (2.9%) recurrences and 3 (2.2%) patients who died from recurrence in the ART group compared with 8 (4.6%) recurrences and 4 (2.3%) patients who died from recurrence in the RH group (p?=?.444 and p?=?.999, respectively). In the ART group, squamous cell carcinoma (SCC) patients had a 5-year overall survival and pregnancy rate similar to those of non-SCC patients (98.1% vs 96.8%, p?=?.999; 33.3% vs 26.7%, p?=?.873), and patients with tumors ≤2 cm and 2 to 4 cm experienced a similar 5-year overall survival rate (97.0% vs 98.6%, p?=?.999), except patients with tumors ≤2 cm had a higher pregnancy rate (45.2% vs 17.2%, p?=?.020).Conclusion: ART seems to have similar surgical and oncologic outcomes to RH, except ART has a longer surgical time. Both non-SCC patients and stage IA2-IB1 patients with 2- to 4-cm tumors can undergo ART safely. Patients with tumors ≤2 cm have a higher pregnancy rate than patients with 2- to 4-cm tumors.     

Mixed invasive pulmonary Mucor and Aspergillus infection: a case report and literature review

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SARS病人治愈后随访13个月细胞因子指标的变化

目的探讨严重急性呼吸综合征（SARS）病人远期细胞因子动态变化及规律。方法采用酶联免疫吸附法（ELISA）检测SARS病人痊愈后mo4、mo10及mo13的血清中IL—1β、TNFα,、TGFβ水平。结果111例病人中,IL—1β升高比率在随访的mo4、mo10、mo13分别为0％、48．6％、18．9％;TNFα升高比率在随访的mo4、mo10、mo13分别为26．1％、0．8％、3．6％;TG邱升高比率在随访的mo4、mo10、mo13分别为93．7％、97．3％、100％。结论随访SARS病人康复后血清的IL—1β、TNFα,和TGF-β水平呈波动状态,炎性细胞因子呈递降趋势,而抗炎性因子呈递升趋势,这种趋势发展是一个长期的过程。     

Decreased expression of claudin-18.2 in alpha-fetoprotein-producing gastric cancer compared to conventional gastric cancer

BackgroundAlpha-fetoprotein-producing gastric cancer (AFPGC) is a subtype of gastric cancer (GC) with more aggressive biological behavior. As a highly specific tight junction component exclusively present in gastric mucosa and gastric adenocarcinomas, claudin-18.2 (CLDN18.2) has become an emerging target in GC. In this study, we aimed to provide insight into AFPGC and investigate the expression and the clinical implications of CLDN18.2 in AFPGC.MethodsWe retrospectively collected 98 cases of AFPGC and reviewed their clinical, morphological, and immunohistochemical features. Another 356 patients with stage-matched conventional GC (cGC) were enrolled as a control group. We further surveyed CLDN18.2 expression by immunohistochemistry (IHC) in 51 AFPGC tissues and explained its association with the clinicopathological parameters of AFPGC.ResultsOur results showed that AFPGC was a unique GC type with elevated serum alpha-fetoprotein (AFP), which was a predictor of a worse prognosis. AFPGC showed typical morphological features and positive staining of at least 1 hepatocytic or enteroblastic marker. The expression rate of CLDN18.2 was low, with a positivity rate of 21.6%, which was much lower than that observed in cGC tissues (38.5%). A significant correlation was found between CLDN18.2 expression and the differentiation of AFPGC. CLDN18.2 expression was negatively correlated with the serum AFP level of AFPGC. We also found that AFPGC with a hepatoid type (HPT) component showed a significantly lower CLDN18.2 expression than those without.ConclusionsThis study demonstrated that CLDN18.2 was significantly decreased in AFPGC and was negatively correlated with the patient’s preoperative serum AFP level. The negative correlation between AFP and CLDN18.2 could be explained by retro-differentiation of AFPGC. Special treatment strategies might be needed for this unique tumor type.     

Combination of C‐reactive protein,procalcitonin, IL‐6, IL‐8, and IL‐10 for early diagnosis of hyperinflammatory state and organ dysfunction in pediatric sepsis

BackgroundAlthough early diagnosis and management are critical for prognosis of pediatric sepsis, there are no specific diagnostic biomarkers for the hyperinflammatory state and organ dysfunction, important stages of sepsis.MethodsWe enrolled 129 children with infection into three groups: non‐sepsis infection (33), Sepsis 1.0 (hyperinflammatory state, 67), and Sepsis 3.0 (organ dysfunction, 29). Another 32 children with no infections were included as controls. Serum C‐reactive protein (CRP), procalcitonin (PCT), interleukin (IL)‐1β, IL‐2, IL‐4, IL‐5, IL‐6, IL‐8, IL‐10, IL‐12p70, IL‐17, tumor necrosis factor (TNF)‐α, interferon (IFN)‐α, and IFN‐γ were assessed to diagnose the two stages, and their diagnostic capacities were evaluated using receiver operating characteristic (ROC) curves. We also examined whether combining biomarkers improved diagnostic efficiency.ResultsSignificantly higher CRP, PCT, and IL‐6 levels were detected in the Sepsis 1.0 than the non‐sepsis infection group (p < 0.001). The areas under the curve (AUCs) for diagnosing Sepsis 1.0 were 0.974 (CRP), 0.913 (PCT) and 0.919 (IL‐6). A combination of any two biomarkers increased diagnostic sensitivity to ≥92.54% and specificity to 100.00%. Significantly higher PCT, IL‐8, and IL‐10 levels were found in the Sepsis 3.0 than the Sepsis 1.0 group (p ≤ 0.01), with AUCs for diagnosing Sepsis 3.0 0.807 (PCT), 0.711 (IL‐8), and 0.860 (IL‐10). Combining these three biomarkers increased diagnostic sensitivity to 96.55% and specificity to 94.03%.ConclusionIn pediatric sepsis, combining any two of CRP, PCT, and IL‐6 can accurately diagnose the hyperinflammatory state and increase diagnostic specificity. Early diagnosis of organ dysfunction requires a combination of PCT, IL‐8, and IL‐10.     

梅花的本草考证

梅花为我国传统药材,具有疏肝和中,化痰散结的作用,常用于治疗梅核气,肝胃气痛,食欲不振,头晕,瘰疬.梅原产中国,其栽培应用历史悠久,品种复杂繁多,现代研究将梅分为果梅与花梅两类,品种达数百个之多.但关于古代文献中统究竟以何种颜色梅花人药为佳,以及药用梅花类群与植物系统学的关联性等尚未有相关的研究报道.为正本清源,笔者对...     

院内脓毒症风险管理系统设计与实现

介绍脓毒症防治现状及存在的问题,详细阐述应用人工智能技术构建院内脓毒症风险管理系统的方法,分析系统应用效果,指出该系统可实现患者住院期间脓毒症筛查指标、诊断指标的持续监测与及时预警。     

胰高血糖素样肽-1受体激动剂治疗多囊卵巢综合征患者有效性与安全性的Meta分析

目的 评价胰高血糖素样肽-1(glucagon like peptide-1,GLP-1)受体激动剂与二甲双胍治疗多囊卵巢综合征(polycystic ovarian syndrome,PCOS)的有效性与安全性.方法 计算机检索英文数据库PubMed、CENTRAL(2020年第3期)、EMbase;中文数据库Wan...