抗疫一线医护人员面部压力性损伤的原因分析与对策

目的分析抗击新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)医护人员面部器械相关压力性损伤(device related pressure injuries,DRPI)的原因并提出对策。方法后方医院压疮管理小组和前线队伍护士长、护理小组组长联合建立战地DRPI管理小组,对抗疫一线医护人员面部防护与DRPI发生情况进行调查,并结合抗疫一线临床实践与某院手术室DRPI管理经验制订对策进行干预。结果抗疫一线医护人员面部DRPI的发生率从51.64%下降至0。结论面对突发COVID-19疫情,加强前后方联动,建立战地DRPI管理小组,联系抗疫一线的实际情况,采取针对性措施,有利于避免或减少抗疫一线医护人员面部DRPI的发生。     

非气管插管麻醉胸腹腔镜联合三切口食管癌根治术一例

正病人,52岁,男性。因进行性吞咽困难5个月余入院。既往无特殊病史,无吸烟史。胃镜检查提示距门齿32 cm处环形狭窄,黏膜隆起。取活检病理检查诊断为鳞状细胞癌。病人心肺功能正常,体质指数22.4 mg/kg2,未见明显手术禁忌证。向病人及家属详细告知非气管插管麻醉胸腹腔镜联合三切口手术优势及可能出现的风险,病人及家属要求采用这一手术方式,签署手术及麻醉知     

留置导尿时间及病区环境对留置导尿后尿路逆行感染的影响

目的　探讨留置导尿时间及病区环境对留置导尿后尿路逆行感染的影响。方法　将 15 3例置入导尿管前中段尿细菌培养阴性的需留置导尿的病人作为研究对象 ,于留置导尿结束拔出导尿管时再取中段尿作细菌培养 ,菌落数大于 10 5个 /ml者判为尿路逆行感染。对不同的留置导尿时间、病区环境下尿路逆行感染的发生情况进行统计学分析。结果　各留置导尿时间组中尿路逆行感染的发生率有显著性差异 (χ2 =13 .2 0 ,P <0 .0 1) ,留置尿管时间越长则尿路逆行感染发生率越高 ;不同病区环境中尿路逆行感染的发生率明显不同 ,烧伤病区组的尿路逆行感染发生率明显高于内科组 (P <0 .0 5 )。结论　尽量避免留置导尿 ,缩短留置导尿时间 ,保持环境清洁 ,注意消毒 ,有利于预防尿路逆行感染。     

磷脂酰肌醇3-激酶调节亚基p55PIK表达载体的构建及单克隆株的筛选

目的 构建表达载体pEGFP-N1-p55PIK,在人胚胎肾细胞株HEK293中筛选其稳定表达的细胞株.方法 PCR扩增p55PIK基因全长,经过Xho1和Xma1酶切、T4 DNA连接酶连接、DH5α转化,酶切和测序鉴定以确定构建质粒正确.转染人胚胎肾细胞株HEK293,G418筛选稳定表达p55PIK的单克隆细胞株,应用Western blot方法检测p55PIK蛋白的表达.结果 pEGFP-N1-p55PIK质粒经PCR、酶切、测序鉴定正确,经过G418筛选后获得稳定细胞株,在荧光显微镜下可观察到绿色荧光蛋白在HEK293细胞中的表达,Western blot检测结果显示稳定转染pEGFP-N1-p55PIK的细胞中p55PIK表达水平增高.结论 正确构建表达载体pEGFP-N1-p55PIK,并在HEK293细胞中成功筛选出稳定表达p55PIK的细胞株,为进一步探讨p55PIK的功能提供了良好的工具.     

肺癌围手术期合并新型冠状病毒肺炎一例

患者,男,61岁,肺癌术后合并新型冠状病毒(2019-nCoV,SARS-CoV-2)肺炎,术前无明确新型冠状病毒肺炎接触史。患者术后第4 d出现一过性发热,调整抗生素后第5 d体温恢复正常,术后6 d再次出现发热伴乏力,查胸部CT提示术后肺炎。加用更昔洛韦及盐酸莫西沙星。术后7~9 d患者体温逐渐下降,第10 d复查CT提示病毒性肺炎,遂立即提升防护等级。患者新型冠状病毒核酸检测阳性,即刻转入定点医院救治,予以阿比多尔、莫西沙星、人免疫球蛋白(PH4)、氨溴索及其他营养对症支持治疗,目前病情平稳。与患者密切接触人员中共10人出现症状,CT均提示病毒性肺炎,其中6人行新型冠状病毒核酸检测提示阳性,其他人继续隔离观察。由此可见肺癌术后肺炎与新型冠状病毒肺炎两者影像学表现较易混淆,应在CT早期尽快行新型冠状病毒核酸检测确诊,应结合疫情重新制定治疗方案。     

Down-regulation of p110β expression increases chemosensitivity of colon cancer cell lines to oxaliplatin

This study examined the synergetic effect of class ?A Phosphoinositide 3-kinases cata-lytic subunit p110β knockdown in conjunction with oxaliplatin treatment on colon cancer cells. Down-regulation of p110β by siRNA interference and oxaliplatin treatment were applied in colon cancer cell lines HT29, SW620 and HCT116. MTT assay was used to measure the inhibitory effect of p110β knockdown on the proliferation of colon cancer cell lines. SubG1 assay and Annexin-Ⅴ FITC/PI double-labeling cytometry were applied to detect cell apoptosis. And cell cycle was evalu-ated by using PI staining and flow cytometry. The expression of caspase 3, cleaved PARP, p-Akt, T-Akt and p110β was determined by western blotting. The results suggested that down-regulation of p110β expression by siRNA obviously reduced cell number via accumulation in G0-G1 phase of the cell cycle in the absence of notablely increased apoptosis in colon cancer cell lines HT29 and SW620 (S phase arrest in HCT116). Moreover, inhibition of p110β expression increased oxaliplatin-induced cell apoptosis and cell cycle arrest in HT29, HCT116 and SW620 cell lines. In addition, increases of cleaved caspase-3 and cleaved PARP induced by oxaliplatin treatment were determined by im-munoblotting in p110β knockdown group compared with normal control group and wild-type group. It is concluded that down-regulated expression of p110β could inhibit colon cancer cells proliferation and result in increased chemosensitivity of colorectal cancer cells to oxaliplatin through augmentation of oxaliplatin-induced cell apoptosis and cell cycle arrest.     

Construction of Recombinant Adenovirus Carrying GRIM19 and Its Effect on SW480 Cells

In order to examine the effect of GRIM19 on colon cancer cell SW480, the recombinant adenovirus carrying GRIM19 gene was constructed and transfected into SW480 cells. GRIM19 cDNA was amplified by PCR with the template pcxn2-GRIM19 and cloned into the shuttle plasmid pAdTrack-CMV. The plasmid pAdTrack-CMV-GRIM19 was linearized by PmeⅠ and homologously recombined with bone plasmid pAdEasy-1 in BJ5183, followed by identification by enzyme digestion. After transfection of linearized pAd-GRIM19 with PacⅠ into HEK293 cells, Ad-GRIM19 was obtained and amplified by 3 circles. SW480 cells were infected with Ad-GRIM19. The apoptosis rate was detected by flow cytometry. Agarose electrophoresis revealed the bands of recombinant plasmids identified by enzyme digestion were in the right range corresponding with expectation. Under the fluorescent microscopy, the package of Ad-GRIM19 in HEK293 cells and the expression of Ad-GRIM19 in SW480 cells were observed. The transfection of Ad-GRIM19 into SW480 cells increased the apoptosis rate of SW480 cells as compared with controls, It was concluded that Ad-GRIM19 was successfully constructed and the overexpression of GRIM19 in colon cancer cell lines could promote the apoptotic cell death.     

Hint2促进乳腺癌细胞株MCF7对紫杉醇注射液的敏感性

目的探讨高表达三联组氨酸核苷酸结合蛋白2(Hint2)增强人乳腺癌细胞株MCF7对紫杉醇注射液敏感性的影响。方法构建高表达Hint2的载体pCMV-HA-Hint2并转染MCF7细胞,通过免疫荧光和Western blot方法检测Hint2的表达,采用噻唑蓝(MTT)法检测高表达Hint2后MCF7细胞对紫杉醇注射液的敏感性,采用流式细胞AnnexinV方法检测细胞凋亡。结果 pCMV-HA-Hint2转染36 h后,细胞的Hint2基因表达明显增加,5μmol.L-1的紫杉醇注射液处理24 h后,Hint2高表达组细胞活性为33.78%,而对照组细胞活性为44.12%。结论 Hint2高表达能显著增加MCF7细胞对紫杉醇注射液的敏感性。     

复方甘草合剂联合复方甲氧那明胶囊治疗非小细胞肺癌术后咳嗽的疗效观察

目的观察复方甘草合剂联合复方甲氧那明胶囊治疗非小细胞肺癌术后咳嗽的疗效。方法非小细胞肺癌术后咳嗽患者随机分为两组。对照组采用复方甲氧那明胶囊治疗,治疗组在对照组治疗的基础上加用复方甘草合剂,均治疗7d。比较两组患者治疗前后日间咳嗽与夜间咳嗽评分,应用中文版莱斯特咳嗽量表(LCQ-MC)进行评分比较以判断临床疗效。结果两组治疗后日间评分无差异(P0.05),夜间评分有差异(P0.05);两组治疗前后LCQ-MC总分都有差异(P0.05),治疗组治疗后的LCQ-MC总分及生理维度分值高于对照组(P0.05)。结论复方甘草合剂联合复方甲氧那明胶囊治疗非小细胞肺癌术后咳嗽比单一使用复方甲氧那明胶囊更具有临床疗效。