长爪沙鼠体外受精与早期胚胎体外培养体系的初步建立

目的 探讨自配的获能液和受精液用于长爪沙鼠体外受精的可行性,为长爪沙鼠的胚胎保种提供参考。方法 用自配的获能液和受精液对长爪沙鼠进行体外受精,并用改良后的KSOM培养液对长爪沙鼠的2细胞胚胎进行体外培养试验。结果 长爪沙鼠体外受精率在60%以上,沙鼠2细胞胚胎能够在体外进一步发育。结论 初步建立了长爪沙鼠体外受精和胚胎发育体系,但需要进一步优化。     

自拟壮骨益气汤联合伊班膦酸钠治疗老年骨质疏松性肱骨近端骨折的临床研究

目的:研究自拟壮骨益气汤联合伊班膦酸钠治疗老年骨质疏松性肱骨近端骨折(PHF)的临床疗效。方法:选取2020年1月—2022年6月我院收治的老年骨质疏松性PHF患者90例,按照随机数字表法分为两组,两组于术后均行常规治疗等措施;其中对照组45例,术后1 d给予伊班膦酸钠注射液;观察组45例,于对照组常规治疗基础上术后1 d行自拟壮骨益气汤内服。连续观察12周。比较两组患者肩关节肿痛与功能改善、骨折愈合时间、骨折愈合治疗效果、氧化应激指标血清血红素加氧酶-1(HO-1)与超氧化物歧化酶(SOD)水平。结果:治疗12 周后,两组肩关节运动疼痛(VAS)评分、肿胀、肩关节功能康斯坦特(Constant)评分比较差异有统计学意义(t=10.609、6.548、2.801,均P＜0.05);治疗12周后,两组腰椎正位(L2-4)、右跟骨的骨密度与骨折愈合时间差异有统计学意义(t=1.730、1.787、7.029,均P＜0.05);治疗12 周后,观察组的骨折愈合总有效率(88.89％)高于对照组(68.89％),差异有统计学意义(χ2=4.270,P＜0.05);治疗1 周后,两组血清HO-1、SOD水平比较差异有统计学意义(t=10.073、7.138,P＜0.05)。结论:自拟壮骨益气汤联合伊班膦酸钠有助于老年骨质疏松性PHF术后患者肩关节功能的康复,提高骨密度,促进骨折愈合,以及改善氧化应激反应。     

The influence of the COVID-19 pandemic on lung cancer surgery in Queensland

Background

The coronavirus disease-19 (COVID-19) pandemic poses unprecedented challenges to global healthcare. The contemporary influence of COVID-19 on the delivery of lung cancer surgery has not been examined in Queensland.

Methods

We performed a retrospective registry analysis of the Queensland Cardiac Outcomes Registry (QCOR), thoracic database examining all adult lung cancer resections across Queensland from 1/1/2016 to 30/4/2022. We compared the data prior to, and after, the introduction of COVID-restrictions.

Results

There were 1207 patients. Mean age at surgery was 66 years and 1115 (92%) lobectomies were performed. We demonstrated a significant delay from time of diagnosis to surgery from 80 to 96 days (P < 0.0005), after introducing COVID-restrictions. The number of surgeries performed per month decreased after the pandemic and has not recovered (P = 0.012). 2022 saw a sharp reduction in cases with 49 surgeries, compared to 71 in 2019 for the same period.

Conclusion

Restrictions were associated with a significant increase in pathological upstaging, greatest immediately after the introduction of COVID-restrictions (IRR 1.71, CI 0.93–2.94, P = 0.05). COVID-19 delayed the access to surgery, reduced surgical capacity and consequently resulted in pathological upstaging throughout Queensland.     

癌症基因组图集数据库及其应用

癌症多是由DNA变异引起的细胞恶性增生,在基因组水平上研究这些变异及变异间相互作用引起的癌变分子机制,将有助于提高我们对癌症的预防、诊断及治疗能力。基于此,美国国家癌症研究所（NCI）和国家人类基因组研究所（NHGRI）联合发起了癌症基因组图集计划（TCGA）,获得了海量数据。这些数据加速了人们对癌变分子机制的认识,为精准治疗和个性化治疗奠定了坚实的基础。此计划完成后国内鲜有对其详实的介绍,本文将对该基因组数据的产生、数据的类型、数据的获取与应用等进行描述,促进这些数据运用于癌症的预防、早期诊断和治疗中。     

慢性粒细胞白血病骨髓巨噬细胞表达与细胞因子的相关性

目的 探讨慢性粒细胞白血病(CML)患者骨髓中巨噬细胞及白细胞介素(IL)-1β、IL-2、IL-4、IL-10、γ干扰素(INF-γ)的表达及相关性以明确其临床意义.方法 选择CML慢性期30例(CML-CP组)、加速期21例(CML-AP组)、急变期20例(CML-BP组)、经治疗后完全缓解的患者44例、未缓解7例以及30例缺铁性贫血患者(对照组),采用免疫组化染色法检测上述各组患者骨髓组织中CD68、CD163的表达变化;应用流式细胞仪分析相应患者骨髓IL-1β、IL-2、IL-4、IL-10、INF-γ表达;比较骨髓巨噬细胞在CML患者不同时期骨髓组织CD68、CD163的表达差异与IL-1β、IL-2、IL-4、IL-10、INF-γ表达变化的关系.结果 CML各组患者骨髓组织中CD68、CD163均有不同程度的表达,且随着病情的进展表达逐渐增高,即对照组＜CML-CP组＜CML-AP组＜CML-BP组,组间比较差异有统计学意义(P＜0.05);同时,CD163与CD68阳性细胞数密切相关(P＜0.05).与对照组比较,CML-CP组骨髓IL-2、INF-γ明显降低(P＜0.05),IL-1β、IL-4、IL-10表达明显升高(P＜0.05);随着病情进展,IL-2、INF-γ表达逐渐降低,即对照组＞CML-CP组＞CML-AP组＞CML-BP组,其组间差异有统计学意义(P＜0.05),且与CD163表达呈负相关;IL-1β、IL-4、IL-10表达逐渐升高,对照组＜CML-CP组＜CML-AP组＜CML-BP组,组间差异有统计学意义(P＜0.05),并与CD163表达呈正相关.患者经治疗完全缓解后,CD68及CD163仍高于对照组(P＜0.05);IL-2、INF-γ有所回升,但仍低于对照组(P＜0.05),IL-1β、IL-4、IL-10有所降低,同样也高于对照组(P＜0.05).未缓解组所测指标与CML-BP组相比,差异无统计学意义(P＞0.05).结论 巨噬细胞在CML患者骨髓中的异常浸润并逐渐从M1型向M2型巨噬细胞激化及IL-1β、IL-2、IL-4、IL-10、INF-γ的异常表达,改变了正常骨髓微环境,有利于白血病细胞的生存和增殖分化,可能与CML的发生、发展相关.     

Neutrophil elastase plays a non-redundant role in remodeling the venular basement membrane and neutrophil diapedesis post-ischemia/reperfusion injury

Ischemia/reperfusion (I/R) injury is a severe inflammatory insult associated with numerous pathologies, such as myocardial infarction, stroke and acute kidney injury. I/R injury is characterized by a rapid influx of activated neutrophils secreting toxic free radical species and degrading enzymes that can irreversibly damage the tissue, thus impairing organ functions. Significant efforts have been invested in identifying therapeutic targets to suppress neutrophil recruitment and activation post-I/R injury. In this context, pharmacological targeting of neutrophil elastase (NE) has shown promising anti-inflammatory efficacy in a number of experimental and clinical settings of I/R injury and is considered a plausible clinical strategy for organ care. However, the mechanisms of action of NE, and hence its inhibitors, in this process are not fully understood. Here we conducted a comprehensive analysis of the impact of NE genetic deletion on neutrophil infiltration in four murine models of I/R injury as induced in the heart, kidneys, intestine and cremaster muscle. In all models, neutrophil migration into ischemic regions was significantly suppressed in NE^−/− mice as compared with wild-type controls. Analysis of inflamed cremaster muscle and mesenteric microvessels by intravital and confocal microscopy revealed a selective entrapment of neutrophils within venular walls, most notably at the level of the venular basement membrane (BM) following NE deletion/pharmacological blockade. This effect was associated with the suppression of NE-mediated remodeling of the low matrix protein expressing regions within the venular BM used by transmigrating neutrophils as exit portals. Furthermore, whilst NE deficiency led to reduced neutrophil activation and vascular leakage, levels of monocytes and prohealing M2 macrophages were reduced in tissues of NE^−/− mice subjected to I/R. Collectively our results identify a vital and non-redundant role for NE in supporting neutrophil breaching of the venular BM post-I/R injury but also suggest a protective role for NE in promoting tissue repair. © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

韩氏穴位神经刺激仪对大鼠佐剂性关节炎的治疗作用

以佐剂性关节炎大鼠作为病理性疼前的实验动物模型，用韩氏穴位神经刺激仪进行治疗，结果发现：关节炎大鼠痛阈较正常鼠明显降低，体温及患肢直径也明显增加；但经过一个疗程治疗后，关节炎大鼠的症状有明显的改善，表现为痛阈显著提高，体温恢复正常和患肢肿胀程度减轻；腹腔注射维生素Ｂ６能显著加强治疗的镇痛作用。结果表明：佐剂性关节为大鼠可作为病理性疼痛的实验动物模型；韩氏穴位神经刺激仪对关节炎大鼠上有良好的治疗作用     

制霉菌素与氟康唑治疗口腔真菌感染的效果分析

目的分析制霉菌素与氟康唑在口腔真菌感染治疗中的应用效果,为临床治疗口腔真菌感染提供科学依据。方法选取2011年6月-2014年12月150例于医院进行诊治的间质性肺炎合并口腔真菌感染患者进行试验观察,分为观察组与对照组,每组各75例,观察组使用制霉菌素药膏治疗,对照组给予氟康唑外用治疗,比较两组患者第4天与第9天的治疗效果及其临床症状变化。结果治疗第4天,观察组患者治疗有效49例,治疗有效率为65.3%;对照组患者治疗有效25例,治疗有效率为33.3%,两组治疗有效率差异有统计学意义(t=5.421,P0.05);治疗第4天采样进行真菌培养,观察组真菌检验阳性28例,阳性率为37.3%;对照组真菌检验阳性38例,阳性率为50.7%,两组阳性率差异有统计学意义(t=6.524,P0.05);观察组与对照组患者的疼痛缓解指数为(58.3±13.6)分与(32.8±8.9)分;创口愈合率为75.8%与48.5%;口腔创口愈合时间为(5.1±1.2)d与(18.2±3.4)d;差异均有统计学意义(P0.05)。结论制霉菌素在治疗口腔真菌感染中的临床疗效显著优于氟康唑,并且安全性能高,能够有效缓解患者的临床症状,提高治愈效果。