The prognostic role of tumour‐infiltrating lymphocytes in oral squamous cell carcinoma: A meta‐analysis

It has been suggested that tumour‐infiltrating lymphocytes (TILs) are associated with the progression of oral squamous cell carcinoma (OSCC). However, the prognostic value of TILs is inconclusive due to the heterogeneity of immune cells within the tumour microenvironment. In this meta‐analysis, we aimed to assess the prognostic value of TILs in OSCC. The PubMed, Cochrane, Embase, Scopus and Web of Science databases were searched up to April 20, 2019, and 33 studies were ultimately included in this meta‐analysis. Our pooled meta‐analysis showed that high infiltration of CD8⁺ TILs, CD45RO⁺ TILs and CD57⁺ TILs favoured better overall survival (OS). However, high infiltration of CD68⁺ macrophages and CD163⁺ macrophages was associated with poor prognosis in OSCC. These findings suggest that CD8⁺ TILs, CD45RO⁺ TILs, CD57⁺ TILs, CD68⁺ macrophages and CD163⁺ macrophages might serve as novel prognostic factors and therapeutic targets in OSCC.     

临床实习生对患者隐私的认知及保护情况调查

目的了解临床实习生对患者隐私的认知以及在临床实践中对患者隐私的保护情况,探讨患者隐私教育及临床实习中存在的问题,分析成因并提出加强患者隐私教育、引导实习生合理获取患者隐私的具体建议,以改善临床医学教育过程中存在的薄弱环节。方法随机选取海军军医大学等5所医学院校的572名临床医学实习生为调查对象,发放调查问卷。主要内容包括实习生隐私教育评分、对于隐私保护法及隐私具体范围的知晓情况、临床实践中是否泄露隐私、隐私与临床诊疗等方面,调查结果采用SPSS 21.0软件进行分析。结果27.6%实习生曾发生过泄露患者隐私的情况,58.9%实习生不了解隐私相关法律法规及隐私具体范围,95.4%实习生认为出于诊疗目的而获取患者隐私信息很有必要,但仍有56.6%实习生曾回避涉及患者隐私的医疗活动。结论临床医学实习生的教育中患者隐私教育相对欠缺并有待进一步加强。实习生应当自觉保护患者隐私,维护患者利益,并树立对于患者隐私的合理认知,从患者隐私中提取有价值的信息。     

ELAM-1在鼻咽癌裸鼠移植瘤中的表达及其与转移的关系

目的 建立裸鼠鼻咽癌转移模型并探讨 E-选择素（ELAM-1）与鼻咽癌转移的相关性。方法 将鼻咽癌5-8F细胞悬液注射于裸鼠左后肢爪垫，观察裸鼠状态、成瘤情况并测量裸鼠体重及移植瘤长短径；采用连续病理切片苏木精-伊红染色观察移植瘤及转移情况，将16只人鼻咽癌荷瘤裸鼠分为转移组和非转移组；采用免疫组织化学法检测两组移植瘤组织中ELAM-1的表达。 结果 16只裸鼠均成瘤，成瘤率为100.0%，其中10只裸鼠出现转移瘤，转移率为62.5%。建模前，两组裸鼠体重差异无统计学意义［（13.83±0.56）g vs （14.62±0.30） g，t=1.026，P=0.071］。建模后4~7周，裸鼠瘤体体积呈指数增长，且转移组移植瘤增长速度较非转移组快，非转移组裸鼠瘤体体积小于转移组［（198.91 ± 163.29） mm³ vs （268.76 ±174.31） mm³，t=4.376，P=0.005］。ELAM-1在鼻咽癌裸鼠移植瘤、淋巴结转移灶及远处转移灶中的表达均为阳性，主要表达于细胞膜。转移组移植瘤光密度值高于非转移组（0.4497±0.0705 vs 0.0435±0.0082，t=4.388，P＝0.001）。结论 本研究成功构建稳定性好、转移率高的鼻咽癌裸鼠移植瘤转移模型，且ELAM-1在裸鼠移植瘤中高表达，可促进鼻咽癌裸鼠移植瘤生长和转移。     

Delivery during extracorporeal membrane oxygenation (ECMO) support of pregnant woman with severe respiratory distress syndrome caused by influenza: a case report and review of the literature

Objective: To report a case of labour induction during extracorporeal membrane oxygenation (ECMO) support in a patient with acute respiratory distress syndrome (ARDS) caused by influenza and review of the literature.

Methods: Case report and the literature search of all English articles on delivery while on ECMO in patients with ARDS caused by influenza.

Results: A 25-year-old pregnant woman was initiated with ECMO due to severe ARDS caused by influenza A (H1N1) virus. When the patient had symptoms of colporrhagia and uterine contractions, the medical team decided to start labour induction while on ECMO. There were in total five case reports identified. Maternal oxygenation was improved after delivery and ECMO was successfully discontinued.

Conclusions: Maternal oxygenation was improved after delivery, which may be beneficial to reduce the duration of ECMO. Caesarean section (CS) may be the most used mode and labour induction could be another option. The procedure should be performed by an experienced ECMO team, cooperating with the obstetrician, anaesthesiologist, and ICU doctors.     

从形气神谈溃疡性结肠炎的中西医认识

溃疡性结肠炎(Ulcerative colitis,UC)是一种病情反复、迁延难愈的炎症肠病,已被世界卫生组织列为现代难治病之一[1]。本病病因及发病机制尚不明确,西药治疗效果欠佳。近年来中医药的介入,临床取得显著疗效。西医学认为疾病是机体在一定致病因素的作用下自稳调节紊乱,经过机体内损伤和抗损伤反应的相互斗争,表现出的一系列功能。     

彩色多普勒血流显像(CDFI)评价胎儿生长发育状况

目的阐明CDFI对评价胎儿宫内状况的可行性。方法200例经普通B超检查的胎儿,按测量各项常规指标的数值分为正常组100例和异常组100例,再分析经CDFI检查,所测定的指标包括胎儿大脑中动脉、肾动脉、胎盘床动脉、脐动脉血流搏动指数(PI)、阻力指数(RI)及脐动脉的收缩与舒张期峰值速率之比(S/D)。对其结果做详细记录,并进行统计学分析。结果正常组100例,经CDFI检查亦正常;胎儿出生时体重在2500g以上,新生儿发育正常。另100例异常组经CDFI检查各项指标中,54例正常,46例异常;胎儿出生时体重均小于2500g,其中54例新生儿虽体重较正常儿偏小,但发育正常;另46例胎儿宫内窘迫,导致导常分娩、新生儿生存率低。结论彩色多普勒血流显像对了解胎儿宫内情况有着重要的作用,是产科检查监护中不可缺少的部分。     

铜绿假单胞菌噬菌体PaP3生物学特性的研究

目的测定铜绿假单胞菌噬菌体PaP3的最佳感染复数、一步生长曲线和吸附K值及交叉吸附K值等基本生物学特性。方法按照感染复数（MOI）分别为0．0001、0．001、0．01、0．1、1和10加入噬菌体纯培养液和宿主菌，充分裂解细菌后，测定噬菌体滴度；以MOI=10的比例加入噬菌体及宿主菌，进行一步生长实验；纯化PaP3颗粒，免疫家兔，获得抗血清，通过中和反应实验测定PaP3和其抗血清之间的吸附反应常数K值。同时，利用抗血清交叉中和试验确定本室分离的三株噬菌体之间的血清学关系。结果当MOI=0．001时PaP3感染其宿主菌产生的子代噬菌体滴度最高；根据一步生长实验结果绘制一步生长曲线；通过血清交叉中和反应得出不同的吸附常数。结论PaP3最佳感染复数为0．001，感染宿主菌的潜伏期是20min，爆发期是60min，平均爆发量约为31，其抗血清反应的吸附常数K值为262。