32P玻璃微球血管栓塞内照射加局部灌注抗癌药对肺癌的治疗作用

目的: 探讨32P玻璃微球(phosphorus-32 glass microspheres,32P-GMS)经支气管动脉栓塞内照射治疗支气管肺癌的有效性和安全性. 方法: 经病理确诊的24例支气管肺癌患者均接受2个周期的全身化疗. 非小细胞肺癌(NSCLC)采用CAP方案化疗;小细胞肺癌(SCLC)采用EP方案化疗. 4 wk为一周期. 所有患者均于第8周后复查胸部CT,在证实其病灶变化不明显后行支气管动脉局部灌注化疗并以32P-GMS与超液化碘油的混悬液进行栓塞. 于第12周观察治疗前后胸部CT影像学改变、临床症状、副作用及介入并发症等发生率. 结果: 32P-GMS支气管动脉超选择性介入栓塞内照射术治疗肺癌疗效显著,完全缓解(CR) 5例(21%),部分缓解(PR) 15例(62%),稳定(SD) 3例(12%),进展(PD) 1例(4%),有效率(CR PR) 83%;除1例出现一过性脊髓缺血,经积极治疗后好转外,未见其他并发症. 结论: 全身化疗后序贯32P-GMS肿瘤血管支栓塞内照射加局部灌注化疗治疗支气管肺癌有较高的近期缓解率,患者耐受良好,是治疗肺癌安全、有效的方法之一.     

妊娠晚期妇女膳食模式与营养相关疾病的关联性研究

目的 了解潍坊市妊娠晚期妇女膳食模式与营养相关疾病的关系。 方法 对在潍坊市某三甲医院产检的350名妊娠晚期妇女进行问卷调查并收集相关信息,膳食调查部分采用半定量食物频率法,数据处理中采用因子分析归纳膳食模式,用logistic回归分析探寻膳食模式与相关疾病的关系。 结果 ①因子分析归纳出4种膳食模式:营养型、零食型、荤食型、素食型。②膳食模式相关分析:4种膳食模式除钙外,蛋白质、脂肪、碳水化合物、维生素A、维生素C、维生素D、铁等各类营养素每日摄入量均不同,差异有统计学意义(P<0.05)。单因素分析显示四型膳食模式孕妇的年龄(χ²=19.852,P=0.019)、体重增长(χ²=30.545,P=0.000)、知识得分(χ²=17.603,P=0.001)、贫血(χ²=15.465,P=0.001)、文化程度(χ²=34.378,P=0.000)、职业(χ²=34.915,P=0.003)、收入(χ²=24.417,P=0.004)、下肢水肿(χ²=10.295,P=0.016)、患病数量(χ²=14.396,P=0.002)及血糖异常(χ²=18.167,P=0.044)分布差异有统计学意义,对膳食模式进行多分类logistic回归分析显示零食型膳食模式与妊娠期糖耐量异常具有相关性(OR=4.986, 95%CI:1.274~19.525),荤食型膳食模式与患妊娠期超重和下肢水肿具有相关性(OR₁=4.707,95%CI:1.084~20.441;OR₂=2.690,95%CI:1.061~6.816),素食型膳食模式与患妊娠期贫血和妊娠期患病数量具有相关性(OR₁=0.443,95%CI:0.254~0.772;OR₂=1.919,95%CI:1.076~3.420)。③膳食模式与营养相关疾病分析:二分类logistic回归分析显示,膳食模式与贫血(OR=2.576,95%CI:1.540~4.309)、妊娠期超重(OR= 6.220,95%CI:2.399~16.127)及妊娠期高血压(OR=20.656,95%CI:1.192~357.867)、糖耐量异常(OR=4.587,95%CI:1.092~19.261)均具有相关性。 结论 膳食模式与妊娠晚期相关疾病如妊娠期贫血、体重增长超标、妊娠期高血压和糖耐量异常的形成密切相关;孕期不合理的营养摄入可以导致相关疾病的发生,应加强健康教育,加强孕期营养监督和指导,改善母婴健康,从而为早期营养干预提供科学依据。     

Factors associated with difficulty accessing crack cocaine pipes in a Canadian setting

Introduction and Aims. Crack cocaine pipe sharing is associated with various health‐related harms, including hepatitis C transmission. Although difficulty accessing crack pipes has been found to predict pipe sharing, little is known about the factors that limit pipe access in settings where pipes are provided at no cost, albeit in limited capacity. Therefore, we investigated crack pipe access among people who use drugs in Vancouver, Canada. Design and Methods. Data were collected through two Canadian prospective cohort studies. Generalised estimating equations with logit link for binary outcomes were used to identify factors associated with difficulty accessing crack pipes. Results. Among 914 participants who reported using crack cocaine, 33% reported difficulty accessing crack pipes. In multivariate analyses, factors independently associated with difficulty accessing crack pipes included: sex work involvement [adjusted odds ratio (AOR) = 1.57; 95% confidence interval (CI): 1.03–2.39], having shared a crack pipe (AOR = 1.69; 95% CI: 1.32–2.16), police presence where one buys/uses drugs (AOR = 1.47; 95% CI: 1.10–1.95), difficulty accessing services (AOR = 1.74; 95% CI: 1.31–2.32) and health problems associated with crack use (AOR = 1.37; 95% CI: 1.04–1.79). Reasons given for difficulty accessing pipes included sources being closed (48.2%) and no one around selling pipes (18.1%). Discussion and Conclusions. A substantial proportion of people who smoke crack cocaine report difficulty accessing crack pipes in a setting where pipes are available at no cost but in limited quantity. These findings indicate the need for enhanced efforts to distribute crack pipes and address barriers to pipe access.[Ti L, Buxton J, Wood E, Shannon K, Zhang R, Montaner J, Kerr T. Factors associated with difficulty accessing crack cocaine pipes in a Canadian setting. Drug Alcohol Rev 2012;31:890–896]     

居住环境因素对出生缺陷影响的Meta分析

目的探讨居住地附近存在污染源、孕期居室装修、室内饲养宠物这三种居住环境因素与出生缺陷的关系。方法在线检索知网、万方和维普数据库,系统收集1977年1月1日—2018年7月30日间公开发表的关于中国出生缺陷影响因素的流行病学相关研究,根据严格的纳入排除标准筛选,对纳入的文献进行异质性检验和效应值合并,并对结果进行敏感性分析、发表偏倚检验及校正。结果最终纳入21篇文献,采用随机效应模型计算居住地附近存在污染源、孕期居室装修、室内饲养宠物因素危险性的合并OR值分别为2.474(1.659～3.688)、2.149(1.807～555)、2.721(2.006～3.693)(校正后)。结论居住地附近存在污染源、孕期居室装修、室内饲养宠物这三种居住环境因素会增加出生缺陷发生的风险。     

Long-term effect of laser treatment for dry age-related macular degeneration on choroidal hemodynamics

PURPOSE: To determine whether laser treatment applied according to the complications of age-related macular degeneration prevention trial (CAPT) has an effect on the choroidal circulation. DESIGN: Randomized controlled trial. METHODS: This study included 30 CAPT patients with bilateral drusen. Laser Doppler flowmetry was used to measure relative choroidal blood flow (Ch(flow)) in the fovea. Measurements were obtained through dilated pupils in both eyes of each patient before photocoagulation was applied in one eye. Measurements were repeated at three months (30 patients) and 28 months (23 patients). RESULTS: Average Ch(flow) at baseline, three months, and 28 months was 7.2 +/- 2.1 (+/-1 SD), 7.3 +/- 2.5, and 6.8 +/- 2.7 arbitrary units (AU) in the control eyes and 6.6 +/- 1.6, 7.0 +/- 2.3, and 7.8 +/- 3.0 AU in the treated eyes. In comparison to control eyes, there was no significant change in Ch(flow) in the treated eyes at three months after treatment. At 28 months, however, there was a 5.6% drop in Ch(flow) in control eyes and an 18.2% increase in Ch(flow) in treated eyes from baseline. The average difference of 23.8% between the percentage changes in Ch(flow) observed in the control and treated eyes was statistically significant (paired two-tailed Student t test; P = .05). CONCLUSIONS: Our results suggest an increase in choroidal blood flow 28 months after laser treatment according to the CAPT protocol. This increase may play a role in the mechanism leading to the disappearance of drusen after photocoagulation. Whether removal of drusen after photocoagulation is beneficial to the patients is not known at this time.     

破骨细胞的骨吸收机制

破骨细胞是一种巨大的多核细胞,起源于单核巨噬细胞/单核系造血前体细胞,在骨吸收过程中发挥重要作用。破骨细胞的形成和活性异常可导致骨质疏松、类风湿关节炎、关节置换后假体无菌性松动等许多疾病,因此破骨细胞是治疗这些疾病的靶点之一。目前对破骨细胞的分化形成研究较多,但对破骨细胞如何识别、降解骨组织方面的研究较少。骨盐被认为是破骨细胞识别的重要成分,但是近年来的研究发现骨基质不是破骨细胞激活的必需成分,玻连蛋白包被的培养皿也能使破骨细胞出现骨吸收的特有形态,玻连蛋白对破骨细胞的激活有重要的作用。此外,最近的研究证明骨基质降解产物的吞入和分泌对破骨细胞的分化和功能的保持有重要意义。这些分子机制的研究可能为骨骼疾病提供新的治疗靶点。     

地塞米松对嗜酸性粒细胞凋亡及Fas mRNA表达的影响

目的:观察地塞米松对哮喘豚鼠体外不同密度嗜酸性粒细胞(Eos)凋亡及Fas mRNA表达的影响,探讨其促进哮喘Eos凋亡的机制。方法:卵蛋白激发哮喘豚鼠动物模型48 h后行支气管肺泡灌洗,分离不同密度Eos。地塞米松(DM)(10-10~10-5mol/L)干预24 h,原位杂交检测Eos的Fas mRNA表达,3'末端脱氧核苷转移酶介导的脱氧三磷酸尿苷(d-UTP)缺口末端标记(TUNEL)法检测细胞凋亡。结果:DM干预24 h,可见Eos凋亡增加,以低密度Eos(HEos)为明显,与对照组相比,在10-9mol/L时出现显著差别(P<0.05);DM可使Eos表达Fas mRNA增加,并具有剂量依赖性;HEos与NEos相比,其Fas mR-NA表达无明显差别;Eos Fas mRNA表达与其细胞凋亡呈正相关。结论:DM可提高Fas mRNA表达,促进Eos凋亡。Fas可能是DM调节Eos凋亡的通路之一。     

含2-N,N-二甲氨基嘧啶环与噻吩环结构的共轭聚合物的合成及其性能

合成了一种新型单体2-N,N-二甲氨基-4,6-二氯嘧啶(ADNP).以二氯-1,3-双(二苯基磷)丙烷基镍(Ⅱ)作催化剂,通过2,5-二溴噻吩格氏试剂与该单体共聚得到了一种新型共轭聚合物,聚[(2-N,N-二甲胺基嘧啶-4,6-二)-2,5-噻吩](PThPm).采用FT-IR、1H-NMR等测试手段对新型单体与共聚物的结构进行了表征,并用UV-Vis、荧光光谱、X射线衍射、循环伏安、热重分析(TGA)等测试方法对单体和共聚物进行了性能分析.结果表明:共聚物在420 nm处出现UV-Vis吸收峰,在528 nm处出现荧光发射峰;共聚物的DMF溶液存在酸致变色现象,加入CF3COOH和CH3SO3H后,溶液由淡绿黄色转变为淡红色,UV-Vis吸收峰发生红移;PThPm共聚物有一定的结晶性和热稳定性;在-1.8～ 1.8 V之间出现电致变色现象,电极周围的溶液颜色从深蓝色变成深红色.     

131I内照射治疗对甲状腺功能亢进症患者血液成分的影响

目的探讨放射性131I治疗甲状腺功能亢进症（甲亢）时,辐射对患者血液成分的影响。方法利用全自动血液分析仪,对20例健康人、128例甲亢患者131I治疗前、治疗后7天及3个月血液成分进行检测并分析研究。结果131I治疗后7天血红蛋白测定、血小板计数显著降低（t=-40.177,t=-4.363,P〈0.01）;白细胞计数升高（t=4.281,P〈0.01）,其中粒细胞明显升高（t=10.114,P〈0.01）;淋巴细胞显著降低（t=6.667,P〈0.01）,其余检测项目与对照组比较均无明显差异;治疗后3个月患者血液成分所有检测项目与对照组比较均无明显差异。结论利用131I治疗甲亢时,辐射对患者血象有一过性轻微影响,随时间推移,血象各项指标均可恢复正常。