基于中华医学科技奖的我国医院科技成果转化现状分析及思考

目的/意义 阐述我国医院科技成果转化及应用现状,为医院临床研究及成果转化工作提供参考。方法/过程 以2015—2021年度医院主持获得的502项中华医学科技奖为分析对象,通过科学计量法对医院主持获奖等级、医院类型、区域及主题分布等方面进行分析。结果/结论 三级医院、高校附属医院是医院科技研究及成果转化的核心力量;各区域临床研究及转化水平仍存在较大差异,亟须加强跨层级跨区域科技合作,提升成果转化效率;现有研究主要聚焦于我国发病率或死亡率较高的疾病领域,符合实际临床需求,但在重大突发公共卫生事件、罕见病等领域仍有待进一步布局。     

Nerve invasion as an independent predictor of poor prognosis in gastric cancer after curative resection

The study aims to reveal the clinical significance of perineural invasion (PNI) for gastric cancer prognosis and determine the risk factors of PNI in gastric cancer. This study retrospectively analyzed 350 patients who were diagnosed with GC and underwent curative surgical resection. Variables used to analyze survival included gender, age, degree of differentiation, T classification, lymph node metastasis, lymphovascular invasion, nerve invasion, mucinous adenocarcinoma component, and signet ring cell carcinoma component. The tumors of all patients were surgically resected. All resected specimens were stained with hematoxylin-eosin and immunohistochemical. The data for the patient’s lymphovascular invasion and PNI came from the collected pathological reports. The results of the survival analysis showed that T staging (P < .001), lymph node metastasis (P < .001), lymphovascular invasion (P = .013), PNI (P = .001), and signet ring cell carcinoma components (P = .046) affect the survival time and have a statistically significant difference. Multivariate analysis indicated that the positivity of PNI was an independent prognostic factor (P = .014). T staging (P = .006) and lymph node metastasis (P = .013) were independent prognostic parameters too. Using the Spearman correlation analysis, the following clinicopathological indicators were associated with PNI positivity, such as tumor differentiation, T staging, lymph node metastasis, vascular invasion, and signet ring cell carcinoma components (P < .05). PNI is an independent marker of poor prognosis in patients with gastric cancer.     

感音神经性耳鸣的足反射疗法疗效分析

目的 探讨足反射疗法对感音神经性耳鸣的疗效。方法 应用足反射疗法治疗１２３例１４８耳感音神经性耳鸣患者,治疗前筛查症状自评量表（ＳＣＬ－９０）、纯音听阈、ＡＢＲ、耳鸣匹配等,治疗后复测耳鸣匹配。结果 治疗后耳鸣消失者１９耳,占１２．８４％,有效６５耳,占４３．９２％,总有效率５６．７６％,耳鸣响度平均下降７．７５分贝,对伴有焦虑、抑郁症状者有效率可达８７％。未出现明显不良反应。结论 足反射疗法是一     

血清CEA和CYFRA21-1对非小细胞肺癌诊断价值的系统评价

目的探讨血清CEA和CYFRA21-1对非小细胞肺癌(NSCLC)的诊断价值。方法计算机检索PubMed、CBM等数据库中的文献,按照纳入排除标准筛选文献,提取纳入研究的特征信息。统计分析过程采用Meta-DiSc 1.4软件。采用QUA-DAS量表进行严格的质量评价,根据异质性特点选择相应效应模型进行计算合并的敏感度、特异度,绘制SROC曲线,并计算曲线下面积(AUC)。结果共检索到相关文献1 679篇,最终纳入38篇文献。经过病理金标准确诊NSCLC患者5 140例,对照组3 834例。Meta分析结果显示,CEA、CYFRA21-1及CEA+CYFRA21-1组的各纳入研究间均存在异质性,SROC曲线下面积分别为0.723 0、0.880 4、0.913 4。结论 CEA、CYFRA21-1对NSCLC皆有一定的诊断价值,联合CEA和CYFRA21-1可进一步提高对NSCLS的诊断效能。     

WT1 mutation and podocyte molecular expression in a Chinese Frasier syndrome patient

We report on a Chinese girl with Frasier syndrome (FS). She presented with steroid-resistant focal segmental glomerulosclerosis (FSGS) and male pseudohermaphroditism. The WT1 IVS 9  +  5 G>A mutation was detected in one allele in the proband. The ratio of +KTS/−KTS was 0.67 in the proband’s cDNA. The expression of podocyte molecules (WT1, nephrin, podocin, α-actinin 4 and CD2AP) were also investigated in a renal specimen of this FS patient. WT1 expression showed diffuse nuclear staining, with less obvious speckles in the patient’s glomeruli than in those of controls. The distribution and intensity of podocyte molecules were altered both in normal- and abnormal-appearing glomeruli. In conclusion, the study presented a case of FS by clinical manifestation, renal pathology, karyotype analysis and genetic testing. A lower ratio of +KTS/−KTS and an abnormal distribution of WT1, as well as abnormal expressions of other podocyte molecules, were also revealed. The mechanisms of WT1 mutation causing FS still need to be investigated. Jianguo Li and Dan Zhao contributed equally to this work.     

老年患者压疮预防的健康宣教

目的:探讨健康宣教在老年压疮患者临床康复中的应用效果.方法制订针对性的健康教育方案,采取集体授课为主、个别讲解为辅的方式,集体教育以录像、专家讲课、集体讨论、患者家属现身说法等方式进行.结果:我们通过运用现代压疮护理观念与程序对患者及家属进行有针对性的健康教育,效果满意.结论:健康宣教能有效预防老年患者压疮的发生.     

Bone marrow-derived mesenchymal stromal cells express cardiac-specific markers, retain the stromal phenotype, and do not become functional cardiomyocytes in vitro

Although bone marrow-derived mesenchymal stromal cells (MSCs) may be beneficial in treating heart disease, their ability to transdifferentiate into functional cardiomyocytes remains unclear. Here, bone marrow-derived MSCs from adult female transgenic mice expressing green fluorescent protein (GFP) under the control of the cardiac-specific alpha-myosin heavy chain promoter were cocultured with male rat embryonic cardiomyocytes (rCMs) for 5-15 days. After 5 days in coculture, 6.3% of MSCs became GFP(+) and stained positively for the sarcomeric proteins troponin I and alpha-actinin. The mRNA expression for selected cardiac-specific genes (atrial natriuretic factor, Nkx2.5, and alpha-cardiac actin) in MSCs peaked after 5 days in coculture and declined thereafter. Despite clear evidence for the expression of cardiac genes, GFP(+) MSCs did not generate action potentials or display ionic currents typical of cardiomyocytes, suggesting retention of a stromal cell phenotype. Detailed immunophenotyping of GFP(+) MSCs demonstrated expression of all antigens used to characterize MSCs, as well as the acquisition of additional markers of cardiomyocytes with the phenotype CD45(-)-CD34(+)-CD73(+)-CD105(+)-CD90(+)-CD44(+)-SDF1(+)-CD134L(+)-collagen type IV(+)-vimentin(+)-troponin T(+)-troponin I(+)-alpha-actinin(+)-connexin 43(+). Although cell fusion between rCMs and MSCs was detectable, the very low frequency (0.7%) could not account for the phenotype of the GFP(+) MSCs. In conclusion, we have identified an MSC population displaying plasticity toward the cardiomyocyte lineage while retaining mesenchymal stromal cell properties, including a nonexcitable electrophysiological phenotype. The demonstration of an MSC population coexpressing cardiac and stromal cell markers may explain conflicting results in the literature and indicates the need to better understand the effects of MSCs on myocardial injury. Disclosure of potential conflicts of interest is found at the end of this article.     

急性心肌梗死血清白细胞介素-6、10水平与心功能研究

目的:观察急性心肌梗死(AMI)合并心力衰竭(心衰)患者血清白细胞介素(IL)-6、10对心功能的影响.方法:选择AMI患者(AMI组)30例于发病后24 h检测血清IL-6、IL-10.在心肌梗死后2周内观察心功能,心脏超声心动图检查测定左室射血分数(EF)、左室短轴缩短率(FS)、等容舒张期时间(IVRT).结果:AMI合并心衰组血清IL-6水平及IL-6/IL-10比值高于未合并心衰组,分别是IL-6:[(306.35±131.32)∶(198.59±52.08)ng/L,P<0.05]、IL-6/IL-10比值:[(18.18±12.66 )∶(11.49±7.47),P<0.05].相关分析:IL-6、IL-10与IVRT呈正相关(r=0.624、r=0.297,P<0.05),与EF(r=-0.559、r=-0.364,P<0.05)、FS(r=-0.453、r=-0.324,P<0.05)呈负相关,IL-6与心功能分级呈正相关(r=0.540、r=0.0.085,P<0.05).结论:AMI合并心衰时IL-6水平增高更为显著,IL-6/IL-10比值增大.     

新型旋转镍钛器械Mtwo在老年人根管治疗中的应用

评价旋转镍钛器械Mtwo在老年患者根管治疗中应用的临床效果.随机选取老年患者中因牙髓炎或根尖周炎需行根管治疗的患牙80例,均分为2 组: M组使用旋转镍钛器械Mtwo、改良步退法预备根管;K组使用手用不锈钢K锉、步退法预备根管, 2 组均采用冷侧压法充填根管.M组能维持根管原有的走向,无根管偏移、台阶、侧穿等并发症;K组并发症的发生率显著多于M组(P<0.05).M组操作时间短,术后疼痛少.在老年患者的根管治疗中, 使用旋转镍钛器械Mtwo进行根管预备,快速、有效,成形效果好,值得临床推荐.