超声乳化吸除及人工晶状体植入术治疗小瞳孔白内障的临床探讨

目的:探讨小瞳孔时的白内障超声乳化术的手术技巧和临床效果。方法:对23例(27眼)散瞳后小瞳孔的白内障患者采用钝性分离及非切开的牵拉法扩大瞳孔,进行原位超声乳化并人工晶状体囊袋内植入术。结果:术后随访6～12mo,所有病例术后视力较术前有不同程度的提高,术后视力0.1～0.2者5眼,0.3～0.5者14眼;0.8以上者8眼。结论:采用钝性分离及非切开的牵拉扩大瞳孔法,原位超声乳化可使小瞳孔的白内障恢复良好的视力和生理性圆瞳孔或近圆瞳孔,手术并发症少。     

羊膜加巩膜前部覆盖防治羟基磷灰石义眼座眶内植入暴露的临床分析

目的:探讨羊膜加前部巩膜覆盖对防治羟基磷灰石(HA)义眼座植入暴露的临床效果。方法:采用羊膜联合自体或异体巩膜为加固物对13例(13眼)行Ⅰ、Ⅱ期HA义眼座植入,随访12～20mo。结果:13例均获得了较好的疗效,未见其他并发症。结论:在行HA义眼座植入时采用羊膜联合前部自体或异体巩膜覆盖加固有利于结膜创口的愈合,预防创口裂开,减少义眼座暴露。     

Immunobiologic, cytogenetic and drug response features of a newly established cell line (SCRC-1) from renal small cell carcinoma

PURPOSE: We describe the establishment and preliminary characterization of a cell line designated SCRC-1, which was derived from a primary renal small cell carcinoma. MATERIALS AND METHODS: Continuous cultures of a primary stage IVa renal small cell carcinoma and a xenograft in nude mice derived therefrom were characterized by immunohistology, electron microscopy, immunofluorescence/flow cytometry, cytogenetic analysis, and an in vitro drug resistance assay. RESULTS: SCRC-1 cells were reactive with antibodies to NSE, chromogranin-A, bombesin, Bcl-2, CD44s, CD44v6, CD44v7 to 8, vimentin and S100 protein (predominantly beta-subunit), and were unreactive with antibodies to EMA, CD54, EGFR(R1), URO-5, URO-7, URO-8 and URO-10. A similar immunoprofile was also found in both the primary tumor and the xenograft. Cytogenetic analysis revealed the following common clonal aberrations in all 50 metaphases analyzed: 45, XX, t (X;10;18) (p11;p11;q11), -der(18)t(X;10;18), indicating the clonal nature of this neoplasm. SCRC-1 cells showed low drug resistance to cyclophosphamide, doxorubicin, gemcitabine and fluorouracil, intermediate resistance to carmustine and mitomycin-C, and extreme resistance to cisplatin. CONCLUSION: We have documented the initial characterization of SCRC-1, which may be the first cell line reported to be derived from a primary small cell carcinoma of the kidney. This cell line can be used for further studies uncovering the biology and histogenesis of this rare cancer and delineating differences among small cell carcinomas of the kidney and other histological types.     

抗单核细胞抗体与冠心病间关系的探讨

目的研究抗单核细胞抗体与冠心病的关系。方法以健康成人外周血单核细胞(MOC)为靶抗原,用微量间接酶免疫组织化学技术检测了35例冠心病(CHD)患者,27例献血员血清中抗单核细胞抗体(AMA)。结果冠心病组和献血员组血清中抗单核细胞抗体阳性率分别为54.3%、14.8%,平均滴度分别为1∶6.05、1∶2.63。病例组与对照组比较阳性率和平均滴度都明显增加(P<0.01),CHD患者血清稀释4倍AMA阳性率为48.6%,其四种临床类型AMA阳性率有差异,但不具显著性(P>0.05)。结论抗单核细胞抗体与冠心病有一定的关系。     

Quality of sleep and related factors during chemotherapy in patients with stage I/II breast cancer.

BACKGROUND: Insomnia causes severe distress in patients with breast cancer who receive chemotherapy. Few studies have focused on using objective methods to assess sleep. This study explored the quality of sleep and related factors in patients with breast cancer during chemotherapy. METHODS: The participants were 16 women with stage I or II breast cancer receiving their third cycle of chemotherapy with cyclophosphamide, epirubicin and fluorouracil, or cyclophosphamide, methotrexate and fluorouracil. The effects of chemotherapy on sleep were assessed on the 8th and 9th days of the third cycle, i.e. the active phase in terms of side effects, and the last 2 days before the start of the fourth cycle for comparison. Instruments used to assess sleep quality and related factors included actigraphy, the Hospital Anxiety and Depression Scale (HADS), the Symptom Distress Scale (SDS), the Fatigue Visual Analogue Scale (FVAS), the Epworth Sleepiness Scale (ESS), and sleep logs. RESULTS: During the active phase, patients showed an anxiety tendency with an average HADS score of 7.8 +/- 3.8. The average FVAS score was 4 +/- 2, indicative of mild fatigue, and SDS score (1.8 +/- 0.3) also indicated mild symptom distress. The number of awakenings each night was 2.2 +/- 1.6 by sleep logs, and the total time spent awake during these episodes was 47.8 +/- 26.1 minutes by Actiwatch. Sleep efficiency measured by Actiwatch in the active phase was 82.1 +/- 9.4% below the normal limit. Daytime sleepiness assessed by ESS showed mild sleepiness (6.0 +/- 3.5) in the active phase. CONCLUSION: The study showed poor sleep quality and daytime sleepiness in patients with breast cancer during the active phase of chemotherapy. Chemotherapy may bring symptom distress to patients and adversely influence sleep quality.     

Pivotal study of iodine-131-labeled chimeric tumor necrosis treatment radioimmunotherapy in patients with advanced lung cancer.

PURPOSE: Tumor necrosis treatment (TNT) uses degenerating tumor cells and necrotic regions of tumors as targets for radioimmunotherapy. Previous studies in animal tumor models and clinical trials have demonstrated that when linked to the therapeutic radionuclide iodine-131, recombinant chimeric TNT antibody ((131)I-chTNT) can deliver therapeutic doses to tumors regardless of the location or type of malignancy. Therapeutic efficacy and toxicity of (131)I-chTNT in advanced lung cancer patients were studied in this pivotal registration trial. PATIENTS AND METHODS: Patients with advanced lung cancer were treated with systemic or intratumoral injection of (131)I-chTNT in eight oncology centers in China. The objective response rate (ORR) was assessed as the primary end point. RESULTS: All 107 patients who were entered onto the study and completed therapy had experienced treatment failure after prior radiotherapy or chemotherapy a mean of three times. The results showed an ORR of 34.6% (complete response, 3.7%; partial response, 30.8%; no change, 55.1%; and progressive disease, 10.3%) in all patients and 33% in 97 non-small-cell lung cancer patients. A biodistribution study demonstrated excellent localization of the radioactivity in tumors in both systemically and intratumorally injected patients. The most obvious adverse side effect was mild and reversible bone marrow suppression. CONCLUSION: Radioimmunotherapy with (131)I-chTNT was well tolerated and can be used systemically or locally to treat refractory tumors of the lung.     

Efficacy and safety of nafamostat mesilate anticoagulation in blood purification treatment of critically ill patients: a systematic review and meta-analysis

BackgroundNafamostat mesilate (NM), a broad-spectrum and potent serine protease inhibitor, can be used as an anticoagulant during extracorporeal circulation, as well as a promising drug effective against coronavirus disease 2019 (COVID-19). We conducted a systematic meta-analysis to evaluate the safety and efficacy of NM administration in critically ill patients who underwent blood purification therapy (BPT).MethodsThe Cochrane Library, Web of Science and PubMed were comprehensively searched from inception to August 20, 2021, for potential studies.ResultsFour randomized controlled trials (RCTs) and seven observational studies with 2723 patients met the inclusion criteria. The meta-analysis demonstrated that conventional therapy (CT) significantly increased hospital mortality compared with NM administration (RR = 1.25, p = 0.0007). In subgroup analyses, the in-hospital mortality of the NM group was significantly lower than that of the anticoagulant-free (NA) group (RR = 1.31, p = 0.002). The CT interventions markedly elevated the risk ratio of bleeding complications by 45% (RR = 1.45, p = 0.010) compared with NM interventions. In another subgroup analysis, NM used exhibited a significantly lower risk of bleeding complications than those of the low-molecular-weight heparin (LMWH) used (RR = 4.58, p = 0.020). The filter lifespan was decreased significantly (MD = −10.59, p < 0.0001) in the NA groups compared with the NM groups. Due to the poor quality of the included RCTs, these results should be interpreted with caution.ConclusionGiven the better survival outcomes, lower risk of bleeding, NM anticoagulation seems to be a safe and efficient approach for BPT patients and could yield a favorable filter lifespan. More multi-center RCTs with large samples are required for further validation of this study.     

妊娠期亚临床甲状腺功能减退孕妇叶酸利用能力与血清同型半胱氨酸、维生素B12的相关性分析

目的 探究妊娠期亚临床甲状腺功能减退(妊娠期亚甲减)孕妇叶酸(FA)利用能力与血清同型半胱氨酸(Hcy)、维生素B₁₂的相关性。方法 选取100例妊娠期亚甲减孕妇为研究组;另选同期100例甲状腺功能正常孕妇为对照组。检测两组孕妇FA、Hcy、维生素B₁₂以及甲状腺功能,并分析其相关性。结果 两组FA利用能力比较,差异具有统计学意义(P<0.05)。研究组血清Hcy水平高于对照组,维生素B₁₂水平低于对照组,差异具有统计学意义(P<0.05)。两组游离三碘甲状腺原氨酸(FT₃)、游离四碘甲状腺原氨酸(FT₄)水平比较,差异无统计学意义(P>0.05),研究组促甲状腺激素(TSH)水平高于对照组,差异具有统计学意义(P<0.05)。FA利用能力与Hcy呈负相关(r=-0.454),与维生素B₁₂呈正相关(r=0.219);Hcy与维生素B₁₂、FT₃、FT₄呈负相关(r=...     

Vitamin D Enhances Neutrophil Generation and Function in Zebrafish (Danio rerio)

Vitamin D (VD) is a major regulator of calcium metabolism in many living organisms. In addition, VD plays a key role in regulating innate and adaptive immunity in vertebrates. Neutrophils constitute an important part of the first line of defense against invading microbes; however, the potential effect of VD on neutrophils remains elusive. Thus, in this study zebrafish in different developmental stages were utilized to identify the potential role of VD in the basal homeostasis and functions of neutrophils. Our results showed that addition of exogenous VD₃ promoted granulopoiesis in zebrafish larvae. Reciprocally, neutrophil abundance in the intestine of adult zebrafish with a cyp2r1 mutant, lacking the capacity to 25-hydroxylate VD, was reduced. Moreover, VD-mediated granulopoiesis was still observed in gnotobiotic zebrafish larvae, indicating that VD regulates neutrophil generation independent of the microbiota during early development. In contrast, VD was incapable to influence granulopoiesis in adult zebrafish when the commensal bacteria were depleted by antibiotic treatment, suggesting that VD might modulate neutrophil activity via different mechanisms depending on the developmental stage. In addition, we found that VD₃ augmented the expression of il-8 and neutrophil recruitment to the site of caudal fin amputation. Finally, VD₃ treatment significantly decreased bacterial counts and mortality in zebrafish infected with Edwardsiella tarda (E. tarda) in a neutrophil-dependent manner. Combined, these findings demonstrate that VD regulates granulopoiesis and neutrophil function in zebrafish immunity.