Multifunctional hollow CaF2:Yb3+/Er3+/Mn2+-poly(2-Aminoethyl methacrylate) microspheres for Pt(IV) pro-drug delivery and tri-modal imaging

Combining the multi-modal medical imaging with cancer therapy in one single system has attracted the great interests for theranostic purpose. In this paper, CaF₂:Yb³⁺/Er³⁺/Mn²⁺-poly(2-Aminoethyl methacrylate) (UCHNs-PAMA) hybrid microspheres were successfully fabricated. The synthetic route to the nanocomposite based on a facile hydrothermal method for fabrication of hollow upconversion (UC) nanospheres at first and then post-filling the PAMA interiorly through photo-initiated polymerization. The UCHNs showed orange fluorescence under 980 nm near infrared (NIR) laser excitation, which provided the upconverting luminescence (UCL) imaging modality. Meanwhile, the presence of functional Mn²⁺ and Yb³⁺ offered the enhanced T₁-weighted magnetic resonance (MR) and computed tomography (CT) imaging, respectively. Thanks to introducing amine groups-containing PAMA inside the hollow nanospheres, the Pt(IV) pro-drug, c,c,t-Pt(NH₃)₂Cl₂(OOCCH₂CH₂COOH)₂ (DSP), can be conveniently bonded on the polymer network to construct a nanoscale anti-cancer drug carrier. The UCHNs-PAMA-Pt(IV) nanocomposite shows effective inhibition for Hela cell line via MTT assay. In contrast, Pt(IV) pro-drug and UCHNs-PAMA microspheres behave little cytotoxicity to Hela cells. This should be attributed the fact that the anti-cancer ability can be recovered only when Pt(IV) pro-drug was reduced to Pt(II)-drug in cellular environment. Furthermore, the in vivo experiments on small mice also confirm that the hybrid microspheres have relatively low toxic side effects and high tumor inhibition rate. These findings show that the multifunctional hybrid microspheres have potential to be used as UCL/MR/CT tri-modal imaging contrast agent and anti-cancer drug carriers.     

A network analysis of posttraumatic stress disorder and dissociation in trauma-exposed adolescents

Posttraumatic stress disorder (PTSD) and dissociation have long been recognized to co-occur, leading the DSM-5 to introduce a dissociative subtype of PTSD into its nomenclature. Most research to date on the dissociative subtype has focused on adults. The current study aimed to extend this research to an adolescent sample and to examine symptom-level associations between PTSD and dissociation using network analysis. The analysis was conducted with 448 trauma-exposed detained US adolescents (24.55% female; mean age 15.98 ± 1.25 years). A network consisting of 20 DSM-5 PTSD symptoms was constructed, followed by a network consisting of 20 PTSD symptoms and five dissociative items. Expected influence bridge centrality was estimated to examine items with the most/strongest cross-construct connections (i.e. between PTSD and dissociation). The PTSD symptoms concentration problems, amnesia and recurrent memories and the dissociative items depersonalization, derealisation and can’t remember things that happened had the highest bridge centrality values. These symptom-level associations extend our understanding of the PTSD-dissociation relationship by pointing to specific symptoms of PTSD and dissociation that may drive the co-morbidity between the two constructs. These findings may inform future intervention efforts.     

血管细胞黏附分子-1和激活素A对多发性骨髓瘤的影响研究

背景　多发性骨髓瘤（MM）是一好发于中老年人的伴有高钙血症、肾损害、贫血及骨质破坏的浆细胞肿瘤，近几年MM发病率明显增高。MM发病机制不明，可能与MM患者复杂的异常肿瘤微环境有关。目的　探究MM患者肿瘤微环境中血管细胞黏附分子-1（VCAM-1）和激活素A对MM发病的影响。方法　选取2012年1月-2014年4月北京朝阳医院西院血液与肿瘤科收治的50例MM住院患者作为研究对象，同时选取在本院体检的健康人20例作为对照组。根据治疗后患者的病情状态分组，新诊断MM（NDMM）组18例、复发MM（RMM）组18例和治疗反应（RG）组14例。根据是否有肾损害〔血肌酐（Scr）>177 μmmol/L〕分为肾损害组（KI）组12例及非肾损害（NKI）组38例；根据是否有贫血〔血红蛋白（Hb）<100 g/L〕分为贫血组29例及非贫血组21例；根据患者骨病程度分为严重骨病变（SBL）组27例和非严重骨病变（NSBL）组23例。应用ELISA法检测MM患者VCAM-1、激活素A、骨代谢标志物〔25-羟维生素D3、血清骨特异性碱性磷酸酶（bALP）、抗酒石酸酸性磷酸酶（TRACP-5b）和Ⅰ型胶原吡啶交联终肽（ICTP）、白介素（IL）-6、IL-6R、肿瘤坏死因子α（TNF-α）和血管内皮生长因子（VEGF）〕水平。相关性分析采用Pearson相关分析。采用受试者工作特征曲线（ROC曲线）评价VCAM-1和激活素A诊断MM的最佳截断值，绘制生存曲线。结果　NDMM组、RMM组VCAM-1、激活素A水平均高于对照组（P<0.05）；NDMM组、RMM组VCAM-1、激活素A水平高于RG组（P<0.05）；NDMM组激活素A水平高于RG组（P<0.05）。KI组VCAM-1、激活素A水平高于NKI组、对照组（P<0.05）。NKI组VCAM-1、激活素A水平高于对照组（P<0.05）。贫血组VCAM-1、激活素A水平高于非贫血组（P<0.05）。SBL组、NSBL组激活素A水平高于对照组（P<0.05）；SBL组激活素A水平高于NSBL组（P<0.05）。VCAM-1水平与激活素A（r=0.627，P<0.001）、Scr（r=0.415，P=0.004）、β2-微球蛋白（r=54.97，P=0.001）、乳酸脱氢酶（r=0.968，P=0.028）、骨髓中骨髓瘤细胞数目（r=1 684.38，P=0.045）呈正相关；与清蛋白（r=-0.589，P<0.001）和Hb水平（r=-0.589，P<0.001）呈负相关。根据ROC曲线得出VCAM-1诊断MM的最佳截断值为1 443.3 μg/L、激活素A诊断MM的最佳截断值为550.7 ng/L。VCAM-1>1 443.3 μg/L患者累积生存率低于VCAM-1<1 443.3 μg/L（χ2=17.105，P<0.001）。激活素A>550.7 ng/L患者累积生存率低于<550.7 ng/L（χ2=15.379，P<0.001）。结论　肿瘤微环境中升高的VCAM-1和激活素A一起参与MM病情进展，且与肾病、贫血和骨病病理过程有关，提示其有希望成为未来抗MM治疗的新靶点。     

医药综合改革对医院门诊患者的影响

目的医药综合改革正在进行大力实施,为了研究医药改革之后,该政策对门诊患者产生的影响,文章进行了详细的研究调查,希望能够为以后医药综合改革的有效实施提供一定的理论依据,并且能够为患者提供很好的服务。方法选择北京市某三级医院为样本来源,根据研究设计调取该三级医院2016年4月8日-2018年4月8日在该院呼吸科门诊就诊患者的完整的诊疗记录,比较北京医改政策前后该院专科门诊临床医生对患者临床处置方式的具体项目,包括患者所接受的检验、检查项目以及患者就诊过程中发生的费用,探索关于北京医改政策的变化对于患者临床处置方式的影响。进一步通过对患者群体与医生群体的问卷调查来了解影响患者临床处置方式的相关因素。结果本院在实行医药改革后,由于门诊患者人数逐渐减少,这使得门诊患者的就诊效率得到了提高,而医药分开改革后,所花费的医疗费用也相对减少,患者门诊就医的时间也相对缩短,患者整体就医体验感有所提高。结论新政策下的医药综合改革有利于为患者减轻负担。     

Effects of the Foliar Application of Water-soluble Chitosan or Na2SiO3 Fertilizer on the Pb Accumulation by a Low-Pb Accumulator Brassica napus Grown on Farmland Surrounding a Working Smelter

Field experiments were conducted to investigate the effects of two foliar fertilizers, water-soluble chitosan (WSC) and Na₂SiO₃ (Si), on the accumulation of Pb by a low-Pb accumulator Brassica napus cultivar (QY-1) grown at two mildly Pb-contaminated farmland sites surrounding working smelters in Jiyuan city, Henan province, China. Regardless of the frequency of the fertilizer treatments, the foliar application of WSC (0.01%) or Si (0.15%) significantly increased the QY-1 biomass and decreased the grain Pb concentrations. Compared with the control treatment, spraying plants once with WSC or Si during the flowering period achieved the best effect in the two soils with different pollution, which may be because inhibiting the accumulation of Pb in grains by decreasing the husk-to-grain transfer coefficient. Thus, the foliar application of WSC or Si combined with the cultivation of a low-Pb accumulator is a promising approach for optimizing the utility of Pb-contaminated farmland affected by atmospheric deposition.

     

医院影像胶片与报告自助打印设计与应用

介绍了传统的影像胶片与报告流程存在很多问题。通过改进流程,构建虚拟打印服务器网络并推行自助式影像胶片与报告打印服务模式,可缩减患者检查后等候时间,降低影像科报告胶片核对错误率,节省成本并提高影像科的工作效率。