Stathmin表达与局部晚期口腔鳞癌患者TPF诱导化疗远期疗效的相关性分析

目的:验证微管解聚蛋白(Stathmin)能否预测口腔鳞癌(oral squamous cell carcinoma,OSCC)患者从多西紫杉醇、顺铂、5氟尿嘧啶(TPF)诱导化疗中远期获益.方法:收集2008年3月-2010年12月入组TPF诱导化疗临床试验的256例OSCC患者的远期随访结果.收集患者肿瘤活检标本,...     

Postoperative complications after induction chemoradiotherapy in patients with non-small-cell lung cancer

Objective: This study evaluates the risks of postoperative complications in 124 patients with non-small-cell lung cancer who received pre-operative induction chemoradiotherapy and surgery. Methods: All patients with non-small-cell lung cancer who underwent surgery after induction therapy between January 1990 and December 2003 were reviewed. We adopted univariate and multiple logistic regression models to identify predictors that increased the incidence of postoperative complications. Results: Of 124 patients, 59 received carboplatin and docetaxel, 53 received cisplatin and etoposide, and 12 received other platinum-based combinations. Pre-operative thoracic radiotherapy was performed concurrently with chemotherapy. The median dose to the primary tumor was 40 Gy, and 29 patients (23.4%) received radiotherapy of more than 45 Gy before surgery. There were 25 pneumonectomies (20.2%). The overall postoperative mortality was 9 of 124 patients (7.3%), and complications developed in 54 patients (43.5%). Multivariate analysis demonstrated that only thoracic radiotherapy of more than 45 Gy predicted postoperative complications (P = 0.021; odds ratio, 3.620; 95% confidence interval, 1.214–10.797). Conclusions: Thoracic radiotherapy of more than 45 Gy, in combination with chemotherapy, was a significant risk factor for postoperative complications.     

人脂肪干细胞向内皮分化最佳诱导体系的建立

目的 探讨人脂肪干细胞(human Adipose-derived stem cells,hADSCs)体外分化为内皮细胞的最佳诱导体系.方法 利用胶原酶消化法和贴壁筛选法从人脂肪组织中分离、培养及扩增hADSCs,分3组分别进行内皮诱导:即纤维连接蛋白(fibronectin,FN)包被组、明胶包被组和未铺组;同时诱导液分为两组:单纯内皮细胞生长培养基(EGM2-MV)组及内皮细胞生长培养基(EGM2-MV)+50 ng/ml血管内皮细胞生长因子(VEGF_(165))组.诱导15 d后,通过流式细胞术检测各组内皮细胞特异性表面抗原CD34的表达;通过相差显微镜观察诱导前后细胞的一般形态学特征.结果 体外分离、培养出高度同源性的hADSCs,CD29、CD44、CD90、CD105及CD166呈阳性表达,而CD34、CD45及HLA-DR呈阴性表达;诱导后细胞流式结果显示单纯EGM-2MV诱导的3组细胞内皮细胞特异性标志CD34阴性表达,而EGM2-MV+50 ng/ml VEGF_(165)诱导的细胞,其中FN包被组CD34表达率为8.4%,明胶包被组为5.4%,未铺组为4.2%;相差显微镜下可见诱导后细胞呈三角形或多边形,融合处呈铺路石样生长.结论 FN作为细胞外基质与EGM2-MV+50 ng/ml VEGF_(165)组成的诱导液协同作用,构成了hADSCs体外分化为内皮细胞的最佳诱导体系,可为临床上缺血性疾病的自体细胞移植治疗提供大量的种子细胞来源.     

Impact of Early versus Late Amniotomy on Induction of Labor in Nulliparous Women after Vaginally Administered Misoprostol: A Randomized Clinical Trial

Objective::To investigate the effect of early versus late amniotomy after induction of labor (IOL) with vaginally administered misoprostol.Methods::This randomi...     

体外诱导多黏菌素耐药肺炎克雷伯菌的适合度代价相关研究

目的 研究体外诱导多黏菌素耐药肺炎克雷伯菌的适合度代价,并分析耐药株的分子特性。方法 采用体外诱导方法将临床分离的3株多黏菌素敏感肺炎克雷伯菌诱导成多黏菌素耐药株;微量肉汤稀释法检测体外诱导耐药前后菌株对临床常用抗菌药物的最低抑菌浓度(minimal inhibititory concentration, MIC);采用PCR方法检测多黏菌素耐药相关基因pmrA、pmrB、mgrB、phoP和phoQ,并对阳性片段进行测序比对分析;对诱导耐药菌株及其对应敏感菌株进行生长曲线分析、生物膜形成能力检测及体外竞争和抗血清试验,分析研究多黏菌素耐药肺炎克雷伯菌的适合度代价。结果 3株诱导耐药株中均检出pmrB(T157P)突变,在诱导株FK713R和FK729R携带的mgrB基因中分别检出ISkpn14和IS5like插入序列。诱导耐药株与敏感株相比,24h生长曲线未发现明显差异;生物膜形成能力检测结果发现诱导耐药株与敏感株生物膜形成能力无明显差异;3株菌获得多黏菌素耐药后均表现出一定程度的体外竞争缺陷,竞争指数(CI值)分别为0.01、0.54和5×10-4;3株诱导耐药菌中有2株(FK713R和FK729R)与其敏感菌相比出现抗血清作用增强现象。结论 肺炎克雷伯菌获得多黏菌素耐药后会出现一定的适合度改变,不同的耐药机制可能会引起不同的适合度表现。     

米索前列醇联合依沙吖啶在中晚期妊娠引产中的临床应用

目的 探讨米索前列醇联合依沙吖啶在中晚期妊娠引产中的应用效果。方法 选取西安交通大学附属3201医院2012年1月—2017年12月收治的138例中晚期妊娠引产患者,按引产方式分为对照组、观察组,各69例。对照组使用乳酸依沙吖啶注射液进行引产,观察组在对照组的基础上联合使用米索前列醇进行引产。比较两组引产效果、胎儿娩出时间、阴道出血量及不良反应的发生情况。结果 观察组引产有效率是100%,显著高于对照组的91.75%（P<0.05）。观察组胎儿娩出时间<35 h的人数占比显著高于对照组（P<0.05）。观察组患者阴道出血量显著低于对照组（P<0.05）,两组不良反应的发生率间差异不显著。结论 米索前列醇联合依沙吖啶在中晚期妊娠引产中的效果较好,可显著提高引产有效率、缩短胎儿娩出时间,值得临床应用。     

Improving outcomes in primary CNS lymphoma

Primary central nervous system lymphoma (PCNSL) is an aggressive disease with previously poor prognosis. The advent of high-dose methotrexate-based induction regimens as well as use of consolidation therapy has greatly improved this prognosis in recent decades, but durable remission still eludes half of patients. In this review, we summarize the progress made in the treatment of PCNSL as well as the challenges that remain, with a focus on defining optimal induction and consolidation regimens, including the promise of developing biotherapies. Future studies will help delineate the best combination of existing and novel treatment strategies, with the goal of expanding the cohort of patients achieving a cure.     

Increase of cytochromes a and a3 in rat kidney mitochondria in response to administration of aldosterone in vivo

Summary The influence of aldosterone in vivo on cytochromes in rat kidney mitochondria is studied, comparing rats in normal state, adrenalectomized state, and adrenalectomized rats 2 hours after administration of adlosterone (7.5 g per 100 g rat as single dose plus infusion of 0.125 g per hour and 100 g rat).No significant changes between these states are observed of either cytochrome b, cytochrome c₁, or cytochrome c content.Cytochrome a, as estimated from the 605 m band of the difference spectrum (reduced vs. oxidized), decreases from 508±51 nanomoles per g protein (n=12) in the controls to 273±65 (n=12) nanomoles per g protein in the adrenalectomized state.After administration of aldosterone to adrenalectomized rats the concentration of cytochrome a increased to 464±38 nanomoles per g protein (n=12).The difference spectrum (anaerob vs aerob+Antimycin A) shows that the absorbancy maximum at 444 m (more specific for cytochrome a₃) is also considerably decreased after adrenalectomy, and increased after administration of aldosterone to adrenalectomized rats. Hence the contents of both compounds of cytochrome oxidase, cytochrome a and cytochrome a₃, appear to be controlled by aldosterone.The molar ratio of cytochrome c to cytochrome a is 1.1 in the controls, 1.8 after adrenalectomy, and 1.1 after administration of aldosterone to adrenalectomized rats.Possible relations of this effect to the previously observed increase of tricarboxylic acid cycle enzyme activities under aldosterone are discussed.The 46% decrease of the cytochrome a content in mitochondria from the whole kidney of adrenalectomized rats, which is restored to the normal level in response to aldosterone, is difficult to reconcile with the concept that the hormone acts on distal tubules only, as these constitute only about 10% of the material used. Therefore, the present result is considered to support the concept that the hormone acts on both distal and proximal tubules.     

Induction of labor in twin pregnancies – A retrospective cohort study

ObjectiveTo investigate outcomes in spontaneous and induced twin deliveries. Secondary aims were to study impact of delivery interval and breech presentation of the first twin.MethodsThis retrospective cohort study comprised 354 twin deliveries at a tertiary Norwegian hospital. Spontaneous labor onset and induction of labor were compared in women with planned vaginal delivery and gestational age ≥ 34 weeks. The main outcome was intrapartum cesarean section. Secondary outcomes were umbilical arterial pH and five-minute Apgar scores.ResultsAmong the induced labors, 63/229 (27.5%) women underwent intrapartum cesarean section, compared to 45/125 (36%) in spontaneous labors (P = 0.10). Odds ratio for intrapartum cesarean section in induced labors was 0.65 (95% CI 0.40–1.04) after adjusting for maternal age and parity.Median umbilical arterial pH was significantly lower in the second twins in both spontaneous and induced labors, 7.28 (6.94–7.43) vs. 7.32 (7.16–7.42), and 7.27 (6.90–7.48) vs. 7.29 (7.08–7.45), respectively. pH < 7.00 rarely occurred. Second twins born after a delivery interval > 30 min had a significantly higher frequency of pH < 7.10 than those with a shorter interval, P < 0.01. No significant difference was found in frequency of pH < 7.10 between breech-presenting and cephalic-presenting first twins (P = 0.65). One unexpected intrapartum fetal death occurred after labor induction.ConclusionOur results support spontaneous onset and induction of labor as safe. Intrapartum cesarean section rates did not differ significantly between spontaneous and induced labors. Delivery interval > 30 min was associated with a lower pH in the second twin.