核素153Sm、89Sr和化疗治疗多发性骨转移癌疗效对比

目的观察化学疗法及核素153Sm-EDTMP、89SrCl2治疗骨转移癌的疗效。方法对骨转移癌患者分别予以化学疗法及核素153Sm-EDT-MP、89SrCl2治疗,观察不同方法的疗效。结果化学疗法治疗组中骨痛的缓解率分别是完全缓解(CR)0%,部分缓解(PR)8.3%;骨显像的变化是CR0%,PR7.7%,稳定0%;而核素治疗骨转移癌的疗效明确,骨痛的缓解率达到70.3%,骨显像异常浓聚点虽然CR为0%,但PR为45.9%,稳定为43.3%。结论核素153Sm-EDTMP、89SrCl2治疗骨转移疗效明确,其中153Sm-EDTMP疗效更优于89SrCl2。     

TP53 variants in p53 signatures and the clonality of STICs in RRSO samples

ObjectivePrecursor lesions may be identified in fallopian tube tissue after risk-reducing salpingo-oophorectomy (RRSO) in patients with pathogenic variants of BRCA1/2. Serous tubal intraepithelial carcinoma (STIC) is considered a precursor of high-grade serous carcinoma, whereas the significance of the p53 signature remains unclear. In this study, we investigated the relationship between the p53 signature and the risk of ovarian cancer.MethodsWe analyzed the clinicopathological findings and conducted DNA sequencing for TP53 variants of p53 signatures and STIC lesions isolated using laser capture microdissection in 13 patients with pathogenic variants of BRCA1/2 who underwent RRSO and 17 control patients with the benign gynecologic disease.Results TP53 pathogenic variants were detected significantly higher in RRSO group than control (p<0.001). No difference in the frequency of p53 signatures were observed between groups (53.8% vs 29.4%; p=0.17). TP53 sequencing and next-generation sequencing analysis in a patient with STIC and occult cancer revealed 2 TP53 mutations causing different p53 staining for STICs and another TP53 mutation shared between STIC and occult cancer.ConclusionThe sequence analysis for TP53 revealed 2 types of p53 signatures, one with a risk of progression to STIC and ovarian cancer with pathological variants in TP53 and the other with a low risk of progression without pathological variants in TP53 as seen in control.     

孔圣枕中丹对痴呆动物模型抗凋亡作用及机制的研究

目的:研究孔圣枕中丹抗痴呆动物模型海马神经元细胞凋亡的作用及机制。方法:将50只Wister大鼠随机分为正常组、模型组、脑复康组、孔圣枕中丹低剂量组、高剂量组,每组10只。除正常组外,将其余大鼠制成血管性痴呆大鼠模型。给大鼠灌胃后,采用流式细胞技术检测神经元凋亡率及bcl-2的表达,采用免疫组织化学法观察p53的表达。结果:孔圣枕中丹、脑复康均能降低血管性痴呆大鼠脑海马神经元凋亡率和bcl-2表达,提高p53表达,两组比较无显著性差异。结论:孔圣枕中丹能抑制神经元细胞凋亡,其机制可能与增强p53表达、降低bcl-2表达有关。     

Efficacy and safety of once‐weekly semaglutide in Japanese individuals with type 2 diabetes by baseline age and body mass index

Aims/IntroductionMany East Asians with type 2 diabetes are elderly and have a low body mass index (BMI), especially in ''super‐aged'' populations, such as Japan. This post‐hoc analysis assessed once‐weekly semaglutide efficacy and safety in Japanese individuals with type 2 diabetes across baseline age and BMI subgroups.Materials and MethodsData were derived from the Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN) Japan monotherapy and SUSTAIN Japan oral antidiabetes drug (OAD) combination trials comparing once‐weekly semaglutide with sitagliptin or OADs, respectively. Participants were grouped by baseline age (<65 and ≥65 years) and/or BMI (<25 and ≥25 kg/m²). Reductions from baseline in glycosylated hemoglobin and bodyweight (efficacy), and adverse events (safety) were assessed.ResultsIn this analysis, participants from the SUSTAIN Japan monotherapy trial (n = 308; n per subgroup; range, 8–73) and SUSTAIN Japan OAD combination trial (n = 601; n per subgroup; range, 20–168) were included. Reductions in glycosylated hemoglobin and bodyweight were numerically greater with semaglutide versus comparators across all age and BMI subgroups. Reductions from baseline in glycosylated hemoglobin ranged from –1.7 to –2.1 with semaglutide 0.5 mg, –1.8 to –2.4 with semaglutide 1.0 mg and –0.6 to –1.0 with comparators. Corresponding ranges for bodyweight (kg) were –1.0 to –2.5, –2.4 to –4.3 and 1.0 to –1.0 kg, respectively. The safety profile of semaglutide was broadly similar across BMI and age subgroups.ConclusionsIn this post‐hoc analysis with modest subgroup numbers, once‐weekly semaglutide appeared consistently more efficacious versus comparators across age and BMI subgroups in Japanese patients, with a similar safety profile.     

应用近红外光谱技术监测脓毒症患儿胃肠功能障碍的前瞻性研究

目的探讨脓毒症患儿胃肠功能障碍的发生率、病死率，应用近红外光谱技术（near-infrared spectroscopy，NIRS）监测肠系膜局部组织血氧饱和度（regional oxygen saturation，rSO₂），观察胃肠功能障碍患儿rSO₂差异。方法前瞻性选择2021年1~12月儿科重症监护病房79例脓毒症患儿（脓毒症组）及儿童保健科40例健康体检儿童（健康对照组）为研究对象，收集患儿入院及出院基本情况、在院治疗情况和实验室检查指标，应用NIRS测定肠系膜rSO₂，根据有无胃肠功能障碍发生进行组间对比。结果79例脓毒症患儿胃肠功能障碍发生率为49%（39/79），胃肠功能障碍患儿28 d病死率为26%（10/39）。胃肠功能障碍患儿机械通气时间更长、28 d病死率更高（P<0.05）。胃肠功能障碍患儿肠系膜rSO₂（64%）低于无胃肠功能障碍患儿（72%）及健康对照组（78%）（P<0.05）。结论脓毒症患儿胃肠功能障碍发生率及病死率较高，影响患儿预后。肠系膜rSO₂的降低与胃肠功能障碍发生相关。     

新型冠状病毒肺炎疫情对极低出生体重儿亲母母乳喂养的影响

目的分析新型冠状病毒肺炎疫情防控期间住院的极低出生体重儿（very low birth weight infants，VLBWI）亲母母乳喂养率和喂养量的特征变化。方法回顾性分析2019年1月至2020年12月出生并收治于南京市妇幼保健院新生儿重症监护病房的胎龄<32周VLBWI的临床资料，比较并分析疫情期间VLBWI亲母母乳喂养率和喂养量的变化。结果共纳入301名VLBWI，根据疫情暴发时间分为疫情前组（n=205）和疫情后组（n=96），疫情后组VLBWI在生后0~28 d及住院期间亲母母乳喂养率均低于疫情前组（P<0.05）。疫情后组VLBWI在生后0~7 d、0~14 d、0~28 d内的亲母母乳喂养量均低于疫情前组（P<0.05）；疫情后组VLBWI中-重度支气管肺发育不良和喂养不耐受的发生率高于疫情前组（P<0.05）。结论新型冠状病毒肺炎疫情对VLBWI的亲母母乳喂养有明显的影响，VLBWI生后28 d内的亲母母乳喂养率和喂养量明显下降，在整个住院期间亲母母乳喂养率也有明显下降。     

转移相关蛋白2在头颈部恶性肿瘤中的作用

转移相关蛋白2(MTA2)是近年来被发现的与肿瘤侵袭进展、转移相关的转录调控家族成员,在肿瘤的增殖、侵袭以及远处转移中起着非常重要的作用。其在多种头颈部恶性肿瘤如鼻咽癌、口腔癌、喉癌、食管癌、甲状腺癌中呈高表达,并且MTA2的高表达与这些恶性肿瘤的不良预后相关。MTA2与头颈部恶性肿瘤的侵袭、进展及预后的关系研究成为了头颈肿瘤研究中的新热点。本文对MTA2的结构与功能、其在不同头颈肿瘤中的表达以及意义、其可能的调节机制以及其研究展望作一个小结,希望对MTA2的后续研究以及头颈肿瘤的综合诊治提供帮助。     

110例儿童奥密克戎变异株感染恢复期血清IgG抗体变化

目的探讨儿童严重急性呼吸综合征冠状病毒2（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）奥密克戎（Omicron）变异株感染后恢复期血清抗SARS-CoV-2受体结构域特异性IgG抗体（简称SARS-CoV-2 IgG抗体）水平，了解SARS-CoV-2疫苗（简称新冠疫苗）接种对奥密克戎感染的保护作用。方法回顾性收集2022年1月8日至2月7日天津市确诊奥密克戎变异株感染的新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）患儿110例，根据患儿确诊前新冠疫苗接种情况分为4组，加强针接种组（3剂）2例，完全接种组（2剂）90例，不完全接种组（1剂）5例，未接种组13例。比较4组患儿的临床资料和SARS-CoV-2 IgG抗体水平。结果完全接种组确诊年龄大于未接种组（P<0.05），完全接种组的传播途径与未接种组比较差异有统计学意义（P<0.05）。4组患儿性别、临床分型、SARS-CoV-2核酸检测再阳性率比较差异无统计学意义（P>0.05）。97例患儿均接种灭活病毒疫苗，以国药集团中国生物北京生物制品研究所疫苗接种人数最多（85/97，88%）。确诊后1个月加强针接种组、完全接种组SARS-CoV-2 IgG抗体水平高于未接种组（P<0.05）；确诊后2个月，完全接种组SARS-CoV-2 IgG抗体水平高于未接种组（P<0.05）。完全接种组患儿确诊后2个月的SARS-CoV-2 IgG抗体水平低于确诊后1个月水平（P<0.05）。结论接种灭活新冠疫苗在奥密克戎流行期对儿童有保护作用，完全接种新冠疫苗的患儿发生奥密克戎感染后保护性抗体SARS-CoV-2 IgG抗体水平在确诊后2个月时有轻度下降。     

知往鉴今：人感染猴痘史及其非同寻常的2022年多国暴发疫情

2022年全球多个非地方性流行国家发生了人感染猴痘（human monkeypox，HMPX）暴发疫情，世界卫生组织（World Health Organization，WHO）评述此次暴发是“非同寻常的（atypical）”。要理解这一评语，就必须对猴痘及HMPX的历史有充分的认识，首先知道什么是“寻常的”暴发。因此，该文系统回顾了猴痘，尤其是HMPX的流行病学史，并结合近期WHO等组织机构，以及专家学者的观点，讨论分析此次疫情非同寻常的表现及可能原因。在为读者呈现64年来发人深省的猴痘病毒与人类互动历史的同时，也提供了HMPX暴发疫情多方面的信息和观点，有助于理解WHO等对当前疫情危险性的评估，认识暴发疫情对未来临床和公共卫生的深远影响。