吻合器痔上黏膜环切术与外剥内扎术治疗重度痔的疗效观察

目的：比较吻合器痔上黏膜环切术（PPH）与外剥内扎术（MMH）治疗Ⅲ、Ⅳ期痔的疗效。方法回顾性分析60例重度痔手术患者的临床资料,根据不同手术方式分为MMH组（30例）和PPH组（30例）,对两组患者手术时间、术后VAS评分、注射止痛药次数、术后并发症、住院时间及住院费用进行比较。结果手术后两组患者的临床症状均得到缓解,尽管PPH组患者住院费用高于MMH组患者,差异有统计学意义（P＜0．05）,但PPH组患者在手术时间、术后疼痛的VAS评分、需用止痛药次数、术后并发症（肛缘水肿）发生率及住院时间等方面均明显优于MMH组,差异有统计学意义（P＜0．05）。结论 PPH治疗重度痔与MMH一样安全、有效,且近期疗效优于MMH。     

MLL5基因敲除对小鼠结肠癌CT26细胞移植瘤生长的影响及其机制

目的：探讨混合谱系白血病5(MLL5)基因在小鼠结肠癌CT26细胞移植瘤生长中的作用及其分子机制。方法：利用CRISPR/Cas9技术构建MLL5基因缺失、MLL5和DDX58双基因缺失的结肠癌CT26细胞模型,用Sanger测序和WB法验证敲除效果。将基因敲除的CT26细胞接种到野生型BALB/c小鼠和免疫缺陷型NSG小鼠皮下,构建基因缺失结肠癌CT26细胞移植瘤小鼠模型,并观察移植瘤的生长及荷瘤小鼠的总生存期（OS）。结果：在野生型小鼠中,MLL5基因缺失的CT26细胞移植瘤生长速度显著性低于野生型癌细胞移植瘤,并延长荷瘤小鼠的OS(P<0.01);在NSG小鼠中,MLL5基因缺失对CT26细胞移植瘤的生长速度以及荷瘤小鼠的OS没有明显改变。MLL5基因缺失提高了癌细胞中视黄酸诱导基因1(RIG-1)蛋白水平,DDX58基因缺失可逆转MLL5基因缺失在CT26细胞移植瘤中的作用。结论：MLL5基因缺失可提高结肠癌CT26细胞中RIG-1蛋白水平、促进肿瘤免疫,从而抑制荷瘤小鼠肿瘤生长,提示MLL5可能成为结肠癌治疗的新靶点。     

补骨脂素混合结晶在S_(180)小鼠腹水和癌细胞内的浓度测定及药代动力学研究

补骨脂素混合结晶中补骨脂素在S_(180)小鼠腹水内属单室模型中呈双峰吸收。其动力学参数如下■l/2(h)为22.19;K_a(h~(-1))为12.3580;K(h-1)为0.0312;tlag(h)为0.0718;C_(max)(μg/ml)为6.3967;t_(max)(h)为0.5570;AUC(μg·h/ml)为175.0300。2亿S_(180)癌细胞内在0.25h时,其补骨脂素含量高达10.97μg/ml,腹水内补骨脂素含量既高且久,有利于肿瘤的冶疗。     

Nd-YAG激光治疗内痔和混合痔的实验和临床应用

本动物实验提示65W功率的激光照射所致的肛管粘膜溃疡表浅,且很快愈合。照射时间缩短,照射分散多点,则照射区形成的疤痕范围大,这有利于内痔的萎缩。应用此原理,我们已用Nd-YAG激光治疗内痔和混合痔248例,即期疗效好。152例经随访一年以上,其便血、痔脱垂和排便不通畅现象有显著改善,其发生率分别由96.4％、76.6％和46.8％下降至2.8％、22.9％和6.9％。我们推荐65W功率的激光多点照射法。Ⅲ°环状痔的效果尚有待进一步提高。     

重组E.coli. LLO/OVA明显增强小鼠CD11c细胞活性及抗肿瘤免疫

目的 探讨重组E.coli. LLO/OVA 诱导C57BL/6小鼠机体免疫的途径,观察其免疫后小鼠机体抑制B16-OVA黑色素瘤的效果.方法 磁珠分离E.coli. LLO/OVA及E.coli. OVA免疫后小鼠脾脏CD11c、CD4 和CD8 T细胞并检测CD11c细胞诱导同源CD4 和CD8 T增殖水平和细胞因子分泌程度;流式细胞检测小鼠脾脏内肿瘤抗原OVA257-264 SIINFEKL特异的细胞毒T细胞含量.比较两种E.coli. 免疫后,恶性黑色素瘤B16-OVA在小鼠肺内形成瘤结节的数量.结果 与E.coli. OVA相比, E.coli. LLO/OVA免疫后小鼠脾脏CD11c细胞诱导同源CD4 T细胞增殖作用增强、IL-2分泌增高;同时诱导CD8 T细胞增殖和IFN-γ分泌的作用也明显增强;OVA257-264 SIINFEKL特异的CD8 T细胞含量也明显增高;小鼠肺内形成B16-OVA瘤结节平均数明显减少. 结论 E.coli. LLO/OVA有效地诱导小鼠CD11c细胞活化,增强其对CD4 T细胞增殖和IL-2分泌以及对CD8 T细胞增殖、IFN-γ分泌的作用,诱导了更多的OVA特异的CD8 T细胞,使机体产生了更强的抗肿瘤免疫.     

Shrinkage estimation and the use of additional information when calibrating in the presence of random effects

Let x denote a precise measurement of a quantity and Y an inexact measurement, which is, however, less expensive or more easily obtained than x. We have available a calibration set comprising clustered sets of (x,Y ) observations, obtained from different sampling units. At the prediction step, we will only observe Y for a new unit, and we wish to estimate the corresponding unknown x, which we denote by ξ. This problem has been treated under the assumption that x and Y are linearly related. Here, we expand on those results in three directions: First, we show that if we center ξ about a known value c, for example, the mean x‐value of the calibration set, then the proposed estimator now shrinks to c. Second, we examine in detail the performance of the estimator, which was proposed when one or more (x,Y ) observations can be obtained for the new subject. Third, we compare the Fieller‐like confidence intervals, previously proposed, with t‐like intervals based on asymptotic moments of the point estimate. We illustrate and evaluate our procedures in the context of a data set of true bladder‐volumes (x) and ultrasound measurements (Y). Copyright © 2013 John Wiley & Sons, Ltd.     

Latent class models for medical diagnostic tests in multicenter trials

Medical diagnostic tests must enjoy appropriate validity and high reliability in order to qualify as adequate assessment tools. Without a gold standard test, available medical diagnostic tests are not perfect; hence, the reliability of such tests must be evaluated precisely. Kappa coefficient statistics are often utilized to assess reliability of tests when there are two or more medical diagnostic tests. However, the statistics are imprecise for a typical case when the prevalence rate of a target disease is unknown. Although latent class models could be used to assess reliability, the models cannot estimate reliability in the case of two tests, due to unidentifiability or the lack of degrees of freedom. An alternative approach to assess reliability for the case of two tests is stratifying a two‐by‐two contingency table under the assumption that sensitivities and specificities between the two tests be equal over all strata and that prevalence rates in the strata be different from each other. Because stratification is basically a multi‐sample analysis, it should not be applied to the situation where subsamples (i.e., centers) are randomly selected from a larger population. In this article, a type of mixed‐effect model is proposed to evaluate the reliability of two tests for trials in randomly selected multiple centers. Several types of distributions for prevalence rates over subpopulations are considered. Simulation studies show that our proposed method performs nicely. Analysis of real data is also reported. Copyright © 2013 John Wiley & Sons, Ltd.     

PCR for detection of respiratory viruses: seasonal variations of virus infections

Real-time PCR and related methods have revolutionized the laboratory diagnosis of viral respiratory infections because of their high detection sensitivity, rapidness and potential for simultaneous detection of 15 or more respiratory agents. Results from studies with this diagnostic modality have significantly expanded our knowledge about the seasonality of viral respiratory diseases, pinpointed the difficulties to make a reliable etiologic diagnosis without the aid of an unbiased multiplex molecular assay for respiratory viruses, and revealed previously unknown details as to possible infections with multiple agents as aggravating factors. The scope of this article is to review and discuss this new knowledge and its implications for diagnostic strategies and other measures essential for the clinical management of respiratory viral infections and for epidemiological surveillance of seasonal respiratory infections.     

纵切横缝分段结扎治疗环形混合痔180例临床观察

[目的]探讨治疗环形混合痔的有效方法。[方法]对180例患者采用纵切横缝分段结扎的手术方法。[结果]180例患者均痊愈,总有效率达100%,切口愈合时间15-30 d。随防2-5年,均无肛门狭窄及肛门失禁,肛门功能正常。[结论]纵切横缝分段结扎治疗环形混合痔,疗效高,无并发症及后遗症。