肌酸化学交换饱和转移加权成像评估大鼠胶质瘤模型肌酸浓度变化

目的 观察肌酸化学交换饱和转移（Cr-CEST）成像评估大鼠胶质瘤Cr浓度的价值。方法 对浓度10 mmol/L的单一Cr试管模型及浓度20、40、60、80、100 mmol/L的混合Cr试管模型（pH均为7.0）行CEST扫描,以优化Cr-CEST成像参数,并计算Cr试管的Cr-CESTR值,观察Cr-CEST效应。将C6胶质瘤细胞接种至8只SD大鼠右侧基底节区,制备脑胶质大鼠模型。于造模后2~3周以优化参数采集Cr-CEST图像,比较肿瘤区域与对侧正常脑组织Cr-CESTR值差异。结果 于单一Cr试管模型Z谱频率2.0 ppm处见明显波谷,提示存在Cr-CEST效应,且B1值为0.5~3.0 μT时,Cr-CEST效应随B1值升高而升高,而B1值增高至5.0 μT后Cr-CEST效应减弱。混合Cr试管模型Z谱显示Cr-CEST效应随Cr浓度升高而增强。大鼠胶质瘤病灶区域Cr-CESTR值[0.098（0.012,0.393）%]低于对侧正常脑组织[3.499（3.072,3.656）%,Z=-3.361,P<0.001]。结论 Cr-CEST成像有助于评估大鼠脑胶质瘤模型Cr浓度变化,有望为活体检测脑内Cr代谢提供新方法。     

急诊绿色通道护理对创伤性膈疝患者救治成功率的影响

目的探究急诊绿色通道护理对创伤性膈疝患者就治成功率的影响。 方法回顾性分析2015年11月至2019年5月,南京医科大学第一附属医院收治的40例创伤性膈疝患者。按急诊护理方法的不同分为对照组和观察组,各20例。对照组行常规护理,观察组行急诊绿色通道护理。分析2组急诊相关指标、术后康复指标,2组护理后1个月的复发率、救治成功率及并发症发生率。采用SPSS 20.0统计软件进行数据分析。 结果与对照组比较,观察组急诊科抢救时间、辅助检查时间、从救治到送入手术室时间、术后机械通气时间均缩短,术后24 h动脉血二氧化碳分压（PaCO₂）水平低于对照组,差异均有统计学意义（均P<0.05）;护理后观察组和对照组的复发率分别为5.00%、25.00%,救治成功率分别为100.00%、90.00%,差异无统计学意义（P>0.05）;护理后观察组并发症总发生率（10.00%）显著低于对照组（45.00%）,差异有统计学意义（P<0.05）。 结论急诊绿色通道护理缩短了创伤性膈疝患者的抢救时间,使患者尽早脱离危险,减少创伤性膈疝患者并发症发生率,可有效改善患者预后。     

Efficacy of an Autologous Neurosensory Retinal Transplant for Recurrent Macular Hole Retinal Detachment in Highly Myopic Eyes

Objective: To study the clinical effect of autologous neurosensory retinal transplants in the treatment of recurrent macular hole retinal detachment (MHRD) in highly myopic eyes. Methods: This was a prospective clinical study. An open qualitative response one-way sequential test method was used. Seven patients (7 eyes) with recurrent macular hole retinal detachment in highly myopic eyes were admitted to Aier Eye Hospital of Wuhan University, and underwent autologous neurosensory retinal transplantation combined with silicone oil tamponade. The follow-up period was at least 3 months after silicone oil removal. The main outcomes included retinal anatomical reattachment rate, best corrected visual acuity (BCVA) and postoperative complications. A sequential test diagram was plotted based on the test results. The pre-BCVA and post-BCVA were compared using a paired t-test. Results: Anatomical reattachment succeeded in 6 cases and failed in 1 case. The test line for the 7th case reached the upper boundary U. The retinal anatomical reattachment rate was 86%. At the last follow-up, the mean BCVA (1.35±0.34) logMARwas significantly improved over the pre-BCVA (2.06±0.33) logMAR (t=5.977, P=0.001). There were no serious complications such as vitreous hemorrhage, endophthalmitis, proliferation or the hole reopening at the retinal resection site. Two patients experienced transient intraocular hypertension, and intraocular pressure returned to normal within one week after antihypertensive drug treatment. Conclusions: Autologous neurosensory retinal transplants can treat recurrent MHRD effectively in highly myopic eyes and can significantly improve BCVA.     

吴宽《家藏集》医学人物阐介与丹溪学派传承脉络探析

[目的] 探析《家藏集》所载医学人物的概况与特点，考证明代中期吴中地区丹溪学派的传承关系。[方法] 运用文献研究方法整理分析《家藏集》所记载的医学人物的家族背景、医事活动、交游情况等，梳理丹溪学派在吴中地区的传承脉络。[结果] 《家藏集》中的医学人物大多出自世医家族，彼此间交流频繁，且部分医学人物与丹溪学派关系密切。王宾为丹溪学派第三代传人，王宽、盛寅、韩存为丹溪学派第四代传人，王敏、刘毓、盛暟为丹溪学派第五代传人，王观为丹溪学派第六代传人。[结论] 《家藏集》对医学人物的记载，对厘清吴中地区丹溪学派的传承脉络具有重要作用。由此可见，别集类文献在医学史料的挖掘方面具有重要价值。     

单克隆抗体双抗体夹心ELISA快速检测肝炎患者血清中TIMP-2

目的建立一种检测人血清中基质金属蛋白酶组织抑制剂-2（TIMP-2）的双抗体夹心ELISA法，探讨血清TIMP-2的水平与肝纤维化病程进展程度的关系。方法确定包被TIMP-2单克隆抗体（McAb）和辣根过氧化物酶（HRP）标记的抗TIMP-2McAb的最佳工作浓度，建立双抗体央心ELISA方法，并用于临床初步检测408例肝炎血清TIMP-2水平。结果包被TIMP-2McAb的最佳工作浓度为2μg／ml，HRP标抗体的最佳工作浓度1：400。该法具有良好的重复性，灵敏度达5ng／ml，中和抑制率在80％以上，稳定性能好，与国外TIMP-2 ELISA试利盒进行对比试验，表明两种检测方法有良好的相关性（Y=1．2752X-4．7465，r=0．976）。临床检测表明TIMP-2随着病损纤维化程度加重而升高，与正常人血清TIMP-2水平相比差异显著（P〈0．01～0．001）。结论该法能够快速检测人血清中TIMP-2浓度，血清TIMP-2可作为定量诊断肝纤维化指标之一。本试验为国内TIMP-2诊断试剂盒的研制和开发提供了科学实验依据     

Antibiotic binding to monozinc CphA beta-lactamase from Aeromonas hydropila: quantum mechanical/molecular mechanical and density functional theory studies

The active-site dynamics of apo CphA beta-lactamase from Aeromonas hydropila and its complex with a beta-lactam antibiotic molecule (biapenem) are simulated using a quantum mechanical/molecular mechanical (QM/MM) method and density functional theory (DFT). The quantum region in the QM/MM simulations, which includes the Zn(II) ion and its ligands, the antibiotic molecule, the catalytic water, and an active-site histidine residue, was treated using the self-consistent charge density functional tight binding (SCC-DFTB) model. Biapenem is docked at the active site unambiguously, based on a recent X-ray structure of an enzyme-intermediate complex. The substrate is found to form the fourth ligand of the zinc ion with its 3-carboxylate oxygen and to hydrogen bond with several active-site residues. The stability of the metal-ligand bonds and the hydrogen-bond network is confirmed by 500 ps molecular dynamics simulations of both the apo enzyme and the substrate-enzyme complex. The structure and dynamics of the substrate-enzyme complex provide valuable insights into the mode of catalysis in such enzymes that is central to the bacterial resistance to beta-lactam antibiotics.     

一清胶囊中指标成分的含量测定

目的建立同时分离测定一清胶囊中大黄酸和大黄素含量的反相高效液相色谱法。方法采用Kromasil ODS-C18色谱柱（200mm×4.6mm,5.0μm）,流动相A为0.003 3%三乙胺甲醇溶液（冰醋酸调pH=3.00）,流动相B为体积分数为0.5%三乙胺水溶液（冰醋酸调pH=3.00）,以A∶B=85∶15进行等度洗脱,检测波长430nm,流速1.0mL·min-1。结果一清胶囊中大黄酸和大黄素含量测定方法的线性关系良好,相关系数（r）分别为0.999 6、0.999 7;回收率分别为97.27%~102.0%。结论该法专属性强,结果准确可靠,重复性好,可用于一清胶囊中大黄酸和大黄素的含量测定,更好地控制一清胶囊的质量。     

Apparent diffusion coefficient values of cryptorchid testes and malignant transformation of cryptorchidism (MTC) (seminoma) in postpubertal patients

Objectives:Diffusion-weighted imaging signal contrast can be quantified by apparent diffusion coefficient (ADC) maps, which reflect the diffusion properties of the examined tissue and are helpful for identifying pathology. To determine ADC values of cryptorchid testes in post-pubertal patients and assess performance for characterizing cryptorchid testes.Methods:The medical records from 35 patients with unilateral scrotal vacuity were retrospectively reviewed. Data were analyzed in three groups: Group A, normal testes (i.e. the contralateral testes of the patients with cryptorchidism or MTC); Group B, cryptorchid testes; and Group C, malignant transformation of cryptorchidism (MTC) (seminoma). DWI used b-values of 0 and 800 s/mm². Mean ADC values were compared using the independent samples t-test. The ability of ADC values was assessed using receiver operating characteristic curve analysis. The sensitivity, specificity, and accuracy were calculated.Results:Mean ADC values for normal testes, cryptorchid testes, and MTC were 1.18 ± 0.18×10⁻³ mm²/s, 1.82 ± 0.40×10⁻³ mm²/s, and 0.80 ± 0.06×10⁻³ mm²/s, respectively. There were statistically significant differences in mean ADC values between normal testes and cryptorchid testes or MTC (p < 0.001). The cut-off ADC value for differentiating normal testes from cryptorchid testes was 1.47 × 10⁻³ mm²/s. The sensitivity, specificity, and accuracy were 88%, 91%, and 90%, respectively. The cut-off ADC value for differentiating normal testes from MTC was 1.22 × 10⁻³ mm²/s. The sensitivity, specificity, and accuracy were 100%, 31%, and 43%, respectively.Conclusion:ADC values of cryptorchid testes may be used to inform clinical decision-making and also monitor testicular function in patients who retain undescended testicles or post-operatively.Advances in knowledge:Mean ADC values of cryptorchidism and MTC (seminoma) were used to reflect their pathological features.     

Expression and prognostic value of FOXP1 in esophageal squamous cell carcinoma

BackgroundForkhead box protein P1 (FOXP1) has been suggested as a prognostic marker in several malignant tumors. However, the significance of FOXP1 in esophageal squamous cell carcinoma (ESCC) is still unclear. The purpose of this study was to investigate the expression pattern of FOXP1 in normal esophageal tissue and ESCC and to analyze the clinicopathological significance and prognostic value of FOXP1 in ESCC.MethodsFOXP1 was detected by immunohistochemistry using tissue microarrays containing tumor tissues and adjacent normal tissues from 270 ESCC patients with oncological follow-up data.ResultsNormal esophageal tissues predominantly showed an exclusive nuclear FOXP1 (n-FOXP1) expression pattern, and no exclusive cytoplasmic FOXP1 (c-FOXP1) staining was found. In ESCC, the expression rates of exclusive n-FOXP1-positive, exclusive c-FOXP1-positive, both nuclear and cytoplasmic positive and complete negative were 14.4%, 28.9%, 10.4% and 46.3%, respectively. High n-FOXP1 expression was significantly correlated with decreased postoperative recurrence and distant metastasis (P < 0.05). Furthermore, elevated c-FOXP1 expression was significantly associated with regional lymph node metastasis and distant metastasis (P < 0.05). High c-FOXP1 expression had an effect on shorter overall survival (OS) time, but the difference was not statistically significant (P > 0.05). Kaplan–Meier analysis showed that ESCC patients with high n-FOXP1 expression survived significantly longer than patients with low n-FOXP1 expression. Multivariate analysis confirmed that patients with high n-FOXP1 staining exhibit good prognosis and n-FOXP1 was an independent factor for ESCC prognosis.ConclusionsOur results suggest that FOXP1 plays an essential role in ESCC progression and prognosis and may be a useful biomarker for predicting survival.