城市居家老年人宜老环境自我报告评估指标的构建

目的 构建城市居家老年人宜老环境自我报告评估指标,为了解城市老年人居家环境的质量水平和相关服务需求提供评价工具.方法 以世界卫生组织老年友好城市指南作为理论框架,在文献回顾和质性访谈的基础上形成草稿.采用德尔菲法对20名专家进行2轮咨询.结果 2轮专家咨询问卷有效回收率分别为90.91％、90.00％;第2轮专家咨询的权威系数为0.865,专家意见协调系数为0.305～0.671;最终确定的指标体系包括户外空间和建筑、交通、家庭住宅、社会交往和参与、社区服务和信息与通讯6项一级指标,84项二级指标.结论 城市居家老年人宜老环境自我报告评估指标有较好的专家认可度,可作为评价中国城市居家老年人环境质量的工具.     

脐血造血干/祖细胞体外扩增及移植动物模型分析

目的　探讨脐血造血干 /祖细胞体外扩增和体内重建造血的潜能。方法　利用造血干 /祖细胞培养、体外扩增、移植动物模型等技术 ,研究不同比密ficoll分离液分离的脐血造血干 /祖细胞的造血活性。结果　比密 1.0 6 4 g/ml分离液分离的 10 5个脐血MNC中 ,CFU GM集落数为 373± 2 89,BFU E为 12 1± 70。在G3(GM CSF和IL 3融合蛋白 )、IL 6、TPO(thrombopoietin)作用下 ,1.0 6 4 g/ml分离液分离的脐血造血干 /祖细胞在体外扩增 14d ,CFU GM扩增 5 2 .2倍。给经 8.5Gy致死剂量照射的小鼠输注 1.0 6 4 g/ml分离液分离的脐血造血干 /祖细胞 ,体内产生的脾结节 (CFU S)是输注 1.0 77g/ml分离液分离细胞的 2 .2倍。结论　比密 1.0 6 4 g/ml分离液分离的脐血造血干 /祖细胞 ,在体外具有较高的增殖、持续造血的能力及较强的体内造血重建潜能     

百合地黄汤的历史沿革研究

目的：系统梳理古代文献中有关百合地黄汤的条文,以期了解百合地黄汤的历史沿革和方义演变,为其成药开发提供文献学支持,为经典名方的现代研究提供理论依据。方法：在古籍数据库中以“百合地黄汤”为主题词进行检索,摘录记载了百合地黄汤的方、药、量、制、治、论等信息的古籍条文,筛选符合纳入标准的古籍和条文,提取朝代、书名、作者、举句、剂量、煎服法、方解、证型等关键信息,并进行文献分析,以了解百合地黄汤的组成、药材基原、炮制、剂量、功能主治、煎煮法和注意事项等方面的历史沿革及方义演变情况。结果：最终纳入古籍101本,共计165条。百合地黄汤首见于汉代张仲景《金匮要略方论》,由百合和地黄两味药组成,用于治疗百合病。随后唐代孙思邈在《备急千金要方》中载录了本方,并增加生地黄汁至两升。宋及宋之后,因度量衡制度的改变,百合地黄汤在药物剂量方面出现了较大变化,此外宋代在炮制和服用量上略有变化。明代在地黄炮制上略有变化,明清代文献多为注释、方解,重在阐述百合地黄汤的病因病机。结论：百合地黄汤首见于汉代,历代古籍均有记载,源远流长,但其历代变化不多,以药物剂量方面变化最为显著。     

Rapid mapping of the IAA in leaves of Arabidopsis thaliana using a simple paper-based electroanalytical device coupled with microsampling

To deeply investigate the pivotal roles of Auxin (mainly indole-3-acetic acid, IAA), it is essential to obtain the contents of IAA in different locations of plants. It is still a challenge to quantify the levels of IAA in different sites of Arabidopsis thaliana leaves because of the small sizes. In this study, a simple paper-based electroanalytical device coupled with microsampling was used to differentiate the IAA amounts in different locations of Arabidopsis thaliana leaves. For the micro real sampling, the different areas of the thaliana leaves were retrieved by the Harris Uni-Core TM Miltex® with diameters: 1.0, 1.5, 2.5, 3.5, and 4.0 mm. The results showed that the contents of IAA can be detected from circle samples with the diameter from 1.0 to 4.0 mm. With 1.5 mm diameter sampling, the levels of IAA could be obtained in different sites of cotyledon and the first true leaf of Arabidopsis thaliana at the seedling stage. Our results suggested that the highest IAA levels were in the near petiole and lowest IAA levels in the leaf tip, which roughly agreed with those in tobacco leaves based on HPLC-MS reported before. In addition, the microsampling has a minor impact on the growth of Arabidopsis thaliana in the following especially for circle samples with the diameter 1.5 mm. This study revealed the potential application of microsampling coupled with a simple paper-based electroanalytical device for the mapping study of IAA in small plants or small tissue samples.

To deeply investigate the pivotal roles of Auxin (mainly indole-3-acetic acid, IAA), it is essential to obtain the contents of IAA in different locations of plants.     

A novel tumor cell line cloned from mutated human embryonic bone marrow mesenchymal stem cells

A novel tumor cell line, denominated F6, was established from mutated human embryonic bone marrow mesenchymal stem cells (MSCs) which were induced by the GM-CSF and IL-4 in vitro. The characteristics of the F6 cell line, such as surface antigens, cell cycle, growth curve, gene expression, morphology, cytogenetics and tumor model were analyzed. The F6 cells were round and grew suspended in a plastic dish. The cell line has a strong self-renewal capability, was positive for CD13, CD29, CD44, but negative for CD1alpha, CD3, CD10, CD14, CD23, CD33, CD34, CD38, CD41, CD45, CD54 and HLA-DR. The surface antigens were lower than those of human embryonic MSCs. The karyotype of F6 cells was abnormal. The cell cycle included: G0/G1 phase, 52.24%; G2/M phase, 8.00%; S phase, 41.76%. After the cells had been passaged serially for more than 17 months (62 passages), their characteristics were still retained. The F6 cells resulted in tumors in SCID nude mice in vivo (8/8) and caused metastasis (3/8). The pathologic examination revealed that the tumor cells extensively invaded surrounding normal tissues such as dermis, muscular tissue, nerve tissue, adipose tissue and lymphoid tissue. F6 cell line, tumor tissues derived from F6 cells and the MSCs expressed different levels of the nucleostemin gene. These findings suggested that F6 may be a novel tumor cell line. It may provide evidence for the theory that cancer originates from stem cells, and may be useful for the investigation on safety of human MSCs in the clinical application.     

常见深部真菌凝集素标记病原学诊断的实验研究

目的探索深部真菌病组织内病原菌检查的新方法。方法应用生物素 卵白素过氧化酶法（ＡＢＣ）研究１７种深部真菌（包括培养中真菌及小鼠实验性感染皮肤及内脏组织内真菌）与１４种凝集素的结合形式。结果１７种真菌的凝集素结合形式稳定。绝大多数真菌的凝集素结合形式呈属间区别，少数亦见种间区别。结论为利用凝集素组织化学鉴定组织内病原菌提供了实验依据。     

Intratumoral and Peritumoral Analysis of Mammography,Tomosynthesis, and Multiparametric MRI for Predicting Ki-67 Level in Breast Cancer: a Radiomics-Based Study

Molecular Imaging and Biology - To noninvasively evaluate the use of intratumoral and peritumoral regions from full-field digital mammography (DM), digital breast tomosynthesis (DBT), dynamic...     

医师定期考核工作的实践总结

目的2010年始北京市某三甲医院共开展两次医师定期考核工作。总结两次医师定期考核工作的完成情况,分析不足,提出改进措施,力求更好的完成此项持续性工作。方法对陔院两次医师定期考核工作进行回顾性总结及分析,探究取得的经验及不足。结果在医师定期考核工作中该院根据上级部门要求,结合实际情况建立该院特有医师定期考核体系,制定考核办法及流程,在实践中发现部分医师对医师定期考核重视不足、基本知识及技能参差等问题。结论医师定期考核工作对医院执业医师自身专业水平建设及医院医疗质量的提高大有裨益,在未来的工作中应不断改进存在的问题,完善此项工作的开展。     

脑脊液细胞因子水平对临床孤立综合征患者复发及转归为多发性硬化的预测价值

目的 探讨临床孤立综合征（CIS）患者急性期脑脊液白细胞介素6（IL-6）等10 种细胞因子 水平对疾病复发和转归为多发性硬化（MS）的预测价值。方法 回顾性连续纳入2015 年1 月至2017 年 8 月在首都医科大学附属北京天坛医院住院的急性期CIS 患者33 例，其中男9 例，女24 例，中位入组年 龄35 岁。使用Luminex 液相芯片法检测脑脊液细胞因子白介素（IL）-6、IL-4、IL-2、IL-10、IL-13、IL-17A、 IL-21、IL-23、干扰素γ（IFN-γ）水平；使用酶联免疫吸附测定法检测转化生长因子β1（TGF-β1）水平。 对患者进行门诊随访，记录其复发、转归为MS 的情况。比较复发及未复发者脑脊液细胞因子的差异。 采用受试者工作特征（ROC）曲线及Cox 回归模型分析脑脊液细胞因子对CIS 患者复发及转归为MS 的预 测价值。结果 入组患者随访时间为10.7～39.9 个月，中位随访时间23.4（17.6，29.1）个月。11 例（33.3%） 患者在随访期出现临床复发，其中4 例诊断为MS。另有2 例患者虽然未出现临床复发，但随访MR 发现 新发病灶最终诊断为MS。复发的CIS 患者首次发病时脑脊液IL-6 水平显著高于未复发的CIS 患者［1.9 （1.4，7.9）ng/L 比1.1（0.9，1.5）ng/L；Z=-2.904，P=0.003］。ROC 曲线分析显示，IL-6 在判断复发时最佳临界 值为1.37 ng/L。单因素Cox 回归结果显示，脑脊液IL-6 ＞ 1.37 ng/L 不能预测CIS 复发（HR=1.54，95%CI： 0.40～5.92，P=0.533）。转归为MS 和未转归为MS 的CIS 患者首次发病急性期脑脊液IL-6 等10 种细胞因 子水差异均无统计学意义（均P＞ 0.05）。结论 本研究所观察的脑脊液IL-6 等10 种细胞因子可能不是 预测CIS 患者复发或转归为MS 的标志物。     

Radiomics signature as a new biomarker for preoperative prediction of neoadjuvant chemoradiotherapy response in locally advanced rectal cancer

PURPOSEWhether radiomics methods are useful in prediction of therapeutic response to neoadjuvant chemoradiotherapy (nCRT) is unclear. This study aimed to investigate multiple magnetic resonance imaging (MRI) sequence-based radiomics methods in evaluating therapeutic response to nCRT in patients with locally advanced rectal cancer (LARC).METHODSThis retrospective study enrolled patients with LARC (06/2014–08/2017) and divided them into nCRT-sensitive and nCRT-resistant groups according to postoperative tumor regression grading results. Radiomics features from preoperative MRI were extracted, followed by dimension reduction using the minimum redundancy maximum relevance filter. Three machine-learning classifiers and an ensemble classifier were used for therapeutic response prediction. Radiomics nomogram incorporating clinical parameters were constructed using logistic regression. The receiver operating characteristic (ROC), decision curves analysis (DCA) and calibration curves were also plotted to evaluate the prediction performance.RESULTSThe machine learning classifiers showed good prediction performance for therapeutic responses in LARC patients (n=189). The ROC curve showed satisfying performance (area under the curve [AUC], 0.830; specificity, 0.794; sensitivity, 0.815) in the validation group. The radiomics signature included 30 imaging features derived from axial T1-weighted imaging with contrast and sagittal T2-weighted imaging and exhibited good predictive power for nCRT. A radiomics nomogram integrating carcinoembryonic antigen levels and tumor diameter showed excellent performance with an AUC of 0.949 (95% confidence interval, 0.892–0.997; specificity, 0.909; sensitivity, 0.879) in the validation group. DCA confirmed the clinical usefulness of the nomogram model.CONCLUSIONThe radiomics method using multiple MRI sequences can be used to achieve individualized prediction of nCRT in patients with LARC before treatment.

Colorectal cancer is one of the most common malignancies. It ranks fourth for morbidity and third for mortality among malignant tumors, among which the proportion of rectal cancer with poor prognosis is over 60% (1, 2). Neoadjuvant therapy, combined with total mesorectal excision, has become a common strategy for rectal cancer (3). Response to neoadjuvant chemoradiotherapy (nCRT) is a marker of good prognosis in patients with locally advanced rectal cancer (LARC) (4). Tumor regression grading (TRG) is a reliable biomarker for evaluating the efficacy of nCRT (5, 6). TRG reflects the treatment effect of nCRT by evaluating fibrosis and the ratio of residual tumor cells (4). The accurate nCRT evaluation can only be achieved by postoperative histopathological TRG (3, 4), and there is still no technology that can noninvasively evaluate the therapeutic response.Magnetic resonance imaging (MRI) is commonly used in the diagnosis, preoperative staging, and therapeutic efficacy evaluation of rectal cancer. Prediction of the efficacy of nCRT by MRI has been rarely reported, partly due to the heterogeneity of the tumor combined with the prevalence of fibrosis and edema of lesions and surrounding tissue after nCRT. Over the recent years, a magnetic resonance TRG system was proposed for the evaluation of nCRT efficacy by using MRI and evaluating residual tumor and fibrosis. Nevertheless, the magnetic resonance TRG method has a low predictive value for pathological TRG and poor consistency, which hinders its clinical applications (7, 8).In recent years, radiomics has drawn increasing attention in oncology. Radiomics features selected from medical images have shown to be highly associated with the diagnosis and prognosis of cancers, and even with gene expression patterns (9). Studies highlighted the value of radiomics approaches in determining tumor status, preoperative staging, and efficacy evaluation (9, 10). Nevertheless, the application of the radiomics methods in evaluating therapeutic responses to nCRT is limited (11).Accordingly, the aim of the present study was to establish an nCRT prediction model based on multiple MRI sequences combined with tumor anatomy and biological characteristics so as to achieve a comprehensive preliminary prediction of nCRT efficacy for rectal cancer before treatment, to provide an essential basis for the rational formulation of clinical diagnosis and treatment decisions, and to avoid unnecessary exposure to radiotherapy and chemotherapy and the related risks such as toxicity and delayed definitive surgery.