基于自动勾画和快速蒙特卡罗计算的放射治疗全身器官剂量数据库平台的可行性研究

目的:探讨建立一种放射治疗全身器官剂量数据库平台的可行性。方法:使用基于深度学习的自动勾画软件DeepViewer?1例食管癌患者的全身CT上勾画全身器官，然后利用基于GPU加速的蒙特卡罗软件ARCHER计算相应的器官剂量分布，最后利用Lyman-Kutcher-Burman（LKB）模型评估放疗患者正常组织并发症概率（NTCP）。结果:针对该病例，成功建立基于DeepViewer?ARCHER和LKB模型的全身器官剂量数据库，发现距离靶区越近的器官剂量越大，其中心脏与靶区间距离最小，剂量为14.11 Gy，但因其模型参数特殊，通过LKB模型计算的NTCP为0.00%；左、右肺的剂量分别为3.19和1.16 Gy，但是NTCP值却很大，分别为2.13%和1.60%。对于距离靶区较远的头颈部器官（视交叉、视神经和眼）和腹部器官（直肠、膀胱和股骨头）剂量分别约为9和2 mGy，并且NTCP均近似为0.00%。结论:研究结果证明通过自动勾画软件DeepViewer?蒙特卡罗软件ARCHER和LKB模型建立全身器官剂量数据库的可行性。     

羊水粪染与羊膜腔感染的关系

【摘要】 目的 :探讨羊水粪染与羊膜腔感染的关系。方法 :选择未临产且胎膜完整的剖宫产产妇 5 6例 ,根据术中所见羊水性状分为羊水清亮组、羊水Ⅰ～II度粪染组和羊水III度粪染组。于剖宫产术中取羊水用双抗体夹心ELISA法测IL 6含量 ,取胎盘胎膜做病理检查以了解有无炎性细胞浸润 ,并记录新生儿Apgar评分 ,观察产妇术后有无产褥感染。结果 :3组羊水中IL 6含量差异无显著性 ,3组胎盘标本病理检查示炎性细胞浸润之差异亦无显著性 ,而羊水粪染组新生儿窒息发生率较清亮组明显增加 (P <0 .0 5 )。结论 :羊水粪染尤其是III度粪染是胎儿窘迫的标志 ,而与羊膜腔感染无明显相关性。     

慢性非细菌性前列腺炎/慢性盆腔疼痛综合征患者前列腺液中炎症因子差异表达的临床意义

Objective To investigate the role of inflammatory cytokines in the pathogenesis of chronic non-bacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS) patients. Methods The 38 cases with CAP/CPPS patients (18 cases of CAP and 20 cases of CPPS) and 20 cases of healthy controls were selected. The differential expressions of 40 kinds of inflammatory cytokines were detec-ted by antibody arrays in prostate fluid. Results The inflammatory cytokines which increased more than 1.5 times expression have been found. There were seven kinds in CAP including monocyte che-moattractant protein (MCP)-1, solution tumor necrosis factor receptor Ⅱ(s TNF R Ⅱ), platelet-de-rived growth faetor-BB (PDGF-BB), interleukin (IL)-β, IL-11、IL-6、MCP-2 and five kinds in CPPS groups including MCP-1、PDGF-BB、MCP-2、s TNF R Ⅱ、It-11 respectively, compared with healthy control group. The cluster analysis results showed that protein expression of Monocyte chemoattrac-tant protein 1 (MCP-1)and platelet-derived growth factor BB (PDGF-BB) were significantly increased in CAP (3.47 and 2.07 times) and CPPS (2.25 and 2.19 times) compared with healthy control group and were the final polymerization of inflammatory cytokines. The protein expression of interleukin 1 β (IL-1 β), MCP-1 and soluble tumor necrosis factor Ⅱ (s TNF R Ⅱ) in CAP group was increased more than 1.85,1.55,1.67 times compared with CPPS group. Conclusions Elevated expression of inflammatory cytokines may play an important role in the course of CAP/CPPS disease. The extent of the inflammatory response of CAP was higher than CPPS. The inflammatory factors of MCP-1 and PDGF-BB could serve as a novel diagnostic marker.     

Identification of the protein encoded by the human diffuse B-cell lymphoma (dbl) oncogene.

The dbl oncogene was initially isolated from a human diffuse B-cell lymphoma. Antisera from mice bearing tumors induced by this oncogene specifically detected a protein of about 66 kDa (p66) in dbl transformants. dbl cDNA-selected poly(A)+ RNA isolated from a transfectant clone expressing p66 directed the in vitro synthesis of this protein, establishing that it is encoded by dbl. Subcellular localization studies revealed that p66 is a cytoplasmic protein distributed between cytosol and crude membrane fractions. Moreover, p66 was shown to be a phosphoprotein, with phosphorylation specific to serine residues. Our characterization of the dbl-encoded protein appears to distinguish this transforming gene product from those of other known oncogenes.     

Safety and efficacy of atorvastatin in heart transplant recipients.

BACKGROUND: Pravastatin and simvastatin prolong survival and reduce transplant-related coronary vasculopathy, although low-density lipoprotein (LDL) lowering with these agents is only modest. The objective of this study was to assess the safety of moderate dose atorvastatin and its efficacy when prior treatment with another statin had failed to lower LDL to < 100 mg/dl. METHODS: Data from 185 patients were retrospectively evaluated for adverse events, duration of exposure (person-days), and the mean atorvastatin dose exposure. Changes in lipid parameters, and prednisone and cyclosporine doses were determined. RESULTS: Safety: 48 patients received atorvastatin for 24,240 person-days at a mean dose exposure of 21 +/- 10 mg. Rhabdomyolysis, myositis, myalgias, and hepatotoxicity occurred in 0, 2, 2, and 0 patients, respectively. All events occurred at the 10-mg dose, within the first 3 months, and were rapidly reversible with atorvastatin discontinuation. Efficacy: Thirty-four patients evaluable for efficacy analyses had a pre-atorvastatin LDL of 145 +/- 38 mg/dl on the following statins: pravastatin (n = 30, 40 +/- 0mg), fluvastatin (n = 3, 33 +/- 12 mg), simvastatin (n = 1, 40 mg). After atorvastatin (21 +/- 9 mg/day) for 133 +/- 67 days, LDL was reduced to 97 +/- 24 mg/dl (relative reduction 31 +/- 20%, p < 0.0001). At the end of the observation period (418 +/- 229 days, atorvastatin final dose 24 +/- 14 mg/day), LDL was further decreased to 88 +/- 23 mg (relative reduction 37 +/- 17%, p < 0.0001). CONCLUSION: Atorvastatin, when used at moderate doses and with close biochemical and clinical monitoring, appears to be safe and is effective in aggressively lowering LDL in heart transplant recipients when treatment with other statins has failed to achieve LDL goals.     

Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving β-blockers

BACKGROUND: The Heart Failure Survival Score (HFSS) has been previously shown to effectively risk-stratify patients under evaluation for heart transplantation. However, this model was developed before broad use of beta blockade. We hypothesized that the prognostic tool would retain its ability to risk stratify patients treated with beta-blockers. METHODS: We collected clinical data on 524 consecutive patients referred for heart transplantation from 1994 to 2001. Kaplan-Meier survival analysis and multivariable Cox regression analysis were performed with events defined as death, left ventricular assist device placement, or United Network of Organ Sharing 1 heart transplantation. RESULTS: Kaplan-Meier analysis of the patient population revealed effective discrimination by the survival score both for beta-blocker treated and untreated patients (both p <0.0001). Two-year event-free survival was 94% +/- 2% and 84% +/- 4% for beta-blocker and no beta-blocker patients in the low-risk HFSS strata. Cox proportional hazard modeling showed that HFSS strata (medium risk: HR 2.65, 95% CI 1.75-4.02, p <0.001; high risk: HR 5.51, 95% CI 3.64-8.33, p <0.001) and beta-blocker treatment (HR 0.45, 95% CI 0.31-0.64, p <0.001) were significant predictors of event-free survival. Receiver operating curves (area under the curve) for HFSS strata used to predict 2-year events were similar for beta-blocker treated (0.78 +/- 0.04) and untreated (0.80 +/- 0.03) patients. CONCLUSIONS: The HFSS provides effective risk stratification with or without beta-blocker therapy. Consideration of beta-blocker therapy with survival score strata improves outcome prediction in patients evaluated for heart transplantation.     

中国三囊库蠓亚属的种类分布及分类研究(双翅目:蠓科)

本文报告了我国三囊库蠓亚属Culicoides(Trithecoides)已知24种。亚属的鉴别特征,主要特征测量值以及雌虫和雄虫分种检索表。     

Role of angiotensin Ⅱ and JAK2 signal pathway in transdifferentation of renal tubular cells in mice after acute ischemic followed by reperfusion

Objective To investigate the effect of angiotensin (Ang) Ⅱ and its Janns-activated kinase-2 (JAK2) signal pathway in transdifferentiation of renal tubular cells under the challenge of acute ischemic reperfusion injury.Methods Models of acute ischemic reperfusion injury were established and the level of local Ang Ⅱ ,a key element of renin-angiotensin system (RAS),in kidney was measured using radioimmunity technique.The expression of α-smooth muscle actin (α-SMA),a phenotype of mesenchymal cells,was detected by RT-PCR and inununohistochemistry methods.Renal tubule cells ( NRK-52E) were cultured with various concentration of Ang Ⅱ ,followed by blocking of PD123319,Ang U receptor 2 antagonist,and AG490,an inhibitor of JAK2 signal pathway.Results Ang 0 of kidney tissue increased immediately after acute ischemic-reperfusion injury,in time dependent fashion.Expression of α-SMA in renal tubule cells was found at 48 hours after ischemic-reperfusion injury and in NRK-52E cells treated by high concentration of Ang Ⅱ and was dose and time dependent.The peak of α-SMA expression was seen after 30 minute treatment at the dose of 10-9'mol/L,which was interrupted by both of PD123319 and AG490.Conclusions Transdifferentiarion of renal tubular epithelial cells occurs under acute ischemic- reperfusion injury.Local renin-angiotensin system may play a role in the transdifferentiation of TEC through AT2 receptor and its JAK2 signal pathway.     

EBVTK激酶基因在原核细胞中的表达及其在NPC诊断中的意义

目的 探索以Epstein-Barr病毒（EBV）TK激酶为抗原，建立简便、快速、敏感和特异的鼻咽癌（NPC）诊断方法。方法 构建原核表达载体pRSET-TK，在原核细胞BL21（DF3）中获得高效表达的TK激酶，以Western blot检测证明其抗原的特异性和应用于NPC检测的可行性。以纯化的TK激酶为抗原初步建立ELISA检测方法，检测NPC患者血清中TK／IgG抗体。结果 在NPC患者血清中含有特异的针对TK激酶的IgG抗体，Western blot TK/IgG检测的敏感度和特异度均为100％。结论 初步建立了ELISA TK／IgG诊断NPC方法，具有较高的敏感性和特异性。