嗜肺军团菌聚合酶链反应检测方法及其应用研究

根据嗜肺军团菌基因组ＤＮＡ的种特异性ＤＮＡ片段序列，合成一对引物进行聚合酶链反应（ＰＣＲ）。经琼脂糖凝胶电泳、ＥＢ染色结果表明，一条８７０ｂｐ的核苷酸区带为嗜肺军团菌１～１４血清型菌株所共有。ＰＣＲ检测水中军团菌，其敏感性为３５０ｃｆｕ／ｍｌ，而用同位素标记探针、斑点杂交法检测，其敏感性为４３ｃｆｕ／ｍｌ。ＰＣＲ检测人工感染嗜肺军团菌的豚鼠组织标本，阳性率为８３．３％，而细菌分离培养的阳性率仅为２６．６％。在现场调查中，用ＰＣＲ法初步验证了一起由Ｌｐ１０引起的军团菌病爆发。上述结果表明，ＰＣＲ法能快速、敏感、特异性检测嗜肺军团菌感染。     

KMG及微导管在部分性脾栓塞中的应用价值

目的研究KMG和微导管系统在部分性脾栓塞中的应用价值。方法应用海藻酸钠微球(KMG)和微导管系统对常规导管不能超选择的18例脾功能亢进患者行部分性脾栓塞术。结果18例脾功能亢进病人均收到良好的疗效,未发生严重并发症。结论KMG配合微导管系统操作简单、方便、超选择成功率高、疗效好、副反应少,具有十分重要的临床应用价值。     

腋神经和桡神经与肱骨的关系及其临床意义

目的　观测腋神经、桡神经与肱骨骨性标志的关系 ,为肱骨手术或外固定提供帮助。方法　在 30例 6 0侧成人上肢标本上观、测了腋神经、桡神经与肱骨有关骨性标志的距离。结果　肱骨最大长 (30 6 6 5± 17 4 8)mm ;肱骨最近端到腋神经(5 8 10± 5 6 1)mm ;肱骨最近端到桡神经穿外侧肌间隔处 (177 75± 11 86 )mm ;解剖颈最低点到腋神经 (16 2 4± 2 78)mm ;肱骨最近端到肱骨肌管入口处 (118 4 9± 6 6 1)mm ;并测量计算了各段占肱骨最大长的比例。结论　腋神经在肱骨近端 1/ 5处容易受损 ,而桡神经在肱骨下 3/ 5段为易损伤部。从术前和术中的影像 ,能测量和计算出神经的基本位置 ,可减少或避免神经损伤     

99m锝标记紫杉醇脂质体在移植荷瘤鼠体内分布的研究

对 2 0只雌性裸鼠建立人卵巢癌裸鼠皮下移植瘤模型 ,经其尾静脉注射锝标紫杉醇脂质体 (99m TC- TL) 0 .2m l,于 15 min、 30 m in、 90 m in各处死动物 5只 ,将心、肝、脾、肺、肾、小肠、子宫附件、骨及肿瘤组织分别称重。其余 5只动物尾静脉注射游离锝 (99m TC— F) 0 .2 m l,于 90 min处死 ,取肝、脾、肺及肿瘤组织称重 ,用 γ-定标仪测其放射强度 (单位 :CPM/ 10 0 mg)。肝、脾、肺脏器内 99m TC动态放射值最高 (5 5 2 .1± 92 .8～ 2 6 0 .1± 2 1.0 cpm/ 10 0m g) ,其放射强度随时间延长呈下降趋势 ,肿瘤组织放射值较低 (3.6± 0 .6 cpm/ 10 0 m g) ,动态测量呈水平位。99m TC- TL组与 99m TC- F组在 99m TC示踪显示 90 min时 ,TC- TL 组肝、脾、肺内放射强度高于 99m TC- F组 (P<0 .0 5 ) ,而肿瘤组织中两组无显著性差异 (P>0 .0 5 )。结论 :静注紫杉醇脂质体在荷瘤鼠体内主要定向分布于网状内皮系统丰富的肝、脾、肺器官内 ,肿瘤组织有一定滞留性 ,但亲和力较差     

醋酸乙烯—二乙烯基苯共聚反应动力学

根据文献查得的Ｑ,ｅ值,计算了醋酸乙烯－二乙烯基二元共聚的竞聚率,预测其共聚的可能性。以甲苯为汽油为致孔剂,采用悬浮聚合方法合成该二元大孔共聚物。红外光谱分析跟踪共聚反应过程中乙酰氧基和苯环相对比例的变化,并测定共聚反应过程中比表面积,孔率和平均孔径的变化。     

Pivotal study of iodine-131-labeled chimeric tumor necrosis treatment radioimmunotherapy in patients with advanced lung cancer.

PURPOSE: Tumor necrosis treatment (TNT) uses degenerating tumor cells and necrotic regions of tumors as targets for radioimmunotherapy. Previous studies in animal tumor models and clinical trials have demonstrated that when linked to the therapeutic radionuclide iodine-131, recombinant chimeric TNT antibody ((131)I-chTNT) can deliver therapeutic doses to tumors regardless of the location or type of malignancy. Therapeutic efficacy and toxicity of (131)I-chTNT in advanced lung cancer patients were studied in this pivotal registration trial. PATIENTS AND METHODS: Patients with advanced lung cancer were treated with systemic or intratumoral injection of (131)I-chTNT in eight oncology centers in China. The objective response rate (ORR) was assessed as the primary end point. RESULTS: All 107 patients who were entered onto the study and completed therapy had experienced treatment failure after prior radiotherapy or chemotherapy a mean of three times. The results showed an ORR of 34.6% (complete response, 3.7%; partial response, 30.8%; no change, 55.1%; and progressive disease, 10.3%) in all patients and 33% in 97 non-small-cell lung cancer patients. A biodistribution study demonstrated excellent localization of the radioactivity in tumors in both systemically and intratumorally injected patients. The most obvious adverse side effect was mild and reversible bone marrow suppression. CONCLUSION: Radioimmunotherapy with (131)I-chTNT was well tolerated and can be used systemically or locally to treat refractory tumors of the lung.     

Assessment of fluid and nutritional status using bioelectrical impedance methods in acute kidney injury patients requiring continuous renal replacement therapy

Objective To investigate the predictive value of nutritional and fluid status measured by bioelectrical impedance methods for the prognosis of acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT). Methods Patients with severe AKI received CRRT in the First Affiliated Hospital of Nanjing Medical University from September 2016 to September 2018 were enrolled, and divided into death group and survival group according to 28-day survival. Cox regression was used to analyze the association between 28-day survival and lean tissue index (LTI), fat tissue index (FTI), the ratio of extracellular water (ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH), respectively. Results A total of 156 patients were included, including 101 males and 55 females. The age was (62.7±15.4) years, with sequential organ failure assessment (SOFA) score of 9.9±3.9. The 28-day mortality rate was 46.2%. The pre-CRRT OH values in the 28-day survival group and death group were 2.95(1.80, 5.50) L and 4.20(2.95, 5.70) L(P=0.016), and ECW/BCM values were 1.00(0.76, 1.18) and 1.07(0.88, 1.25) (P=0.033), respectively. Univariate Cox regression analysis showed that pre-CRRT high OH values (HR=1.08, 95%CI 1.00-1.17, P=0.040) and high ECW/BCM values (HR=3.02, 95%CI 1.46-6.22, P=0.003) were associated with 28-day death. The changes of OH values (HR=0.83, 95%CI 0.72-0.95, P=0.008) and ECW/BCM values (HR=6.79, 95%CI 1.72-26.82, P=0.006) between pre-CRRT and the 7th day after CRRT initiation were significantly associated with 28-day mortality in patients who survived 7 days after CRRT initiation. After adjusting for age, gender, and SOFA scores, multivariate Cox regression analysis showed that the high OH value (HR=1.16, 95%CI 1.06-1.27, P=0.002) and the high ECW/BCM value (HR=2.80, 95%CI 1.30-6.06, P=0.003) before CRRT, the change of OH value (HR=0.82, 95%CI 0.72-0.95, P=0.008) and ECW/BCM value (HR=2.79, 95%CI 1.30-5.98, P=0.009) between the 7th day after CRRT initiation and pre-CRRT, were independently associated with 28-day death, while LTI (HR=0.93, 95%CI 0.86-1.02, P=0.113) and FTI (HR=0.98, 95%CI 0.92-1.04, P=0.475) before CRRT were uncorrelated with 28-day death. Conclusions In bioelectrical impedance analysis, the high OH value and high ECW/BCM value before CRRT are associated with 28-day mortality in patients with AKI, while the nutritional indicators LTI and FTI before CRRT are not significantly related. The correction of fluid overload by CRRT within 7 days may reduce the risk of 28-day mortality.     

Delayed acute kidney injury recognition is not associated with poor short?term outcomes: a propensity score matched study

Objective Acute kidney injury (AKI) is common but usually under?diagnosed in hospitalized patients, of the impact of which on patients is still unclear. The paper was aimed to investigate the impact of delayed recognition of AKI on short?time prognosis of patients through a propensity score matched study． Methods From Oct 2013 to Sep 2014，1401 adult hospitalized patients with AKI in the First Affiliated Hospital of Nanjing Medical University were divided into delayed recognition group and timely?diagnosed group according to propensity score matching (1∶1) without replacement method. Primary endpoint was 30?day all?cause mortality, and secondary endpoints included recovery of kidney at discharge, length of hospitalization, length of intensive care unit stay and hospital costs．Results There were significant differences in age, department distribution, complications, stage of AKI, Charlson index, APACHEⅡ score, SOFA score between the two groups before matching. After matching, there were no significant difference in demographic data, department distribution, complications, stage of AKI, Charlson index, APACHE II score, SOFA score between the two groups except in blood urea nitrogen (P=0.039) and use of diuretics (P=0.018). Delayed recognition of acute kidney injury was not associated with 30?day all?cause mortality in univariate (P=0.711) and multivariate Logistic regression analyses. The secondary endpoints did not differ in two groups. Conclusion Delayed acute kidney injury recognition did not associate with poor short?term outcomes in adult hospitalized patients．     

癌症患者家庭照顾者负担评估工具的研究进展

癌症患者家庭照顾者负担影响照顾者的生活质量与家庭照顾质量,是影响癌症患者及其家庭照顾者心理健康的重要因素。该文从癌症患者家庭照顾者负担的普适性、特异性评估量表的特性、应用领域等方面对国内外癌症患者家庭照顾者负担评估工具进行综述,分析现有癌症患者家庭照顾者负担评估工具存在的问题并提出建议,以期为建立和应用本土化测评工具提供借鉴,并为开展相关研究提供参考。