健康教育在白血病护理中的应用效果

目的评价血液科白血病疾病护理中应用健康教育的临床效果,为白血病护理工作提供参考。方法选择医院收治的白血病患者,总计60例。进行白血病患者随机分组护理,对照组与试验组各30例白血病患者,分别采取常规护理和常规护理+健康教育,比较2组白血病患者的负性情绪、自我效能状况评分以及护理满意度、护理依从率。结果试验组白血病患者干预后SAS、SDS、GSES评分均明显优于对照组,护理满意度与护理依从率均明显高于对照组,指标差异具有统计学意义,P>0.05。结论血液科白血病治疗期间配合落实常规护理、健康教育可以在提高患者自我效能的同时提高患者的依从性,符合患者身心护理需求,整体护理效果显著。     

Combination of 18F-Fluorodeoxyglucose PET/CT Radiomics and Clinical Features for Predicting Epidermal Growth Factor Receptor Mutations in Lung Adenocarcinoma

ObjectiveTo identify epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma based on ¹⁸F-fluorodeoxyglucose (FDG) PET/CT radiomics and clinical features and to distinguish EGFR exon 19 deletion (19 del) and exon 21 L858R missense (21 L858R) mutations using FDG PET/CT radiomics.Materials and MethodsWe retrospectively analyzed 179 patients with lung adenocarcinoma. They were randomly assigned to training (n = 125) and testing (n = 54) cohorts in a 7:3 ratio. A total of 2632 radiomics features were extracted from the tumor region of interest from the PET (1316) and CT (1316) images. Six PET/CT radiomics features that remained after the feature selection step were used to calculate the radiomics model score (rad-score). Subsequently, a combined clinical and radiomics model was constructed based on sex, smoking history, tumor diameter, and rad-score. The performance of the combined model in identifying EGFR mutations was assessed using a receiver operating characteristic (ROC) curve. Furthermore, in a subsample of 99 patients, a PET/CT radiomics model for distinguishing 19 del and 21 L858R EGFR mutational subtypes was established, and its performance was evaluated.ResultsThe area under the ROC curve (AUROC) and accuracy of the combined clinical and PET/CT radiomics models were 0.882 and 81.6%, respectively, in the training cohort and 0.837 and 74.1%, respectively, in the testing cohort. The AUROC and accuracy of the radiomics model for distinguishing between 19 del and 21 L858R EGFR mutational subtypes were 0.708 and 66.7%, respectively, in the training cohort and 0.652 and 56.7%, respectively, in the testing cohort.ConclusionThe combined clinical and PET/CT radiomics model could identify the EGFR mutational status in lung adenocarcinoma with moderate accuracy. However, distinguishing between EGFR 19 del and 21 L858R mutational subtypes was more challenging using PET/CT radiomics.     

健脾类中药多糖对脾虚相关病症肠道菌群影响研究现状

中医认为,脾乃后天之本,气血生化之源,若脾失健运,运化失司,则出现腹胀、肠鸣、泄泻等症状,与现代医学胃肠、免疫、代谢等疾病密切相关。肠道菌群作为与机体长期共生的微生物系统,在抵御病原入侵、保护胃肠、恢复免疫等一系列病理生理过程中发挥重要作用。近年研究表明,肠道菌群紊乱可看作中医"脾失健运"病理体现,健脾类中药及其组分可通过调节肠道菌群改善其相关病理,尤其多糖是发挥功能的主要活性成分。本文对健脾类中药多糖组分调节肠道菌群的相关作用及可能机制进行综述,可为改善脾虚相关疾病的进一步研究及临床应用提供参考。     

Alisol B 23-acetate promotes liver regeneration in mice after partial hepatectomy via activating farnesoid X receptor

Liver resection has become a common treatment for liver tumors and hepatocellular carcinoma over the past decades. However, after surgery, the remnant livers in some patients fail to regenerate. Therefore, there is an urgent medical need to develop drugs that can promote liver regeneration. The purpose of the current study is to investigate the promotive effect of alisol B 23-acetate (AB23A) on liver regeneration in mice following partial hepatectomy (PH), and further elucidate the involvement of farnesoid X receptor (FXR) in the liver regeneration-promotive effect using in vivo and in vitro experiments. The results showed that AB23A dose-dependently promoted hepatocyte proliferation via upregulating hepatocyte proliferation-related protein forkhead box M1b (FoxM1b), Cyclin D1 and Cyclin B1 expression, and attenuated liver injury via an inhibition in Cyp7a1 and an induction in efflux transporters Bsep expression resulting in reduced hepatic bile acid levels. These changes in the genes, as well as accelerated liver regeneration in AB23A-treated mice were abrogated by FXR antagonist guggulsterone in vivo. In vitro evidences also directly showed the regulation of these genes by AB23A was abrogated when FXR was silenced. Luciferase reporter assay in HepG2 cells and molecular docking further demonstrated the effect of AB23A on FXR activation in vitro. In conclusions, AB23A produces promotive effect on liver regeneration, due to FXR-mediated regulation of genes involved in hepatocyte proliferation and hepato-protection. AB23A has the potential to be a novel therapeutic option for facilitating efficient liver regeneration in patients subjected to liver resection.     

Bisphenol A replacement chemicals,BPF and BPS,induce protumorigenic changes in human mammary gland organoid morphology and proteome

Environmental chemicals such as bisphenol A (BPA) are thought to contribute to carcinogenesis through their endocrine-disrupting properties. Due to accumulating evidence about negative human health effects, BPA is being phased out, but in parallel, exposures to replacement chemicals such as bisphenol S (BPS) and bisphenol F (BPF) are increasing. Little is known about their biologic effects, but because of their high degree of chemical relatedness, they may have overlapping as well as distinct actions as compared with BPA. We investigated this theory using a nonmalignant, human breast tissue-derived organoid system and two end points: morphologic and proteomic alterations. At low-nanomolar doses, replacement chemicals—particularly BPS—disrupted normal mammary organoid architecture and led to an increased branching phenotype. Treatment with the various bisphenols (vs. 17-β-estradiol or a vehicle control) produced distinct proteomic changes. For example, BPS up-regulated Cdc42-interacting protein 4, which supports the formation of invadopodia and a mesenchymal phenotype. In summary, this study used a highly physiologically relevant organoid system to provide evidence that replacement bisphenols have protumorigenic effects on the mammary gland at morphologic and proteomic levels, highlighting the importance of studies to evaluate the potential harmful effects of structurally related environmental chemicals.

Bisphenols, of which the most prevalent is bisphenol A (BPA), are environmental chemicals that are used as plasticizers in a variety of goods, including plastic bottles, children''s toys, eyeglass lenses, food containers, and some types of thermal paper (e.g., cash register receipts). They leach from these products, contaminating humans (and animals) either directly or indirectly via other environmental media, such as household dust. Thus, in most adults, BPA is detected in serum, tissues, and urine (1, 2). Children (ages 6 to 11) have the highest concentrations of urinary BPA (3, 4). This chemical has structural similarities to estrogen (17-β-estradiol [E2]) and as a result, weakly mimics its activity (5). Hormones and growth factors play an important role in controlling prenatal mammary gland development and later on, the morphologic and functional alterations that occur during puberty, pregnancy, and eventually, menopause. Due to this plasticity, the mammary gland is particularly susceptible to the actions of endocrine-disrupting chemicals (EDCs), such as BPA (6–8). In vivo and in vitro studies have consistently shown that exposures to BPA at crucial developmental stages impair mammary gland development and increase neoplastic transformation (9–12). Treating rats with BPA results in mammary epithelial hyperplasia and enhances proliferation (13), common features of precancerous lesions. Additionally, BPA induces cell cycle progression and increases proliferation of human breast cancer cells in vitro via the up-regulated expression of estrogen-dependent genes (14).Based on these and other data, BPA has been removed from many commercial products. Most commonly, this chemical of concern is replaced by bisphenol S (BPS) and bisphenol F (BPF) compounds that share close structural similarities with BPA. However, little is known about their endocrine effects and more broadly, their biological activities. Marketing a product as “BPA free” suggests to the consumer that a product is safer, but research shows that replacement bisphenols have adverse effects similar to, or even greater than, BPA. For example, studies in zebrafish, rodents, and human cell culture models show that BPS and BPF have endocrine-disrupting activities. In zebrafish, despite species-specific differences in estrogen receptor (ER) affinity and specificity, BPF and BPS have estrogenic activities similar to BPA (15–17). In rats, exposure to BPF induces uterine growth, which suggests estrogenic effects (18). BPA, BPF, and BPS promote estrogen-dependent cell cycle progression, proliferation, and migration of human MCF-7 breast cancer cells along with epigenetic changes (19, 20). BPS exposure of pregnant and lactating mice limits milk production, suggesting alterations in mammary gland composition (21). In addition to estrogen signaling, BPF affects other endocrine pathways; in rats, oral administration of this compound alters thyroid hormone levels (22).Current research on bisphenol actions is mainly focused on endocrine effects. It is less well understood whether these chemicals have additional protumorigenic effects independent of their endocrine-disrupting activity. Moreover, tumor development is a multistep process involving heterogeneous cell types and numerous factors, including the potential roles of a variety of environmental chemicals (23, 24). Recapitulating this complexity in an experimental setup is challenging. In this context, tissue organoids are valuable models for understanding the early steps of carcinogenesis. They can be derived from nonmalignant primary tissues ex vivo. When grown for short periods of time in vitro, they maintain many of the genetic and epigenetic features of their normal cognates. Also, organoids have the added advantage of consisting of multiple cell types that are representative of the complexity of the tissue from which they are derived (25, 26).In this study, we exploited the strengths of the human mammary gland organoid culture system to understand the impact of the BPA replacements, BPF and BPS. Organoids established from nonmalignant human mammary gland tissues were exposed to one of the bisphenols, E2, or the vehicle control. The results showed that BPA replacements, in particular BPS, disrupted organoid architecture, enhanced branching, and caused compound-specific proteomic alterations—effects that were mostly E2 independent. Together, these observations suggested that the mammary gland effects of BPA substitutes should be equally or more concerning than those of the compound they are replacing.     

Environmental DNA: An Emerging Tool in Ecological Assessment

Bulletin of Environmental Contamination and Toxicology - Environmental DNA (eDNA), as a recent research hotspot in environmental science, the use of eDNA in biological monitoring has the advantages...     

睾丸微小结石症的超声诊断

目的探讨睾丸微小结石症的超声表现特点及临床意义。方法应用二维超声观察睾丸微小结石症的声像图表现特点并利用彩色多普勒检测内部血流信号进行描述。结果睾丸微小结石症特征性的二维图像表现为斑点数量由睾丸白膜向纵隔、由密集到稀疏的分布特点;图像放大后的斑点多呈短棒状改变;彩色多普勒显示,睾丸内血流信号正常。结论二维超声和彩色多普勒血流显像是诊断睾丸微小结石症的首选影像学诊断方法。睾丸微小结石症可能对生育产生影响。     

大鼠颅脑损伤早期血清IL-6和CRP的动态变化及意义

目的 探讨大鼠颅脑损伤早期血清IL-6和CRP的变化及与颅脑损伤程度的关系.方法 用双抗体夹心酶标免疫分析法测定颅脑损伤大鼠血清IL-6和CRP的水平.结果 轻中重度颅脑损伤大鼠血清IL-6和CRP水平均有升高,其水平与颅脑损伤的严重程度显著相关(P＜0.01),并且颅脑损伤大鼠血清IL-6和CRP含量之间呈正相关(P＜0.05).结论 血清IL-6和CRP是评价颅脑损伤早期炎症损伤程度的重要生化指标,其含量变化与伤情严重程度密切相关,通过对其动态观察可及时判断颅脑损伤的严重程度及预后.     

连续椎弓根螺钉技术在治疗胸腰椎骨折中的应用

目的探讨经骨折椎连续椎弓根螺钉内固定术治疗胸腰椎骨折的可行性、适应证和临床疗效。方法对62例胸腰椎骨折患者采用单侧或双侧的经骨折椎连续椎弓根螺钉内固定术,分别测量术前、术后和随访时椎体高度、脊柱Cobb＇s角,椎管内占位百分比,以ASIA2000分级标准评定神经功能,以Charles标准评定临床疗效。结果随访12～36个月,平均18个月,无断钉断棒及内固定松动发生,骨折椎椎体前缘高度值由术前的31.2%±3.0%恢复至91.7%±2.0%,脊柱Cobb＇s角由术前的30.5°±4.0°矫正至7.1°±1.0°,椎管占位率由术前的75%（30%～95%）减少到3%（0～8%）,神经功能ASIA分级提高1～3级,临床疗效按Charles标准优良率为88.7%。结论在适应证范围内采用连续椎弓根螺钉内固定术治疗胸腰椎骨折可弥补传统跨节段椎弓根螺钉内固定术的不足而非替代,在提高复位效果、维持有效生理弧度、减少内固定失效等方面具有一定优势。