肺癌患者弥散功能特点及临床意义探讨

目的：探讨肺癌患者弥散功能特点及临床意义。方法：用复重呼吸法对138例原发性肺癌患者的弥散功能进行测定。结果：弥散量（DLCOrb）、校正弥散量（DLCOrbc）在不同类型和不同程度及通气功能障碍的组间及不同大体类型间均无显著性差异（P＞0．05），但是肺通气功能正常的肺癌患者弥散系数（DLCOrb／VA）略降低，限制型组校正弥散系数（DLCOc／VA）降低（P＜0．01），阻塞型组和混合型组弥散系数降低（P＜0．05）。肺通气功能轻度减退和显著减组的肺癌患者校正弥散系数降低（P＜0.05).中心型肺癌患者校正弥散系数降低且与周围型组间有显著性差异（P＜0．01）。术后呼衰组弥散量、校正弥散系数低于无呼衰组，有显著性差异（P＜0．05）。校正弥散系数＜80％和弥散系数＜70％预测术后呼衰诊断正确率和诊断指数较高。结论：肺癌患者存在弥散功能减退，主要表现在弥散系数和校正弥散量的异常，肺癌的大体类型和患者的肺通气功能状态对肺弥散功能均有影响，应选择校正弥散系数＜80％和弥散系数＜70％预测术后呼衰。     

宫颈鳞状细胞癌ATP-TCA法体外药敏试验与耐药相关蛋白表达的关系

目的:探讨代表不同耐药机制的P糖蛋白(P-gp)、谷胱甘肽S-转移酶(GST-π)、DNA拓扑异构酶Ⅱ(TopoⅡ)、胸苷酸合成酶(TS)在原发宫颈鳞癌组织中的表达及其与临床病理参数的关系;分析三磷酸腺苷生物荧光法体外药敏试验(ATP-TCA)结果与耐药蛋白表达的关系。方法:收集32例宫颈鳞癌患者的新鲜癌组织制成单细胞悬液,采用ATP-TCA法成功检测上述细胞对11种化疗药物(共16种组合)的体外敏感性;采用EnVision二步法免疫组化检测32例宫颈鳞癌组织中P-gp、GST-π、TopoⅡ、TS蛋白的表达,并分析其与临床分期、肿瘤分化程度的关系。结果:耐药蛋白P-gp、GST-π、TopoⅡ、TS在宫颈鳞癌组织中的表达与临床分期、肿瘤分化程度无相关性;耐药蛋白P-gp表达与体外PTX+CBP耐药正相关(P=0.040);耐药蛋白TS表达与体外5-FU、5-FU+MMC、5-FU+DDP耐药正相关(P=0.015,0.012,0.006);TopoⅡ,GST-π蛋白表达与宫颈鳞癌体外耐药均无相关性。结论:体外药敏试验联合免疫组化检测,有可能用于宫颈鳞癌化疗前药敏预测。     

酶法和Jaffe速率法测定血清肌酐的方法学比较

目的：了解酶法和Jaffe速率法测定血清肌酐结果的偏倚大小，为室间评估结果分组提供依据。方法：按照美国全国临床实验标准委员会（NCCLS）EP9－A文件进行评估，将测得的数据进行相关回归分析。计算两方法间的偏倚。结果．；酶法和Jaffe速率法测定肌酐，其回归方程式Y＝1．005X＋17．9（Y为Jaffe速率法，X为酶法），相关系数r=0.998，有明显恒定偏倚。结论：必须对不同方法原理的肌酐室间评估结果作分组处理。     

A systematic review of asymptomatic infections with COVID-19

Since the outbreak of coronavirus disease 2019 (COVID-19) in late December 2019, it has brought significant harm and challenges to over 200 countries and regions around the world. However, there is increasing evidence that many patients with COVID-19 are asymptomatic or have only mild symptoms, but they are able to transmit the virus to others. There are difficulties in screening for asymptomatic infections, which makes it more difficult for national prevention and control of this epidemic. This article reviews the characteristics, treatment, and outcomes of asymptomatic infections with COVID-19, hoping it would be helpful for early prevention and control of this severe public health threat worldwide.     

Theoretical study of substituent effects on electride characteristics and the nonlinear optical properties of Li@calix[4]pyrrole

Electrides, a novel kind of ionic compound in which electrons serve as anions, have been proposed as potential second-order nonlinear optical (NLO) materials. In this work, the substituent effects on the electride characteristics and the NLO behaviour of Li@calix[4]pyrrole with an electride-like structure were studied theoretically. The results show that electron-donating and electron-withdrawing groups can effectively increase and decrease the first hyperpolarizability (β₀), respectively, without affecting the electride characteristics (electron population). More interestingly, lithiation in which four H atoms bonded to N atoms are substituted by four Li atoms within the core structure of Li@calix[4]pyrrole remarkably improves the electride characteristics, with a large electron population of 0.74 e (1.02 e) at the NNA (ELF) basins, making this structure perhaps the first formal molecular electride with almost one electron isolated from the rest of the molecules. Furthermore, a relationship between the electride characteristics and the NLO properties is found: the more delocalization the excess electron of the electride experiences, the larger the β₀ value is. The present investigation may provide useful information for exploring high-performance second-order nonlinear optical materials based on organic electrides.

A relationship between the electride characteristics and the NLO properties is found: the more delocalization the excess electron of the electride experiences, the larger the β₀ value is.     

Tryptophan promoted β-defensin-2 expression via the mTOR pathway and its metabolites: kynurenine banding to aryl hydrocarbon receptor in rat intestine

In this study, we investigated the signalling pathways mediating tryptophan (Trp)-promoted β-defensin-2 (BD-2) expression in rat intestinal mucosa. Sprague Dawley rats were administered with l-Trp and treated with rapamycin (RAPA), 1-methyltryptophan (1-MT), or para-chlorophenyl-amine (PCPA) to inhibit mammalian target of rapamycin (mTOR), indoleamine-2,3-dioxygenase (IDO), or tryptophan hydroxylase (TPH), respectively. The mRNA and protein levels of BD-2 in the jejunal and ileal mucosa of rats increased with administration of l-Trp. Intraperitoneal injection of RAPA significantly decreased the mRNA level of BD-2 and the concentrations of p-mTORC1 and BD-2 in the jejunal and ileal mucosa of rats with administration of l-Trp (P < 0.05). Oral administration of 1-MT decreased the IDO activity and the mRNA and protein levels of BD-2, and increased the concentrations of tumour necrosis factor (TNF-α), interleukin (IL)-17, and IL-22 in the jejunal and ileal mucosa of rats with administration of l-Trp (P < 0.05). Intraperitoneal injection of PCPA decreased the TPH activity and increased the mRNA and protein levels of BD-2, but did not change the concentrations of TNF-α, IL-17, or IL-22 in the jejunal and ileal mucosa of rats with administration of l-Trp. The results indicate the Trp-promoted BD-2 expression in the jejunum and ileum via the mTOR pathway and its metabolites: kynurenine banding to aryl hydrocarbon receptor in rat intestine.

In this study, we investigated the signalling pathways mediating tryptophan (Trp)-promoted β-defensin-2 (BD-2) expression in rat intestinal mucosa.     

宫颈鳞状细胞癌对DDP和DDP+5-FU的体外药敏检测及与耐药蛋白表达的关系研究

目的通过对宫颈鳞状细胞癌进行顺铂(DDP)和DDP+5-氟尿嘧啶(5-FU)体外药敏检测,比较两种化疗方案的体外有效率。同时检测其耐药蛋白P糖蛋白(P-gp)、谷胱甘肽S-转移酶-π(GST-π)、DNA拓扑异构酶Ⅱ(TopoⅡ)、胸苷酸合成酶(TS)的表达,探讨DDP和DDP+5-FU体外药敏与耐药蛋白表达的关系。方法收集35例宫颈鳞状细胞癌患者的新鲜肿瘤组织,采用三磷酸腺苷生物荧光法(ATP-TCA)对DDP和DDP+5-FU进行体外药敏检测,同时采用EnVision二步法检测宫颈鳞状细胞癌组织中耐药蛋白P-gp、GST-π、TopoⅡ、TS的表达,并分析DDP和DDP+5-FU的体外药敏与耐药蛋白P-gp、GST-π、TopoⅡ、TS表达的关系。结果 35例标本均进行药敏试验,DDP的体外有效率为37.14%,与DDP+5-FU的51.43%比较,差异无统计学意义(P> 0.05)。经多因素分析发现,患者年龄、临床分期、分化程度均不为DDP、DDP+5-FU药物敏感性的影响因素(P> 0.05)。P-gp、GST-π、TopoⅡ、TS蛋白阳性表达率分别为57.14%(20/35)、51.43%(18/35)、71.43%(25/35)、57.14%(20/35)。GST-π蛋白阳性表达是宫颈鳞状细胞癌对DDP耐药的影响因素(P=0.002);TS蛋白阳性表达是宫颈鳞状细胞癌对DDP+5-FU耐药的影响因素(P=0.001)。结论 宫颈鳞状细胞癌ATP-TCA法检测DDP+5-FU与单药DDP相比,体外有效率无显著差异。GST-π、TS蛋白阳性表达可用于临床宫颈癌患者对DDP、5-FU化疗耐药的预测指标。     

糖尿病患者下肢神经传导功能异常的特征分析

目的探讨糖尿病患者下肢神经传导功能异常的特征。方法搜集223例T2DM患者下肢神经传导检测资料,分析腓深、腓肠、胫神经传导功能。结果(1)158例神经传导异常,异常率70.85%,糖尿病病史1年内、1~4年、5~9年、10~30年异常率分别为61.54%、67.5%、71.19%、79.41%。(2)上述三神经传导速度(NCV)异常率分别为20.67%、16.86%、16.28%;腓深、胫神经波幅异常率为19.94%、11.73%,其末梢潜伏时(DL)异常率为8.94%、5.57%。(3)NCV减慢伴波幅降低和(或)DL延长占47.47%,单纯运动神经(MN)波幅降低占29.75%,单纯NCV减慢占16.46%,DL延长和(或)波幅降低占6.35%。结论(1)T2DM患者随病史延长,糖尿病周围神经病(DPN)发病率升高。(2)T2DM患者下肢神经中,腓深神经较易受累,腓肠神经次之,胫神经受累率低于前两者;在判断MN传导功能指标中,敏感性由高至低依次为NCV、波幅、DL。(3)DPN中,NCV减慢伴随波幅降低和(或)DL延长发生率高于单纯NCV减慢。     

Influence of ethanol on the metabolism of alprazolam.

Background: Alprazolam is a commonly used benzodiazepine in clinical practice, and when coingested with ethanol, alprazolam can increase behavioral irritability and aggression. However, the mechanism of its interaction with ethanol remains unknown.

Research design and methods: The pharmacokinetics of alprazolam was studied in vivo in rat experiments involving the simultaneous administration of alprazolam and ethanol, and the interactions between ethanol and alprazolam were investigated in vitro in human liver microsomes. In silico molecular docking was applied to analyze the change in the CYP3A4–alprazolam-binding conformation when ethanol was coadministered with alprazolam.

Results: Compared with alprazolam administered alone (2 mg/kg), the C_max of alprazolam increased when ethanol was simultaneously administered at 3 g/kg. The concentrations of alprazolam significantly increased by 39%, 17%, 105%, and 642% at 5, 10, 30, and 120 min intervals in the brain when coadministered with ethanol, respectively. Molecular docking results suggested that the conformation of CYP3A4 with alprazolam changed when ethanol was bound to the SER119 residue, which seems critical in the process of CYP3A4–alprazolam binding.

Conclusions: Ethanol might increase the toxicity of alprazolam by inhibiting the activity of CYP3A4, although other pharmacokinetic processes may be affected. Ethanol could change the conformation of CYP3A4 and affect alprazolam binding.