手术治疗甲状腺疾病的临床研究（附2092例报告）

目的：探讨甲状腺疾病的外科治疗。方法：回顾性研究近２０年来甲状腺疾病２０９２例。结果：３手术治愈率１００％,死亡率为零,术后并发症甲亢４．４％,甲状腺癌３．３％,甲状腺瘤０．４４％。结论：手术治疗甲头腺疾病是安全、有效、合理可行的。术前充分准备是减少并发症的关键。     

北柴胡多糖对D-半乳糖致衰老模型小鼠的保护作用及其机制

探讨北柴胡多糖（BCP）对D-半乳糖诱导的衰老模型小鼠的保护作用并阐明其作用机制。     

数据库研究第五部分:结直肠癌的肿瘤特征

目的分析目前版本的华西肠癌数据库(Database from Colorectal Cancer,DACCA)中有关结直肠癌数据所具有的肿瘤特征。方法本次数据分析选取的DACCA版本为2019年9月26日更新版,其中数据项目包括:手术日期、癌前病变、癌家族史、肿瘤部位、缘距、肿瘤形态、大小、方位、发生、分化、肿瘤病理、Ki-67指数及并发症(梗阻、套叠、穿孔、疼痛、水肿和出血),分别对各选取的数据项目作特征分析。结果按照条件筛选DACCA数据库获得11 898条可分析数据行。11 898条数据中,癌前病变有效数据为1 275条,提示结直肠癌患者有癌前病变的数据为541条(42.4%),没有癌前病变的数据734条(57.6%)。癌家族史有效数据为1 116条,有癌家族史的数据为761条(6.4%)。Ki-67指数有效数据共计1 893条,为0~95%、(59.0±20.1)%。根据"肿瘤发生"的类型划分后,原发性的结直肠癌占绝大多数(92.8%),转移性的结直肠癌最少(0.3%)。按原发性和多原发分别对肿瘤部位、缘距、肿瘤形态、大小、方位、分化和肿瘤病理进行分析,结果显示,肿瘤部位大多都在直肠(76.9%和41.9%),形态中最常见的都为溃疡型(42.4%和51.5%),肿瘤方位为一圈者居多(44.6%和35.0%),分化程度多为中分化(65.4%和61.3%),肿瘤病理大多都为腺癌(77.8%和64.0%)。结论通过DACCA数据库对结直肠癌的肿瘤特征进行更精确细致的分析,有利于在临床工作中确定诊疗计划、判断预后等。     

HIV-1中国流行株CRF01_AE env基因改造及其重组DNA疫苗的构建

目的 构建表达含有密码子优化的HIV-1 CRF01_AE亚型env基因的DNA疫苗,为多载体艾滋病治疗性疫苗的应用提供候选疫苗.方法 对HIV-1感染者血液样本进行型别分析,分型得到的AE亚型标本采用亚型特异性引物克隆env基因,通过序列比对获得其共有序列,对该序列按照哺乳动物密码子使用的偏嗜性进行优化,将人工合成的优化基因克隆至pVR载体,构建DNA疫苗.通过Western Blot方法比较优化前后env基因的表达.结果 成功获得32条具有完整的开放性阅读框的env克隆,型别分析确认均为CRF01_AE亚型.成功对其共有序列进行了优化、合成并构建了DNA疫苗pVR-mod.AE env,该疫苗与野生型的env基因（wt.AE env）相比可以高水平表达env基因,且不依赖Rev的存在.结论 对HIV-1中国流行株CRF01_AE env基因的优化改造及重组DNA疫苗的构建是成功的.     

基于胸部CT影像学表现的肺部感染病原体的评估和甑别

肺部感染是最常见的感染性疾病,早期快速、准确的病原学诊断、精准治疗是改善肺部感染预后、降低死亡率的关键。不少特定病原体引起的肺部感染病灶,在胸部CT表现具体一定的特征。根据病灶形态、大小、数量、变化速度,可评估和甑别引起肺部感染可能的病原体。本文介绍肺部感染相关的胸部CT常见和重要的影像学特征,以提升临床医生对评估肺部感染病原体、合理使用抗菌药物和改善肺部感染预后的能力和重视。     

儿童结肠镜术前肠道准备质量的影响因素

目的评估行结肠镜检查术前患儿的肠道准备质量,并探讨其影响因素。方法前瞻性纳入2017年8月1日至2018年3月31日期间行结肠镜检查术的患儿198例。根据Boston肠道准备评分量表(The Boston Bowel Preparation Scale,BBPS)进行肠道准备质量评价,并收集患儿一般资料、肠道准备过程相关情况;采用有序logistic回归分析肠道准备质量的影响因素。结果纳入的198例患儿中,男116例、女82例;平均年龄(8.70±2.87)岁;总BBPS得分为(7.45±1.31)分。肠道准备清洁程度为优104例(52.5%),良74例(37.4%),差20例(10.1%);发生不良反应90例(45.5%)。清洁度优、良、差三组患儿之间便秘史,服药后大便次数,最后一次大便性状,不良反应,服药前、服药期间、服药后运动的差异均有统计学意义(P0.05)。Logistic回归分析发现服药后大便次数少,最后一次大便性状为稀糊状、深黄色或褐色有渣、淡黄水样,服用泻药期间无运动和没有完全服用泻药是降低肠道准备清洁度的独立影响因素(P0.05)。结论临床应早期识别影响肠道准备质量的相关因素,并及时采取相应干预措施,以提高肠道准备质量。     

Citrinin-Induced Hepatotoxicity in Mice Is Regulated by the Ca2+/Endoplasmic Reticulum Stress Signaling Pathway

Citrinin (CTN) is a mycotoxin found in crops and agricultural products and poses a serious threat to human and animal health. The aim of this study is to investigate the hepatotoxicity of CTN in mice and analyze its mechanisms from Ca²⁺-dependent endoplasmic reticulum (ER) stress perspective. We showed that CTN induced histopathological damage, caused ultrastructural changes in liver cells, and induced abnormal values of biochemical laboratory tests of some liver functions in mice. Treatment with CTN could induce nitric oxide (NO), malondialdehyde (MDA), and reactive oxygen species (ROS) accumulation in mice, accompanied with losses of activities of superoxide dismutase (SOD) and catalase (CAT), levels of glutathione (GSH), and capacities of total antioxidant (T-AOC), resulting in oxidative stress in mice. Furthermore, CTN treatment significantly increased Ca²⁺ accumulation, upregulated protein expressions of ER stress-mediated apoptosis signal protein (glucose regulated protein 78 (GRP78/BIP), C/EBP-homologous protein (CHOP), Caspase-12, and Caspase-3), and induced hepatocyte apoptosis. These adverse effects were counteracted by 4-phenylbutyric acid (4-PBA), an ER stress inhibitor. In summary, our results showed a possible underlying molecular mechanism for CTN that induced hepatocyte apoptosis in mice by the regulation of the Ca²⁺/ER stress signaling pathway.     

Polymeric microbubbles for ultrasonic molecular imaging and targeted therapeutics

Gas-filled microbubbles ultrasound agent have received wide attention, not only because they can improve ultrasound signals, but also they can be used as drug/gene carriers. Among all types of microbubbles fabricated by different membrane materials and core gases, polymer-shell microbubbles are highly promising. Polymeric microbubbles are more stable than other soft shell microbubbles in vivo. Under destructive ultrasound, polymer-stabilized microbubbles disintegrate and emit a strong non-linear signal, which enables ultrasound imaging with superior sensitivity. Except for ultrasound imaging, polymeric microbubbles could also be applied as drug/gene-delivery system. The thick polymeric shells allow loading a large amount of drugs. Meanwhile, site-specific targeting and controlled drug release in the area of interest can be realized through chemical and physical modification. In this review, we highlight some of the recent examples on polymeric microbubbles and their applications in ultrasound molecular imaging and drug delivery.     

罗格列酮相关心血管事件概述

罗格列酮为噻唑烷二酮类口服降糖药,能改善胰岛素敏感性,用于治疗2型糖尿病.近年,罗格列酮的心血管风险受到人们关注.一项荟萃分析显示:罗格列酮组与对照组比较,心肌梗死的优势比(OR)为1.43,[95%可信区间(13/)1.03～1.98,P=0.03];心血管性死亡OR为1.64,(95%Cl0.98～2.74,P=0.06),表明罗格列酮与心肌梗死及心血管性死亡有关联.然而,最近RECORD中期研究显示:罗格列酮组心肌梗死49例,对照组40例(P=0.34),而两组的充血性心力衰竭分别为47例和22例(P=0.003),表明罗格列酮不增加心肌梗死和心血管性死亡风险,但可使充血性心力衰竭风险增加.另外,FDA 2008年发布了有关罗格列酮的用药指南和处方信息,罗格列酮禁用于严重心力衰竭患者.因此,使用罗格列酮时应权衡利弊,并应个体化用药.