信息化技术应用于静脉血栓栓塞症护理的研究进展

综述信息化技术在静脉血栓栓塞症护理领域中风险预测、警报接收与上报、抗凝防治管理、医护人员相关继续医学教育、患者疾病预后管理的应用现状，总结其应用阻碍因素，旨在为我国静脉血栓栓塞症护理信息化建设提供参考。     

Diagnosis of intrahepatic cholangiocarcinoma by Raman spectroscopy provides high efficiency: A protocol for systematic review and meta-analysis

Background:We aim to evaluate the efficiency of Raman spectroscopy (RS) in diagnosing suspected patients with intrahepatic cholangiocarcinoma (ICC), manifested by diagnostic sensitivity, specificity, and accuracy.Methods:We will research widely the articles concerning the use of RS in ICC through authenticated database including PubMed/Medline, EMBASE, Web of Science, Ovid, Web of Knowledge, Cochrane Library, and CNKI between January 2012 and November 2020, retrieving at least 1500 spectra with strict criteria. This study will be carried out in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We are going to summarize the test performance using random effects models.Results:Based on the pooled sensitivity, specificity, and diagnostic accuracy, we intend to provide the relative diagnostic efficiency in ICC through RS.Conclusion:Through this systematic review and meta-analysis, we intend to provide the pooled sensitivity, specificity and diagnostic accuracy of RS in the diagnosis of suspected ICC. Other parameters like positive likelihood ratios (LR), negative LR, diagnostic odds ratio (DOR), and area under curve (AUC) of the summary receiver operating characteristics (SROC) curve will also be calculated and related figures will be drawn to help illustrate the efficacy of RS in the diagnosis of ICC.     

柴松岩学术思想在妇科临床的应用体会

柴松岩主任是全国名老中医师承导师之一，从事中医妇科临床工作50余年。临证主张辨证与辨病相结合，重视女性的生理病理特点，强调参考基础体温、结合月经周期组方遣药，注重“治未病”理念在妇科临床的应用，在继承祖国医学的基础上不断创新，并已形成自己独到的理论特色。现就在跟师期间的些许体会加以总结，以飨同道。     

黄连素对缺血再灌注心肌细胞损伤的保护作用

目的　研究黄连素对新生大鼠心肌细胞缺血再灌注损伤的保护作用。方法　取体外培养的新生大鼠心肌细胞于缺氧 2 4h复氧 1h造成缺血再灌注 ( I/ R)模型 ,观察细胞损伤情况 ;并将黄连素以 1.5× 10 - 6 m ol/ L、1.5× 10 - 5m ol/ L、1.5× 10 - 4 mol/ L 三种浓度分别加入培养基中 ,预处理 2 4h后 ,再置于上述缺氧复氧环境中培养 ,检测以上不同条件下细胞上清液中的乳酸脱氢酶 ( L DH)、丙二醛 ( MDA)、超氧化物歧化酶 ( SOD)含量 ,并检测各组细胞的凋亡率。结果　与正常对照组相比 ,缺血及再灌组细胞上清液中 L DH、MDA含量明显升高 ( P<0 .0 1) ,SOD活力则显著降低 ( P<0 .0 1) ,缺血组和再灌组凋亡率均升高明显 ( P<0 .0 1)。而用黄连素预处理后缺血及再灌组的 L DH、MDA显著低于用药前 ( P<0 .0 1) ,SOD则高于单纯缺血和再灌组 ( P<0 .0 1) ,上述作用在本实验黄连素浓度为 1.5× 10 - 6 m ol/ L～ 1.5× 10 - 4 mol/ L 范围内 ,随浓度升高而更加明显。特别是用黄连素 1.5× 10 - 5mol/ L 浓度预处理后 ,缺血组和再灌组的细胞凋亡率分别是 14.4%和 2 0 % ,分别与用药前 ( 17.4%和 41% )比较有显著性差异 ( P<0 .0 1)。结论　黄连素对缺血再灌心肌细胞有保护作用 ,其作用与浓度有一定依赖关系     

7种凝集素在乳腺癌的定位

应用7种凝集素的亲合组织化学染色法对94例不同的乳腺病变石蜡包埋切片进行定位。结果表明:凝集素受体在正常乳腺组织和良性病变中多定位于腺腔面,而在乳腺癌中则多分布于细胞浆内,提示凝集素有助于区别乳腺的良恶性肿瘤。     

The direct effect of carbon monoxide on KCa channels in vascular smooth muscle cells

 The vasorelaxation induced by carbon monoxide (CO) has been demonstrated previously. Both a guanosine cyclic monophosphate (cGMP) signalling pathway and cGMP-independent mechanisms have been proposed to be responsible for the vascular action of CO. A direct effect of CO on the activity of calcium-activated K (K_Ca) channels in vascular smooth muscle cells (SMCs) and the underlying mechanisms were investigated in the present study. It was found that CO hyperpolarized single SMCs isolated from rat tail arteries. The whole-cell outward K⁺ channel currents in vascular SMCs, but not in neuroblastoma cells, were enhanced by CO. Extracellularly or intracellularly applied CO increased the open probability of single high-conductance K_Ca channels concentration-dependently without affecting the single channel conductance. Although it did not increase the resting level of intracellular free calcium concentration, CO significantly enhanced the calcium sensitivity of single K_Ca channels in SMCs. Furthermore, the effect of CO on K_Ca channels was not mediated by cGMP or guanine nucleotide-binding proteins (G proteins, G_i/G_o or G_s) in excised membrane patches. Our results suggest that the direct modulation of high-conductance K_Ca channels in vascular SMCs by CO may constitute a novel mechanism for the vascular effect of CO. Received: 9 January 1997 / Received after revision: 21 February 1997 / Accepted: 10 March 1997     

早中期结直肠癌根治术后中西结合心理康复干预指南解读及典型病例

我国癌症患者普遍存在着心理康复需求,中医药对其有良好的干预效果。目前已有肿瘤相关西医心理指南及标准治疗方案发表,然而中西医结合及中医干预方案仍有待规范。结直肠癌作为中国高发病率、长生存期的肿瘤,其根治术后的时期作为中西医结合心理康复的良好切入点,前期已有一定基础的研究发表。为规范该类疾病的诊疗及随访,提高中西医结合治疗早中期结直肠癌根治术后心理问题的效果,2022年中华中医药学会发布《早中期结直肠癌根治术后中西医结合心理康复干预指南》,包含12条推荐意见。该指南为结直肠癌领域首个中西医结合心理干预指南,但受限于相关研究的数量与质量,未来尚需要更多高质量研究结果的发表以促进其更新完善。     

Prognostic markers in pT3 bladder cancer: A study from the international bladder cancer tissue microarray project

PurposeWe evaluated the prognostic value of 10 putative tumor markers by immunohistochemistry in a large multi-institutional cohort of patients with locally advanced urothelial cancer of the bladder (UCB) with the aim to validate their clinical value and to harmonize protocols for their evaluation.Materials and MethodsPrimary tumor specimens from 576 patients with pathologic (p)T3 UCB were collected from 24 institutions in North America and Europe. Three replicate 0.6-mm core diameter samples were collected for the construction of a tissue microarray (TMA). Immunohistochemistry (IHC) for 10 previously described tumor markers was performed and scored at 3 laboratories independently according to a standardized protocol. Associations between marker positivity and freedom from recurrence (FFR) or overall survival (OS) were analyzed separately for each individual laboratory using Cox regression analysis.ResultsThe overall agreement of the IHC scoring among laboratories was poor. Correlation among the 3 laboratories varied across the 10 markers. There was generally a lack of association between the individual markers and FFR or OS. The number of altered cell cycle regulators (p53, Rb, and p21) was associated with increased risk of cancer recurrence (P < 0.032). There was no clear pattern in the relationship between the percentage of markers altered in an 8-marker panel and FFR or OS.ConclusionsThis large international TMA of locally advanced (pT3) UCB suggests that altered expression of p53, Rb, and p21 is associated with worse outcome. However this study also highlights limitations in the reproducibility of IHC even in the most expert hands.     

表皮生长因子受体在结直肠癌的表达及临床病理意义

目的 探讨表皮生长因子受体（ＥＧＦＲ）在结直肠癌中的表达情况及其与病理特征和预后的关系。方法 采用免疫组化ＳＰ法对有随访资料的５５例结直肠癌标本进行ＥＧＦＲ检测,结合图像分析观察判定结果。结果 结直肠癌ＥＧＦＲ表达的阳性率为６９．０９％,ＥＧＦＲ的表达与肿瘤的浸润深度,淋巴结转移,Ｄｕｋｅ‘ｓ分期和生存期有关,而与分化程度无关。结论ＥＧＦＲ在结直肠癌的扩散和转移过程中可能产生一定的作用,并可作为预     

论医学院校大学生社会实践中创新能力的培养

深化社会实践活动,培养新时期社会需要的创新人才,不仅是经济与社会发展对高校的客观要求,也是高校深化教育教学改革,培养高素质创新人才的必然需要.医学院校的大学生因其自身专业的特殊性更加要求在其社会实践中要有所针对地加强、侧重某些方面或环节的重要攻关,从而使社会实践有的放矢,目的性更强,更有实效性.