超声联合胸腔镜在胸腔积液良恶性诊断中的价值

目的探讨超声联合胸腔镜在胸腔积液良恶性诊断中的价值。方法选取2020年1月~2021年3月在我院就诊的不明原因的胸腔积液患者102例,其中,良性患者76例,恶性患者26例,分析良恶性胸腔积液患者胸腔镜下形态、超声特征差异。分析胸膜厚度鉴别良恶性胸腔积液的价值和超声联合胸腔镜诊断良恶性胸腔积液的价值。结果良性患者病因均为结核性胸膜炎,恶性患者病因以胸膜转移性腺癌为主（88.46%）;恶性组胸腔镜下胸膜肿块、胸膜瓷片状增厚的比例高于良性组（P < 0.05）,而胸膜充血水肿、胸膜粘连带比例分低于良性组（P < 0.05）;恶性组胸膜厚度、胸膜非均匀性增厚比例明显高于良性组（P < 0.05）,而强回声纤维分隔带比例低于良性组（P < 0.05）;胸膜厚度鉴别恶性胸腔积液的ROC曲线下面积为0.736（P < 0.05）,截断值为10.73mm,敏感度和特异性分别为53.80%和99.70%;超声联合胸腔镜下形态诊断恶性胸腔积液的敏感度、特异性、准确率、阳性预测值和阴性预测值分别为76.92%、81.58%、80.39%、58.82%和91.18%。结论超声联合胸腔镜在胸腔积液良恶性诊断中有一定的应用价值。      

Genetic polymorphisms of pharmacogenomic VIP variants in the lhoba population of southwest China

Background: It is well-established that differences among ethnic groups in drug responses are primarily due to the genetic diversity of pharmacogenes. A number of genes or variants that play a crucial role in drug responses have been designated Very Important Pharmacogenes (VIP) by the PharmGKB database. Clarifying the polymorphic distribution of VIPs in different ethnic groups will aid in personalized medicine for specific populations. Methods: We sequenced 85 VIP variants in the Lhoba population based on the PharmGKB database. The polymorphic distribution of the 85 VIP variants in 100 Lhoba subjects was determined and compared with that of 11 major HapMap populations, including ASW, CEU, CHB, CHD, GIH, JPT, LWK, MEX, MKK, TSI, and YRI. We used χ² tests to identify significantly different loci between these populations. We downloaded SNP allele frequencies from the ALlele FREquency Database to observe the global genetic variation distribution for these specific loci. And then we used Structure software to perform the genetic structure analysis of 12 populations. Results: Based on comparisons of selected available loci, we found that 23, 28, 16, 10, 20, 16, 24, 19, 22, 21 and 36 of the selected VIP variant genotype frequencies in the Lhoba population differed from those of the ASW, CEU, CHB, CHD, GIH, JPT, LWK, MEX, MKK, TSI, and YRI populations, respectively. In addition, Pairwise FST values and clustering analyses also showed the VIP variants in Lhoba exhibited a close genetic affinity with CHD, CHB and JPT populations. Conclusion: Our results complement pharmacogenomic data on the Lhoba ethnic group and may be helpful in the diagnosis of certain diseases in minorities.     

金鸡毛草提取物经Wnt/β-catenin信号通路促进大鼠Ⅲ期压疮溃疡愈合的作用研究

目的观察金鸡毛草提取物经Wnt/β-连环蛋白(β-catenin)信号通路促进大鼠Ⅲ期压疮溃疡愈合的作用。方法建立Ⅲ期压疮溃疡大鼠模型,将造模成功的SD大鼠随机分为模型组与金鸡毛草提取物低、中、高(4、8、16 g/kg)剂量组,每组12只。另取12只正常大鼠作为对照组。金鸡毛草提取物低、中、高剂量组大鼠灌胃4、8、16 g/kg的金鸡毛草提取物,灌胃体积10 mL/kg,对照组和模型组大鼠灌胃等体积生理盐水,每天1次,给药周期为2周。给药周期结束后,检测大鼠创面愈合率,酶联免疫吸附试验(ELISA)法测定大鼠血清白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)水平,苏木素-伊红(HE)染色观察大鼠压疮溃疡组织和正常组织病理变化,实时荧光定量PCR及蛋白免疫印迹法测定大鼠压疮溃疡组织和正常组织中Wnt、β-catenin mRNA和蛋白水平。结果对照组大鼠皮肤组织结构正常,可见大量成纤维细胞及毛细血管;模型组大鼠压疮溃疡组织大量炎症细胞浸润,成纤维细胞及毛细血管数目明显减少,表皮明显变薄;金鸡毛草提取物低、中、高剂量组大鼠压疮溃疡创面组织已经出现结痂,且表皮明显增厚,炎性细胞浸润较轻。与对照组比较,模型组大鼠血清IL-2、IL-4、TNF-α、压疮溃疡组织Wnt、β-catenin mRNA和蛋白水平升高(P <0.05);与模型组比较,金鸡毛草提取物低、中、高剂量组大鼠创面愈合率依次升高,血清IL-2、IL-4、TNF-α、压疮溃疡组织Wnt、β-catenin mRNA和蛋白水平依次降低(P <0.05),呈剂量依赖性(P <0.05)。结论金鸡毛草提取物能加速大鼠Ⅲ期压疮溃疡愈合,减轻大鼠Ⅲ期压疮炎症反应;其机制可能与金鸡毛草提取物可促进大鼠Ⅲ期压疮溃疡组织Wnt、β-catenin mRNA和蛋白的表达进而激活Wnt/β-catenin信号通路有关。     

主动脉瓣二叶畸形行主动脉瓣置换术后疗效的中期随访研究——基于倾向性评分匹配法分析

目的 探讨主动脉瓣二叶畸形(bicuspid aortic valve,BAV)与三叶主动脉瓣(tricuspid aortic valve,TAV)患者行主动脉瓣机械瓣置换(aortic valve replacement,AVR)术后中期疗效差异及影响因素.方法 回顾性分析2014年1月至2019年6月在陆军军医大...     

小儿外伤性脑梗塞的CT及临床分析

目的 探讨小儿外伤性脑梗塞的发病机理、CT表现、临床诊治及预后。方法 35例患儿均行横断位头颅CT扫描，予扩血管、解痉、神经营养及抗凝等治疗。结果 小儿外伤性脑梗塞好发于基底节区，CT扫描均表现为低密度影，治愈33例，CT低密度影消失，好转2例，CT低密度影范围缩小。结论CT扫描和追踪观察对小儿外伤性脑梗塞诊断有重要价值。本病经及早诊断治疗，预后良好。     

塔中某井区扭力冲击器应用效果分析

塔中某井区平均井深6000m 以上, 地层岩石抗压强度高, 研磨性强, 可钻性差。为了提高钻井速度, 控制 钻井成本, 该井区引入了“PDC+扭力冲击器” 钻井工艺。扭力冲击器通过把钻井液的能量转化成高频冲击力作用在钻 头上, 增加瞬时扭矩, 减少钻头卡滑效应, 提高钻头破岩效率。应用表明: 从二叠系到奥陶系井段, 使用PDC 扭力冲 击器较常规钻井工艺平均提速可达35%, 并节省3 趟起下钻时间, 其中在卡拉沙依组、巴楚组提速高达62%, 取得了显 著的提速效果, 为优化提速钻井工艺提供了一定的参考。     

Association of five single nucleotide polymorphisms at 6q25.1 with breast cancer risk in northwestern China

CCDC170 and ESR1, located at 6q25.1, were associated with breast cancer (BC) risk by genome-wide association studies. Our goal was to validate the association between CCDC170-ESR1 polymorphisms and BC risk in the population of northwestern China. A case-control study of 551 patients with BC and 577 control individuals was conducted from January 2011 to November 2014. We analyzed five BC-associated single nucleotide polymorphisms (SNPs) identified in CCDC170-ESR1 by previous studies. Logistic regression models were used to derive odds ratios (ORs) and 95% confidence intervals after adjusting for body mass index and age. The minor alleles of rs3757318, rs3734805, and rs2046210 were associated with increased BC risk (OR = 1.30, p = 0.005; OR = 1.28, p = 0.006; OR = 1.20, p = 0.033, respectively) in an allelic model analysis. Those three SNPs had a coincident significant association with increased BC risk in genetic models and stratification analyses. A new haplotype, “CT”, was associated with a 1.31-fold increased risk of BC (OR = 1.31, p = 0.006). The “C” allele of rs9383951 was associated with a reduced risk of BC (OR = 0.69, p = 0.048) in estrogen receptor-positive individuals under the log-additive model. Our data provide new evidence of the association between CCDC170-ESR1 and BC susceptibility in the population of northwestern China.     

Increased NUCKS expression is a risk factor for poor prognosis and recurrence in endometrial cancer

Nuclear ubiquitous casein and cyclin-dependent kinases substrate (NUCKS) was reported to function as a potential biomarker in various tumors. Thus, we aimed to explore the expression of NUCKS in endometrial cancer (EC) and its clinical significance using quantitative real-time PCR (qRT-PCR) and immunohistochemistry (IHC). qRT-PCR results showed that NUCKS mRNA expression gradually elevated from normal endometrium to atypical endometrial hyperplasia, and to EC (P < 0.05 between each group). NUCKS overexpression was strongly associated with FIGO stage (P = 0.002), histologic grade (P = 0.029), lympho-vascular space involvement (P = 0.014), lymph node metastasis (P = 0.019), and recurrence (P < 0.001). Cox multivariate analysis revealed that NUCKS overexpression was an independent factor for overall survival and recurrence-free survival (P < 0.001 for both). Multivariate logistic regression suggested that recurrence was independently correlated with NUCKS overexpresion (P = 0.039), FIGO stage (P = 0.002), and lymph node metastasis (P = 0.002). In summary, NUCKS overexpression may function as a potential biomarker for prognosis especially for recurrence in ECs.     

中药夜交藤化学成分的研究

从中药夜交藤中分得的Ⅰ、Ⅱ、Ⅲ、Ⅳ4种结晶性成分,通过化学及光谱分析证明,依次为大黄素、大黄素-6-甲醚、β-谷甾醇、大黄素-8-O-β-D-单葡萄糖甙。