糖尿病合并结核潜伏感染的研究热点与趋势分析

目的 探讨糖尿病合并结核潜伏感染的研究现状、热点与前沿。方法 收集Web of Science核心合集于2000年1月1日至2021年11月20日发表的糖尿病合并结核潜伏感染的相关文章，运用CiteSpace 5.8.R3软件进行可视化分析。结果 共纳入英文文献148篇，近20年来该领域发文量呈上升趋势。美国发文量最多（46篇, 31.08%），机构间合作情况的可视化分析共得到个340节点、929条连线，网络密度为0.0161，作者间合作关系的知识图谱共得到790个节点、2425条连线，网络密度为0.0078，关键词共现分析结果显示，糖尿病合并结核潜伏感染的危险因素、患病率、诊断和治疗是该领域的研究热点和趋势。结论 糖尿病合并结核潜伏感染的发文量不断增加，机构间、区域内和国际范围内的合作有待进一步开展。立足国情，探索慢病共病的管理模式将有助于优化共病管理，进一步推动慢病管理的进程。     

A Phase I Dose Escalation Study of the Safety,Tolerability, and Pharmacokinetics of Ipilimumab in Chinese Patients with Select Advanced Solid Tumors

Lessons Learned

• The overall safety profiles of ipilimumab 3 mg/kg and 10 mg/kg administered every 3 weeks, were consistent between Chinese patients with solid tumors in the current study and patients from previous U.S. ipilimumab monotherapy studies. No new safety signals were identified.
• The mean systemic exposures to ipilimumab (assessed by first dose area under the curve during the dosing interval and maximum serum concentration) were numerically lower in the Chinese patient population than in U.S. patients for both 3 mg/kg and 10 mg/kg doses; however, the range of serum concentrations in the Chinese and U.S. populations overlapped (3 mg/kg and 10 mg/kg), suggesting that ipilimumab pharmacokinetics was ethnically insensitive in this study.

BackgroundThis phase I, open‐label study assessed ipilimumab safety, tolerability, pharmacokinetics (PK), immunogenicity, and antitumor activity in Chinese patients with unresectable, metastatic, recurrent malignant melanoma (MM) or nasopharyngeal carcinoma (NPC).MethodsOf 39 patients enrolled, 25 received ipilimumab (11 patients received 3 mg/kg, and 14 patients received 10 mg/kg). Reasons for not receiving treatment were withdrawal of consent (3 patients), no longer meeting the criteria (10 patients), and one recorded as “other.” During the induction phase, patients received ipilimumab (3 mg/kg, i.v.), on day 1 of a 3‐week cycle, to a maximum of four doses or progressive disease (PD). During the maintenance phase at week 24, patients received ipilimumab (3 mg/kg, i.v.) on day 1 of a 12‐week cycle, to a maximum of 3 years or PD. Considering the co‐primary safety and PK endpoints, the successive dosing required nine patients with two or fewer dose‐limiting toxicities during the 42‐day observation period to proceed with a new cohort of nine patients at 10 mg/kg.ResultsIpilimumab safety and PK profiles were similar in Chinese and predominantly White populations. Ipilimumab was well tolerated. Most adverse events (AEs) were grades 1–2 and experienced by 11 patients treated with 3 mg/kg and 14 patients treated with 10 mg/kg. There were no new safety concerns. Incidence of anti‐ipilimumab antibodies was low (1 of 10 in the 3 mg/kg patients and 2 of 13 in the 10 mg/kg patients) and without safety implications. In the 3 mg/kg group, 8 of 11 patients had PD. In the 10 mg/kg group (all NPC, 0 MM patients), 11 of 14 patients had PD. Three patients had stable disease (one at 3 mg/kg and two at 10 mg/kg).ConclusionIpilimumab was well tolerated in Chinese patients, showing similar safety and PK to previous studies in predominantly White populations.     

Hepatotoxicity of cantharidin is associated with the altered bile acid metabolism

Cantharidin (CTD) is an effective antitumor agent. However, it exhibits significant hepatotoxicity, the mechanism of which remains unclear. In this study, biochemical and histopathological analyses complemented with ultra-high-performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS)-based targeted metabolomic analysis of bile acids (BAs) were employed to investigate CTD-induced hepatotoxicity in rats. Sixteen male and female Sprague–Dawley rats were randomly divided into two groups: control and CTD (1.0 mg/kg) groups. Serum and liver samples were collected after 28 days of intervention. Biochemical, histopathological, and BA metabolomic analyses were performed for all samples. Further, the key biomarkers of CTD-induced hepatotoxicity were identified via multivariate and metabolic pathway analyses. In addition, metabolite–gene–enzyme network and Kyoto Encyclopedia of Genes and Genomes pathway analyses were used to identify the signaling pathways related to CTD-induced hepatotoxicity. The results revealed significantly increased levels of biochemical indices (alanine aminotransferase, aspartate aminotransferase, and total bile acid). Histopathological analysis revealed that the hepatocytes were damaged. Further, 20 endogenous BAs were quantitated via UHPLC-MS/MS, and multivariate and metabolic pathway analyses of BAs revealed that hyocholic acid, cholic acid, and chenodeoxycholic acid were the key biomarkers of CTD-induced hepatotoxicity. Meanwhile, primary and secondary BA biosynthesis and taurine and hypotaurine metabolism were found to be associated with the mechanism by which CTD induced hepatotoxicity in rats. This study provides useful insights for research on the mechanism of CTD-induced hepatotoxicity.     

甲状腺疾病患者血清 Tg-CIC 中 Tg-Ab 水平检测及相关临床研究

目的　对血清甲状腺球蛋白免疫复合物 (thyroglobulin circulating immune complex, Tg-CIC) 中抗甲状腺球蛋白抗体 (anti-thyroglobulin antibody, Tg-Ab) 含量检测，探讨 Tg-CIC 在甲状腺疾病中的临床以及流行病学意义。方法　收集甲状腺疾病患者血清标本 187 例，每例血清标本分为两组 ( 实验组和空白对照组 )，采用免疫复合物解离专利技术对甲状腺疾病患者血清标本 Tg-CIC 进行分离、解离，通过检测 Tg-CIC 解离后的 Tg-Ab 含量来间接反映甲状腺疾病患者血清中Tg-CIC 水平，按照不同的甲状腺疾病进行分组并对实验结果分析讨论。结果　不同甲状腺患者血清中 Tg-CIC 总阳性率达 92.51%，不同甲状腺疾病血清中 Tg-CIC 的阳性率差异无统计学意义 (χ?=2.917, P>0.05)。不同甲状腺疾病患者间血清游离 Tg-Ab 含量差异无统计学意义 (H=3.882, P>0.05)，不同甲状腺疾病患者间血清 CIC 中 Tg-Ab 含量差异无统计学意义(H=5.5842, P>0.05)。不同甲状腺疾病患者中，甲状腺功能亢进、甲状腺炎以及甲状腺结节患者血清游离 Tg-Ab 的含量与血清 CIC 中的 Tg-Ab 含量呈正相关 (P<0.05)，甲状腺功能减退、甲状腺肿瘤患者血清游离 Tg-Ab 的含量与血清 CIC 中的Tg-Ab 含量不相关 (P>0.05)。结论　在甲状腺疾病患者血清中，大部分可检出 Tg-CIC，与疾病类型无关。而甲状腺疾病患者中，甲状腺功能亢进、甲状腺炎以及甲状腺结节患者血清游离 Tg-Ab 含量与血清 CIC 中 Tg-Ab 含量存在相关性，为我们进一步了解 Tg-CIC 与甲状腺疾病的发生、发展的相关性研究奠定了基础，提供了新的研究视角。     

改良三点式重睑成形术的临床应用研究

目的:探讨改良三点式重睑术的临床应用疗效。方法:2012年6月-2019年6月,共165例单睑患者采用了改良三点式重睑术,沿术前标记线将三点处皮肤切开,剪刀将切口下唇的眼轮匝肌适当去除,同时将切口与切口在皮下层打通,剪除切口与切口之间的眼轮匝肌,6-0可吸收线挂睑板前筋膜或提上睑肌腱膜及切口下唇皮下组织缝合,三点切口各缝1针。再用6-0单丝尼龙线按照常规重睑线缝合方法挂切口下唇皮肤、睑板前筋膜或提上睑肌腱膜及切口上唇皮肤缝合打结,三点切口各缝1针。伴内眦赘皮者同时行内眦赘皮矫正术。结果:152例患者获得随访,随访患者大部分获得了比较满意的重睑,睁眼重睑流畅、自然,闭眼刀口痕迹不明显。2例患者出现内侧重睑线变浅,1例患者出现外侧重睑线变浅,所有患者均未出现重睑消失。5例患者双侧重睑线有轻度不对称。患者总体满意率为94.7%(144/152)。结论:改良三点式重睑术具有创伤小、并发症少、效果逼真、不易脱落、手术痕迹不明显等优点,值得推广应用。     

经9次核酸检测终确诊的新型冠状病毒肺炎患者1例分析

目前新型冠状病毒肺炎(COVID-19)疫情在全球蔓延,形势严峻,并对全球公共卫生事业构成巨大挑战,快速准确的诊断COVID-19对疫情的防控有重要意义。本文报道1例COVID-19患者的调查和确诊过程,以对COVID-19确诊和疫情防控提供有价值的参考。患者为赴渝务工于2020年1月23日返乡人员,在渝期间,其同工地的一同事确诊为COVID-19,之后该工地接连有另外8位同事被确诊。患者返乡后2月2日被当地疫情防控单位采取医学隔离。患者于隔离后不久出现咳嗽,阵发性,干咳为主,偶可咳出黄色痰液等COVID-19相关临床症状,遂被当地新型冠状病毒肺炎定点医疗单位收治,后经市级新型冠状病毒肺炎诊治专家组远程视频会诊转入四川大学华西医院资阳医院。患者先后经历9次核酸检测,在前8次核酸检测均为阴性的情况下,于第9次核酸检测结果为阳性,2月21日最终确诊为新型冠状病毒肺炎。     

半夏白术天麻汤治疗眩晕高血压病举隅

高血压病是我国发病率较高的疾病之一,西医治疗以长期服用降压药物为主要治疗方式,但常因依从性差的原因导致血压控制不佳,而用中医辨证治疗对于首次发现高血压的患者,可明显有效地降低高血压的发病率。高血压病在中医学中属"眩晕",在临床中常常会用半夏白术天麻汤来治疗眩晕,本文通过跟师医案及临床收集介绍半夏白术天麻汤治疗高血压眩晕临证方药的运用。