肺结节患者的临床特征在判断良恶性中的意义

目的探究肺结节特点与其病理结果的相关性,分析患者临床特征（临床因素、检验结果、胸部CT影像特征）对判断肺结节良恶性的临床意义。 方法回顾性分析147例肺结节患者,根据病理活检结果分为良性组39例,恶性组108例。比较两组患者的一般情况（性别、年龄、吸烟史、恶性肿瘤家族史）、肺癌4项[癌胚抗原（CEA）、鳞状上皮细胞抗原（SCCAg）、神经元特异性烯醇化酶（NSE）、细胞角蛋白19片段（Cyfra21-1）]以及高分辨率CT征象,评估差异有统计学意义的因素在鉴别良恶性肺结节中的效能。 结果两组患者在性别、吸烟史、4个肺癌指标（CEA、SCCAg、NSE、Cyfra21-1）、结节大小、结节边缘、毛刺征的比较,差异均无统计学意义（均P＞0.05）,在年龄、恶性肿瘤家族史、结节形态、分叶征、空泡征、胸膜牵拉征、血管集束征的比较,差异均有统计学意义（均P＜0.05）。在高分辨率CT征象中,分叶征对判断肺结节良恶性的效能最高,敏感度达79.6%。Logistic线性回归分析显示磨玻璃结节、分叶征、空泡征都是恶性的危险因素（均P＜0.05）。 结论患者的年龄、恶性肿瘤家族史、结节形态（磨玻璃结节）、分叶征、空泡征、胸膜牵拉征、血管集束征对鉴别肺结节良恶性有一定的参考意义。     

温阳活血方对大鼠阿霉素肾病模型的影响

目的：探讨不同治法治疗原发性肾病综合征高脂血症的疗效差异。方法：用阿霉素（ADR）诱导一种类似人类微小病变肾病模型,然后用中药温阳方、活血方及温阳活血方对模型进行治疗,并设空白、病理及强的松组对照。结果：温阳活血方组尿蛋白、血脂、脂蛋白及肾脏病理损害明显改善;温阳方及活血方组血脂、脂蛋白部分指标及肾脏病理损害有所改善。结论：温阳活血方对ADR肾病的治疗作用较全面,其疗效优于温阳法和活血法。     

大鼠小肠粘膜淋巴管的图像分析

大鼠腹主动脉注入１％墨汁硝酸银溶液，可同时显示小肠淋巴管和微血管，浆膜下注入１０％ＡＢＳ丁酮溶液可制成小肠粘膜淋巴管的铸型标本，用光镜和ＳＥＭ观察，利用图像分析仪测量了肠粘膜淋巴管的数量、管径、长度等。小肠粘膜初始淋巴管数为２７５±５２／ｍｍ２，管径为３４９±４０μｍ，长度为２０８５μｍ，初始后淋巴管管径为３４９＋４０μｍ，长度１０７４μｍ，提出了区分初始淋巴管和初始后淋巴管的依据，获得了有关汇合淋巴管、粘膜下层淋巴管网数、园形因子等数据，小肠不同区段如十二指肠、空肠、回肠、淋巴管的上述数据有某些差别。我们的研究结果加深了对大鼠小肠淋巴管的分布、走行和形态等的认识     

A Prenatal Ultrasound Scanning Approach: One-Touch Technique in Second and Third Trimesters

This study was aimed at evaluating the performance of the innovative technique Smart Fetus (SF) developed to recognize the planes and obtain the basic biometric measurements of fetuses automatically. This prospective study included 1005 uncomplicated singleton pregnancies undergoing routine examinations. For every pregnancy, planes, including the transverse section of the thalami, transverse section of the abdomen and longitudinal section of the femur, were acquired, and standard biometric measurements, including biparietal diameter, head circumference, abdominal circumference and femur length, were obtained using SF and traditional ultrasound technique (TUT). The accuracy, reproducibility and time required for the analysis of SF were compared with those of TUT. In 998 of 1005 cases (99.30%), SF successfully acquired the sections and made all measurements. The agreement between the techniques was high for all measurements. The time to obtain sections and measure biometric parameters or solely measure biometric parameters was significantly shorter with SF than with TUT. No significant differences were found in SF repeated measurements obtained by two independent observers. The SF technique helped in the acquisition of reliable standard sections and biometric measurements and saved time. It might serve as a novel ultrasound scanning approach and improve workflow efficiency.     

Study on the interactions of pharmacokinetics and liver distributions between rosuvastatin and repaglinide in rats

In the present study,we aimed to investigate the interactions of pharmacokinetics and liver distributions between rosuvastatin and repaglinide in rats.Coadministration of repaglinide (0.5 mg/kg, 1 mg/kg and 2 mg/kg) for 7 d significantly increased the AUC_0–24 and C_max of rosuvastatin (P<0.01), but dramatically decreased the CL/F of rosuvastatin (P<0.01) after a single dose of rosuvastatin (10 mg/kg). There were no obviously changes in the parameters of T_max and t_1/2. Coadministration of repaglinide also decreased the liver distribution of rosuvastatin (P<0.01). Coadministration of rosuvastatin (20 mg/kg) for 7 days significantly increased the AUC_0–12 and C_max of repaglinide (P<0.05), and decreased the CL/F of repaglinide (P<0.01) after a single dose of repaglinide (1 mg/kg). The liver distribution of repaglinide was also decreased (P<0.01). Our animal study indicated that repaglinide could significantly affect the pharmacokinetics and liver distribution of rosuvastatin in rats and vice versa.     

Large-scale synthesis and luminescence of GdPO4 hollow microspheres

GdPO₄ hollow microspheres were synthesized by using a novel multi-step transformation synthetic route for the first time with polystyrene (PS) spheres as the template, followed by the combination of a facile homogeneous precipitation method, an ion-exchange process, and a calcination process. The XRD results indicated that the GdPO₄ hollow microspheres have a pure hexagonal phase. The SEM and TEM images confirmed that the as-obtained GdPO₄ hollow spheres have a uniform morphology with an average diameter of 2.7 μm and shell thickness of about 150 nm. The up-conversion luminescence properties as well as the emission mechanisms of the GdPO₄:Yb³⁺, Ln³⁺ (Ln³⁺ = Tm³⁺, Er³⁺ and Ho³⁺) hollow microspheres were systematically investigated, which show blue (Tm³⁺, ¹G₄ → ³H₆), green (Er³⁺, ⁴S_3/2, ²H_11/2 → ⁴I_15/2), and red (Ho³⁺, ⁵F₅ → ⁵I₈) luminescence under 980 nm NIR excitation, providing potential applications in bioanalysis, optoelectronic and nanoscale devices, future color displays and light-emitting devices, and so on.

GdPO₄ hollow microspheres were synthesized by using a novel multi-step route for the first time with polystyrene (PS) spheres as the template, followed by the combination of a facile homogeneous precipitation method, an ion-exchange process, and a calcination process.     

老年专科护士临床实践培训模式探讨

目的 探讨老年专科护士临床实践培训的模式.方法 采取导师制形式,对粤港联合培养的10名老年专科护士学员,按照专科化和个体化的培训计划进行老年专科临床实践.结果 学员掌握了基础和老年专科护理理论知识和技能,全面提高了临床思维能力、理论联系实际的能力,循证的能力,独立思考的能力,科学解决问题的能力,综合分析的能力.结论 老年专科护士缺乏,不能满足临床需求;专科护士教育资源缺乏,需进一步探索适合我国国情和院情的老年专科护士临床实践培训模式.     

胎儿小脑表面叶裂的产前超声研究

目的研究正常胎儿小脑表面叶裂随孕周的变化规律并建立孕16~32周正常胎儿小脑叶裂数目参考值。 方法选取2019年6月至2020年12月在南方医科大学附属深圳妇幼保健院行产前超声检查无结构异常的644名妊娠12~32周的单胎孕妇,按孕周分为2个时间段观察：孕12~15周为阶段1,孕16~32周为阶段2,在二维图像上观察原裂、水平裂的显示情况并计数孕16~32周小脑原裂之前、原裂与水平裂之间、水平裂之后的叶裂数目及总数目,并分析其形态变化。随机抽取40名阶段2胎儿行叶裂数目两测量者间的组内相关系数（ICC）分析;建立阶段2胎儿小脑叶裂数目的参考值范围,采用Spearman相关行叶裂数目与孕周的相关性分析并建立拟合方程。 结果叶裂数目的计数两观察者之间的重复性检验一致性较好（ICC=0.969,P＜0.001）。各散点图显示正常胎儿小脑原裂之前、原裂与水平裂之间、水平裂之后叶裂数目及总数目与孕周呈正相关（r=0.863、0.698、0.831、0.932,P均＜0.001）。建立了各区域叶裂数目及总数目与孕周的二次多项式回归方程,原裂之前、原裂与水平裂之间、水平裂之后叶裂数以及总数目与孕周的回归方程分别为：Y=0.974X-0.014X ² -12.65,Y=0.362X-0.005X ² -4.843,Y=-0.125X+0.006X ² +0.285,Y=1.800X-0.024X ² -22.904。 结论利用产前超声可以较好地观察胎儿小脑表面叶裂并对其发育情况作出初步评估。胎儿小脑表面叶裂数目的正常参考值以及形态变化规律能为产前超声评估小脑皮质发育作出参考。     

错配修复蛋白表达与乳腺癌新辅助化疗效果的关系

目的探究错配修复（MMR）蛋白表达与乳腺癌新辅助化疗（NACT）疗效的关系。 方法收集潍坊市人民医院2016年1月1日至2018年10月31日53例行NACT治疗的乳腺癌患者临床病理资料,采用组织芯片（TMAs）技术、免疫组织化学（IHC）方法检测NACT前乳腺癌组织4种MMR蛋白（MSH2、MSH6、PMS2、MLH1）表达水平。Miller/Payne分级G5定义为病理完全缓解（pCR）,G2~4定义为部分缓解（PR）,G1定义为稳定（SD）。应用SPSS 22.0软件进行数据统计分析。 结果53例乳腺癌患者NACT疗效：pCR（G5）10例（18.9％）,PR（G2~4）36例（67.9％）,SD（G1）7例（13.2％）。IHC结果显示：53例患者MSH2、MSH6、PMS2、MLH1蛋白均表达阳性,未发现错配修复缺陷患者。患者各临床T分期间MSH6蛋白表达强度构成比具有统计学差异（χ²=6.09,P=0.04）,患者各年龄、月经状态、临床T分期、淋巴结状态、雌激素受体、孕激素受体、人表皮生长因子受体2、Ki-67指数、分子分型间MSH2、PMS2及MLH1蛋白表达强度构成比差异均无统计学意义（P＞0.05）。乳腺癌NACT疗效与MLH1（r=0.40,P=0.00）、MSH6（r=0.37,P=0.01）蛋白表达强度呈正相关关系,而与MSH2、PMS2蛋白表达强度无相关性（P＞0.05）。 结论乳腺癌活检组织MSH6、MLH1蛋白表达增强提示更好的NACT疗效,值得进一步研究。