超声光散射断层成像中血红蛋白值与乳腺癌CerbB-2表达相关性的研究

目的:探讨超声光散射断层成像技术中血红蛋白值(HBT)与乳腺癌中原癌基因CerbB-2表达的相关性。方法:87例乳腺癌患者经超声光散射断层成像系统测量HBT值,免疫组化SP法检测CerbB-2在乳腺癌组织中的表达情况,分析HBT值与CerbB-2表达的关系。结果:乳腺癌组织中CerbB-2阴性、阳性的HBT值之间的差异有统计学意义(P<0.05),CerbB-2的表达与HBT值呈正相关(r=0.675,P<0.001)。结论:超声光散射成像作为一种新的功能性乳腺成像技术,其检测的HBT值可为临床上判断肿瘤CerbB-2表达及患者诊疗计划的制定提供有价值的参考。     

Anatomical specificity of O6-methylguanine DNA methyltransferase protein expression in glioblastomas

O6-methylguanine DNA methyltransferase (MGMT) is one of the important tumor-related biomarkers and is considered to be a prognostic factor for glioblastoma. This study aimed to investigate the anatomical location of tumor-related MGMT protein expression in histologically confirmed de novo glioblastoma multiforme (GBM). Preoperative magnetic resonance images were retrospectively examined from GBM patients. Tumor tissues were manually segmented based on the structural image of each patient and subsequently registered to a standard brain atlas. Superimposition of the tumor tissues was carried out in patients with and without epigenetic changes. We used voxel-based lesion symptom mapping (VLSM) to identify the specific brain regions that were associated with level of MGMT protein expression. The tumors with low expression of MGMT protein and those with high expression of MGMT protein showed not significant differences in tumor size on T2 imaging. The VLSM analysis demonstrated that tumors with low expression of MGMT protein were more likely to occur in the right temporal-parietal lobe, while tumors with high expression of MGMT protein occurred more often in the left frontal lobe. Based upon VLSM data, our results suggest that the epigenetic changes, which occur during tumorigenesis, may have anatomical specificity. The identified correlation between molecular biomarkers and anatomical distribution underscores the current understanding of the biological characteristics of glioblastoma.     

连续性静脉—静脉血液透析滤过治疗慢性肾功能衰竭合并心力衰竭患者的疗效观察及护理

目的探讨连续性静脉-静脉血液透析滤过(continuous veno-venous hemodiafiltration,CVVHDF)治疗慢性肾功能衰竭合并心力衰竭患者的疗效及总结护理要点。方法采用CVVHDF方式对40例慢性肾功能衰竭合并心力衰竭患者进行肾脏替代治疗,观察患者治疗前后各种生化指标及生命体征变化情况。结果 CVVHDF治疗后患者血压(BP)、心率(HR)、呼吸(R)频率明显下降,血氧饱和度(SPO2)明显升高;血肌酐(Cr)、尿素氮(BUN)、血钾(k+)明显下降,治疗前后各项指标比较,差异具有统计学意义(均P0.01),血钠(Na+)、血氯(Cl-)水平保持平稳(均P0.01)。结论 CVVHDF能有效改善慢性肾功能衰竭合并心力衰竭患者的症状,减少透析过程发生不良反应的风险性;科学的护理对CVVHDF的顺利进行至关重要。     

Quantification of granulocyte-macrophage colony-stimulating factor hypersensitivity in juvenile myelomonocytic leukemia by 3H-thymidine assay

Recent molecular studies have revealed that the GM-CSF/RAS signaling pathway plays a central role in the pathogenesis of juvenile myelomonocytic leukemia (JMML). CFU-GM colony assay is an important test for GM-CSF hypersensitivity in patients with JMML, but requires specific skills. We established a simple and easy quantification method to test GM-CSF hypersensitivity, using a (3)H-thymidine assay. With this quantification method, JMML patients with RAS mutations showed significantly higher GM-CSF sensitivity than JMML patients with PTPN11 mutations. This method will be useful not only in the diagnosis of JMML, but also to evaluate the difference of GM-CSF sensitivity among patients.     

准分子激光角膜原位磨镶术后的增进手术

目的　评价准分子激光角膜原位磨镶术 (excimer laser in situ keratom ileusis,L ASIK)后残留屈光度的增进手术的结果。方法　 10 1例患者 (12 1只眼 )于 L ASIK术后平均 12 5± 6 3天后进行增进手术 ,L ASIK术前的平均屈光度为 - 10 .7± 4.8D(- 2 .5 D～ - 2 7.5 D) ,增进手术前平均屈光度为 - 2 .19± +2 .47D(- 11.88D～ +2 .2 5 D)。术后随访时间为第 1天、第 1周、3个月、6个月和 1年 ,平均随访时间为 2 77± 113天 ,增进手术前裸眼视力40只眼为 2 0 /4 0或更好 ,其中 11只眼为 2 0 /30 ,4只眼为 2 0 /2 5。结果　增进手术后平均屈光度为 - 0 .5 2± 1.2 3D(- 7D± 1.88D) ,110只眼术后裸眼视力有所提高 ,有 10 9只眼为 2 0 /4 0或更好 ,其中 2 3只眼为 2 0 /30 ,2 5只眼为2 0 /2 5 ,41只眼为 2 0 /2 0。结论　 L A SIK增进手术对于减低 L ASIK术后的残留屈光度和改善裸眼视力是非常有效的。     

Protective effect of adenoviral-mediated brain derived neurotrophic factor gene on spiral ganglion]

OBJECTIVE: To observe the expression of brain derived neurotrophic factor (BDNF) in the cochlea of guinea pig, and assess the activity of BDNF in spiral ganglion cell following the damage of noise. METHODS: Twenty-seven guinea pigs were exposed to a 4 kHz narrow band noise at 135 dB SPL for 4 hours. At seven days after the noise exposure, twelve guinea pigs were inoculated with ad-BDNF, and twelve guinea pigs were inoculated with ad-LacZ, while three guinea pigs were inoculated with artificial perilymphatic fluid. The animals were sacrificed After 1 week, 4 weeks and 8 weeks, respectively. The cochlea was stained with immunohistochemisty (ABC method) to examine the expression of BDNF. The number of spiral ganglion cell was counted to assess the activity of BDNF. RESULTS: BDNF gene was expressed in whole cochlea, and the expression was obviously elevated 1 week after the adenovirus administration and reduced thereafter. The number of degenerated cells in ad-BDNF group in the eight weeks was lower than that in another two groups and the different between them was statistical significant (P < 0.01). CONCLUSION: Adenoviral-mediated brain derived neurotrophic factor can be expressed in a high level in the cochlea of guinea pig, and may prevent the cell of spiral ganglion from the damage of noise. This study lays the groundwork for alleviation of hearing loss using gene therapy.     

全头皮撕脱伤原位再植术的护理配合

目的探讨全头皮撕脱伤原位再植术的手术室护理要点。方法对10例全头皮撕脱伤患者进行撕脱头皮原位再植术。给予术前积极心理支持、快速有效扩容,术中体温保护、严格的空间、感控管理以及显微器械等物品的精细管理,术后规范转运。结果10例患者手术均成功,术后32~85d出院,效果满意。结论有效的心理支持、早期抗休克、保护体温和严格的术间管理、熟练规范的手术配合是全头皮撕脱伤原位再植术成功的关键。     

临床药师参与重症监护室新生儿万古霉素个体化治疗实践

目的：探讨呼出气一氧化氮（FeNO）水平与低出生体质量儿支气管肺发育不良（BPD）的关系。方法：采用回顾性研究方法,选取2013年8月至2018年2月湖北黄石爱康医院新生儿重症监护病房收治的低出生体质量儿94例,根据BPD发病情况分为BPD组和非BPD组,所有患儿均给予FeNO检测,同时收集患儿临床资料进行相关性分析。结果：94例低出生体质量儿中,BPD发病率为10.6%。BPD组的出生胎龄小于非BPD组,有创通气时间、需氧吸入时间均长于非BPD组,使用肺表面活性物质治疗、雾化吸入激素治疗的比例均高于非BPD组（P<0.05）。BPD组与非BPD组出院时的FeNO水平分别为（13.67±4.29）ppb、（8.09±3.10）ppb（P<0.05）。BPD的FeNO最佳阈值为11.55 ppb,诊断特异度为75.0%、灵敏度为72.7%。Logistic回归分析显示出生胎龄、FeNO水平是导致BPD发病的危险因素（P<0.05）。结论：FeNO参与了低出生体质量儿BPD的病理生理过程,FeNO检测具有无创、快速、重复性好等优点,可相对客观地评价生后早期肺功能,有效反映BPD发病状况。