静脉化疗和介入性动脉化疗结合手术治疗局部晚期宫颈癌的临床疗效对比

目的分析静脉给药和介入性动脉给药两种化疗给药途径结合手术治疗局部晚期宫颈癌的临床效果。方法选取我院2010年4月至2011年4月收治的60例局部晚期宫颈癌的患者为研究对象,根据治疗方法的不同将其分为观察组和对照组各30例,观察组采用介入性动脉化疗联合手术治疗,对照组采用静脉化疗结合手术治疗。比较两组化疗的效果和不良反应以及术后复发的危险因素。结果两组总有效率相比差异不显著(P>0.05)。观察组化疗后骨髓抑制和肝肾功能损害的发生率均显著低于对照组,术后脉管浸润和深层肌受累发生率均明显低于对照组,差异均具有统计学意义(P<0.05)。结论介入性动脉化疗治疗局部晚期宫颈癌的效果较好,不良反应发生率低,术后复发的风险低,临床上建议推广。     

尼帕病毒N基因的原核表达

目的利用尼帕病毒(NiV)的N基因进行原核表达,探讨NiV N蛋白作为检测NiV存在的抗原的可能性。方法利用pET-28a(+)作为表达载体,构建pET-NiV N重组质粒,通过IPTG诱导使其表达蛋白,并用Western blot方法进行原核表达NiV N蛋白的检测。结果通过PCR、酶切和连接反应,成功构建N蛋白的pET-NiV N重组质粒,大小为1596 bp;利用IPTG诱导pET-NiV N重组质粒在宿主菌中表达N蛋白,SDS-PAGE结果显示,55 k D有特异蛋白条带,与蛋白预计大小相符,经Bandscan软件扫描分析,重组蛋白量占菌体总蛋白量的12%;Western blot法检测显示,55 k D的条带显色良好,证明是本实验所需要得到的目的蛋白。结论使用原核表达系统成功表达了NiV的N蛋白,为其进一步的抗体制备、活性鉴定及研究应用奠定了基础。     

中医藏象辨证法辨治三阴性乳腺癌

吴承玉教授创建藏象辨证理论体系,将藏象辨证应用于三阴性乳腺癌的辨治,通过病证结合,从症辨证,明辨病位,详审病性,使复杂难治的三阴性乳腺癌的辨证更为简便、精准。肝、脾、肾是三阴性乳腺癌的重要病位,气滞、痰、瘀、火毒是三阴性乳腺癌的重要病性。运用藏象辨证原理指导三阴性乳腺癌的治疗,病证结合施治,使三阴性乳腺癌的中医治疗更为有效。      

A study on antigenicity and receptor-binding ability of fragment 450-650 of the spike protein of SARS coronavirus

The spike (S) protein of SARS coronavirus (SARS-CoV) is responsible for viral binding with ACE2 molecules. Its receptor-binding motif (S-RBM) is located between residues 424 and 494, which folds into 2 anti-parallel beta-sheets, beta5 and beta6. We have previously demonstrated that fragment 450-650 of the S protein (S450-650) is predominantly recognized by convalescent sera of SARS patients. The N-terminal 60 residues (450-510) of the S450-650 fragment covers the entire beta6 strand of S-RBM. In the present study, we demonstrate that patient sera predominantly recognized 2 linear epitopes outside the beta6 fragment, while the mouse antisera, induced by immunization of BALB/c mice with recombinant S450-650, mainly recognized the beta6 strand-containing region. Unlike patient sera, however, the mouse antisera were unable to inhibit the infectivity of S protein-expressing (SARS-CoV-S) pseudovirus. Fusion protein between green fluorescence protein (GFP) and S450-650 (S450-650-GFP) was able to stain Vero E6 cells and deletion of the beta6 fragment rendered the fusion product (S511-650-GFP) unable to do so. Similarly, recombinant S450-650, but not S511-650, was able to block the infection of Vero E6 cells by the SARS-CoV-S pseudovirus. Co-precipitation experiments confirmed that S450-650 was able to specifically bind with ACE2 molecules in lysate of Vero E6 cells. However, the ability of S450-510, either alone or in fusion with GFP, to bind with ACE2 was significantly poorer compared with S450-650. Our data suggest a possibility that, although the beta6 strand alone is able to bind with ACE2 with relatively high affinity, residues outside the S-RBM could also assist the receptor binding of SARS-CoV-S protein.     

反置肩关节置换治疗肱骨近端骨折中影响术后肱骨大结节愈合的因素分析

目的分析探讨肱骨近端骨折反置肩关节置换术治疗中可能影响术后肱骨大结节愈合时间的影响因素。方法回顾分析2018年8月至2019年8月上海交通大学医学院附属瑞金医院骨科收治的14例患者;其中男4例,女10例,年龄67~95(80.0±8.1)岁;左侧8例,右侧6例。所有患者均因肱骨近端骨折行反置肩关节置换术。通过术前及术后影像学测量分析可能的影响因素。结果肱骨近端骨折反置肩关节置换治疗中,影响肱骨大结节骨折愈合时间的主要因素为大结节与近端皮质是否接触(P<0.01)、肱骨大结节骨块是否粉碎(P=0.01;P=0.04)以及肱骨大结节骨块前后向长度(P=0.02)。相比之下,肱骨近端骨折骨折是否合并不可修复肩袖损伤对反置肩关节置换术后肱骨大结节愈合时间无明显影响。结论采用反置肩关节置换治疗肱骨近端骨折,肱骨大结节与近端皮质不连续会导致肱骨大结节术后延迟愈合。粉碎的肱骨大结节尤其是前后向骨块较小的肱骨大结节可延长术后大结节愈合所需时间。     

乳腺恶性肿瘤手术方式探讨

乳腺癌是严重威胁女性身心健康的恶性肿瘤之一,国内主流术式根治性乳房切除术可以大大降低乳腺癌死亡率。保乳手术在肿瘤治疗基础上兼顾乳房外形和患者心理,乳房肿瘤整形术通过将整形技术应用于乳腺肿瘤手术的诸多环节从而获得更显著的美学效果,两者在国内均有很大的发展空间,术式选择应当更加理性和乐观。     

COVID-19 Severity Potentially Modulated by Cardiovascular-Disease-Associated Immune Dysregulation

Patients with underlying cardiovascular conditions are particularly vulnerable to severe COVID-19. In this project, we aimed to characterize similarities in dysregulated immune pathways between COVID-19 patients and patients with cardiomyopathy, venous thromboembolism (VTE), or coronary artery disease (CAD). We hypothesized that these similarly dysregulated pathways may be critical to how cardiovascular diseases (CVDs) exacerbate COVID-19. To evaluate immune dysregulation in different diseases, we used four separate datasets, including RNA-sequencing data from human left ventricular cardiac muscle samples of patients with dilated or ischemic cardiomyopathy and healthy controls; RNA-sequencing data of whole blood samples from patients with single or recurrent event VTE and healthy controls; RNA-sequencing data of human peripheral blood mononuclear cells (PBMCs) from patients with and without obstructive CAD; and RNA-sequencing data of platelets from COVID-19 subjects and healthy controls. We found similar immune dysregulation profiles between patients with CVDs and COVID-19 patients. Interestingly, cardiomyopathy patients display the most similar immune landscape to COVID-19 patients. Additionally, COVID-19 patients experience greater upregulation of cytokine- and inflammasome-related genes than patients with CVDs. In all, patients with CVDs have a significant overlap of cytokine- and inflammasome-related gene expression profiles with that of COVID-19 patients, possibly explaining their greater vulnerability to severe COVID-19.     

穿戴式心电信号质量的三分类评估方法

研究一种穿戴式心电信号质量的三分类评估方法。心电信号质量三分类源于临床诊断需求,具体分为如下3类:一是临床有用,信号质量好;二是临床有用,信号质量差;三是临床无用。该方法首先提取心电信号时域、频域、非线性域中共计12个特征,然后构建特征矩阵,通过融合径向基核函数的支持向量机(SVM)分类器,实现穿戴式心电信号质量的三分类。实际结果表明,所提出的方法在375例经临床专家标注的独立测试集上信号质量三分类F测度结果分别为0.909、0.827和0.973,整体分类准确度为92.3%,相比于基于CNN的模型和传统SVM模型,准确度分别升高2.2%和6.4%。研究证明,新的信号质量三分类模型在穿戴式动态心电信号质量分类中有一定的应用价值。