认知功能障碍对脑卒中预后的影响

为探讨认知功能障碍对脑卒中患者预后的影响，分别对伴发血管性痴呆（VD）患者32例及无认知功能障碍患者37例进行了为期6个月的随访，定期以脑卒中神经功能缺损评分标准对受试者进行评分。结果显示：发病时神经功能缺损评分无显著差异的两组患者，经过同样的治疗，预后却显示了具有非常显著性意义的差异。表明认知功能障碍可明显影响脑卒中患者神经功能的恢复。提示：早期发现脑卒中患者的智能障碍、寻求改善认知功能障碍的有效治疗方法、在康复治疗中增强各种智能训练将有助于改善伴发血管性痴呆的脑卒中患者的预后。     

Study of the correlation between the vacA genotype of Helicobacter pylori,the VacA product and gastroduodenal disease

OBJECTIVE : To determine vacA genotypes and the vacuolating cytotoxin (VacA) activity of Helicobacter pylori strains isolated from patients with chronic gastritis (CG), peptic ulcers (PU) and gastric cancer (GC), and to investigate the relationship between the vacA genotypes of H. pylori, their product, VacA, and gastroduodenal diseases. METHODS : Sixty‐two H. pylori strains were isolated from patients with CG (27 cases), PU (24 cases) and GC (11 cases) as diagnosed by either endoscopy or surgical pathology. The vacA genotypes of the H. pylori strains were tested by polymerase chain reaction (PCR). HeLa cell assays for VacA activity were carried out using a 20‐fold concentrated culture supernatant of H. pylori in vitro. Culture supernatants of H. pylori strain NCTC 11637 and culture supernatants without H. pylori were used as positive and negative controls, respectively. RESULTS : All 62 H. pylori strains contained the vacA gene. The signal sequence and mid‐region gene of the 62 H. pylori strains were s1a and m2 types, respectively. Mosaicism in vacA alleles was type s1a/m2 exclusively. The total rate of VacA expression in vitro was 37.1%; the rates of VacA expression in H. pylori strains isolated from patients with CG, PU and GC were 33.33, 29.17 and 63.64%, respectively. The proportion of strains expressing VacA in patients with GC was higher than those in patients with CG and PU, but the difference in VacA expression rates in CG, PU and GC strains was not significant (P > 0.05). CONCLUSIONS : The vacA genotype of H. pylori cannot be used to predict the clinical consequences of infection with that strain of H. pylori. Moreover, the VacA activity of H. pylori in vitro cannot be used to predict whether subjects infected with H. pylori will be more likely to develop CG, PU or GC. No correlation between vacA genotype and VacA expression was found in the present study.     

SDF‐1α stiffens myeloma bone marrow mesenchymal stromal cells through the activation of RhoA‐ROCK‐Myosin II

Multiple myeloma (MM) is a B lymphocyte malignancy that remains incurable despite extensive research efforts. This is due, in part, to frequent disease recurrences associated with the persistence of myeloma cancer stem cells (mCSCs). Bone marrow mesenchymal stromal cells (BMSCs) play critical roles in supporting mCSCs through genetic or biochemical alterations. Previously, we identified mechanical distinctions between BMSCs isolated from MM patients (mBMSCs) and those present in the BM of healthy individuals (nBMSCs). These properties of mBMSC contributed to their ability to preferentially support mCSCs. To further illustrate mechanisms underlying the differences between mBMSCs and nBMSCs, here we report that (i) mBMSCs express an abnormal, constitutively high level of phosphorylated Myosin II, which leads to stiffer membrane mechanics, (ii) mBMSCs are more sensitive to SDF‐1α‐induced activation of MYL2 through the G_(i./o)‐PI3K‐RhoA‐ROCK‐Myosin II signaling pathway, affecting Young's modulus in BMSCs and (iii) activated Myosin II confers increased cell contractile potential, leading to enhanced collagen matrix remodeling and promoting the cell–cell interaction between mCSCs and mBMSCs. Together, our findings suggest that interfering with SDF‐1α signaling may serve as a new therapeutic approach for eliminating mCSCs by disrupting their interaction with mBMSCs.     

青稞红曲的质量标准研究

目的：建立青稞红曲的质量标准。方法：采用显微、薄层色谱法建立定性鉴别;参考2010年版《中国药典》（一部）相关方法测定其水分、总灰分、酸不溶性灰分和浸出物的含量;采用高效液相色谱法测定酸式洛伐他汀和内酯型洛伐他汀的含量。结果：青稞红曲的显微、薄层色谱鉴别特征明显,专属性强;青稞红曲中水分6.04%-8.78%,总灰分2.15%-2.92%,酸不溶性灰分0.23%-0.29%,水浸出物27.99%-30.17%,醇浸出物14.12%-18.51%。青稞红曲中酸式洛伐他汀含有量在0.11%-0.29%范围内,内酯型洛伐他汀在0.02%-0.08%范围内。结论：本文建立的方法操作简单、准确可靠、重复性良好,可用于控制青稞红曲质量。     

miR-448在溃疡性结肠炎组织中的表达水平及意义

目的探讨miR-448在溃疡性结肠炎(UC)组织中的表达水平及意义。方法选取2015年7月至2017年7月宣城市人民医院收治的67例UC患者(UC组)作为研究对象,另选取同期在该院行结肠息肉切除术的60例受试者作为对照组。采用实时荧光定量PCR(real-time PCR)法检测miR-448的相对表达量,并分析其与UC疾病活动度及患者预后的关系。结果UC组的miR-448相对表达量高于对照组,差异有统计学意义(P<0.05)。缓解期组的miR-448相对表达量低于轻度组、中度组及重度组,轻度组低于中度组及重度组,中度组低于重度组,差异均有统计学意义(P均<0.05)。67例UC患者随访期间的预后不良发生率为41.79%。预后不良组的miR-448相对表达量高于预后良好组,差异有统计学意义(P<0.05)。miR-448评估UC患者预后的受试者工作特征曲线下面积(AUC)、敏感度和特异度分别为0.854、75.00%和92.31%。多因素Logistic回归分析结果显示,肛周病变、miR-448与UC患者的预后密切相关。结论miR-448与UC疾病活动度及预后关系密切,检测miR-448相对表达量有助于评估患者的预后情况。     

High expression of PYK2 is associated with poor prognosis and cancer progression in early-stage cervical carcinoma

Proline-rich tyrosine kinase-2 (PYK2), also known as calcium dependent tyrosine kinase, regulates different signal transduction cascades that control cell proliferation, migration, and invasion. However, the role of PYK2 in cervical cancer remains to be elucidated. The current study retrospectively included 134 patients with cervical cancer from December 2007 to September 2014. PYK2 expression was detected in tissue microarray and cervical cancer cell lines. Statistical analysis was performed to evaluate its clinicopathological significance. Small interfering RNA (siRNA) was employed to suppress endogenous PYK2 expression in cervical cancer cells to observe the biological function. PYK2 expression was up-regulated in cervical cancer specimens compared with paired adjacent normal cervical tissue samples. Statistical analyses indicated that PYK2 expression might be an independent prognostic indicator for patients with early-stage cervical cancer. A nomogram model was constructed based on PYK2 expression and other clinicopathological risk factors, and it performed well in predicting patients survival. In cellular studies, down-regulation of PYK2 remarkably inhibited cellular proliferation, migration and invasion. PYK2 expression possessed the potential to serve as a novel prognostic marker in cervical cancer patients.     

前置基础课程教学在临床病理科住院医师规范化培训中的实践研究

为探究前置基础课程教学在临床病理科住院医师规范化培训中的作用,本基地自主设计构建了以解剖学和组织胚胎学为主干的前置基础课程教学体系,开展各年级学员小讲座和导师系统授课2个层次的理论教学,以及取材教学及病例教学2个维度的实践操作培训,探索出以“讲教结合、实践操作、归纳总结、考核评估、回顾反馈”为核心的教学模式。通过探索与实践,取得了较好的教学效果。结果显示,试验组理论结业成绩为（458.80±17.60）,实践结业成绩为（415.40±19.30）,高于对照组的（444.50±20.90）和（398.80±23.70）,差异有统计学意义。对2019至2021级28名学员实施效果反馈调查显示,学员对该教学模式的满意度达96.43%。该教学模式的建立和应用为临床病理科住院医师规范化培训教学方法改革提供了新的思路。     

北京市三阶段新生儿听力筛查成本效果分析

目的 比较新生儿听力筛查两阶段和三阶段的成本效果, 为普遍性筛查提供依据。方法 对2010年10月至2012年12月北京市7家医院出生的正常新生儿进行听力筛查, 分别采用两阶段和三阶段策略及听力诊断性检查, 比较两种筛查的成本/效果比。其中筛查和诊断成本数据源自医院, 采用自行设计问卷对家长调查额外交通费和误工费。根据依从率进行敏感性分析。结果 新生儿初筛62 695人, 未通过5 809人, 阳性率为9.30%;复筛4 933人, 未通过972人, 阳性率为19.70%;复筛未通过并就诊于指定医疗机构者412人。完成诊断性评估360人, 听力异常者217例, 听力异常率为60.28%。完成三阶段筛查共276人, 未通过163人。其中125人完成诊断性检查, 异常112例(中度以上45例), 听力异常率为89.60%。以实际筛查率和诊断率计算成本/效果比, 两阶段(19 985元/例)优于三阶段(37 242元/例), 但随着筛查依从率的提高, 三阶段筛查的成本效果也随之提高。结论 筛查依从率影响三阶段筛查的成本效果, 在筛查依从率较高(>90%)的地区可考虑使用三阶段筛查方法。     

高效液相色谱法测定奥美拉唑血浆药物浓度

用反相高效液相色谱法测定人体血浆中奥美拉唑的浓度。采用国产填料（ＹＷＧ－Ｃ１８，１０ｕｍ）反相色谱柱，１．０％三乙胺甲醇：水（６０：４０，Ｖ：Ｖ）为流动相，心律平为内标。紫外检测波长为３０２ｎｍ。方法回收率分别为９８．０３％（５０ｎｇ／ｍｌ）、１０１．５５％（４００ｎｇ／ｍｌ）和１０３．１３％（１０００ｎｇ／ｍｌ），相应变异系数（ＣＶ）分别为２．９６％（ｎ＝３）、１．９２％（ｎ＝３）和１．０４％（ｎ＝３）。本方法最小检测量为３ｎｇ，最低检测血药浓度为１０ｎｇ／ｍｌ。至少在５０ｎｇ／ｍｌ至１０００ｎｇ／ｍｌ范围内呈良好线性关系。本方法专一性强、灵敏度高、准确、简便、快速。