巢式PCR法在早期梅毒诊断中的应用评价

目的：评价巢式PCR（nPCR）法在早期梅毒诊断中的临床应用价值,以提高早期梅毒诊断的灵敏度和特异性。方法：选择2010年10月至2011年11月来我院就诊,经临床综合分析为一期梅毒的患者195例和同期就诊的120例非梅毒患者为研究对象,采用nPCR法对棉拭子标本和血液标本中梅毒螺旋体特异性基因tpp47进行扩增检测,所有标本同时做暗视野镜检和Tp—ELISA血清学检测。结果：nPCR法共检测出阳性标本176例,其灵敏度和特异性分别为90．3％和100％,明显高于暗视野镜检和Tp-ELISA法,差异有统计学意义。结论：nPCR法在早期梅毒诊断中具有较高灵敏度和特异性,可以作为暗视野镜检和血清学检测的补充试验。     

贝那普利联合肾炎四味片对慢性肾小球肾炎患者临床疗效的影响及机制研究

目的:探讨贝那普利联合肾炎四味片对慢性肾小球肾炎患者临床疗效的影响及其作用机制。方法:收集我院收治的慢性肾小球肾炎患者120例,随机分为观察组和对照组,每组各60例。对照组给予肾炎四味片治疗;观察组在对照组的基础上给予贝那普利片。治疗结束后,比较两组患者白细胞诱素1(Lkn-1)、尿酸、TNF-α、收缩压、舒张压、24小时蛋白尿水平的变化及临床总有效率。结果:与治疗前相比,两组患者治疗后Lkn-1、尿酸、TNF-α、收缩压、24小时蛋白尿水平均显著降低(P0.05);与对照组比较,观察组患者Lkn-1、尿酸、TNF-α、收缩压、24小时蛋白尿水平较低(P0.05),临床总有效率较高(P0.05)。结论:贝那普利联合肾炎四味片可有效治疗慢性肾小球肾炎,推测其机制与降低Lkn-1、尿酸、TNF-α、收缩压、24小时蛋白尿水平有关。     

原发性及狼疮性肾病综合征患者血清PAI-1、Lp(a)水平变化及其临床价值探讨

目的:探讨原发性及狼疮性肾病综合征患者纤溶酶原激活物抑制因子1(PAI-1)和血清脂蛋白a[Lp(a)]的水平变化及其检测的临床应用价值。方法:选取病理类型明确,临床初诊为肾病综合征的患者138例。其中原发性肾病综合征70例,为PNS组;系统性红斑狼疮继发性肾病综合征患者68例,为LNS组。同期选取本院健康体检正常者64例,为正常对照NC组。全自动生化分析仪检测各组血清Lp(a)和血脂等指标;酶联免疫吸附(Elisa)法测定血清PAI-1水平。结果:1与NC组比较,血清Lp(a)和PAI-1水平在PNS和LNS两组中均显著升高(P0.05),PNS组比LNS组升高更为明显,差异有统计学意义(P0.05);2LP(a)与PAI-1秩相关系数(rs)分析,在PNS组中r_s=0.328,P=0.006,LNS组中r_s=0.439,P=0.006;3二元logistic回归分析表明,LP(a)和PAI-1均是PNS和LNS的危险因素;4ROC曲线分析表明,血清Lp(a)、PAI-1对PNS和LNS诊断的ROC曲线下面积(AUC~(ROC))分别为0.895、0.874和0.848、0.813,两者联合检测对PNS和LNS诊断的AUC~(ROC)分别为0.947和0.919。结论:血清Lp(a)与PAI-1水平在PNS和LNS患者体内均明显升高,PNS患者升高更为显著;Lp(a)与PAI-1水平在PNS和LNS患者中均显著正相关;LP(a)和PAI-1均是PNS和LNS的危险因素,两者水平的变化与PNS和LNS的发生相关。联合检测Lp(a)与PAI-1水平对PNS和LNS的诊治具有一定的临床应用价值。     

Parametric analysis of the biomechanical response of head subjected to the primary blast loading – a data mining approach

Traumatic brain injury due to primary blast loading has become a signature injury in recent military conflicts and terrorist activities. Extensive experimental and computational investigations have been conducted to study the interrelationships between intracranial pressure response and intrinsic or ‘input’ parameters such as the head geometry and loading conditions. However, these relationships are very complicated and are usually implicit and ‘hidden’ in a large amount of simulation/test data. In this study, a data mining method is proposed to explore such underlying information from the numerical simulation results. The heads of different species are described as a highly simplified two-part (skull and brain) finite element model with varying geometric parameters. The parameters considered include peak incident pressure, skull thickness, brain radius and snout length. Their interrelationship and coupling effect are discovered by developing a decision tree based on the large simulation data-set. The results show that the proposed data-driven method is superior to the conventional linear regression method and is comparable to the nonlinear regression method. Considering its capability of exploring implicit information and the relatively simple relationships between response and input variables, the data mining method is considered to be a good tool for an in-depth understanding of the mechanisms of blast-induced brain injury. As a general method, this approach can also be applied to other nonlinear complex biomechanical systems.     

正肝化症方联合隔姜灸对原发性肝癌行经肝动脉化疗栓塞术患者肝功能和免疫功能的影响

目的:探讨正肝化症方联合隔姜灸对原发性肝癌(PHC)行经肝动脉化疗栓塞术(TACE)患者肝功能和免疫功能的影响。方法:选取2015年2月～2018年11月期间广东省第二人民医院收治的PHC患者121例,根据数表法将患者随机分为对照组(n=60)和研究组(n=61),其中对照组予以TACE治疗,研究组在对照组基础上予以正肝化症方联合隔姜灸治疗,比较两组患者临床疗效、生活质量及肝功能、免疫功能指标水平,记录两组治疗期间不良反应发生情况。结果:研究组治疗后临床总有效率为75.41%(46/61),高于对照组患者的56.67%(34/60)(P0.05)。两组患者治疗后谷氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)均较治疗前降低,且研究组低于对照组(P0.05)。两组患者治疗后CD4~+、CD4~+/CD8~+均较治疗前升高,且研究组高于对照组(P0.05);CD8~+较治疗前降低,且研究组低于对照组(P0.05)。两组患者治疗后健康调查简表(SF-36)评分较治疗前升高,且研究组高于对照组(P0.05)。研究组不良反应总发生率低于对照组(P0.05)。结论:正肝化症方联合隔姜灸辅助TACE治疗PHC患者,疗效确切,可有效改善患者肝功能以及免疫功能,提高患者生活质量,减少不良反应发生率。     

Comparative study on different therapies on patients with primary central nervous system lymphoma

Objective

To compare and analyze three therapies on patients with primary central nervous system lymphoma (PCNSL), aiming to provide evidences for future treatment and prognosis.

Association between hypertension and cutaneous melanoma,and the effect of aspirin: extended follow-up of a large randomised controlled trial

BackgroundThe association between hypertension and melanoma is unclear, and previous analyses of data from the ASPirin in Reducing Events in the Elderly (ASPREE) study demonstrated a reduced number of invasive melanoma events amongst aspirin-exposed hypertensive individuals.MethodsData from the ASPREE study which included (1) the intervention period with a median follow-up of 4.7 years, and (2) the observational period with an additional 2 years follow-up, were combined for this analysis. Logistic regression analyses examined the association between baseline hypertension and treatment status and past melanoma history. Survival analyses examined the association between hypertension and melanoma risk, and the effect of aspirin across hypertension groups. Cox proportional hazards models were used to compare incidence across groups.Results19,114 participants (median age of 74 years) were randomised to daily 100 mg aspirin or placebo. At baseline, hypertension and past melanoma history were recorded in 14,195 and 685 individuals, respectively. After adjustment for confounders, hypertension was significantly associated with past melanoma history (OR=1.34, 95%CI: 1.11–1.62). In a prospective analysis, baseline hypertension was not associated with melanoma risk. However, aspirin was associated with a reduced risk of incident melanoma amongst individuals with uncontrolled hypertension (blood pressure ≥140/90 mmHg; HR=0.63, 95%CI 0.44–0.89), but not in those with controlled hypertension (HR=1.04, 95%CI 0.74–1.46).ConclusionOur results support a reduced melanoma incidence amongst individuals with uncontrolled hypertension exposed to aspirin. Additional studies are required to confirm these findings.     

Development of the post-natal growth plate requires intraflagellar transport proteins

In the post-natal growth plate, chondrocytes are arranged in columns parallel to the long axis of the bone. Chondrocytes divide perpendicular to this axis and then move into position one on top of another in a process called "rotation" that maintains columnar organization. Primary cilia are non-motile microtubule base appendages extending from the surface of almost all vertebrate cells. Primary cilia were described on chondrocytes almost 40 years ago but the function of these structures in cartilage biology is not known. Intraflagellar transport (IFT) is the process by which primary cilia are generated and maintained. This study tested the hypothesis that IFT plays an important role in post-natal skeletal development. Kif3a, a subunit of the Kinesin II motor complex, that is required for intraflagellar transport and the formation of cilia, was deleted in mouse chondrocytes via Col2a-Cre-mediated recombination. Disruption of IFT resulted in subsequent depletion of cilia and post-natal dwarfism due to premature loss of the growth plate likely a result of reduced proliferation and accelerated hypertrophic differentiation of chondrocytes. Cell shape and columnar orientation in the growth plate were also disrupted suggesting a defect in the process of rotation. Alterations in chondrocyte rotation were accompanied by disruption of the actin cytoskeleton and alterations in the localization of activated FAK to focal adhesion-like structures on chondrocytes. This is the first report indicating a role for IFT and primary cilia in the development of the post-natal growth plate. The results suggest a model in which IFT/cilia act to maintain the columnar organization of the growth plate via the process of chondrocyte rotation.     

A switch in the cellular basis of skeletogenesis in late-stage sea urchin larvae

Primary mesenchyme cells (PMCs) are solely responsible for the skeletogenesis during early larval development of the sea urchin, but the cells responsible for late larval and adult skeletal formation are not clear. To investigate the origin of larval and adult skeletogenic cells, I first performed transplantation experiments in Pseudocentrotus depressus and Hemicentrotus pulcherrimus, which have different skeletal phenotypes. When P. depressus PMCs were transplanted into H. pulcherrimus embryos, the donor phenotype was observed only in the early larval stage, whereas when secondary mesenchyme cells (SMCs) were transplanted, the donor phenotype was observed in late and metamorphic larvae. Second, a reporter construct driven by the spicule matrix protein 50 (SM50) promoter was introduced into fertilized eggs and their PMCs/SMCs were transplanted. In the resultant 6-armed pluteus, green fluorescent protein (GFP) expression was observed in both PMC and SMC transplantations, suggesting SMC participation in late skeletogenesis. Third, transplanted PMCs or SMCs tagged with GFP were analyzed by PCR in the transgenic chimeras. As a result, SMCs were detected in both larval and adult stages, but GFP from PMCs was undetectable after metamorphosis. Thus, it appears that SMCs participate in skeletogenesis in late development and that PMCs disappear in the adult sea urchin, suggesting that the skeletogenesis may pass from PMCs to SMCs during the late larval stage.