非小细胞肺癌术后并发乳糜胸对患者生活质量影响的研究

目的:探讨非小细胞肺癌术后并发乳糜胸对患者生活质量的影响。方法:采用生活质量测定量表(QLQ-C30)回顾性分析第四军医大学唐都医院胸外科自2013年至2016年中收治的1015例肺癌手术患者的生活质量,发生乳糜胸组记为A组,未发生乳糜胸组记为B组。对比术前和术后1、3、6和12个月的生活质量有无统计学差异。结果:(1)术后1月时,除了社会功能、便秘、腹泻以外,两组生活质量指标评分均显著低于术前,且B组均显著低于A组,有统计学差异(表3,P0.05)。在手术后3月及以后逐渐恢复,至12月时,各组指标与术前基本相同(表3,P0.05);(2)两组术后生活质量相比较,术后1、3月,除社会功能、便秘、腹泻以外,其余生活质量功能指标B组均显著优于A组,有统计学差异(表3,P0.05)。在手术后6月及以后,B组所有指标与A组无统计学差异(表3,P0.05)。结论:肺癌根治术后发生乳糜胸患者生活质量显著低于未发生乳糜胸患者,因此应合理选择手术方式,注意术中操作,降低乳糜胸发生率,提高肺癌患者术后的生活质量。     

Evaluating the role of livelihood assets in suitable livelihood strategies: Protocol for anti-poverty policy in the Eastern Tibetan Plateau,China

Although numerous studies have been conducted on the relationship between livelihood assets and strategies, only a few quantitative studies exist on the topic for anti-poverty policies with regard to the Tibetan Plateau. This study investigated 357 households in the upper reaches of the Dadu River watershed in the Eastern Tibetan Plateau, China, using the participatory rural appraisal method. Then, applying a multinomial logistic regression model, we quantitatively analyzed the relationship between livelihood assets and livelihood strategies, the findings of which have implications for local agricultural policy interventions. The preliminary results indicate that of the four classifications of livelihood strategies used in this study, the main livelihood strategy is that of the non-farming-dependent household type (i.e., Type III in our study) that combines agricultural and non-farm activities or practices self-employment for wages. There are significant differences in the livelihood assets owned by households with different livelihood strategies. Human, natural, and financial assets have significant influences on livelihood strategies, and the choice of livelihood strategy varies by livelihood assets. Further, with improvements in household labor capacity and cash income per capita, the livelihood strategies of non-agricultural and non-farming households may shift away from agriculture, while an increase in farmland cultivated per capita, cash income per capita, and household labor capacity may encourage households to adopt agriculture-dependent livelihood strategies. These findings contribute to research on livelihood and related development strategies and anti-poverty policies in not only the Eastern Tibetan Plateau but also other regions with similar livelihood strategies.     

The evolution of intermediate castration virulence and ant coexistence in a spatially structured environment

Theory suggests that spatial structuring should select for intermediate levels of virulence in parasites, but empirical tests are rare and have never been conducted with castration (sterilizing) parasites. To test this theory in a natural landscape, we construct a spatially explicit model of the symbiosis between the ant-plant Cordia nodosa and its two, protecting ant symbionts, Allomerus and Azteca . Allomerus is also a castration parasite, preventing fruiting to increase colony fecundity. Limiting the dispersal of Allomerus and host plant selects for intermediate castration virulence. Increasing the frequency of the mutualist, Azteca , selects for higher castration virulence in Allomerus , because seeds from Azteca -inhabited plants are a public good that Allomerus exploits. These results are consistent with field observations and, to our knowledge, provide the first empirical evidence supporting the hypothesis that spatial structure can reduce castration virulence and the first such evidence in a natural landscape for either mortality or castration virulence.     

Identification of cardiac stem cells within mature cardiac myocytes

Cardiac stem cells are described in a number of mammalian species including humans. Cardiac stem cell clusters consisting of both lineage-negative and partially committed cells are generally identified between contracting cardiac myocytes. In the present study, c-kit⁺, Sca⁺, and Isl1⁺ stem cells were revealed to be located inside the sarcoplasm of cardiac myocytes in myocardial cell cultures derived from newborn, 20-, and 40-day-old rats. Intracellularly localized cardiac stem cells had a coating or capsule with a few pores that opened into the host cell sarcoplasm. The similar structures were also identified in the suspension of freshly isolated myocardial cells (ex vivo) of 20- and 40-day-old rats. The results from this study provide direct evidence for the replicative division of encapsulated stem cells, followed by their partial cardiomyogenic differentiation. The latter is substantiated by the release of multiple transient amplifying cells following the capsule rupture. In conclusion, functional cardiac stem cells can reside not only exterior to but also within cardiomyocytes.     

Dynamic Lung Tumor Tracking for Stereotactic Ablative Body Radiation Therapy

Physicians considering stereotactic ablative body radiation therapy (SBRT) for the treatment of extracranial cancer targets must be aware of the sizeable risks for normal tissue injury and the hazards of physical tumor miss. A first-of-its-kind SBRT platform achieves high-precision ablative radiation treatment through a combination of versatile real-time imaging solutions and sophisticated tumor tracking capabilities. It uses dual-diagnostic kV x-ray units for stereoscopic open-loop feedback of cancer target intrafraction movement occurring as a consequence of respiratory motions and heartbeat. Image-guided feedback drives a gimbaled radiation accelerator (maximum 15 x 15 cm field size) capable of real-time ±4 cm pan-and-tilt action. Robot-driven ±60° pivots of an integrated ±185° rotational gantry allow for coplanar and non-coplanar accelerator beam set-up angles, ultimately permitting unique treatment degrees of freedom. State-of-the-art software aids real-time six dimensional positioning, ensuring irradiation of cancer targets with sub-millimeter accuracy (0.4 mm at isocenter). Use of these features enables treating physicians to steer radiation dose to cancer tumor targets while simultaneously reducing radiation dose to normal tissues. By adding respiration correlated computed tomography (CT) and 2-[¹⁸F] fluoro-2-deoxy-ᴅ-glucose (¹⁸F-FDG) positron emission tomography (PET) images into the planning system for enhanced tumor target contouring, the likelihood of physical tumor miss becomes substantially less¹. In this article, we describe new radiation plans for the treatment of moving lung tumors.     

一种新型免疫层析技术在临床乳腺癌Her-2蛋白定量检测中的应用

建立一种靶点蛋白质快速定量检测方法。在原有侧向流动免疫层析技术的基础上,通过优化层析材料和纳米微球的均一性、改进检测区的检测方法,经逐点扫描技术,建立标准浓度曲线,以达到对临床靶点蛋白质的定量检测。以乳腺癌组织中的Her2表达为例,通过对已知浓度样品的检测,验证本技术方法的准确度大于96%。另外,以蛋白质免疫印迹作为组织中特定蛋白质检测金标准,分析临床肿瘤组织中Her2蛋白的含量,其准确率也达到95.5%,而免疫组织化学方法检测准确率仅为69.58%。新型免疫层析法检测结果与靶向治疗患者的愈后密切相关(P<0.01)。改进后的新型免疫层析方法能够准确地对临床靶点蛋白质进行定量检测,而且结合侧向流动技术的简单、快速和易用性,这种新型检测方法可以广泛应用于临床组织标本、血液标本和体液标本中靶点蛋白质的临场定量检测,在一定程度上可以替代免疫组化技术。     

On Connectedness of a Two-way Elimination of Heterogeneity Design

For some subclass of a two-way elimination of heterogeneity design, necessary and sufficient conditions are established for row-connectedness and column-connectedness of a design to imply its connectedness.     

Central Place Foraging in Nonpatchy Habitats

This paper deal with a model of optimal foraging in a habitat with arbitrary food distribution. It takes into account an arbitrary risk cost related to the distance to the animal's nest. Food acquisition and risk cost are accounted for in common units of fitness. The resulting problem is solved in the context of Calculus of Variations. The optimal duration of absence from the nest and the optimal spatial allocation of foraging time are obtained: the optimal strategy leads to separate the habitat into a region to exploit and a region to ignore. The definition of these two distinct regions depends on the relative importance of risk and food availability. With realistic risk costs, the resulting strategy indicates a highly selective behaviour when far from the nest, as observed in field studies. The model is also extended to take account of the need of returning to the nest to guard it or to feed the young.