儿童肺炎肺实变住院患儿支气管肺泡灌洗液病原分析

本研究分析肺炎肺实变患儿支气管肺泡灌洗液病原谱构成,旨在为临床经验性抗感染治疗提供指导。收集2019年1月-2020年1月复旦大学附属儿科医院纤维支气管镜室诊治的住院肺炎病例临床资料,其中肺实变的诊断基于影像学证据,依托国家儿童医学中心病原学检测平台,并参考感染传染科医生解读,本研究对肺炎伴肺实变患儿支气管肺泡灌洗液标本的病原学检测结果进行回顾性分析。结果显示,286例肺炎患儿的286份支气管肺泡灌洗液标本被纳入研究,平均年龄5.5(5.8±3.1)岁,其中195例(68.2%)存在肺炎伴肺实变。总病原体检出率为76.6%(219/286),肺实变和无肺实变肺炎患儿病原体检出率分别为77.9%(152/195)和73.6%(67/91),差异无统计学意义;检出的前5种病原体均为肺炎支原体、腺病毒、鼻病毒、呼吸道合胞病毒和副流感病毒3型。5周岁及以上患儿肺炎支原体检出率达最高77.0%(127/165),肺实变病例和无肺实变病例肺炎支原体检出率分别为67.2%(131/195)和61.5%(56/91),差异无统计学意义。本研究结果提示,肺炎支原体、腺病毒、鼻病毒、呼吸道合胞病毒和副流感病毒3型是导致本研究目标人群患病的主要病原体;病原体检出率高低与是否肺实变无关。     

MA诱导方案与DA诱导方案对老年急性髓系白血病患者血清炎症因子及复发率的影响

目的:探讨米托蒽醌联合阿糖胞苷(MA方案)与柔红霉素联合阿糖胞苷(DA方案)对老年急性髓系白血病(AML)患者血清炎症因子及复发率的影响。方法:选取2015年1月~2018年1月期间深圳市人民医院收治的老年AML患者129例,根据治疗方案的不同将患者分为DA组(n=64,DA方案治疗)和MA组(n=65,MA方案治疗),比较两组患者疗效、炎症因子、不良反应及复发情况。结果:MA组治疗后的临床总有效率高于DA组(P<0.05)。两组患者治疗后血清干扰素γ诱导蛋白-10(IP-10)、巨噬细胞炎症蛋白-1α(MIP-1α)及可溶性细胞间黏附分子1(sICAM-1)水平均降低,且MA组低于DA组(P<0.05)。MA组完全缓解患者中累计复发率低于DA组(P<0.05)。两组不良反应发生率比较无差异(P>0.05)。结论:与DA诱导方案相比,MA诱导方案治疗老年AML患者,可有效改善炎症因子水平,减少复发,且用药安全性较好。     

Effects of Different Ambient Temperatures on Caecal Microbial Composition in Broilers

Short-term or acute temperature stress affect the immune responses and alters the gut microbiota of broilers, but the influences of long-term temperature stress on stress biomarkers and the intestinal microbiota remains largely unknown. Therefore, we examined the effect of three long-term ambient temperatures (high (HC), medium (MC), and low (LC) temperature groups) on the gene expression of broilers’ heat shock proteins (Hsps) and inflammation – related genes, as well as the caecal microbial composition. The results revealed that Hsp70 and Hsp90 levels in HC group significantly increased, and levels of Hsp70, Hsp90, IL-6, TNF-α, and NFKB1 in LC group were significantly higher than in MC group (p < 0.05). In comparison with the MC group, the proportion of Firmicutes increased in HC and LC groups, while that of Bacteroidetes decreased in LC group at phylum level (p < 0.05). At genus level, the proportion of Escherichia/Shigella, Phascolarctobacterium, Parabacteroides,and Enterococcus increased in HC group; the fraction of Faecalibacterium was higher in LC group; and the percentage of Barnesiella and Alistipes decreased in both HC and LC groups (p < 0.05). Functional analysis based on communities’ phylogenetic investigation revealed that the pathways involved in environmental information processing and metabolism were enriched in the HC group. Those involved in cellular processes and signaling, metabolism, and gene regulation were enriched in LC group. Hence, we conclude that the long-term temperature stress can greatly alter the intestinal microbial communities in broilers and may further affect the host’s immunity and health.     

超声引导下硬膜外阻滞在老年髋关节置换手术中的应用

目的:探讨超声引导下硬膜外阻滞在老年髋关节置换手术中的应用方法与效果。方法:2017年6月至2020年5月选择在本院进行髋关节置换手术的老年患者112例,根据随机数字表法把患者分为研究组与对照组,各56例。研究组给予超声引导下硬膜外阻滞,对照组给予传统的静脉持续镇痛。两组都给予全麻诱导与维持,记录镇痛效果与患者术后康复情况。结果:两组的性别、年龄、麻醉时间、手术时间与术中出血量等对比差异无统计学意义(P>0.05),研究组的术后住院时间显著短于对照组(P<0.05)。两组术后1 d、3 d、7 d的疼痛视觉模拟评分法(Visual Analogue Scale/Score,VAS)评分都低于术前1 d,观察组也都显著低于对照组,对比差异都有统计学意义(P<0.05)。研究组术后1 d、3 d、7 d的髋关节活动度都显著高于对照组(P<0.05)。研究组术后1 d、3 d、7 d的血清P物质(Substance P,SP)、前列腺素E2(Prostaglandin E2,PGE2)含量都高于术前1 d,观察组低于对照组,对比差异都有统计学意义(P<0.05)。结论:超声引导下硬膜外阻滞在老年髋关节置换手术中的应用能抑制血清SP、PGE2的释放,能缓解患者术后疼痛,促进髋关节功能的恢复,缩短患者的康复时间。     

肝脏类器官的研究及应用进展

肝脏疾病易感性差异大且个体间的肝脏细胞存在明显的异质性,因此开发体外能够长期存活并具有代谢功能的人体类肝组织细胞模型,对治疗终末期肝病、开展肝脏致病机理研究及药物筛选具有重要意义。过去十年中,体外三维类器官模型发展迅猛,为疾病模拟、精准化治疗领域的研究提供了新的工具,显示出巨大潜力。肝脏类器官具有患者的基因表达与突变特征,在体外能够较长时间地保持肝脏细胞功能,已被应用于疾病模拟及药物有效性研究,并具有进行原位或异位移植发挥治疗作用的应用潜能。就干细胞、肝脏原代细胞等不同来源的肝脏类器官的发展及近年的研究进展作了综述,以期为肝脏类器官在疾病建模、药物发现和器官移植领域的研究和应用提供新的思路。     

蛋白质晶体的物理性质及其鉴别方法研究进展

蛋白质晶体由蛋白质分子有序排列的框架组成,其内部富含溶剂（水）分子,外观形貌多种多样,其物理性质与常规固态晶体相比有很大不同。我们针对蛋白质晶体的一些物理性质（包括低密度、机械性能、声学、热学、光学等性质）,进行了研究进展评述,并根据蛋白质晶体的特殊物理性质,评述了人们发展出的从蛋白质结晶液中区分蛋白质晶体的方法。     

Oncogenic Fibulin-5 Promotes Nasopharyngeal Carcinoma Cell Metastasis through the FLJ10540/AKT Pathway and Correlates with Poor Prognosis

Background

Nasopharyngeal carcinoma (NPC) is known for its high metastatic potential and locoregional recurrence, although the molecular alterations that are driving NPC metastasis remain unclear at this time. This study aimed to examine the expression of fibulin-5 in NPC, correlate the results with clinicopathological variables and survival, and to investigate the role of fibulin-5 in human NPC cell lines.

Material and Methods

Standard semi-quantitative-RT-PCR, quantitative-RT-PCR, immunoblotting, and immunohistochemistry were used to investigate the mRNA and protein expression profiles of fibulin-5 in normal and NPC tissues. Immunohistochemistry of fibulin-5 was correlated with clinicopathological characteristics by univariate analyses. NPC cells overexpressing fibulin-5 or fibulin-5-siRNA cells were generated by stable transfection to characterize the molecular mechanisms of fibulin-5-elicited cell growth and metastasis.

Results

Our results demonstrated that fibulin-5 overexpression in NPC specimens and significantly correlated with advanced tumor metastasis indicating a poor 5-year overall survival. Fibulin-5 was mainly expressed in the nucleus in human NPC specimens and cell lines. Functionally, fibulin-5 overexpression yielded fast growth in NPC cells. In addition, fibulin-5 promotes cell metastasis in NPC cells through increased FLJ10540 and phosphor-AKT activity. In contrast, siRNA depletion of fibulin-5 suppressed FLJ10540 expression and phosphor-AKT activity. Suppression of either fibulin-5 or FLJ10540 can cause significant inhibition with regards to cell motility in NPC cells. Finally, immunohistochemical analysis of human aggressive NPC specimens showed a significant and positive correlation between fibulin-5 and FLJ10540 expression.

Conclusion

Higher fibulin-5 expression is not only an important indicator of poor survival, but also contributes to the development of new therapeutic strategies in the FLJ10540/AKT pathway for NPC treatment.     

糖尿病肾病与非糖尿病肾病维持性血液透析患者血钙、血磷及甲状旁腺激素水平的分析

目的：探讨糖尿病肾病（diabtic nephropgthy,DN）与非糖尿病肾病（non-DN）维持性血液透析患者（maintenance hemodialysis,MHD）血钙、血磷、甲状旁腺激素（intact parathyroid hormone,iPTH）水平的差异;分析其血钙、血磷、iPTH和糖化血红蛋白（glycosylated hemoglobin,HbA1c）水平的相关性。方法：选择沈阳军区总医院血液透析中心收治的148例MHD患者,分为糖尿病组（58例）和非糖尿病组（90例）,比较两组间血钙、血磷、甲状旁腺激素水平的差异,并分析其血钙、血磷、iPTH、HbA1c水平的相关性。结果：糖尿病组iPTH、血磷水平均明显低于非糖尿病组（P〈0.05）,两组血钙水平比较无明显差异。在非DN组中,iPTH与血钙水平呈显著负相关（r=-0.320,P=0.036）,iPTH与血磷水平呈明显正相关（r=0.426,P=0.005）。在DN组中,iPTH与血钙、血磷无显著相关性,而iPTH与HbA1C水平呈显著负相关（r=-0.732,P=0.007）。结论：糖尿病肾病血液透析患者的iPTH水平和血磷水平明显低于非糖尿病肾病血液透析患者,HbA1c可能抑制iPTH的分泌。     

一条新的柱层析纯化路径对HBsAg免疫原性的影响

摘要目的：建立一条新的毕赤酵母表达乙肝表面抗原（HepatitisBantigen,HBsAg）柱层析纯化方法,保持HBsAg结构完整性和提高免疫原性。方法：毕赤酵母发酵料液经过菌体破碎、聚乙二醇沉淀、疏水层析、超滤和凝胶分子筛精纯,收集HBsAg合格样品液适当稀释后加入铝佐荆吸附,制成乙肝疫苗半成品免疫BALB／c小鼠。结果：纯化产物经SDS-PAGE银染鉴定得单一条带,分子量在23kD左右,凝胶成像软件分析纯度超过95％;该纯化方法得到的HBsAg颗粒电镜观察得平均直径为22nm病毒样颗粒,结构较均一完整;自制疫苗免疫小鼠后,其血清抗体水平高于葛兰素史克生产的Engerix—B（安在时）,存在显著性差异（P〈0．05）。结论：通过该方法纯化的HBsAg结构完整性良好,疫苗免疫效果优于酵母表达的Engerix—B,纯化路径简单高效,易于放大用于工业化生产。     

SIRT1在宫颈癌细胞耐药中的作用及其机制研究

摘要目的：探讨沉默交配型信息调节因子2同源蛋白1（silentmatingtypeinformationregulation2homologyl,SIRTl）在宫颈癌化疗耐药中的作用及其机制。方法：体外培养人宫颈癌Hela细胞系和宫颈癌Hela／MMC耐药细胞亚系,westernblotting检测MMC对Hela和Hela／MMC细胞内SIRTl蛋白表达的影响;MTT法检测MMC及Nicotinamide对Hela和Hela／MMC细胞增殖的影响;AnnexinV-PI试验检测Hela／MMC细胞凋亡的亡的情况;RT—PCR方法检测耐药相关蛋白P—gP的mRNA表达情况。结果：正常情况下,Hela／MMC细胞中SIRTl的表达显著高于Hela细胞（P〈0．05）,MMC处理的Hela／MMC细胞中SIRTl的表达显著高于未经MMC处理（P〈0．05）。Nicotinamide对Hela和Hela／MMC细胞具有相似的生长抑制作用,Nicotinamide可使MMC诱导的Hela／MMC细胞凋亡增加,同时降低细胞内P-gP的mRNA表达（P〈0．05）。结论：SIRTl表达下调能显著减轻Hela／MMC细胞对MMC的耐药性,其作用可能与P—gp有关。