医护人员对抗肿瘤药物的职业暴露及防护措施

配置和输入化疗药物是护士的主要工作之一,故对护理人员的健康造成了很大的威胁。职业防护已成我们近年来高度关注的话题。虽很多医院现已改为中心配液,但在工作中仍有很多临时化疗医嘱需要临床护士,接触抗肿瘤药物可能导致个人健康风险。本文综述了抗肿瘤治疗过程中常见的职业暴露途径,并提出了针对性的防护措施,以期为医护人员提供安全保障信息。     

响应面法优化木薯淀粉发酵生产单细胞油脂工艺

采用响应面分析法对发酵性丝孢酵母菌株以木薯淀粉水解液为原料合成微生物油脂的培养条件进行优化。首先利用Plackett-Burman试验设计确定影响油脂产量的主要因素,在此基础上再利用Box-Behnken试验设计及响应面分析法对其进行条件优化。结果表明,发酵温度、C/N、pH对油脂产量具有显著影响,产油脂的最佳发酵条件为:发酵温度28.78°C、C/N 126.18、pH 6.69,油脂产量达到14.88g/L,比优化前提高了28.6%。同时,气相色谱分析表明,微生物油脂脂肪酸组成成分主要包括棕榈酸、硬脂酸、油酸、亚油酸酯等,是优良的生物柴油制备原料。     

Study of Regulatory T-Cells in Patients with Gastric Malt Lymphoma: Influence on Treatment Response and Outcome

Purpose

FOXP3+ regulatory T cells (Treg) play an essential role in modulating host responses to tumors and infections. The role of these cells in the pathogenesis of MALT lymphomas remains unknown. The aims of the study were to quantify the number of infiltrating FOXP3+ and CD3+ cells in patients with gastric MALT lymphoma at diagnosis and to study kinetics of these cells and CD20+ tumor cells after treatment and during long-term follow-up.

Methods

FOXP3+, CD3+ and CD20+ cells were analyzed by immunohistochemistry and the number of cells was quantified using a micrometric ocular. Samples of 35 patients with gastric MALT lymphoma at diagnosis and after treatment were included. Diagnostic samples were compared to 19 cases of chronic gastritis and diffuse large B-cell lymphoma (DLBCL) of the stomach.

Results

The median number of FOXP3+ infiltrating cells was higher (27 cells/cm²) in gastric MALT patients than in DLBCL (10 cells; p = 0.162) but similar to chronic gastritis (20 cells; p = 0.605). No characteristic or specific distribution pattern of infiltrating FOXP3+ cells was found. Gastric MALT lymphoma patients responding to bacterial eradication therapy had higher number of FOXP3+ cells at study entry. Kinetics of both infiltrating FOXP3+ cells and tumor CD20+ cells were strongly dependent on the treatment administered.

Discussion

Gastric MALT lymphomas have a number of Treg cells more similar to chronic gastritis than to DLBCL. Patients with higher number of tumor infiltrating FOXP3+ cells at study entry seem to have better response to antibiotics. Kinetics of Treg and tumor cells are influenced by type of treatment.     

Stochastic amplification of fluctuations in cortical up-States

Cortical neurons are bistable; as a consequence their local field potentials can fluctuate between quiescent and active states, generating slow [Formula: see text] Hz oscillations which are widely known as transitions between Up and Down States. Despite a large number of studies on Up-Down transitions, deciphering its nature, mechanisms and function are still today challenging tasks. In this paper we focus on recent experimental evidence, showing that a class of spontaneous oscillations can emerge within the Up states. In particular, a non-trivial peak around [Formula: see text] Hz appears in their associated power-spectra, what produces an enhancement of the activity power for higher frequencies (in the [Formula: see text] Hz band). Moreover, this rhythm within Ups seems to be an emergent or collective phenomenon given that individual neurons do not lock to it as they remain mostly unsynchronized. Remarkably, similar oscillations (and the concomitant peak in the spectrum) do not appear in the Down states. Here we shed light on these findings by using different computational models for the dynamics of cortical networks in presence of different levels of physiological complexity. Our conclusion, supported by both theory and simulations, is that the collective phenomenon of "stochastic amplification of fluctuations" - previously described in other contexts such as Ecology and Epidemiology - explains in an elegant and parsimonious manner, beyond model-dependent details, this extra-rhythm emerging only in the Up states but not in the Downs.     

重庆市中药研究院实验兔球虫感染种类调查

2009年6月对重庆市中药研究院实验兔场的实验兔球虫感染种类进行了调查.采用兔粪分离沉淀孵化法获得充分孢子化的卵囊,通过对卵囊形态鉴定,发现该兔场的家兔感染球虫达13种之多,以斯氏艾美尔球虫(占23％)、盲肠艾美尔球虫(占15.33％)、大型艾美尔球虫(占12.67％)和长形艾美尔球虫(占12％)4种为主,长艾美尔球虫和那格浦耳艾美尔球虫在重庆地区首次被检出.提示很有必要深入调查重庆地区的兔球虫种类和感染强度,积极探索适合重庆特点的兔球虫病防制措施和方法.     

The Obestatin/GPR39 System Is Up-regulated by Muscle Injury and Functions as an Autocrine Regenerative System

The maintenance and repair of skeletal muscle are attributable to an elaborate interaction between extrinsic and intrinsic regulatory signals that regulate the myogenic process. In the present work, we showed that obestatin, a 23-amino acid peptide encoded by the ghrelin gene, and the GPR39 receptor are expressed in rat skeletal muscle and are up-regulated upon experimental injury. To define their roles in muscle regeneration, L6E9 cells were used to perform in vitro assays. For the in vivo assays, skeletal muscle tissue was obtained from male rats and maintained under continuous subcutaneous infusion of obestatin. In differentiating L6E9 cells, preproghrelin expression and correspondingly obestatin increased during myogenesis being sustained throughout terminal differentiation. Autocrine action was demonstrated by neutralization of the endogenous obestatin secreted by differentiating L6E9 cells using a specific anti-obestatin antibody. Knockdown experiments by preproghrelin siRNA confirmed the contribution of obestatin to the myogenic program. Furthermore, GPR39 siRNA reduced obestatin action and myogenic differentiation. Exogenous obestatin stimulation was also shown to regulate myoblast migration and proliferation. Furthermore, the addition of obestatin to the differentiation medium increased myogenic differentiation of L6E9 cells. The relevance of the actions of obestatin was confirmed in vivo by the up-regulation of Pax-7, MyoD, Myf5, Myf6, myogenin, and myosin heavy chain (MHC) in obestatin-infused rats when compared with saline-infused rats. These data elucidate a novel mechanism whereby the obestatin/GPR39 system is coordinately regulated as part of the myogenic program and operates as an autocrine signal regulating skeletal myogenesis.     

容积弧形调强放疗同步化疗治疗晚期非小细胞肺癌患者的短期疗效及对血清TSGF、TK1、CA125水平的影响

目的:探讨容积弧形调强放疗同步化疗治疗晚期非小细胞肺癌患者的短期疗效及对血清肿瘤特异性生长因子(TSGF)、胸苷激酶1(TK1)、糖类抗原125(CA125)水平的影响。方法:选择2015年1月至2018年1月我院接诊的95例晚期非小细胞肺癌患者,按照随机数表法分为观察组48例和对照组47例。观察组使用容积弧形调强放疗,对照组使用三维适行放疗,临床靶区(CTV)剂量均为2.0Gy/次,总剂量50Gy,1次/d,5次/周,两组均使用长春瑞滨+顺铂同步化疗。比较两组的临床疗效、治疗前后血清TSGF、TK1、CA125水平的变化及不良反应的发生情况。结果:治疗后,观察组疾病总缓解率为43.75%,明显高于对照组(23.4%,P0.05),血清TSGF、TK1、CA125均明显低于对照组(P0.05)。两组治疗期间胃肠道反应、血液毒性、心脏毒性、骨髓抑制、肝功能损伤、放射性肺炎、放射性食管炎不良反应发生率比较差异均无统计学意义(P0.05)。结论:容积弧形调强放疗同步化疗治疗晚期非小细胞肺癌患者的短期效果显著优于三维适行放疗,其可更有效降低血清TSGF、TK1、CA125的表达水平,且安全性更高。     

密闭生态系统中大黑甲生长发育及虫沙营养成分的初步研究

密闭受控生态系统中,大黑甲(俗称大麦虫)不仅可以作为乘员日常饮食中动物蛋白的重要来源之一,且对作物秸秆、餐厨垃圾等物质转化起到重要作用,其虫沙可配制新型有机肥料。本试验在密闭受控生态系统中,通过测定大黑甲日增数量、质量及大黑甲各生长阶段呼吸代谢量,研究密闭生态环境对大黑甲的生长发育及其虫沙营养成分价值的影响。试验表明,大黑甲在受控密闭生态系统中生长良好,生长速率为0.79%,大黑甲幼虫时期CO_2产生速率为0.0439 g/g虫/d,O_2消耗速率为0.027 g/g虫/d,大黑甲成年期CO_2产生速率为0.0109 g/g虫/d,O_2消耗速率为0.0126 g/g虫/d,大黑甲的呼吸代谢对密闭系统中大气循环起到一定作用。此外,大黑甲每日能够消耗一定量的植物不可食部分,其虫沙营养全面,具有用作植物培养基质的潜力。     

慢性肾小球肾炎患者血清MMP-9和TIMP-1的浓度及意义

目的:观察慢性肾小球肾炎血清基质金属蛋白酶9(matrix metalo protein-ase-9,MMP-9)、金属蛋白酶组织抑制剂1(tissue inhibitors of metalloproteinases,TIMP-1)的浓度与肾组织中MMP-9、TIMP-1表达的相关性,探讨慢性肾小球肾炎血清MMP-9、TIMP-1对肾脏纤维化的判断价值。方法:通过肾组织活检病理检查,将入选慢性肾炎的病例分增生组(A组)15例,纤维化组(B组)15例,另选10例志愿者作为健康对照组C组。应用免疫组化法观察A、B两组MMP-9、TIMP-1在肾组织中的表达情况,并且进行半定量分析,比较它们之间有无差别。应用ELISA双抗体夹心法检测A、B、C三组MMP-9、TIMP-1在血清中的浓度,比较它们之间有无差别。观察A、B两组MMP-9、TIMP-1在肾组织中的表达水平与在血清的浓度有无相关性。结果:A、B两组MMP-9在肾小球和肾间质少见表达,主要在肾小管上皮细胞浆中表达增高,两组之间表达的强度有显著差异性;A组TIMP-1在肾小球中少见表达,在肾小管上皮细胞增强。B组TIMP-1在肾小球中有少量表达,在肾小管上皮细胞较A组进一步增强,两组之间表达的强度有显著差异性(P0.05)。血清中MMP-9、TIMP-1浓度在A、B组显著高于C组,血清中MMP-9在A、B两组之间无显著差异性,血清中TIMP-1在A、B、C三组间两两比较有显著差别(P0.05)。结论:慢性肾炎患者血清中MMP-9、TIMP-1浓度与肾脏组织中MMP-9、TIMP-1的表达呈正相关。MMP-9、TIMP-1的相关性分析P值小于0.01。血清MMP-9、TIMP-1参与了肾脏纤维化的进展,慢性肾小球肾炎血清中MMP-9、TIMP-1的浓度可在一定程度上反映肾脏纤维化程度。     

MRI检查中发生幽闭恐惧症的心理疏导对策探讨

目的:探讨MRI检查中发生幽闭恐惧症患者的心理特征及其心理疏导对策。方法:根据Marks的4条诊断幽闭恐惧症的标准,选择2008年1月~2011年6月在我院磁共振室检查的102例出现不同程度幽闭恐惧症且MRI检查无法顺利完成的患者,分析其临床症状,查找检查失败发生的原因,并进行心理疏导、改善检查环境、家属陪同检查、优化扫描时间、程序以及口服镇静药物等方法保证检查的顺利完成。对干预前后患者的生命体征和检查中不适症状发生情况的差异进行比较。结果:102例发生幽闭恐惧症的患者通过心理疏导、改善检查环境、家属陪同检查、优化扫描时间、程序以及口服镇静药物等方法实施有效的护理干预,第二次检查成功87例,第三次成功10例,5例患者放弃检查,有效率达95.1%,干预后患者的生命体征:呼吸、脉搏、收缩压、舒张压等较干预前有明显的减轻;检查中不适症状:心悸、头晕、窒息感、压抑感等在干预后也明显减轻,各项指标的干预前后的变化有统计学差异,P0.05。结论:积极有效的心理疏导护理可缓解MRI检查中幽闭恐惧症的不适症状,使多数患者顺利完成MRI检查。