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。     

食管癌三维适形放疗前后肺功能、生活质量的变化及放射性肺炎的影响因素分析

目的:探讨食管癌三维适形放疗前后肺功能、生活质量的变化及放射性肺炎的影响因素。方法:收集2017年11月~2019年11月在我院进行三维适形放疗的食管癌患者102例,对患者放疗前后的肺功能进行检测对比,并采用生活质量评价简表(QLQ-C30)对患者放疗前后的生活质量进行评估对比。统计患者放疗后放射性肺炎的发生率,根据患者放疗后是否发生放射性肺炎将患者分为放射性肺炎组和非放射性肺炎组,对两组患者的临床资料进行对比分析,采用单因素和多因素Logistic回归分析影响食管癌三维适形放疗后放射性肺炎发生的影响因素。结果:放疗前后患者肺活量(VC)占预计值的百分比、用力肺活量(FVC)占预计值的百分比、第一秒用力呼气容积(FEV1)占预计值的百分比、最大通气量(MVV)占预计值的百分比对比无统计学差异(P>0.05),放疗后患者一氧化碳弥散量(DLCO)占预计值的百分比低于放疗前(P<0.05)。放疗后患者的QLQ-C30各项评分均低于放疗前(P<0.05)。102例患者中放疗后出现放射性肺炎33例,发生率为32.35%。经单因素分析显示,两组患者在性别、体质量指数(BMI)、吸烟史、饮酒史、肿瘤大小、病理类型、肿瘤位置、合并化疗方面比较差异无统计学意义(P>0.05),而在年龄、合并肺基础疾病、全肺接受20Gy的体积(V20)、全肺照射平均剂量(MLD)方面比较差异有统计学意义(P<0.05)。经多因素Logistic回归分析显示,年龄≥60岁、合并肺基础疾病、V20≥30%、MLD≥1200cGy是食管癌三维适形放疗后出现放射性肺炎的危险因素(OR=1.309、1.193、1.416、1.309,P<0.05)。结论:食管癌三维适形放疗会对患者的肺部弥散功能、生活质量产生负面影响。部分患者放疗后会出现放射性肺炎,其主要受年龄、肺基础疾病、V20、MLD的影响。     

Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and severe patients with COVID-19

Science China Life Sciences -     

Development and validation of glycolysis-related prognostic score for prediction of prognosis and chemosensitivity of pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy with aggressive biological behaviour. Its rapid proliferation and tumour growth require reprogramming of glucose metabolism or the Warburg effect. However, the association between glycolysis-related genes with clinical features and prognosis of PDAC is still unknown. Here, we used the meta-analysis to correlate the hazard ratios (HR) of 106 glycolysis genes from MSigDB by the cox proportional hazards regression analysis in 6 clinical data sets of PDAC patients to form a training cohort, and a single group of PDAC patients from the TCGA, ICGC, Arrayexpress and GEO databases to form the validation cohort. Then, a glycolysis-related prognosis (GRP) score based on 29 glycolysis prognostic genes was established in 757 PDAC patients from the training composite cohort and validated in 267 ICGC-CA validation cohort (all P < .05). In addition, including PADC, the prognostic value was also confirmed in other 7 out of 30 pan-cancer cohorts. The GRP score was significantly related to specific metabolism pathways, immune genes and immune cells in the patients with PADC (all P < .05). Finally, by combining with immune cells, the GRP score also well-predicted the chemosensitivity of patients with PADC in the TCGA cohort (AUC = 0.709). In conclusion, this study developed a GRP score for patients with PDAC in predicting prognosis and chemosensitivity for PDAC.     

KDM5A silencing transcriptionally suppresses the FXYD3-PI3K/AKT axis to inhibit angiogenesis in hepatocellular cancer via miR-433 up-regulation

Hepatocellular cancer (HCC) has been reported to belong to one of the highly vascularized solid tumours accompanied with angiogenesis of human umbilical vein endothelial cells (HUVECs). KDM5A, an attractive drug target, plays a critical role in diverse physiological processes. Thus, this study aims to investigate its role in angiogenesis and underlying mechanisms in HCC. ChIP-qPCR was utilized to validate enrichment of H3K4me3 and KDM5A on the promotor region of miR-433, while dual luciferase assay was carried out to confirm the targeting relationship between miR-433 and FXYD3. Scratch assay, transwell assay, Edu assay, pseudo-tube formation assay and mice with xenografted tumours were conducted to investigate the physiological function of KDM5A-miR-433-FXYD3-PI3K-AKT axis in the progression of HCC after loss- and gain-function assays. KDM5A p-p85 and p-AKT were highly expressed but miR-433 was down-regulated in HCC tissues and cell lines. Depletion of KDM5A led to reduced migrative, invasive and proliferative capacities in HCC cells, including growth and a lowered HUVEC angiogenic capacity in vitro. Furthermore, KDM5A suppressed the expression of miR-433 by demethylating H3K4me3 on its promoterregion. miR-433 negatively targeted FXYD3. Depleting miR-433 or re-expressing FXYD3 restores the reduced migrative, invasive and proliferative capacities, and lowers the HUVEC angiogenic capacity caused by silencing KDM5A. Therefore, KDM5A silencing significantly suppresses HCC tumorigenesis in vivo, accompanied with down-regulated miR-433 and up-regulated FXYD3-PI3K-AKT axis in tumour tissues. Lastly, KDM5A activates the FXYD3-PI3K-AKT axis to enhance angiogenesis in HCC by suppressing miR-433.     

Toward a phylogeny and biogeography of Diaphanosoma (Crustacea: Cladocera)

Aquatic Ecology - Diaphanosoma s.l., with 40+? described species, is the largest genus of the Sididae and the Ctenopoda, similar in many ways to the anomopod genus Daphnia. Here, we offer a c...     

乳酸菌素片联合标准四联疗法对社区消化性溃疡患者胃电图及肠道菌群的影响

目的探讨乳酸菌素片结合标准四联疗法对社区消化性溃疡(PU)患者胃电图及肠道菌群的影响,为该类患者的治疗提供参考。方法选取2018年1月至2020年3月社区PU患者128例,随机分为对照组和试验组,各64例。对照组患者给予标准四联疗法,试验组在对照组基础上给予乳酸菌素片,两组患者均治疗14 d。观察两组患者H.pylori根除率、治疗效果、再生黏膜组织学成熟度、不良反应及治疗前后胃电图(胃肠电节律紊乱、平均频率)、胃肠激素[胃蛋白原Ⅰ(PGⅠ)、生长抑素(SS)、生长激素释放多肽(Ghrelin)]、肠道菌群(革兰阳性球菌、革兰阴性球菌、革兰阳性杆菌)水平,并于治疗后3个月随访PU复发率。结果试验组患者治疗总有效率(95.31%)、H.pylori根除率(87.50%)及再生黏膜组织学成熟度均高于对照组(均P0.05)。胃电图检测显示,治疗后试验组患者餐前、餐后平均频率及胃肠电节律紊乱均低于对照组(均P0.05)。治疗后试验组患者血清SS水平高于对照组,PGⅠ、Ghrelin水平低于对照组(均P0.05)。治疗后试验组患者肠道革兰阴性球菌数量高于对照组,革兰阳性杆菌数量低于对照组(均P0.05)。两组患者不良反应发生率及PU复发率比较差异无统计学意义(均P0.05)。结论乳酸菌素片结合标准四联疗法治疗社区PU患者的疗效确切,可有效调控患者胃肠激素,提高H.pylori根除率,安全性较高。     

晋西黄土区典型乔灌木短期水分利用效率对环境因子的响应

为明确晋西黄土区植物的水分利用规律及对半干旱区的适应策略, 提高黄土地区植被建设效益, 该研究对该地区典型乔灌木短期水分利用效率随环境因子的变化进行了探究。以典型乔木油松(Pinus tabuliformis)、刺槐(Robinia pseudoacacia)及其林下灌木黄刺玫(Rosa xanthina)、杠柳(Periploca sepium)为研究对象, 测定叶片可溶性糖稳定碳同位素比值(δ¹³C_leaf)与枝条渗出液稳定碳同位素比值(δ¹³C_branch), 使用δ¹³C_leaf推导计算7-10月叶片尺度下植物短期水分利用效率(WUE_leaf)变化趋势, 使用δ¹³C_branch明确植物光合作用后分馏情况, 确定半干旱区植物在生长季的水分变化规律对环境因子变化的响应。结果表明: (1) 7-10月4种植物δ¹³C_leaf总体呈现降低趋势, δ¹³C_branch呈现先升高后降低趋势。δ¹³C_leaf在种间和生活型中均存在差异。具体表现为: 灌木>乔木, 常绿乔木(油松) >落叶乔木(刺槐)。研究过程中未发现明显的碳同位素在光合作用后发生分馏的情况。(2) 4种植物WUE_leaf在7-8月保持稳定, 9-10月逐渐升高。21.5 ℃、0.9 kPa、52.4%分别为WUE_leaf随温度(T_a)、饱和水汽压差(VPD)、相对湿度(RH)变化的突变点, 突变点之后4种植物WUE_leaf均表现出稳定的变化趋势, 不再随T_a、VPD、RH升高而降低。(3) WUE_leaf与T_a、RH、VPD之间存在显著负相关关系, T_a通过非气孔因素, 即酶的作用改变光合速率, 引起WUE_leaf变化。RH、VPD等水分因子则通过改变气孔开度, 影响蒸腾, 进而改变WUE_leaf。随着土壤含水量(SWC)的升高, WUE_leaf呈现先升高后降低的趋势。油松林和刺槐林在SWC分别达到15%-18%、13%-14%时, WUE_leaf达到最高值。经过混合线性模型(LMM)分析得到, 油松和刺槐WUE_leaf主导环境因子分别为RH和VPD, 黄刺玫和杠柳WUE_leaf主导环境因子均为T_a。该研究得到了黄土地区典型乔灌木生长季水分利用效率变化的规律和主要环境影响因子, 明确了黄土地区植物对气候因子变化的适应机制。