肺癌初治患者睡眠障碍调查及与生活质量和睡眠卫生意识的关系研究

摘要 目的：分析肺癌初治患者睡眠障碍情况及其与生活质量和睡眠卫生意识的关系。方法：选取400例肺癌初治患者为研究对象,采用阿森斯失眠量表（AIS）评定患者睡眠质量,采用肺癌生活质量评估量表（FACT-L）评定患者生活质量,采用睡眠卫生意识量表（SHA）评定患者睡眠卫生意识,采用本院自制调查问卷收集患者临床资料。应用Pearson相关性分析AIS总分与FACT-L总分、SHA总分的相关性。根据AIS总分将患者分为睡眠障碍组（AIS总分>6分）和非睡眠障碍组（AIS总分≤6分）,应用单因素和多因素Logistic回归分析睡眠障碍的影响因素。结果：400例肺癌初治患者共有252例发生睡眠障碍,睡眠障碍发生率为63.00%（252/400）。睡眠障碍组生理/情感/功能/（社会/家庭）维度、肺癌附加模块、FACT-L总分低于非睡眠障碍组（P<0.05）。睡眠障碍组患者SHA总分、睡前2h剧烈运动、白天睡午觉、定期服用催眠类药物、晚上喝酒得分维度评分均低于非睡眠障碍组（P<0.05）。Pearson相关性分析结果显示：AIS总分与FACT-L总分、SHA总分呈负相关（P<0.05）。单因素分析结果显示：肺癌初治患者睡眠障碍与性别、化疗次数、肿瘤分期、疼痛、焦虑、抑郁有关（P<0.05）。多因素Logistic回归分析结果显示：肺癌初治患者睡眠障碍的危险因素包括焦虑、疼痛、肿瘤分期、抑郁（P＜0.05）。结论：肺癌初治患者睡眠障碍发生率较高,且受疼痛、肿瘤分期、焦虑、抑郁等因素的影响。此外,不良的睡眠卫生意识可导致较为严重的睡眠障碍,从而降低患者生活质量。     

Immortalized mesenchymal stem cells: an alternative to primary mesenchymal stem cells in neuronal differentiation and neuroregeneration associated studies

Background  

Mesenchymal stem cells (MSCs) can be induced to differentiate into neuronal cells under appropriate cellular conditions and transplanted in brain injury and neurodegenerative diseases animal models for neuroregeneration studies. In contrast to the embryonic stem cells (ESCs), MSCs are easily subject to aging and senescence because of their finite ability of self-renewal. MSCs senescence seriously affected theirs application prospects as a promising tool for cell-based regenerative medicine and tissue engineering. In the present study, we established a reversible immortalized mesenchymal stem cells (IMSCs) line by using SSR#69 retrovirus expressing simian virus 40 large T (SV40T) antigen as an alternative to primary MSCs.     

Expression analysis of asthma candidate genes during human and murine lung development

Background

Little is known about the role of most asthma susceptibility genes during human lung development. Genetic determinants for normal lung development are not only important early in life, but also for later lung function.

Objective

To investigate the role of expression patterns of well-defined asthma susceptibility genes during human and murine lung development. We hypothesized that genes influencing normal airways development would be over-represented by genes associated with asthma.

Methods

Asthma genes were first identified via comprehensive search of the current literature. Next, we analyzed their expression patterns in the developing human lung during the pseudoglandular (gestational age, 7-16 weeks) and canalicular (17-26 weeks) stages of development, and in the complete developing lung time series of 3 mouse strains: A/J, SW, C57BL6.

Results

In total, 96 genes with association to asthma in at least two human populations were identified in the literature. Overall, there was no significant over-representation of the asthma genes among genes differentially expressed during lung development, although trends were seen in the human (Odds ratio, OR 1.22, confidence interval, CI 0.90-1.62) and C57BL6 mouse (OR 1.41, CI 0.92-2.11) data. However, differential expression of some asthma genes was consistent in both developing human and murine lung, e.g. NOD1, EDN1, CCL5, RORA and HLA-G. Among the asthma genes identified in genome wide association studies, ROBO1, RORA, HLA-DQB1, IL2RB and PDE10A were differentially expressed during human lung development.

Conclusions

Our data provide insight about the role of asthma susceptibility genes during lung development and suggest common mechanisms underlying lung morphogenesis and pathogenesis of respiratory diseases.     

Pulmonary cytochrome P450 enzymes belonging to the CYP4B subfamily from an Australian marsupial,the tammar wallaby (Macropus eugenii)

Cytochromes P450 (CYPs) are critically important in the oxidative metabolism of a diverse array of xenobiotics and endogenous substrates. We have previously reported the cloning and characterisation of the koala CYP4A15, the first reported member of the CYP4 family from marsupials, and have demonstrated important species differences in CYP4A activity and tissue expression. In the present study, the cloning of CYP4B1 in the wallaby (Macropus eugenii) and their expression across marsupials is described. Rabbit anti-mouse CYP4B1 antibody detected immunoreactive proteins in lung and liver microsomes from all test marsupials, with relative weak signal detected from the koala, suggesting a species-specific expression. Microsomal 2-aminofluorene bio-activation (a CYP4B1 marker) in wallaby lung was comparable to that of rabbit, with significant higher activities detected in wallaby liver and kidneys compared to rabbit. A 1548 bp wallaby lung CYP4B complete cDNA, designated CYP4B1, which encodes a protein of 510 amino acids and shares 72% nucleotide and 69% amino acid sequence identity to human CYP4B1, was cloned by polymerase chain reaction approaches. The results demonstrate the presence of wallaby CYP4B1 that shares several common features with other published CYP4Bs; however the wallaby CYP4B1 cDNA contains four extra amino acid residues at the NH₂-terminal, a fundamentally conserved transmembrane anchor of all eukaryote CYPs.     

Identification of differentially expressed proteins in blood plasma of control and cigarette smoke-exposed mice by 2-D DIGE/MS

Cigarette smoke exposure is known to induce obstructive lung disease and several cardiovascular disease states in humans and also in animal models. Smoking leads to oxidative stress and inflammation that are important in triggering pulmonary and cardiovascular disease. The objective of the current study was to quantify differences in expression levels of plasma proteins of cigarette smoke -exposed and control mice, at the time of disease onset, and identify these proteins for use as potential biomarkers of the onset of smoking-induced disease. We utilized 2-D DIGE/MS to characterize these proteomic changes. 2-D DIGE of plasma samples identified 11 differentially expressed proteins in cigarette smoke -exposed mice. From these 11 proteins, 9 were downregulated and 2 were upregulated. The proteins identified are involved in vascular function, coagulation, metabolism and immune function. Among these, the alterations in fibrinogen (2.2-fold decrease), α-1-antitrypsin (1.8-fold increase) and arginase (4.5-fold decrease) are of particular interest since these have been directly linked to cardiovascular and lung pathology. Differences in expression levels of these proteins were also confirmed by immunoblotting. Thus, we observe that chronic cigarette smoke exposure in mice leads to prominent changes in the protein expression profile of blood plasma and these changes in turn can potentially serve as markers predictive of the onset and progression of cardiovascular and pulmonary disease.     

神经内科住院患者肺部感染的相关危险因素分析及护理对策

目的：确定影响神经内科患者肺部感染的危险因素,为预防和控制住院患者肺部感染提供依据。方法：本研究采用回顾性调查方法,对我院神经内科2010年3月至2011年3月住院患者发生肺部感染的案例进行回顾性调查分析。结果：研究发现,调查的2091名患者中,肺部感染例数为41例,发生率为1．96％。内源性因素包括：年龄,意识障碍,瘫痪,卧床,严重的基础疾病;外源性因素包括：住院日,侵入性检查、人工气道与人工机械通气,不合理使用抗生素以及误吸。结论：外源性的感染,通过科学有效的护理措施,在临床上及早进行预防性的护理干预,采取有针对性的护理措施,预防患者肺部感染的发生,降低患者的发病率和死亡率。     

Mechanisms of the protective effects of BMSCs promoted by TMDR with heparinized bFGF‐incorporated stent in pig model of acute myocardial ischemia

This study investigates the mechanism by which transmyocardial drilling revascularization combined with heparinized basic fibroblast growth factor incorporated degradable stent implantation (TMDRSI) enhanced effects of bone marrow mesenchymal stem cells (BMSCs) transplantation against acute ischemic myocardial injury. After the mid‐third of left anterior descending artery was ligated, miniswine were divided into none‐treatment group (control, n = 6), BMSCs implantation group (C, n = 6), TMDRSI group (TS, n = 6) and TMDRSI and BMSCs implantation group (TSC, n = 6). Two channels of 3.5 mm diameter were established by a self‐made drill in the ischemic region, into which a stent was implanted for the TS and TSC groups. Autologous BMSCs were transplanted into the ischemic region in C group or around the channels in TSC group. Expression of von Willebrand factor, vascular endothelial growth factor, interleukin‐1β, transforming growth factor‐β₃, cell proliferation and apoptosis, histological and morphological analyses, myocardial remodelling and cardiac function were evaluated at different time‐points. Six weeks after the operation, the above indices were significantly improved in TSC group compared with others (P < 0.05), though C and TS groups also showed better results than the control group (P < 0.05). The new method was shown to have activated paracrine pathway of transplanted BMSCs, increased survival and differentiation of such cells, and enhanced effects of BMSCs transplantation on myocardial remodelling, which may provide a new strategy for cell therapies against acute ischemic myocardial injury.     

无症状吸烟者的肺功能改变情况分析

目的：探讨烟龄215年,日吸烟量≥15支的无症状男性吸烟者的肺功能改变情况。方法：选择男性无症状吸烟者190人及非吸烟者180人,进行肺功能测定,并比较两组人群的肺功能改变情况。结果：吸烟组与非吸烟组比较,肺活量（VC）、用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、Tiffeneau1秒率（FEV1／VC）结果改变不明显,而Gaensler1秒率（FEV1/FVC）、最大分钟通气量（MVV）、用力呼气50％肺活量的呼气流量（FEF50％）、用力呼气75％肺活量的呼气流量（FEF75％）、呼出25％-75％肺活量时的平均流量（FEF25％～75％）、肺一氧化碳弥散量（DLCO）结果均有显著降低,有统计学意义。结论：通过对无症状吸烟人群肺功能测定结果进行分析。发现有些吸烟者虽无临床症状,但已经出现了小气道及肺弥散功能的损伤,提醒吸烟者应早期戒烟,关爱自身健康,净化生存环境,提高生活质量。     

硝普钠灌注对移植小肠粘膜细胞凋亡的影响

目的:探讨外源性一氧化氮(nitric oxide,NO)供体硝普钠(sodium nitroprusside,SNP)对移植小肠粘膜细胞凋亡的影响。方法:64只220～300g雄性SD大鼠随机分成3组:A1组(n=8),仅行剖腹关腹手术;A2组(n=12):12对大鼠随机作为供受体行同种异体节段小肠移植,无SNP干预;A3组(n=16):16对大鼠随机作为供受体行同种异体节段小肠移植,SNP加入灌注液进行供肠灌注。采用前述3组动物模型再灌注5小时肠造口标本,TUNEL法检测小肠蜡块标本的细胞凋亡情况。结果:与A1组(3.86±4.74%)相比,A2(22.44±10.94%)、A3组(17.12±8.44%)小肠粘膜的细胞凋亡指数均有显著增高(P<0.05),A3组较A2组细胞凋亡指数显著降低(P<0.05)。结论:小肠移植导致小肠粘膜细胞凋亡增加,外源性NO供体SNP灌注能够显著降低植入小肠的细胞凋亡,从而可能减弱粘膜屏障的损伤。