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广州医药杂志服务号
论著

综合性口腔护理干预方案在机械通气患儿中的应用

Application of comprehensive oral nursing intervention scheme in children with mechanical ventilation

:619-624
 
      目的 探究综合性口腔护理干预方案在机械通气患儿中的应用效果。方法 将2023年5月—12月泉州市妇幼保健院重症监护科接收的66例机械通气患儿选为研究对象。以密封信封抽签法分为综合干预组(n=33)及常规干预组(n=33)。常规干预组实施常规口腔护理,综合干预组实施综合性口腔护理模式干预。对比两组患儿口腔情况、并发症、静态全唾液流率(UWS)及机械通气时间。结果 干预后综合干预组Beck总分为(6.33±1.05)分,低于常规干预组的(8.55±1.85)分(t=6.069,P<0.001)。综合干预组出现呼吸机相关肺炎(VAP)发生率较常规干预组更低(3.03% vs 18.18%)(χ2=3.995,P=0.046)。干预后综合干预组UWS为(0.37±0.09)mg/min,高于常规干预组的(0.29±0.09)mg/min(t=3.611,P=0.001)。结论 综合性口腔护理模式能较大程度改进机械通气患儿的口腔卫生问题,对菌斑、口腔异味及牙龈情况均有改善作用;也能减少并发症发生率,提升UWS,维持口腔卫生健康。

      Objective To explore the effect of comprehensive oral nursing intervention in children with mechanical ventilation.Methods A total of 66 mechanically ventilated children admitted to the intensive care department of the hospital from May 2023 to December 2023 were selected as the study objects.They were divided into comprehensive intervention group(n=33)and routine intervention group(n=33)by sealed envelope lottery method.The routine intervention group implemented routine oral care,and the comprehensive intervention group implemented comprehensive oral care mode intervention.Oral conditions,complications,unstimulated whole saliva(UWS)and mechanical ventilation time were compared between the two groups.Results After the intervention,the total Beck score of the comprehensive intervention group was(6.33±1.05),which was lower than that of the conventional intervention group([8.55±1.85],t=6.069,P<0.001).The incidence of ventilator-associated pneumonia(VAP)in the comprehensive intervention group was lower than that in the conventional intervention group(3.03% vs 18.18%)(χ2=3.995,P=0.046).After the intervention,the UWS of the comprehensive intervention group was(0.37±0.09)mg/min,which was higher than that of the conventional intervention group([0.29±0.09] mg/min,t=3.611,P=0.001).Conclusions The comprehensive oral care mode can improve the oral health of children with mechanical ventilation to a great extent,and can improve the plaque,oral odor and gingiva condition.It can also reduce the incidence of complications,improve UWS,and maintain oral health.

论著

个性化营养干预联合分级步行运动方案对肺癌化疗患者癌因性疲乏及生活质量的影响

Effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy

:367-372
 
       目的  分析对肺癌化学治疗(化疗)患者采取个性化营养干预联合分级步行运动方案的应用价值。   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象,通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案,观察组则联合分级步行运动方案,两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏[Piper疲乏修订量表(PFS-R)]、营养状况、睡眠质量[匹茨堡睡眠质量指数(PSQI)]、生活质量[生活质量评估量表(SF-36)]水平予以比较。结果  相较于对照组,干预后观察组PFS-R、PSQI评分较低,白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高(P<0.05)。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案,有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。
       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy.Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects.They were divided into an observation group and a control group,with 99 cases in each group,by the random number table method.The control group only received individualized nutritional intervention,while the observation group received graded walking exercise additionally.Both groups of patients were enrolled at the same time and received continuous intervention for three months.Cancer-related fatigue(Piper’s Fatigue Scale-Revised[PFS-R]),nutritional status,sleep quality(Pittsburgh Sleep Quality Index[PSQI]),and quality of life(Quality of Life Scale[SF-36]) before and after the intervention were compared between the two groups.Results  Compared with the control group,the observation group had lower PFS-R and PSQI scores and higher albumin,prealbumin,hemoglobin,transferrin levels and SF-36 scores after the intervention(P<0.05).Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status,sleep quality and quality of life.
医学教育

“新医科”背景下《生物化学》教学改革探索与实践

Study and practice of teaching reformation on biochemistry under the background of New Medicine

:117-212
 
      生物化学是临床医学专业的一门重要基础课程,其教学质量可直接影响临床医学生物的培养目标。文章探讨了“新医科”背景下生物化学课程的教学改革,从思政元素融入课堂、教学手段的改革、开放实验平台的搭建和课程考核的改革等方面入手,着力培养学生自主学习的能力,解决临床问题的能力和提升科研素养。
      For students who majored in clinical medicine,biochemistry is a crucial foundation course,and the teaching quality of which directly influence the educational objectives of clinical medicine students.In this study,we explored the teaching reformation methods of biochemistry course under the background of New Medicine.We integrated ideological elements into classroom teaching,and used various teaching methods in the classroom,built an open experiment platform and innovated course assessment mode,for trying to improve the students’ ability of self-study,clinical problems resolving and scientific literacy.
论著

脓毒性休克患者 TRAF6、ChE 和 APACHE Ⅱ评分与预后的关联及预测价值

Correlation of TRAF6,ChE and APACHE II scores with prognosis and predictive value in patients with septic shock

:1630-1637
 
       目的   探讨脓毒性休克患者肿瘤坏死因子相关受体6 (TRAF6)、胆碱酯酶(ChE)及急性生理学和慢性健康状况评价Ⅱ(APACHE Ⅱ)对预后不良的预测价值。方法   回顾分析2023年2月—2024年3月于某院ICU病区收治的226例脓毒性休克患者的临床资料,基于患者预后情况分为预后良好组(n=151)以及预后不良组(n=75)。回顾226例脓毒性休克患者入院时及治疗后的TRAF6、ChE表达变化,并记录患者APACHEⅡ评分和序贯器官功能衰竭评估(SOFA)评分动态变化;比较并分析两组患者详尽的临床资料,探讨TRAF6、ChE联合APACHE Ⅱ评分之间的关联性以及上述指标对脓毒性休克患者预后情况的临床评估价值。采用Logistic回归来分析对脓毒性休克患者生存状况产生影响的潜在因素。结果   多因素Logistic回归分析,年龄、APACHE Ⅱ评分、SOFA评分、机械通气时间、TRAF6与ChE表达水平均是影响患者预后的独立危险因素(P<0.05);受试者操作特征曲线分析显示,年龄、APACHE Ⅱ评分、机械通气时间、SOFA评分、TRAF6、ChE表达水平联合预测脓毒性休克患者预后不良的曲线下面积为0.925,高于单独检测的0.689、0.783、0.794、0.781、0.708、0.827。结论   临床需要及时识别高龄、长时间机械通气时间、高APACHE Ⅱ与SOFA评分、高TRAF6和ChE表达水平的高风险患者,TRAF6、ChE表达水平、SOFA评分、APACHE Ⅱ评分可作为评估脓毒性休克患者预后情况的临床指标,联合应用能进一步提升临床价值。
      Objective  To explore the predictive value of tumor necrosis factor receptor associated factor 6(TRAF6),cholinesterase(ChE)and Acute Physiology and Chronic Health Evaluation II scove(APACHE II)for adverse prognosis in patients with septic shock.Methods  The clinical data of 226 patients with septic shock admitted to the Intensive Care Unit(ICU) of a hospital from February 2023 to March 2024 were retrospectively analyzed,and the patients were divided into a good prognosis groupn=151)and an adverse prognosis group(n=75)based on their prognosis.The expression of TRAF6 and ChE in 226 patients with septic shock was reviewed at admission and after treatment,while the dynamic changes of APACHE  II score and Sequential Organ Failure Assessment(SOFA)score were recorded.Detailed clinical data of the two groups were compared and analyzed to explore the correlation between TRAF6,ChE,APACHE II scores and the clinical evaluation value of the above indexes in the prognosis of patients with septic shock.Logistic regression was used to analyze the potential factors affecting the survival of septic shock patients.Results  Multiple Logistic regression analysis revealed that age,APACHE II score,SOFA score,mechanical ventilation time,TRAF6 and ChE expression levels were independent risk factors for prognosis(P<0.05).Receiver Operating Characteristic(ROC)curve analysis showed that the area under curve(AUC)was 0.925,which was higher than single index prediction(0.689,0.783,0.794,0.781,0.708 and 0.827).Conclusions  High-risk patients with advanced age,prolonged mechanical ventilation,high APACHE II and SOFA scores,and high TRAF6 and ChE expression levels need to be identified in time.TRAF6,ChE expression levels,SOFA scores,and APACHE  II scores can be used as clinical indicators to evaluate the prognosis of septic shock patients.The combined application of those four indicators can further improve the clinical value.
论著

急性缺血性脑卒中介入治疗优化护理路径的构建及应用

Development and application of an optimized nursing pathway for endovascular therapy in acute ischemic stroke

:1563-1568
 
       目的   探讨优化护理路径在急性缺血性脑卒中介入手术中的应用及效果。方法   采用随机对照研究,纳入2024年1月—2025年1月收治的112例急性缺血性脑卒中取栓患者,观察组(56例)实施优化介入护理路径,对照组(56例)采用常规护理。结果   观察组患者的满意度评分、医护满意度评分均优于对照组(P<0.05);观察组的术前等待时间、患者自进入介入室至股动脉穿刺时间、手术时间、住院费用、并发症发生率、差错事故发生率也优于对照组(P<0.05)。结论   通过标准化术前准备、术中多学科协作及术后康复衔接,优化护理路径可显著提升急性缺血性脑卒中治疗时效性(缩短急性脑卒中患者从进入医院到开始静脉溶栓给药的时间至黄金时间窗内),改善患者神经功能预后。
       Objective  To explore the application and efficacy of an optimized nursing pathway in endovascular therapy for acute ischemic stroke(AIS).Methods  A randomized controlled trial was conducted,enrolling 112 AIS patients undergoing mechanical thrombectomy from January 2024 to January 2025.Patients were randomly assigned to either the observation groupn=56),which received the optimized interventional nursing pathway,or the control group(n=56),which  received  routine nursing care.Results  Patient satisfaction score,medical staff satisfaction score,and postoperative favorable  recovery  rate in observation group were better than those of control group(P<0.05).Additionally,the observation group  showed  significant improvements in preoperative waiting time,time from entering the operation room to femoral artery puncture,surgical duration,hospitalization costs,complication incidence rate,and medical error incidence rate(P<0.05).Conclusions  By standardizing preoperative preparations,implementing intraoperative multidisciplinary collaboration,and enhancing postoperative  rehabilitation coordination,the optimized nursing pathway significantly improved the timeliness of thrombectomy treatment(shortening door-to-needle time to reach the golden time window)and enhanced neurological functional prognosis in AIS patients,demonstrating substantial clinical applicability.
论著

非霍奇金淋巴瘤患者化疗后感染及平均住院日的影响因素分析

Factors influencing post-chemotherapy infections and length of hospital stay in patients with non-Hodgkin’s lymphoma

:1511-1518
 
       目的   探讨营养评估及炎症因子水平对非霍奇金淋巴瘤(NHL)患者化学治疗(化疗)后感染及平均住院日的影响。方法   回顾性分析接受R-CHOP治疗的NHL患者95例。通过受试者工作特征(ROC)曲线确定患者主观整体营养评估(PG-SGA)预测患者化疗后感染的界值。将患者分为PG-SGA<4组与PG-SGA≥4组,比较两组间营养及炎症相关指标的差异。采用单因素与多因素回归分析NHL患者化疗后感染及平均住院日延长的危险因素。结果  ROC曲线显示PG-SGA为3.5时,约登指数最大,预测NHL患者化疗后感染灵敏度为92%,特异度为11.1%。PG-SGA≥4组患者平均年龄、国际预后指数(IPI)及Ann arbor Ⅲ~Ⅳ期比例均高于PG-SGA<4组(P<0.05)。与PG-SGA<4组相比,PG-SGA≥4组患者白介素6(IL-6)及中性粒细胞与淋巴细胞比值(NLR)明显升高,且化疗后感染率及平均住院日≥5 d比例高于对照组P<0.05);与对照组相比,PG-SGA<4组患者前白蛋白、白蛋白和血红蛋白水平升高(P均<0.05)。多因素回归分析显示,PG-SGA≥4及合并糖尿病是NHL患者化疗后感染率的独立危险因素(P均<0.05)。白蛋白低于35 g/L及合并化疗后感染是NHL患者平均住院日延长的独立危险因素(P均<0.05)。结论   基于PG-SGA的营养评估及炎症因子分析对NHL患者化疗后感染及平均住院日的预测具有临床指导意义。
       Objective  To explore the effects of nutritional assessment and inflammatory factor levels on post-chemotherapy infections and length of hospital stay in patients with non-Hodgkin’s lymphoma(NHL).Methods  A total of 95 NHL patients treated with the R-CHOP regimen were retrospectively analyzed.The  cut-off  value  of  Patient-Generated  Subjective Global Assessment (PG-SGA) for post-chemotherapy infection in NHL patients was evaluated by Receiver Operating Characteristic(ROC)curves.Patients were categorized into PG-SGA<4 and PG-SGA≥4 groups and compared for differences of nutritional and inflammation-related factors.Univariate and multivariate logistic regression were used to analyze the risk factors for post-chemotherapy infection and length of hospital stay(LHS).Results  The ROC curve showed that the Youden index was largest at PG-SGA of 3.5,which predicted post-chemotherapy infection in NHL patients with a sensitivity of 92% and a specificity of 11.1%.The mean age,International Prognostic Index(IPI),and Ann Arbor stage Ⅲ~IV proportion in patients with PG-SGA≥4 were higher compared with the control(P<0.05).Patients with PG-SGA≥4 had significantly higher interleukin-6 and neutrophil-to-lymphocyte ratio(NLR),and the infection rate and the proportion of LHS≥5 days after chemotherapy were higher than those in the control group(P<0.05).Patients in the PG-SGA<4 group had significantly higher prealbumin,albumin,and hemoglobin levels compared to the PG-SGA≥4 group(P<0.05).Multifactorial logistic regression analysis revealed that PG-SGA≥4 and combined diabetes mellitus were independent risk factors for post-chemotherapy infection rate in NHL patients(both P<0.05).Albumin less than 35 g/L and combined post-chemotherapy infection were independent risk factors for prolonged LHS in NHL patients(both P<0.05).Conclusions  PG-SGA nutritional assessment and inflammatory factor analysis are clinically instructive in predicting post-chemotherapy infections and LHS in NHL patients.
论著

PNF技术与居家康复联合治疗缺血性脑卒中患者的临床疗效

Clinical efficacy of PNF combined with home-based rehabilitation in patients with ischemic stroke

:1404-1408
 
目的 探究本体感觉神经肌肉促进疗法(PNF)技术与居家远程康复治疗对缺血性脑卒中患者凝血功能、平衡状态的影响。方法 选择2023年1月—2024年1月在宁乡市中医医院择期治疗的60例缺血性脑卒中患者为研究对象。按照患者选择的治疗方案进行分组, 观察组接受PNF技术联合居家远程康复指导治疗, 对照组接受常规居家远程康复指导治疗。记录疗效、凝血功能、神经功能缺损症状。结果 凝血功能方面,观察组治疗后活化部分凝血酶时间(APTT)、凝血酶原时间(PT)高于治疗前, 二聚体(D-D)、纤维蛋白原(FIB)低于治疗前,组间比较差异有统计学意义(P<0.05)。与对照组相比, 观察组的APTT、PT、D-D、FIB指标相近,组间比较差异无统计意义(P>0.05)。治疗后, 观察组平衡功能(BBS)评分比治疗前高, 组间比较差异有统计学意义(P<0.05)。观察组BBS评分、FMA评分、肌力等级更高, 组间比较差异有统计学意义(P<0.05)。结论 PNF技术+居家远程康复指导治疗可作为缺血性脑卒中患者治疗的有效手段。联合治疗后凝血功能、平衡状态、肢体功能状况、肌力明显改善, 可见联合治疗对于减轻患者病情尤为明显。
Objective To explore the effects of proprioceptive neuromuscular facilitation(PNF)and home-based remote rehabilitation on coagulation function and balance function in patients with ischemic stroke.Methods From January 2023 to January 2024, 60 patients with ischemic stroke were selected from our hospital.The patients were divided into two groups according to the treatment plan chosen by themselves.The patients in the observation group received PNF technology combined with home-based remote rehabilitation guidance, while the patients in the control group received routine home-based remote rehabilitation guidance.The curative effect, coagulation function and neurological deficit were recorded.Results After treatment, activated partial thrombin time(APTT)and prothrombin time(PT)were significantly higher, D-dimer(D-D)and fibrinogen(FIB)were significantly lower in the observation group than those before treatment(P<0.05).Compared with the control group, the APTT, PT, D-D and FIB of the observation group were similar, and there was no significant difference between the two groups(P>0.05).After treatment, the Berg Balance Scale score of the observation group was higher than that before treatment, and there was significant difference between the two groups(P<0.05).The Berg Balance Scale score, Fugl-Meyer Assessment score and muscle strength grade of observation group were higher than those of control group(P<0.05).Conclusions PNF combined with home-based remote rehabilitation can be used as an effective method for the treatment of patients with ischemic stroke.The coagulation function, balance, extremity function and muscle strength were significantly improved after combined treatment, which indicated that the combined treatment was especially effective in relieving the patients’ symptoms.
论著

GSDME对SKOV-3卵巢癌细胞化疗耐药的影响

Effect of GSDME on chemoresistance in ovarian cancer

:1363-1371
 
目的 探讨卵巢癌化学治疗(化疗)耐药与焦孔素E(GSDME)基因的甲基化是否有关, 以及地西他滨是否可以通过去甲基化使GSDME蛋白表达水平升高从而逆转卵巢癌化疗耐药。方法 顺铂逆浓度梯度构建SKOV-3卵巢癌耐顺铂细胞株(SKOV-3/DDP); CCK8法检测耐药前后细胞株的半抑制浓度(IC50); 实时荧光定量甲基化特异性PCR法检测两组细胞中GSDME基因的甲基化水平; Wetern Blot检测两组细胞中GSDME的表达水平。将耐药细胞株用不同质量浓度的地西他滨处理,重复上述实验, 检测地西他滨处理前后细胞的IC50GSDME基因的甲基化水平及GSDME蛋白的表达程度。结果 与SKOV-3细胞相比, SKOV-3/DDP中GSDME基因的甲基化水平升高(P<0.01), 同时GSDME蛋白的表达水平降低(P<0.001); 随着地西他滨作用浓度的升高, 耐药细胞中GSDME基因的甲基化程度逐渐降低, 蛋白的表达水平逐渐升高, 细胞的IC50逐渐降低:在用0.5 μg/mL地西他滨处理耐药细胞后GSDME基因的甲基化水平虽然降低(P<0.01), 但是此时蛋白的表达水平及耐药细胞的IC50均无明显改变(P>0.05); 当地西他滨的浓度增加到1.0 μg/mL时蛋白的表达水平才明显升高(P<0.05), 而此时细胞的IC50仍未见明显降低(P>0.05); 待药物浓度达到1.5 μg/mL时, 细胞的IC50才表现出明显的下降趋势(P<0.05)。结论 GSDME的表达与卵巢癌的化疗耐药密切相关, GSDME的高甲基化水平致使其低表达可促进卵巢癌的化疗耐药。但地西他滨可以通过去甲基化使卵巢癌耐药细胞中GSDME的表达水平升高, 从而增加卵巢癌细胞对化疗药物的敏感性, 进而逆转卵巢癌化疗耐药。
Objective To explore whether drug resistance in ovarian cancer is associated with gasdermin E(GSDME) methylation, and to explore whether decitabine can reverse ovarian cancer chemoresistance by increasing GSDME protein expression levels through demethylation.Methods The cisplatin-resistant cell line(SKOV-3/DDP)was constructed by inverse concentration gradient of cisplatin.Semi-inhibitory concentration(IC50)of cell lines after drug resistance was detected using the CCK8 assay.Real-time fluorescence quantitative methylation-specific PCR was used to detect the methylation level of GSDME gene in the two groups of cells.Wetern Blot was used to detect the expression level of GSDME in the two groups of cells.Drug-resistant cell lines were treated with different concentrations of the demethylating drug decitabine.Experiments above were repeated to detect the methylation degree of IC50 and GSDME genes and the expression level of GSDME protein in drug-resistant cells before and after decitabine treatment.Results Compared with SKOV-3 cells, the methylation level of GSDME gene in SKOV-3/DDP was significantly increased(P<0.01), while the expression level of GSDME protein was significantly decreased(P<0.001).With the increase of decitabine concentration, the methylation degree of GSDME gene in drug-resistant cells was gradually decreased, the expression level of protein was gradually increased, and the IC50 of cells was gradually decreased:the methylation level of GSDME gene was decreased after 0.05 μg/mL decitabine treatment(P<0.01), but there were no significant changes in protein expression level and IC50 of drug-resistant cells(P>0.05).The protein expression level was significantly increased when the concentration of local citabine was increased to 0.10 μg/mL(P<0.05), while the IC50 of the cells was not significantly decreased(P>0.05).When the drug concentration reached 0.15 μg/mL, he IC50 of the cells showed a significant downward trend(P<0.05).Conclusions The expression of GSDME is closely related to chemoresistance in ovarian cancer, and the low expression of GSDME due to its high methylation level can promote chemoresistance in ovarian cancer.However, decitabine can increase the expression level of GSDME in drug-resistant ovarian cancer cells through demethylation,thereby increasing the sensitivity of ovarian cancer cells to chemotherapeutic drugs, and then reversing the chemoresistance of ovarian cancer.
论著

颈源性头痛患者棘突偏歪和椎体滑脱X线研究

A X-ray observation of spinous process deviation and spondylolisthesis in patients with cervical headache

:494-499
 
目的 研究颈源性头痛患者颈椎X线中C2~C7棘突偏歪和椎体滑脱情况,总结其中存在的规律,为治疗颈源性头痛提供影像学理论支持。方法 选取颈源性头痛患者96例,观察并记录每位患者颈椎X线片中C2~C7棘突偏歪和椎体滑脱情况。用统计软件分别对棘突偏歪和椎体滑脱数据进行分析。结果 颈源性头痛患者较常出现棘突偏歪,右侧偏歪明显多于左侧偏歪。其中C2棘突偏歪最常见,出现比例为66.7%。C2棘突偏歪率与C3~C7分别进行χ2检验,其中C5、C6与C2均有显著差异。C3、C4、C7与C2均无显著差异。椎体滑脱亦常出现于颈源性头痛患者,其中C7椎体向前Ⅰ度滑脱最常见,出现比例为50.0%。C7椎体向前Ⅰ度滑脱率与C2~C6分别进行χ2检验,其结果均有显著差异。结论 C2棘突偏歪和C7椎体向前Ⅰ度滑脱较常出现于颈源性头痛患者。在治疗颈源性头痛患者时,与C2和C7相关的软组织损伤和关节紊乱应引起重点关注。
Objective To study the skew of C2~C7 spinous process deviation and spondylolisthesis in cervical spine X-ray of patients with cervical headache,and summarize the existing rules,so as to provide imaging theoretical support for the treatment of cervical headache.Methods The C2~C7 spinous process distortion and spondylolisthesis in cervical radiographs of 96 patients with cervical headache were observed,recorded and analyzed.Results Skew of spinous process was more common in patients with cervicogenic headache,and skew of right side was more obvious than skew of left side.C2 spinous process was the most common,and the proportion of occurrence was 66.7%.The skew rate of C2 spinous process were compared with that of C3~C7 by χ2 test.There were significant differences between C5,C6 and C2.There were no significant difference between C3,C4,C7 and C2.Spondylolisthesis was commonly seen in patients with cervicogenous headache,and I degree spondylolisthesis was most commonly seen in C7,and the proportion of occurrence was 50.0%.There were significant differences between the anterior Ⅰ degree slip rate of C7 vertebrae and that of C2~C6 vertebrae by χ2 test.Conclusions C2 spinous process and C7 spondylolisthesis I are more commonly seen in patients with cervicogenic headache.Soft tissue injuries and joint disorders associated with C2 and C7 should be paid more attention in the treatment of patients with cervicogenic headache.
论著

化疗联合NKG2A抑制剂抗头颈部鳞状细胞癌作用的研究

Effect of chemotherapy combined with NKG2A inhibitor on head and neck squamous cell carcinoma

:860-868
 
目的 研究靶向NKG2A抑制剂抗头颈部鳞状细胞癌(HNSCC)的作用。方法 应用GEO和TCGA数据库分析NKG2A及其配体HLA-E单细胞表达情况、与患者预后以及免疫微环境的相关性。构建HNSCC皮下抑制瘤模型,流式细胞技术检测化学治疗(化疗)对免疫检测点NKG2A表达的影响。动物实验验证NKG2A抑制剂以及NKG2A抑制剂联合多西他赛化疗的抗肿瘤作用。结果 NKG2A(KLRC1)主要表达在NK细胞,少量表达在T淋巴细胞。HNSCC肿瘤高表达NKG2A/HLA-E(P<0.01),与患者不良预后密切相关;肿瘤微环境中NKG2A/HLA-E与多个免疫细胞浸润以及免疫检测点表达密切相关(P<0.01)。动物实验显示化疗能上调T、B淋巴细胞表达免疫检查点NKG2A的表达水平(P<0.01);化疗的基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用(P=0.013)。结论 化疗基础上联合NKG2A抑制剂能更有效地介导抗肿瘤作用,为探索HNSCC临床新策略提供实验和理论基础。
Objective To investigate the anti-tumor effects of NKG2A inhibitor on head and neck squamous cell carcinoma(HNSCC).Methods The single-cell expression of NKG2A ,its ligand HLA-E and their correlations with patient prognosis and immune microenvironment were analyzed in GEO and TCGA databases.The subcutaneous tumor model of HNSCC was constructed,and the effects of chemotherapy on the expression of NKG2A on T and B lymphocytes were detected by flow cytometry.Animal experiments were used to confirmed the anti-tumor effects of NKG2A inhibitor and NKG2A inhibitors combined with docetaxel.Results NKG2A(KLRC1)was mainly expressed in NK cells,and a small amount was expressed in T lymphocytes.The high expression of NKG2A/HLA-E in HNSCC tumors(P<0.01)were closely related to poor prognosis.NKG2A/HLA-E in tumor microenvironment were closely related to the infiltration of multiple immune cells and the expression of immune checkpoints(P<0.01).Animal experiments showed that chemotherapy could up-regulate the expression of NKG2A in T and B lymphocytes(P<0.01).Chemotherapy in combination with NKG2A inhibitor could mediate more effective antitumor effects in HNSCC(P=0.013).Conclusions Combined with NKG2A inhibitor on the basis of chemotherapy can mediate more effective anti-tumor effects,and this study may provide experimental and theoretical basis for exploring new clinical strategies of HNSCC.
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