目的 探讨制何首乌、巴戟天及二者配伍,对氧化型低密度脂蛋白(ox-LDL)诱导的人脐静脉内皮细胞(HUVEC)损伤的影响,以示临床。方法 建立ox-LDL诱导的HUVEC损伤模型,分别用制何首乌、巴戟天、二者配伍的水煮物干预,检测HUVEC的细胞增殖、相对活率、细胞凋亡率、细胞周期、NFκB mRNA的表达。结果 ①制何首乌、巴戟天均能抑制ox-LDL诱导的HUVEC凋亡,二者配伍的抑制作用强于单味中药制何首乌。②制何首乌、巴戟天均能延长ox-LDL诱导的HUVEC的细胞周期(S+G2)%,制何首乌、巴戟天的延长作用相似,二者配伍的延长作用强于单味中药制何首乌、巴戟天。③制何首乌组、巴戟天组的NFκB mRNA的表达量下降,制何首乌组的抑制作用强于巴戟天组,二者配伍的抑制作用强于单味中药制何首乌、巴戟天。结果 制何首乌、巴戟天均能抑制ox-LDL诱导的HUVEC损伤,二者配伍的作用强于单味中药制何首乌、巴戟天。

Objective To investigate the effects of Polygonum multiflorum praeparata, Morinda officinalis and their compatibility on ox-LDL-induced injury of human umbilical vein endothelial cells(HUVEC). Methods We established an ox-LDL-induced HUVEC injury model, made intervention with Polygonum multiflorumpraeparata, Morinda officinalis and their compatibility, the HUVEC cell proliferation, relative viability, apoptosis, cell cycle, NFκB mRNA were detected. Results ①Both Polygonum multiflorumpraeparata, Morinda officinalis reduced the apoptosis rate of HUVEC, and their compatibility had a stronger effect on reducing the apoptosis rate of HUVEC than single Polygonum multiflorumpraeparata. ②Both Polygonum multiflorumpraeparata, Morinda officinalis increased the HUVEC cell cycle (S+G2)%, the extension between Polygonum multiflorumpraeparata and Morinda officinalis was similar, and their compatibility increased HUVEC cell cycle (S+G2)%, it was stronger than single Polygonum multiflorumpraeparata and single Morinda officinalis. ③Both Polygonum multiflorumpraeparata and Morinda officinalis down-regulated the expression of NFκB mRNA in HUVEC, their compatibility down-regulated HUVEC NFκB mRNA expression,it was stronger than Polygonum multiflorumpraeparata, Morinda officinalis. Conclusion Polygonum multiflorumpraeparata, Morinda officinalis and their compatibility can inhibit ox-LDL-induced HUVEC injury, and their compatibility inhibition is stronger than single Polygonum multiflorumpraeparata, and Morinda officinalis.

目的 构建靶向CXCR7基因的CRISPR/Cas9基因编辑系统,并应用于HEK 293T细胞系。方法 设计两对靶向CXCR7基因的sgRNAs,分别插入PX458载体中,并转化DH5α大肠埃希菌。经菌液PCR和测序验证,挑选序列正确的sgRNA-CXCR7-PX458质粒,转染HEK 293T细胞,用流式分选转染阳性细胞,提取其DNA,PCR扩增后测序验证。结果 经测序验证,成功构建了靶向CXCR7基因的CRISPR/Cas9系统,转染HEK 293T细胞后,测序鉴定发现成功编辑CXCR7基因。结论 成功构建了靶向CXCR7的sgRNA-CXCR7-PX458质粒,可在HEK 293T上成功编辑CXCR7基因,为进一步的功能研究奠定基础。

Objective To construct the CRISPR/Cas9 gene editing system targeting C-X-C chemokine receptor 7 (CXCR7) gene and to edit CXCR7 gene in 293T cell line. Methods Two pairs of small guide RNAs (sgRNAs) targeting CXCR7 gene were designed and inserted into PX458 vector, which were transformed into host bacterium Escherichia coliDH5α. The correct sgRNA-CXCR7-PX458 plasmids were selected by PCR and further Sanger sequencing verification. HEK 293T cell line was transfected by DNA of sgRNA-CXCR7-PX458 plasmid. After 72 hours,GFP-positive cells were sorted by flow cytometry. We did DNA extraction of the GFP-positive cells and amplified the CXCR7 gene corresponding fragment by PCR and investigated the CXCR7 gene editing results by Sanger sequencing. Results The CRISPR/Cas9 system targeting CXCR7 gene was successfully constructed. After 293T cells were transfected, the CXCR7 gene was edited in HEK 293T cells successfully. Conclusion The sgRNA-CXCR7-PX458 plasmid targeting CXCR7 gene was successfully constructed. The CRISPR/Cas9 gene editing system targeting CXCR7 gene were used on the HEK 293T cell line, which lays a foundation for further study of BCOR function.

目的 随着治疗水平和疗效的不断提高,急性白血病患者的生存质量越来越受到广泛的关注,本研究旨在探讨急性白血病(AML)患者化疗后生活质量及其相关因素。方法 采用癌症患者生存质量测定量表(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30)中文版、患者一般状况调查问卷,对268例按照AML患者治疗后1年生活质量进行调查,并将EORTC-QLQ-C30各领域评分与患者的特征进行相关性分析。结果 AML患者年龄、FAB分型、是否恢复工作、ECOG评分、婚姻状态、生存质量评分比较上,差异有统计学意义(P>0.05);不同年龄组AML患者PF、RF、EF、SF、QL、FI评分比较上,差异有统计学意义(P<0.05);不同分型AML患者患者RF、EF、SF、QL、DY、SL、FI评分比较上,差异有统计学意义(P<0.05),恢复工作的AML患者PF、RF、SF、QL评分高于未恢复工作的AML患者,恢复工作的AML患者FA、DY、FI评分则低于未恢复工作的AML患者(P<0.05),结婚AML患者PF、RF、SF、QL评分高于未结婚患者,结婚AML患者FA评分低于未结婚患者(P<0.05);逐步多元回归分析发现,年龄、分型、ECOG评分、婚姻状况与AML生存质量有关。结论 高龄、非M3型、ECOG评分高、未婚是AML生存质量差危险因素,可能作为改善AML患者生活质量预期指标。

Objective With the continuous improvement of treatment level and efficacy, the quality of life of patients with acute myeloid leukemia (AML) has attracted more and more extensive attention. This study aimed to explore the quality of life and related factors of patients with acute leukemia (AML) after chemotherapy. Methods The Chinese version of the quality of life scale for cancer patients(European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30, and the general situation questionnaire were was used to investigate quality of life for 268 AML patients one year after treatment.And then the correlation between the EORTC-QLQ-C30 scores in various fields and the characteristics of patients were analyzed. Results There were statistical differences in the scores of age, AML types, work(yes or no),ECOG scores, and marital status in patients (P<0.05).The differences of PF, RF, EF, SF, QL, FI score of AL in different age groups were statistically significant (P<0.05), The PF, RF, EF, SF, QL and FI scores of AML patients in different age groups were statistical different (P<0.05).The scores of PF, RF, SF and QL in AML patients who returned to work were higher than those in AML patients who did not returned to work,while FA, DY and FI scores were the opposite(P<0.05).The PF, RF, SF and QL scores of married AML patients were higher than those of unmarried AML patients,while FA scores were the opposite(P<0.05).Age, classification, ECOG score, marital status were found to be associated with quality of life of AML patients by stepwise multiple regression analysis (P<0.05). Conclusion Old age, non-M3 type, high ECOG score, and unmarried are risk factors for poor quality of life for AML, which may serve as expected indicators for improving the quality of life of patients with acute leukemia.

目的 分析人脑胶质瘤组织中O6—甲基鸟嘌呤—DNA甲基转移酶(MGMT)、DNA拓扑异构酶Ⅱ(TopoⅡ)基因的表达情况及其对化疗敏感性的影响。方法 收集医院2012年4月—2018年6月期间进行开颅手术切除的新鲜人脑胶质瘤标本80例和同期经颅脑手术治疗的脑外伤或脑出血内减压切除的正常脑组织30例。采用免疫组化法检测两种标本中MGMT和TopoⅡ基因表达情况,并通过脑胶质瘤U251和U87细胞培养、体外药物(替莫唑胺)干预、Transwell体外侵袭实验分析其对化疗敏感性的影响。结果 胶质瘤标本、正常脑组织MGMT和TopoⅡ基因表达程度分布比较差异均有统计学意义(P＜0.05),且二者MGMT基因阳性表达率分别为63.75%、3.33%,TopoⅡ基因阳性表达率分别为55.00%、0.00%,差异有统计学意义(P＜0.05)。MGMT、TopoⅡ基因均在细胞核显示为阳性染色。体外药物干预的实验组、未进行药物干预的阴性对照组干预前U251、U87细胞穿膜细胞计数比较无统计学意义(P＞0.05),但干预后实验组U251、U87细胞穿膜细胞计数高于阴性对照组(P＜0.05),干预后实验组U251、U87细胞有更强的侵袭力。结论 MGMT和TopoⅡ基因在人脑胶质瘤标本中阳性表达率高,且可能参与促进脑胶质瘤细胞侵袭,影响肿瘤化疗敏感性。

Objective To analyze the expression of O6-methylguanine-DNA methyltransferase (MGMT) and DNA topoisomerase II (Topo II) genes in human brain gliomas and its influence on the chemosensitivity. Methods A total of 80 fresh human brain glioma specimens resected by craniotomy and 30 normal brain tissues resected by craniocerebral operation for traumatic brain injury or decompression for cerebral hemorrhage during the period from April 2012 to June 2017 were collected. The expression of MGMT and Topo II genes in the two kinds of specimens was detected by immunohistochemical method, and the influence on chemosensitivity was analyzed through brain glioma U251 and U87 cell culture, in vitro drug (temozolomide) intervention and Transwell invasion in vitro. Results There was a significant difference in the expression of MGMT and Topo II genes in glioma specimens and normal brain tissues (P<0.05). The positive expression rates of MGMT gene in the two kinds of specimens were 63.75% and 3.33% respectively while the positive expression rates of Topo II gene were 55.00% and 0.00%, respectively (P<0.05). Both of MGMT and Topo II genes were displayed in the nucleus as positive staining. There was no significant difference in transmembrane cell count of U251 and U87 cells between the experimental group given drug intervention in vitro and negative control group without drug intervention before the intervention (P>0.05). However, the transmembrane cell count of U251 and U87 cells in the experimental group after intervention was higher than that in the negative control group (P<0.05). After intervetion, U251 and U87 cells were with stronger invasiveness in the experimental group. Conclusion The positive expression rates of MGMT and Topo II genes are high in human brain glioma specimens. They may be involved in promoting glioma cell invasion, affecting tumor chemosensitivity.

目的 探讨特发性肺纤维化(IPF)患者和结缔组织病相关性纤维化间质性肺疾病(CTD-fILD)患者急性加重(AE)的短期内死亡的危险因素。方法 回顾性分析2017年10月—2019年9月在深圳大学和广州医科大学附属第一医院住院的25例 AE-CTD-fILD和26例AE-IPF患者临床信息,Kaplan-Merier法对两组患者进行生存分析,Cox回顾分析年龄、性别、吸烟、白细胞总数、C反应蛋白、红细胞沉降率及肿瘤指标在急性加重患者死亡中的作用。结果 与AE-CTD-fILD比较,AE-IPF患者组男性比例、年龄、吸烟比例较高,红细胞沉降率较低(24/26 vs 10/25,P<0.001;63.77±9.97 vs 58.00±10.32,P=0.048;16/26 vs 9/25,P=0.02;28.07±29.45 vs 64.35±40.34,P=0.002 );90天内,26例AE-IPF患者11例死亡,25例AE-CTD-fILD患者5例死亡,死亡率无明显差异(42.3% vs 20%,P=0.073);Cox回归分析显示,白细胞计数是AE-IPF和AE-CTD-fILD患者的死亡危险因素(HR=1.305,P=0.001;HR=1.529,P=0.009);CA15-3是AE-IPF患者死亡危险因素(HR=1.015,P=0.005)。结论 急性加重IPF和CTD-fILD患者短期内死亡风险相似,白细胞计数及外周CA15-3水平可能是肺纤维化急性加重患者短期内死亡的危险因素。

Objective To explore the risk factors for acute exacerbation (AE) in patients with idiopathic pulmonary fibrosis (IPF) and connective tissue disease associated with fibrotic interstitial lung disease (CTD-fILD). Methods We retrospectively reviewed 25 patients with AE-CTD-fILD and 26 patients with AE-IPF, and Kaplan-Merier was used to analyze the survival of the two groups of patients. The impact of age,gender, smoking,WBC,CRP,ESR and tumor markers on acute exacerbation death were performed by Cox regression analysis. Results The AE-IPF patients had a higher proportion of men,age and smoking,and a lower ESR compared with AE-CTD-fILD patients(24/26 vs 10/25,P<0.001;63.77±9.97 vs 58.00±10.32,P=0.048;16/26 vs 9/25,P=0.02;28.07±29.45 vs 64.35±40.34,P=0.002 ). 11 cases of 26 patients with AE-IPF and 5 cases of 25 patients with AE-CTD-fILD died within 90 days, Log-rank tests showed patients with CTD-fILD had similar mortality rate compared with IPF patients after AE(42.3% vs 20%,P=0.073). The WBC count was negatively correlated with survival and the independent predictors for patients with AE-IPF and AE-CTD-fILD after adjusting for other clinical variates in Cox regression models(HR=1.305,P=0.001;HR=1.529,P=0.009). CA15-3 may be a risk factor for death of AE-IPF patients(HR=1.015,P=0.005). Conclusion AE-CTD-fILD and AE-IPF were associated with similar poor short-term survival, WBC count and plasma CA15-3 may be the independent survival predictors respectively for patients with acute exacerbation of pulmonary fibrosis in short term.

目的 分析酶联免疫法(ELISA)联合核酸检测技术(NAT)在献血者血液筛查和输血残余风险分析中的应用价值。方法 选取2019年1月—8月惠州市中心血站2 514例无偿献血者为研究对象,采集血液标本,分别应用两种不同ELISA试剂盒检测乙肝病毒表面抗原(HBsAg)、丙肝抗体(抗-HCV)、艾滋病抗体(抗-HIV),并以核酸扩增技术(NAT)进行HBV DNA、HCV RNA、HIV RNA检测,对ELISA检测阴性,而NAT检测阳性的标本进行进一步追踪分析。结果 ELISA检测结果显示27例阳性,阳性率1.07%,其中2例同时HBsAg阳性、丙肝抗体(抗-HCV)阳性。NAT技术检测结果显示12例阳性,阳性率0.48%,其中1例同时HBV DNA阳性、HCV RNA阳性。27例ELISA检测阳性中,10例经NAT技术检测证实为阳性,17例为阴性;2 487例ELISA检测阴性中,2例NAT技术检测HBV DNA阳性,2 485例为阴性。对2例ELISA检测阴性、NAT技术检测阳性者进行随访追踪证实HbsAg阳性。结论 2次ELISA筛查献血者血液仍然存在漏检误检风险,存在输血残余风险,联合应用NAT技术能够降低输血残余风险。

目的 探讨品管圈(Quality Control Circle, QCC)活动对降低造影剂外渗的效果观察。方法 根据QCC的方法和步骤,成立QCC小组,通过比较和分析QCC活动实施前后外渗率的变化,找出导致CT增强扫描前接受高压静脉造影剂注射外渗的主要原因,提出针对性的改进措施并分析其效果。结果 QCC活动实施前外渗率达0.17%,而实施后外渗率为0.07%,差异有统计学意义(P<0.05)。结论 开展QCC活动可降低CT增强扫描前造影剂外渗发生率,值得临床推广应用。

Objective To investigate the effect of quality control circle (QCC)activity on reducing contrast agent extravasation. Methods According to the steps and methods of the quality control circle, a QCC group was set up to compare and analyze the data before and after the implementation of QCC activities to find out the main reason for the extravasation of high-pressure intravenous contrast agent injection before CT enhanced scanning, and put forward targeted improvement measures to analyze its effect. Results The extravasation rate before QCC activity was 0.17%, and the extravasation rate after implementation was 0.07%, the difference was statistically significant (P <0.05). Conclusion Carrying out QCC activities may reduce the incidence of contrast agent extravasation before CT enhanced scanning, which is worthy of clinical application.

新型冠状病毒肺炎是一种新发的急性呼吸道疾病,如何准确、完整、及时的记录好新冠肺炎患者的病历信息,为医学研究提供科学的依据是医院病案管理统计的工作重点。本文结合国家相关的规定和某新冠肺炎定点救治医院疫情防控工作经验,提出针对新冠肺炎病历的管理方案,包含病历的书写、编码、运行管理三方面,配合医院做好疫情防控工作的同时妥善记录好新冠肺炎患者病历信息。

Coronavirus disease 2019 is a new type of acute respiratory disease. Recording accurately, completely and timely the medical records of patients with COVID-19 and providing a scientific basis for medical research are the focus of the medical records management statistics. This paper proposes a management plan including writing, coding, and operation management for COVID-19 medical records, combining with the relevant national regulations and a COVID-19 designated hospital's experiences of epidemic prevention and control. This management plan cooperates with the hospital to do epidemic prevention and control work, and properly recordes the medical records of COVID-19 patients.

目的 研究疫情下护理人员的情绪障碍和睡眠障碍情况。方法 应用广泛性焦虑障碍量表(GAD-7),病人健康问卷(抑郁)(PHQ-9),病人健康问卷(躯体症状)(PHQ-15)和匹兹堡睡眠质量指数(PSQI)量表对临床一线护理人员进行心理和睡眠问卷调查,统计情绪和睡眠障碍的发病率,以及其相关性。结果 126名完成量表的临床一线护理人员,焦虑,抑郁,躯体症状,睡眠障碍的发病率分别为:41.9%、31.5%、9.5%和30.8%。相关性分析显示学历,年龄,婚育情况及是否为独生子女与上述情绪、睡眠障碍有相关,差异有统计学意义(P <0.05)。结论 临床一线护理人员焦虑和睡眠障碍发病率高,且二者明显相关,存在相互影响。建议医院随时更新知识指南,加强对护理人员的心理疏导和人文关怀,以减轻护理人员的心理压力。

Objective To study the emotional and sleep disorders of nursing staff under the emerging infections diseases. Methods The generalized anxiety disorder scale anxiety (GAD-7), patient health questionnaire 9(depression)(PHQ-9), patient health questionnaire 15 (somatic symptoms)(PHQ-15), and Pittsburgh sleep quality index (PSQI)were used in our investment. Statistics on the incidence of emotional and sleep disorders, and their correlation were done in our study. Results The incidence of anxiety, depression, physical symptoms, and sleep disorders in 126 nurses were 41.9%, 31.5%, 9.5%, and 30.8%, respectively. Correlation analysis showed that education, age, marital status, and whether or not they were the only children in the family were related to the above-mentioned emotions and sleep disorders (P<0.05). Conclusion The incidence of anxiety and sleep disorders in clinical front-line nurses is high. There are high and significant correlation and interaction between mood and sleep disorders. It is recommended that hospital need to update the knowledge and strengthen the psychological counseling and humanistic care of the nursing staff to reduce the psychological pressure of the nursing staff.

目的 比较细胞因子TGF-β、IL-10、TNF-α、Th17在不同妊娠结局的妊娠期亚临床甲减孕妇血清中的差异,探索细胞因子在不同妊娠结局中的作用。方法 随机选择2018年1月—2018年12月在我院就诊的66例确诊为因妊娠期亚临床甲减而出现不良妊娠结局的孕妇与同期妊娠结局正常的66例孕妇进行病例对照研究,比较不同妊娠结局孕妇的血清TGF-β、IL-10、TNF-α、Th17的差异;结果 ① 亚临床甲减组的TPOAb、TgAb、TRAb阳性率高于正常妊娠组,同时TNF-α、Th17均高于正常妊娠组,而TGF-β、IL-10均低于正常妊娠组,差异有统计学意义(P<0.05)。② 因子分析发现:在TPOAb、TgAb、TRAb、TGF-β、IL-10、TNF-α、Th17七个影响妊娠期亚临床甲减不良妊娠结局的相关因素中,TGF-β、IL-10、TNF-α、Th17在第1影响因子,特征值达2.347;TPOAb、TgAb、TRAb是次要影响因子,特征值为1.162。结论 TGF-β、IL-10、TNF-α、Th17与妊娠期亚临床甲状腺功能减退症的不良妊娠结局有密切关系,TGF-β、IL-10、TNF-α、Th17是影响妊娠期亚临床甲减不良妊娠结局的主要因子;TPOAb、TgAb、TRAb是影响妊娠期亚临床甲减不良妊娠结局的次要因子。

Objective To compare the serum levels of TGF-β, IL-10, TNF-α and Th17 in pregnant women with subclinical hypothyroidism in different pregnancy outcomes. Methods A case-control study was conducted in 66 pregnant women with adverse pregnancy outcomes due to subclinical hypothyroidism during pregnancy and 66 pregnant women with normal pregnancy outcomes during the same period. The differences of serum TGF-β, IL-10, TNF-α and Th17 among pregnant women with different pregnancy outcomes were compared. Results ①The positive rates of TPOAb, TgAb and TRAb in subclinical hypothyroidism group were higher than those in normal pregnancy group, and TNF-α and Th17 were higher than those in normal pregnancy group, while TGF-βand IL-10 were lower than those in normal pregnancy group (P<0.05). ②Factor analysis found that TPOAb, TgAb, TRAb, TGF-β, IL-10, TNF-α and Th17 were the factors related to adverse pregnancy outcomes of subclinical hypothyroidism in pregnancy. TGF-β, IL-10, TNF-α and Th17 were the main influencing factors with a characteristic value of 2.347; TPOAb, TgAb and TRAb were the second influencing factors,with a characteristic value of 1.162. Conclusion ①TGF-β, IL-10, TNF-α, Th17 are closely related to the occurrence and pregnancy outcome of subclinical hypothyroidism in pregnancy. ②TGF-β, IL-10, TNF-α and Th17 are the main factors affecting the adverse pregnancy outcomes of subclinical hypothyroidism in pregnancy;TPOAb, TgAb and TRAb are the secondary factors affecting the adverse pregnancy outcomes of subclinical hypothyroidism in pregnancy,