目的 分析超声引导下经皮肾穿刺活检术对弥漫性肾病进行病理诊断的临床应用价值。方法 回顾性分析我院275例弥漫性肾病患者经超声引导下行经皮肾穿刺活检术进行诊断的情况,针对上述患者的穿刺活检情况、穿刺满意度、取材成功率、并发症发生状况、弥漫性肾病病理分型结果以及术后诊断更正的情况进行分析。结果 275例患者穿刺满意度、取材成功率、并发症总发生率分别为94.91%,100%、10.91%。275例患者术后并发症的发生与年龄、穿刺次数、肾实质厚度、术前血肌酐水平有关。275例患者以膜性肾病、IgA肾病居多,分别占比23.27%、18.55%。275例患者术后诊断更正率为19.79%。结论 超声引导下经皮肾穿刺活检术是一种安全有效的弥漫性肾病诊断方法,其术后并发症发生率较低且较轻。在弥漫性肾病病理分型诊断中以膜性肾病、IgA肾病的发病率较高。超声引导下经皮肾穿刺活检术可早期诊断弥漫性肾病的病理类型,为确定治疗方案提供可靠依据,改善肾脏疾病的预后。

Objective To analyze the clinical value of ultrasound-guided percutaneous renal biopsy for pathological diagnosis of diffuse renal disease. Methods Retrospective analysis of 275 patients with diffuse renal disease in our hospital underwent ultrasound-guided percutaneous renal biopsy for diagnosis. According to the above-mentioned patients' biopsy status,puncture satisfaction,success rate of material extraction,complications,and diffuse results of pathological typing of nephropathy and correction of postoperative diagnosis were analyzed. Results The satisfaction rate of puncture,the success rate of material extraction and the total incidence of complications were 94%,100%,and 10.91%,respectively. The incidence of postoperative complications in 275 patients was related to age,number of punctures,thickness of renal parenchyma,and preoperative serum creatinine levels. Membrane nephropathy and IgA nephropathy were the most common in 275 patients,accounting for 23.27% and 18.55% respectively. The correction rate of postoperative diagnosis in 275 patients was 19.79%. Conclusion Ultrasound-guided percutaneous renal biopsy is a safe and effective method for diagnosing diffuse nephropathy,and the incidence of postoperative complications is low and mild. Membrane nephropathy and IgA nephropathy have a higher incidence in the diagnosis of diffuse nephropathy. Ultrasound-guided percutaneous renal biopsy may early diagnose the pathological type of diffuse renal disease,provide a reliable basis for determining the treatment plan,and improve the prognosis of renal disease.

目的 分析彩色多普勒超声在小儿阴囊急症诊断中的应用价值。方法 于2019年1月—2019年12月选取院内收治的100例以阴囊急症就诊的患儿作为研究对象,使用彩色多普勒超声对所有患儿进行诊断,分析患儿的超声影像学特点,并对彩色多普勒超声的诊断结果与手术和病理结果进行对比。结果 急性睾丸扭转患儿的影像学形态以睾丸肿胀(90.63%)、阴囊壁水肿(75.00%)、鞘膜积液(68.75%)、睾丸实质回声异常(59.38%)和附睾增大(53.13%)为主,其中睾丸肿胀和睾丸实质回声异常的患儿例数明显高于其他疾病类型(P＜0.05);急性睾丸附件扭转患儿的影像学形态以睾丸外结节(96.30%)、附睾增大(74.07%%)、阴囊壁水肿(70.37%)和鞘膜积液(51.85%)为主,其中睾丸外结节的患儿例数高于其他疾病类型(P＜0.05);急性附睾炎患儿的影像学形态以阴囊壁水肿(82.61%)、附睾增大(73.91%)和鞘膜积液(52.17%)为主;急性睾丸炎患儿的影像学形态也以阴囊壁水肿(83.33%)、附睾增大(83.33%)、和鞘膜积液(55.56%)为主,急性附睾炎和急性睾丸炎患儿的影像学形态相比差异无统计学意义(P＞0.05);急性睾丸扭转患儿的睾丸内血流分布主要为减少或消失和精索扭转,与其他疾病类型患儿相比差异有统计学意义(P＜0.05);急性睾丸附件扭转患儿的睾丸内血流分布主要为正常,与其他疾病类型患儿相比差异有统计学意义(P＜0.05);急性附睾炎和睾丸炎患儿的睾丸内血流分布主要为增加,与其他疾病类型患儿相比差异有统计学意义(P＜0.05),急性附睾炎和急性睾丸炎患儿的睾丸内血流分布情况相比差异无统计学意义(P＞0.05);彩色多普勒超声在阴囊急症中的总诊断率为97%,与手术病理结果相比无差异(P＞0.05),在急性睾丸扭转中的诊断符合率为96.88%,在急性睾丸附件扭转中的诊断率为96.30%,在急性附睾炎中的诊断符合率为95.65%,在急性睾丸炎中的诊断率为100.00%,不同疾病类型阴囊急症患儿中的诊断率与手术病理结果相比均无差异(P＞0.05)。结论 彩色多普勒超声在小儿阴囊急症的诊断中发挥出了较好的临床诊断效果,在不同疾病类型阴囊急症中的诊断符合率均相对较高,应当作为小儿阴囊急症早期筛查的主要影像学方法,值得广泛应用及推广。

Objective To analyze the value of color Doppler ultrasound in the diagnosis of scrotal emergency in children. Methods From January 2019 to December 2019,100 children admitted to the hospital with scrotal emergency were selected as the research objects. All patients were diagnosed by color Doppler ultrasound and the characteristics of ultrasound imaging were analyzed. The diagnostic results of color Doppler ultrasound were compared with surgical and pathological results. Results The imaging morphology of children with acute testicular torsion was testicular swelling (90.63%),scrotal wall edema (75.00%),hydrocele (68.75%),abnormal testicular parenchymal echo (59.38%),and enlarged epididymis (53.13%) mainly. The numbers of children with testicular swelling and abnormal testicular parenchymal echo were higher than other disease types (P<0.05); the imaging morphology of children with acute testicular attachment reversal was extratesticular nodules (96.30%) and enlarged epididymis (74.07 %%),scrotal wall edema (70.37%),and hydrocele (51.85%) were predominant,and the numbers of children with extra testicular nodules were higher than other disease types (P<0.05); acute epididymis morphology of scrotal wall edema (82.61%),enlarged epididymis (73.91%),and hydrocele (52.17%) in children with inflammation are mainly; the morphology of scrotal wall edema in children with acute orchitis (83.33%) also,epididymis enlargement (83.33%),and hydrocele (55.56%) were the main factors. There was no significant difference in imaging morphology between children with acute epididymitis and acute orchitis (P> 0.05); Testicular blood flow distribution in children with acute testicular torsion was mainly reduced or disappeared and spermatic cord twisted,the difference was statistically significant compared with children with other disease types (P<0.05); blood distribution in the testis of children with acute testicular accessory torsion was mainly normal,compared with children with other disease types. The difference was statistically significant (P<0.05); the distribution of blood flow in the testis of children with acute epididymitis and orchitis was mainly increased,and the difference was statistically significant compared with children with other disease types (P<0.05). There was no significant difference in testicular blood flow distribution between children with inflammation and acute orchitis (P> 0.05);The overall diagnosis rate of color Doppler ultrasound in scrotal emergency was 97%,and there was no significant difference compared with the surgical pathological results (P> 0.05). The diagnostic coincidence rate in acute testicular torsion was 96.88%,and in acute testis, the diagnostic rate of attachment reversal was 96.30%,the diagnostic coincidence rate in acute epididymitis was 95.65%,the diagnostic rate in acute orchitis was 100.00%. Compared with the diagnosis rates and surgical pathology results in children with scrotal emergency of different disease types,there were no significant differences (P> 0.05). Conclusion Color Doppler ultrasound has a good clinical diagnosis effect in the diagnosis of scrotal emergencies in children,and the diagnostic coincidence rate in different types of scrotal emergencies is relatively high. It should be used as the main early screening for scrotal emergencies. The imaging method is worthy of wide application and promotion.

目的 探讨子午流注开穴法对薄型子宫内膜患者妊娠结局的影响。方法 将同期在门诊行B超监测排卵、指导受孕的薄型子宫内膜患者80例随机分为两组,每组各40例,观察组采用子午流注开穴法及药物治疗,对照组则单纯给予药物治疗。比较两组治疗前后的子宫内膜厚度、子宫内膜形态、子宫内膜血流搏动指数(PI)、血流阻力指数(RI)及临床妊娠率(PR)。结果 两组治疗后子宫内膜厚度与同组治疗前均有不同程度的改善(P<0.05),治疗后子宫内膜厚度两组间比较差异有统计学意义(P<0.05)。观察组治疗后A型子宫内膜的比例较治疗前增加,差异有统计学意义(P<0.05);与对照组比较,差异有统计学意义(P<0.05)。观察组临床妊娠率为27.5%,对照组临床妊娠率为10%,两组相比较差异有统计学意义(P<0.05)。结论 子午流注开穴法在薄型子宫内膜患者中的应用有效促进子宫内膜容受性的建立,从而改善其妊娠结局。

Objective To explore the effects of selection points by earth meridian ebb-flowing rule on infertile women suffering from thin endometrium. Methods 80 patients with thin endometrium who were monitored ovulation and guided pregnancy under B-mode ultrasound were randomly divided to two groups: the observation group and the control group, 40 patients for each group. The observation group was treated with selection points by earth meridian ebb-flowing rule and medication, while the control group was treated with medication only. The endometrial thickness, endometrial morphology, endometrial blood flow Pulsation Index (PI), Resistance Index (RI) and Clinical Pregnancy Rate (PR) before and after treatment were compared between the two groups. Results After treatment, the endometrial thickness was improved in both groups, which was statistical significant between the two groups(P<0.05). The proportion of type A endometrium in the observation group was increased compared with that before treatment and the control group, the difference was statistical significant(P<0.05). The clinical pregnancy rate was 27.5% in the observation group and 10% in the control group, and the difference between the two groups was statistically significant(P<0.05). Conclusion The application of selection points by earth meridian ebb-flowing rule in patients with thin endometrium may effectively promote the establishment of endometrial receptivity and improve the pregnancy outcome.

目的 本研究通过已建立的稳定表达人血小板CD36的HEK293T细胞系,制备鼠源的抗人CD36单克隆抗体并进行特性鉴定。方法 利用已经建立的稳定表达人血小板CD36的HEK293T细胞系对CD36(-/-)C57小鼠进行免疫,取脾脏与小鼠骨髓瘤细胞融合,筛选出阳性克隆。纯化单克隆抗体后,利用Western blot检测抗体结合活性。利用小鼠IgG类/单抗亚型鉴定试剂鉴定单克隆抗体的抗体亚型。通过流式细胞检测和血小板抗原单克隆抗体特异性免疫固定检测(MAIPA)鉴定其诊断应用价值。结果 经筛选后得到一株杂交瘤细胞,抗体亚型为IgG2a,轻链为κ链,Western blot试验表明该单克隆抗体特异性识别人血小板CD36抗原。MAIPA结果显示,与商业化单克隆抗体FA6-152相比,该单克隆抗体灵敏度更高。结论 成功制备了一种鼠抗人CD36单克隆抗体,为临床鉴定CD36抗体,筛选CD36阴性献血员提供了新的工具,也为今后进一步研究CD36在血液免疫疾病中作用机制提供了实验基础。

Objective In this study, by the established HEK293T cell line with stable expression of human platelet CD36, murine anti-human CD36 monoclonal antibody was prepared and characterized. Methods The established HEK293T cell line with stable expression of human platelet CD36 was used to immunize CD36 (-/-) C57 mice, and the spleen was fused with mouse myeloma cells to screen for positive cloning.After the purification of monoclonal antibody, the antibody binding activity was detected by Western blot.Mouse rapid antibody isotyping reagent was used to identify the subtype of monoclonal antibody.Its diagnostic value was evaluated by flow cytometry and monoclonal antibody-specific immobilization of platelet antigen (MAIPA). Results After screening, a high-producing hybridoma cell was obtained, the subtype of monoclonal antibody was IgG2a and the light chain was κ chain. Western blot analysis showed that the monoclonal antibody could specifically recognize CD36 antigen of human platelet. MAIPA results showed that the monoclonal antibody was more sensitive than the commercial monoclonal antibody FA6-152. Conclusion It is concluded that a mouse anti-human CD36 monoclonal antibody with biological activity has been obtained, which provides a new tool for the clinical identification of CD36 antibody and the screening of CD36 negative blood donors, and also provides an experimental basis for further research on the mechanism of CD36 in blood immune diseases.

目的 研究NR3C1(核受体亚科3,C组,成员1)又称糖皮质激素受体(GR)表达量对前列腺癌恶性程度的影响及其与前列腺癌生化复发的相关性。方法 通过组织芯片免疫组化染色检测的方法检验NR3C1在不同恶性程度前列腺癌组织的表达情况,结合Taylor数据库分析NR3C1表达水平与前列腺癌临床病理特征关系,再采用Kaplan-Meier法分析NR3C1对前列腺癌生化复发生存率的影响,最后用Cox回归分析临床病理特征与生化复发的相关性。结果 组织芯片免疫组化结果显示NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.028)。结合Taylor公用数据库分析,NR3C1在前列腺癌组织中的表达低于癌旁组织(P＜0.001),NR3C1在Gleason评分低的前列腺癌组织中表达高于Gleason评分高的前列腺癌组织(P=0.005),NR3C1低表达与PSA复发(P=0.028)和转移(P=0.003)相关。Kaplan-Meier结果提示:NR3C1高表达组患者术后的生化复发生存率更高(P=0.043),总体生存率没有明显区别(P=0.872)。单因素分析结果显示:NR3C1(P=0.002),病理分期(P＜0.001),Gleason评分(P＜0.001),是否转移(P=0.012)是前列腺癌生化复发的影响因素。多因素分析结果显示:高Gleason 评分(P=0.017)和转移(P<0.001)均为生化复发危险因素。结论 NR3C1影响前列腺癌的发病进程,检验NR3C1的表达情况,能预测前列腺癌患者生化复发的概率,可协助判断前列腺癌预后。

Objective We study the role of NR3C1 (nuclear receptor subfamily 3,group C,member 1) in PCa progression,and the correlation between its expression level and the biochemical recurrence of PCa. Methods Immunohistochemistry was used to detect the expression of NR3C1 in PCa tissues of different degrees of malignancy. The associations of NR3C1 expression and clinical pathological features were analyzed using the Taylor dataset. Kaplan-Meier was used to detect the relationship between NR3C1 expression and biochemical recurrence survival rate in PCa. Cox-regressive analysis was used to detect the relationship between clinical pathological features and biochemical recurrence. Results Immunohistochemistry analysis showed the expression of NR3C1 was higher in which its Gleason Score was lower(P=0.028). Base on the Taylor dataset,the expression of NR3C1 was higher in the adjacent benign tissues than that in PCa(P＜0.001). The expression of NR3C1 was higher in which its Gleason Score was lower(P=0.005). Furthermore,low NR3C1 expression was associated with PSA failure(P=0.028) and Metastasis(P=0.003). Kaplan-Meier showed the biochemical recurrence-free time of PCa patients in low NR3C1 expression groups reduced(P=0.043). The overall survival time of PCa patients was not correlated to NR3C1 expression levels(P=0.872). Single factor analysis showed the biochemical recurrence is associated with NR3C1 expression(P=0.002),pathological stage(P＜0.001),Gleason score(P＜0.001), Metastasis status(P=0.012). Multivariate analysis by Cox regression further identified the high Gleason Score(P=0.017) and Metastasis status (P<0.001)were hazards of the biochemical recurrence. Conclusion Our study showed that the expression of NR3C1 critically connected with the process of PCa,which indicated that we can predict the probability of the biochemical recurrence and determine the prognosis of prostate cancer by detecting the expression of NR3C1 in PCa patients.

目的 探讨骨髓间充质干细胞源性微泡(BMSC-MV)修复大鼠早发性卵巢功能不全的自噬机制。方法 大鼠骨髓分离培养骨髓间充质干细胞;超速离心法从骨髓间充质干细胞培养液中分离微泡;腹腔注射顺铂溶液制备早发性卵巢功能不全(POI)模型,制备后3 d尾静脉取血ELISA检测血清雌二醇(E2)及卵泡刺激素(FSH);尾静脉注射BMSC-MV移植治疗POI大鼠模型,移植后28 d尾静脉取血ELISA检测E2、FSH及抗苗勒管激素(AMH),同时取卵巢组织检测自噬相关蛋白LC3及P62。结果 模型对照组及微泡移植组在模型制备后3 d的E2 含量低于正常对照组,FSH 含量高于正常对照组(P<0.001);微泡移植组在移植后28 d的E2、AMH含量高于模型对照组(P<0.001),FSH含量低于模型对照组(P<0.001);微泡移植组的LC3较模型对照组表达升高,而P62表达降低(P<0.001)。结论 BMSC-MV介导自噬修复大鼠早发性卵巢功能不全。

Objective To investigate the autophagy mechanism of bone marrow mesenchymal stem cell-derived microvesicle (BMSC-MV) in repairing premature ovarian dysfunction in rats. Methods The whole bone marrow adherence method was used to isolate,culture and identify BMSCs of SD rats. Microvesicles were isolated from bone marrow mesenchymal stem cell by ultracentrifugation. Premature ovarian insufficiency (POI) model was prepared by intraperitoneal injection of cisplatin solution,and serum estradiol (E2) and follicular stimulating hormone (FSH) were detected by ELISA from tail vein 3 days after preparation. Rat model of POI was treated with BMSC-MV transplantation by tail vein. Blood from tail vein was collected 28 days after transplantation to detect E2,FSH and AMH by ELISA. Meanwhile,ovarian tissues were collected to detect autophagy-related proteins LC3 and P62. Results The E2 content of the model control group and the microvesicle transplantation group was lower than that of the normal control group,and the FSH content was higher than that of the normal control group (P<0.001). The content of E2 and AMH in the microvesicle transplantation group at 28 days after transplantation was higher than that in the model control group (P<0.001),and the content of FSH was lower than that in the model control group (P<0.001). Compared with the model control group,LC3 expression in the microvesicle transplantation group was increased,while P62 expression was decreased (P<0.001). Conclusion BMSC -MV mediate autophagy to repair premature ovarian insufficiency in rats.

目的 探讨PAD方案治疗初发多发性骨髓瘤(MM)有效性及安全性。方法 统计54例接受PAD方案治疗的初发MM患者临床资料,采用回顾性分析方法。PAD方案:P(硼替佐米)1.3 mg/m²,第1、4、8、11天皮下注射,A(脂质体阿霉素)25～30 mg/m²,第1天静脉滴注,D(地塞米松)40 mg,第1～4 天静脉滴注或口服,每21天为1个疗程。采用IMWG疗效标准判定疗效,按NCICTCAE(第3版)标准判断不良反应。结果 ①总体疗效:平均4(2~8)个疗程后,47例(87.0%)患者获部分缓解(PR)以上疗效,其中完全缓解(CR)20例(37.0%),很好的部分缓解(VGPR)19例(35.2%),部分缓解(PR)8例(14.9%),疾病稳定(SD)5例(9.3%),病情进展率(PD)2例(3.7%)。②亚组疗效:54例患者中,35例治疗4个以上疗程,19例小于4个疗程,ORR分别为97.1%(34/35)、68.4%(13/19)(P=0.003)。按照年龄、肾功能、骨破坏数目、骨髓浆细胞比例、ALB、LDH、β2-MG、细胞遗传学、ISS分期、临床分型进行队列亚组疗效比较,结果提示亚组疗效差异无统计学意义(P＞0.05);③总体安全性:中性粒细胞减少8例(14.8%),血小板减少8例(14.8%),周围神经病变16例(29.6%),腹泻2例(3.7%),便秘2例(3.7%),带状疱疹4例(7.4%),细菌感染5例(9.3%),以上不良反应经对症治疗后症状减轻或消失。④亚组安全性:按照年龄和疗程数进行亚组比较,年龄大于60岁患者和年龄小于60岁患者总不良反应发生率和3/4级不良反应发生率分别是47.4% vs 60.0% 和15.8% vs 20.1%,(P=0.404和P=1.00);治疗4个以上疗程患者和小于4个疗程患者总不良反应发生率和3/4级不良反应发生率分别是57.9% vs 54.3%和21.2% vs 17.1%,(P=1.00和P=0.728)。结论 PAD方案治疗初发MM效果显著,缓解率和疗程数有相关性,疗效与传统的生存预后因素无关,可作为MM诱导治疗的一线方案。脂质体阿霉素心脏毒性小,替代传统蒽环类药物阿霉素,不良反应可控,耐受性良好,更适用于老年MM患者。

Objective To investigate the efficacy and safety of PAD regimen in previously untreated patients with multiple myeloma(MM). Methods We retrospectively analyzed 54 patients with newly-diagnosed MM,who were treated with PAD regimen: Bortezomib 1.3mg/m² subcutaneously on day 1,4,8,11. Liposomal doxorubicin 25～30 mg/m² intravenously on the first day. Dexamethasone 40 mg/d intravenously or orally on days 1～4. Treatment was repeated every 21 days. Response was evaluated according to the International Uniform Response Criteria for MM.Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria,version 3.0. Results ①Overall response:after median 4(2～8) courses of PAD,47patients(87.0%)responsed,including complete response (CR) in 20 (37.0%),very good partial response (VGPR) in 19 (35.2%),partial response (PR) in 8 (14.9%),stable disease (SD) in 5 (9.3%) and progressive disease (PD) in 2 (3.7%). ②Subgroups efficacy: among the 54 patients,35 patients received more than 4 therapeutic courses,and 19 patients received less than 4 courses.The ORR was 97.1% (34/35) and 68.4% (13/19) respectively (P=0.003). Subgroups efficacy were compared according to age,renal function,number of bone destruction,proportion of bone marrow plasma cells,ALB,LDH,β2-MG,cytogenetics,ISS staging and clinical classification. The results indicated that there was no statistical difference(P>0.05). ③Overall safety: adverse events included neutropenia in 8 (14.8%),thrombocytopenia in 8 (14.8%),peripheral neuropathy in 16 (29.6%),diarrhea in 2 (3.7%),constipation in 2 (3.7%),herpes zoster in 4 (7.4%) and bacterial infection in 5 (9.3%). The adverse events relieved or disappeared after symptomatic treatment. ④Subgroups safety: compared by age and courses of treatment,the incidence of overall adverse events and grade 3/4 adverse events in patients older than 60 years and ones younger than 60 were 47.4% vs 60.0% and 15.8% vs 20.1% respectively,(P=0.404,P=1.00). The incidence of overall adverse events and grade 3/4 adverse events in patients with more than 4 therapeutic courses and ones with less than 4 courses were 57.9% vs 54.3% and 21.2% vs 17.1% respectively,(P=1.00和P=0.728). Conclusion PAD regimen has really curative effect in treating patients with newly diagnosed MM. There is a correlation between remission rate and therapeutic courses. It can be used as the first selected protocol for the induction therapy of MM. Its efficacy is independent of traditional prognostic factors.Liposomal doxorubicin has almost no cardiotoxicity. Replacing traditional anthracycline doxorubicin,the adverse events are controllable and the tolerance is generally well. PAD regimen is more proper to be applied to older patients with MM.

目的 应用生物信息学的方法筛选参与星型胶质细胞瘤的预后生物标志物。方法 首先,下载GEO(gene expression omnibus,GEO)数据库中星型胶质细胞瘤的基因芯片数据,通过R语言将来自4个数据集的基因芯片数据进行合并,将合并后的194人来源的脑组织样本分为:星型胶质细胞瘤组和正常组。然后对原始基因芯片数据进行批次效应去除和标准化处理,并使用密度图和主成分分析监测处理前后的效果。利用R语言中的limma包对处理后的基因芯片数据进行差异表达分析,从而筛选得到星型胶质细胞瘤组和正常组中之间的差异表达基因(differentially expressed genes,DEGs)。接着对差异表达基因进行GO(gene ontology,GO)分析和KEGG(kyoto encyclopedia of genes and genomes,KEGG)分析,并对所有基因的表达矩阵进行GSEA(gene set enrichment analysis,GSEA)分析。通过STRING数据库构建差异表达基因的蛋白—蛋白相互作用网络(protein-protein interaction,PPI),通过Cytoscape中的cytoHubba插件筛选Hub基因。为了探索Hub基因在星型胶质细胞中的诊断价值和预后价值,我们下载TCGA(the cancer genome atlas,TCGA)数据库中的基因表达数据和临床预后资料,使用ROC曲线评价Hub基因的诊断价值,并对诊断价值较高的Hub基因进行COX回归,筛选HR值最有意义的基因进行总生存分析(overall survival,OS)。结果 通过limma包总共分析得到1 043个差异表达基因。GO分析结果表明差异表达基因主通过影响神经突触的功能而发挥作用。KEGG分析结果显示钙信号通路、cAMP信号通路、MAPK信号通路、PI3K-Akt信号通路、Rap1信号通路和Ras信号通路等通路等在星型胶质细胞瘤中发挥着重要的作用。GSEA富集分析结果主要富集于细胞因子-细胞因子受体相互作用、JAK-STAT信号通路、逆行内源性大麻素信号、神经活性配体-受体相互作用、GABA能突触和钙信号通路等通路。通过PPI网络总共分析得到ADCY1、ANXA1和PENK等20个Hub基因。通过对Hub基因的诊断价值和预后价值进行评价,发现SST在星型胶质细胞瘤既可作为诊断标志物,也可作为预后生物标志物。结论 我们通过生物信息学分析发现SST可作为星型胶质细胞的预后生物标志物,又预测了Rap1信号通路有可能成为星型胶质细胞分子机制中的新通路。

Objective To screen biomarkers involved in the prognosis of astrocytoma by bioinformatics. Methods Firstly,the gene chip data of astrocytoma in GEO database were downloaded. The gene chip data from four data sets were combined by R language. The combined 194 human brain samples were divided into astrocytoma group and normal group. Then,the original microarray data were processed by batch effect removal and standardization,and the effects before and after processing were monitored by density map and principal component analysis. The differentially expression genes (DEGs) between astrocytoma group and normal group were screened by using limma package of R language to analyze the differentially expression of the processed gene chip data. Then gene ontology(GO) analysis and Kyoto encyclopedia of genes and genes (KEGG) analysis were carried out for the differentially expressed genes,and gene set enrichment analysis (GSEA) was carried out for the expression matrix of all genes. The protein-protein interaction (PPI) network of differentially expressed genes was constructed by using string database,and the Hub gene was screened by using the cytohubba plug-in of Cytoscape. In order to explore the diagnostic value and prognostic value of Hub gene in astrocytes,we downloaded the gene expression data and clinical prognostic data in the Cancer Genome Atlas(TCGA) database,used ROC curve to evaluate the diagnostic value of hub gene,and Cox regression for Hub gene with high diagnostic value,and screen the most significant gene of HR value for overall survival(OS) analysis. Results A total of 1 043 differentially expressed genes were obtained by limma analysis. Go analysis showed that the differentially expressed genes played an important role by affecting the function of synapses. KEGG analysis showed that calcium signaling pathway,cAMP signaling pathway,MAPK signaling pathway,PI3K Akt signaling pathway,Rap1 signaling pathway and Ras signaling pathway played an important role in astrocytoma. The results of GSEA enrichment analysis were mainly enriched in cytokine cytokine receptor interaction,JAK-STAT signaling pathway,retrograde endogenous cannabinoid signaling,neuroactive ligand receptor interaction,GABAergic synapse and calcium signaling pathway. A total of 20 Hub genes such as ADCY1,ANXA1 and PINK were obtained by PPI network analysis. By evaluating the diagnostic and prognostic value of hub gene,we found that SST could be used as both a diagnostic marker and a prognostic biomarker in astrocytoma. Conclusion We found that SST could be used as a biomarker for the prognosis of astrocytes by bioinformatics analysis,and predicted that Rap1 signaling pathway may be a new pathway in the molecular mechanism of astrocytes.

目的 研究富血小板血浆联合强骨胶囊对大鼠骨质疏松性骨折骨愈合的影响。方法 80只未交配、3月龄雌性健康SD大鼠作为研究对象,将以上大鼠分为空白组(K组)、PRP组(P组)、强骨胶囊组(Q组),联合组(L组),每组大鼠20例,分析四组大鼠的骨痂显微形态、组织形态学以及生物力学指标之间的差异。结果 经过两两比较,联合用药组患者的骨小梁体积、数量、厚度、连接密度高于单独用药组,分离度、表面积体积比低于对照组(P＜0.05);联合用药组患者的最大载荷、结构能量吸收、材料最大应力、材料能量吸收高于单独用药组;经过两两比较,联合用药组患者的骨架面积及软骨或骨性骨痂面积比高于单独用药组。结论 富血小板血浆联合强骨胶囊通过对骨折部位骨质密度以及骨质强度的增强,大鼠骨质疏松性骨折骨愈合情况良好。

Objective To study the effect of platelet rich plasma combined with Qianggu capsule on osteoporotic fracture healing in rats. Methods 80 unmatched and 3-month-old female healthy SD rats were divided into blank group (group K),PrP group (group P),Qianggu capsule group (group Q),combined group (group L) and 20 rats in each group. The differences of callus morphology,histomorphology and biomechanical indexes among the four groups were analyzed. Results After comparing the two groups,the volume,quantity,thickness and connection density of trabecula in the combined group were higher than those in the single drug group,and the separation and surface area volume ratio were lower than those in the control group (P< 0.05); the maximum load,structural energy absorption,material maximum stress and material energy absorption in the combined group were higher than those in the single group; after comparing the two groups,in the combined group,skeleton area and area ratio of cartilage or osteotylus in the treatment group were higher than that in single-drug group. Conclusion Platelet rich plasma combined with Qianggu capsule may enhance the bone density and bone strength of the fracture site,and the osteoporotic fracture healing in rats is good.

目的 对胎儿中枢神经系统发育异常的患者进行回顾性分析,探讨处理及预后。方法 收集2016—2018年在本院因胎儿畸形就诊的275例患者行病案追踪和电话随访。结果 275例产前彩超提示胎儿神经系统异常中,侧脑室增宽比列最高,112例(40.73%,112/275)。其他类型的异常包括后颅窝池增宽、脉络丛囊肿、胼胝体发育不全、Dandy-Walker综合征、脊柱裂、小脑病变、蛛网膜囊肿、室管膜囊肿、复杂性畸形等,共163 例(59.27%,163/275)。112例胎儿侧脑室增宽病例中,产前或产后消退 80例(71.43%,80/112),引产25例(22.32%,25/112),其引产病例中15例(60%,15/25)为重度侧脑室增宽。结论 胎儿侧脑室增宽是一动态发展过程,产前超声发现轻中度胎儿侧脑室增宽,不用盲目引产,可定期追踪观察。对严重侧脑室增宽,或存在其他明显脑结构异常的胎儿,致残率和致死率很高,一旦发现,应给予高度重视,综合评估以明确诊断、评估预后,告知患者及家属保留胎儿可能存在的风险及近远期并发症,充分沟通,减少严重畸形儿的出生。