目的 探讨不同年龄段皮罗序列征患儿血气分析的特点、手术后机械通气时间和住院时间。方法 收集新生儿及非新生儿III度皮罗序列征(PRS)患儿各30例,PRS患儿入院后通过桡动脉进行采集血标本进行血气分析,比较2组血标本的 pH 值、PCO₂ 、PO₂ 、HCO^-₃、BE、乳酸、AG、A-aDO₂的特点、手术后机械通气时间及住院时间。结果 新生儿组PCO₂、HCO^-₃、BE、乳酸及A-aDO₂高于非新生儿组,非新生儿组PO₂及AG高于新生儿组。2组pH值、PO₂、AG均在正常范围,机械通气及住院时间与乳酸呈正相关,与年龄呈负相关。结论 不同的年龄阶段,PRS患儿的动脉血气分析的结果不同,高乳酸与低年龄PRS患儿手术后机械通气时间及住院时间长。

Objective To investigate the characteristics of arterial blood gas analysis, time of mechanical ventilation and hospital stay in different age patients with Pirre Robin sequence (PRS). Methods Sixty children with III-grade PRS were divided into two groups according to their age, as neonate group and non-neonate group. The blood samples were collected from radial artery after admission for blood gas analysis, the characteristics of pH value, partial pressure of carbon dioxide (PCO₂), partial pressure of blood oxygen (PO₂), bicarbonate ion (HCO^-₃), base excess (BE), lactic acid (Lac), anion gap (AG) , alveolar artery oxygen pressure difference (A-aDO₂) , postoperative mechanical ventilation time and hospital stay were compared between the two groups. Results The levels of PCO₂, HCO^-₃, BE, Lac and A-aDO₂ in neonate group were higher than those in non-neonate group, and the levels of PO₂ and AG in non-neonate group were higher than those in neonate group. The pH value, PO₂ and AG of the two groups were in the normal range. Post-operative mechanical ventilation time and hospital stay were positively correlated with Lac and negatively correlated with age. Conclusions In different age groups, the results of arterial blood gas analysis in PRS children were different, and the time of mechanical ventilation and hospital stay were longer in higher Lac level and younger patients with PRS.

目的 观察低氧对p53RFP基因表达及启动子活性的影响,探索低氧反应元件(HRE)是否参与了低氧对p53RFP基因启动子活性的调控。方法 将HEK293细胞置于低氧条件下培养,实时定量PCR及Western blot 检测p53RFP mRNA及蛋白表达水平;通过定点突变技术构建HRE突变型p53RFP启动子双荧光素酶报告基因载体并转染HEK293细胞,分别置于常氧和低氧条件下培养,双荧光素酶报告基因检测系统检测启动子活性。结果 低氧处理不同时间点p53RFP mRNA 表达水平均显著增加,差异有统计学意义(F=96.493,P<0.001);低氧组p53RFP 及HIF-1α蛋白表达量均呈时间依赖性递增。成功构建了HRE 突变型p53RFP 启动子双荧光素酶报告基因载体,双荧光素酶报告基因检测显示,与常氧组相比,低氧条件下野生型p53RFP基因启动子活性增加(t=-19.504,P<0.001),HRE单突变或双突变后启动子活性均较野生型降低(F=160.891,P<0.001)。结论 低氧可诱导p53RFP基因表达上调;成功构建了HRE 突变型p53RFP 双荧光素酶报告基因载体,HRE 位点可能在低氧调控p53RFP基因启动子活性中发挥关键作用。

Objective To investigate the effect of hypoxia on p53RFP gene expression and p53RFP promoter activity, and explore whether hypoxia responsive element (HRE) is involved in the regulation of p53RFP gene promoter activity by hypoxia. Methods HEK293 cells were cultured under normoxia and hypoxia conditions, p53RFP expressions at mRNA and protein levels were detected by real-time PCR and Western blot respectively. The HRE mutant p53RFP promoter dual luciferase reporter gene vector was constructed by site-directed mutagenesis technology and transfected into HEK293 cells under normoxia and hypoxia conditions. The promoter activities were detected by dual luciferase reporter system. Results Compared with the normoxia group, the expression of p53RFP mRNA in the hypoxia group increased significantly at different time points, and the difference was statistically significant(F=96.493,P<0.001); the expression of p53RFP and HIF-1α protein in the hypoxia group increased in a time-dependent manner. The luciferase reporter vectors containing p53RFP with mutant HRE were successfully constructed. The dual luciferase reporter gene assay showed that the activity of the wild-type p53RFP gene promoter was significantly increased under hypoxic conditions compared to normoxic condition(t=-19.504,P<0.001),and the promoter activity of p53RFP with HRE single mutation or double mutation were both significantly lower than that of wild type under hypoxic condition (F=160.891,P<0.001). Conclusions p53RFP gene expression was induced by hypoxia; the p53RFP promoter with mutant HRE dual luciferase reporter gene vectors were successfully constructed, and the HRE locus may play a key role in the hypoxia regulation of p53RFP gene promoter activity.

目的 探究长链非编码RNA SNHG12在乙肝病毒X蛋白(HBx)诱导肝癌发生过程中的作用。方法 把课题组构建的肝前体细胞14-19、EGFP-14-19、HBx-EGFP-14-19通过小鼠肝门静脉注射到体内;采用 qRT-PCR、Western blot 方法检测30 d,90 d,180 d,360 d小鼠肝脏组织及细胞模型中HBx、SNHG12以及下游调节基因的mRNA和蛋白表达情况;使用si-SNHG12干扰其表达,并通过CCK-8、划痕实验、transwell实验、流式细胞术观察其对体外表型影响;检测SNHG12及下游的 mRNA 和蛋白表达;HE染色观察小鼠肝组织切片。结果 qRT-PCR结果表明SNHG12、Notch1、Hes1在HBx-EGFP-14-19细胞及各时间段的小鼠肝组织中均上调(F=48.808,P<0.000 1;F=13.322,P<0.000 1);Western blot结果显示在HBx过表达细胞及动物模型中,受HBx诱导SNHG12表达升高后Notch1信号通路被激活,促凋亡因子Bax下调,抗凋亡因子Bcl-2上调,细胞周期因子CDK2和Cyclin E上调;抑制SNHG12表达后,qRT-PCR、Western blot实验结果显示SNHG12(t=22.746,P<0.000 1)及其上述基因表达均扭转,CCK-8实验显示细胞增殖受到明显抑制,流式细胞术检测显示细胞凋亡增多,划痕及transwell实验表明细胞迁移及侵袭减弱。结论 HBx通过上调SNHG12诱导Notch1表达,导致细胞增殖、周期和凋亡异常,从而促进肝癌的发生。

Objective In order to explore the role of long non-coding RNA SNHG12 in hepatitis B virus X protein (HBx) induced hepatocarcinogenesis. Methods The liver precursor cells 14-19, EGFP-14-19 and HBx-EGFP-14-19 constructed by the research group was injected into the body through the hepatic portal vein of KM mice; qRT-PCR and Western blot were used to detect the mRNA and protein expression of HBx, SNHG12 and downstream regulatory genes in liver tissues of 30 d, 90 d, 180 d and 360 d mice and cell models. Si-SNHG12 was used to interfere with SNHG12 expression in vitro, the mRNA and protein expression of SNHG12 and downstream genes were detected, and its effect on phenotype in vitro was observed by CCK-8, flow cytometry, scratch test and transwell test. HE staining was used to observe the liver sections of mice. Results qRT-PCR showed that SNHG12, Notch1 and Hes1 were up-regulated in HBx overexpression cells and mouse liver tissue at each time point (F=48.808,P<0.000 1;F=13.322,P<0.000 1); the results of Western blot showed that in HBx over-expressing cells and animal models, the expression of SNHG12 was increased induced by HBx, resulting in the activation of Notch1 signal pathway, the down regulation of pro-apoptotic factor Bax, anti-apoptotic factor Bcl-2, and the up-regulation of cell cycle factors CDK2, cyclin E. After inhibiting the expression of SNHG12, the results of qRT-PCR and Western blot showed that SNHG12 (t=22.746,P<0.000 1) and the above genes were inhibited; CCK-8 experiment showed that cell proliferation was significantly inhibited, flow cytometry showed that cell apoptosis increased, scratch experiment and transwell experiment showed that cell migration and invasion decreased. Conclusions HBx induced Notch1 expression by up regulating SNHG12, resulting in abnormal cell proliferation, cycle and apoptosis, so as to promote the occurrence of liver cancer.

临床研究中,我们会经常遇到多重检验的问题。当同时检验多个假设时,如何控制犯Ⅰ类错误的概率,保证结果的准确性,是研究者面对的首要问题。然而未对多重检验进行校正的文章比例仍较大。本文从简单的单个检验假设出发,回答为什么需要进行多重校正,何时进行多重校正,同时介绍总体错误率(FWER)和错误发现率(FDR)两种重要的错误率以及在此基础上的Bonferroni和Benjamini-Hochberg校正方法,从而避免因多重检验问题带来的混乱。

In clinical research, we often encounter the problem of multiple testing. When testing many hypotheses at the same time, how to control the type I error to ensure the accuracy of the results is the primary problem faced by researchers. However, the proportion of articles that didn't correct the multiple testing remains substantial. Starting with the simple hypothesis of a single test, this article provides an introduction to multiple testing issues, answers why and when multiple corrections are needed, introduces two important error rates which are family-wise error rate (FWER) and false discovery rate (FDR), and the Bonferroni and Benjamini-Hochberg correction methods based on them, thereby avoiding confusion caused by multiple testing.

纳米材料作为一种新兴材料,在疾病诊断与治疗中拥有极大的应用潜力。为平衡纳米材料的生物活性和生物毒性之间的关系,清楚了解纳米材料在体内的清除机制和清除速率至关重要。其中,肾脏,作为人体重要的清除器官,直接影响纳米材料从血液清除到尿液的速率,进而影响其在生物体内的血液循环、肿瘤靶向效率和体内滞留等系列问题,最终影响其临床应用。基于近年来已报道的关于纳米材料与肾脏相互作用的诸多研究,本文系统介绍了肾脏结构、纳米材料在肾脏中的传输机制、理化性质对其肾脏清除效率的影响以及纳米材料在肾脏疾病诊疗中的应用。本文有望为精准纳米医学的发展以及纳米材料未来的临床转化起到促进作用。

Nanomaterials, as emerging materials, show great promise for the detection, diagnosis and treatment of diseases. Fully understanding their elimination pathway and clearance efficiency is important to better balance the bioactivity and biotoxicity of nanomaterials. Kidneys, as a major organ, play a key role in the clearance of nanomaterials from blood to urine. The clearance rate of nanomaterials in the kidneys directly affects their blood circulation, retention in the body and tumor targeting efficiency as well as final clinical applications. Based on current understanding of nano-bio interactions of nanomaterials in the kidneys, in this review, we introduced the kidney structure and elimination mechanism of nanomaterials in the kidneys. Then, how the physicochemical properties of nanomaterials affect their renal clearance efficiency are summarized. Finally, their applications in the kidney disease detection and treatment are presented. The basic understanding of nano-bio interactions of nanomaterials in the kidneys would promote the development of precise nanomedicine and their future clinical translation.

目的 分析接受永久性膀胱造瘘男性患者相关尿标本病原菌学分布特点及耐药性,进一步为药物防治导管伴随性尿路感染提供科学依据。方法 回顾性分析2019年1月—2021年8月我院收治的368例接受永久性膀胱造瘘男性患者尿标本病原菌分离培养结果,观察其病原菌构成和分布特征,进一步分析相关耐药性。结果 (1)本组接受永久性膀胱造瘘男性患者共368例,尿培养阳性316例,阳性率85.87%(316/368);共分离出病原菌112株,分离率30.43%(112/368),其中革兰阴性菌80株,占71.43%(80/112),以大肠埃希菌、铜绿假单胞菌为主;革兰阳性菌31株,占27.68%(31/112),以表皮葡萄球菌、粪肠球菌为主;真菌1株,占0.89%(1/112)。(2)大肠埃希菌对氨苄西林耐药率66.67%、哌拉西林64.71%、头孢曲松60.78%、头孢他啶60.78%、环丙沙星62.75%,对青霉素耐药率较低,仅为5.88%,对亚胺培南和美罗培南的耐药性为0。铜绿假单胞菌对氨苄西林、头孢噻肟完全耐药,耐药率高达100.00%;对头孢曲松83.33%、哌拉西林72.20%、头孢他啶72.22%;对庆大霉素的耐药率较低,仅为16.67%,对亚胺培南、美罗培南无耐药性。(3)表皮葡萄球菌对氨苄西林耐药性和青霉素的耐药性均为100.00%;对哌拉西林、头孢曲松、头孢噻肟耐药率＞60%;对磺胺甲噁唑／甲氧苄啶的耐药率较低,仅为12.50%,对万古霉素无耐药性。粪肠球菌对庆大霉素完全耐药,耐药率为100.00%;对头孢曲松、环丙沙星、左氧氟沙星、红霉素的耐药率＞60.00%;对头孢他啶的耐药性较低,耐药率仅为25.00%,对青霉素、万古霉素无耐药性。结论 永久性膀胱造瘘患者病原菌主要是大肠埃希菌、铜绿假单胞菌等革兰阴性菌,革兰阳性菌以表皮葡萄球菌为主,对于不同抗菌药物的耐药性差异较大。

目的 观察超声心动图(UCG)+心肌损伤标志物水平检测在急性心肌梗死(AMI)患者诊断中的应用价值。方法 选取2020年6月—2021年9月我院收治的74例AMI患者为观察组,另选取同期65例疑似AMI患者为对照组,2组均进行UCG检测,并对比入院后0~2 h、2~12 h、12~24 h心肌损伤标志物[肌酸激酶同工酶(CK-MB)、氨基末端脑钠肽前体(NT-proBNP)、肌钙蛋白(cTnI)、心脏型脂肪酸结合蛋白(H-FABP)]水平,分析心肌损伤标志物与AMI病情程度的关联性及UCG+心肌损伤标志物水平检测对AMI诊断的应用价值。结果 UCG检查结果显示观察组阳性率86.79%高于对照组9.23%(P＜0.001);对照组入院后各时间段CK-MB、NT-proBNP、cTnI、H-FABP水平差异无统计学意义(P＞0.05)观察组入院后各时间段CK-MB、NT-proBNP、cTnI、H-FABP水平均高于对照组(P＜0.05);Spearman相关分析可知,血清CK-MB、NT-proBNP、cTnI、H-FABP水平与AMI患者病情程度呈正相关(r₁=0.648,r₂=0.692,r₃=0.704,r₄=0.683,P＜0.05);受试者工作特征曲线(ROC)曲线分析显示,UCG+血清CK-MB、NT-proBNP、cTnI、H-FABP联合检测对AMI患者的诊断敏感度(85.14%)、特异度(100.00%)较高(P＜0.05)。结论 UCG+心肌损伤标志物水平检测应用于AMI患者有利于提高诊断敏感度、特异度,诊断价值较高。

目的 比较宫腔镜下子宫内膜息肉切除术(TCRP)后采用地屈孕酮以及少腹逐瘀汤两种不同治疗方法对预防息肉复发的效果。方法 从北京中医药大学深圳医院(龙岗)妇科2019年1月—2020年7月间收治的子宫内膜息肉患者中随机选取150例作为研究对象,采取随机数字表法将患者随机分为对照组、地屈孕酮组和少腹逐瘀汤组,每组各50例。对照组患者实施TCRP治疗,地屈孕酮组实施TCRP+地屈孕酮治疗,少腹逐瘀汤组实施TCRP+地屈孕酮+少腹逐瘀汤治疗,术后对3组患者随访12个月,比较3组患者干预3、6、12个月息肉复发情况、子宫内膜厚度以及不良情况应发生率。结果 治疗第6、12个月时,地屈孕酮组及少腹逐瘀汤组复发率情况均低于对照组(P＜0.05),地屈孕酮组及少腹逐瘀汤组子宫内膜息肉复发率比较差异无统计学意义(P＞0.05)。少腹逐瘀汤组及地屈孕酮组3次复查子宫内膜厚度均小于对照组(P＜0.05);少腹逐瘀汤组治疗12个月时子宫内膜厚度小于地屈孕酮组(P＜0.05)。3组患者不良反应发生率比较,差异不具有统计学意义(P＞0.05)。结论 宫腔镜下息肉切除术后加服少腹逐瘀汤与地屈孕酮片对宫腔镜下子宫内膜息肉切除术后患者进行干预,可有效降低患者子宫内膜息肉复发率,促进患者术后月经恢复正常,且将两者联合应用疗效安全,具有较高的应用价值。

目的 统计分析茂名市2016—2021年各种成分血临床供血情况,分析不同成分ABO血型供血特点,总结供血趋势,为今后采供血工作提供参考。方法 通过血液信息管理系统和统计“血库库存监控”中血库预警情况,统计分析茂名市2016—2021年各类成分血临床供应情况。结果 2016—2021年茂名市中心血站临床供血总量1 635 494.5 U,年平均增长率10.74%;红细胞类、血浆类、冷沉淀和浓缩血小板临床供应量年平均增长速度分别为11.58%、8.68%、5.88%、19.41%,各血型占比均为O型>A型>B型>AB型;2018年后机采血小板临床供应量逐年增长;AB型浓缩血小板报废占比最大。结论 2016—2021年茂名市中心血站临床血液供应量逐年增长,O型用血在茂名地区所占比例最大,AB型所占比例最小。在未来采供血工作中,结合临床不同血型成分血使用特征,注意不同血型血液库存,优化血库库存警戒线,防止过多血液过期报废。

Objective To statistically analyze the clinical supply of various blood components in Maoming City from 2016—2021, analyze the characteristics of various ABO blood components supply, and summarize the trend of blood supply as a reference for future blood collection. Methods Using the blood information management system and the early warning situation of the blood bank in “blood bank inventory monitoring”, the clinical supply of various blood components from 2016 to 2021 was statistically analyzed. Results The total supply amount of clinical blood from Maoming Central Blood Bank in 2016-2021 was 1635 494.5 U, with an average annual growth of 10.74%; the percentage of each blood components (red cell, plasma, cryoprecipitate and pooled platelets) was O>A>B>AB, with an average annual growth rate of 11.58%, 8.68%, 5.88% and 19.41%.After 2018, the clinical supply of mechanically collected platelets increased year by year.Scrapped pooled platelets of AB type accounted for the largest proportion. Conclusions Clinical blood supply in Maoming central blood bank was increasing yearly from 2016 to 2021, with the largest proportion of blood type O in Maoming region and the smallest proportion of blood type AB.In the future blood collection and supply, we will pay attention to blood products for different blood types in stock by taking into account the different blood types usage,pay attention to the blood stocks of different blood types, optimize the alarm threshold of blood bank stocks, to prevent overmuch blood from expiring and being scrapped.