目的 观察乌司他丁对多发伤患者的治疗作用和对肝、肾功能的保护作用。方法 46例多发伤患者随机分为治疗组（23例）和对照组（23例）。治疗组从入院第1天开始，每天静脉点滴乌司他丁10万单位+生理盐水100 ml，每8 h 1次，连续用药6 d，观察患者的临床指标判断疗效，并在入院时以及术后第1、3、5、7天检测谷丙转氨酶（ALT）、谷草转氨酶（AST）、血尿素氮（BUN）、血肌酐（Scr）、血浆肿瘤坏死因子-α（TNF-α）、白细胞介素-2（IL-2）、白细胞介素-6（IL-6）以及白细胞介素-8（IL-8）含量的变化。结果 多发伤患者治疗组平均住院时间及平均住ICU时间均低于对照组，差异有显著性意义（P＜0.05）； 治疗组术后血浆ALT、AST、BUN及Scr浓度均明显低于对照组（P＜0.05）； 治疗组术后血浆TNF-α水平逐渐降低，对照组维持在较高水平； IL-2、IL-6及IL-8水平低于对照组（P＜0.05）。结论 乌司他丁对多发伤有治疗作用，并能减轻机体的全身炎症反应程度，有保护和改善肝、肾功能的作用。
Objective To examined gene mutations in thymic carcinoma (TC) patients and to explore prognostic correlates and potential targets for therapy. MethodsWe retrospectively included TC patients in Sichuan Cancer Hospital between January 2015 and Febuary 2021.Whole-exome sequencing was performed on tumor tissues from TC patients and their control peripheral blood samples, and the raw data were subjected to bioinformatics analysis and statistical analysis. Results We finally included 24 TC patients with 16 males and 8 females at a median age of 55 (42-74) years. The highest frequency of single nucleotide mutations in this cohort were in the TTN gene (42%), HSPG2 (29%), and OBSCN (29%). Higher frequency of copy number variations occurred in ZNF276 gene (54%, loss), BEND3 (50%, loss), DHODH (50%, loss), and VAC14 (50%, loss). Microsatellite instability (MSI) phenotype was found in 25% of the patients, and the mean tumor mutation burden (TMB) was 9.86. Conclusion This study is the first comprehensive analysis of the mutation profile of thymic carcinoma in China to date. The mutation frequencies of TTN, OBSCN, and ZNF276 genes were high. The biomarker analysis suggests that patients may benefit from immunotherapy and have a long effective survival.