Objective To explore the clinical significance of estrogen receptor α( ERα) , estrogen receptor β( ERβ) in non-small cell lung cancer( NSCLC) .Methods EnVision method was used to detect the expressions of ERα, ERβ, vascular endothelial growth factor( VEGF) , and microvessel density( MVD) in 54 NSCLC patients, 10 patients with lung benign lesions, and 10 normal controls. The interrelation between ERα, ERβ, VEGF, and MVD was analyzed. Results No obvious expressions of ERα and ERβwere observed in the normal lung tissues and lung benign lesions. The positive expression rates of ERα, ERβ, and VEGF in NSCLC were 20. 4% ( 11/54) , 64. 8% ( 35/54) , and 64. 8% ( 35/54) , respectively. There were no significant differences between ERαin regard to clinical parameters of NSCLC. But the expression of ERβwas dependent on pathological classification and differentiation of NSCLC. The expression of ERβ was significantly higher in adenocarcinoma than in squamous cell carcinoma( P lt; 0. 05) . The expression rate of ERβin well differentiated group was significantly higher than that in low, moderately differentiated group( P lt;0. 05) . There were significant differences between VEGF in regard to lymph node metastasis and TNM stage. The expression of ERαinterrelated with VEGF and MVD with r value of 0. 4 and 0. 685 respectively ( P lt;0. 05) . There was little correlation between ERβ and VEGF, MVD( P gt; 0. 05) . Conclusion Theexpression of ERβ correlates with pathological classification and differentiation of NSCLC, suggesting its significance in evaluating the pathological classification and malignant degree of NSCLC. The expression of ERαcorrelates with VEGF and MVD, suggesting that ERαpossibly promote micro-angiogenesis of NSCLC by VEGF pathway.
目的:探讨甲亢性心脏病的临床特点及131碘治疗的疗效分析。方法:对124例甲心病患者的临床资料及131碘治疗后疗效进行回顾性分析。结果:甲亢患者中甲心病发生率为86%,各年龄段均可发病,但40～60岁年龄段较高;甲亢病程越长甲心病发生率越高;甲心病131碘治疗的治愈率为879%;甲心病心律失常类型较多,以房颤最为多见; 131碘治疗后,各种心律失常复律百分率均大于80%。结论:甲亢患者并发甲心病的发病率与甲亢病程成正相关。早期正确诊断甲心病,可明显提高甲心病的疗效。131碘治疗是目前甲心病的最佳治疗方法。
Peptidoglycan is an important component of bacterial cell wall, which plays an important role in maintaining the integrity of bacterial cell structure, stimulating immune response, and anti-infection. Peptidoglycan recycling is an indispensable process for bacterial cell growth and reproduction. In recent years, it has been reported that the peptidoglycan recycling is closely related to the occurrence and development of bacterial resistance, especially with the antibacterial activity of β-lactam antibiotics. In this paper, the relationship between peptidoglycan recycling and resistance is described by combining relevant reports and taking Mycobacterium tuberculosis and Pseudomonas aeruginosa as examples, so as to promote the understanding of bacterial resistance mechanisms and provide potential targets for the development of new antimicrobial drugs.
Every country has its own clinical guideline to standardize medical care, and China is developing guidehnes too. Viewing the guidehne＇s usage in the world over many years, we find that it hasn＇t achieved good effect. The development of evidence-based medicine brings a primal change to guideline development. The evidence-based clinical guidehnes are arising in the world. We summarized the principle of developing evidence-based guideline according to the experience of Scotland to provide reference for domestic peers.
【摘要】 目的 探讨放射性核素骨显像和血清前列腺特异抗原（PSA），碱性磷酸酶（ALP），骨特异性碱性磷酸酶（BAP）测定在前列腺癌骨转移诊断中的价值。 方法 回顾性分析2006年10月-2009年10月50例前列腺癌（PCa）患者骨显像结果及PSA、ALP、BAP测定结果。 结果 50例Pca患者骨显像阳性率为70.0%。35例Pca骨转移患者分布在PSAgt;20.0 ng/mL时占97.1%，BAPgt;20.1 μg/L时占88.6%，ALPgt;130.0 μg/L时占94.3%。血清PSA、ALP、BAP水平随着放射性核素骨显像分级的增高而逐步增高，呈高度正相关。 结论 放射性核素骨显像仍然是目前诊断PCa骨转移的主要方法；PSA、ALP、BAP亦是重要的辅助诊断指标；PSAgt;20.0 ng/mL时，患者应常规行全身骨显像检查。【Abstract】 Objective To explore the clinical value of radionuclide bone scintigraphy and measurements of serum prostate-specific antigen (PSA), alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (BAP) in the diagnosis of bone metastasis in prostate cancer (PCa) patients from October 2006 to October 2009. Methods The results of bone scintigraphy, serum PSA, ALP and BAP were analyzed retrospectively in 50 PCa patients. Results The positive rate of bone scintigraphy was 70.0% in 50 PCa patients. In 35 patients with PCa bone metastasis, 97.1% of them were PSAgt;20.0 ng/mL, 88.6% were BAPgt;20.1 μg/L, and 94.3% were ALPgt;130.0 μg/L. The serum levels of PSA, ALP and BAP were increased step by step along with the advancement of bone metastatic grading from M0 to M3. They were significantly positively correlated. Conclusion Radionuclide bone scintigraphy is a major method in the diagnosis of bone metastasis in PCa patients currently. PSA, ALP and BAP are also important auxiliary diagnostic markers. Patients with the level of PSAgt;20.0 ng/mL should take a routine whole-body examination of bone scintigraphy.
ObjectiveTo investigate the relationship between the red blood cell distribution width (RDW) and the severity of acute exacerbation of bronchiectasis in elderly patients.MethodsThe clinical data of 216 elderly patients with acute exacerbation of bronchiectasis admitted from January 2015 to October of 2018 were analyzed retrospectively. The severity of acute exacerbation of bronchiectasis in the elderly was evaluated by bronchiectasis severity index (BSI) score. Meanwhile, 50 elderly people receiving qualified medical examination were collected as a healthy control group in the same period. The distributions of BSI score, RDW, procalcitonin (PCT), neutrophil percentage (NEU%) and C-reactive protein (CRP) were described in the patients with different risk degree. The severity of acute exacerbation of bronchiectasis in the elderly was evaluated by BSI. The patients were divided into three groups by BSI score: a low risk group, a middle risk group, and a high risk group. The indexes were described including the distribution of stratified BSI score, RDW, PCT, NEU%, CRP at different risk levels. The correlation of each index was analyzed by Spearman correlation. The threshold value of RDW was calculated by general linear regression, and the influencing factors of BSI score were analyzed by multivariate linear regression analysis.ResultsThe higher the risk stratification, the higher the BSI score, RDW, PCT, NEU% and CRP were. RDW was positively correlated with PCT, NEU% and CRP (r values were 0.425, 0.311, 0.177, respectively, P<0.05). BSI score was positively correlated with RDW, PCT, NEU%, and CRP (r values were 0.425, 0.394, 0.650, 0.578, respectively, P<0.05). RDW was positively correlated with PSI score (r=0.425, P<0.05). The thresholds of RDW were 11.45% and 14.03%. Multiple linear regression showed that RDW, PCT, NEU% and CRP were all influential factors of BSI score and explained 52.3% of the total mutation rate.ConclusionRDW is related to the severity of acute exacerbation of bronchiectasis in the elderly, and can predict the severity of acute exacerbation of bronchiectasis in the elderly.
Objective To analyze the hot spot and future application trend of artificial intelligence technology in the field of intensive care medicine. Methods The CNKI, WanFang Data, VIP and Web of Science core collection databases were electronically searched to collect the related literature about the application of artificial intelligence in the field of critical medicine from January 1, 2013 to December 31, 2022. Bibliometrics was used to visually analyze the author, country, research institution, co-cited literature and key words. Results A total of 986 Chinese articles and 4 016 English articles were included. The number of articles published had increased year by year in the past decade, and the top three countries in English literature were China, the United States and Germany. The predictive model and machine learning were the most frequent key words in Chinese and English literature, respectively. Predicting disease progression, mortality and prognosis were the research focus of artificial intelligence in the field of critical medicine. ConclusionThe application of artificial intelligence in the field of critical medicine is on the rise, and the research hotspots are mainly related to monitoring, predicting disease progression, mortality, disease prognosis and the classification of disease phenotypes or subtypes.
Objective To determine the incidence of vitamin B1 deficiency in critically ill patients, to compare vitamin B1 levels between septic and non-septic patients, and to explore the relationship between vitamin B1 levels and lactate levels. Methods Using a retrospective study method, critically ill patients admitted to the Department of Intensive Care of Nanjing Drum Tower Hospital from February 2022 to November 2022 were included in the study, and the patients were divided into sepsis and non-sepsis groups according to the admission diagnosis, and the differences in the vitamin B1 levels of the patients between the two groups were analyzed, as well as the correlation between the vitamin B1 levels and the lactic acid levels. Results There was a significant difference in serum vitamin B1 levels between the sepsis patients and the non-sepsis patients [(1.6±0.3)ng/mL vs. (2.1±0.2)ng/mL, P=0. 009]. For all patients, there was no correlation between vitamin B1 levels and lactate levels. But when the patient was in a hyperlactate state (lactate level ≥2 mmol/L), vitamin B1 levels were significantly negatively correlated with lactate levels (r=–0. 229, P=0. 004). Conclusions Vitamin B1 deficiency is prevalent in critically ill patients and is strongly correlated with whether or not the patient is septic. Vitamin B1 levels are significantly and negatively correlated with lactate levels when the patient's lactate level is ≥2 mmol/L.
Objective To explore the effect of toremifene on estrogen receptor （ER） expression and tumor micro-angiogenesis in rat Lewis lung carcinoma. Methods Cell suspension of rat Lewis lung carcinoma was implanted into 40 female Wistar rats subcutaneously. The rats were randomly divided into a control group，a estradiol group （0.006 mg/mL），a low dose toremifene group （0.25 mg/mL） and a high dose toremifene group （5 mg/mL）. Tumor size was measured every 3 days and the tumor growth curve was charted. On 15th day，the tumor weight and the growth inhibition rate were measured. Immunohistochemical method was used to detect the expressions of estrogen receptor α （ERα），estrogen receptor β （ERβ），vascular endothelial growth factor （VEGF），and platelet endothelial cell adhesion molecule-1 （PECAM-1）. Integral optical density （IOD） of ERα，ERβ and VEGF was calculated by image analysis software. Quantitative method of Weidner with PECAM-1 was employed for microvessel density （MVD） count. Results Tumor size of the four groups all presented a quadratic function growth trend with time （Plt;0.05）. Tumor growth speed was slower in toremifene groups of low and high doses than that in the control group and the estradiol group. The growth inhibition rate of the estradiol group，the low dose toremifene group and the high dose toremifene group was －15.1%，22.6%，and 45.1%，respectively. The expressions of ERα，VEGF，and MVD in the estradiol group were significantly higher than those in the control group，the low dose toremifene group and the high dose toremifene group （all Plt;0.05）. The expressions of ERα，VEGF，and MVD in the low dose toremifene group were significantly lower than those in control group，but higher than those in high dose toremifene group （all Plt;0.05）.The expression of ERα was positively related to VEGF （r=0.664，Plt;0.05） and MVD（r=0.593，Plt;0.05）. Conclusion Toremifene can inhibit tumor growth，which maybe involved in inhibiting ERα mediated VEGF expression.
Due to the decline of motor ability and the impact of the diseases, abnormalities in gait is common in the elderly population, which will raise the risk of fall and cause serious injury. This study focuses on the analysis of the gait kinematics parameters of normal adults’ gait, aiming to investigate the characteristics of gait parameters in different age groups and to explore the role of gait parameters in motor function assessment and clinical diagnosis. Based on the gait data gained by electronic walkway, the relationship among the toe out angles and their correlation with age and gender etc. were quantitatively analyzed. The results show that most normal subjects walk with positive toe out angles, and the angles increase with age. Such changes are slow in the young and middle age groups. However, the elevations of the left out toe angle and the angles between the feet are statistically significant after entering elder age ( >60 years). The results also suggest that the angle between the feet is a kind of practical gait parameter for varying applications. This study concludes that feet angle analysis is potential to provide a convenient and quantitative tool for the assessment of lower limb motor ability and the diagnosis of knee joint diseases.