[目的]研究天冬氨酸氨基转移酶/血小板比值指数(APRI)和基于4因子的肝纤维化指数(FIB-4)对判断自身免疫性肝炎(AIH)患者肝纤维化程度的意义,为AIH肝纤维化的早期诊断提供依据.[方法]选取就诊于青岛大学附属医院行肝穿刺活检并诊断为AIH的患者51例,根据肝穿刺病理结果分为F0～F4期共5组,收集研究对象的一般资料、血小板计数(PLT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)等指标,计算APRI、FIB-4.绘制并分析APRI、FIB-4诊断轻度纤维化(≥F1)、显著纤维化(≥F2)、进展期纤维化(≥F3)的受试者工作特征曲线(ROC曲线).[结果]APRI、FIB-4对≥F1缺乏敏感性和特异性;对≥F2的曲线下面积(AUC)分别为0.688、0.809,敏感性分别为58.3％、75.0％,特异性均为74.1％;对≥F3的AUC分别为0.753、0.865,敏感性分别为64.3％、78.6％,特异性分别为81.1％、89.2％.[结论]APRI、FIB-4对≥F1无明确的诊断价值,而对于≥F2及≥F3均有诊断价值,其中FIB-4的诊断效能优于APRI,且二者对于进展期纤维化的诊断效能更高.

[目的]探讨中性粒细胞/淋巴细胞比值(Neutrophil to Lymphocyte Ratio,NLR)与急性胰腺炎(acute pancreatitis,AP)的严重程度及全身并发症之间的关系.[方法]回顾性纳入182例AP患者,根据修订后的亚特兰大分类将AP患者分为轻症、中重症及重症3组.计算入院时NLR值四分位数,并将患者分为4组:NLR≤4.91组、4.92≤NLR＜7.80组、7.81≤NLR≤13.78组、NLR≥13.78组,分别比较修订后的亚特兰大分类、Ranson评分、全身并发症在4组间差异有无统计学意义.采用受试者工作特征(ROC)曲线比较NLR、NLR48 h、白细胞计数及中性粒细胞计数预测AP全身并发症的有效性.[结果]根据修订后的亚特兰大分类,患者入院时NLR水平重症组＞中重症组＞轻症组[15.13(7.86)∶10.07(7.98)∶5.43(4.33),P＜0.001].重症组及中重症组AP患者NLR48 h水平明显高于轻症组患者[8.10(6.74)∶7.62(4.57)∶3.16(2.58),P＜0.001].根据四分位数分组,随着NLR水平升高,Ranson评分重度、修订后亚特兰大分类重症、有全身并发症患者所占比例明显升高(均P＜0.001).计算炎性标志物预测AP全身并发症的ROC曲线下面积,入院时NLR曲线下面积最大,为0.863.当NLR截断值＞10.56时,敏感性为85.7％,特异性为76.2％.[结论]NLR与AP严重程度密切相关,且NLR是预测AP患者全身并发症的重要参数.

Long non-coding RNAs (lncRNAs) are a class of more than 200 nucleotides RNA transcripts which have limited protein coding capacity. They regulate numerous biological processes in cancers through diverse molecular mechanisms. Aberrant expression of lncRNAs has been frequently associated with human cancer. Furthermore, the tumor microenvironment (TME) is composed of different cells such as cancer-associated fibroblasts (CAFs), endothelial cells and infiltrated immune cells, and all of which participate in communication with tumor cells affecting the progression of tumor. LncRNAs are directly and indirectly involved in the crosstalk between stromal cells and tumor cells and dysregulated lncRNAs expression in these cells could drive tumorigenesis. In this review, we explore the influence of aberrantly expressed lncRNAs in tumor progression, clarify the critical roles of lncRNAs in the TME, summarize findings on crosstalk between infiltrated immune cells, CAFs, endothelial cells, and tumor cells via lncRNAs, and discuss the promise of lncRNAs as tumor diagnostic markers and therapeutic targets.

《中华二千年史》是邓之诚先生毕生致力于中国通史教学与研究的结晶.在这部通史体裁的选择上,他匠心独运,主要综合了章节体、纪事本末体和纲目体三者的优点,将“新史学”的某些历史观和史学思想熔铸到传统史学的编纂形式中,形成了一种全新的“纲目体”.为中国传统历史编纂学在新时期的进步发展做出了有价值的探索,同时也体现了他卓越的历史见识、撰述思想和创新精神.

Purpose: The rapidly rising incidence of esophageal adenocarcinoma (EAC), which is usually diagnosed late with a poor prognosis, has become a growing problem. This study investigated the potential transcription factor (TF)-related molecular mechanisms of EAC by using bioinformatics analysis and qRT-PCR validation. Methods: Expression profile datasets for mRNAs (GSE92396, GSE13898, GSE26886 and GSE1420) and miRNAs (GSE16456) were downloaded from the GEO database. Overlapping differentially expressed genes (DEGs) and differentially expressed miRNAs (DEMs) were identified through integrative analysis. Then, a TF-miRNA-mRNA network was constructed based on bioinformatics data from the TRRUST, TRED and miRTarBase database. Furthermore, overall survival analysis for the mRNAs and miRNAs in the TF-miRNA-mRNA network was performed with data from TCGA, and qRT-PCR was used to validate the results. Results: A total of 294 overlapping DEGs were identified in EAC tissues compared to normal tissues, including 181 downregulated and 113 upregulated genes. Then, 16 TFs that could target the DEGs and were related to cancer were predicted based on public databases, and 41 DEGs that could be targeted were identified as key genes. Additionally, 12 DEMs were predicted through miRTarBase to be associated with the key genes, and TP53-(miR-125b)-ID2 and JUN-(miR-30a)-IL1A from the TF-miRNA-mRNA network were identified to potentially play significant roles in EAC. Furthermore, CCL20, IL1A, ABCC3, hsa-miR-23b, and hsa-miR-191, which are involved in the TF-miRNA-mRNA network, were found to be significantly associated with patient survival in EAC. Finally, the expression of a miRNA-mRNA pair (hsa-miR-30a-5p and IL1A) was revealed to be correlated with prognosis. Conclusion: In this study, a TF-miRNA-mRNA network was constructed to analyze the potential molecular mechanisms of EAC. Key genes and miRNAs associated with patient survival were identified, which may reveal promising approaches for EAC diagnosis and therapy.

巯嘌呤类药物如硫唑嘌呤和6-巯基嘌呤,常用于治疗炎症性肠病(IBD).然而,接受这类药物治疗的患者易出现药物不良反应,其中骨髓抑制最为严重且存在潜在的致命风险.巯嘌呤类药物导致的骨髓抑制具有明显的种族和个体差异.目前,多种遗传标志物被用来鉴定对巯嘌呤类药物敏感的IBD患者.本文就基因检测改善巯嘌呤类药物治疗IBD的安全性作一综述.

1942年山东抗日根据地困难重重,领导人之间争论很大.刘少奇受命到达后洞察秋毫,从减租减息入手,把减租减息当作当时的中心工作,倡导了一系列行之有效的方法,如召开全省减租减息工作会议;开展声势浩大的群众运动,把减租减息作为群众运动的主要内容;先行实验试点、以点带面,派驻工作团、实行"中心突破"等.刘少奇圆满完成了任务,使山东抗日根据地转危为安.

邓之诚(1887-1960)的青年时代是在云南度过的,原籍江苏江宁,生于四川成都.他与李根源为同学,二人都毕业于云南两级师范学堂.云南两级师范学堂是清末边疆省份开办较早的高等学校之一,其中走出过众多杰出人才.邓之诚从该校“选科”毕业后,就未闻再进过任何学校(按,该校前身为云南高等学堂,光绪二十八年(1902年)二月创办.后改两级师范学堂,学堂分为“优级师范选科”,学制3年,等同大专;“初级师范简易科”,学制1-2年,等同中专.参见《云南优级师范选科同学录》,宣统元年(1909年)石印本,云南省图书馆藏).可以说,云南两级师范学堂为他日后的学术成就,奠定了坚实的基础.邓之诚在辛亥革命前后任《滇报》编辑、云南第一中学地理教师(参见《云南第一中学校丁一班学生毕业纪念册》,1914年石印本,云南省图书馆藏.邓之诚等该校老师皆有《序》文),此后又参与“护国运动”,其间结识了孙中山、黄兴、蔡锷等人,对“护国运动”感到失望后,选择离开昆明北上.