Background:The prevalence of COPD is increasing annually, accompanied by a growing number of complications and organ function abnormalities. Thyroid dysfunction is prevalent among patients with chronic obstructive pulmonary disease (COPD). Updated evidence is needed to complement previous systematic reviews on this topic to provide best practice. Methods:The EMBASE, Web of Science, Cochrane and PubMed databases were searched for articles containing the keywords "COPD" and "thyroid dysfunction" (PROSPERO CRD42024592606). Eligibility screening, data extraction and quality assessment of retrieved articles were performed independently by two reviewers. Meta-analyses were performed to determine the prevalence of thyroid dysfunction in patients with COPD. Regression analyses were used to explore sources of heterogeneity. The clinical features of COPD combined with thyroid dysfunction were clarified by comparing the age, sex (percentage of males), BMI, smoking index, Forced Vital Capacity (FVC%), Forced Expiratory Volume in One Second (FEV1%), partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), and albumin in patients with and without thyroid dysfunction. The differences in the prevalence of thyroid dysfunction between stable and acute exacerbations in COPD were also compared. Results:Twelve studies were included, with an overall prevalence of 42.1% (95% CI, 31.8-52.9). The most common type of thyroid dysfunction in COPD was non-thyroidal illness syndrome (NTIS) in 45.3% (95% CI, 22.3-68.3). There was no difference in the prevalence of dysfunctions between stable and acute exacerbations of COPD. Patients in the thyroid dysfunction group in COPD had lower PCO2 and albumin and higher FEV1%. Conclusion:Thyroid dysfunction has a high prevalence among patients with COPD, with NTIS being the most common. Thyroid dysfunction in COPD may affect lung function and lead to decreased albumin. Patients with COPD should be screened for thyroid function, and attention should be paid to the clinical features of this group of patients with thyroid dysfunction to facilitate better identification and management. Systematic review registration:https://www.crd.york.ac.uk/PROSPERO/myprospero, PROSPERO ID (CRD42024592606).

Individual free fatty acids (FAs) play important roles in metabolic homeostasis, many through engagement with more than 40G protein-coupled receptors. Searching for receptors to sense beneficial omega-3 FAs of fish oil enabled the identification of GPR120, which is involved in a spectrum of metabolic diseases. Here, we report six cryo-electron microscopy structures of GPR120 in complex with FA hormones or TUG891 and Gi or Giq trimers. Aromatic residues inside the GPR120 ligand pocket were responsible for recognizing different double-bond positions of these FAs and connect ligand recognition to distinct effector coupling. We also investigated synthetic ligand selectivity and the structural basis of missense single-nucleotide polymorphisms. We reveal how GPR120 differentiates rigid double bonds and flexible single bonds. The knowledge gleaned here may facilitate rational drug design targeting to GPR120.

目的 了解妇科恶性肿瘤患者经济毒性的现况,探究妇科恶性肿瘤患者经济毒性的影响因素.方法 以便利抽样方法,选取2020年6月～12月在广西壮族自治区某三级甲等肿瘤专科医院行住院治疗的199例妇科恶性肿瘤患者为研究对象,采用一般资料调查问卷、患者报告结局的经济毒性综合评分量表(COST-PROM)进行横断面调查,采用Kruskal-Wallis H秩和检验与Mann-Whitney U秩和检验,多元线性回归分析与妇科恶性肿瘤患者经济毒性相关的影响因素.结果 妇科恶性肿瘤患者经济毒性得分为12.00(6.00,20.00).婚姻状况、家庭月总收入、医疗付费方式、肿瘤分期、手术、放疗以及化疗的妇科恶性肿瘤患者经济毒性总分差异均具有统计学意义(均P<0.05).多元线性回归分析结果显示,肿瘤分期、医疗付费方式、手术情况以及家庭月总收入是妇科恶性肿瘤患者经济毒性的独立影响因素(P<0.05),共解释总变异的33.1％.结论 本横断面调查显示妇科恶性肿瘤患者经济毒性严重,提示临床医务工作者应根据妇科恶性肿瘤患者经济毒性的特点,通过与患者进行成本讨论、进行个性化的心理护理以及围手术期综合管理等方式进行干预,提高妇科恶性肿瘤患者的应对能力,确保抗癌治疗的有序进行.

为探究细胞膜中不同脂质成分对γ-Fe2 O3纳米颗粒物(nanoparticles,NPs)与膜相互作用的影响,参考真实细胞膜的脂质类型合成13种脂质成分不同的模型细胞膜,并测定γ-Fe2 O3 NPs诱导的模型细胞膜完整性及膜流动性变化.结果表明,γ-Fe2 O3 NPs能够吸附在膜上(甚至造成膜破碎)并诱导膜流动的增加.NPs与不同的模型细胞膜相互作用的强度不同,特别是鞘磷脂和胆固醇在膜中的共存(模拟脂筏的存在)会减弱NPs与膜的相互作用,而膜中正电位点的存在增强了NPs与膜的相互作用.脂质成分的不同会造成模型细胞膜表面电荷、活性基团和脂质分子堆积强度等膜性质的差异,进而影响NPs与膜相互作用的强度.本研究为探索γ-Fe2 O3 NPs与细胞膜的相互作用提供了新的思路.

恶性肿瘤伤口(maligant fungating wounds,MFWS )是由原发性或转移性恶性肿瘤浸润皮肤所形成的开放性的恶性皮肤伤口,多表现为皮肤表面溃疡性伤口、皮肤结节或从皮肤表面扩散生长出的蕈状结节,常常累及周围组织、血管及淋巴管[1 ].研究报道[2],恶性肿瘤伤口的发生率为 5％～14.5％,其中66％好发于乳腺癌病人.鉴于肿瘤疾病本身的特点,病人伤口往往迁延不愈且常伴随着大量渗液、恶臭、瘙痒、出血、疼痛等不良症状,严重影响了病人的生活质量.因此,恶性肿瘤伤口的症状管理是临床伤口护理的重点[3 ].利用循证的观念和方法有助于护理人员用科学的方法寻求信息、分析信息、利用信息、从而解决临床实践中的实际问题[4-5].目前,恶性肿瘤伤口尚未形成系统规范的护理标准.2020年6月对本院收治的1例乳腺癌伴有恶性肿瘤伤口病人,通过循证护理方法使其伤口逐渐愈合,现报道如下.

背景与目的:妇科恶性肿瘤患者术后发生深静脉血栓(DVT),可引起患者肺栓塞或猝死,严重威胁患者的生命,本研究通过Meta分析明确妇科恶性肿瘤患者术后发生DVT的危险因素,为预防和降低妇科恶性肿瘤患者术后DVT的发生提供循证依据.方法:计算机检索多个国内外数据库,搜集有关妇科恶性肿瘤患者术后DVT危险因素的队列研究或病例对照研究,检索时限均为建库至2021年3月,采用Revman 5.3软件进行Meta分析.结果:共纳入19篇文献,包含4964例患者,其中病例组1040例,对照组3924例,共研究了36项危险因素.将其中10项危险因素进行了数据合并分析显示,既往有DVT史(OR=3.70,95％ CI=2.15～6.35,P＜0.001)、年龄大(OR=2.99,95％ CI=1.85～4.82,P＜0.001)、合并高血压(OR=2.25,95％ CI=1.32～3.83,P=0.003)、手术时间长(OR=1.03,95％ CI=1.02～1.04,P＜0.001)、BMI增加(OR=1.87,95％ CI=1.55～2.25,P＜0.001)、术后卧床时间长(OR=3.17,95％ CI=2.56～3.92,P＜0.001)、纤维蛋白原高(OR=2.80,95％ CI=2.26～3.47,P＜0.001)、肿瘤分期晚(OR=2.56,95％ CI=1.83～3.57,P＜0.001)、发生淋巴结转移(OR=2.88,95％ CI=1.58～5.25,P=0.0006)、D-二聚体高(OR=2.52,95％ CI=t.84～3.43,P＜0.001)均为妇科恶性肿瘤患者术后发生危险因素.结论:临床医护人员应结合本研究结果所确定10项危险因素,积极识别术后易发生DVT的妇科恶性肿瘤高危人群,并提供针对性的措施预防或降低其术后发生DVT风险.

The various applications of iron oxide nanoparticles (NPs) in clinical care and wastewater treatment are rapidly developing, thus their biological safety is worth attention. The electrostatic interaction between cell membranes and NPs is the key mechanism behind membrane damage and membrane penetration. Cell membranes are generally negatively charged with a few positively charged domains. The role of the positively charged sites in the NP-membrane interaction needs further investigation. In this study, the ratio of the positively charged sites was adjusted in two model cell membranes: giant and small unilamellar vesicles (GUVs and SUVs). After exposure to negatively charged γ-Fe2O3 NPs, the adhesion of NPs on the membranes and the induced membrane disruption were studied by microscopic observation and quartz crystal microbalance (QCM) monitoring. γ-Fe2O3 NPs adhered to and disrupted the membranes containing even few positively charged sites, although the whole membrane exhibited a negative zeta potential and hence electrostatically repels the NPs. The number of adhered γ-Fe2O3 NPs increased remarkably on membranes with overall positive zeta potential, but more serious disruption happened to membranes with higher ratios of positively charged sites. Therefore, the membrane rupture was more correlated to the number of positively charged sites than to the zeta potential of the whole membrane. In addition, exposure to γ-Fe2O3 NPs decreased the order of the lipid molecules and hence increased the fluidity of the membrane phase, and the most significant phase change occurred in the negatively charged membrane with the highest ratio of positively charged sites. Infrared spectra indicated that γ-Fe2O3 NPs probably interact with the membranes via the phosphodiester and trimethylamine groups in the lipid head groups. Our research furthers our knowledge of the electrostatic interaction between NPs and cell membranes, which should help to predict the biological effects of γ-Fe2O3 NPs.

Aims: To assess the clinical efficacy and safety of administration of a low dosage of cardio-selective β- receptor blocker in treating Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) complicated with right cardiac failure. Methods: In total, 100 AECOPD patients were randomly assigned into the experimental (n=50) and control groups (n=50). Patients in the control group received standard treatment according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2013 edition). Based upon conventional therapy, those in the experimental group received oral administration of metoprolol tartrate tablets. All patients were followed up for 1 year. Results: The Forced Expiratory Volume in one second (FEV1) did not significantly differ between two groups (both P>0.05). Prior to the treatment, no statistical significance was observed in heart rate between two groups (P>0.05), whereas heart rate in the experimental group was significantly improved (P 0.05). In the experimental group, 3 patients (6.3%) suffered from adverse events, and 4 (8.4%) in the control group (P>0.05). In the experimental group, the frequency of acute exacerbation, mortality rate and NT-proBNP level were significantly lower than those in the control group (all P 0.05). Conclusion: Use of a low-dose cardio-selective β-receptor blocker can effectively alleviate AECOPD complicated with right heart failure, improve heart function and decrease the frequency of acute exacerbation. No severe adverse events are noted after administration of cardio-selective β-receptor blocker.

Objective To observe the clinical efficacy of alteplase in the treatment of thrombolytic therapy in patients with acute pulmonary embolism (APE)and the changes of N-terminal B-type natriuretic peptide (NT-proBNP)in plasma before and after thrombolysis.Patients with recurrent pulmonary embolism and chronic thrombotic pulmonary hypertension (CTEPH) and other complications after treatment.Methods 60 patients with APE were enrolled in our hospital in May 2015.Patients were treated with intravenous thrombolytic therapy with alteplase.The clinical manifestations and complications of patients with thrombolysis were recorded before and after thrombolysis.NT-proBNP levels were changed and follow-up were performed.The mean follow-up time was (14.29 ± 9.21) months.Results Compared with the thrombolysis,the blood pressure of the patients was increased after the thrombolytic therapy,the pulse pressure difference was increased,the heart rate and the breathing were slowed down,the difference was statistically significant(P ＜ 0.05).Patients with APE had a decrease in arterial oxygen saturation (SO2),oxygen partial pressure (PO2)and carbon dioxide partial pressure (PCO2),and an increase in alveolar arterial blood pressure.After treatment with thrombolytic therapy,the levels of SO2,PO2 and PCO2 were increased,the difference of alveolar arterial blood pressure was decreased,the D-dimer increased rapidly and NT-proBNP was significantly decreased(P ＜0.001).Patients with thrombolytic therapy after thrombolytic therapy significantly improved,the difference was statistically significant (P ＜ 0.001).Of the 60 patients,21 patients underwent echocardiography before thrombolysis showed normal fight ventficular size,39 had right ventricular enlargement,thrombolytic therapy after right ventricular reduction.Thrombolytic process more without fatal bleeding events.Patients with no pulmonary hypertension after discharge were not present in patients with newly diagnosed CTEPH.Conclusion Alteplase has a good clinical efficacy and safety in patients with APE.

目的 观察经纤维支气管镜下注射异烟肼治疗气管支气管结核的效果与安全性.方法 以2012年3月至2014年3月在成都市双流区第一人民医院呼吸内科接受治疗的气管支气管结核患者85例作为研究对象,随机分为观察组与对照组.对照组41例患者接受常规抗结核治疗,观察组44例患者在此基础上加以经纤维支气管镜下注射异烟肼治疗,随访观察6个月,记录随访结束时抗酸杆菌涂片检查结果,与治疗前进行比对,进行肺功能测试,密切观察并记录两组患者在随访期间临床症状变化,记录随访过程中抗结核药物不良反应发生情况.结果 在随访结束时,观察组患者主要症状、痰菌涂片阳性率、肺功能改善情况优于对照组患者,差异有统计学意义(P＜0.05);两组患者的不良反应发生率无明显区别.结论 常规口服药物联合经纤维支气管镜下注射异烟肼治疗气管支气管结核的临床疗效要优于单纯常规口服药物治疗,不良反应发生率无明显增加,具有较好的临床应用价值.

Objective To explore the effect of salmeterol fluticasone propionate combined with tiotropium bromide powder for inhalation in treating severe and very severe stable chronic obstructive pulmonary disease(COPD)patients. Meth-ods A total of 100 patients with severe and very severe stable COPD were selected in the First People’s Hospital of Shuangliu County from February 2013 to January 2015,they were randomly divided into study group and control group,50 cases in each group. Control group were given salmeterol fluticasone propionate treatment,study group were given tiotropium bromide powder for inhalation treatment on the basis of control group. Clinical effect,before and after treatment 6 - minute walking distance and incidence condition of adverse reaction were compared between the two groups. Results The total effective rate of study group was higher than that of control group(P ﹤ 0. 05);before treatment,6 - minute walking distance showed no significant differ-ences between the two groups(P ﹥ 0. 05),after treatment,6 - minute walking distance of study group was longer than that of control group(P ﹤ 0. 05);incidence of adverse reactions showed no significant differences between the two groups( P ﹥0. 05). Conclusion Salmeterol fluticasone propionate combined with tiotropium bromide powder for inhalation have notable curative effect in the treatment of severe and very severe stable COPD patients,can improve the clinical symptoms and has less adverse reaction.

目的：观察血凝酶局部雾化吸入对咯血的治疗效果。方法：选择2001年1月至2003年1月收入院住院的咯血患者61例，随机分为2组，治疗组31例，予以常规镇静、止血、抗感染的基础上予以雾化吸入血凝酶（2u）。对照组30例，仅给予常规镇静、止血、抗感染治疗。观察两组患者咯血停止时间。结果：治疗组31例，显效16例，有效13例，无效2例，总有效率93.5%。对照组：总有效率70.9%。差异有显著（p<0.05）。结论：血凝酶雾化吸入治疗咯血起效迅速，疗效确切，副作用小，值得推广。

目的 通过利用恶性肿瘤特异性标志物(TSGF)检测早期肺癌,分析其在肺癌早期诊断中的实用价值.方法 随机选取2010年1月--2013年1月的30例,全部都是经过临床病理学和细胞学检查确诊的早期肺癌患者作为实验组;再随机选择在同一地区的30例健康人作为对照组,所有对照组成员都经过详细体检确认无任何疾病.两组患者均对恶性肿瘤特异性标志物进行检测,确定实验组与对照组的区别,分析该方法检测早期肺癌的敏感性、反应的特异性和诊断的正确率,说明在实际应用中恶性肿瘤特异性标志物在诊断早期肺癌中的价值.结果 采用恶性肿瘤特异性标志物诊断早期肺癌的实验灵敏度高,反应有特异性,可作为判断的指标,且该方法诊断的正确率普遍能达到93.33%.讨论 利用恶性肿瘤特异性标志物诊断早期肺癌的灵敏度高、特异性强、诊断正确率高,在临床上用其进行肺癌早期诊断有很大的实用价值.

目的:探讨无创正压通气(NPPV)对慢性阻塞性肺病急性加重期并Ⅱ型呼吸衰竭患者的疗效。方法:将86例慢性阻塞性肺病急性加重期并Ⅱ型呼吸衰竭患者随机分为观察组和对照组,对照组采用常规治疗,观察组采用常规治疗联合无创正压通气治疗,测定治疗前及治疗3天后患者的动脉血血气分析二氧化碳分压(PaCO2)及氧分压值(PaO2)。结果:观察组PaCO2值明显低于对照组(P<0.05),PaO2值及治疗有效率明显高于对照组(P<0.05)。结论:NPPV治疗慢性阻塞性肺病急性加重期并Ⅱ型呼吸衰竭,可以较迅速地改善患者的病情,提高临床治疗效果,降低相关并发症的发生率及病死率。

Objective To evaluate the association between the hr241Met polymorphism in the XRCC3 gene and the risk of lung cancer in Chinese population by meta-analysis.Methods Databases including PubMed,EMbase,CNKI,VIP and WanFang Data were searched to identify domestic and foreign case-control studies concerning the association between hr241Met polymorphism in XRCC3 gene and the risk of lung cancer in Chinese population from the inception to August 20th,2013.Two reviewers independently screened the literature according to the inclusion and exclusion criteria,extracted data and assessed quality.hen meta-analysis was performed using RevMan 5.0 sotware and Stata 10.0 sotware.Results A total of 5 case-control studies involved 2 999 lung cancer cases and 2 994 controls were included.he results of meta-analysis showed that,Chinese population who carry the variant genotype or allele had no increased risk of lung cancer: Met/Met vs.hr/hr: OR=1.00,95%CI(0.38,2.59),P=0.99;Met/Met vs.hr/Met: OR=1.06,95%CI(0.83,1.36),P=0.63;Met/Met vs.hr/Met+hr/hr: OR=0.99,95%CI(0.38,2.57),P=0.98;hr/Met+Met/Met vs.hr/hr: OR=1.06,95%CI(0.82,1.37),P=0.65;Met vs.hr: OR=1.05,95%CI(0.82,1.35),P=0.68.Conclusion Currently,hr241Met polymorphism in the XRCC3 gene is not found to be associated with the risk of lung cancer in Chinese population.Considering the limited quality of the included case-control studies,more high quality studies with large sample size are needed to verify the above conclusion.