目的 检测分析电离辐射前后人外周血淋巴细胞RAD54L、SMC1B、INIP和HIST1H4K基因启动子区域甲基化变化,为筛选辐射敏感基因甲基化标志物提供理论依据.方法 3名健康男性为研究对象.1.0 Gy X线照射人外周血全血,剂量率为0.5 Gy/min,照射2min,未照射样本为阴性对照组.通过焦磷酸测序法对RAD54L、SMC1B、INIP和HIST1H4K 4个基因启动子区域13个富含CpG位点的片段进行DNA甲基化检测,采用配对样本t检验进行统计分析.结果 照射后,RAD54L-1&3(11.360％±0.726％vs 10.636％±0.859％,P<0.05)和INIP-8(6.443％±1.308％vs 4.478％±1.005％,P<0.05)甲基化水平升高、SMC1B-7(12.164％±1.226％vs 13.895％±1.381％,P<0.05),HIST1H4K-11(33.863％±3.957％vs 39.868％±4.703％,P<0.01)以及HIST1H4K-11&13(12.259％±1.389％vs 14.104％±1.520％,P<0.01)甲基化水平降低.此外,照射组与对照组相比,上述片段中,分别有6(6/14,43％)、3(3/3,100％)、14(14/16,88％)、2(2/3,67％)、9(9/11,82％)个位点甲基化水平变化与各自所在片段甲基化水平变化趋势一致.结论 本研究通过检测1Gy照射后与DNA修复和维持基因组稳定性相关基因启动子区甲基化改变,初步发现RAD54L-1&3、SMC1B-7、INIP-8、HIST1H4K-11和HIST1H4K-11&13及其相关位点甲基化水平的变化与辐射密切相关,可进一步研究将这些基因片段与位点作为潜在的辐射损伤标志物的可行性.

目的 构建可同时检测多个辐射相关基因单核苷酸多态性(single nucleotide polymorphism,SNP)的高通量、高分辨率、快速的方法.方法 选取 2020 年 4～6 月火箭军特色医学中心 75 例年满 18 周岁的健康男性为研究对象,采集外周血并提取DNA.文献筛选辐射相关17种基因28个SNP,设计多重PCR引物和单碱基延伸引物,通过PCR扩增和延伸,应用DP-TOF型飞行时间质谱检测系统对SNP位点进行基因分型,并对其中7份样本用Sanger测序法进行验证.结果 构建的28个SNP均分型成功.75份DNA样本28个SNP的基质辅助激光解吸电离飞行时间质谱(martix-assisted laser desorption/ionization time of flight mass spectrometry,MALDI-TOF-MS)检测结果显示基因分型检出率为 100.0%.7 份DNA样本 28 个SNP的基因型与Sanger测序结果完全符合,其准确度为 100.0%.结论 成功构建可同时检测 17种基因28个辐射相关SNP的核酸质谱检测技术平台,该方法具有高通量、快速准确的优点.

目的 探讨X射线照射人外周血淋巴细胞后miRNA表达谱的变化,为寻找新的辐射损伤生物标志物奠定基础.方法 采集健康成年男性外周血,给予2Gy与4Gy X射线照射后分别于12h和24h分离外周血淋巴细胞,提取各组细胞总RNA,采用Taqman低密度流体芯片技术检测照射组与对照组的miRNA表达谱差异,并选取4种miRNAs进行PCR单管验证.结果 2Gy与4Gy X射线照射人外周血淋巴细胞12h可诱导283种miRNAs表达上调,473种miRNAs表达下调;2Gy与4Gy X射线照射人外周血淋巴细胞24h可诱导464种miRNAs表达上调,331种miRNAs表达下调.其中,2Gy与4Gy X射线照射后,有20种miRNAs同时表现出时间反应性,即随着照射时间的延长而升高,其升高倍数为0.25～27.43倍;8种miRNA随着照射时间的延长而降低,其下调倍数为0.11～13.84倍.其次,照射12h与24h后,外周血淋巴细胞中仅发现2种miRNAs表现出剂量反应性,即随着照射剂量的升高而升高,其升高倍数为0.16至1.12倍;24种miRNAs随着剂量的增加而降低,其下调倍数为0.08～45.34.结论 人外周血淋巴细胞经2Gy与4Gy X射线照射后,不同时间点可筛选出多种差异表达的miRNAs,这些差异表达的miRNAs表现出一定的时间和剂量反应性,可能是辐射损伤评估的潜在指标.

We aimed to investigate the ability of MRI radiomics features-based machine learning (ML) models to classify the time since stroke onset (TSS), which could aid in stroke assessment and treatment options. This study involved 84 patients with acute ischemic stroke due to anterior circulation artery occlusion (51 in the training cohort and 33 in the independent test cohort). Region of infarct segmentation was manually outlined by 3D-slicer software. Image processing including registration, normalization and radiomics features calculation were done in R (version 3.6.1). A total of 4312 radiomic features from each image sequence were captured and used in six ML models to estimate stroke onset time for binary classification (≤ 4.5 h). Receiver-operating characteristic curve (ROC) and other parameters were calculated to evaluate the performance of the models in both training and test cohorts. Twelve radiomics and six clinic features were selected to construct the ML models for TSS classification. The deep learning model-based DWI/ADC radiomic features performed the best for binary TSS classification in the independent test cohort, with an AUC of 0.754, accuracy of 0.788, sensitivity of 0.952, specificity of 0.500, positive predictive value of 0.769, and negative predictive value of 0.857, respectively. Furthermore, adding clinical information did not improve the performance of the DWI/ADC-based deep learning model. The TSS prediction models can be visited at: http://123.57.65.199:3838/deeptss/ . A unique deep learning model based on DWI/ADC radiomic features was constructed for TSS classification, which could aid in decision making for thrombolysis in patients with unknown stroke onset.

介绍了"医院大脑"产生的背景、定义及特征,阐述了"医院大脑"的总体架构和体系构成,分析了"医院大脑"主要建设的内容及示范应用系统.指出了"医院大脑"的建成有利于提升医院管理水平,并助推区域医疗发展,为建设新一代智慧医院系统提供有力支持.

目的 探讨精神分裂症患者CYP2C19、CYP2D6基因多态性对氯氮平(CZ)代谢的影响.方法 采用实时荧光定量PCR检测224例精神分裂症患者的CYP2C19与CYP2D6基因型,根据CYP2C19的代谢类型,将患者分为快代谢型、中间代谢型和慢代谢型,根据CYP2D6的代谢类型,将患者分为快代谢、中间代谢型和中低代谢型.高效液相色谱技术检测各组患者氯氮平及其代谢产物去甲氯氮平(NCZ)的血药浓度.分别计算各组基因型分布和等位基因频率、CZ、NCZ、CZ+NCZ总血药浓度以及NCZ/CZ比值.结果 224例精神分裂症患者CYP2C19等位基因?1、?2和?3的基因频率分别为62.3％、33.9％和3.8％.CYP2D6等位基因?1、?2、?4、?10和?41的基因频率分别为22.3％、11.8％、0.7％、61.2％和4.0％.CYP2C19快代谢型NCZ/CZ比值为0.41±0.31,CYP2C19中间代谢型NCZ/CZ比值为0.39±0.19,CYP2C19慢代谢型的NCZ/CZ为0.30±0.12,CYP2C19快代谢型、CYP2C19中间代谢型NCZ/CZ比值高于CYP2C19慢代谢型,差异有统计学意义(F=9.11,P<0.05).结论 CYP2C19可影响CZ的代谢,且CYP2C19慢代谢型显著降低CZ代谢率.CYP2D6对CZ代谢影响不显著.

Aspergillus fumigatus is one of the ubiquitous fungi with airborne conidia, which accounts for most aspergillosis cases. In immunocompetent hosts, the inhaled conidia are rapidly eliminated. However, immunocompromised or immunodeficient hosts are particularly vulnerable to most Aspergillus infections and invasive aspergillosis (IA), with mortality from 50% to 95%. Despite the improvement of antifungal drugs over the last few decades, the therapeutic effect for IA patients is still limited and does not provide significant survival benefits. The drawbacks of antifungal drugs such as side effects, antifungal drug resistance, and the high cost of antifungal drugs highlight the importance of finding novel therapeutic and preventive approaches to fight against IA. In this article, we systemically addressed the pathogenic mechanisms, defense mechanisms against A. fumigatus, the immune response, molecular aspects of host evasion, and vaccines' current development against aspergillosis, particularly those based on AFMP4 protein, which might be a promising antigen for the development of anti-A. fumigatus vaccines.

关于电离辐射对生物体的影响存在很多争论.低剂量电离辐射可能会对生物体产生有益影响,但是对于男性生殖系统,几乎没有文献提及电离辐射对其存在有益影响.我们需要正视电离辐射对男性生殖系统的危害并加以预防.

目的 了解火箭军某涉核部队官兵的膳食结构和营养摄入状况,为涉核官兵膳食营养的改善提供参考,也为今后调整伙食标准提供科学依据.方法 采用称重法调查4天内该部队官兵膳食摄入情况.结果 该部队官兵膳食结构不合理,粮食类、蔬菜类食物摄入过多,超过了推荐比例,脂肪含量高的食物摄入过多.结论 该部队官兵每日能量摄入较多,超过了每日能量消耗量,膳食营养搭配不合理,蔬菜和粮食类食物供给较多,水果类、奶制品及蛋类供给不足.建议调整膳食结构,减少脂肪摄入量,增加富含抗氧化剂的食物摄入量,从而提高官兵抗辐射损伤能力.

目的 了解掌握一线官兵心理健康现状,为做好战时部队心理服务工作和特殊作业环境下官兵心理健康维护提供依据.方法 采用军人心理素质量表、状态特质焦虑量表、抑郁自评量表、安森斯失眠量表、冲动性量表和军人心理应激自评问卷,对特殊密闭环境下工作60天的官兵和待进入密闭环境中的官兵心理健康进行调查研究.结果 两组人群的调查结果 均高于普通军人常模,而在密闭环境中人员调查结果 低于待进入人员的调查结果 .结论 全封闭环境会对官兵心理健康产生一定影响,主要表现在情绪烦躁、心理孤独、想家思亲,但比预期的影响小一些.

Serum microRNAs (miRNAs) have been implicated as noninvasive biomarkers for lung cancer diagnosis. However, there are no sensitive and specific biomarkers for the detection of radiotherapy-related non-small cell lung cancer (NSCLC) metastasis. The present study aimed to investigate the role of three serum miRNAs, namely miRNA (miR)-130a, miR-25 and miR-191*, in diagnosing NSCLC, and their biological functions in radiation-mediated development of metastatic properties in A549 cells. To determine this, serum samples were collected from 84 patients with NSCLC and 42 age- and sex-matched healthy controls. Differential expression of serum miRNAs was analyzed by quantitative PCR. Significant associations between miRNA expression and overall survival of patients with NSCLC were identified using the Cox proportional regression model. A receiver operating characteristic curve was generated to evaluate diagnostic accuracy. The functions of miR-130a, miR-25 and miR-191* in lung cancer cells were studied by transfecting A549 cells with miRNA mimics and inhibitors. The results of the present study demonstrated that the expression levels of miR-130a, miR-25 and miR-191* in the serum of patients with NSCLC were increased compared with those in healthy controls, and these increases were associated with advanced age (>= 60 years), radiotherapy, histological type (squamous carcinoma), low survival rate and low median survival time. Additionally, irradiation induced the upregulation of miR-130a, miR-25 and miR-191* expression in A549 cells in vitro and in a xenograft mouse model. Irradiation also promoted the invasiveness of A549 cells in vitro and metastasis in vivo. In conclusion, miR-130a, miR-25 and miR-191* may be potential biomarkers for the diagnosis of patients with NSCLC and may serve oncogenic roles in radiation-mediated metastasis of NSCLC.

目的 分析火箭军某部官兵营养健康状况及影响因素,为制定针对性膳食营养保障措施提供理论依据.方法 采用分层整群随机抽样,选择1414名官兵作为调查对象,进行体格检查,利用SPSS进行统计分析.结果 1414名官兵中,BMI超重和肥胖者占29.3％,偏瘦者占0.8％;体脂含量偏高者占43.2％,偏低者占32.2％;上臂肌围偏低者占8.3％.热区、温区、寒区和高原地区官兵的体脂含量和上臂肌围存在显著差异(P<0.05),BMI无显著差异.导弹发射、技术保障、作战保障和工程作业等单位官兵BMI、体脂含量和上臂肌围指标均具有显著差异(P<0.05).结论 火箭军某部官兵营养健康状况不容乐观,不同地理环境和职能岗位官兵营养健康状况存在差异,应依照地域和岗位特点调整优化膳食结构,以保证营养均衡、促进健康.