目的 探讨颅内压(ICP)及相关参数与老年高血压性脑出血预后的关系.方法 回顾性分析南京市溧水区人民医院神经外科2017年1月—2018年7月收治的37例老年高血压性脑出血患者的临床资料.根据患者出院后的格拉斯哥预后量表(GOS)评分分成预后良好组及预后不良组,分析比较两组患者的平均ICP、平均压力反应指数(PRx)、Dicp20及平均颅内压波幅(mean ICP wave amplitude,MWA)值的差异.结果 预后良好组患者的平均ICP、平均PRx、Dicp20及平均MWA值圴明显低于预后不良组,差异有统计学意义(均P<0.01).结论 平均ICP、平均PRx、Dicp20及平均MWA与老年高血压性脑出血患者的预后有密切的关系;其数值低的患者预后较好.

目的:比较SiewertⅡ/Ⅲ型食管胃结合部腺癌(adenocarcinoma of esophagogastric junction,AEG)不同手术路径患者的病理特征.方法:回顾性分析52例SiewertⅡ/Ⅲ型AEG患者病理资料,其中经胸手术路径19例,经腹路径33例.比较两组年龄、性别、Siewert分型、胃切除范围、肿瘤浸润深度、脉管癌栓、神经侵犯、TNM分期、肿瘤大小、切缘距离、淋巴结清扫数.结果:经胸组与经腹组在年龄、性别、Siewert分型、浸润深度、脉管癌栓、神经侵犯和TNM分期、淋巴结清扫总数、淋巴结阳性数、小弯侧淋巴结总数间的差异均无统计学意义(均P>0.05).经胸组行近端胃切除术为94.7％(18例),明显高于经腹组12.1％(4例).与经腹组比较,经胸组肿瘤直径更大,上切缘距离更长,但下切缘距离较短,差异有统计学意义(P<0.05).结论:与经胸路径手术比较,经腹路径手术在肿瘤R0切除和淋巴结清扫上无差别,但手术损伤小,可作为SiewertⅡ/Ⅲ型AEG治疗的首选手术路径.

目的 观察护理干预对激光治疗糖尿病视网膜病变患者依从性的影响.方法 选择2014年11月—2016年4月确诊为中重度非增生性糖尿病视网膜病变患者126例为研究对象.随机分为实验组和对照组,实验组在激光治疗期间结合规范的护理干预;对照组在激光治疗期间只做常规教育指导.分别于患者首次激光治疗后1、3、6个月进行依从性调查.结果 开始1个月两组依从性变化差异无统计学意义(P>0.05);3、6个月时实验组依从性明显高于对照组,差异有统计学意义(P<0.05).两组在治疗后随着时间延长,对照组依从性下降明显,差异有统计学意义(P<0.05);实验组依从性变化差异无统计学意义(P>0.05).结论 规范的护理干预能提高糖尿病视网膜病变激光治疗患者的依从性.

Objective To investigate the specificity of virulence effector protein SseL in hy-drolysis of ubiquitin (Ub) chains. Methods gene was cloned from the serovar Typhi strain Ty2. GST-SseL was expressed and purified and its ability in hydrolysis of Ub-AMC and various ubiquitin chains was studied. Results SseL had only low hydrolytic activity to Ub-AMC and no hydrolytic activity to linear ubiquitin chains. Moreover, SseL showed higher hydrolytic activity to Lys63-linked diubiqui-tin (K63 diUb) than to Lys48-linked diubiquitin (K48 diUb). Conclusions effector protein SseL has higher hydrolytic specificity for isopeptide-linked ubiquitin and higher hydrolytic efficiency to Lys63-linked polyubiquitin.

[目的]探讨不同疗法在治疗顺产后尿潴留中的效果.[方法]选取2015年5月-2016年3月顺产后尿潴留产妇90例,按随机数字表法等分为A组、B组、C组,A组采用新斯的明1 mg肌肉注射联合低频脉冲刺激,B组采用新斯的明1 mg肌肉注射,C组采用低频脉冲刺激,治疗后观察排尿后膀胱残余尿量和自行排尿率.[结果]A组排尿后膀胱残余尿量与B组和C组比较,差异无统计学意义(P>0.05),A组自行排尿率与B组和C组比较,差异有统计学意义(P<0.05).[结论]新斯的明联合低频脉冲刺激能有效帮助顺产后尿潴留产妇自行排尿.顺产后尿潴留产妇经临床干预排尿后,仍有较多产妇存在排尿不尽现象,需寻求更多治疗方法帮助产后膀胱功能的恢复.

Mesenchymal stem cells (MSCs) could be ideal delivery vehicles for antitumor biological agents in pancreatic adenocarcinoma (PA). While the role of MSCs in tumor growth is elusive. Inflammation is an important feature of PA. In this study, we reported that MSCs pre-stimulated with the combination of TNF-α and IFN-γ promote PA cells invasion. The invasion of PA cell lines were evaluate by wound healing assay and transwell assay in vitro and liver metastasis in nude mice. We observed MSCs pre-stimulated with the combination of TNF-α and IFN-γ promoted PA cells invasion in vitro and in vivo. Consistent with MSCs promoting PA cells invasion, PA cells were found undergo epithelial-mesenchymal transition (EMT). We demonstrated that MSCs pre-stimulated with both of TNF-α and IFN-γ provoked expression transforming growth factor-β1 (TGF-β1). MSCs promoting EMT-mediated PA cells invasion could be reversed by short interfering RNA of TGF-β1. Our results suggest that MSCs could promote PA cells invasion in inflammation microenvironment and should be cautious as delivery vehicles in molecular target therapy.

分析当前影响医学生人文素质的主要因素，提出医学教育必须与人文素质教育相互融合，通过营造良好的社会人文环境、优化课程设置、建设师资队伍、鼓励学生参加各类社会实践活动等相应策略，提高医学生的人文素养，将其培养成尊重生命、有高尚职业情感的人类健康的守护者。