【摘要】 目的 探討肺動脈高壓患者藥物靶向治療的效果與耐受性。 方法 回顧分析2008年1月〖CD3/5〗2009年8月期間8例肺動脈高壓患者分別接受波生坦及西地那非治療的臨床資料,評估其臨床表現、WHO肺動脈高壓功能分級、6 min步行距離及肺動脈收縮壓在基線及治療3個月后的變化。 結果 治療后3個月,患者均能耐受藥物治療,無嚴重不良反應發生。WHO肺動脈高壓功能分級在治療前平均(31±04),治療后為(23±09),明顯得到改善(Plt;005)。肺動脈收縮壓在治療前平均(695±112 ) mm Hg(1 mm Hg=0133 kPa),治療后為(483±124) mm Hg,明顯降低(Plt;005)。6 min步行距離在治療前平均(324±48) m,治療后為(400±43) m,明顯延長(Plt;005)。 結論 肺動脈高壓患者藥物靶向治療的療效顯著,且耐受良好。【Abstract】 Objective To examine the effects of target medical therapy in patients with pulmonary arterial hypertension(PAH). Methods To determine the safety and efficacy of bosentan and sildenafil in eight patients with PAH.The patients’ clinical features, six minutes walking diastance, WHO functional class and systolic pulmonary arterial pressure (SPAP) were measured at baseline and at three months after initiating target medial treatment. Results At the three months followup assessments, WHO functional class was improved with 31±04 vs 23±09 (Plt;005); SPAP was significantly decreased with(695±112 ) mm Hg vs (483±124) mm Hg (Plt;005), the six minutes walking distance was significantly increased with(324±48) m vs(400±43) m (Plt;005). Target medical treatment was well tolerated. Conclusion Target medical treatment is well tolerated and has beneficial effects on PAH.
Objective To investigate the influence of undercorrected orthokeratology on myopia control, and the correlation between target and central corneal epithelial damage. Methods A retrospective study was conducted on 22 undercorrected orthokeratology lens wearers (37 eyes) from January 2016 to February 2017, and 25 full corrected wearers (47 eyes) during the concurrent period were randomly selected as the control group. The changes of axial length before and after orthokeratology lens wearing and the within-6-month central corneal epithelial damage after orthokeratology lens wearing were analyzed. Results The average annual increase of axial length was (0.13±0.15) mm in the undercorrected group, and (0.14±0.16) mm in the full corrected group, the difference was not statistically significant (P>0.05). Multiple linear regression analysis showed that there was no correlation between the axial growth and the undercorrection of the target (P>0.05), but a negative correlation between the axial growth and the age (P<0.01). After using orthokeratology, the average annual growth of the axial length in children aged 7-10 years was (0.25±0.16) mm, and (0.10±0.14) mm in children aged 11-15 years, the difference was statistically significant (P<0.01). The incidence of central corneal epithelial punctate staining in the (–4.25)-(–5.00) D target group was 27.08%, and that in the (–3.00)-(–4.00) D target group was 16.67%, the difference was not statistically significant (P>0.05). Conclusions The effect of orthokeratology on myopia growth is not affected by the undercorrected target, not related to the undercorrection of target, but negatively correlated with the age. Undercorrected orthokeratology can still be used for myopia control in high myopia patients. No correlation is found between the target and central corneal staining.
ObjectiveTo observe the effect of target monitoring on the patients with ventilator-associated pneumonia (VAP) in intensive care unit (ICU), analyze the risk factors and take effective measures to reduce the VAP occurrence. MethodsTarget monitoring was performed on patients with ventilator in ICU from January to July 2013 (observation group), and they were compared with those patients accepting general comprehensive monitoring in ICU from January to July 2012 (control group). The incidence of VAP was compared between the two groups. ResultsThe incidence of VAP in the observation group and the control group was 21.73‰ and 53.33‰, respectively. There was a significant difference between the observation group and the control group (P<0.05). ConclusionFor patients undergoing mechanical ventilation, target monitoring can control the risk factors and incidence of VAP, adjust the interference in time, and improve the curing rate.
ObjectiveTo explore the relationship of the clinicopathological characteristics of non-small cell lung cancer (NSCLC) with the mutations of epidermal growth factor receptor (EGFR), K-ras and EML4-ALK fusion gene in cell blocks of pleural effusion (PLE). MethodsA total of 268 cytological specimens of PLE (pleural effusion), from Central Hospital of Zibo city were collected from advanced NSCLC patients between January 2012 year and June 2014 year. There were 165 male and 103 female patients at age of 53.6 (31-76) years. Qualitative diagnosis has been made in the 268 patients using PLE samples with conventional smear. Immunohistochemical staining combined with cell block section were used for further classification. There were 76 patients diagnosed as NSCLC with 39 patients of adenocarcinoma and 37 patients of squamous-cell carcinoma. In the 76 patients of lung biopsy specimens and PLE, EGFR and K-ras mutations, EML4-ALK fusions were tested. ResultsEGFR mutations rate was 34.21% (26/76). K-ras mutations rate was 6.58% (5/76). EML4-ALK fusions rate was 7.89% (6/76) at the same time. EGFR and K-ras mutations, EML4-ALK fusions were mostly found in young female adenocarcinoma patients who were non-smokers. EGFR and K-ras mutations or EML4-ALK fusions were not found in the same patient. ConclusionCytological specimens are feasible for detecting EGFR were K-ras mutations and EML4-ALK fusions. This will especially benefit to patients whose histological specimen can not be obtained.
ObjectiveTo analyze the efficacy, hospitalization cost and cost-effect of different treatments for multiple myeloma, so as to provide references for the treatment and development medical insurance payment policy of multiple myeloma.MethodsA total of 60 cases of multiple myeloma patients who were treated in the General Hospital of Shenyang Military Command from January 1st, 2013 to December 31st, 2017 were included. According to the treatment method, they were categorized into the traditional treatment group (n=37) and novel drug treatment group (n=23). The total response rate and hospitalisation expenses for patients with medical insurance of the two groups were calculated and compared, and cost-effectiveness analysis was then performed.ResultsThe overall response rate in patients in traditional treatment group was 56.76% (21/37), and in novel drug treatment group was 82.61% (19/23) (χ2=4.366, P=0.039). The annual average drug fee, annual average novel drug fee, secondary average drug fee, secondary average novel drug fee, annual average total cost, and secondary average total cost of the medical insurance patients in the novel drug treatment group were significantly higher than those in the traditional treatment group (P<0.05). The annual average cost of personal and coordinated payment for the medical insurance patients in the novel drug treatment group were 172 229.53 yuan and 48 237.51 yuan, respectively, which were significantly higher than the traditional treatment group (P<0.01). The cost-effectiveness ratio of the traditional treatment group was 884.44 yuan/%, the novel drug treatment group was 2 821.80 yuan/%, the cost-effective incremental ratio was 7 075.75 yuan/%, the incremental cost-effective ratio was 7 075.75 yuan/%, and the sensitivity analysis was consistent with the results.ConclusionsThe total response rate of novel drug treatment is significantly higher than traditional treatment. However, novel drug treatment costs higher, and patient's economic burden is also higher. The traditional treatment is superior to novel drug treatment in cost-effectiveness analysis.
Magnetic ferrite nanoparticles (MFNPs) have great application potential in biomedical fields such as magnetic resonance imaging, targeted drugs, magnetothermal therapy and gene delivery. MFNPs can migrate under the action of a magnetic field and target specific cells or tissues. However, to apply MFNPs to organisms, further modifications on the surface of MFNPs are required. In this paper, the common modification methods of MFNPs are reviewed, their applications in medical fields such as bioimaging, medical detection, and biotherapy are summarized, and the future application directions of MFNPs are further prospected.
【Abstract】ObjectiveTo construct a recombinant adeno-associated virus(rAAV2) vectors carrying the combined transcriptional regulatory sequences of α-fetoprotein enhancer and albumin promoter for the purpose of targeted gene therapy for hepatocellular carcinoma (HCC). MethodsThe fragment of combined transcriptional regulatory sequences of α-fetoprotein enhancer and albumin promoter was amplified through polymerase chain reaction (PCR) and cloned into the promoter site of pAAV-IRES-hrGFP instead of the CMV promotor in AAV Helper-Free System to construct the rAAV2 expression plasmid pAAV-IRES-hrGFP-EP. Then the packaging cell lines (HEK 293 cell) was co-transfected with the pAAV-IRES-hrGFP-EP together with the control plasmid pAAV-RC and pHelper in AAV Helper-Free System by means of lipofectamine.The recombinant adenoassociated virus vector(rAAV2-EP) carrying the combined transcriptional regulatory sequences of α-fetoprotein enhancer and albumin promoter was packaged and amplified in the HEK 293 cell. Then the viral titer was checked by GFP. ResultsThe recombinant adeno-associated virus vector(rAAV2-EP) carrying the combined transcriptional regulatory sequences of α-fetoprotein enhancer and albumin promoter was constructed successfully, the b green fluorescence was observed in HEK 293 cells under fluorescence microscope. The viral titer was 1.2×105. ConclusionConstruction of the recombinant adeno-associated virus vector rAAV2-EP driven by the combined transcriptional regulatory sequences of α-fetoprotein enhancer and albumin promoter would provide a sound basis and improved vector for targeted gene therapy for HCC.
Rapid serial visual presentation-brain computer interface (RSVP-BCI) is the most popular technology in the early discover task based on human brain. This algorithm can obtain the rapid perception of the environment by human brain. Decoding brain state based on single-trial of multichannel electroencephalogram (EEG) recording remains a challenge due to the low signal-to-noise ratio (SNR) and nonstationary. To solve the problem of low classification accuracy of single-trial in RSVP-BCI, this paper presents a new feature extraction algorithm which uses principal component analysis (PCA) and common spatial pattern (CSP) algorithm separately in spatial domain and time domain, creating a spatial-temporal hybrid CSP-PCA (STHCP) algorithm. By maximizing the discrimination distance between target and non-target, the feature dimensionality was reduced effectively. The area under the curve (AUC) of STHCP algorithm is higher than that of the three benchmark algorithms (SWFP, CSP and PCA) by 17.9%, 22.2% and 29.2%, respectively. STHCP algorithm provides a new method for target detection.
Metastatic renal cell carcinoma accounts for 20%-30% of newly diagnosed renal cell carcinoma and its prognosis is poor. It is not sensitive to radiotherapy or chemotherapy, and traditional cytokine therapy has limited efficacy in patient with metastatic renal cell carcinoma. In recent years, with the emergence of targeted drugs and immune checkpoint inhibitors, the survival of patients with metastatic renal cancer has been greatly improved. This article reviews treatment and research progress of metastatic renal cell carcinoma. It mainly introduces the medical treatment, including cytokine therapy, targeted therapy and emerging immunotherapy, and further analyzes the value of cytoreductive nephrectomy in the context of targeted therapy. The purpose of this article is to provide evidence for reasonable choices of treatment regimens in order to better guide clinical treatment.
Angiopoietin-like protein (ANGPTL), a group of secreted glycoproteins, is widely expressed in vivo and is involved in many pathophysiological processes such as glycolipid metabolism, stem cell growth, local inflammation, vascular leakage and angiogenesis. Many kinds of ANGPTL are closely related to the occurrence and development of diabetic retinopathy (DR), especially ANGPTL4, which has gradually become a new hotspot in the field of DR Research. ANGPTL is involved in glucose metabolism and lipid metabolism, promotes increased vascular permeability, pathological angiogenesis, and participates in intraocular inflammation. ANGPTL is a promising molecular target. It can not only be used as a biomarker to predict the occurrence and progression of DR, but also provide new ideas for the treatment of DR by making antibody drugs to interfere with this molecule.