简介：基于Docetaxel的化疗在中国与变形阉割抵抗的前列腺癌症(mCRPC)为病人仍然是首要的治疗；然而，在这些病人与效果联系的预示的因素仍然是争论的。在这研究，我们回顾地从在我们的医院里从2009～2016收到了docetaxel化疗并且经历了前列腺特定的抗原(PSA)的减小的71个合格中国病人考察了数据在治疗期间的水平50%并且调查了PSA的天底(TTN)的时间的潜在的角色。TTN在治疗期间从化疗的开始被定义为时间到PSA水平的天底。穆尔蒂瓦拉布尔·考克斯回归模型和Kaplan-Meier分析被用来预言全面幸存(OS)。在这些病人，TTN中部是17个星期。有TTN17星期的病人与TTN相比有一更长的反应时间到化疗<17个星期(42.83对21.50个星期，P<0.001)。在有TTN17星期的病人的PSA前进的时间是与TTN是的5.63个星期相比的11.44个星期<17个星期。我们发现了几个因素与OS被联系，包括TTN(危险比率[HR]：3.937，95%信心间隔[CI]：1.502-10.309，P=0.005)，在癌症的诊断的PSA水平(HR：4.337，95%CI：1.616-11.645，P=0.004)，起始的雄激素剥夺治疗的持续时间(HR：2.982，95%CI：1.104-8.045，P=0.031)，neutrophil-to-lymphocyte比率(HR：3.963，95%CI：1.380-11.384，P=0.011)，并且全部的PSA反应(班1[<0反应]与班2相比[0-50%反应]，HR：3.978，95%CI：1.278-12.387，P=0.017)。在结论，PSA的TTN在在中国人口预言治疗学的结果仍然是一个重要预示的标记为mCRPC收到化疗并且有>50%PSA宽恕。

简介：AbstractBackground:China and the United States (US) ranked first and third in terms of new liver cancer cases and deaths globally in 2020. Therefore, a comprehensive assessment of trends in the incidence of primary liver cancer with four major etiological factors between China and the US during the past 30 years with age-period-cohort (APC) analyses is warranted.Methods:Data were obtained from the Global Burden of Disease 2019, and period/cohort relative risks were estimated by APC modeling from 1990 to 2019.Results:In 2019, there were 211,000 new liver cancer cases in China and 28,000 in the US, accounting for 39.4% and 5.2% of global liver cancer cases, respectively. For China, the age-standardized incidence rate (ASIR) consecutively decreased before 2005 but increased slightly since then, whereas the ASIR continuously increased in the US. Among the four etiological factors of liver cancer, the fastest reduction in incidence was observed in hepatitis B virus-related liver cancer among Chinese women, and the fastest increase was in nonalcoholic steatosis hepatitis (NASH)-related liver cancer among American men. The greatest reduction in the incidence of liver cancer was observed at the age of 53 years in Chinese men (-5.2%/year) and 33 years in Chinese women (-6.6%/year), while it peaked at 58 years old in both American men and women (4.5%/year vs. 2.8%/year). Furthermore, the period risks of alcohol- and NASH-related liver cancer among Chinese men have been elevated since 2013. Simultaneously, leveled-off period risks were observed in hepatitis C viral-related liver cancer in both American men and women.Conclusions:Currently, both viral and lifestyle factors have been and will continue to play an important role in the time trends of liver cancer in both countries. More tailored and efficient preventive strategies should be designed to target both viral and lifestyle factors to prevent and control liver cancer.

简介：AbstractBackground:With the ongoing worldwide coronavirus disease 2019 (COVID-19) pandemic, an increasing number of viral variants are being identified, which poses a challenge for nucleic acid-based diagnostic tests. Rapid tests, such as real-time reverse transcription-polymerase chain reaction (rRT-PCR), play an important role in monitoring COVID-19 infection and controlling its spread. However, the changes in the genotypes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may result in decreased sensitivity of the rRT-PCR assay and it is necessary to monitor the mutations in primers and probes of SARS-CoV-2 detection over time.Methods:We developed two rRT-PCR assays to detect the RNA-dependent RNA polymerase (RdRp) and nucleocapsid (N) genes of SARS-CoV-2. We evaluated these assays together with our previously published assays targeting the ORF1ab and N genes for the detection and confirmation of SARS-CoV-2 and its variants of concern (VOCs). In addition, we also developed two rRT-PCR assays (S484K and S501Y) targeting the spike gene, which when combined with the open reading frames (ORF)1ab assay, respectively, to form duplex rRT-PCR assays, were able to detect SARS-CoV-2 VOCs (lineages B.1.351 and B.1.1.7).Results:Using a SARS-CoV-2 stock with predetermined genomic copies as a standard, the detection limit of both assays targeting RdRp and N was five copies/reaction. Furthermore, no cross-reactions with six others human CoVs (229E, OC43, NL63, HKU1, severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus) were observed using these assays. In addition, the S484K and S501Y assays were combined with the ORF1ab assay, respectively.Conclusions:Four rRT-PCR assays (RdRp, N, S484K, and S501Y) were used to detect SARS-CoV-2 variants, and these assays were shown to be effective in screening for multiple virus strains.

简介：AbstractFever and rash illnesses (FRIs) are a series of common diseases with fever and rashes as clinical manifestations, most of which are caused by viral infection. The rashes of FRIs are generally nonspecific; therefore it is difficult to identify FRI-associated viruses solely based on clinical symptoms. To achieve rapid and accurate identification of FRI pathogens, a multiplex one-step real-time reverse transcription-polymerase chain reaction (RT-PCR) assay was developed and evaluated in this study. Primers and probes were selected for the detection of measles virus (MeV), rubella virus (RV), human enterovirus (EV), varicella-zoster virus (VZV), dengue virus (DENV), human parvovirus B19 (B19), Epstein-Barr virus (EBV), and human herpes virus 6 (HHV-6), which cover the most common pathogenic viruses of FRIs. Detection of the eight FRI-associated viruses, which was divided into two groups/tubes, was simultaneously performed under universal optimized reaction conditions in multiplex one-step real-time RT-PCR assay. The multiplex realtime RT-PCR showed high sensitivity and specificity in detecting the eight FRI-associated viruses. The limits of detection (LODs) for the eight viruses were in the range of 47–177 copies/reaction, and no cross reactions for the eight FRI-associated viruses were found in the multiplex assay. In addition, the results of the multiplex real-time RT-PCR assay were consistent with the results of a monoplex real-time RT-PCR assay and sequencing for clinical specimens obtained from FRI patients. With its advantages of high efficiency and rapid and accurate diagnosis, multiplex real-time RT-PCR was very feasible for the early diagnosis of FRI pathogenic viruses and would be of great help for the proper treatment, monitoring, and initiation of preventive measures for FRI cases.

简介：摘要目的探讨乳腺良恶性疾病MRI动态增强扫描SI-Time曲线分布特征及鉴别诊断价值。方法选择经病理学检查证实的乳腺占位性病变69例患者（72乳）MRI资料，其中乳腺癌46乳，良性占位26乳，观察良恶性乳腺占位MRI增强扫描SI-Time曲线分布特征，比较MRI动态增强扫描与平扫鉴别诊断乳腺癌的特异度、灵敏度与准确性。结果①乳腺恶性占位SI-Time曲线廓清型、平台型、渐进型构成比分别为84.78%、13.04%、2.17%，良性病变分别为0%、15.38%、84.62%，良恶性占位比较SI-Time曲线类型分布差异有统计学意义（P＜0.05）；②MRI动态增强扫描检查乳腺恶性病变灵敏度、特异度及准确率分别为100%、96.15%、98.61%，均高于MRI平扫的82.61%、84.62%、83.33%，比较差异均有统计学意义（P均＜0.05）。结论乳腺良恶性疾病动态增强MRI扫描SI-Time曲线具有特异性表现，对鉴别诊断乳腺癌具有显著临床价值。

简介：【摘要】目的 探索“TIME-CDST 原则”指导下肛周坏死性筋膜炎术后伤口床准备的临床疗效。方法 回顾性分析 2018 年3月至 2020 年5 月乐山市中医院肛肠科收治的 5 例肛周坏死性筋膜炎患者，在“TIME-CDST 原则”指导下肛周坏死性筋膜炎术后伤口床准备的临床资料。5 例患者全部治愈（图7）。住院 10-15 天，换药时间20-30 天，三月后随访确认无术后致残

简介：Si-Miao-Wan(SMW),atradiationalChinesemedicinalformulaconsistingofAtractylodisRhizoma,PhellodendriChinensisCortex,CoicisSemen,andAchyranthisBidentataeRadix,hasbeenusedforthetreatmentofgoutandgoutyarthritisformanyyears.Inthepresentstudy,aliquidchromatographyquadrupole-time-of-flightmassspectrometry(LC-Q-TOF/MS)methodwasestablishedtoidentifythemultipleconstituentsofSMWanditsmetabolitesinratbiologicalsamplesafteroraladministration.Atotalof48compoundsinSMW,including21alkaloids,12organicacids,2terpenes,3lactones,2phytosterols,and8othercompounds,weretentativelycharacterizedwiththediagnostic-ionfilteringstrategy.BasedonthediagnosticionsappliedtoidentifycompoundsinSMW,28prototypecompoundsand10metaboliccompoundsweredetectedinthebiologicalsamples.ThiswasthefirstcomprehensivedrugmetabolisminvestigationofSMWinrats.Thedevelopedmethodcouldbeausefulmeansforidentifyingthemulti-componentsinSMWandthemetaboliccomponents.TheresultsmayhelpexplorethepossiblemetabolicprocessesandmechanismofactionforSMWinvivo.

简介：摘要目的探讨微视频联合Time-out警示巾在提高三方核查执行率中的应用效果。方法随机抽取2018年11月择期手术600例，将手术患者300例作为对照组，对照组采用常规安全核查方法进行核查；另300例手术患者作为试验组，试验组在常规安全核查的基础上采用微视频培训及联合使用Time-out警示巾的执行方案。观察分析两组手术安全核查执行情况及手术安全核查手术开始前执行规范化情况。结果使用微视频联合Time-out警示巾后，试验组在麻醉实施前（300例）、手术切皮前（297例）及患者离开手术室前（294例）核查执行的例数明显升高，与对照组比较差异均有统计学意义（均P<0.001）。比较手术团队对手术安全核查执行内容知晓情况，试验组核查时间、核查内容及核查方法的知晓例数均高于对照组（均P<0.001）。结论微视频联合Time-out警示巾，配合微信群信息交流工具及三级质控，能有效提高三方核查执行率中的规范化，保障患者安全。

简介：AbstractBackground:It remains unclear whether the outcomes of ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PPCI) during off-hours are as favorable as those treated during on-hours, especially those with a first medical contact-to-device (FMC-to-device) time within 90 min. We aimed to determine whether off-hours admission impacted late outcomes in patients undergoing PPCI and with an FMC-to-device time ≤90 min.Methods:This multicenter retrospective study included 670 STEMI patients who underwent successful PPCI and had an FMC-to-device time ≤90 min from 19 chest pain centers in Beijing from January 2018 to December 2018. Patients were divided into on-hours group and off-hours group based on their arrival time. Baseline characteristics, clinical data, and key time intervals during treatment were collected from the Quality Control & Improvement Center of Cardiovascular Intervention of Beijing by the "Heart and Brain Green Channel" app.Results:Overall, the median age of the patients was 58.8 years and 19.9% (133/670) were female. Of these, 296 (44.2%) patients underwent PPCI during on-hours and 374 (55.8%) patients underwent PPCI during off-hours. Compared with the on-hours group, the off-hours group had a longer FMC-to-device time and fewer patients with FMC-to-device time ≤60 min (P < 0.05). During the mean follow-up period of 24 months, a total of 64 (9.6%) participants experienced a major adverse cardiovascular event (MACE), with 28 (9.1%) in the on-hours group and 36 (9.6%) in the off-hours group (P > 0.05). According to the Cox regression analyses, off-hours admission was not a predictor of 2-year MACEs (P = 0.788). Similarly, the Kaplan-Meier curves showed that the risks of a MACE, all-cause death, reinfarction, and target vessel revascularization were not significantly different between the two groups (P > 0.05).Conclusions:This real-world, multicenter retrospective study demonstrated that for STEMI patients who underwent PPCI within 90 min, off-hours admission was safe, with no difference in the risk of 2-year MACEs compared with those with on-hours admission.

简介：摘要目的探讨胚胎早期发育动态表型和动力学参数是否受培养液组分差异的影响。方法回顾性队列研究分析广西壮族自治区人民医院生殖医学与遗传中心2016年10月至2018年12月期间收治的体外受精（in vitro fertilization，IVF）周期患者的临床资料，根据使用的培养液品牌不同，将IVF周期分为Cook组和Vitrolife组，经1∶1倾向性评分匹配后，每组纳入59个，采用延时成像技术分析正常受精卵裂胚胎授精后68 h内的早期发育形态动力学。记录胚胎发育动态表型，比较两组胚胎7种发育动态表型构成的差异；计算正常表型胚胎的13个早期发育动力学参数，比较两组之间动力学参数的差异；基于两个已发表的time-lapse胚胎筛选模型，比较两组正常动态表型胚胎的等级分布差异。结果①Cook组胚胎发育动态表型构成如下：正常表型54.0%、胞质异常波动（abnormal first cytokinesis，A1cyt）3.0%、不规则卵裂（abnormal cleavage，AC）17.4%、逆向卵裂（reverse cleavage，RC）5.2%、无序卵裂（chaotic cleavage，CC）3.2%、多核（multinucleation，Mn）3.5%以及混合表型13.7%；Vitrolife组胚胎发育动态表型构成如下：正常表型49.3%、A1cyt 4.0%、AC 19.1%、RC 7.5%、CC 2.1%、Mn 6.4%以及混合表型11.6%，两组间表型构成差异没有统计学意义（P>0.05）。②相较于Vitrolife组，Cook组正常动态表型胚胎13个发育动力学参数（tPNa、tPNf、t2、t3、t4、t5、t6、t7、t8、cc2、s2、t5_PNf和t8_PNf）均略长，授精后68 h胚胎平均卵裂球数略少，但差异均无统计学意义（均P>0.05）。③基于模型A，Vitrolife组与Cook组胚胎等级分布差异没有统计学意义（P>0.05）；基于模型B，两组胚胎等级分布差异存在统计学意义（P=0.040），其中Vitrolife组A+级胚胎比例较Cook组高［59.8%（125/209）比43.3%（94/217）］，而C级胚胎比例较Cook组低［9.6%（20/209）比20.3%（44/217）］。结论胚胎早期发育动态表型及动力学参数不受Cook与Vitrolife序贯培养液差异的影响，但不同time-lapse胚胎筛选模型对不同培养液体系的适用性存在差异，选择或建立模型时应充分考虑所使用的胚胎培养液体系。

简介：雄激素在前列腺癌症致病起一个中央作用，并且因此病人的大多数对雄激素剥夺治疗作出回应。然而，病人们与好攻击的前列腺癌症趋于到恶化，它是被称为荷尔蒙倔强。识别调停的蛋白质前进到荷尔蒙倔强的状态，我们为病人的sera介绍的质量使用了蛋白质薄片技术。这研究与变形荷尔蒙倔强的前列腺癌症包括了16个病人开始与雄激素剥夺被对待治疗。浆液样品在五个次点从每个病人被收集：点A，预告的处理；削尖B，在前列腺特定的抗原(PSA)的天底水平；点C，PSA失败；点D，早荷尔蒙倔强的阶段；并且削尖E，晚荷尔蒙倔强的阶段。用提高表面的激光解吸附作用/电离time-of-flight团spectrometry，我们执行了病人的sera介绍的蛋白质质量并且识别了与疾病前进增加了的6640-Da山峰。目标蛋白质部分被净化，并且由氨基酸定序，山峰作为apolipoproteinC-I的碎片被识别(ApoC--我)。浆液ApoC--我蛋白质层次与疾病前进增加了。在immunohistochemical分析上，ApoC--我蛋白质被发现局部性到荷尔蒙倔强的癌症房间的细胞质。在这研究，我们在浆液ApoC显示出增加--我蛋白质在他们的前进期间在前列腺癌症病人铺平到荷尔蒙倔强的状态，它建议那ApoC--我蛋白质与前列腺癌症的前进有关。然而，ApoC的准确角色--我在前列腺癌症致病是不清楚的，进一步的研究被要求。

简介：

简介：TocharacterizeandidentifymultipleconstituentsinDanhonginjection(DHI),afastultra-highperformanceliquidchromatographycoupledtoelectrosprayionizationquadrupoletime-of-flighttandemmassspectrometry(UHPLC-ESI-QTOF/MS)methodwasestablishedandvalidatedinthepresentstudy.Atotalof63compounds,including33phenolicacids,2C-glycosylquinochalcones,6flavonoidO-glycosides,4iridoidglycosides,6organicacids,5aminoacids,and3nucleosides,wereidentifiedortentativelycharacterized.Inconclusion,theUHPLC-ESI-QTOF/MSmethodisusefulandefficientforin-depthstructuralelucidationofchemicalcompoundsincomplexmatricesofherbalmedicinessuchasDHI.

简介：

简介：AbstractBackground:The programmed intermittent epidural bolus (PIEB) technique is widely used in labor analgesia, but the parameter settings of PIEB have not yet been standardized. We designed a study to identify the optimal interval duration for PIEB using 10 mL of ropivacaine 0.08% and sufentanyl 0.3 μg/mL, a regimen commonly used to control labor pain in China, to provide effective analgesia in 90% of women during the first stage of labor without breakthrough pain.Methods:We conducted a double-blind sequential allocation trial to obtain the effective interval 90% (EI90%) during the first stage of labor between April 2019 and May 2019. This study included the American Society of Anesthesiologists physical status II–III nulliparous parturients at term, who requested epidural analgesia. The bolus volume was fixed at 10 mL of ropivacaine 0.08% with sufentanyl 0.3 μg/mL. Participants were divided into four groups (groups 60, 50, 40, and 30) according to the PIEB intervals (60, 50, 40, and 30 min, respectively). The interval duration of the first parturient was set at 60 min and that of subsequent parturients varied according to a biased-coin design. The truncated Dixon and Mood method and the isotonic regression analysis method were used to estimate the EI90% and its 95% confidence intervals (CIs).Results:Forty-four women were enrolled in this study. The estimated optimal interval was 44.1 min (95% CI 41.7–46.5 min) and 39.5 min (95% CI 32.5–50.0 min), using the truncated Dixon and Mood method and isotonic regression analysis, respectively. The maximum sensory block level above T6 was in nearly 20% of parturients in group 30; however, 5.3%, 0%, and 0% of the parturients presented with sensory block level above T6 in groups 40, 50, and 60, respectively. There were no cases of hypotension and only one parturient complained of motor block.Conclusion:With a fixed 10 mL dose of ropivacaine 0.08% with sufentanyl 0.3 μg/mL, the optimal PIEB interval is about 42 min. Further studies are warranted to define the efficacy of this regimen throughout all stages of labor.Trial registration:Chinese Clinical Trial Registry, ChiCTR1900022199; http://www.chictr.org.cn/com/25/historyversionpuben. aspx?regno=ChiCTR1900022199.

简介：Thepresentstudywasdesignedtodevelopandvalidateasensitiveandreliableultrahighperformanceliquidchromatographycoupledwithquadrupoletime-of-flightmassspectrometry(UPLC-QTOF/MS)methodtoseparateandidentifythechemicalconstituentsofQixueShuangbuTincture(QXSBT),aclassictraditionalChinesemedicine(TCM)prescription.UndertheoptimizedUPLCandQTOF/MSconditions,56componentsinQXSBT,includingchalcones,triterpenoids,protopanaxatriol,flavonesandflavanoneswereidentifiedandtentativelycharacterizedwithinarunningtimeof42min.Thecomponentswereidentifiedbycomparingtheretentiontimes,accuratemass,andmassspectrometricfragmentationcharacteristicions,andmatchingempiricalmolecularformulawiththatofthepublishedcompounds.Inconclusion,theestablishedUPLC-QTOF/MSmethodwasreliableforarapididentificationofcomplicatedcomponentsintheTCMprescriptions.

简介：BACKGROUND:Alpha-actinin(α-actinin)playsakeyroleinneuronalgrowthconemigrationduringdirectionaldifferentiationfromneuralstemcells(NSCs)toneurons.OBJECTIVE:Todetectinsitumicrodistributionandquantitativeexpressionofα-actininduringdirectionaldifferentiationofNSCstoneuronsinthetemporallobecerebralcortexofneonatalrats.DESIGN,TIMEANDSETTING:BetweenJanuary2006andDecember2008,cultureanddirectionaldifferentiationofNSCswereperformedatDepartmentofHistologyandEmbryology,PreclinicalMedicalCollege,ChinaMedicalUniversity.ImmuneelectronmicroscopywasperformedatDepartmentofHistologyandEmbryologyandDepartmentofElectronMicrology,PreclinicalMedicalCollege,ChinaMedicalUniversity.SpectrumanalysiswasperformedatLaboratoryofElectronMicroscopy,MentalResearchInstitute,ChineseAcademyofSciences.MATERIALS:Basicfibroblastgrowthfactor,epidermalgrowthfactor,brain-derivednervegrowthfactor,type-1insulinlikegrowthfactor,andα-actininantibodywereprovidedbyGibcoBRL,USA;rabbit-anti-ratnestinmonoclonalantibody,rabbit-anti-ratneuronspecificenolasepolyclonalantibody,andEDAX-9100energydispersiveX-rayanalysiswereprovidedbyPHILIPSCompany,Netherlands.METHODS:NSCs,followingprimaryandpassageculture,weredifferentiatedwithserumculturemedium(DMEM/F_(12)+10%fetalbovineserum+2ng/mLbrain-derivednervegrowthfactor+2ng/mLtype-1insulinlikegrowthfactor).MAINOUTCOMEMEASURES:Expressionofα-actinininneuron-likecellswasquantitativelyandqualitativelydetectedwithimmunocytochemistryusingenergydispersiveX-rayanalysis.RESULTS:Immunocytochemistry,combinedwithelectronmicroscopy,indicatedthatpositiveα-actininexpressionwaslikeaspheroidparticlewithhighelectrondensity.Inaddition,theexpressionwasgraduallyconcentratedfromthenuclearedgetothecytoplasmandexpandedintodevelopingneurites,duringdifferentiationofneuralstemcellstoneurons.Conversely,energydispersive