妊娠期亚临床甲减孕妇血清铁蛋白、同型半胱氨酸水平及左旋甲状腺激素替代治疗效果

目的:探讨妊娠期亚临床甲减(SCH)患者血清铁蛋白、同型半胱氨酸(Hcy)变化及其治疗效果。方法:选取2019年3月-2021年12月淮安市妇幼保健院产科门诊建立产前登记且确诊为妊娠期SCH者104例(甲减组)、甲状腺功能正常孕妇110例为正常组,对比两组血清铁蛋白、Hcy及甲状腺功能指标水平,简单线性相关分析法分析血清铁蛋白、Hcy与甲状腺功能指标的关系;观察甲减组采用左旋甲状腺激素替代治疗前后上述指标变化。结果:甲减组血清Hcy(14.39±3.80μmol/L)、促甲状腺激素(TSH)(4.40±1.26 mU/L)、甲状腺过氧化物酶抗体(TPOAb)(11.74±2.60 IU/ml)水平均高于正常组(11.64±3.11μmol/L、1.69±0.66 mU/L、5.71±1.13 IU/ml)(均P<0.05),铁蛋白、甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平两组无差异(P>0.05);甲减组血清铁蛋白、Hcy与血清TSH、FT3、FT4、TPOAb水平均无相关性(P>0.05)。甲减组经过左旋甲状腺激素替代治疗,血清Hcy、TSH水平降低(P<0.05)。结论:妊娠期SCH患者Hcy水平异常升高,左旋甲状腺激素替代治疗可改善妊娠期亚临床甲减患者甲状腺功能指标及Hcy水平。

含奥沙利铂化疗方案联合热疗治疗原发性肝癌的临床治疗效果研究

目的探讨含奥沙利铂化疗方案联合热疗治疗原发性肝癌的临床治疗效果。方法将90例原发性肝癌患者随机分为观察组和对照组,每组45例。对照组给予常规含奥沙利铂化疗方案,观察组在此基础上加用热疗治疗。对比两组患者短期疗效、疼痛缓解水平、免疫细胞变化及不良反应。结果观察组治疗有效率、疼痛缓解水平与对照组比较,差异有统计学意义(P<0.05),观察组治疗有效率高于对照组,观察组疼痛缓解水平优于对照组患者。治疗后观察组四型免疫细胞(CD4^+)、CD4^+/CD8^+及自然杀伤细胞(NK)细胞与对照组比较,差异有统计学意义(P<0.05),观察组高于对照组。观察组消化道反应和肝功能损伤不良反应发生率与对照组比较,差异有统计学意义(P<0.05),观察组低于对照组。结论热疗联合含奥沙利铂化疗方案治疗原发性肝癌的短期疗效确切且能有效缓解癌痛、免疫损伤及不良反应,具有临床应用价值。

基于微信平台的以问题为基础教学法在妇科肿瘤带教中的应用

目的研究微信平台联合以问题为基础(PBL)教学模式在妇科肿瘤带教中的应用价值。方法选取2018年3—6月在南京医科大学附属淮安第一医院实习的临床医学专业本科生64人作为研究对象,将其按随机数字表法分为试验组和对照组各32人。试验组采用微信平台联合PBL教学模式,对照组采用传统PBL教学模式,教学时长均为3周,通过出科理论考试和技能操作成绩评价教学效果,并制定调查问卷,由学生自己对其教学模式进行评分。结果试验组学生的出科考试理论成绩(84.66±4.56)分和操作技能评分(86.28±5.20)分均高于对照组的(80.18±4.11)分和(79.42±4.24)分(P<0.05)。两组学生对两种教学模式都有良好适应性,两组适应性评分差异无统计学意义(P>0.05)。试验组学生的其余九项问卷调查评分高于对照组,差异有统计学意义(P<0.05)。结论微信平台联合PBL教学模式能有效激发实习生在妇科肿瘤中的学习兴趣,提升理论和技能操作水平,更易被实习学生所接受。

Step it up: Advancing physical activity research to promote healthy aging in China

1.Introduction China has been transforming.Since the late 1970s,China’s economy has increased many fold,the proportion of Chinese living in urban areas has more than doubled,life expectancy has increased by 10 years^1 and the country has transitioned from the'bicycle kingdom'to the world’s largest'auto market'.~2 As a result,China is now challenged by the'side effects'of eco-

Bone integration properties of antibacterial biomimetic porous titanium implants

A novel antibacterial biomimetic porous titanium implant with good osseointegration was prepared by freeze-casting and thermal oxidation.Bone integration properties of the porous titanium implant were evaluated by cell proliferation assay,alkaline phosphatase activity assay,X-ray examination and hard bone tissue biopsy.The in vitro cell proliferation and the level of differentiation of the group with a modified nano-porous implant surface were significantly higher than those in the group without surface modification and the dense titanium control group(P<0.05).In vivo,bone growth and osteogenesis were found in the experimental groups with modified and unmodified porous titanium implants;osteoblasts in the modified group had more mature differentiation in the pores compared to the unmodified group.Such implants can form solid,biologically compatible bone grafts with bone tissues,exhibiting good osseointegration.

Physiological and genome-wide gene expression analyses of cold-induced leaf rolling at the seedling stage in rice(Oryza sativa L.)

Leaf rolling and discoloration are two chilling-injury symptoms that are widely used as indicators for the evaluation of cold tolerance at the seedling stage in rice. However, the difference in cold-response mechanisms underlying these two traits remains unknown. In the present study, a cold-tolerant rice cultivar, Lijiangxintuanheigu, and a cold-sensitive cultivar, Sanhuangzhan-2, were subjected to low-temperature treatments and physiolog-ical and genome-wide gene expression analyses were conducted. Leaf rolling occurred at temperatures lower than 11℃, whereas discoloration appeared at moderately low temperatures such as 13℃. Chlorophyll contents in both cultivars were significantly decreased at 13℃, but not altered at 11℃. In contrast, the relative water content and relative electrolyte leakage of both cultivars decreased significantly at 11℃, but did not change at 13℃. Expression of genes associated with calcium signaling and abscisic acid (ABA) degradation was significantly altered at 11℃ in comparison with 25℃ and 13℃. Numerous genes in the DREB, MYB, bZIP, NAC, Zinc finger, bHLH, and WRKY gene families were differentially expressed. Many aquaporin genes and the key genes in trehalose and starch synthesis were down regulated at 11℃ in comparison with 25℃ and 13℃. These results suggest that the two chilling injury symptoms are temperature-specific and are controlled by different mechanisms. Cold-induced leaf rolling is associated with calcium and ABA signaling pathways and is regulated by multiple transcriptional regulators. The suppression of aquaporin genes and reduced accumulation of soluble sugars under cold stress results in a reduction in cellular water potential and consequently leaf rolling.

Nanospike surface-modified bionic porous titanium implant and in vitro osteogenic performance

This work aimed to prepare the nanospike surface-modified bionic porous titanium implants that feature favorableosteointegration performance and anti-bacterial functions.The implant was prepared using freeze casting,and nanospikesurface-modification of the implant was performed using thermal oxidation.The pore morphology and size,mechanical properties,and osteogenic performance of the implants were analyzed and discussed.The results showed that when the volume ratio of titaniumpowder in slurry was set to be10%,the porosity,pore diameter,compressive strength,and elastic modulus of the porous sampleswere(58.32±1.08)%,(126.17±18.64)μm,(58.51±20.38)MPa and(1.70±0.52)GPa,respectively.When the porous sample wassintered at a temperature of1200°C for1h,these values were(58.24±1.50)%,(124.16±13.64)μm,(54.77±27.55)MPa and(1.63±0.30)GPa,respectively.The nanospike surface-modified bionic porous titanium implants had favorable pore morphology andsize,mechanical properties and osteointegration performance through technology optimization,and showed significant clinicalapplication prospect.

Neurovascular compression and decompression of the intracranial vagus for blood pressure

BACKGROUND： Previous researches demonstrated that neurovascular decompression could cure hypertension; however, whether it could effectively control refractory hypertension after hypertensive cerebral hemorrhage should be further studied. OBJECTIVE： To observe the effect of neruovascular compression on intracranial vagus for blood pressure of dogs and investigate the effect of neurovascular decompression on blood pressure of patients with hypertensive cerebral hemorrhage. DESIGN： Randomized controlled animal study, clinical effects and retrospective analysis. SETTING： Department of Neurosurgery, Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA. MATERIALS： The experiment was carried out in the Department of Neurosurgery, Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA from May to October 2006. A total of 15 healthy adult dogs of both genders were randomly divided into experimental group （n =10） and control group （n =5）. Clinical observation： A total of 41 patients with hypertensive cerebral hemorrhage were selected from the Department of Neurosurgery, General Hospital of Nanjing Military Area Command of Chinese PLA and the Department of Neurosurgery, Changzheng Hospital Affiliated to the Second Military Medical University of Chinese PLA from October 1999 to October 2006. Among them, one patient had brain stem hemorrhage. There were 27 males and 14 females aged from 41 to 66 years. Inclusion criteria： All patients were diagnosed with CT examination once or several times. Volume of hematoma ranged from 50 to 120 mL and had obviously operative indication. All patients provided consents. In addition, another 281 patients with hypertensive cerebral hemorrhage who received traditionally internal and surgical therapies in our departments of neurosurgery, neurology and emergency room were selected in the control group. METHODS： ①Animal experiments： 20 cm autochthonous great saphenous vein was taken from dogs in the experimental group and coincided with tip of facial artery to form arterial loop so as to oppress left vagus and lateral bulb abdomen. In addition, 20 cm autochthonous great saphenous vein was taken from dogs in the control group and coincided with tip of facial artery to establish arterial loop so as to oppress left cerebellum to observe changes of blood pressure before and at 1, 2, 3 and 4 weeks after operation. ②Clinical observation： Among 41 patients with hypertensive cerebral hemorrhage including one with brain stem hemorrhage, they received microvascular decompression of vagus immediately after getting rid of intracerebral hematoma and stopping bleeding to observe its effect of depressurization. ALL patients and their relatives provided consents. ③A total of 281 patients with hypertensive cerebral hemorrhage who discharged after the treatment of traditionally internal and surgical therapies were studied retrospectively to observe changes of blood pressure after routine treatment and compare the results with neurovascular decompression. MAIN OUTCOME MEASURES： ①Changes of blood pressure of experimental dogs; ②effect of vascular decompression of vagus for blood pressure of patients with hypertensive cerebral hemorrhage after cleating intracerebral hematoma; ③different effects ofneurovascular decompression and routinely internal and surgical therapies on hypertension. RESULTS： ①Results of animal experiments： Nine dogs in the experimental group survived. At 1, 2, 3 and 4 weeks after operation, blood pressure of dogs in the experimental group was （139.77 ±4.06）, （149.11 ±4.90）, （148.10±4.16）, （147.76±4.15） mm Hg （1mm Hg=0.133 kPa）, which was higher than that of dogs in the control group [（117.20±2.74）, （116.65±3.74）, （116.26±1.8）, （115.81±3.76） mm Hg, P 〈 0.01]. ②Results of clinical observation： Among 41 patients, 8 （20%） cases died during the operation. In addition,among other 33 （80%） survival patients, 11 （33%） cases had normal blood pressure; blood pressure of 14 （43%） cases was improved or closed to nonnal value; blood pressure of 8 （24%） cases was not changed obviously as compared with that before operation. ③ The restllts demonstrated that, by using traditionally internal and surgical therapies, among 281 patients with hypertensive cerebral hemorrhage, blood pressure of about 15% cases was recovered or closed to normal value. Those mentioned above did not have history of hypertension before hemorrhage. However, patients who had history of hypertension before hemorrhage received the traditionally internal or surgical therapies, and the blood pressure was not improved to the normal value after the treatment. CONCLUSION： ① Neurovascular compression in left intracranial vagus can cause obvious increase of blood pressure of dogs, and the increasing volume was 30 mm Hg. ② Vascular decompression of vagus has a great effect on refractory hypertension, and the improvement of blood pressure is superior to traditionally internal and surgical therapies in clinic.

抗震螺纹钢HRB400E脆性断裂分析及控制措施

以Nb为微合金化元素的抗震螺纹钢HRE400E少部分出现冷弯脆断现象,本文对脆断试样进行宏观形貌、金相分析和局部成分分析。发现钢筋局部形成高成分的Mn、C,在轧后快冷条件下,使得较多脆性粒状贝氏体组织形成,是造成冷弯脆断现象产生的直接原因。从转炉炼钢工艺和凝固偏析模型上对成分异常原因进行分析,并提出了相关工艺措施,对提高抗震螺纹钢HRB400E质量具有显著意义。

Structural and functional analysis of a potent human neutralizing antibody against enterovirus A71

Enterovirus A71(EV-A71) causes major outbreaks of hand,foot,and mouth disease(HFMD) in many countries,most frequently affecting children,and a small proportion of cases may lead to death.Currently,no vaccine is available in most endemic regions,and no licenced treatments for EV-A71 infection are available.Here,we characterize a human monoclonal antibody(Hu MAb),E1,by screening a Fab antibody phage library derived from patients who recovered from EV-A71 infection.E1 exhibits strong neutralizing activity against EV-A71 virus in cells.The cryo-electron microscopy(cryo-EM) structures of the EV-A71 virion in complex with E1 Fab fragments demonstrated that E1 recognized an epitope formed by residues in the BC and HI loops of VP1.In a mouse model,E1 effectively protected against lethal EV-A71 challenge in both prophylactic and therapeutic treatment.In particular,E1 significantly reduces virus titers and muscle damage.E1 might represent a potential adjunct to EV-A71 treatment.

Photocatalytic direct oxygen-isotopic labelings of carbonyls in ketones and aldehydes with oxygen-isotopic waters

Oxygen-isotopic labelings play important roles in identifying and understanding chemical and biological processes.Direct C=O to C=^(18)O or C=^(17)O conversion in a single step leading to labeled compounds can alleviate synthetic burdens without the need for resynthesis.Here we describe a photocatalytic oxygenisotopic labeling protocol that can efficiently and selectively install ^(18)O and ^(17)O on carbonyls of ketones and aldehydes via oxygen isotope exchange with oxygen-isotopic waters(H_(2)^(18)O or H_(2)^(17)O)as the sources of oxygen isotopes,in which light and oxygen-enabled sodium alkanesulfinates catalyzed this process.This strategy was extended to the in-situ formed ketones from the photocatalytic aerobic oxidation of alkyl arenes and secondary alcohols.Furthermore,reduction of the oxygen-isotopically labeled aldehydes with NaBH_(4) provided the corresponding oxygen-isotopically labeled primary alcohols.We believe that the oxygen-isotopically labeling method will be widely used in chemistry,biology and medicine fields.

Interactions between long interpregnancy interval and advanced maternal age on neonatal outcomes

Background After the implementation of the universal two-child policy in China,it was more frequent to have long interpregnancy intervals(IPIs)and advanced maternal age.However,the interactions between long IPIs and advanced maternal age on neonatal outcomes are unknown.Methods The study subjects of this historical cohort study were multiparas with singleton live births between October 1st,2015,and October 31st,2020.IPI was defned as the interval between delivery and conception of the subsequent pregnancy.Logistic regression models were used to calculate adjusted odds ratios(aORs)and 95%confdence intervals(CIs)of the risks of preterm birth(PTB),low birth weight(LBW),small for gestation age,and 1-min Apgar score≤7 in diferent IPI groups.Relative excess risk due to interaction(RERI)was used to evaluate the additive interaction between long IPIs and advanced maternal age.Results Compared with the 24≤IPI≤59 months group,the long IPI group(IPI≥60 months)was associated with a higher risk of PTB(aOR,1.27;95%CI:1.07–1.50),LBW(aOR,1.32;95%CI 1.08–1.61),and one-minute Apgar score≤7(aOR,1.46;95%CI 1.07–1.98).Negative additive interactions(all RERIs<0)existed between long IPIs and advanced maternal age for these neonatal outcomes.Meanwhile,IPI<12 months was also associated with PTB(aOR,1.51;95%CI 1.13–2.01),LBW(aOR,1.50;95%CI 1.09–2.07),and 1-min Apgar score≤7(aOR,1.93;95%CI 1.23–3.04).Conclusions Both short and long IPIs are associated with an increased risk of adverse neonatal outcomes.Appropriate IPI should be recommended to women planning to become pregnant again.In addition,better antenatal care might be taken to balance the inferiority of advanced maternal age and to improve neonatal outcomes.

A High Consistency Wireless Key Generation Scheme for Vehicular Communication Based on Wiener Filter Extrapolation

Secret key generation from wireless channel is an emerging technology for communication network security,which exploits the reciprocity and time variability of wireless channels to generate symmetrical keys between the communication parties.Compared to the existing asymmetric key distribution methods,secret key generation from wireless channel has low complexity and high security,making it especially suitable for distributed networks.In vehicular communications,the reciprocity of wireless channel is degraded due to the movement of vehicular.This paper proposes a high consistency wireless key generation scheme for vehicular communication,especially applied to LTE-V2X(LTE vehicle to everything)systems.A channel reciprocity enhancement method is designed based on Wiener filter extrapolation,which can efficiently reduce the mismatch between the channels at the receiver and significantly reduce key disagreement rate.A real experimental system based on vehicle and universal software radio peripheral(USRP)platform is setup to verify the secret key generation in LTE-V2X systems.The effectiveness of the proposed method is verified in simulations and extensive practical tests.

宫颈癌组织中趋化因子CXCL13和Dyrk1b蛋白表达及意义

目的探讨趋化因子CXCL13、双特异性酪氨酸磷酸化调节激酶1b (dual specificity tyrosine phosphorylationregulated kinase 1b,Dyrk1b)蛋白在宫颈癌组织中的表达及与临床病理特征的关系。方法宫颈癌和子宫肌瘤患者各98例,分别取手术切除宫颈癌组织、癌旁组织以及子宫肌瘤组织,采用免疫组织化学法检测3组CXCL13、Dyrk1b蛋白阳性表达率;分析CXCL13、Dyrk1b蛋白阳性表达率与宫颈癌患者临床病理特征的关系;Spearman法分析CXCL13、Dyrk1b蛋白阳性表达率与临床病理特征的相关性;比较CXCL13、Dyrk1b蛋白阳性与阴性表达宫颈癌患者3a生存率及无进展生存期。结果癌旁组织、子宫肌瘤组织CXCL13蛋白均呈阴性表达,宫颈癌组织CXCL13蛋白阳性表达率为66.33%;宫颈癌组织Dyrk1b蛋白阳性表达率(82.65%)高于癌旁组织(15.31%)和子宫肌瘤组织(10.20%)(P<0.05);肿瘤直径≤3cm、高分化、FIGO分期Ⅰ期、无淋巴结转移、无脉管浸润的宫颈癌患者CXCL13蛋白阳性表达率(38.89%、28.57%、49.10%、39.47%、37.14%)、Dyrk1b蛋白阳性表达率(63.89%、61.90%、70.91%、65.79%、60.00%)低于肿瘤直径>3cm(82.26%、93.55%)、中低分化(76.62%、88.31%)、FIGO分期Ⅱ期(88.37%、97.67%)、有淋巴结转移(83.33%、93.33%)、有脉管浸润(82.53%、95.23%)者(P<0.05),不同年龄、肿瘤类型宫颈癌患者CXCL13、Dyrk1b蛋白阳性表达率比较差异无统计学意义(P>0.05);Spearman相关分析显示,CXCL13、Dyrk1b蛋白阳性表达与肿瘤直径(r=0.575,P=0.023;r=0.617,P=0.033)、FIGO分期(r=0.732,P=0.001;r=0.697,P=0.021)、淋巴结转移(r=0.563,P=0.031;r=0.757,P=0.006)、脉管浸润(r=0.586,P=0.045;r=0.633,P=0.009)呈正相关,与肿瘤分化程度(r=-0.781,P=0.005;r=-0.813,P=0.001)呈负相关,CXCL13阳性表达与Dyrk1b蛋白阳性表达呈正相关(r=0.633,P=0.009);CXCL13、Dyrk1b蛋白阴性表达的宫颈癌患者无进展生存期[(25.0±10.2)、(28.0±9.8)个月]、3a生存率(63.64%、70.59%)高于CXCL13[(12.0±8.5)个月、30.77%]、Dyrk1b蛋白[(10.0±9.6)个月、32.10%]阳性表达者(P<0.05)。结论宫颈癌组织CXCL13、Dyrk1b蛋白均呈高表达,且表达程度与肿瘤进展有关,其高阳性表达率提示患者预后不良。

上皮性卵巢癌组织miR-338-3p、miR-1294的表达及临床意义

目的:探讨上皮性卵巢癌组织中微小RNA(miR)-338-3p、miR-1294表达与患者临床病理参数的关系,并分析其表达对上皮性卵巢癌预后的影响。方法:收集2010年6月~2015年6月我院行手术治疗的上皮性卵巢癌患者的石蜡组织样本(癌组织和癌旁正常组织),实时荧光定量PCR(RT-PCR)技术检测组织样本中miR-338-3p、miR-1294的表达情况;分析癌组织中miR-338-3p、miR-1294表达与患者临床病理参数的关系;Kaplan-Meier生存曲线分析miR-338-3p、miR-1294表达与患者预后的关系;Cox回归模型分析上皮性卵巢癌患者的预后影响因素。结果:与癌旁正常组织相比,上皮性卵巢癌组织中miR-338-3p、miR-1294表达均降低(均P<0.05);miR-338-3p表达与组织学分级、淋巴结转移、FIGO分期相关(均P<0.05);miR-1294表达与肿瘤直径、淋巴结转移、FIGO分期相关(均P<0.05)。Kaplan-Meier生存曲线结果显示,miR-338-3p低表达组患者、miR-1294低表达组患者的预后较差(均P<0.05)。Cox回归模型分析结果显示,淋巴结转移、较高FIGO分期、miR-338-3p低表达、miR-1294低表达是上皮性卵巢癌预后的危险因素(均P<0.05)。结论:上皮性卵巢癌组织中miR-338-3p、miR-1294均低表达,且均与较差临床病理参数、预后不良相关;miR-338-3p、miR-1294可能是上皮性卵巢癌患者预后预测的潜在指标。

胃癌和癌前病变黏膜组织环氧化酶-2、表皮生长因子受体表达与幽门螺杆菌感染的相关性

目的:胃癌和癌前病变黏膜组织环氧化酶-2(COX2)、表皮生长因子受体(EGFR)表达与幽门螺杆菌(HP)感染的相关性.方法:选取2015年3月~2018年6月在我院接受治疗的胃癌患者86例为胃癌组,以及同期接受治疗的胃黏膜高级别上皮内瘤变患者117例为癌前病变组,同时收集慢性浅表性胃炎患者60例为对照组.采集三组患者病灶组织制备石蜡切片,采用免疫组织化学法检测COX2、EGFR表达,采用快速尿素酶试验和改良Ciemsa法检测HP感染.结果:胃癌组HP感染阳性率(75.6%)高于癌前病变组(45.3%)和对照组(23.3%),癌前病变组又高于对照组,差异均有统计学意义.胃癌组COX2、EGFR阳性率高于癌前病变组和对照组,癌前病变组又高于对照组,差异均有统计学意义.HP感染阳性胃癌和癌前病变组织中COX2、EGFR阳性率(77.9%,36.4%)高于HP感染阴性患者(25.9%,9.4%),差异均有统计学意义.胃癌和癌前病变组织中COX2、EGFR表达阳性率与HP感染阳性率呈正相关.结论:HP感染可能是导致COX2、EGFR表达增加的重要原因,并共同参与了胃癌的发生发展.

Metal-free synthesis of substituted phenols from arylboronic acids in water at room temperature

A convenient,efficient and practical metal-free method for the synthesis of substituted phenols from arylboronic acids has been developed.The protocol uses hydrogen peroxide as a hydroxylating agent ammonium bicarbonate as an additive,and the reactions were conveniently performed in water at room temperature.The method shows an excellent tolerance of functional groups,so it will find a wide variety of applications in academic and industrial research.