社区参与安宁疗护对临终期肿瘤患者干预效果的Meta分析

背景社区干预是临终期肿瘤患者安宁疗护的重要组成部分,其在临终期肿瘤患者健康管理中的作用尚有待循证医学证据的支持。目的评价社区参与安宁疗护对临终期肿瘤患者的干预效果。方法于2022-05-22,采用Cochrane系统评价方法,以“社区”“医疗模式”“临终期肿瘤”等为检索词检索万方数据知识服务平台、中国知网、维普网,以“Community-based”“Model of Palliative Care”“Advanced Cancer”“Quality of Life”等为检索词检索Cochrane Library、PubMed、Web of Science,以获取和社区参与安宁疗护干预效果相关的文献,研究类型设定为随机对照试验(RCT),检索时限设定为2007-01-01至2022-05-10。对符合纳入标准的RCT进行质量评价,提取有效信息进行Meta分析。结果共纳入11项英文RCT(涉及患者2356例),9项中文RCT(涉及患者1238例)。Meta分析结果显示:与常规肿瘤护理相比,社区参与的安宁疗护能够改善临终期肿瘤患者的生活质量和症状严重程度,其可提高患者的慢性病支持治疗功能评价量表得分〔MD(95%CI)=3.77(0.83,6.71),P=0.01〕、癌症患者生命质量测定量表总分〔MD(95%CI)=12.53(2.36,22.69),P=0.02〕,降低患者的癌症治疗功能评价量表总分〔MD(95%CI)=-2.61(-3.53,-1.70),P<0.01〕、埃德蒙顿量表得分〔MD(95%CI)=-2.45(-4.70,-0.20),P=0.03〕。但是否能改善患者的抑郁症状、总体生存率存在争议,而对于入院率、住院天数/次数等经济学指标的作用有待进一步研究。结论社区参与的安宁疗护可以改善临终期肿瘤患者的生活质量和症状严重程度,但在改善抑郁、提高生存率、降低医疗成本方面的作用有待进一步研究。

Discovery and validation of prognostic markers in gastric cancer by genome-wide expression profiling

AIM: To develop a prognostic gene set that can predict patient overall survival status based on the whole genome expression analysis. METHODS: Using Illumina HumanWG-6 BeadChip followed by semi-supervised analysis, we analyzed the expression of 47 296 transcripts in two batches of gastric cancer patients who underwent surgical resection. Thirty-nine samples in the first batch were used as the training set to discover candidate markers correlated to overall survival, and thirty-three samples in the second batch were used for validation. RESULTS: A panel of ten genes were identified as prognostic marker in the first batch samples and classified patients into a lowand a high-risk group with significantly different survival times (P = 0.000047). This prognostic marker was then verified in an independent validation sample batch (P = 0.0009). By comparing with the traditional Tumor-node-metastasis (TNM) staging system, this ten-gene prognostic marker showed consistent prognosis results. It was the only independent prognostic value by multivariate Cox regression analysis (P = 0.007). Interestingly, six of these ten genes are ribosomal proteins, suggesting a possible association between the deregulation of ribosome related gene expression and the poor prognosis. CONCLUSION: A ten-gene marker correlated with overall prognosis, including 6 ribosomal proteins, was identified and verified, which may complement the predictive value of TNM staging system.

Enhanced performance of a solar cell based on a layer-by-layer self-assembled luminescence down-shifting layer of core–shell quantum dots

In this paper, core–shell quantum dots(QDs) with two polar surface functional groups(ZnSe/ZnS–COOH QDs and ZnSe/ZnS–NH_2 QDs) are synthesized in an aqueous phase. Photoluminescence(PL) and absorption spectra clearly indicate luminescence down-shifting(LDS) properties. On the basis of QDs, surface functional group multilayer LDS films(MLDSs) are fabricated through an electrostatic layer-by-layer(LBL) self-assembly method. The PL intensity increases linearly with the number of bilayers, showing a regular and uniform film growth. When the M-LDS is placed on the surface of a Si-based solar cell as an optical conversion layer for the first time, the external quantum efficiency(EQE) and shortcircuit current density(Jsc) notably increases for the LDS process. The EQE response improves in a wavelength region extending from the UV region to the blue region, and its maximum increase reaches more than 15% between 350 nm and 460 nm.

论数据全球化大生产

随着新一代数字技术的成熟完善,数据要素逐渐成为影响经济发展的关键生产要素,数据业也已成为引领经济发展的重要未来产业,数据全球化大生产将成为大势所趋。本文全面分析了数据全球化大生产的实现条件,提炼概括了数据全球化大生产的内涵和特征,系统阐述了数据全球化大生产在引领新一轮全球化的巨大作用,并对此进行了前瞻性的分析和展望,提出政策建议。

Production and Characterization of Monoclonal Antibodies of Shrimp White Spot Syndrome Virus Envelope Protein VP28

BALB/c 老鼠与净化的白点症候群病毒(WSSV ) 被使免疫。六根 monoclonal 抗体房间线被 ELISA 选择， VP28 蛋白质在 E 表示了。coli。在 vitro 中立化，实验证明他们中的 4 个能在喇蛄禁止病毒感染。西方污点建议所有这些 monoclonal 抗体对 VP28 的 conformational 结构。monoclonal 抗体 7B4 用胶体的金粒子被标记并且过去常由标记的 immunogold 在病毒信封上定位 VP28。这些 monoclonal 抗体能被用来为 WSSV 感染开发免疫学的诊断方法。关键词怀特点症候群病毒(WSSV )- Mab - 信封 - 本地化 - 中立化 CLC 数字 S945.

Effects of Zingiber officinalis (WILLD.)ROSC.Membranes on minor recurrent aphthous stomatitis: a randomized pragmatic trial

Objective:To evaluate the effects of dried ginger rhizome (DGR;Zingiber officinalis (WILLD.) ROSC.),prepared as a membrane,in minor recurrent aphthous stomatitis (miRAS)treatment and explore its mechanism of action by detecting changes in levels of epidermal growth factor (EGF) and tumor necrosis factor (TNF)-α in saliva.Methods:Fifty-nine miRAS patients were enrolled in this study.The number of participants in the dried ginger rhizome membrane (DGRM) group was 30,and 29 were in the placebo membrane (PM) group.Sixty sealed envelopes containing either type of membrane were coded randomly.Investigators and participants were blinded to group assignments.A visual analog scale (VAS) was used for pain,follow-up information for healing time,and enzyme-linked immunosorbent assays to measure the concentrations of EGF and TNF-α.Results:In terms of VAS,there was a significant difference between pre-and post-DGRM treatment (P <.001),but not so for the PM group (P >.05).A significant difference was observed in the healing time between the two groups (6.08 (2.712) vs.8.04 (2.142) days).The mean healing time in the DGRM group was shorter than that in the PM group (P <.05).In both groups,the salivary EGF concentration decreased significantly after treatment (P <.05),but the mean level in the DGRM group was significantly lower than that in the PM group (P <.05).The mean TNF-α level in both groups was increased significantly after treatment (P <.05),but patients who used DGRMs had a significantly lower level than that in the PM group (P <.05).Conclusion:The present study provides evidence that DGRMs are effective treatment for RAS.Dried ginger rhizome has obvious effects on pain relief,shortening of healing time,reducing the EGF level in saliva,and has an inhibitory effect on TNF-α release.

Effect of Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin on lipid metabolism and insulin resistance in patients with polycystic ovary syndrome

Objective:To investigate the effect of Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin on lipid metabolism and insulin resistance in patients with polycystic ovary syndrome (PCOS).Methods: A total of 108 patients with PCOS who were treated in our hospital between November 2014 and April 2017 were reviewed and divided into routine group (n=67) who received routine therapy and Bailing capsule group (n=41) who received Bailing capsule combined with routine therapy. Routine group received ethinylestradiol and cyproterone acetate and metformin therapy, and Bailing capsule group were treated with Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin therapy. The differences in the levels of lipid metabolism, insulin resistance indexes as well as inflammatory factors were compared between the two groups before and after treatment.Results: There was no statistically significant difference in serum levels of lipid metabolism, insulin resistance-related indexes and inflammatory factors between the two groups before treatment. After treatment, serum HDL-C content of Bailing capsule group was higher than that of routine group whereas LDL-C and TC contents were lower than those of routine group;serum insulin resistance-related indexes FINS and HOMA-IR levels were lower than those of routine group;serum inflammatory cytokines IL-6, TNF-α, APN and LEP contents were lower than those of routine group.Conclusion: Bailing capsule combined with ethinylestradiol and cyproterone acetate and metformin therapy can effectively improve the lipid metabolism level and inhibit the insulin resistance in patients with PCOS.

Metformin combined with cisplatin inhibits the ovarian cancer cell growth and invasion in vitro: an experimental study

Objective: To study the effect of metformin combined with cisplatin on the expression of genes related to ovarian cancer cell growth and invasion in vitro. Methods: SKOV3 ovarian cancer cell lines were cultured and randomly divided into the control group treated with serum-free DMEM, the DDP group treated with serum-free DMEM containing 10 μmol/L cisplatin, the MET group treated with serum-free DMEM containing 10 mmol/L metformin and the DDP+MET group treated with serum-free DMEM containing 10 μmol/L cisplatin and 10 mmol/L metformin. Results: 24 h after treatment, GRP78, TBX2, CyclinD1, Ki-67, MTA1, CTHRC1, Slug and MMP2 protein expression in DDP group, MET group and DDP+MET group were significantly lower than those in control group whereas Fn14, NDRG2, SOCS1, Beclin1 and ST7L protein expression were significantly higher than those of control group;GRP78, TBX2, CyclinD1, Ki-67, MTA1, CTHRC1, Slug and MMP2 protein expression in DDP+MET group were significantly lower than those in DDP group and MET group whereas Fn14, NDRG2, SOCS1, Beclin1 and ST7L protein expression were significantly higher than those in DDP group and MET group. Conclusion: metformin combined with cisplatin can inhibit the expression of pro-proliferation and invasion genes and promote the expression of pro-apoptosis genes in ovarian cancer cells so as to inhibit cancer cell growth and invasion.

密闭式延长管预防人工气道吸痰作业期间气道漏气的实验研究

目的探讨密闭式延长管在人工气道吸痰作业期间预防气道漏气的作用。方法采用人工模肺连接呼吸机进行机械通气,呼吸回路中分别连接开放式延长管或密闭式延长管,呼吸机参数设置为16/5、20/6、24/7、28/8、32/9、36/10 cmH_(2)O(1 cmH_(2)O=0.098 kPa)六组递增压力,观察吸痰作业期间气道压力和潮气量的变化。结果(1)呼吸机参数设置在16/5~36/10 cmH_(2)O之间,连接开放式延长管机械通气回路的气道压力分别为(15.94±0.27)/(4.81±0.04)、(20.09±0.23)/(6.05±0.16)、(23.89±0.41)/(6.94±0.06)、(27.90±0.22)/(7.71±0.18)、(31.92±0.13)/(8.74±0.12)、(35.65±0.31)/(9.72±0.07)cmH_(2)O;相同参数下连接密闭式延长管机械通气回路的气道压力分别为(16.36±0.06)/(4.85±0.04)、(20.54±0.26)/(6.44±0.12)、(24.36±0.24)/(7.01±0.33)、(28.69±0.25)/(8.07±0.08)、(32.97±0.33)/(8.93±0.09)、(37.34±0.29)/(9.75±0.08)cmH_(2)O。连接开放式延长管机械通气回路的气道压力均低于连接密闭式延长管的(均P<0.05);随呼吸机设置压力的增加,两种延长管气道压力的差值逐渐增加,当呼吸机设置最高吸气压力为36 cmH_(2)O时,差值达到1.69 cmH_(2)O。(2)机械通气回路连接开放式延长管,吸痰作业拔插口开放时,通气回路的气道压力分别从(15.94±0.27)/(4.81±0.04)、(20.09±0.23)/(6.05±0.16)、(23.89±0.41)/(6.94±0.06)、(27.90±0.22)/(7.71±0.18)、(31.92±0.13)/(8.74±0.12)、(35.65±0.31)/(9.72±0.07)cmH_(2)O下降至(13.42±0.4)/(3.15±0.14)、(16.81±0.6)/(4.30±0.14)、(20.22±0.5)/(5.48±0.45)、(23.73±1.4)/(6.25±0.22)、(24.78±0.7)/(7.13±0.21)、(20.83±0.4)/(6.61±0.19)cmH_(2)O,(均P<0.05);潮气量分别从(0.328±0.004)、(0.580±0.012)、(0.621±0.003)、(0.626±0.003)、(0.615±0.003)、(0.603±0.002)L下降到(0.272±0.008)、(0.416±0.051)、(0.487±0.047)、(0.396±0.116)、(0.507±0.022)、(0.508±0.079)L(均P<0.05);随呼吸机设置的压力增加,通气回路的压力和潮气量下降幅度逐渐增加,当呼吸机设置参数为36/10 cmH_(2)O时,吸气压力下降幅度高达(14.82±0.51)cmH_(2)O;潮气量下降幅度最高时可达(0.164±0.021)L。(3)相同呼吸机参数下从处于开放状态的延长管插拔口插入吸痰管时,通气回路的气道压力分别上升为(15.70±0.23)/(4.80±0.33)、(19.01±0.81)/(5.71±0.34)、(22.27±0.62)/(6.85±0.44)、(25.35±2.09)/(7.94±0.16)、(28.38±0.46)/(8.96±0.23)、(33.34±0.71)/(9.71±0.25)cmH_(2)O,潮气量分别为(0.340±0.016)、(0.563±0.020)、(0.571±0.030)、(0.556±0.026)、(0.514±0.021)、(0.512±0.031)L。气道压力和潮气量较插拔口开放状态时增加,但仍低于插拔口处于关闭状态的(均P<0.05),与插拔口处于关闭状态比较,压力下降幅度最大为(3.53±0.46)cmH_(2)O,潮气量下降幅度最大为(0.101±0.011)L。(4)呼吸回路连接密闭式延长管,压力参数设置在16/5~36/10 cmH_(2)O之间,从密闭式延长管的插拔口插入吸痰管期间,气道压力分别从(16.26±0.04)/(4.85±0.04)、(20.74±0.15)/(6.42±0.11)、(25.09±0.31)/(7.10±0.13)、(29.38±0.24)/(8.17±0.09)、(33.80±0.16)/(9.02±0.17)、(37.89±0.19)/(9.83±0.07)cmH_(2)O下降到(16.36±0.06)/(4.85±0.04)、(20.54±0.26)/(6.44±0.12)、(24.36±0.24)/(7.01±0.33)、(28.69±0.25)/(8.07±0.08)、(32.97±0.33)/(8.93±0.09)、(37.34±0.29)/(9.75±0.08)cmH_(2)O,潮气量分别从(0.361±0.005)、(0.592±0.003)、(0.631±0.001)、(0.642±0.007)、(0.633±0.007)、(0.626±0.08)L下降到(0.335±0.005)、(0.588±0.008)、(0.631±0.002)、(0.638±0.004)、(0.628±0.004)、(0.618±0.005)L。气道压力下降幅度最大为(0.83±0.27)cmH_(2)O,潮气量下降幅度最大为(0.008±0.006)L,气道压力和潮气量的下降值均明显低于相同压力参数下通气回路连接开放式延长管的水平(均P<0.05)。结论机械通气回路中连接密闭式延长管可降低人工气道吸痰作业期间气道漏气情况,值得临床推荐使用。

Removal of dispersant-stabilized carbon nanotubes by regular coagulants

Coagulation followed by sedimentation, as a conventional technique in the water treatment plant, can be the first line of defense against exposures of carbon nanotubes （CNTs） to aquatic organisms and human beings, which has been rarely documented. This study investigated the removal of dispersant-stabilized CNT suspensions by poly aluminum chloride （PAC1） and KAl（SO4）2-12H20 （alum）, with a focus on the effects of dispersant type, coagulant type and dosage. PAC1 performed better than alum in the removal of tannic acid-, humic acid-, and sodium dodecyl benzenesulfonate-stabilized CNTs, but worse for polyethylene glycol octylphenyl ether （TX100）-stabilized CNTs. Neither coagulant could effectively precipitate cetyltrimethyl ammonium bromide-stabilized CNTs. The removal by PACl first increased up to a plateau and then decreased with the continued increase of coagulant dosage. However, the removal rates leveled off but did not decrease after achieving their highest level with the continued addition of alum. The coagulation and flocculation of the CNT suspensions by PACl could be regulated mainly by the mechanism of adsorption charge neutralization, whereas the coagulation by alum mainly involved electrical double-layer compression.

Adsorption of 17β-estradiol from aqueous solution by raw and direct/pre/post-KOH treated lotus seedpod biochar

Five biochars derived from lotus seedpod(LSP)were applied to examine and compare the adsorption capacity of 17β-estradiol(E2)from aqueous solution.The effect of KOH activation and the order of activation steps on material properties were discussed.The effect of contact time,initial concentration,p H,ionic strength and humic acid on E2 adsorption were investigated in a batch adsorption process.Experimental results demonstrated that the pseudo second-order model fitted the experimental data best and that adsorption equilibrium was reached within 20 hr.The efficiency of E2 removal increased with increasing E2 concentration and decreased with the increase of ionic strength.E2 adsorption on LSP-derived biochar(BCs)was influenced little by humic acid,and slightly affected by the solution p H when its value ranged from 4.0 to 9.0,but considerably affected at p H 10.0.Low environmental temperature is favorable for E2 adsorption.Chemisorption,π–πinteractions,monolayer adsorption and electrostatic interaction are the possible adsorption mechanisms.Comparative studies indicated that KOH activation and the order of activation steps had significant impacts on the material.Post-treated biochar exhibited better adsorption capacity for E2 than direct treated,pretreated,and raw LSP biochar.Pyrolyzed biochar at higher temperature improved E2 removal.The excellent performance of BCs in removing E2 suggested that BCs have potential in E2 treatment and that the biochar directly treated by KOH would be a good choice for the treatment of E2 in aqueous solution,with its advantages of good efficiency and simple technology.

Slow-release praziquantel for dogs:presentation of a new formulation for echinococcosis control

Background:Echinococcosis is a serious,zoonotic,parasitic disease with worldwide distribution.According to a epidemiological survey in 2012 in China,there are 20,000 infected patients and more than 50 million people at the risk.As the dog is the main,definitive host,the Government of China encourages monthly praziquantel treatment of every dog.However,this is difficult to achieve in geographically challenging areas,such as the Tibetan plateau,where there are also many dogs without owners.To overcome these problems,we investigated the transmission blocking capacity of a slow-release formulation of praziquantel administered by subcutaneous injection.Methods:The impact of a slow-release preparation of two pharmacokinetically stereoselective praziquantel enantiomers,i.e.,R-(−)-praziquantel(R-PZQ)and S-(+)-praziquantel(S-PZQ)absorbed into a biodegradable polymer was studied in beagle dogs(N=6).The preparation was given by subcutaneous injection using a single dose of 100 mg/kg.Chiral-selective,high-performance liquid chromatography(HPLC)and high-resolution mass spectrometry(HRMS)were applied to measure the praziquantel enantiomers in the plasma of the dogs.The lower limit for estimating plasma concentrations accurately for R-PZQ was 4 ng/ml and for S-PZQ 20 ng/ml.The pharmacokinetic parameters were calculated by a noncompartmental analysis model using Drug Analyze System(DAS)software 2.0.The SPSS 19.0 software was used for statistical analysis,and the statistical comparison between enantiomers was assessed using the two-tailed t-test.Results:Two hours after administration,peak concentrations of R-PZQ and S-PZQ:321±26 and 719±263 ng/ml,respectively,were achieved.After 180 days,the average plasma concentration of R-PZQ in the six dogs had decreased to 13 ng/ml.The average concentration value of S-PZQ was higher than that of R-PZQ in the first 90-day period but fell afterwards and could not be accurately estimated when dropping below 20 ng/ml(the lower methodological limit for this enantiomer).Taking all the dogs into account,the average maximum concentration(Cmax)of S-PZQ in plasma over the first 3 months was higher than that of R-PZQ by 114.0%(P<0.05),while the average mean retention time(MRT)of R-PZQ in plasma was higher than that of S-PZQ by 96.3%(P<0.05).Conclusions:Praziquantel given as an in situ slow-release formulation by subcutaneous injection resulted in concentrations of the active principle in beagle dogs,which should be capable of resisting new Echinococcus infections for at least 6 months.The new formulation of praziquantel represents a potential,alternative way of presenting medication against tapeworm infections in dogs.