【摘要】 目的 探讨脓毒血症患者胆碱酯酶水平与患者病情及预后的关系。 方法 2007年6月-2009年6月，将89例脓毒血症患者设定为脓毒血症组，进行血清胆碱酯酶测定及APACHEⅡ评分；另择82例健康人为正常组，测定血清胆碱酯酶值，比较两者之间差异；89例脓毒症患者按病况再分为存活组及死亡组，比较两者之间血清胆碱酯酶及APACHEⅡ评分差异。 结果 治疗前脓毒血症组胆碱酯酶水平明显低于正常组，有统计学意义（Plt;0.01）；脓毒血症组APACHEⅡ评分与血清胆碱酯酶呈负相关；死亡组APACHEⅡ评分明显高于存活组，而血清胆碱酶低于存活组（Plt;0.01）。 结论 胆碱酯酶同APACHEⅡ评分呈负相关，能明显反映脓毒症患者病情严重程度及预后。【Abstract】 Objective To explore the relationship between the level of cholinesterase and the patients condition and the prognosis in the patients with sepsis. Methods From June 2007 to June 2009, 89 patients with sepsis were selected as the sepsis group, whose cholinesterase level was assayed and evaluated by APACHE Ⅱ score. Another 82 healthy people were as the control whose cholinesterase level was assayed and compared with that in the sepsis group. The patients in the sepsis group were subdivided into survival and death group; the level of cholinesterase and the result of APACHE Ⅱ score were compared between the two groups. Results The level of cholinesterase in sepsis group was significantly lower than that in the control group before treatment, and the difference was significant (Plt;0.01); the APACHE Ⅱ score negatively correlated with the serum cholinesterase in sepsis group. The APACHE Ⅱ score in the death group was significantly higher than that in the survival group, but the level of cholinesterase was obviously lower in the death group than that in the survival group (Plt;0.01). Conclusion The serumal cholinesterase negatively correlates with the APACHE Ⅱ score, which could obviously reflect the patients condition and the prognosis of sepsis.
Tyrosine kinase inhibitors (TKIs) are the standard of care for non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutation. The efficacy of TKIs and prognosis of EGFR-mutated patients with compound EGFR mutation, oncogene mutation, suppresser gene mutation or other diver gene mutation are worse than those of patients with a single EGFR mutation. This article makes a review of related clinical researches aiming to provide references for clinical scenarios. To sum up, molecular alterations and clinical features should be correlated as accurately and dynamically as possible in the diagnostic and therapeutic process, and combined therapeutic strategies should be chosen flexibly and reasonably to improve patients’ survival and prognosis.
目的 分析比较锥形束CT(CBCT)与MOSAIQ两系统用于测量胸部放射治疗(放疗)摆位误差情况。 方法 2011年2月－9月,随机选择21例用热塑模固定的胸部调强治疗患者，进行同次摆位的CBCT图像采集和电子射野影像(EPID)正侧位图像采集。将CBCT图像与定位CT图像进行匹配，图像经iViewGT系统传输至MOSAIQ系统图像处理模块中与计划生成的数字重建图像(DRR)正侧位片进行匹配，分别记录两套系统图像匹配结果在X(左右)方向、Y(头脚)方向、Z(前后)方向的平移误差及CBCT的旋转误差值，计算其均值、标准差，进行统计学处理。 结果 本研究共获取图像106组，每组内包含一次CBCT图像和EPID图像。CBCT和MOSAIQ系统下EPID匹配结果平移误差在X、Y、Z方向分别为(−0.103 ± 0.240)cm、(−0.086 ± 0.342)cm、(0.017 ± 0184)cm和(0.005 ± 0.214)cm、(−0.004 ± 0.0.315)cm、(−0.113 ± 0.239)cm；旋转误差在X、Y、Z方向分别为(0.792 ± 1.173)°、(−0.130 ± 1.407)°、(0.793 ± 0.960)°，其中≤3°的概率分别为98.2%、97.2%、99.1%，最大绝对值分别为5°、3.4°、3.3°。两套系统在X、Y、Z三个方向的平移误差经配对样本检验，在Y方向P＞0.05，在X和Z方向上P值均＜0.05， 两系统的测量差值有直线负相关关系。 结论 CBCT和EPID在测量胸部放疗靶区中心的平移误差中差异有统计学意义，因此建议在做胸部放疗时有CBCT的情况下应优先使用。
ObjectiveThis study applied Mendelian randomization to explore the potential causal relationship between inflammatory factors and diabetic nephropathy. MethodsSummary-level data from genome-wide association studies of inflammatory factors and diabetic nephropathy were used, and inverse variance weighted analysis was used as the primary analytical method, complemented by results from weighted median, MR-Egger regression, simple model, and median model approaches. Sensitivity analysis was used to test the reliability of the MR analysis results. ResultsIn the inverse variance weighted method, stem cell factor (OR=1.28, 95%CI 1.04 to 1.58, P=0.020) and interferon-γ (OR=1.36, 95%CI 1.10 to 1.70, P=0.005) were positively correlated with diabetic nephropathy, and diabetic nephropathy was positively correlated with interferon-inducible protein 10 (OR=0.90, 95%CI 0.83 to 0.98, P=0.012) were negatively correlated with diabetic nephropathy. Sensitivity analysis showed that MR analysis was reliable. ConclusionStem cell factors and interferon-γ are associated with an increased risk of developing diabetic nephropathy, and diabetic nephropathy decreases the expression of interferon-inducible protein 10 in vivo. Our results demonstrate a potential causal relationship between inflammatory factors and the development of diabetic nephropathy. This finding is of clinical significance for the pre-diagnosis and treatment of diabetic nephropathy.