Objective To study effect of carcinoembryonic antigen (CEA) positive targeted lymphocytes on gastric cancer cells in vitro and in vivo. Methods The peripheral blood mononuclear cells (PBMCs) were isolated from the peripheral blood of healthy volunteers. The recombinant vector anti-CEA-scFv-CD3ζ-pcDNA3.0 was transfected into the PBMCs by lipofectamine 2000, by this means, the CEA special lymphocytes were obtained. Meanwhile, the PBMCs transfected with empty plasmid pcDNA3.0 were used as control (empty vector lymphocytes). The different lymphocytes and gastric cancer cells (CEA positive KATOⅢ gastric cancer cells and CEA negative BGC-823 gastric cancer cells) were co-cultured, then the ability to identify the gastric cancer cells and it’s effect on apoptosis of gastric cancer cells were observed at 24 h or 36 h later respectively. The CEA special lymphocytes and empty vector lymphocytes were injected by the tail vein of nude mice bearing gastric cancer cells, then it’s effect on the tumor was observed. Results ① The CEA special lymphocytes could strongly identify the KATOⅢ gastric cancer cells (identification rate was 72.3%), which could weakly identify the BGC-823 gastric cancer cells (identification rate was 7.8%). ② The apoptosis rate of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly higher than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (P=0.032), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (P=0.118). ③ The tumor volume of the co-culture of CEA special lymphocytes and KATOⅢ gastric cancer cells was significantly smaller than that of the co-culture of empty vector lymphocytes and KATOⅢ gastric cancer cells (F=5.010, P<0.01) or the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells (F=4.982, P<0.01), which had no significant difference between the co-culture of CEA special lymphocytes and BGC-823 gastric cancer cells and the co-culture of empty vector lymphocytes and BGC-823 gastric cancer cells (F=1.210, P>0.05). Conclusion CEA special lymphocytes can promote cell apoptosis and inhabit tumor reproduction of CEA positive gastric cancer cells in vitro and in vivo.
目的:研究替米沙坦對合并高血壓的陣發性房顫患者轉復為竇性心律后復發的影響。方法: 選擇84例合并高血壓的陣發性房顫患者,隨機分成觀察組及對照組,觀察組降壓藥使用替米沙坦,對照組使用氨氯地平,兩組均使用胺碘酮復律,隨訪2年,觀察兩組患者的療效及超聲心動圖(左房內徑)變化。結果:觀察組治療合并高血壓的陣發性房顫復發率顯著低于對照組。結論:替米沙坦聯合抗心律失常藥物,能有效防止房顫復發,維持竇性心律。
目的 調查安置永久性人工心臟起搏器的老年患者術前焦慮狀況，為制訂護理對策提供依據。 方法 2004年7月-2008年7月收治需安置永久性人工心臟起搏器的心臟病患者78例，術前采用焦慮自評量表（SAS）對其進行問卷調查，并采用自制一般情況問卷調查了解情況。 結果 植入永久性心臟起搏器的老年患者術前SAS得分高于國內常模（Plt;0.05）。根據自制調查問卷結果，差異有統計學意義（Plt;0.05）的項目:老年患者隨年齡增長焦慮量表評分降低；喪偶者焦慮評分高于有配偶者；完全公費、部分公費、自費的焦慮量表評分依次增高；老年患者對起搏器知識了解程度越少，焦慮評分越高；無家人陪伴者比有家人陪伴者焦慮評分高。而性別、文化水平差異無統計學意義。 結論 植入永久性起搏器的老年患者術前多數存在焦慮情緒，且焦慮與年齡、婚姻、費用支付方式、有無家人陪伴、相關知識等有一定關系，醫護人員應針對性地做好患者術前護理，幫助患者面對現實，以積極的心態接受手術治療。
Objective To evaluate the effect of day surgery with diagnosis-related groups (DRG) evaluation indicators. Methods The inpatients undergoing surgery in Beijing Tongren Hospital of Capital Medical University between March and September 2022 were enrolled in this study. The medical quality, medical efficiency, hospitalization cost, DRG insurance payment and other DRD-related indicators were retrospectively collected and compared between day surgery patients and non-day surgery patients, and the average length of hospital stay and hospitalization costs were compared between the two surgery modes within DRGs. Chi-square test was used for enumeration data, and t-test and Mann-Whitney U test were used for measurement data. Results A total of 29339 day surgery patients and 19019 non-day surgery patients were enrolled. In the day surgery group, the proportions of local patients (71.71% vs. 68.62%), routine discharge (99.93% vs. 99.78%), and class A incisions (99.92% vs. 99.55%) were better than those in the non-day surgery group (P<0.05), and the average length of hospital stay [(1.00±0.00) vs. (6.98±5.00) d] and the average hospitalization costs [(7306.62±4605.73) vs. (24913.97±24623.54) yuan] were lower than those in the non-day surgery group (P<0.05). The top 2 reduction of average length of hospital stay were in the CB49 group and CB39 group, decreasing by 87.45% and 86.24%, respectively. The top 2 reduction of hospitalization costs were in the DC19 group and CC15 group, decreasing by 84.15% and 73.61%, respectively. DRG payment balance of medical insurance in the day surgery group was higher than that in the non-day surgery group (22.95% vs. 5.98%). Conclusions Day surgery not only ensure the medical quality, but also shorten the length of hospital stay and reduce the burden of medical expenses. Day surgery can effectively improve the utilization efficiency of hospital bed resources, it is an effective measure to promote the high quality development of hospital and comply with DRG payment reform.
ObjectiveTo investigate the method for generating anchor chemric T lymphocytes that can target tumor associated glycoprotein-72 (TAG72) antigen and analyze their repressive effects on proliferation of TAG72 positive hepatocarcinoma cells. MethodsFirstly, peripheral blood mononuclear cells (PBMCs) from healthy volunteers were isolated. And then, CD8+ T cells were isolated from PBMCs via magnetic activated cell sorting (MACS). These lymphocytes were transfected with recombinant vector, anti-TAG72-scFv-CD28-pcDNA3, through Lipofectamine2000 to gernerate anchor chimeric TAG72-specific CD8+ T cells. SMMC7721 (TAG72 positive) hepatocarcinoma cells were co-cultured with chimeric T lymphocytes and their cell cycles were analyzed by flow cytometry (FCM). ResultsAnchor chmeric T lymphcytes targetting TAG72 recognized TAG72 positive SMM7721 cells and repressive effects on their proliferation were observed by flow cytometry. ConclusionAnchor chmeric T lymphcytes targetting TAG72 on tumor surface can specifically recognize TAG72 positive hepatocarcinoma cells and may exert repressive effect on their proliferation.
Objective To construct a green fluorescent protein expression plasmid pEGFP-C3-anti-TAG72 scFv-CD28, containing anti-TAG72 single chain variable fragment (scFv) fused into the transmembrane and intracellular domain of the signal-transducing chain of CD28 gene, and to transfect it into peripheral blood mononuclear cells． Methods Recombinant transmembrane and intracellular domain of CD28 cDNA and anti-TAG72 scFv cDNA fragment was subcloned into pEGFP-C3 vector. Recombinant clones were selected by Kanamyein， and then identified by PCR， enzyme digestion analysis and DNA sequencing. The recombinant plasmid was transfected into peripheral blood mononuclear cells by means of lipofection. The recombinant protein expression was confirmed by immunocytochemistry, laser scanning confocal microscope, PCR and Western blot analysis. Results The fused gene fragment of anti-TAG72 scFv-CD28 was successfully inserted into pEGFP-C3 plasmid, and it was confirmed by enzyme digestion and DNA sequencing. The fused anti-TAG72 scFv-CD28 gene and its protein was identified in peripheral blood mononuclear cells． Conclusion The eukaryotic expression plasmid pEGFP-C3-anti-TAG72 scFv-CD28 was successfully constructed and transiently expressed in peripheral blood mononuclear cells， which would lay a foundation for further studies on the role of it to activate tumor-associated antigen-specific T lymphocyte, for generating of modified T lymphocytes targeting gastrointestinal tumors.
目的 了解糖尿病患者院外自行注射胰島素存在的風險。 方法 2010年1月－12月，通過隨訪調查老年組83例，中青年組69例糖尿病患者院外自行注射胰島素的實施情況，對存在的問題進行歸類、統計。調查的內容主要包括3個方面：胰島素裝置的正確使用、胰島素的規范注射、血糖監測及低血糖處理。分析兩組患者院外注射胰島素的風險，并對存在的問題進行原因分析、提出解決方法。 結果 發放調查表152份，有效回收131份，其中老年組73份，中青年組58份。在胰島素裝置使用方面，老年組存在問題48項，中青年組27項，兩者間差異無統計學意義（χ2=2.432，P＞0.05）。在胰島素的規范注射方面，老年組存在問題176項，中青年組77項，老年組在胰島素注射方面存在的問題明顯高于中青年組（χ2=25.009，P＜0.001）。在低血糖的認識及正確處理上，老年組存在問題115項，中青年組33項，兩組差異具有統計學意義（χ2=40.383，P＜0.001）。 結論 糖尿病患者院外自行注射胰島素存在諸多風險。老年糖尿病患者院外胰島素注射需在他人協助、監督下進行。
目的:觀察等效劑量瑞芬太尼和芬太尼誘導氣管插管對小兒血流動力學的影響。方法:40例擇期行全麻患兒隨機分為瑞芬太尼組和芬太尼組,麻醉誘導使用咪唑安定0.15mg/kg、丙泊酚2.5mg/kg、芬太尼2.5μg/kg或瑞芬太尼2μg/kg和維庫溴銨0.1mg/kg。分別于麻醉誘導前(T0)、誘導后2min(T1)、插管后1、2min(T2、T3)記錄心率、收縮壓和舒張壓。結果:兩組誘導前血流動力學指標相似。與T0時比較,兩組患兒T1時收縮壓、舒張壓均降低(Plt;0.05或Plt;0.01),心率均減慢(Plt;0.05或Plt;0.01);瑞芬太尼組T2.T3時收縮壓、舒張壓降低(Plt;0.05或Plt;0.01),心率減慢(Plt;0.05);芬太尼組T2、T3時收縮壓、舒張壓升高(Plt;0.05),心率增快(Plt;0.05)。與芬太尼組比較,瑞芬太尼組T1、T2和T3時收縮壓、舒張壓均降低(Plt;0.05),心率減慢(Plt;0.05)。結論:瑞芬太尼比等效劑量芬太尼能更好地抑制小兒全麻誘導氣管插管時的心血管反應。
目的 了解成都市臥床老年人的抑郁發生情況及影響因素。 方法 對2009年12月－2011年2月臥床時間＞1個月的325例臥床老年人采用老年抑郁量表、焦慮自評量表、生活滿意度指數A進行調查，并對影響的抑郁的相關因素進行統計分析。 結果 成都市臥床老年人抑郁的發生率為57.5%。不同病情、生活自理能力、焦慮情況、社會交往情況、生活的滿意度和家庭功能的老年人，其抑郁評分差異有統計學意義（P＜0.05）。多重線性回歸分析發現影響老年人抑郁的主要因素有病情、臥床分級、焦慮、社會活動、滿意度、文化程度，其中對生活滿意、有社會活動、文化程度高是保護因素，而焦慮、病情較重、臥床等級高是抑郁的危險因素。 結論 臥床老年人的抑郁發生率較高，應加強對臥床老年人，特別是病情重、焦慮、大部分或者全天臥床、低文化的臥床老人抑郁發生的關注，鼓勵老年人增加社會活動、提高老年人對生活的滿意度和增進他們的心理健康。
Objective To evaluate the analgesic effect of intra-articular ropivacaine with lidocaine. Methods A double-blind randomized controlled trial was conducted. Ninety patients receiving selective knee arthroscopy were randomized into three groups of 30 patients. At the end of the operation, before the release of the tourniquet, an intra-articular injection was administered to each patient through arthroscope, in accordance with their random allocation: 0.9% normal saline (normal saline group); 100 mg ropivacaine (ropivacaine alone group) and 100 mg ropivacaine and 100 mg 2% lidocaine (ropivacaine with lidocaine group). Pain intensity was assessed after the operation using the 100-mm visual-analog scale (VAS), and the amount of supplemental analgesics used within the following 24 hours were recorded. Results The VAS scores of 2 hours postoperatively at rest, and 1, 2, 4, and 8 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine alone group (Plt;0.05). The VAS scores 0.5, 1 and 2 hours postoperatively at rest, and at the awaking moment, 0.5, 1, 4, 8, and 24 hours postoperatively at motion, were significantly higher in the normal saline group than in ropivacaine with lidocaine group (Plt;0.05). Conclusion Intra-articular ropivacaine can reduce a patient’s pain after operation. The combination of lidocaine with intra-articular ropivacaine can reduce the patient’s pain severity immediately after the operation and achieve an early analgesic effect.