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目的 对比观察 300 mg/次、1 g/次利妥昔单抗静脉滴注治疗特发性膜性肾病的疗效及安全性, 为特发 性膜性肾病治疗药物利妥昔单抗选择适宜剂量。方法 以随机数字表法将 64 例特发性膜性肾病患者分为单次 小剂量组、常规剂量组, 各 32例。在基础支持治疗基础上, 单次小剂量组予以利妥昔单抗 300 mg/次, 常规剂量组 给予利妥昔单抗 1 g/次, 均静脉滴注, 连续治疗 6个月。比较两组总有效率, 治疗前、治疗 6个月的肾功能 (血清肌 酐、肾小球滤过率、24 小时尿蛋白定量)、免疫功能 (CD4+/CD8+、外周血免疫球蛋白 G)、M 型磷脂酶 A2 受体 (PLA2R) 抗体、25 (OH) D3水平及不良反应发生率。结果 治疗 6 个月, 常规剂量组与单次小剂量组总有效率比 较, P>0. 05。与治疗前对比, 治疗 6 个月两组血清 PLA2R 抗体、CD4+/CD8+、24 h 尿蛋白定量 (24 h UP)、血清肌酐 (sCr)水平均降低, 外周血免疫球蛋白 (IgG) 水平、肾小球滤过率 (eGFR)、25 (OH) D3水平均升高 (P均<0. 05)；两组 间外周血 IgG、血清 sCr、PLA2R 抗体、25 (OH) D3水平、CD4+/CD8+、24 h UP 水平、eGFR 比较, P 均>0. 05。与常规剂 量组不良反应总发生率 (34. 38%) 比较, 单次小剂量组 (9. 38%)低 (P<0. 05)。结论 300 mg/次、1 g/次利妥昔单 抗治疗特发性膜性肾病, 均能稳定患者病情, 改善其肾功能及免疫功能, 且疗效相当, 但 300 mg/次利妥昔单抗治 疗的安全性相对更高。 [ABSTRACT FROM AUTHOR]

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

骨肉瘤具有病情进展快、转移早、预后差、治疗困难、易复发等特点，其靶向治疗是在特定导向机制作用 下，借助载体、配体、抗体将药物选择性浓集定位于靶器官、靶组织、靶细胞等特定结构，提高肿瘤局部治疗效果，同 时减少对周围健康组织的毒性反应。骨肉瘤的器官、组织、分子水平靶向治疗阶段不同，决定其不同的治疗耙点和 治疗方式。靶向治疗骨肉瘤药物的研发及临床应用已经取得一定疗效，并对原有骨肉瘤治疗学观念和模式产生了 较大影响。 [ABSTRACT FROM AUTHOR]

Objective To observe the effect of anterior lower tibiofibular ligament rupture on ankle joint stability.Methods Ten normal adult right lower limb specimens fixed with formaldehyde for 3 months were selected. The knee joint was severed from the knee joint. The lower part of the knee joint was retained. The knee joint and sole were fixed with selfmade steel plate cap and cement base,respectively. Opening the capsule of ankle joint,placing two low-pressure pressure pressure sensitive sheets wrapped in plastic film in the tibial talus joint,and measuring the vertical compression displacement of anterior tibiofibular ligament before and after disruption of anterior tibiofibular ligament at neutral position of ankle foot,at 20 degree of dorsal extension and 30 degree of plantar flexion,under 700,1 400,2 800,and 3 500 N vertical pressure load,as well as the pressure area of tibiotalus joint surface,the pressure intensity,and the distribution of force on the tibial-talus joint surface,respectively. The data measured before the anterior lower tibiofibular ligament rupture were taken as the control group,and the data measured after the anterior lower tibiofibular ligament rupture were taken as the observation group. Results With the increase of the vertical pressure load,the vertical compression displacement,the pressure area and the pressure of the lower tibial talus joint increased gradually( all P < 0. 05). The vertical compression displacement and the pressure area of the lower tibial talus articular surface in the observation group were significantly higher than those in the control group at the same position and pressure load,and the pressure of the lower tibial talus articular surface was significantly lower than those in the control group( all P < 0. 05). When foot was in the neutral position,the medial side of the tibial-talus articular surface of the ankle joints of the two groups was firstly stressed. With the increase of pressure load,the range of force gradually extended to the front,rear,lateral and middle parts of the tibial-talus joint,and finally formed a triangular figure with narrow inside and wide inside. The concentrated area of force was distributed in the medial part of the middle of the tibial-talus articular surface. At 20 degrees of dorsal extension,the medial front of the tibial talus joints of the two groups were first stressed. With the increase of pressure load,the range of force gradually extended to the middle,lateral and posterior sides of the tibial talus joint surface,forming a right-angled triangular figure with anteriormedial width and posterolateral narrowness. The concentrated area of force was distributed in the medial front of the tibial talus joint. At 30 degrees of plantar flexion,the posteromedial part of the tibial-talus articular surface of the ankle joints in the two groups was firstly stressed. With the increase of pressure load,the range of force gradually extended to the middle,front and outside sides of the tibial-talus articular surface,forming an inverted triangle-like figure with front width and back narrowness,and the concentrated stress area was distributed in the front and middle parts of the tibial-talus articular surface. Compared with the control group,the stress area of the observation group tended to increase under the same pressure load. Conclusion The anterior lower tibiofibular ligament rupture can change the biomechanical properties of ankle joint and destroy its stability. [ABSTRACT FROM AUTHOR]

肾癌是临床上较为常见的恶性肿瘤。由于早期症状不明显,约30%的肾癌患者在确诊时已发生远处转移。肿瘤细胞进入血液循环是肿瘤转移过程中的重要步骤,循环肿瘤细胞(CTCs)是指脱离原发病灶并进入外周血循环系统的一类细胞。目前已经报道的CTCs检测技术有50余种,其中应用较为广泛的方法为RT-PCR法及Cell Search法,近年新开展的微流体芯片法和eTumor Type法表现出了较高的检出率,具有较好的应用前景。研究提示,外周血CTCs水平可以用于判断肾癌患者的临床分期和评估预后,在肿瘤的早期微转移中具有重要作用。 [ABSTRACT FROM AUTHOR]

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

外泌体(Exosomes)是囊泡转运的主要组成部分之一,囊泡转运对于细胞发挥多种功能活动起重要作用。释放至细胞外面的Exosomes参与一系列生物过程,如免疫应答、凋亡、血管生成、炎症反应、凝结过程、肿瘤转移、动脉硬化、抗原提呈和治疗受损器官等。诸多研究表明,不同细胞来源的Exosomes,通常含有相同的一套蛋白质来调节膜骨架的动态性及膜融合;另外,Exosomes中还包含核酸物质,统称为eRNA,Exosomes的生物学功能通过其携带蛋白质和miRNA等到达受体细胞而发挥调控作用。Exosomes可由树突状细胞、血小板、肥大细胞、内皮细胞间充质干细胞和肿瘤细胞等不同细胞类型分泌,并可在多数体液如外周血、尿液、唾液、羊水、乳汁、脑脊液、支气管肺泡灌洗液等体液中检测到。诸多研究表明Exosomes携带的mRNA、miRNA和蛋白质在疾病发生发展过程中会发生明显变化,可作为疾病诊断的理想标记物。在Exosomes治疗疾病研究方面,目前比较关注的是骨髓间充质干细胞和树突状细胞来源Exosomes的治疗作用。 [ABSTRACT FROM AUTHOR]

骨肉瘤具有进展快、转移早、预后差、易复发等特点。手术治疗骨肉瘤是最基础、传统、经典的方式,包括截肢手术和保肢手术。截肢手术是将包括肿瘤在内的肢体整段切除,适用于巨大肿瘤、肿瘤广泛扩散、经济条件差的肿瘤患者。截肢手术的优点是能够最大程度切除原发肿瘤病灶,对技术水平及设备要求低,手术操作相对容易,术后早期联合辅助化疗可预防肿瘤转移,甚至可能起到根治效果。截肢手术的缺点是患者肢体缺失导致功能障碍,严重影响患者的生活质量,常见的术后并发症是幻肢痛。保肢手术方式主要包括生物性关节成形、关节融合、灭活再植、骨移植、假体置换等,适应于肿瘤周围主要血管和神经未受侵蚀、转移病灶可以治愈、可能或者无转移病灶、患处软组织以及全身状况良的、保肢欲望强烈的患者等。保肢手术的优点是可以最大程度保全肢体,缺点是术后可能发生肿瘤复发和转移。对骨肉瘤患者行手术治疗时需要根据患者具体情况个性化选择手术方式,保全生命是骨肉瘤手术治疗的基本原则、主要目的和最低要求。 [ABSTRACT FROM AUTHOR]

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Shandong Medical Journal is the property of Shandong Medical Health Newspapers and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

目的：观察维持性血液透析（MHD）患者钙磷代谢紊乱及腹主动脉钙化（AAC）情况。方法 MHD患者60例，其中＜50岁28例、≥50岁32例，血液透析时间＜36个月34例、≥36个月26例，有钙化39例、无钙化21例。采用全自动生化仪和化学发光免疫分析仪检测血钙、血磷、血清全段甲状旁腺激素（iPTH），根据血钙、血磷指标计算出钙磷乘积；并对所有患者进行腹部多层螺旋CT检查，记录有无AAC。结果不同年龄患者血钙、血磷、血清iPTH水平及钙磷乘积比较，P均＞0．05。与透析时间≥36个月者比较，透析时间＜36个月者血磷、血清iPTH水平升高，钙磷乘积增加（P均＜0．05）。与无钙化者比较，钙化者年龄大、透析时间长、血磷水平升高、钙磷乘积增加（P均＜0．05）。结论 MHD患者钙磷代谢紊乱及AAC发生率较高，并随着透析时间的延长而增加。 [ABSTRACT FROM AUTHOR]