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关键词： 横纹肌溶解   脑白质病   液体复苏   出血灶   呼吸支持   糖皮质激素   免疫球蛋白   血液净化  

摘要： 嗜肺军团菌肺炎合并出血性脑白质病与横纹肌溶解临床罕见,本文报道1例罹患嗜肺军团菌肺炎合并出血性脑白质病与横纹肌溶解的女性患者,其肌酸激酶和肌红蛋白显著升高,头颅CT示脑内多发出血灶,给予抗感染、呼吸支持、液体复苏、血液净化、脑保护、糖皮质激素、免疫球蛋白及对症支持治疗后,患者病情好转痊愈出院。

关键词： 上皮性卵巢癌   红细胞体积分布宽度   白介素-6   糖类抗原125   诊断  

摘要： 目的探讨外周血红细胞体积分布宽度(RDW)、白介素-6(IL-6)、糖类抗原125(CA125)对上皮性卵巢癌(EOC)的诊断价值。方法回顾性分析2019年8月至2021年8月舟山市妇女儿童医院收治的186例EOC患者的临床资料作为研究组,选取同期在同一医院进行体检的97名健康女性作为对照组,收集两组基线资料。比较两组外周血RDW、IL-6、CA125水平,采用受试者工作特征(ROC)曲线分析外周血RDW、IL-6、CA125对EOC的诊断价值,分析外周血RDW、IL-6、CA125与患者临床病理特征的关系,采用Kaplan-Meier曲线分析外周血RDW、IL-6、CA125与无病生存期(DFS)的关系。结果研究组外周血RDW、IL-6、CA125水平均高于对照组(P<0.05)。外周血RDW、IL-6、CA125联合诊断效能高于单独诊断(P<0.05)。国际妇产科联盟(FIGO)分期Ⅰ~Ⅱ期、无淋巴结转移、高度分化患者外周血RDW、IL-6、CA125水平均低于FIGO分期Ⅲ~Ⅳ期、有淋巴结转移、低度分化患者(P<0.05)。外周血RDW、IL-6、CA125低表达患者DFS长于高表达患者(P<0.05)。结论EOC患者外周血RDW、IL-6、CA125表达水平升高,与FIGO分期、淋巴结转移、分化程度有关,三者联合检测对EOC具有较高的诊断价值,其水平低表达患者DFS较长。

关键词： bone cancer pain   interleukin-18   microglia   nuclear factor of activated T cells 1   p38 MAPK  

摘要： Aims: This study aimed to test the hypothesis that nuclear factor of activated T cells 1 (NFAT1) signaling contributes to bone cancer pain by regulating interleukin (IL)-18 expression in spinal microglia. Methods: This study was performed on male mice using a Lewis lung carcinoma-induced bone cancer pain model. Nociceptive behaviors were evaluated by measuring mechanical allodynia, thermal hyperalgesia, and spontaneous pain. Expression levels were measured via real-time quantitative polymerase chain reaction, western blotting, and immunofluorescence analysis. The effect of pharmacologic intervention of spinal NFAT1/IL-18 signaling on bone cancer pain was the primary outcome. Results: NFAT1 expression was upregulated in the spinal microglia after tumor inoculation. Pharmacological inhibition of NFAT1 upregulation prevented and reversed bone cancer-related pain behaviors. In spinal microglia, NFAT1 inhibition decreased p38 MAPK phosphorylation and IL-18 production. Blocking NFAT1 signaling suppressed tumor-induced neuronal sensitization and microglial activation as well as activation of the N-methyl-D-aspartate receptor and the subsequent Ca²⁺-dependent signaling. Conclusion: Microglia NFAT1-p38 signaling contributes to bone cancer pain through IL-18-mediated central sensitization in spinal microglia. NFAT1 could be a potential target for therapeutic intervention to prevent bone cancer pain. © 2025 The Author(s). CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.

关键词： 乳腺癌   白细胞介素-28受体α亚基   预后  

摘要： 目的探究白细胞介素-28受体α亚基(IL-28RA)在乳腺癌组织中的表达及其临床意义。方法选取2018年1月-2020年9月新疆医科大学第三临床医学院附属肿瘤医院收治的女性乳腺癌患者88例,均行乳腺癌根治性切除术,术后采用免疫组织化学法检测雌激素受体(ER)、孕激素受体(PR)、人类表皮生长因子受体2(HER-2)、细胞黏附分子(CAM)、肿瘤蛋白53(p53)、Ki-67、IL-28RA表达,采用实时荧光定量聚合酶链反应检测乳腺癌组织及癌旁正常组织中IL28RA mRNA的表达。术后随访3年,根据预后结局分为无疾病生存期(DFS)组和非DFS组,分析乳腺癌患者病情进展的影响因素,分析IL-28RA mRNA与乳腺癌预后的关系。结果截至随访日期,失访9例,有效随访率为89.77%。剩余79例乳腺癌患者中非DFS 16例(25.32%)。癌组织IL-28RA mRNA相对表达量低于癌旁正常组织(P<0.05)。非DFS组TNMⅢ期、低分化占比高于DFS组(P<0.05)。非DFS组IL-28RA阳性表达率、IL-28RA mRNA相对表达量均低于DFS组(P<0.05)。多因素逐步Logistic回归分析结果显示:TNM分期Ⅲ期[O^R=3.688(95%CI:1.183,11.495)]、低分化[O^R=3.607(95%CI:1.157,11.246)]、IL-28RA mRNA水平高[O^R=3.865(95%CI:1.239,12.050)]是乳腺癌患者病情进展的危险因素(P<0.05)。ROC曲线结果显示,IL-28RA mRNA预测乳腺癌病情进展的截断值为0.67,敏感性为81.7%(95%CI:0.752,0.941),特异性为72.9%(95%CI:0.651,0.829)。IL-28RA mRNA低表达患者的DFS短于IL-28RA mRNA高表达患者(P<0.05)。结论IL-28RA表达降低与乳腺癌的DFS有关。

摘要： In the original publication [1], there was a mistake in Figures 5F and 6A as published. One of the images in Figure 4F was inadvertently duplicated in Figure 5F during our figure preparation process. A similar error was also noted between Figure 6A,D. The corrected Figure 5 and Figure 6 appear below. The authors state that the scientific conclusions are unaffected. This correction was approved by the Academic Editor. The original publication has also been updated. © 2025 by the authors.

关键词： T淋巴细胞亚群   多发性骨髓瘤   预后   预测  

摘要： 目的探究外周血T淋巴细胞亚群表达水平对多发性骨髓瘤(MM)患儿预后的预测价值。方法收集90例MM患儿临床资料进行回顾性分析。根据患儿预后情况将其分为良好组(n=68例)和不良组(n=22例)。比较两组患儿的一般资料、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、NK细胞的表达情况,并分析外周血T淋巴细胞亚群相关指标表达水平对MM患儿预后的评估价值。结果两组患儿年龄、性别、M蛋白、血肌酐比较差异不显著(P>0.05)。不良组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞均显著低于良好组(t=3.276,P=0.002、t=6.635,P=0.000、t=2.242,P=0.028、t=6.271,P=0.000),CD8^(+)高于良好组,差异有统计学意义(t=3.603,P=0.001)。外周血T淋巴细胞亚群相关指标CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、NK细胞的表达水平在MM患儿预后的评估中有良好的应用价值,AUC分别为0.701、0.880、0.711、0.621、0.860、0.959,上述指标联合应用对MM患儿预后的预测效能最高,AUC最大,为0.959,灵敏度为0.935,特异度为0.921。CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、NK细胞的预测阈值分别为57.252%、34.255%、42.241%、0.847、22.144%。结论外周血T淋巴细胞亚群表达水平对MM患儿预后有良好的预测价值,可将外周血T淋巴细胞亚群检测作为临床上MM患儿预后的评估方法。

关键词： 溃疡性结肠炎   脾胃虚弱型   竹圈盐灸   健脾愈肠汤   细胞因子  

摘要： 目的:观察竹圈盐灸合健脾愈肠汤治疗脾胃虚弱型溃疡性结肠炎(UC)的疗效及对细胞因子的影响。方法:选取2021年6月—2023年6月赣州市中医院收治的脾胃虚弱型UC患者120例,随机分为3组,各40例。对照组采取常规治疗,中药组使用常规治疗+健脾愈肠汤治疗,综合治疗组采用常规治疗+竹圈盐灸合健脾愈肠汤治疗。3组均治疗4周,治疗后比较3组临床疗效、中医证候积分及细胞因子水平。结果:综合治疗组总有效率依次高于中药组、对照组,中药组亦高于对照组(P<0.05)。3组治疗后的中医证候积分均较治疗前降低,且综合治疗组低于中药组、对照组,中药组亦低于对照组(P<0.05)。3组治疗后的肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平均较治疗前降低,且综合治疗组低于中药组、对照组,中药组亦低于对照组(P<0.05);3组治疗后的白细胞介素10(IL-10)水平均较治疗前升高,且综合治疗组高于中药组、对照组,中药组亦高于对照组(P<0.05)。结论:采用竹圈盐灸合健脾愈肠汤治疗脾胃虚弱型UC患者效果满意,其可调节细胞因子水平、改善患者临床症状。

关键词： 铁蛋白   糖类抗原153   多模态超声   乳腺癌   超微血流显像   剪切波弹性成像  

摘要： 目的探讨血清铁蛋白(SF)、糖类抗原153(CA153)与多模态超声在肿瘤最大径≤2 cm乳腺癌诊断中的应用价值。方法选择2020年5月至2023年5月该院收治肿瘤最大径≤2 cm的106例乳腺癌患者为试验组,106例乳腺良性病变患者为对照组。2组患者均接受超微血流显像(SMI)、剪切波弹性成像(SWE)检查及SF、CA153水平检测,分析2组间超声指标及SF、CA153水平的差异,并探讨各指标对乳腺癌的诊断价值。结果试验组患者中SMI恶性病变占比、最大弹性值(E_(max))、平均弹性值(E_(mean))、最小弹性值(E_(min))及SF、CA153水平均高于对照组,差异均有统计学意义(P<0.05)。受试者工作特征曲线分析结果显示,SMI血流分级、E_(max)、E_(mean)、E_(min)、SF、CA153诊断乳腺癌的曲线下面积(AUC)分别为0.740、0.930、0.934、0.793、0.836、0.872,联合诊断的AUC为0.944,高于各指标单独诊断(P<0.05)。结论在乳腺癌患者中,SMI恶性病变占比、E_(max)、E_(mean)、E_(min)及SF、CA153水平均明显升高,且SMI血流分级、E_(max)、E_(mean)、E_(min)、SF、CA153联合对肿瘤最大径≤2 cm乳腺癌具有较高的诊断价值。

关键词： IL-6   Legionella pneumophila   caspase 3   enteritis   inflammatory cytokines  

摘要： BACKGROUND:Since (Lp) is widely present in natural and artificial water environments, it has a high potential risk of outbreak. Diarrhea caused by Lp pulmonary infection is an important symptom of Legionnaires' disease (LD); however, the underlying mechanism of the diarrhea has not yet been revealed. This not only has a negative impact on clinical diagnosis and treatment, but may also cause misdiagnosis. METHODS:In the present study, a mouse model of enteritis caused by pulmonary infection of Lp was established. By using this mouse model, we explored the underlying mechanisms of the enteritis caused by Lp pulmonary infection. RESULTS:The results indicated that the systemic inflammatory response played a very important role in the enteritis phenotype caused by a strong-virulence strain of Lp. Furthermore, we found that the expression of Bcl-2 was downregulated by IL-6 through the p53 signaling pathway, thereby activating the caspase 3 of intestinal epithelial cells (IECs), causing the apoptosis of IECs, and ultimately leading to the enteritis phenotype. CONCLUSIONS:The IL-6-caspase 3 axis plays an important role in enteritis caused by Lp pulmonary infection.

关键词： ABPA   allergic bronchopulmonary aspergillosis   asthma biologics   dupilumab   severe asthma  

摘要： Background: Allergic bronchopulmonary aspergillosis (ABPA) is a disease resulting from an overactive type 2 response to Aspergillus. Initial studies suggest that asthma biologics can effectively treat ABPA, but it is unclear which biologic class is superior. Objective: We sought to compare the effectiveness of asthma biologics in the treatment of ABPA. Methods: We performed a retrospective analysis of patients with ABPA treated with asthma biologics, and measured outcomes of respiratory exacerbations, daily oral corticosteroids, and antifungals. We assessed these variables while individuals were treated with 1 of 3 biologic classes: anti-IgE, anti–IL-5/IL-5 receptor alpha (IL-5Ra), anti–IL-4 receptor alpha (IL-4Ra). Results: A total of 21 patients were included in our analysis. Anti–IL-4Ra was associated with a significantly lower number of exacerbations and oral corticosteroid use compared with anti-IgE or anti–IL-5/IL-5Ra therapies. Anti–IL-4Ra also had significantly lower antifungal use than anti-IgE, and there was a trend toward lower antifungal use when compared with anti–IL-5/IL-5Ra. In a subgroup of 10 patients treated with 2 or more biologics sequentially, we found that 8 of them achieved clinical control on anti–IL-4Ra therapy after failing anti-IgE and/or anti–IL-5/IL-5Ra therapies. Conclusions: Dupilumab blocks the IL-4Ra, resulting in the downstream inhibition of both IL-4 and IL-13 effector pathways. Dupilumab may benefit patients with ABPA by inhibiting the generation of airway mucus (IL-13), and by reducing local B-cell differentiation into IgE antibody–secreting cells (IL-4). On the basis of our findings and with the known molecular mechanisms of dupilumab, we believe that anti–IL-4Rα–targeted therapy may be more effective than anti-IgE or anti–IL-5/IL-5Rα therapies to treat ABPA. © 2024 The Author(s)