目的分析首发精神分裂症患者认知水平与血清高迁移率族蛋白B1(high mobil ity group protein B1,HMGB1)、胃饥饿素(Ghrelin)、程序性细胞死亡因子4(programmed cell death factor 4,PDCD4)的相关性。方法选定乌鲁木齐市第四人民医院2021...目的分析首发精神分裂症患者认知水平与血清高迁移率族蛋白B1(high mobil ity group protein B1,HMGB1)、胃饥饿素(Ghrelin)、程序性细胞死亡因子4(programmed cell death factor 4,PDCD4)的相关性。方法选定乌鲁木齐市第四人民医院2021年6月~2023年6月就诊的60例首发精神分裂症患者为研究对象,以MATRICS公认认知成套测验(MATRICS consensus cognitive battery,MCCB)量表对患者进行认知功能评价,以MCCB量表评价患者认知功能并分组,比较认知功能正常组(39例)、认知功能障碍组(21例)阳性阴性症状评定量表(PANSS)评分、血清HMGB1、Ghrelin、PDCD4水平的差异,Pearson分析血清HMGB1、Ghrelin、PDCD4与MCCB评分、PANSS评分的相关性。结果认知功能障碍组MCCB评分、血清Ghrelin、PDCD4水平均低于认知功能正常组(P<0.05);认知功能障碍组PANSS评分、血清HMGB1均高于认知功能正常组(P<0.05);血清HMGB1与MCCB评分呈负相关性(P<0.05,r值=-0.394),与PANSS评分呈正相关性(P<0.05,r值=0.405),血清Ghrelin、PDCD4与MCCB评分均呈正相关性(P均<0.05,r值=0.386、0.412),血清Ghrelin、PDCD4与PANSS评分均呈负相关性(P<0.05,r值=-0.392、-0.402)。结论首发精神分裂症患者血清Ghrelin、PDCD4水平较低,血清HMGB1水平较高,血清HMGB1、Ghrelin、PDCD4与首发精神分裂症患者认知功能具有相关性。展开更多
Peking Union Medical College(PUMC)launched the"4+4"Medical Doctor(MD)pilot program in 2018,admitting students with non-medical backgrounds from top universities,aligning with national medical talent training...Peking Union Medical College(PUMC)launched the"4+4"Medical Doctor(MD)pilot program in 2018,admitting students with non-medical backgrounds from top universities,aligning with national medical talent training policies to foster diverse and eager learners in medicine.On the occasion of the graduation of the first class of the"4+4"MD pilot class at PUMC in 2023,we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students,faculties,and management staff of the pilot class.This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting,and demonstrates the achievements of the pilot class in terms of student academic background structure,knowledge acquisition and skill learning,scientific research ability,and course evaluation.The results indicated that the pilot class had met the national demand for the"Medicine+X"talent training model.More specifically,with a diverse academic backgrounds,the pilot class graduates had academic levels comparable to the eight-year medical education graduates,and their scientific research abilities were satisfactory.The pilot program at PUMC will optimize the curriculum setting,strengthen the construction of faculty,learning resources,and teaching facilities,and reform the academic evaluation methods,thus deepening the reform of medical education and improving the"4+4"MD program as a novel medical education model.展开更多
目的探索肝细胞癌(HCC)患者外周血程序性细胞死亡受体1(programmed death-1,PD-1)、细胞毒T淋巴细胞相关抗原4(cytotoxic T lymphocyte-associated antigen-4,CTLA-4)、Th1/Th2及其相关细胞因子水平,并分析其与肿瘤标志物甲胎蛋白(alpha...目的探索肝细胞癌(HCC)患者外周血程序性细胞死亡受体1(programmed death-1,PD-1)、细胞毒T淋巴细胞相关抗原4(cytotoxic T lymphocyte-associated antigen-4,CTLA-4)、Th1/Th2及其相关细胞因子水平,并分析其与肿瘤标志物甲胎蛋白(alpha fetoprotein,AFP)、异常凝血酶原(protein induced by vitamin K absence or antagonistⅡ,PIVKAⅡ)的相关性。方法选择2021年1月至2022年12月简阳市中医医院收治的50例HCC患者作为HCC组,选择同期行健康体检者作为对照组。采用酶联免疫吸附法测定测定外周血AFP、PIVKAⅡ、CTLA-4、PD-1、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、γ干扰素(interferonγ,IFN-γ)、白细胞介素-6(interleukin-6,IL-6)和白细胞介素-10(interleukin-10,IL-10)的水平。采用酶联免疫斑点法测定外周血Th1/Th2。比较两组患者上述指标差异,并采用Pearson法将上述指标与HCC组患者AFP和PIVKAⅡ水平进行相关性分析。结果与对照组相比,HCC组患者外周血TNF-α、IFN-γ及Th1/Th2细胞比例明显下降,而AFP、PIVKAⅡ、IL-6、IL-10、CTLA-4和PD-1水平则明显升高,差异有统计学意义(P<0.05)。相关性分析表明,Th1/Th2与AFP和PIVKA负相关性最高,而PD-1与AFP和PIVKA正相关性最高(r>|7|,P<0.05)。结论HCC患者外周血Th1/Th2明显降低,而CTLA-4和PD-1显著升高,且与HCC血清肿瘤标志物AFP和PIVKA具有密切关系,基于上述指标可为HCC的临床诊断和免疫治疗评估提供参考依据。展开更多
4D printing technology represents a new generation of additive manufacturing methods that enable three-dimensional(3D)printed structures to change their shapes or properties over time(the fourth dimension)in response ...4D printing technology represents a new generation of additive manufacturing methods that enable three-dimensional(3D)printed structures to change their shapes or properties over time(the fourth dimension)in response to external stimuli such as temperature,magnetic fields,and light.Among the most popular types of 4D-printed structures are thermally responsive bilayer actuators using shape memory polymers,valued for their programmability and convenience.However,achieving precise deformations without collisions is hindered by the nonlinear and time-varying morphing process of these bilayer actuators,which is crucial for creating dynamically controllable shapes on demand in 4D printing.This study presents a rapid and effective design and optimization strategy for 4D printed self-folding structures that can be sequentially and accurately folded.Theoretical analyses were conducted to guide the design of the folding processes.The response surface method(RSM)was used to investigate key parameters affecting the design of 4D-printed bilayer actuators.The results indicate that increasing printing speed enhances internal strain,whereas higher printing temperatures,layer heights,or actuator heights have the opposite effect.The RSM model achieved an R-squared value of 0.983,accurately capturing the coupling effects of these variables on the output responses,thereby enabling controlled timescales for bending motion and sequential folding without collisions.These findings can be applied to enhance the design and acceleration of 4D-printed self-folding structures,ensuring controlled speed of shape transformation.To validate this concept,a self-folding hand-shaped structure with five fingers was designed and fabricated,demonstrating how design and printing parameters can precisely control the timescale of shape changes for each finger based on the design specifications.展开更多
目的:探究血清中程序性细胞死亡因子4(programmed cell death 4,PDCD4)蛋白水平与急性缺血性脑卒中(acute ischemic stroke,AIS)患者的神经功能缺损和预后的相关性。方法:回顾性连续纳入2023年6月—2024年3月南通大学第二附属医院神经...目的:探究血清中程序性细胞死亡因子4(programmed cell death 4,PDCD4)蛋白水平与急性缺血性脑卒中(acute ischemic stroke,AIS)患者的神经功能缺损和预后的相关性。方法:回顾性连续纳入2023年6月—2024年3月南通大学第二附属医院神经内科诊治的110例AIS患者作为研究对象,根据美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)将患者分为轻度神经功能缺损(n=70)和中重度神经功能缺损(n=40)。采用改良Rankin量表(modified Rankin scale,mRS)将患者分为预后良好组(n=69)和预后不良组(n=41)。收集各组患者的人口学资料(年龄、性别、糖尿病病史等)及临床检验指标(中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比值等)。采用酶联免疫吸附法测定血清PDCD4蛋白浓度,并分析其与NIHSS评分、mRS评分及炎症指标的相关性。使用Logistic回归分析模型推断AIS患者中重度神经功能缺损和预后不良发生的危险因素,并通过受试者工作特征(receiver operating characteristic,ROC)曲线来评估血清PDCD4蛋白水平对预测AIS患者神经功能缺损程度及预后情况的有效性。结果:AIS患者中,中重度神经功能缺损及预后不良者血清PDCD4蛋白水平显著高于轻度神经功能缺损及预后良好者。血清PDCD4水平与NIHSS评分、mRS评分、降钙素原、超敏C反应蛋白、中性粒细胞/淋巴细胞比值呈正相关。排除混杂因素的干扰后,PDCD4蛋白水平仍是AIS患者的独立危险因素。ROC曲线显示,血清PDCD4蛋白水平对AIS患者神经功能缺损程度和预后情况均有较高的预测价值。结论:在中重度神经功能缺损及预后不良的AIS患者中,血清PDCD4蛋白水平显著升高,且可作为预测AIS患者神经功能缺损程度及预后的独立指标。展开更多
目的探究血清乙酰胆碱酯酶(AChE)、脂蛋白相关磷脂酶A2(Lp-PLA2)、程序性细胞死亡因子4(PDCD4)表达水平对急性脑梗死(ACI)患者并发卒中后认知功能障碍(PSCI)的评估价值。方法选择2021年12月—2024年2月本院收治的156例ACI患者作为ACI组...目的探究血清乙酰胆碱酯酶(AChE)、脂蛋白相关磷脂酶A2(Lp-PLA2)、程序性细胞死亡因子4(PDCD4)表达水平对急性脑梗死(ACI)患者并发卒中后认知功能障碍(PSCI)的评估价值。方法选择2021年12月—2024年2月本院收治的156例ACI患者作为ACI组,同期选取体检健康者156名人员作对照组。根据简易精神状态检查(MMSE)评分,将患者分为PSCI组(62例)与非PSCI组(94例)两组。比较各组血清AChE、Lp-PLA2、PDCD4表达水平。采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析血清AChE、Lp-PLA2、PDCD4水平对ACI并发PSCI的评估价值。多因素logistic回归分析影响ACI并发PSCI的因素。结果ACI组血清AChE、Lp-PLA2、PDCD4水平比对照组高(P<0.05)。PSCI组血清AChE、Lp-PLA2、PDCD4水平比非PSCI组高,MMSE评分比非PSCI组低(P<0.05)。AChE、Lp-PLA2、PDCD4评估患者并发PSCI的曲线下面积(Area under the curve,AUC)是0.786(95%CI:0.712~0.860)、0.769(95%CI:0.691~0.846)、0.758(95%CI:0.679~0.837),三者联合检测的AUC为0.905(95%CI:0.861~0.949),联合检测的AUC高于单独检测(Z=2.679、3.004、3.186,P<0.05)。logistic分析显示,血清AChE、Lp-PLA2、PDCD4是ACI患者并发PSCI的危险因素(P<0.05)。结论ACI并发PSCI患者血清AChE、Lp-PLA2、PDCD4表达水平较高,三者联合对ACI并发PSCI的诊断效能较高,可能是评估ACI并发PSCI的血清指标。展开更多
文摘目的分析首发精神分裂症患者认知水平与血清高迁移率族蛋白B1(high mobil ity group protein B1,HMGB1)、胃饥饿素(Ghrelin)、程序性细胞死亡因子4(programmed cell death factor 4,PDCD4)的相关性。方法选定乌鲁木齐市第四人民医院2021年6月~2023年6月就诊的60例首发精神分裂症患者为研究对象,以MATRICS公认认知成套测验(MATRICS consensus cognitive battery,MCCB)量表对患者进行认知功能评价,以MCCB量表评价患者认知功能并分组,比较认知功能正常组(39例)、认知功能障碍组(21例)阳性阴性症状评定量表(PANSS)评分、血清HMGB1、Ghrelin、PDCD4水平的差异,Pearson分析血清HMGB1、Ghrelin、PDCD4与MCCB评分、PANSS评分的相关性。结果认知功能障碍组MCCB评分、血清Ghrelin、PDCD4水平均低于认知功能正常组(P<0.05);认知功能障碍组PANSS评分、血清HMGB1均高于认知功能正常组(P<0.05);血清HMGB1与MCCB评分呈负相关性(P<0.05,r值=-0.394),与PANSS评分呈正相关性(P<0.05,r值=0.405),血清Ghrelin、PDCD4与MCCB评分均呈正相关性(P均<0.05,r值=0.386、0.412),血清Ghrelin、PDCD4与PANSS评分均呈负相关性(P<0.05,r值=-0.392、-0.402)。结论首发精神分裂症患者血清Ghrelin、PDCD4水平较低,血清HMGB1水平较高,血清HMGB1、Ghrelin、PDCD4与首发精神分裂症患者认知功能具有相关性。
文摘Peking Union Medical College(PUMC)launched the"4+4"Medical Doctor(MD)pilot program in 2018,admitting students with non-medical backgrounds from top universities,aligning with national medical talent training policies to foster diverse and eager learners in medicine.On the occasion of the graduation of the first class of the"4+4"MD pilot class at PUMC in 2023,we reviewed the teaching reform in the pilot program and carried out a systematic survey and interviews with students,faculties,and management staff of the pilot class.This article reports on the measures taken by the pilot class at PUMC in enrollment and curriculum setting,and demonstrates the achievements of the pilot class in terms of student academic background structure,knowledge acquisition and skill learning,scientific research ability,and course evaluation.The results indicated that the pilot class had met the national demand for the"Medicine+X"talent training model.More specifically,with a diverse academic backgrounds,the pilot class graduates had academic levels comparable to the eight-year medical education graduates,and their scientific research abilities were satisfactory.The pilot program at PUMC will optimize the curriculum setting,strengthen the construction of faculty,learning resources,and teaching facilities,and reform the academic evaluation methods,thus deepening the reform of medical education and improving the"4+4"MD program as a novel medical education model.
文摘目的探索肝细胞癌(HCC)患者外周血程序性细胞死亡受体1(programmed death-1,PD-1)、细胞毒T淋巴细胞相关抗原4(cytotoxic T lymphocyte-associated antigen-4,CTLA-4)、Th1/Th2及其相关细胞因子水平,并分析其与肿瘤标志物甲胎蛋白(alpha fetoprotein,AFP)、异常凝血酶原(protein induced by vitamin K absence or antagonistⅡ,PIVKAⅡ)的相关性。方法选择2021年1月至2022年12月简阳市中医医院收治的50例HCC患者作为HCC组,选择同期行健康体检者作为对照组。采用酶联免疫吸附法测定测定外周血AFP、PIVKAⅡ、CTLA-4、PD-1、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、γ干扰素(interferonγ,IFN-γ)、白细胞介素-6(interleukin-6,IL-6)和白细胞介素-10(interleukin-10,IL-10)的水平。采用酶联免疫斑点法测定外周血Th1/Th2。比较两组患者上述指标差异,并采用Pearson法将上述指标与HCC组患者AFP和PIVKAⅡ水平进行相关性分析。结果与对照组相比,HCC组患者外周血TNF-α、IFN-γ及Th1/Th2细胞比例明显下降,而AFP、PIVKAⅡ、IL-6、IL-10、CTLA-4和PD-1水平则明显升高,差异有统计学意义(P<0.05)。相关性分析表明,Th1/Th2与AFP和PIVKA负相关性最高,而PD-1与AFP和PIVKA正相关性最高(r>|7|,P<0.05)。结论HCC患者外周血Th1/Th2明显降低,而CTLA-4和PD-1显著升高,且与HCC血清肿瘤标志物AFP和PIVKA具有密切关系,基于上述指标可为HCC的临床诊断和免疫治疗评估提供参考依据。
基金supported by National Natural Science Foundation of China(Grant No.52375272)Zhejiang Provincial Natural Science Foundation of China(Grant No.LR22E050006)China Postdoctoral Science Foundation(Grant Nos.2024M751644,2024M754069).
文摘4D printing technology represents a new generation of additive manufacturing methods that enable three-dimensional(3D)printed structures to change their shapes or properties over time(the fourth dimension)in response to external stimuli such as temperature,magnetic fields,and light.Among the most popular types of 4D-printed structures are thermally responsive bilayer actuators using shape memory polymers,valued for their programmability and convenience.However,achieving precise deformations without collisions is hindered by the nonlinear and time-varying morphing process of these bilayer actuators,which is crucial for creating dynamically controllable shapes on demand in 4D printing.This study presents a rapid and effective design and optimization strategy for 4D printed self-folding structures that can be sequentially and accurately folded.Theoretical analyses were conducted to guide the design of the folding processes.The response surface method(RSM)was used to investigate key parameters affecting the design of 4D-printed bilayer actuators.The results indicate that increasing printing speed enhances internal strain,whereas higher printing temperatures,layer heights,or actuator heights have the opposite effect.The RSM model achieved an R-squared value of 0.983,accurately capturing the coupling effects of these variables on the output responses,thereby enabling controlled timescales for bending motion and sequential folding without collisions.These findings can be applied to enhance the design and acceleration of 4D-printed self-folding structures,ensuring controlled speed of shape transformation.To validate this concept,a self-folding hand-shaped structure with five fingers was designed and fabricated,demonstrating how design and printing parameters can precisely control the timescale of shape changes for each finger based on the design specifications.
文摘目的:探究血清中程序性细胞死亡因子4(programmed cell death 4,PDCD4)蛋白水平与急性缺血性脑卒中(acute ischemic stroke,AIS)患者的神经功能缺损和预后的相关性。方法:回顾性连续纳入2023年6月—2024年3月南通大学第二附属医院神经内科诊治的110例AIS患者作为研究对象,根据美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)将患者分为轻度神经功能缺损(n=70)和中重度神经功能缺损(n=40)。采用改良Rankin量表(modified Rankin scale,mRS)将患者分为预后良好组(n=69)和预后不良组(n=41)。收集各组患者的人口学资料(年龄、性别、糖尿病病史等)及临床检验指标(中性粒细胞计数、淋巴细胞计数、中性粒细胞/淋巴细胞比值等)。采用酶联免疫吸附法测定血清PDCD4蛋白浓度,并分析其与NIHSS评分、mRS评分及炎症指标的相关性。使用Logistic回归分析模型推断AIS患者中重度神经功能缺损和预后不良发生的危险因素,并通过受试者工作特征(receiver operating characteristic,ROC)曲线来评估血清PDCD4蛋白水平对预测AIS患者神经功能缺损程度及预后情况的有效性。结果:AIS患者中,中重度神经功能缺损及预后不良者血清PDCD4蛋白水平显著高于轻度神经功能缺损及预后良好者。血清PDCD4水平与NIHSS评分、mRS评分、降钙素原、超敏C反应蛋白、中性粒细胞/淋巴细胞比值呈正相关。排除混杂因素的干扰后,PDCD4蛋白水平仍是AIS患者的独立危险因素。ROC曲线显示,血清PDCD4蛋白水平对AIS患者神经功能缺损程度和预后情况均有较高的预测价值。结论:在中重度神经功能缺损及预后不良的AIS患者中,血清PDCD4蛋白水平显著升高,且可作为预测AIS患者神经功能缺损程度及预后的独立指标。
文摘目的探究血清乙酰胆碱酯酶(AChE)、脂蛋白相关磷脂酶A2(Lp-PLA2)、程序性细胞死亡因子4(PDCD4)表达水平对急性脑梗死(ACI)患者并发卒中后认知功能障碍(PSCI)的评估价值。方法选择2021年12月—2024年2月本院收治的156例ACI患者作为ACI组,同期选取体检健康者156名人员作对照组。根据简易精神状态检查(MMSE)评分,将患者分为PSCI组(62例)与非PSCI组(94例)两组。比较各组血清AChE、Lp-PLA2、PDCD4表达水平。采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析血清AChE、Lp-PLA2、PDCD4水平对ACI并发PSCI的评估价值。多因素logistic回归分析影响ACI并发PSCI的因素。结果ACI组血清AChE、Lp-PLA2、PDCD4水平比对照组高(P<0.05)。PSCI组血清AChE、Lp-PLA2、PDCD4水平比非PSCI组高,MMSE评分比非PSCI组低(P<0.05)。AChE、Lp-PLA2、PDCD4评估患者并发PSCI的曲线下面积(Area under the curve,AUC)是0.786(95%CI:0.712~0.860)、0.769(95%CI:0.691~0.846)、0.758(95%CI:0.679~0.837),三者联合检测的AUC为0.905(95%CI:0.861~0.949),联合检测的AUC高于单独检测(Z=2.679、3.004、3.186,P<0.05)。logistic分析显示,血清AChE、Lp-PLA2、PDCD4是ACI患者并发PSCI的危险因素(P<0.05)。结论ACI并发PSCI患者血清AChE、Lp-PLA2、PDCD4表达水平较高,三者联合对ACI并发PSCI的诊断效能较高,可能是评估ACI并发PSCI的血清指标。
