Kaplan reading(P189-196)
血浆辅酶Q10的高效液相色谱快速测定
血浆辅酶Q10的高效液相色谱快速测定第25卷第2期2006年3月分析测试学报FENXICESHIXUEBAO(JournalofInstrumentalAnalysis)V o1.25No.21O6一108血浆辅酶Qo的高效液相色谱快速测定江平,何代平,许国旺(1.两华师范大学化学化工学院,四川南充637002;2.中国科学院大连化学物理研究所,辽宁大连116023)摘要:建立了一种简单快速测定血浆辅酶Q..(CoQ..)的反相高效液相色谱方法.血浆经正丙醇萃取,上层清液直接进样分析.色谱柱为HypersilODS25m,150mmx4.6mmi.d.,以异丙醇一甲醇(体积比1:9)作流动相,275nm作检测波长外标法定量.在0.05—20mg/L范围内,峰高与质量浓度呈良好的线性关系(r=0.9998),血浆中辅酶Q的检出限为0.03mg/L(S/N=3).该方法简单,快速,精密度高(RSD<5%),适宜于血浆辅酶Q,.含量的检测.关键词:血浆;辅酶Q..;高效液相色谱中图分类号:0657.72;Q551;Q592.1文献标识码:A文章编号:1004—4957(2006)02—0106—03RapidDeterminationofCoenzymeQl0inHumanPlasmaby HighPerformanceLiquidChromatographyJIANGPing一,HEDai—ping,XUGuo-wang(1.DepartmentofChemist~,ChinaWestNormalUniversity,Nanchong637002,China;2.Da lianInstituteofChemicalPhysics,【heChineseAcademyofSciences,Dalian116011,China) Abstract:Asimpleandrapidhighperformanceliquidchromatographic(HPLC)methodfort hedeter-minationofcoenzymeQl0(CoQ10)inhumanplasmawasdeveloped.CoQ1ocanbedissociat edfromlip-oproteinsandcompletelyextractedinto凡-propano1.Aftercentrifugation,thesupernatantwasfiltrated andanalyzedbyHPLC.HypersilODS25lxm(150mmX4.6mmi.d.)was.selectedastheanaly ticalcolumn,isopropanol—methanol(1:9byvolume)asthemobilephasewithflow-rateof1.5mL/min,andUV275nmasthedetectionwavelength.ThelevelofCoQl1)wasquantitativelydetermin edbyanextemalstandardmethod.The1inearrangeofthecalibrationcurveofconcentrations.,peakh eightis0.05—20mg/Lwithacorrelationcoefficientof0.9997.ThedetectionlimitofCoQlf1inplasmawas 0.03mg/L(S/N=3).ThismethodissuitableforthedeterminationofCoQloinhumanplasma. Keywords:Plasma;CoenzymeQIo;HPLC辅酶Q,.(CoQ.)是一种脂溶性的类维生素物质,广泛存在于动物,植物,微生物的细胞内并与线粒体内膜相结合.CoQ..的生物活性主要来自其醌环的氧化还原特性及其侧链的理化性质(结构见图1).CoQ.是细胞代谢和细胞呼吸的激活剂,具有天然的抗氧化活性,能保持膜质流动性并增强人体非特异性免疫功能.研究表明,细胞组织缺氧或肌体代谢过旺都会引起体内CoQ..的消耗,此外,HMG—COA还原酶在抑制胆固醇合成的同时也阻碍了体内CoQ的生物合成.因此,检测CoQ.的含量具有重要的生物学意义.cH,对CoQ.的含量检测已有很多报道:光度法],色谱…法¨',伏安法¨,化学发光法…],荧光法,电子磁共振法¨等,其中最常用的还是液相色谱法.CoQⅢ和脂质结合在一起,文献[9]报道了其在各类脂质中的分布:低密度脂蛋白中占60%,高密度脂蛋白中占25%,其他脂蛋白中占15%.因此,测定前定CH3H—c—CH2_士图lCoQ..的结构Fig.1StructureofCoQIo收稿日期:2005—03—07;修回日期:2005—06—21基金项目:国家科技部国家高技术研究发展计划(2OO3AA223O61);中国科学院知识创新工程领域前沿课题作者简介:江平(1976一),女,四川绵阳人,硕士,Te1:0817—2568288,E—mail:*************.toni一术~一实一~与~~置~一装~一器~~仪~第2期江平等:血浆辅酶Q..的高效液相色潜快速测定107量地萃取CoQ..成为整个分析过程的关键.很多文献[1—3,5—8]采用亲水性的有机溶剂(比如乙醇或甲醇)去除血浆脂蛋白,然后再用强疏水性的有机溶剂进行萃取.该过程常常需要多次反复操作以保证CoQ.完全进入疏水相,因此操作较为繁琐,且需大量有机溶剂.此外,用这种提取方法作定量分析时,需用大量氮气吹扫后定容,成本较高,人为操作误差也较大.本文采用一种简单的前处理方法,只需一种溶剂便可实现脱脂和萃取两种功效,该方法应用于血浆CoQ..的检测,简单快速,回收率高,精密度较好.1实验部分1.1仪器与试剂Shimadzu液相色谱系统(日本岛津公司),配有LC.1OATvp泵,SPD.1OAvp检测器,SIL10ADvp型自动进样器,SCL-10Avp系统控制器和ShimadzuCLass—VP色谱工作站;色谱柱ODS2(4.6mmi.d.×150mm,5m,大连依利特公司);有机系针筒式微孔滤膜(0.22i.Lm,大连依利特公司);超速低温离心机(美国科俊仪器公司).CoQ..标准品(Sigma公司),甲醇,正丙醇,异丙醇均为色谱纯(北京天地公司).所有血样由大连市中心医院提供.1.2实验方法1.2.1标准溶液的配制称取约lOmgCoQ..标准品,加入无水乙醇溶解并定容至25mL,由275nm处的吸光值(摩尔吸光系数=14600)测定其准确浓度,然后将该溶液稀释成100mg/L的储备液,在避光条件下于冰箱中冷冻保存.1.2.2血样的收集将新鲜血液注入以肝素作抗凝剂的试管中,立即在2500r/min下离心10min,取上层血浆,迅速放入冰箱(一2O℃中保存).分析时,将冰冻血浆置于室温下解冻2h后,进行血浆的预处理.1.2.3血浆的预处理因CoQ.结构中含有异戊烯基,见光易降解,故样品的预处理均在避光条件下进行.取0.3mL血浆于离心管中,加入1mL正丙醇,振荡5min,在8000r/min下离心10min,取上层清液,经微孔式针筒过滤器过滤后进行色谱分析.,1.2.4色谱条件采用ODS色谱柱(4.6nlnli.d.×150mnl,5m):流动相为异丙醇一甲醇(体积比1:9);流速:1.5mL/min;检测波长:275liB;进样量:400L.2结果与讨论2.1萃取溶剂的选择CoQ.和血浆中的脂蛋白结合在一起,因此,往往需要先经亲水性的溶剂脱脂蛋白,然后采用疏水性的溶剂对CoQ进行萃取.本文比较了几种常见的有机溶剂,发现正丙醇既能脱脂又能定量萃取CoQ大大简化了CoQ.的提取过程.己烷,甲醇,乙腈和三氯乙酸因其极性太弱或太强,均不能将CoQ.从血浆中提取出来,其回收率为零.其它几种常见有机溶剂的萃取回收率见表1.表1各种有机溶剂的萃取回收率TablelExtractionrecoveryusingdifferentsolventslO8分析测试学报第25卷2.2血浆与正丙醇用量的最佳体积比血浆CoQ..的浓度较低,过多的萃取溶剂会造成CoQ.浓度的进一步稀释.萃取溶剂过少又不能保证CoQ.的定量萃取.本文比较了血浆和正丙醇在不同体积比情况下,CoQ.的萃取回收率变化,其结果见表1.从表1结果可看出,实验采用1mL正丙醇定量萃取0.3mL血浆较适宜.2.3流动相的选择比较异丙醇和甲醇在不同配比,不同流速情况下CoQ..的色谱行为时,发现当两者的体积比为1:9及流速为1.5mL/min时,CoQ.峰能很好地和干扰峰分离.在此条件下,标样和血样的色谱行为分别见图2和图3.2.4方法的线性和灵敏度考察准确量取一定体积的CoQ,.贮备液,配制CoQ.质量浓度分别为0.05,0.2,0.4,0.8,1.2,2.0,4.0,10.0,20.0mg/L的系列标液.分别取标液0.3mL,加水0.3m【,正丙醇0.7mL(与血浆相同的醇水比例),振荡混匀,按上述"1.2.3"分析条件进行分析.结果表明,在0.05~20.0mg/L范围内,峰高与浓度呈良好的线性关系,Y=1458.4+15.095(Y为峰高,为浓度,相关系数r=0.9998).方法的检出限为0.03mg/L(S/N=3).2.5测定的精密度及回收率考察平行取3份相同的混合血浆,振荡摇匀后,按上述方法进行CoQ.含量的测定,其结果为0.57-4-0.008mdL(mean±sD),测定精密度(相对标准偏差)为1.4%.回收率实验采取实际样品加标样的方法测得,取"精密度"实验中的同一血浆样品,从中称取12份平行样,平分为3组,每组依次加入10,20,30IxLCoQ10标液(20mg/L),分别记录为加标血样1,加标血样2及加标血样3,按上述方法检测,其结果见表2.表2样品的加标回收率(=3)t/rain图2标样色谱图Fig.2ChromatogramofCoQl0standardTable2RecoveryofCoQl0spikedtoaplasmasample(=3)参考文献:[1]KOMMURUTR,KHANMA,ASHRAFM.eta1.Asimplifiedchromatographicmethod forquantitativedetermination0fcoenzymeQIoindogplasma[J].JournalofPharmaceuticalandBiomedicalAnalysis,1998,1 6:1037—1040.[2]GROSSIG,BARGOSSIAM,FIORELLAPL.eta1.Improvedhigh—performanceliquidchromatographicmethodforthe determinationofcoenzymeQl0inplasma[J].JChromatogr,1992.593:217—226.[3]JOANNAK,BOZENAM,JANINAPJ.Applicationofderivativespectrophotometryfor determinationofcoenzvmeO.inpharmaceuticalsandplasma[J].JournalofPharmaceuticalandBiomedicalAnalysis,1998,1 7:1345—1350.[4]方兴华,徐宏祥.一阶导数紫外光谱法测定辅酶Q..胶囊的含量[J].中国生化药物杂志,2000,21(3):133—134.[5]WANGQ,LEEBL,ONGCN.Automatedhigh—performanceliquidchromatographicmethodwithDre—c0lumnreductionf0rthedeterminationofubiquinolandubiquinoneplasma[J].JChromatogr,B,1999,726:297—302.[6]马金才,宋秀红.测定人血浆中辅酶Q..的反相高效液相色谱法[J].分析测试学报,2002,21(6):89—91.(下转第111页)第2期黄宝美等:高效毛细管电泳电导法测定青蒿素的含量灵敏度,若进样时间超过15s,峰拖尾现象较严重,故选择进样时间为15s.操作电压也是影响分离的重要因素.实验中比较了不同电压(6~30kV)对分离结果的影响,发现电压太低(6kV),出峰时间较长,大约在26rain左右,提高电压,出峰时间明显提前,综合考虑了电压对分离度和柱效的影响,选择15kV为最佳检测电压.2.5线性范围和精密度实验在最佳的实验条件下,将青蒿素标准品进样6次,迁移时间和峰面积的相对标准偏差分别为1.2%和3.5%.青蒿素标准品在20~280mg/L范围内峰高(y)与质量浓度(p,mg/L)之间呈现良好的线性关系,其线性回归方程为:Y=2.02+102P,r=0.9956,检出限为3,2mg/L.2.6样品测定和加标回收实验按照1.3制备好样品溶液,在最佳的实验条件下进行测定,其毛细管电泳图如图2所示.分别加入1.52,8.05,12.0mg对照品进行加标回收,实验结果如表1所示.参考文献:[1]宋振玉,赵凯存.1989,5(1):12.[2]沈旋坤,严克东,[3]张积强,陈强,[4]黄海滨,岑家铭,(19):194—196.}l2l62O0246t/rain't/rain图2对照品(a)和样品(b)的毛细管电泳图Fig.2Eleetropherogramofstandard(a)andsample(b)1.artemisinin表1样品的测定结果及回收率TablelDeterminedresultsandrecovery青蒿素及其活性衍生物在生物样品中的测定及代谢动力学研究[J].中国临床药理学杂志,岁峄渊,等.紫外分光光度法测定青蒿素的含量[J].药物分析杂志,1983,(1):24.刘宗怀,等.青蒿中青蒿素含量的测定[J].陕西化工,1996,(3):36—38.奉建芳,等.RP—HPLC测定青蒿中青蒿素的含量[J].广西大学学报:自然科学版,1994『5]CHENGYQ,HONGLF,LIUY,etal,On.1ineconversionanddeterminationofartemisin inanditskineticparametersU—singoflhogonaldesignbycouplingofflowinjectionwithcapillaryelectrophoresis[J].Analy ticaChimicaActa,2004,(525):239—245.[6]CHENHL,W ANGKK,PUQS,eta1.On—lineconversionanddeterminationofartemisininusingaflow-injectioncapil—laryelectrophoresissystemlJI.Electrophoresis,2002,(23):2865—2871.『7]CHRISTENP,VEUTHEYJL.Newtrendsinextraction,identificationandquantificatio nofartemisininanditsderivativesl.CurrentMedicalChemistry,2001,(18):l827..,-,.r.^:^?Ⅲ!"…'??●'…一(上接第108页)………,…….,.….一''……^!…[7]周田彦,孙华东,张大卫,等.多剂量口服给药后辅酶Q,.缓释片和普通片在健康人体内的血药浓度[J].中国药学杂志,2002,37(3):189—192.『8]KAPLANP,SEBESTIANOV AN,TURIAKOV AJ,eta1.DeterminationofCoenzyme Ql(1inhumanplasma[J].PhysiolRes,1996,45(1):39—45.[9]TANGPH,MILESMV,DEGRAUWA,eta1.HPLCanalysisofreducedandoxidizedcoen zymeQl0inhumanplasma『J].ClinicalChemistry,200l,47(2):256—265.[10]LITESCUSC,DIVADIG,RADUGL,eta1.V ohammetrledeterminationofeoenzymeQ l0atasolidglassycarbonelec—trode『J].InstrumentationScience&Technology,2001,29(2):109一l16.『11]BATFINOM,FERRIE,GIROTI'IS.FreeradicalscavengingactivityofcoenzymeQm easuredbyachemiluminescentas?sayfJ].AnalyticaChimicaAeta,1991,255:367—371.『12]ROKOSJA.Determinationofubiquinoneinsubnanomolequantitiesbyspeetrofluoro metryofitsproductwithalkalineeth?ylcyanoacetate『J].AnalBiochem,1973,56(1):26—33.『13]LONGYT,YuzH,CHENHY.DeterminationofcoenzymeQ10byinsituEPRspectroel eetrochemistry[J].Electro?chemistryCommunications,1999,l:194—196.。
统计(5)
24.生存率:表示观察对象的生存时间T大于时间t的概率,常用S(t)表示,称为累计生存概率,简称生存率。*
1)根据样本数据求得模型参数的估计值
2)对回归方程及各自变量做假设检验,并对方程的拟和效果及各自变量的作用大小做出评价。
7.自变量选择方法:
一.全局择优法:校正决定系数选择法,Cp选择法
二.逐步选择法:前进法,后退法,逐步回归法
*8.多元线性回归的应用:
影响因素分析
估计与预测
统计控制
*9.多元线性回归应用的注意事项:
*12多元线性回归模型的参数估计方法:最小二乘法
13.多元线性回归的应用:影响因素分析,估计与预测,统计控制
14.生存结局:分为“死亡”和删失(左删失,右删失,区间删失)
15.生存分析的统计方法:①描述分析②比较分析③影响因素分析(方法:参数法,半参数法,非参数法)
生存率估计方法:Kaplan-Meier法 频数表资料采用寿命表法估计生存率
回归系数(b)和标准回归系数(b’):b反映X对生存时间影响的强度,各bj之间不能直接比较;b’:将Xj标准化后求出的b’,各b’之间可以直接比较。
31.预后指数:COX回归模型的线性部分β1X1+β2X2+...+βmXm与风险函数h(t)成正比,因此模型的线性部分反映了一个个体的预后,有人称PI=β1X1+β2X2+...+βmXm为预后指数(PI)。预后指数越大,患者风险越大,预后越差;反之,预后指数越小,预后越好。
肾性贫血中红细胞生成刺激剂(ESA)和缺氧诱导因子-脯氨酰羟化酶抑制剂(HIF-PHI)治疗
• 在动物模型中观察到降血压作用(HIF参与血管舒缩控制)
• 目前处于2 期试验中
HIF-PHI的利弊
• 优势
▪ 口服给药,从而避免了注射带来的不适和疼痛
▪ 与ESA疗法相比,达到血红蛋白目标时血浆EPO
水平低,从而减少由EPO造成的心血管疾病
▪ 抑制肝脏铁调素的产生及其对铁动员的不利影响,
治疗益处。与所有医疗一样,需要临床判断,根据患者特征考虑个性化
Hb目标
HIF稳定剂
• 缺氧诱导因子(HIF)通路的发现代表了医学领域的一个开创性时
刻,在2019年获得了诺贝尔生理学或医学奖,该通路已被用于
开发HIF稳定剂,新药可能成为治疗CKD贫血的重要方案
HIF
•
•
•
•
•
•
•
•
•
所有组织中均存在
由α和β亚基组成的异源二聚体
▪ β亚基始终存在
▪ α亚基有3种亚型:HIF-1α、HIF-2α和HIF-3α,其中任何一种都可
以与β亚基结合
① HIF-1α mRNA在组织表达普遍存在
② HIF-2α的mRNA表达主要在脑、心脏、肺、肾(间质和肾小球
肾细胞)、肝脏、胰腺和肠道,主要参与上调EPO基因表达和激活缺氧
调节HIF靶基因
HIF对红细胞生成作用
• ① HIF上调二价金属转运蛋白1(DMT1)和十二指
肠细胞色素B(DcytB),增加肠道对铁的吸收
• ② 转铁蛋白将Fe转运至骨髓中的转铁蛋白受体
• ③ Fe从转铁蛋白释放到发育中的红细胞中
• ④ HIF上调促红细胞生成素(EPO)受体(EPO-R)和
乳腺真空辅助旋切系统活检后乳腺癌患者针道转移的几率
乳腺真空辅助旋切系统活检后乳腺癌患者针道转移的几率任重阳;廖宁;张国淳;安胜利;温灵珠;钱学珂;吕海通【摘要】Objective To study the incidence of implantation metastasis of breast cancer in vacuum-assisted breast biopsy (VABB) needle tract in Chinese patients and evaluate the effect of neoadjuvant chemotherapy on needle tract metastasis following VABB. Methods The breast cancer patients with established diagnosis by VABB were divided into two groups to receive open surgery or neoadjuvant chemotherapy prior to open surgery. The incidence of needle tract metastasis, disease-free survival (DFS) and overall survival (OS) were compared between the two groups. Results A total of 214 patients were enrolled, among whom 94 directly underwent surgeries and 120 had neoadjuvant chemotherapy before surgery. The two groups showed no significant differences in the incidence of needle tract metastasis (3.2%vs 0.8%, P=0.206), DFS (P=0.221), or OS(P=0.531). Conclusion The incidence of needle tract metastasis is low after VABB, and neoadjuvant chemotherapy does not increase this risk.%目的:研究中国人群乳腺癌患者发生真空辅助旋切系统活检(VABB)针道种植转移的几率及新辅助化疗对其产生的影响。
Kaplan reading(P189-196)
Typical lemurs are primates with bodies similar to those monkeys but pointed muzzles and large eyes; most have with pointed tails. Their fur is woolly and may be colored red, gray, brown or black. The name of the lemur stems from the Latin lemures, the Roman name for vampire-like ghosts of the dead which these large-eyed creatures were thought to resemble. Found only off the east coast Africa on the island of Madagascar and neighboring islands, lemurs spend some time on the ground but most often are in the trees, building nests high in the branches. Besides leaves, lemurs eat eggs, fruit, insects, and small animals. They are active throughout the day and night and are reputed to be gentle, friendly creatures. Besides typical lemurs, the lemur family includes avahi, aye-aye, loris and galogo. However, contrary to popular belief, the so-called flying lemur is not even a primate, much less a true lemur; it is , in fact, a member of an altogether different order of mammals known as Dermoptera.1. The style of the passage is most like that found in aA. biology textbookB. novel about MadagascarC. zoologist’s diaryD. tourist’s guidebookE. personal letter2. Which of the following would be the best title for this passage?A. The Lemur: Friend or FoeB. Madagascar’s Loneliest HuntersC. Facts About LemursD. African VampiresE. The Diet of the Lemur3. According to the passage, all of the following are true about lemurs EXCEPTA. they spend much of their time in treesB. most have long, bushy tails.C. the flying lemur is not a true lemurD. they eat only fruits and leavesE. the body of the lemur resembles the body of the monkey4. The passage suggests thatA. the typical lemur is a member of an order of mammals known as DermopteraB. flying lemurs are only active during the nightC. the lemur is not an aggressive animalD. lemurs spend most oft their time on the groundE. flying lemurs can only be found on Madagascar and neighboring islandsEleanor Roosevelt was the niece of the 26th president of the United States, Theodore Roosevelt, and the wife of the 33rd president, Franklin D. Roosevelt. It would be doing her a great injustice, however, to describe her only in terms of her relationship to men in powerful and important positions. She was, in her own right, an important figure in twentieth-century American history who strongly supported a variety of social causes and simply used her political position to further these causes.A dedicated worker fro humanitarian causes before her marriage, and prior to her husband’s election to the presidency, she simply expanded her role when she became the First Lady. She took a more powerful voice on behalf of a broad range of social issues, which included employment of youths and civil rights for women and blacks. She conducted press conferences, had her own radio program, and wrote a nationally syndicated column in a daily newspaper. After her husband died, she served as the United States delegate to the United Nations and played a role in the drafting of the UN Declaration of Human Rights. In short, she clearly proved to be an important and influential figure, above and beyond her political connections.5. All of the following are true about Eleanor Roosevelt EXCEPTA. she was the First Lady of the United StatesB. she served as the United Sates delegate to the United NationsC. she was a dedicated supporter of many social causesD. she began to work for humanitarian causes only after her marriageE. she had her own radio program6. When discussing Eleanor Roosevelt, the author’s tone in this passage could best be described asA. criticalB. admiringC. bitterD. sereneE. neutral7. The passage is mainly aboutA. the success of the Roosevelt familyB. Eleanor Roosevelt’s background and accomplishmentsC. the various social causes that Eleanor Roosevelt supportedD. Eleanor Roosevelt’s role in the United NationsE. important figures in twentieth-century American history8. The author of the passage describes Eleanor Roosevelt’s accomplishments in order to show thatA. she should have been elected to the presidencyB. she could have done more with her life if she had used her politicalC. her greatest achievement was marrying a man who later became presidentD. she was more successful than either her uncle or husband in gaining public supportE. she deserves recognition beyond her family and marital connectionsBefore a joint session of Congress in January 1918, President Woodrow Wilson outlined his plan for a post-World War I peace settlement. Known as the Fourteen Points, Wilson’s plan is best remembered for its first point, which declared that international diplomacy should be conducted in the open and that quiet, unpublicized diplomacy should be made illegal. Wilson believed that public diplomacy would end the threat of war by preventing immoral national leaders from secretly plotting aggressive action against others.Although Wilson was a highly intelligent and well-meaning man, he lacked insight into the complexities of international politics. Contrary to Wilson’s belief, war rarely results from the behind-the-scenes plotting of unscrupulous national leaders. Rather, war usually stems from unresolved disagreements among nations – disagreements over territory, access to resources, and so forth. Even if quiet diplomacy could be eliminated, these disagreements would still remain, as would the threat of war.9. The second paragraph of this passage is primarily aboutA. a post-World War I peace settlementB. diplomacy’s role in international politicsC. disagreements among nationsD. the actual causes of warE. the first point in Wilson’s Fourteen Points10. The attitude of the writer toward the subjects isA. calculatingB. suspiciousC. opinionatedD. cheerfulE. apologetic11. The author would most likely agree that war between country A and country B would result from which of the following situations?A. A dispute over ownership of a piece of land bordering both countriesB. An agreement by a leader in country A to tax imports from a third countryC. The capture of a spy from country A in country BD. An unpublicized agreement by country A to sell weapons to country BE. A secret alliance made between country A and another country12. Why does the author say that open diplomacy would not prevent war?A. Quiet diplomacy will always be a part of international relations.B. War breaks out because immoral rulers make decisions in secret.C. Open diplomacy is not a solution to the problems which lead to war.D. Disagreements over territory and resources rarely lead to conflict.E. International relations are too complex to be conducted in the public eye.13. Which of the following is the author most likely to discuss next?A. Wilson’s domestic policies in the post World War I periodB. The impact of import taxes on foreign trade relationsC. An example of a war that resulted from a territorial or resource disputeD. The events leading up to World War IE. Other examples of Wilson’s intelligenceLine Live thy life,Young and old,Like yon oak,Bright in spring,5 Living gold,Summer-richThen: and thenAutumn-changed,soberer-hued10 Gold again.All his leavesFall’n at length,Look, he standsTrunk and bough,15 Naked strength.“The Oak,” by Alfred, Lord Tennyson.14. In this poem, the seasons represent differentA. kinds of treesB. times of dayC. stages of lifeD. styles of dressE. periods of history15. The “he” mention in 13 refers toA. the poetB. lifeC. the oakD. autumnE. the reader 16. What does “Gold again” in line 10 signify?A. The arrival of autumnB. The richness of summerC. The increased wealth of the narratorD. The color of oak treesE. The revival of the past17. During which season is the oak referred to as “living gold”>A. SpringB. SummerC. AutumnD. WinterE. This description does not refer to aseason.18. With which of the following statements about life would the speaker be most likely to agree?A. People should live every period oftheir lives to the fullest.B. It is important to try to accomplishsomething during one’s lifetime.C. Life is too short to spend time doingunpleasant tings.D. The seasons are unpredictable.E. Trees are an integral part of theenjoyment of life.Tea is consumed by more people and in greater amounts than any other beverage in the world, with the exception of water. The tea plant, from whose leaves tea is mad, is native to India, China, and Japan and was first cultivated for use by the Chinese in prehistoric times. The plant, which is characterized as an evergreen, can fresh a height of about thirty feet but is usually pruned down to three or four feet for cultivation. It has dark green leaves and cream-colored, fragrant blossoms.Cultivation of the tea plant requires a great deal of effort. The plant must grow in a warm, wet climate, in a carefully protected, well-drained area. Its leaves must be picked by hand. (Cultivation in North America has been attempted, but was found to be impractical because of a shortage of cheap labor.) Today, the plant is cultivated in the lands to which it is native, as well as in Sri Lanka, Indonesia, Taiwan, and South America.Tea was probably first used as a vegetable relish and f or medicinal purpose. In the 1400’s Chinese and Japanese Buddhists developed a semi-religious ceremony surrounding tea-drinking. It was not until after 1700, however, that it was not first imported into Europe. Today, the United Kingdom imports more tea than does any other nation – almost one third of the world’s production. The United States is also a large importer, but Americans have seemed to prefer coffee ever since the famous Boston Tea Party in 1773.19. This passage is mainly aboutA. the tea plantB. the uses of the tea plantC. tea-drinking throughout historyD. the tea tradeE. the cultivation of the tea plant20. According to the passage, the tea plantA. was first cultivated in Japan in prehistoric timesB. requires well-drained soil to grow properlyC. is the largest import of the United KingdomD. has odorless flowersE. is native to South America21. Why is large supply of cheap labor important for the cultivation of tea?A. Since the tea plant can reach a height ofthirty feet, several workers are required toharvest each plant.B. Since tea is exported all over the world, a lotof people are needed to handle the tradecomplications that arise.C. Since tea has been around since prehistorictimes, many workers are employed toprotect it and ensure that it doesn’t die out.D. Since England and China are far away fromeach other, many workers are required tocoordinate tea shipments and deliveries.E. Since the tea plant is hand picked, many 22. The style in the passage is most like thatfound in aA. newspaper articleB. passage in an encyclopediaC. cookbookD. journal entryE. history textbook23. Which of the following is the author most likelyto discuss next?A. The details and aftermath of the Boston T eaPartyB. Other major imports of the United Kingdomand United StatesC. Current trends in tea consumptionD. Other examples of plants that have amedicinal valueE. A description of what China was like inprehistoric times24. The purpose of the second paragraph is toA. describe the role of tea in religiousceremoniesB. explain why Americans prefer coffeeC. discuss historical uses of teaD. describe the cultivation of teaE. question the importance of teaAcupuncture is a type of medical therapy that has been part of Chinese medicine since ancient times. It involves the insertion of thin, solid needles into specific sites on the body’s surface. The belief is that the application of a needle at one particular point produces a specific response at a second point. It is based on the ancient Chinese philosophy that human beings are miniature versions of the universe and that the forces that control nature also control health. These forces are divided between two main principles called the yin and the yang, which have an opposite but complementary effect on each other. For example, one force keeps the body’s temperature from rising too high and the other keeps it from dropping too low. When they are in balance, the body maintains a constant, normal state. Disease occurs when these forces get out of balance.Although acupuncture had been used in Western countries during many periods, it was not until the 1970s that it gained widespread interest, when it was determined that it could be used to control pain during surgery. The mechanism for its effectiveness is still a mystery, but it has become a very popular technique in many countries in the treatment of various diseases and medical problems.30. Which of the following is true about acupuncture?I. Although originally only a part of Chinese medicine, it is now practiced in many Western countries. II. It has been used to control pain during surgery since ancient times.III. The mechanism for its effectiveness was discovered during the 1970s.A. I onlyB. I and II onlyC. I and III onlyD. II and III onlyE. I, II and III31. This passage is primarily aboutA. various diseases that are particularly common among the ChineseB. the meaning and use of the yin and the yangC. different types of medical therapies and their relative effectivenessD. the historical and philosophical background to acupunctureE. modern use of acupuncture both in China and in Western countries32. According to the passage, acupuncture is based onA. the idea that the human body is a model of the universe and is therefore controlled by the forces ofnatureB. a firm belief in the Chinese gods known as the yin and the yangC. an ancient Chinese religious ceremony that involves the insertion of needles into the bodyD. a philosophy of health and disease that originated in China but has been totally changed byWestern countriesE. the ideas of an astronomer who was attempting to study the universe in ancient times33. According to the passage, the yin and the yang are principles that representA. high and low extremes of temperatureB. states of health and diseaseC.。
维持性血液透析患者自体动静脉内瘘使用时间及其影响因素研究
维持性血液透析患者自体动静脉内瘘使用时间及其影响因素研究王博;魏芳;孙桂江;陈海燕;卢志;贾岚;姜埃利【摘要】目的探讨维持性血液透析患者自体动静脉内瘘(AVF)使用时间及其影响因素.方法选取2010—2011年天津医科大学第二医院初次行AVF手术的患者126例,从数字化管理系统中获取患者AVF自建立之初至5年末的临床资料,根据AVF使用情况分为AVF丧失功能组(61例)与AVF通畅组(65例),采用Kaplan-Meier方法绘制生存曲线,采用多因素Cox比例风险回归模型分析AVF使用时间的影响因素.结果 126例患者AVF 1年使用率为92.1%,3年使用率为69.8%,5年使用率为51.6%.AVF丧失功能组与AVF通畅组患者糖尿病检出率、血液透析中低血压(IDH)发生率、血磷水平比较,差异均有统计学意义(P<0.05).多因素Cox比例风险回归分析结果显示,糖尿病〔HR=2.187,95%CI(1.303,3.670)〕、IDH〔HR=1.703,95%CI(1.004,2.888)〕、高磷血症〔HR=1.893,95%CI(1.295,2.766)〕与AVF使用时间有回归关系(P<0.05).结论维持性血液透析患者AVF使用时间较短,糖尿病、IDH、高磷血症发生是缩短AVF使用时间的危险因素.【期刊名称】《中国全科医学》【年(卷),期】2018(021)029【总页数】5页(P3577-3581)【关键词】肾透析;动静脉瘘;影响因素分析【作者】王博;魏芳;孙桂江;陈海燕;卢志;贾岚;姜埃利【作者单位】300211 天津市,天津医科大学第二医院肾脏疾病与血液净化科;300211 天津市,天津医科大学第二医院肾脏疾病与血液净化科;300211 天津市,天津医科大学第二医院肾脏疾病与血液净化科;300211 天津市,天津医科大学第二医院肾脏疾病与血液净化科;300211 天津市,天津医科大学第二医院肾脏疾病与血液净化科;300211 天津市,天津医科大学第二医院肾脏疾病与血液净化科;300211 天津市,天津医科大学第二医院肾脏疾病与血液净化科【正文语种】中文【中图分类】R459.52本研究创新点:研究表明慢性肾脏病患者发病率呈逐年上升趋势,进而终末期肾脏疾病(ESRD)患者也越来越多。
伴13q14缺失的初诊多发性骨髓瘤患者的临床特征和治疗反应
伴13q14缺失的初诊多发性骨髓瘤患者的临床特征和治疗反应刘延方;孙玲;汤平;王萌;姜中兴;万鼎铭;白俊俊;王树娟;郝倩倩;王冲;侯降雪;郭程娱;廖林晓;孙慧【摘要】目的:探讨伴13q14缺失的初诊多发性骨髓瘤(MM)患者的临床特征和治疗反应.方法:选择初诊MM患者251例,利用荧光原位杂交技术检测其13q14异常情况,应用Kaplan-Meier生存曲线和Cox回归分析13q14缺失对预后的影响.结果:251例中,13q14缺失80例(31.9%).13q14缺失组初诊时血清钙离子、β2MG、M蛋白水平及骨髓浆细胞水平高于未缺失组,血红蛋白、血小板水平低于未缺失组,DSⅢ期患者比例、ISSⅢ期患者比例均高于未缺失组(P<0.05).2组OS和PFS生存曲线比较结果显示,13q14缺失组预后差于未缺失组(P<0.05).Cox回归分析结果显示,13q14缺失是PFS和OS的独立危险因素,HR(95%CI)分别为1.7(1.1~2.7)和2.3(1.2~4.5).治疗1个疗程、4个疗程后,BD方案组M蛋白下降率均高于传统方案组(P均<0.05).结论:伴13q14缺失的MM患者初诊时肿瘤负荷高,整体预后差;含硼替佐米方案可改善其预后.【期刊名称】《郑州大学学报(医学版)》【年(卷),期】2019(054)001【总页数】5页(P110-114)【关键词】多发性骨髓瘤;13q14缺失;硼替佐米;预后【作者】刘延方;孙玲;汤平;王萌;姜中兴;万鼎铭;白俊俊;王树娟;郝倩倩;王冲;侯降雪;郭程娱;廖林晓;孙慧【作者单位】郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052;郑州大学第一附属医院血液科郑州450052【正文语种】中文【中图分类】R733.3多发性骨髓瘤(multiple myeloma,MM)是一组发病机制尚不明确的异质性浆细胞疾病[1],患者的生存期从几个月到数年不等。
云南省邵通一中等三校2024-2025学年高三上学期8月高考备考实用性联考卷(二)英语试卷
云南省邵通一中等三校2024-2025学年高三上学期8月高考备考实用性联考卷(二)英语试卷一、听力选择题1.What is Allen doing?A.He’s working out.B.He’s doing chores.C.He’s writing a report. 2.Why does the woman talk to the man?A.To ask about a party.B.To reschedule a meeting.C.To cancel an appointment. 3.What did the woman do yesterday evening?A.She watched TV.B.She went shopping.C.She played football. 4.What is the woman’s suggestion?A.Having a break.B.Going for a meal.C.Walking along the beach. 5.When will the train arrive in Boston?A.At 10: 00 a. m.B.At 10: 25 a. m.C.At 10: 35 a. m.听下面一段较长对话,回答以下小题。
6.What do we know about The Mall Road?A.It can be overcrowded sometimes.B.Its history can be traced back to 1587.C.It is the largest marketplace in Pakistan.7.What food did the man dislike?A.Dal bhat.B.Tarkari.C.Beef biryani.听下面一段较长对话,回答以下小题。
8.What are the speakers discussing?A.A website.B.A YouTuber.C.An online repair store. 9.Why did Robert Kenney start “Dad, how do I? ” at first?A.To teach adults how to fix things.B.To do YouTube marketing.C.To help fatherless children.听下面一段较长对话,回答以下小题。
英语泛读教程1第3版参考答案
Unit 1Text:A. dB. 1. c 2. d 3. d 4. a 5. d 6. c, 7. a 8. c 9. dC. 1. d 2. b 3. d 4. d 5. a 6. d 7. c 8. b 9. d 10. d Fast Reading:1. c2. d3. b4. c5. c6. d7. a8. c9. d 10. c 11. c 12. c 13. b 14. c 15. dHome Reading:1. d2. b3. b4. c5. c6. b7. a8. b9. d 10.c Unit 2Text:A. dB. 1. b 2. c 3. c 4. d 5. c 6. c, 7. a 8. cC. 1. a 2. d 3. d 4. b 5. a 6. b 7. b 8. b 9. c 10. a Fast Reading:1. b2. d3. d4. a5. c6. c7. d8. b9. c 10. a 11. d 12. d 13. d 14. c 15. dHome Reading:1. c2. d3. d4. c5. c6. d7. d8. d9. d 10. b 11. b 12. aUnit 3Text:A.cB.1.c 2.d 3.b 4.c 5.c 6、d 7.c 8.c 9.b10.d 11,d 12.cC.1.b 2.a 3.a 4.d 5.b 6.a 7.a 8.d 9.a 10.aFast Reading:1.b 2.c 3.c 4.d 5.b 6.c 7.b 8.a 9.c 10.c 11.d 12.d 13.d 14.d 15.bHome Reading:1.c 2.d 3.c 4.b 5.b 6.a 7.d 8.bUnit 4Text:A.cB.1.b 2.d 3.c 4.d 5.c 6.b 7.d 8.b 9.d 10.cC.1.a 2.a 3.b 4.d 5.a 6.d 7.b 8.d 9.c Fast Reading:1.c 2.c 3,d 4.a 5。
从目前可获得的循证医学证据评价鬼臼毒素的临床应用
循证医学作业临床995班马媛990155081、题目:从目前可获得的循证医学证据评价鬼臼毒素的临床应用2、临床底线:对鬼臼毒素有效性、安全性和经济性进行评价。
根据近年来国外、国内发表的研究资料,按照循证医学的原则进行归纳综合。
3、临床问题:早在1880年podwyssotzki从美洲鬼臼树脂中首次得到白色晶状物质,即鬼臼毒(Podophyllotoxin,1.1)。
1942年,Kaplan记述了局部应用鬼臼树脂治疗尖锐湿疣获得满意效果,后来King等发现它可以引起正常人体的外皮肤明显的细胞学改变,后证实它对微管和肿瘤细胞具有抑制作用,但毒性较大。
50年代初,国外开始对鬼臼毒素进行结构改造,合成并筛选了大量的衍生物。
目前在抗癌方面应用的主要是鬼臼毒素的衍生物,如鬼臼衍生物疣鬼臼酰乙基肼(SP-1),依托泊苷(Etoposide,VP-16)和替尼泊苷(Teniposide,VM-26),而对鬼臼毒素的临床应用的研究主要集中在治疗尖锐湿疣上。
尖锐湿疣由人类乳头瘤病毒感染引起。
目前常用的治疗方法有药物、激光、高频电刀、手术和冷冻等。
药物中以0.5%鬼臼毒素最为常用,能阻遏细胞的有丝分裂,促进巨噬细胞的增殖,阻抑线粒体的代谢,是临床上治疗尖锐湿疣的首选药。
4、检索词:鬼臼毒素临床应用5、研究:根据近年来国外、国内发表的研究资料,按照循证医学的原则进行归纳综合。
本次检索文献,较为全面的检索了CBM(1987-2002)、MEDLINE(1980-2002)、EMBASE (1989-2002)以及Cochrane图书馆(Issue 3, 2003),共得随机对照试验89篇, meta 分析2篇,经筛选仅有19篇[1-19]随机对照实验符合纳入的标准(见鬼臼毒素的RCT 检索结果汇总)。
其中有10个RCT以安慰剂为对照组,双盲试验有11组,单盲试验有2组,未设盲的有2组,盲法未提及的有4组。
病例总数有2185,其中有一个试验未说明病例数。
自噬基因预测肝癌患者长期生存及通路分析
自噬基因预测肝癌患者长期生存及通路分析陈懿李雪林文雅陈金霞张友才摘要目的探究自噬相关基因(autophagy-related genes,ARGs)对肝细胞癌(hepatocellular carcinoma,HCC)患者整体生存(overall survival,OS)的影响。
方法收集TCGA数据库中377例肝细胞癌患者组织的全部转录组表达数据,利用GO及KEGG 富集分析差异表达的自噬相关基因(DEARGs)涉及的信号通路。
利用COX回归方法确立预后相关的ARGs,提出基于ARGs构建的预后指标。
结果发现32个ARGs与HCC患者预后明显相关,其中FOXO1是患者的保护基因。
经过多因素COX回归纳入14个ARGs构建风险模型,将患者分为低风险组和高风险组,高低风险组患者OS比较差异有统计学意义(P<0.001)o进一步多因素COX回归分析14个ARGs具有独立预后价值,1年、3年的受试者工作特征(ROC)曲线下面积分别为0.765、0.732。
结论基于14个ARGs构建的模型,可用来预测HCC患者预后,同时也是潜在的治疗靶点。
关键词自噬肝细胞癌预后信号通路中图分类号R73文献标识码A DOI10.11969/j.issn.1673-548X.2021.01.029Autophagy Gene Predicts Long-term Survival and Pathway Analysis in Patients with Hepatocellular Carcinoma.Chen Yi,Li Xue,Lin Wenya,et al.The First Affiliated Hospital of Wenzhou Medical University,Zhe/'iang325000,ChinaAbstract Objective To invesLigaLe Lhe effecL of auLophagy-relaLed genes(ARGs)on Lhe overall survival(OS)of paLienLs wiLh hepaLocellular carcinoma(HCC).Methods We collecLed all LranscripLome expression daLa of377hepaLocellular carcinoma paLienLs in the TCGA database,using GO and KEGG enrichment to analyze the signal pathways involved in differentially expressed autophagy一related genes(DEARGs).COX regression method was used to establish prognoses related ARGs,and a prognostic index based on ARGs was proposed.Results32ARGs were found to be significantly related to the prognosis of HCC patients,of which FOXO1was the protective gene.After Multivariate COX regression,14ARGs were included to construct the risk model,and patients were divided in to low一risk group and high一risk group.There was significant difference in OS between high一risk group and low一risk group(P<0.001).Further COX regression analysis showed that14ARGs had independent prognostic value.The area under the receiver operating characteristic (ROC)curve at1-and3一year was0.765and0.732,respectively.Conclusion The model based on14ARGs could be used to pre-dicL Lhe prognosis of HCC paLienLs,and iL was also a poLenLial LherapeuLic LargeL.Key words AuLophagy;HepaLocellular carcinoma;Prognosis;Signaling paLhway自噬是发生在所有真核细胞内的一种稳态过程,涉及双膜自噬体中细胞质成分的分离[1,2]。
瘤组织中黏蛋白CD10、MUC2、MUC5AC、MUC6_表达与进展期胃癌临床病理参数及预后的关系
瘤组织中黏蛋白CD10、MUC2、MUC5AC、MUC6表达与进展期胃癌临床病理参数及预后的关系王晨晨1,2,张静2,张欢2,王彩虹1,张久聪3,刘东1,王志斌11 中国人民解放军联勤保障部队第940医院重症医学科,兰州730050;2 空军军医大学西京医院消化内科肿瘤生物学国家重点实验室国家消化系统疾病临床医学研究中心;3 中国人民解放军联勤保障部队第940医院消化内科摘要:目的 分析进展期胃癌患者肿瘤组织中黏蛋白CD10、MUC2、MUC5AC、MUC6表达与胃癌临床病理参数及预后的相关性。
方法 进展期胃癌患者762例,采用免疫组化法检测胃癌组织中的黏蛋白CD10、MUC2、MUC5AC、MUC6。
分析黏蛋白表达与胃癌临床病理参数及预后的相关性。
根据胃癌预后影响因素建立胃癌预后预测的列线图模型并验证其效能。
结果 胃癌组织中CD10、MUC2、MUC5AC、MUC6表达阳性分别为244例(32.02%)、282例(37.01%)、484例(63.52%)、502例(65.88%)。
CD10在肠型胃癌中表达高于混合型和弥漫型,MUC5AC和MUC6在混合型胃癌中表达高于肠型和弥漫型(P均<0.05)。
MUC2、MUC5AC在黏液腺癌中表达高于低分化和中高分化胃癌(P均<0.05)。
MUC2、MUC5AC、MUC6在脉管侵犯阳性胃癌中表达高于阴性组织(P均<0.05)。
MUC6在神经侵犯阳性胃癌中表达高于阴性组织(P均<0.05)。
MUC2在Ⅲ期胃癌中表达高于Ⅱ期胃癌(P<0.05)。
单因素Kaplan-Meier生存分析结果显示,脉管侵犯、分化程度、TNM分期、辅助化疗是进展期胃癌患者总生存期(OS)的影响因素,MUC5AC阳性患者OS低于阴性患者(P<0.05)。
多因素Cox分析结果显示,MUC5AC表达、术后辅助化疗、分化程度、Lauren分型及肿瘤TNM分期是进展期胃癌患者OS的独立影响因素(P均<0.05)。
330例Ⅳ a期鼻咽癌的预后分析
330例Ⅳ a期鼻咽癌的预后分析黄朝斌;黄清廷;郭秀琳;邱素芳;许元基;郑崴【摘要】目的探讨Ⅳa期鼻咽癌患者的预后及不良预后因素.方法收集初治的Ⅳa 期鼻咽癌患者330例,均接受根治性放疗,其中接受调强放疗113例,接受常规放疗217例;所有患者均行铂类为基础的化疗,其中94例接受同步化疗为基础的治疗,236例接受诱导化疗为基础的治疗.采用Kaplan-Meier法进行单因素生存分析,预后采用多因素Cox比例风险模型分析.结果随访3~75个月,中位时间56个月,全组病例5年无局部区域复发生存率、无远处转移生存率、总生存率分别为84.9%、77.8%、69.9%.单因素分析结果显示女性、年龄≤50岁、N0~1分期患者总生存率高于男性、年龄>50岁、N2~3分期患者(P<0.05或<0.01),角化性病理类型患者无局部区域复发生存率高于非角化性病理类型患者(P<0.05),女性、N0~1分期患者无远处转移生存率高于男性、N2~3分期患者(P<0.05或<0.01).多因素分析结果显示性别、年龄、N分期是总生存率的影响因素(P<0.05或<0.01),性别、N分期是无远处转移生存率的影响因素(P<0.05),病理类型是无局部区域复发生存率的影响因素(P<0.05或<0.01).结论Ⅳa期鼻咽癌患者中N分期是影响无远处转移生存率及总生存率的预后不良因素.N2~3患者较N0~1转移率高,预后差.【期刊名称】《河北医科大学学报》【年(卷),期】2015(036)011【总页数】4页(P1300-1303)【关键词】鼻咽肿瘤;预后;危险因素【作者】黄朝斌;黄清廷;郭秀琳;邱素芳;许元基;郑崴【作者单位】福建省肿瘤医院放疗科,福建福州350014;福建省肿瘤医院放疗科,福建福州350014;福建省肿瘤医院放疗科,福建福州350014;福建省肿瘤医院放疗科,福建福州350014;福建省肿瘤医院放疗科,福建福州350014;福建省肿瘤医院放疗科,福建福州350014【正文语种】中文【中图分类】R739.63·论著·鼻咽癌是东南亚和我国南方地区的高发恶性肿瘤,由于其解剖位置特殊,早期症状隐匿,至少60%以上的患者就诊时已属中晚期[1],且初诊患者中以晚期鼻咽癌Ⅳa期为主。
宫颈癌预后、预测因素及其数学模型的建立
宫颈癌预后、预测因素及其数学模型的建立田泽平;蔡禄;赵秀娟;黄桂香;王克芳【摘要】目的回顾性分析在我院住院并行宫颈癌根治术的693例病例,探讨影响宫颈癌预后的高危因素,建立预测宫颈癌3年及5年生存率的数学模型,以指导临床上患者的个体化治疗.方法对2005.1-2011.3在我院住院手术的693例宫颈癌患者,利用Kaplan-Meier和 Cox Regression方法对临床资料进行单因素及多因素的分析,从中建立宫颈癌预后指数模型并予以验证.结果多因素分析提示病理类型、FIGO分期和淋巴结是否阳性、肿瘤分化程度及HPVE6E7表达与患者预后关系更密切.建立了预测宫颈癌3年及5年生存率数学模型.结论建立预测生存率数学模型,可以很好的指导临床治疗,有临床应用价值.【期刊名称】《中国实验诊断学》【年(卷),期】2013(017)006【总页数】5页(P1006-1010)【关键词】宫颈癌;预后因素;预测因素;数学模型【作者】田泽平;蔡禄;赵秀娟;黄桂香;王克芳【作者单位】内蒙古科技大学生物工程与技术研究所,内蒙古,包头014010;内蒙古科技大学生物工程与技术研究所,内蒙古,包头014010;包头医学院第一附属医院中心实验室;包头市中心医院妇产科;首都医科大学附属北京安贞医院妇产科【正文语种】中文【中图分类】R737.33宫颈癌是女性仅次于乳腺癌的第二个最常见的恶性肿瘤,严重危及妇女的健康,中国每年新增宫颈癌病例130,000例,约占全球总新增病例数的28%。
宫颈癌是目前唯一已被证实由病毒直接引起的癌症。
如今,虽然多数的宫颈癌可经手术或放疗等局部治疗手段而治愈,但其中20%-25%左右的病例却因治疗后的复发和远处转移而致治疗失败。
因此,如何利用宫颈癌患者的临床病理和实验室指标来评估患者的预后,将宫颈癌患者的预后预测因素对宫颈癌病人预后影响进行综合评估,建立宫颈癌病人的预后模型,有利于计算患者个体的复发、转移危险程度以指导临床治疗。
睡眠障碍对中老年鼻咽癌患者预后的影响
睡眠障碍对中老年鼻咽癌患者预后的影响翁敬锦;韦嘉章;李敏;陆锦龙;覃扬达;江河;瞿申红【摘要】目的探讨睡眠障碍对中老年鼻咽癌(nasopharyngeal carcinoma,NPC)患者预后的影响.方法共纳入符合标准的315例NPC患者,其中睡眠障碍组42例,非睡眠障碍组273例.应用Kaplan-Meier生存曲线进行单因素生存分析,用log-rank检验进行组间生存曲线的比较,COX回归进行多因素分析.结果睡眠障碍组复发/转移率高于非睡眠障碍组(40.48%vs 26.01%,P<0.05).3年总生存率非睡眠障碍组为87.75%,睡眠障碍组为77.59%(P<0.05).多因素分析显示,T分期、N分期、治疗方式、放疗方式和睡眠情况是影响NPC患者总生存率的独立危险因素,T分期、N分期和治疗方式是影响NPC患者无瘤生存率的独立危险因素.结论睡眠障碍是影响NPC预后的独立危险因素,对睡眠障碍患者可能需要进一步干预.【期刊名称】《广东医学》【年(卷),期】2018(039)021【总页数】5页(P3192-3196)【关键词】鼻咽癌;睡眠障碍;预后【作者】翁敬锦;韦嘉章;李敏;陆锦龙;覃扬达;江河;瞿申红【作者单位】广西壮族自治区人民医院耳鼻咽喉头颈科广西南宁530021;广西壮族自治区人民医院耳鼻咽喉头颈科广西南宁530021;广西壮族自治区人民医院耳鼻咽喉头颈科广西南宁530021;广西壮族自治区人民医院耳鼻咽喉头颈科广西南宁530021;广西壮族自治区人民医院耳鼻咽喉头颈科广西南宁530021;广西壮族自治区人民医院耳鼻咽喉头颈科广西南宁530021;广西壮族自治区人民医院耳鼻咽喉头颈科广西南宁530021【正文语种】中文鼻咽癌(nasopharyngeal carcinoma,NPC)是我国南方地区常见的恶性肿瘤[1],其好发于中老年人。
由于早期症状隐匿,大部分患者就诊时多为中晚期患者。
盐酸安罗替尼胶囊治疗晚期软组织肉瘤Ⅱb期多中心临床试验的单中心数据分析
盐酸安罗替尼胶囊治疗晚期软组织肉瘤Ⅱb期多中心临床试验的单中心数据分析刘佳勇;樊征夫;李舒;薛瑞峰;高天;白楚杰;张路;谭智超;方志伟【摘要】Objective: To investigate the efficacy and safety of anlotinib hydrochloride capsules for the treatment of advanced soft tissue sarcoma based on the data from Department of Bone and Soft Tissue Tumor, Peking University Cancer Hospital&Institute. Methods: Patients were randomized allocated at 2:1 ratio for the anlotinib treatment and placebo group. The treatment group received 12 mg/day of anlotinib for 14 consecutive days in a 21-day cycle. The primary end-point was progression-free survival (PFS), and the secondary end-points were disease control rate (DCR), overall survival (OS), and adverse event rate. Results: A total of 46 patients were enrolled in this study; 7 of them were excluded from per protocol set (PPS). Among the remaining 39 patients, 28 were included in the anlotinib group and 11 in the placebo group. In the anlotinib group, 4 patients had partial remission and 13 had stable disease (SD), whereas in the placebo group, 3 patients had SD. The difference in DCR between the 2 groups was statistically significant (60.7% vs . 27.3%,P=0.082). The DCR of the advanced soft tissue sarcoma in the anlotinib group was 78.6% (11/14). The median PFS in the anlotinib group was 12.4 (95% confidence interval [CI]: 7.6 to 17.2) months, which was significantly longer than 4 months in the placebo group (95% CI: 1.7 to 6.3 months,P=0.043); however, the difference in OS between the 2 groups was notsignificant (19.4 vs . 17.6 months, P=0.961). Regarding the safety, 2 patients had severe adverse events (7.14%) possibly related with treatment in the anlotinib group; one of them had pneumothorax. The other adverse events were grade 1 to 2. Conclusions: Soft tissue sarcoma is highly responsive to anlotinib, with prolonged PFS. Anlotinib is well tolerated and can be used as a treatment option for advanced soft tissue sarcoma.%目的:根据单中心的临床试验数据,分析安罗替尼治疗晚期软组织肉瘤(soft tissue sarcoma,STS)的有效性和安全性.方法:收集2015年6月至2017年3月在北京肿瘤医院骨与软组织肿瘤科参加盐酸安罗替尼胶囊治疗晚期软组织肉瘤Ⅱb临床试验的46例患者.患者按照2 :1的比例随机分成安罗替尼治疗组和安慰剂组,治疗组接受安罗替尼12 mg/d,d1~d14,21天为一个周期.主要研究终点为疾病无进展期(progression free survival,PFS),次要研究终点为疾病控制率(disease control rate,DCR)、总生存时间(overall survival,OS)和安全性.结果:共入组46例,其中7例从符合方案集(per protocol set,PPS)中移除,剩余39例患者中安罗替尼治疗组28例,安慰剂组11例.安罗替尼治疗组中4例PR,13例SD;安慰剂组3例SD,两组的DCR接近统计学差异(60.7% vs . 27.3%,P=0.082);其中安罗替尼治疗组中腺泡状软组织肉瘤的DCR为78.6%(11/14).安罗替尼治疗组的中位PFS为12.4个月(95%CI:7.6~17.2个月),显著优于安慰剂组4.0月(95%CI:1.7~6.3个月,P=0.043);但是两组的OS无显著性差异(19.4个月vs. 17.6个月,P=0.961).安全性方面,安罗替尼治疗组中共2例(7.14%)患者出现了可能与药物相关的严重不良反应(severe adverse event,SAE),其中1例(3.6%)为气胸,其余不良反应均为1~2级.结论:安罗替尼在软组织肉瘤患者中表现出良好的DCR率,且能显著延长患者的PFS,并且患者的耐受性良好.安罗替尼可以作为晚期软组织肉瘤的治疗选择,尤其是腺泡状软组织肉瘤.【期刊名称】《中国肿瘤临床》【年(卷),期】2018(045)020【总页数】5页(P1066-1070)【关键词】软组织肉瘤;靶向治疗;安罗替尼;疾病无进展生存期;腺泡状软组织肉瘤【作者】刘佳勇;樊征夫;李舒;薛瑞峰;高天;白楚杰;张路;谭智超;方志伟【作者单位】北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142;北京肿瘤医院暨北京市肿瘤防治研究所,骨与软组织肿瘤科北京市100142【正文语种】中文目前晚期软组织肉瘤(soft tissue surcoma,STS)患者可采取的治疗方案有限,一旦肿瘤发生转移,患者的平均生存期仅有12~18个月[1-2]。
华蟾素胶囊辅助治疗原发性肝癌的临床研究
华蟾素胶囊辅助治疗原发性肝癌的临床研究沈天白;张玮;陈阳;卢双;李莹【摘要】目的:探讨华蟾素胶囊辅助治疗原发性肝癌的临床疗效及对生存质量的影响.方法:74例原发性肝癌患者随机分为治疗组40例和对照组34例,在前期综合治疗(包括手术切除术、射频消融术或肝动脉化疗栓塞术等)基础上,对照组患者采用水飞蓟宾葡甲胺片治疗,治疗组患者采用华蟾素胶囊治疗,疗程6个月.观察丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转移酶(GGT)、甲胎蛋白(AFP)、血清铁蛋白(SF)、CD3+、CD4+、CD8+、CD56+16、Child Pugh分级、Karnofsky评分(KPS)和生存率等变化.结果:治疗6个月后,治疗组患者肝功能指标(ALT、AST、GGT)水平较治疗前明显降低(P<0.05).AFP水平较治疗前降低(P<0.05).在细胞免疫功能方面,治疗组CD3+、CD4+、CD8+比例明显高于对照组(P<0.05).治疗组患者Child-Pugh分级较对照组降低(P<0.05).治疗组患者KPS评分改善率为70%,对照组为52.9%,两人组比较(P<0.05).但两组患者生存率差异无统计学意义.结论:华蟾素胶囊能有效保护肝细胞,改善免疫功能,并能改善患者生活质量.【期刊名称】《中西医结合肝病杂志》【年(卷),期】2019(029)002【总页数】4页(P124-126,142)【关键词】原发性肝癌;华蟾素胶囊;Child-Pugh分级;Karnofsky评分【作者】沈天白;张玮;陈阳;卢双;李莹【作者单位】上海中医药大学附属龙华医院上海,200032;上海中医药大学附属龙华医院上海,200032;上海中医药大学;上海中医药大学;上海中医药大学附属龙华医院上海,200032【正文语种】中文原发性肝癌(PLC)是一种常见的恶性肿瘤,其发病率在恶性肿瘤中排行第六,也是由癌症导致死亡的第三大原因,其死亡率占总死亡率的93%[1,2]。
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Typical lemurs are primates with bodies similar to those monkeys but pointed muzzles and large eyes; most have with pointed tails. Their fur is woolly and may be colored red, gray, brown or black. The name of the lemur stems from the Latin lemures, the Roman name for vampire-like ghosts of the dead which these large-eyed creatures were thought to resemble. Found only off the east coast Africa on the island of Madagascar and neighboring islands, lemurs spend some time on the ground but most often are in the trees, building nests high in the branches. Besides leaves, lemurs eat eggs, fruit, insects, and small animals. They are active throughout the day and night and are reputed to be gentle, friendly creatures. Besides typical lemurs, the lemur family includes avahi, aye-aye, loris and galogo. However, contrary to popular belief, the so-called flying lemur is not even a primate, much less a true lemur; it is , in fact, a member of an altogether different order of mammals known as Dermoptera.1. The style of the passage is most like that found in aA. biology textbookB. novel about MadagascarC. zoologist’s diaryD. tourist’s guidebookE. personal letter2. Which of the following would be the best title for this passage?A. The Lemur: Friend or FoeB. Madagascar’s Loneliest HuntersC. Facts About LemursD. African VampiresE. The Diet of the Lemur3. According to the passage, all of the following are true about lemurs EXCEPTA. they spend much of their time in treesB. most have long, bushy tails.C. the flying lemur is not a true lemurD. they eat only fruits and leavesE. the body of the lemur resembles the body of the monkey4. The passage suggests thatA. the typical lemur is a member of an order of mammals known as DermopteraB. flying lemurs are only active during the nightC. the lemur is not an aggressive animalD. lemurs spend most oft their time on the groundE. flying lemurs can only be found on Madagascar and neighboring islandsEleanor Roosevelt was the niece of the 26th president of the United States, Theodore Roosevelt, and the wife of the 33rd president, Franklin D. Roosevelt. It would be doing her a great injustice, however, to describe her only in terms of her relationship to men in powerful and important positions. She was, in her own right, an important figure in twentieth-century American history who strongly supported a variety of social causes and simply used her political position to further these causes.A dedicated worker fro humanitarian causes before her marriage, and prior to her husband’s election to the presidency, she simply expanded her role when she became the First Lady. She took a more powerful voice on behalf of a broad range of social issues, which included employment of youths and civil rights for women and blacks. She conducted press conferences, had her own radio program, and wrote a nationally syndicated column in a daily newspaper. After her husband died, she served as the United States delegate to the United Nations and played a role in the drafting of the UN Declaration of Human Rights. In short, she clearly proved to be an important and influential figure, above and beyond her political connections.5. All of the following are true about Eleanor Roosevelt EXCEPTA. she was the First Lady of the United StatesB. she served as the United Sates delegate to the United NationsC. she was a dedicated supporter of many social causesD. she began to work for humanitarian causes only after her marriageE. she had her own radio program6. When discussing Eleanor Roosevelt, the author’s tone in this passage could best be described asA. criticalB. admiringC. bitterD. sereneE. neutral7. The passage is mainly aboutA. the success of the Roosevelt familyB. Eleanor Roosevelt’s background and accomplishmentsC. the various social causes that Eleanor Roosevelt supportedD. Eleanor Roosevelt’s role in the United NationsE. important figures in twentieth-century American history8. The author of the passage describes Eleanor Roosevelt’s accomplishments in order to show thatA. she should have been elected to the presidencyB. she could have done more with her life if she had used her politicalC. her greatest achievement was marrying a man who later became presidentD. she was more successful than either her uncle or husband in gaining public supportE. she deserves recognition beyond her family and marital connectionsBefore a joint session of Congress in January 1918, President Woodrow Wilson outlined his plan for a post-World War I peace settlement. Known as the Fourteen Points, Wilson’s plan is best remembered for its first point, which declared that international diplomacy should be conducted in the open and that quiet, unpublicized diplomacy should be made illegal. Wilson believed that public diplomacy would end the threat of war by preventing immoral national leaders from secretly plotting aggressive action against others.Although Wilson was a highly intelligent and well-meaning man, he lacked insight into the complexities of international politics. Contrary to Wilson’s belief, war rarely results from the behind-the-scenes plotting of unscrupulous national leaders. Rather, war usually stems from unresolved disagreements among nations – disagreements over territory, access to resources, and so forth. Even if quiet diplomacy could be eliminated, these disagreements would still remain, as would the threat of war.9. The second paragraph of this passage is primarily aboutA. a post-World War I peace settlementB. diplomacy’s role in international politicsC. disagreements among nationsD. the actual causes of warE. the first point in Wilson’s Fourteen Points10. The attitude of the writer toward the subjects isA. calculatingB. suspiciousC. opinionatedD. cheerfulE. apologetic11. The author would most likely agree that war between country A and country B would result from which of the following situations?A. A dispute over ownership of a piece of land bordering both countriesB. An agreement by a leader in country A to tax imports from a third countryC. The capture of a spy from country A in country BD. An unpublicized agreement by country A to sell weapons to country BE. A secret alliance made between country A and another country12. Why does the author say that open diplomacy would not prevent war?A. Quiet diplomacy will always be a part of international relations.B. War breaks out because immoral rulers make decisions in secret.C. Open diplomacy is not a solution to the problems which lead to war.D. Disagreements over territory and resources rarely lead to conflict.E. International relations are too complex to be conducted in the public eye.13. Which of the following is the author most likely to discuss next?A. Wilson’s domestic policies in the post World War I periodB. The impact of import taxes on foreign trade relationsC. An example of a war that resulted from a territorial or resource disputeD. The events leading up to World War IE. Other examples of Wilson’s intelligenceLine Live thy life,Young and old,Like yon oak,Bright in spring,5 Living gold,Summer-richThen: and thenAutumn-changed,soberer-hued10 Gold again.All his leavesFall’n at length,Look, he standsTrunk and bough,15 Naked strength.“The Oak,” by Alfred, Lord Tennyson.14. In this poem, the seasons represent differentA. kinds of treesB. times of dayC. stages of lifeD. styles of dressE. periods of history15. The “he” mention in 13 refers toA. the poetB. lifeC. the oakD. autumnE. the reader 16. What does “Gold again” in line 10 signify?A. The arrival of autumnB. The richness of summerC. The increased wealth of the narratorD. The color of oak treesE. The revival of the past17. During which season is the oak referred to as “living gold”>A. SpringB. SummerC. AutumnD. WinterE. This description does not refer to aseason.18. With which of the following statements about life would the speaker be most likely to agree?A. People should live every period oftheir lives to the fullest.B. It is important to try to accomplishsomething during one’s lifetime.C. Life is too short to spend time doingunpleasant tings.D. The seasons are unpredictable.E. Trees are an integral part of theenjoyment of life.Tea is consumed by more people and in greater amounts than any other beverage in the world, with the exception of water. The tea plant, from whose leaves tea is mad, is native to India, China, and Japan and was first cultivated for use by the Chinese in prehistoric times. The plant, which is characterized as an evergreen, can fresh a height of about thirty feet but is usually pruned down to three or four feet for cultivation. It has dark green leaves and cream-colored, fragrant blossoms.Cultivation of the tea plant requires a great deal of effort. The plant must grow in a warm, wet climate, in a carefully protected, well-drained area. Its leaves must be picked by hand. (Cultivation in North America has been attempted, but was found to be impractical because of a shortage of cheap labor.) Today, the plant is cultivated in the lands to which it is native, as well as in Sri Lanka, Indonesia, Taiwan, and South America.Tea was probably first used as a vegetable relish and f or medicinal purpose. In the 1400’s Chinese and Japanese Buddhists developed a semi-religious ceremony surrounding tea-drinking. It was not until after 1700, however, that it was not first imported into Europe. Today, the United Kingdom imports more tea than does any other nation – almost one third of the world’s production. The United States is also a large importer, but Americans have seemed to prefer coffee ever since the famous Boston Tea Party in 1773.19. This passage is mainly aboutA. the tea plantB. the uses of the tea plantC. tea-drinking throughout historyD. the tea tradeE. the cultivation of the tea plant20. According to the passage, the tea plantA. was first cultivated in Japan in prehistoric timesB. requires well-drained soil to grow properlyC. is the largest import of the United KingdomD. has odorless flowersE. is native to South America21. Why is large supply of cheap labor important for the cultivation of tea?A. Since the tea plant can reach a height ofthirty feet, several workers are required toharvest each plant.B. Since tea is exported all over the world, a lotof people are needed to handle the tradecomplications that arise.C. Since tea has been around since prehistorictimes, many workers are employed toprotect it and ensure that it doesn’t die out.D. Since England and China are far away fromeach other, many workers are required tocoordinate tea shipments and deliveries.E. Since the tea plant is hand picked, many 22. The style in the passage is most like thatfound in aA. newspaper articleB. passage in an encyclopediaC. cookbookD. journal entryE. history textbook23. Which of the following is the author most likelyto discuss next?A. The details and aftermath of the Boston T eaPartyB. Other major imports of the United Kingdomand United StatesC. Current trends in tea consumptionD. Other examples of plants that have amedicinal valueE. A description of what China was like inprehistoric times24. The purpose of the second paragraph is toA. describe the role of tea in religiousceremoniesB. explain why Americans prefer coffeeC. discuss historical uses of teaD. describe the cultivation of teaE. question the importance of teaAcupuncture is a type of medical therapy that has been part of Chinese medicine since ancient times. It involves the insertion of thin, solid needles into specific sites on the body’s surface. The belief is that the application of a needle at one particular point produces a specific response at a second point. It is based on the ancient Chinese philosophy that human beings are miniature versions of the universe and that the forces that control nature also control health. These forces are divided between two main principles called the yin and the yang, which have an opposite but complementary effect on each other. For example, one force keeps the body’s temperature from rising too high and the other keeps it from dropping too low. When they are in balance, the body maintains a constant, normal state. Disease occurs when these forces get out of balance.Although acupuncture had been used in Western countries during many periods, it was not until the 1970s that it gained widespread interest, when it was determined that it could be used to control pain during surgery. The mechanism for its effectiveness is still a mystery, but it has become a very popular technique in many countries in the treatment of various diseases and medical problems.30. Which of the following is true about acupuncture?I. Although originally only a part of Chinese medicine, it is now practiced in many Western countries. II. It has been used to control pain during surgery since ancient times.III. The mechanism for its effectiveness was discovered during the 1970s.A. I onlyB. I and II onlyC. I and III onlyD. II and III onlyE. I, II and III31. This passage is primarily aboutA. various diseases that are particularly common among the ChineseB. the meaning and use of the yin and the yangC. different types of medical therapies and their relative effectivenessD. the historical and philosophical background to acupunctureE. modern use of acupuncture both in China and in Western countries32. According to the passage, acupuncture is based onA. the idea that the human body is a model of the universe and is therefore controlled by the forces ofnatureB. a firm belief in the Chinese gods known as the yin and the yangC. an ancient Chinese religious ceremony that involves the insertion of needles into the bodyD. a philosophy of health and disease that originated in China but has been totally changed byWestern countriesE. the ideas of an astronomer who was attempting to study the universe in ancient times33. According to the passage, the yin and the yang are principles that representA. high and low extremes of temperatureB. states of health and diseaseC.。