[摘 要] 目的：探讨复发/转移性鼻咽癌（NPC）接受含PD-1单抗免疫治疗的临床特征和预后影响因素。方法：回顾性分析2019年3月至2024年7月期间南部战区总医院确诊的95例NPC患者的临床资料和外周血生化及免疫学指标。预后分析采用Kaplan-Meier曲线，组间比较使用Log-rank检验，采用Cox比例风险模型进行单因素和多因素分析。结果：95例患者中男性81例，女性14例，中位年龄49.72岁（16~74岁），Ⅳ期91例（95.79%），所有患者均采用免疫治疗，联合或不联合化疗方案治疗，中位无进展生存期（mPFS）为10.5个月，客观缓解率（ORR）70.53%，疾病控制率（DCR）89.47%，接受含铂治疗方案患者PFS相对更长，且差异有统计学意义。紫杉醇 + 顺铂 + 氟尿嘧啶（TPF）对比吉西他滨 + 顺铂（GP）和紫杉醇 + 顺铂（TP）显示出更长的PFS，但差异无统计学意义。不同PD-1单抗治疗组间的PFS未显示出有统计学意义的差异。单因素及多因素Cox回归分析结果显示，肿瘤复发状态、初始血浆EBV感染状态、治疗周期数、基线外周血SII是复发/转移性NPC患者接受PD-1抑制剂治疗疗效预测的独立相关因素（均P < 0.05），并且非复发患者、初始血浆EBV DNA阳性、接受 ≥ 4治疗周期、基线外周血SII < 772.81的患者接受PD-1抑制剂治疗预后相对更好。结论：在接受PD-1抑制剂治疗的复发/转移性NPC患者中，非复发患者、初始血浆EBV DNA阳性、≥ 4治疗周期且外周血SII < 772.81者PFS相对更长，可早期识别免疫治疗效果不佳患者并精准干预。

Objective: To explore the differential lipid metabolites in the plasma of mice with idiopathic pulmonary fibrosis(IPF). Methods : Thirty SPF C57BL/6 male mice were randomly divided into 2 groups with 15 mice in each group. The experimental groups were divided into control group and bleomycin(BLM) group. The model of idiopathic pulmonary fibrosis was induced by one-time intratracheal infusion of BLM(1 mg/kg). Hematoxylin-eosin(HE) staining was used to observe the lung histopathology. The collagen fiber deposition in lung tissue was observed by Sirius red staining. The differential lipid metabolites in plasma of IPF mice were screened and enriched by lipidomics. Results : HE staining showed that the pulmonary tissue structure was disordered, alveolar septum was broken and alveolar wall was destroyed in BLM group. Sirius red staining showed a large amount of collagen fiber deposition in the lung interstitium of BLM group. The results of lipidomics analysis showed that the lipid metabolism profile of BLM group changed, 15 differential lipid metabolites were screened out, of which 11 differential lipid metabolites were up-regulated, and 4 differential lipid metabolites were down-regulated, mainly concentrated in glycerophosphoglycerophosphates, glycerophosphocholines, steroid lactones, etc. Conclusion The lipid metabolism profile of BLM group mice changes, differential lipid metabolites such as phosphoglycolate phosphatase(PGP)(18:0/18:0), PGP(i-12:0/i-24:0), PGP(i-13:0/a-25:0), and phosphatidylcholine(PC)(18:0/14:0), PC(18:3/16:0), lysophosphatidylcholine(LPC)(16:1), and LPC(18:3) may play an important role in the progression of IPF. These findings provide a new reference for further study of the molecular mechanism of IPF, and also provide a potential new target for clinical treatment.

Objective: To investigate the incidence of road traffic injuries among online deliverymen and its influencing factors, so as to provide insights into prevention of road traffic injuries. Methods: Online deliverymen who were registered on a takeaway platform and delivered within Baotou City, Inner Mongolia Autonomous Region were recruited using a convenience sampling method, and demographic information, delivery work conditions and road traffic injury data were collected through questionnaire surveys from June to September, 2023. Factors affecting the incidence of road traffic injuries were identified by a multivariable logistic regression model. Results: A total of 603 questionnaires were allocated, and 584 were valid, with an effective rate of 96.85%. There were 467 men (79.97%) and 117 women (20.03%), 200 participants at ages of 31-40 years (34.25%), 215 crowdsourcing deliverymen (36.82%) and 510 full-time (87.33%). The incidence of road traffic injuries in the past one year was 14.90%, and 59 injuries were mild (67.82%). The parts of injuries were mainly upper limbs (31.03%) and lower limbs (45.98%). Multivariable logistic regression analysis showed that online deliverymen who did not wear a helmet at work (OR=2.591, 95%CI: 1.354-4.958) and worked as a crowdsourcing deliverymen (OR=2.232, 95%CI: 1.041-4.786) had higher risks of road traffic injuries, while online deliverymen who worked part-time (OR=0.154, 95%CI: 0.034-0.706) had lower risks of road traffic injuries. Conclusions The incidence of road traffic injuries among online deliverymen is associated with post, type of work and wearing helmets or not. The traffic safety education and management should be strengthened among online deliverymen.

Hepatocellular carcinoma(HCC),one of the most prevalent malignant tumors causing the highest mortality globally,imposes an especially heavy burden of disease in China.Individuals living in high-altitude areas have a lower incidence of and mortality resulting from HCC compared with those in low-altitude regions do,potentially due to adaptive evolution in responses to hypoxic stress.Notably,high-altitude hypoxic stress is associated with the development and progression of HCC.Hypoxic stress may be involved in the development and progression of HCC by modulating the senescence,apoptosis,metabolism,tumor microenvironment,and tumor immunity of HCC cells.Additionally,the latest clinical findings indicate that high-altitude hypoxic environment has a significant impact on liver regeneration after HCC resection surgery.However,there is still a debate going on regarding whether high-altitude hypoxic stress promotes or inhibits the progression of HCC.This review covers three main aspects,the impact of adaptive evolution to high-altitude hypoxic stress on the development and progression of HCC in long-term residents of high-altitude areas,the effects of high-altitude hypoxic stress on the senescence,apoptosis,metabolism,tumor microenvironment,tumor metabolism,and tumor immunity of HCC cells,and the effect of high-altitude hypoxic stress on liver regeneration after HCC resection.We discussed the effect of changes in oxygen concentrations,cellular context,and tissue microenvironment on HCC development and progression.Moreover,we highlighted the potential for using research findings on mechanisms underlying high-altitude hypoxic stress to optimize HCC treatment strategies.

Clinical microbiology examination technology experiment is an important part of clinical microbiology examination technology teaching. In the experimental teaching of clinical microbiology examination technology, the virtual simulation technology was combined with traditional teaching to give full play to the advantages of the virtual experimental platform. As to experimental projects that couldn't be carried out in traditional teaching and some important experimental projects, students could learn on the virtual experimental platform, and after learning, they would participate in the corresponding assessment. The perfect combination of the two can solve the problem of high experimental cost and limited experimental content in the current experimental class, make up for the shortcomings of traditional teaching, realize the sharing of teaching resources. Besides, it can strengthen the students' experimental operation skills and enhance the interest of learning for cultivation of application-oriented medical talents.

The new training standards of medical laboratory technology demand the graduates of medical laboratory technology should have the basic scientific research ability and quality. In order to com-plete the teaching work better and achieve the above training objectives, the members of the research group have made some attempts, adopting PBL, CBL and other teaching methods in theoretical teaching, develop-ing open experiments and comprehensive design experiments in experimental teaching, organizing students to study extracurricular undergraduate subject in spare time, in order to provide some basis for the training of students majoring in medical laboratory technology.

OBJECTIVE To explore the immunity-enhancing effect of ABP-AW1, a low-molecular-mass polysaccharides isolated from Agaricus blazei Murill, on immunosuppressive mice. METHODS ICR mice were ip injected cyclophosphamide 80 mg · kg-1, once daily for 3 d, to establish an immuno?suppressive mouse model. Then, ABP-AW1125, 250 and 500 mg · kg-1 were ig given to the immuno?suppressive mice,respectively, once daily for 7 d. The mouse thymus index and spleen index were calcu?lated, and the phagocytic function of phagocytes was determined using carbon clearance test. Splenic lym?phocyte proliferation was measured by MTT method. The interleukin 2 (IL-2) and interferon γ (IFN-γ) production from splenic lymphocytes was examined by ELISA. The splenic lymphocyte CD4+/CD8+ratio was determined by flow cytometric analysis. RESULTS Compared with normal control group, the thymus index, spleen index and phagocytic index of phagocytes in the immunosuppressive model mice declined (P<0.05). ABP-AW1250 and 500 mg·kg-1 treatment significantly increased the thymus index, spleen index and phagocytic index in immunosuppressive mice (P<0.05). Compared with normal control group, concanavalin A (Con A) and lipopolysaccharide (LPS) induced T and B lymphocyte proliferation, respectively, and IL-2 and IFN-γproduction from splenic lymphocytes in the immunosuppressive model mice was lower (P<0.05). Compared with model group, ABP-AW1250 and 500 mg·kg-1 promoted Con A and LPS induced T and B lymphocyte proliferation (P<0.05) , and elevated IL-2 and IFN-γ production from splenic lymphocytes (P<0.05). In addition, ABP-AW1250 and 500 mg·kg-1 reversed the decreased splenocyte CD4+/CD8+ratio in immunosuppressive model mice (P<0.05). CONCLUSION ABP-AW1 has immuneity-enhancing effect on cyclophosphamide-induced immunosuppressive mice.