[摘 要] 过继细胞疗法在肿瘤免疫治疗领域持续革新，其中双特异性抗体武装T细胞/自然杀伤细胞（T/NK细胞）技术通过抗体靶向并桥接免疫细胞，赋予其精准靶向杀伤能力的同时突破传统技术局限，兼具制备标准化程度高、安全性可控及临床转化周期短等核心优势，在实体瘤及血液系统恶性肿瘤治疗中均呈现出突破性临床潜力。本文系统评述嵌合抗原受体基因修饰T淋巴细胞/自然杀伤细胞（CAR-T/NK细胞）、肿瘤浸润淋巴细胞（TIL）和细胞因子诱导的记忆样NK细胞（CIML NK细胞）疗法的研究进展，并重点探讨双特异性抗体武装T/NK细胞技术的作用机制、优势、临床进展及前沿趋势。

Objective To analyze the prevalence of chronic diseases and its influencing factors of dust-exposed male workers in a coal mine. Methods A total of 9 782 dust-exposed male workers from a coal mine in Shanxi Province were selected as the study subjects using the purposive sampling method. Their occupational health examination results were collected to analyze the prevalence of chronic diseases and its influencing factors. Results The prevalence of dyslipidemia, hyperuricemia, hypertension and diabetes were 40.3%, 30.7%, 23.5% and 5.6%, respectively. The prevalence of chronic diseases was 64.8%. Among them, the prevalence of having one, two, three or more chronic diseases were 36.5%, 21.6% and 6.7%, respectively. The prevalence of comorbid chronic diseases was 28.3%, with the highest prevalence of concurrent dyslipidemia and hyperuricemia of 11.0%. The results of binary logistic regression analysis showed that the risk of chronic disease was higher in workers <40 years old, smoking, overweight, obesity and total working years >20 years (all P<0.05). The results of multinomial logistic regression analysis showed that workers <40 years old, overweight, obesity and total working years >20 years were risk factors for having one chronic disease (all P<0.05). The workers <40 years old, smoking, overweight, obesity and total working years >20 years were risk factors for having two chronic diseases (all P<0.05). The workers <40 years old, smoking, alcohol consumption, overweight, obesity, other types of work, and working years >20 years were risk factors for having three or more chronic diseases (all P<0.05). Conclusion The prevalence of chronic diseases is high and the comorbidity of chronic diseases is common among dust-exposed male workers. The main influencing factors were age, smoking, alcohol consumption, overweight, obesity, type of work, and working year. Workers with more contributing factors have higher risk of chronic comorbidities.

Clinical trials are an important method for evaluating the safety and efficacy of in vitro diagnostic reagents, and are a key basis for product registration review and approval. In order to strengthen the management of clinical trials of in vitro diagnostic reagents, the National Medical Products Administration and relevant departments have formulated a series of regulations at the regulatory level, and require applicants and clinical trial institutions to establish a quality management system for clinical trials of in vitro diagnostic reagents. Medical laboratory is the main department and implementer of in vitro diagnostic reagent clinical trials in medical institutions. In recent years, with the rapid development of the in vitro diagnostic industry, the clinical trial projects of in vitro diagnostic reagents conducted by medical laboratory have been increasing day by day. However, there are currently few discussions on the clinical trial of in vitro diagnostic reagents from the perspective of researchers. Therefore, this article summarizes the characteristics of clinical trials of in vitro diagnostic reagents, analyzes the problems and difficulties in conducting clinical trials of in vitro diagnostic reagents in current medical laboratories, and introduces the laboratory′s experience in management; to provide reference for medical testing laboratories that have not yet conducted or have already conducted clinical trials of in vitro diagnostic reagents, in order to improve the quality and efficiency of clinical trials.

Clinical trials are an important method for evaluating the safety and efficacy of in vitro diagnostic reagents, and are a key basis for product registration review and approval. In order to strengthen the management of clinical trials of in vitro diagnostic reagents, the National Medical Products Administration and relevant departments have formulated a series of regulations at the regulatory level, and require applicants and clinical trial institutions to establish a quality management system for clinical trials of in vitro diagnostic reagents. Medical laboratory is the main department and implementer of in vitro diagnostic reagent clinical trials in medical institutions. In recent years, with the rapid development of the in vitro diagnostic industry, the clinical trial projects of in vitro diagnostic reagents conducted by medical laboratory have been increasing day by day. However, there are currently few discussions on the clinical trial of in vitro diagnostic reagents from the perspective of researchers. Therefore, this article summarizes the characteristics of clinical trials of in vitro diagnostic reagents, analyzes the problems and difficulties in conducting clinical trials of in vitro diagnostic reagents in current medical laboratories, and introduces the laboratory′s experience in management; to provide reference for medical testing laboratories that have not yet conducted or have already conducted clinical trials of in vitro diagnostic reagents, in order to improve the quality and efficiency of clinical trials.

Objective: To prospectively compare single-shot (SS) echo-planar imaging (EPI) and field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding (FOCUS MUSE) for diffusion-weighted imaging (DWI) in evaluating thyroid-associated ophthalmopathy (TAO). Materials and Methods: SS EPI and FOCUS MUSE DWIs were obtained from 39 patients with TAO (18 male; mean ± standard deviation: 48.3 ± 13.3 years) and 26 healthy controls (9 male; mean ± standard deviation: 43.0 ± 18.5 years). Two radiologists scored the visual image quality using a 4-point Likert scale. The image quality score, signal-to-noise ratio (SNR), contrast-tonoise ratio (CNR), and apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) were compared between the two DWIs. Differences in the ADC of EOMs were also evaluated. The performance of discriminating active from inactive TAO was assessed using receiver operating characteristic curves. The correlation between ADC and clinical activity score (CAS) was analyzed using Spearman correlation. Results: Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated significantly higher image quality scores (P < 0.001), a higher SNR and CNR on the lateral rectus muscle (LRM) and medial rectus muscle (MRM) (P < 0.05), and a non-significant difference in the ADC of the LRM and MRM. Active TAO showed higher ADC than inactive TAO and healthy controls with both SS EPI and FOCUS MUSE DWIs (P < 0.001). Inactive TAO and healthy controls did not show a significant ADC difference with both DWIs. Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated better discrimination of active from inactive TAO (AUC:0.925 vs. 0.779; P = 0.007). The ADC was significantly correlated with CAS in SS EPI DWI (r = 0.391, P < 0.001) and FOCUS MUSE DWI (r = 0.645, P < 0.001). Conclusion FOCUS MUSE DWI provides better images for evaluating EOMs and better performance in diagnosing active TAO than SS EPI DWI. The application of FOCUS MUSE will facilitate the DWI evaluation of TAO.

Objectives:To study the computed tomography features of banded adhesions(BA) and matted adhesions(MA) of adhesive small bowel obstruction(ASBO).Methods:We enrolled 150 patients operated on for ASBO. According to intraoperated findings, ASBO were classified into those caused by BA or MA. A multivariable logistic regression was established to analyze independent risk factors on Computed Tomography features.Results:There were significant differences in closed-loop sign (36.8% vs. 14.3%, P=0.002) mesenteric haziness (43.7% vs. 17.5%, P=0.001), beak sign (48.3% vs. 17.5%, P<0.001), fat notch sign (39.1% vs. 9.5%, P<0.001) and peritoneal fluid (54.0% vs. 34.9%, P=0.015) between the two groups. The presence of beak sign [ OR=6.15, 95% CI (2.55-14.84), P<0.001], fat notch sign [ OR=6.19, 95% CI (2.16-17.82), P=0.001] and mesenteric haziness [ OR=3.34, 95% CI (1.34-8.32), P=0.009] were independent risk factors with BA. Conclusion:Beak sign, fat notch sign and mesenteric haziness were independent risk factors for diagnosing BA.

OBJECTIVE To explore and establis h a general pharmacist system suitable for China ’s national conditions ，and to improve the rational use of drugs in primary medical institutions . METHODS Under the leadership of Tianhe District Health Bureau of Guangzhou ，relying on the regional pharmaceutical specialty alliance ，general pharmacist system of medical consortium was established ，and the general pharmacist was responsible for the overall planning of pharmaceutical care in the medical consortium. The joint management office of pharmaceutical care was established ，and the training of the pharmacists in the medical consortium was organized. A regional audit center was established to realize the prescription review of 13 community health service centers in the medical consortium. “Internet plus ”home pharmaceutical care was carried out ，and science popularization education was provided for communities ，schools，enterprises and institutions. RESULTS After systematic training and assessment ，three pharmacist teams had been successfully established in the medical consortium to provide prescription review ，science popularization and education and family pharmacist services for community residents ；the regional audit center successfully intercepted 17.17％ of unreasonable prescriptions ，reducing the amount of unreasonable drug use by a total of 6.56 million yuan. After the intervention of prescription review system ，the qualified rate of outpatient prescriptions in community health service centers was ≥95％，and the qualified rate increased by an average of 6％. The department of pharmaceutical science popularization and education held 35 science popularization and free clinic activities ，of which 71.20％ of the residents believed that the activities had improved their understanding of drugs. In addition ，111 cases patients serviced by home pharmaceutical care were carried out successfully by pharmacist team ，and the patients ’acceptance of pharmacist intervention was 91.89％ . CONCLUSIONS Under the new medical reform ，it is feasible to implement a regional general pharmacist system within the medical consortium ， which improves the pharmaceutical administration and pharmaceuticalcare capabilities of m edical institutions in the medical consortium，as well as the level of rational drug use ，and reduces the me dical burden.

OBJECTIVE: To construct a multiple linear regression model of forced expiratory volume in 1 second (FEV1) for estimating FEV1 in special populations unable to receive or uncooperative in pulmonary ventilation function tests. METHODS: The multiple linear regression model of FEV1 was constructed based on the data of 813 individuals undergoing pulmonary function tests in First Affiliated Hospital of Zhejiang Chinese Medical University between September, 2017 and September, 2019, and was validated using the data of another 94 individuals from the same hospital between January and July, 2020. FEV1 of the individuals was measured by pulmonary ventilation function test, and respiratory resistance (Rrs) was measured using forced oscillation technique (FOT). Pearson correlation analysis was used to assess the correlation between the factors, and the model equation was established by multiple stepwise regression analysis. The calculated FEV1 based on the model was compared with the measured FEV1 among both the individuals included for modeling and validation. RESULTS: FEV1 was not significantly correlated with BMI ( CONCLUSIONS The multiple linear regression model for calculating FEV1 constructed in this study is suitable for clinical application.
Adult ; Forced Expiratory Volume ; Humans ; Linear Models ; Lung ; Respiratory Function Tests ; Sex Factors

Objective To analyze the relationship between preoperative serum sodium concentration and preoperative status of liver transplantation recipients and it's effect on early prognosis. Methods Retrospectively collected the clinical data of 281 patients underwent liver transplantation in First Affiliated Hospital of Zhengzhou University from January 2016 to September 2017. According to the preoperative serum sodium concentration, they were divided into hyponatremia group (< 130 mmol/L) 18 patients, normonatremia group (130-145 mmol/L)232 patients and hypernatremia group(> 145 mmol/L) 31 patients. The SPSS 21.0 statistical software was used to analyze the difference of preoperative MELD score, Child-Pugh score, postoperative survival rate and the incidence of graft dysfunction among three groups. Multivariate comparisons of measurement data were performed using analysis of variance. Pairwise comparisons between groups were performed using the LSD-t test. Chi-square tests were used to compare the count data sets. Results The preoperative MELD score was(19.27 ±7.35) scores, Child-Pugh score was(10.39±2.28) scores, serum creatinine concentration was(95.89 ± 49.40) μmol/L in hyponatremia group, the preoperative MELD score was(12.17土8.79) scores(P=0.001), Child-Pugh score was(8.50±2.68) scores (P =0.004) and serum creatinine was(66.07 ±24.13) μmol/L(P <0.05) in normonatremia group, the difference between two groups were statistically significant. There were no significant difference in the length of postoperative ICU stay and postoperative hospital stay among the three groups, there were no significant difference between the 30th and 90th postoperative survival rates and the incidence of graft dysfunction. Conclusions Hyponatremia is an indicator of poor preoperative status in liver transplantation recipients. Preoperative serum sodium concentration has no significant effect on early prognosis of liver transplantation.

Objective To evaluate the impact of different reconstruction parameter setting of knowledge-based iterative model reconstruction (IMR) technique on image quality of low-dose hepatic contrast-enhanced CT.Methods Forty patients underwent hepatic contrast-enhanced CT scanning were enrolled.Plain CT and triphasic contrast-enhanced CT scans,including hepatic arterial phase,portal-venous phase and delayed phase were performed.Low-dose scan was used in delayed phase,with tube voltage of 80 kV and tube current of 150 mAs.Images of delayed phase were reconstructed with both filtered back projection (FBP) and IMR techniques.Parameter setting applied in IMR reconstructions consisted of body routine and body soft tissue modes with three levels (Level 1-3),so 6 subgroups (R1,R2,R3,S1,S2,S3) were included.Subjective and objective evaluations of image quality were compared among those groups.Subjective evaluations included the scores of low contrast detectability (LCD),image distortion (ID) and diagnostic confidence (DC).Objective evaluations included image noise,signal to noise ratio (SNR) and contrast to noise ratio (CNR).Results There were statistical differences of scores in LCD,ID and DC among all the reconstruction parameter setting groups (all P＜0.01).The noise,SNR and CNR among different parameter setting groups had statistically significant differences (all P＜0.01).Except for subgroup S1 and subgroup R2,subgroup S2 and subgroup R3 (all P＞0.05),the other multiple comparisons showed significant differences (all P＜0.01).Conclusion IMR can improve image quality of low-dose hepatic contrast-enhanced CT.IMR reconstruction parameter setting of S1 and R2 are optimal for low-dose hepatic contrast-enhanced CT protocal.