目的研究红细胞免疫[免疫黏附促进因子(Erythrocyte immune adhesion promoter,FEER)、协同肿瘤红细胞花环率(Erythrocyte synergism with tumor erythrocyte wreath rate,ATER)、直向肿瘤红细胞花环率(Erythrocyte direct to tumor erythrocyte wreath rate,DTER)、红细胞C3b受体花环率(Erythrocyte C3b receptor wreath rate,RBC-C3bR)]与脊柱术后外科伤口感染(Surgical Site Infection,SSI)的关系。方法选取2015年2月-2018年3月河南省人民医院脊柱术后SSI患者64例,为感染组;未发生SSI患者83例,为未感染组;常规例行体检者45名,为对照组。感染组患者分别于入组感染诊断明确时(T0)、感染干预24 h时(T1)、感染干预72 h(T2),发热等临床症状控制、实验室指标恢复正常时(T3)检测感染组患者肿瘤坏死因子(Tumor necrosis factor-α,TNF-α)、红细胞免疫状态(FEER、ATER、DTER、RBC-C3bR)、APACHEⅡ(Acute physiology and chronic health status scoreⅡ)评分;未感染组、对照组仅于入组研究时(T0)检测以上指标水平。结果 T0时,感染组TNF-α水平(162.00±63.00)pg/mL高于未感染组、对照组,未感染组高于对照组(P<0.05);FEER、ATER、DTER、RBC-C3bR水平(46.50±4.00)%、(52.10±3.98)%、(28.40±2.07)%、(14.50±1.06)%低于未感染组、对照组,未感染组低于对照组(P<0.05);T1、T2、T3时,感染组TNF-α水平先升高、后下降,FEER、ATER、DTER、RBC-C3bR水平先下降、后升高(P<0.05);T0、T1、T2时,中重度感染者TNF-α水平分别高于轻度感染者,FEER、ATER、DTER、RBC-C3bR水平低于轻度感染者(P<0.05);Logistic逐步回归模型显示红细胞免疫(FEER、ATER、DTER、RBC-C3bR)是引起脊柱术后SSI的风险因素;且红细胞免疫(FEER、ATER、DTER、RBC-C3bR)分别与TNF-α水平呈负相关关系(P<0.05)。结论红细胞免疫(FEER、ATER、DTER、RBC-C3bR)在机体免疫应答中具有显著价值,是机体重要的防御机制,与脊柱术后SSI发生发展密切相关;加强其水平监测,利于评定脊柱术后SSI发生
卵巢癌是一种常见妇科恶性肿瘤,侵袭性高、隐匿性强、病死率高、易复发,具有高度异质性和复杂性,传统诊治方法存在局限性。近年来,卵巢癌治疗中多学科诊疗(Multi-Disciplinary Treatment, MDT)模式的作用愈加重要,通过MDT团队协作,可以为患者提供更加全面化、个性化的诊疗方案,更能满足患者需求。本文将对近年来MDT模式在卵巢癌中的相关临床研究进行综述,阐述其在卵巢癌诊治中的优势、局限性及未来方向,旨在为临床实践和未来研究提供参考。Ovarian cancer is a common gynecological malignant tumor with high invasiveness, high occult, high mortality, easy recurrence, high heterogeneity and complexity, and traditional diagnosis and treatment methods have limitations. Recently, the role of multidisciplinary treatment in ovarian cancer has become more important, and through multi-disciplinary teams, patients can be provided with a more comprehensive and personalized treatment plan to better meet the needs of patients. This paper will review the relevant clinical research of MDT diagnosis and treatment model in ovarian cancer in recent years, explaining its advantages, limitations and future direction in the diagnosis and treatment of ovarian cancer, aiming to provide reference for clinical practice and future research.
