他克莫司的生物信息学分析及其对自闭症谱系障碍的潜在治疗意义

目的：探讨他克莫司对自闭症谱系障碍的潜在治疗作用。方法：从基因表达谱数据库获取他克莫司及自闭症谱系障碍的数据,分别进行差异分析、基因本体学富集分析、京都基因与基因组百科全书富集分析、蛋白质相互作用网络分析并筛选关键基因,将二者的差异基因及KEGG通路进行关联分析,以及利用表观精准治疗预测平台进行药物与疾病关联分析,筛选出与他克莫司相关的疾病、药物及体内作用靶点,并在中文、英文数据库中检索自闭症谱系障碍与关键基因作用的相关文献加以验证。结果：他克莫司组共筛选出差异基因451个,其中基因本体学富集的基因大多参与小分子分解代谢过程、过氧化物酶体基质、黄素腺嘌呤二核苷酸结合、烟酰胺腺嘌呤二核苷酸磷酸结合等过程;京都基因与基因组百科全书通路富集主要和炎症反应、补体和凝血系统、氧化应激、过氧化物酶体增殖物激活受体信号通路、丝裂原活化蛋白激酶信号通路、哺乳动物雷帕霉素靶点信号通路等过程或功能相关。结合表观精准治疗预测平台的计算结果,发现他克莫司对全基因组表达谱的影响复杂,在蛋白质相互作用网络中共得到449个蛋白,筛选出12个关键基因,主要与细胞周期进程、炎症反应、免疫反应等功能相关;他克莫司和自闭症谱系障碍有关联。并验证了关键靶点的有效性。结论：他克莫司对免疫反应、炎症反应、细胞周期等过程或通路具有调控作用,其可能在抑制免疫反应的同时,还具有抑制神经炎症的功能,对自闭症谱系障碍患者有潜在的治疗意义。     

阿米替林合用阿普唑仑治疗抑郁症的观察

目的：了解阿普唑仑合并阿米替林对治疗抑郁症的疗效。方法：将68例抑郁症患随机分为单用阿米替林治疗组及阿米替林合并阿普唑仑治疗组，分别于治疗前及后第1、2、4周末采用汉密顿抑郁量表（HAMD）一不良反应症状量表（TESS）评定两组病例的疗效与副反应。结果：合并阿普唑仑组的抗抑郁疗效优于单用阿米替林组，且见效快。结论：阿米替林合并阿普唑仑治疗抑郁症比单用阿米替林效果更好。     

博乐欣与阿米替林治疗抑郁障碍对照观察

目的：探讨博乐欣与阿米替林对抑郁障碍的疗效及副反应。方法：对５０例抑郁障碍患者应用博乐欣（２５例）与阿米替林（２５例）进行对照治疗,疗程６周。     

万拉法新与阿米替林治疗老年脑卒中后抑郁的疗效对照研究

目的：比较万拉法新与阿米替林对老年脑卒中后抑郁的疗效和副反应。方法：将57例符合脑卒中后抑郁诊断标准的老年患者随机分为两组，分别给予万拉法新与阿米替林治疗6周，采用汉密尔顿抑郁量表（HAMD）、临床总体印象量表（CGI）、不良反应症状量表（TESS）评定疗效和副反应。结果：万拉法新疗效优于阿米替林，且起效快、副反应少而轻微。结论：万拉法新是是值得推荐的治疗老年脑卒中后抑郁的一线药物。     

博乐欣与阿米替林治疗抑郁障碍对照研究

目的:验证博乐欣治疗抑郁症的疗效。方法:采用开放性对照研究方法,观察博乐欣与阿米替林对抑郁症的疗效及不良反应。以汉密尔顿抑郁量表(HAMD)及副反应量表(TESS)评价。结果:博乐欣的疗效和起效时间与阿米替林相当,其抗胆碱能不良反应小于阿米替林。结论:博乐欣对抑郁症的疗效肯定,且治疗依从性好。     

基于网络药理学探究肉桂治疗慢性肾脏病的作用机制

目的:采用网络药理学方法建立"药效成分-疾病靶标-生物学通路"之间的关系,筛选肉桂治疗慢性肾脏病的作用靶点,明确其作用机制。方法:采用中药系统药理学成分分析平台(BATMAN-TCM)数据库获得肉桂的活性化合物,利用PubChem数据库,获取化合物的SMILES结构,将SMILES结构导入SwissTargetPrediction平台,预测活性成分的潜在靶点,再通过GeneCards数据库获得相关化合物靶点,取两者交集得到肉桂作用靶点。通过TTD、DrugBank、OMIM、GAD、DisGeNET数据库获得CKD疾病相关靶点,并与肉桂作用靶点取交集。利用STRING数据库及Cytoscape3.2.1软件构建靶点相互作用网络图,并利用cytoHubba插件的MCC算法筛选关键靶点;基于DAVID数据库对靶点进行GO富集和KEGG富集分析。结果:共得到肉桂活性化合物18个,肉桂-CKD交集靶点29个。经过MCC算法筛选得到关键基因10个,包括雌激素受体alpha、人环加氧酶1、表皮生长因子受体、血管内皮生长因子受体、基质金属蛋白酶9、基质金属蛋白酶2、成纤维细胞生长因子受体1、丝氨酸蛋白酶抑制剂-1、DNA多聚酶B、多药耐药性蛋白1、B细胞淋巴瘤/白血病-2。GO富集共118个结果,主要包括细胞对缺氧的反应、丝裂原活化蛋白激酶活性的正调节、血管生成的正调节、炎症反应、磷脂酶C活性的正调节、蛋白自体磷酸化、对白细胞介素-1的细胞反应、血管内皮生长因子受体信号通路的正调节等。KEGG富集相关通路共51条,包括NF-кB信号通路、PI3K-Akt信号通路、TNF信号通路、Ras信号通路、Rap1信号通路等。结论:通过网络药理学初步预测肉桂在慢性肾脏病治疗中改善糖脂代谢与胰岛素抵抗、抗氧化、抗炎与免疫调节、抗凝、促进成血管生成、改善组织局部血供等潜在作用机制,为下一步研究提供理论依据。     

氟西汀与阿米替林治疗抑郁症的对照研究

目的：比较氟西汀与阿米替林治疗抑郁症的疗效及安全性。方法：用氟西汀和阿米替林对60例抑郁症患者进行为期6周的随机对照试验,采用汉密顿抑郁量表（HAMD）及临床疗效总评量表（CGI-SI）评定疗效,用不良反应量表（TESS）评定不良反应。结果：治疗前后氟西汀组与阿米替林组间HAMD,CGI-SI评分比较,差异均无统计学意义（P〉0.05）。氟西汀组的不良反应发生率明显低于阿米替林组（P〈0.01）。结论：氟西汀治疗抑郁症的疗效同阿米替林相当,不良反应少。     

早期应用小剂量阿米替林干预首发脑卒中患者脑卒中后抑郁

目的:研究和探讨早期小剂量阿米替林对首发脑卒中后抑郁的临床治疗情况。方法:对75例首发脑卒中后抑郁患者,采用小剂量阿米替林给予治疗干预,在连续治疗6周后,通过汉密尔顿抑郁量表对临床效果进行评定。结果:早期应用小剂量阿米替林干预首发脑卒中患者脑卒中后抑郁,有效率达到69.3%。结论:治疗首发脑卒中患者脑卒中后抑郁阿米替林疗效较可靠,可进行推广。     

万拉法新与阿米替林治疗老年脑卒中后抑郁的疗效对照研究

目的:比较万拉法新与阿米替林对老年脑卒中后抑郁的疗效和副反应。方法:将57例符合脑卒中后抑郁诊断标准的老年患者随机分为两组,分别给予万拉法新与阿米替林治疗6周,采用汉密尔顿抑郁量表(HAMD)、临床总体印象量表(CGI)、不良反应症状量表(TESS)评定疗效和副反应。结果:万拉法新疗效优于阿米替林,且起效快、副反应少而轻微。结论:万拉法新是是值得推荐的治疗老年脑卒中后抑郁的一线药物。     

舌鳞状细胞癌关键基因的筛选及其潜在治疗药物的预测

目的 通过生物信息学方法筛选舌鳞状细胞癌的关键基因,并预测其潜在的治疗药物。方法 从GEO数据库中下载GSE34105和GSE13601数据集,并利用limma包筛选DEGs。DAVID数据库对DEGs进行GO及KEGG富集分析。STRING数据库构建PPI网络,并在Cytoscape中进行可视化。“CytoHubba”筛选Hub基因,并利用TCGA数据库、HPA数据库及RT-qPCR进行验证。最后,在Cellminer数据库中筛选Hub基因潜在的治疗药物。结果 共筛选出192个DEGs,其中上调基因84个,下调基因108个。GO富集分析显示,DEGs主要涉免疫反应、细胞外基质分解等生物学过程;KEGG富集分析显示,DEGs主要富集在EMC-受体相互作用信号通路。筛选出IFIT3、OAS2 作为Hub基因。预测出布加替尼、艾沙佐米柠檬酸盐及硼替佐米等19种可能靶向作用于舌鳞状细胞癌的药物。结论 通过生物信息学方法筛选出两个Hub基因,并预测其潜在的治疗药物,为研究舌鳞状细胞癌的分子机制及开发治疗药物提供理论基础。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.