基于网络药理学和实验验证研究柴胡疏肝散治疗慢性萎缩性胃炎的作用机制＊

目的 通过网络药理学的方法进行预测，再深一步进行动物实验验证来研究柴胡疏肝散治疗CAG的作用机制。方法 首先在TCMSP数据库中检索柴胡疏肝散的所有活性成分与药物靶点；通过收集PharmGkb、OMIM、GeneCards和DrugBank数据库中收录的慢性萎缩性胃炎的相关靶点。将药物靶点与疾病靶点进行映射筛选出交集靶点，将得到的交集靶点构建PPI网络与活性成分-共同靶点网络，并对其进行GO和KEGG富集分析。最后利用Vina软件进行分子对接实验验证，并通过免疫印迹法验证柴胡疏肝散对两种受体蛋白EGFR和STAT1的影响。结果 最终筛选得到柴胡疏肝散活性成分104个，潜在靶点238个，与慢性萎缩性胃炎的交集靶点52个；GO与KEGG富集分析分别得到2166条目和148条目，主要涉及到JAK-STAT信号通路、TNF信号通路、HIF-1信号通路等；分子对接结果显示EGFR、STAT1两个靶点能够与核心活性成分能够自发结合成较为稳定的构像；免疫印迹法实验证明柴胡疏肝散能够降低大鼠胃黏膜组织EGFR和STAT1蛋白表达。结论 通过网络药理学和实验验证，发现柴胡疏肝散可能通过调节EGFR和STAT1蛋白表达来共同调控胃黏膜细胞增殖与凋亡，进而发挥着治疗慢性萎缩性胃炎的效果，为深入进行柴胡疏肝散治疗慢性萎缩性胃炎的作用机制研究提供新思路和新方法。     

Clinical Study on CT-guided Modified Akupotomye in the Treatment of Lumbar Nerve Posterior Branch Compression

Objective: To observe the clinical effect of modified akupotomye closed lysis under CT guidance on compression of posterior lumbar nerve branch.Methods: Patients were diagnosed by HRCT 3-D reconstruction combined with clinical symptoms and signs.After HRCT three-dimensional reconstruction combined with clinical symptoms and signs, the patients were confirmed as posterior lumbar nerve compression.After CT accurate surface positioning, CT-guided modified akupotomye was used for closed lysis of the posterior lumbar nerve branch.Oswestry Dysfunction Index Questionnaire(ODI) was used for quantitative scoring, 7 days before and after treatment and 6 months after treatment.Results: In 62 cases, 20 cases were cured, with 25 cases markedly effective, 11 cases effective, and 36 cases ineffective.The total effective rate was 90.3%.ODI score: Self-paired t test 7 days before after treatment, P < 0.01;Before treatment and 6 months after treatment, self-paired t test(P < 0.01);Self-paired t-test was performed 7 days after treatment and 6 months after treatment(P > 0.05).Conclusion: With CT precise positioning, the modified akupotomye can be used to do closed lysis, to relieve the adhesion and compression, so that the low back pain can be relieved, with good clinical.The akupotomye closed lysis, combined with modern imaging technology has not only achieved good clinical effect, but also can improve the accuracy, safety and scientificity of akupotomye treatment.     

放射治疗记录与验证系统质量控制指南

放疗记录与验证系统(RVS)是一套用于防止医用电子加速器等放疗设备治疗参数设置错误,并且记录所有放疗阶段执行参数的医用计算机软件控制系统。为确保患者的治疗安全,必须对记录与验证系统采取必要的质量控制措施。本指南内容涉及:RVS安装和参数设定过程中的质量控制;RVS的验收测试;RVS在临床使用过程中的持续质量控制;使用RVS过程中的典型错误类型;执行RVS验收测试的具体测试例。     

Three-dimensional measurement of radiographic bone–implant contact lengths of zygomatic implants in zygomatic bone: a retrospective study of 66 implants in 28 patients

Zygomatic implant treatment is widely applied for severe maxillary atrophy to help rehabilitate the maxillary dentition. This retrospective study was performed to evaluate the actual radiographic bone–implant contact (rBIC) lengths of zygomatic implants. The records of 28 patients who underwent zygomatic implant surgery and subsequent follow-up examinations between August 2013 and September 2018 in the Department of Oral and Maxillofacial Surgery, Taipei Tzu Chi Hospital were reviewed. The surgeries were performed by a single surgeon using the same treatment protocol. All patients had a computed tomography scan at 1 year after the surgery. Using three-dimensional imaging software, an investigator measured the rBIC lengths of 66 implants and documented their clinical status. The implant survival rate was 100%. The mean rBIC length was significantly longer in male patients than in female patients (20.80 ± 5.88 mm versus 17.79 ± 6.34 mm; P = 0.028). The mean rBIC length of double zygomatic implants was significantly longer when compared to that of single implants (21.11 ± 6.23 mm versus 17.75 ± 5.85 mm; P = 0.027). This article is novel in reporting the exact rBIC lengths of zygomatic implants in a clinical setting. The results showed that zygomatic implants are a viable treatment modality for full-mouth rehabilitation.     

尿液10项肾损伤标志物检测试剂的性能评价

摘要:目的对尿液 10项肾损伤标志物检测试剂进行性能评价,并评估其临床适用性。方法对北京利德曼公司尿液a1 微球蛋白(u-a|MG)、总蛋白(u-TP)、免疫球蛋白G(u-IgG) 、微量清蛋白(u-Alb)、中性粒细胞明胶酶相关脂质运载蛋白(u-NGAL)、半胱氨酸蛋白酶抑制剂C(u-CysC).视黄醇结合蛋白(u-RBP)、β2微球蛋白(u-β2MG)、N-乙酰-β-D-氨基葡萄糖苷酶(u-NAG).、转铁蛋白(u-Trf)检测试剂盒进行性能评价。正确度和精密度验证参考美国临床和实验室标准协会(CLSI)EP15-A3,验证物质采用ERM-DA470k、ERM-DA471、B2M-NIBSC等参考物质及纯度物质;线性验证参考CLSI EP06;抗干扰能力参考CISI EP07;不同检测系统间比对参考CISI EP09。结果正确度方面,10 项标志物检测试剂测定标准物质在低值、中值、高值的偏倚分别为-2.69% ~4.67%、-3.60% ~3.33% .-2.38% ~3.02%;不精密度方面,重复性以不精密度表示,在低值和高值处分别为1.90%~5.43%、0.63% ~2.42%,室内不精密度为2.27%~5.63%、1.09%~3.41%,均满足临床要求;10项尿液标志物线性范围在0.06~4.40 mg/L至21.83~2 146.77 mg/L之间。抗干扰方面,u-1 MG、u-Alb、u-β2MG、u-Trf 、u-CysC、u-NAG分别在血红蛋白终浓度≤8 g/L、≤8 g/L、≤4 g/L、≤4 g/L、≤2g/L、≤1 g/L时,未受到明显干扰(百分偏差≤+ 10%) ,而u-TP、u-IgG、 u-RBP、u-NGAL在血红蛋白终浓度≥0.125 g/L时即受干扰。不同检测系统间偏差超出临床允许范围。结论尿液 10项肾损伤标志物的正确度、精密度、线性范围和抗血红蛋白干扰能力满足临床需要,不同检测系统间标志物测量结果可比性欠佳。     

ArcCHECK系统在食管癌螺旋断层放疗计划验证中的应用

目的 探讨ArcCHECK系统在食管癌断层治疗旋转照射和固定野照射计划验证中的应用,总结相关经验。方法 对32例不同部位食管癌分别制作Helical旋转照射和Direct固定野照射验证计划,并通过ArcCHECK测量、分析,对比验证结果通过率。分析靶体积与计划验证通过率的相关性。将靶体积较小的治疗验证计划分别放在ArcCHECK模体中心和外周探测点处,分析验证通过率差异。结果 Helical计划验证通过率高于Direct计划(P<0.01),其靶体积与验证通过率的相关系数分别为-0.364和-0.042,P值分别为0.041和0.819。Helical计划采用3%/2mm标准时,高剂量区放在模体中心和外周探测点处测得的通过率不同(P=0.005),后者通过率更高;采用3%/3mm标准时与Direct计划的3%/3m、3%/2mm标准的相近(P均>0.05)。结论 Helical计划验证通过率普遍高于Direct计划,原因可能与ArcCHECK探测器的角度响应以及因更多参考点受到低剂量辐射而未参与计算有关,另外还可能跟Direct计划对断层治疗剂量控制系统要求更高有关。在Helical验证计划中,当采用3%/3mm标准时,靶体积越大,验证时出现较低通过率的可能性增加,但相关系数较低。验证计划的高剂量区位于模体中心或者探测点处都可以实现计划验证,综合考量建议放在模体等中心处。     

颈前入路相关结构三维可视化研究

目的：建立颈前入路相关结构的三维可视化模型。方法：选取首例中国数字化可视人体数据集中第3颈椎上缘至第7颈椎下缘的连续薄层断面图像。运用3D—DOCTOR软件，在计算机上分割重建该手术入路相关的解剖结构并立体显示。结果：成功重建并立体显示第3～7颈椎、椎间盘、脊髓、颈神经、椎动脉、颈长肌、喉（气管）、咽（食管）、颈总动脉（颈内、外动脉）、颈内静脉、迷走神经和胸锁乳突肌等解剖结构的位置关系，建立了颈前入路相关结构的三维可视化模型。结论：在颈部三维可视化模型基础上，参照颈前入路手术步骤可逐层显示该手术相关的重要结构．为该手术的术前训练和模拟提供形态学依据。