ERK1／2-STAT3通路在H2O2预处理导致的适应性细胞保护中的作用

目的:探讨ERKI/2一STAT3通路在H2O2预处理导致的适应性细胞保护中的作用.方法:在PCI2细胞建立H2O2预处理对抗氧化应激(300 pmot/L H202)损伤细胞的模型.应用Hoechst33258核染色法观察细胞调亡的形态学改变;应用碘化丙啶(P1)染色流式细胞术检测细胞凋亡率;免疫印记法(Western blotting)测定P-ERKI／2和P-STAT3的表达水平.结果:100μmol/L H2O2预处理PCI2细胞90 rain可明显抑制300μmol/LH2O2作用12 h引起的细胞凋亡,并激活ERKl/2和STAT3;ERKI/2抑制剂U0126和JAK2抑制剂AG一490(10μmol/L)均可明显地阻断H2O2预处理引起的细胞保护作用;U0126(10μmol/L)亦能明显地抑制H2O2预处理对STAT3的上调作用.结论:H202预处理能激活PCI2细胞的ERKl/2-STAT3信号转导旁路,这可能是预处理的细胞保护机制之一.     

Morphological study of the tegmental pedunculopontine nucleus, substantia nigra and subthalamic nucleus, and their interconnections in rat organotypic culture

The morphological organization of the tegmental pedunculopontine nucleus, midbrain extrapyramidal area, substantia nigra and subthalamic nucleus and their interrelationships were studied in rat organotypic culture using immunohistochemistry and NADPH-diaphorase histochemistry. Three coronal sections, one containing the tegmental pedunculopontine nucleus/midbrain extrapyramidal area, another with the substantia nigra and the third with the subthalamic nucleus, were obtained from postnatal 1-2-day-old rats. These sections were co-cultured for 3-4 weeks using the roller-tube technique. In the tegmental pedunculopontine nucleus/midbrain extrapyramidal area, the distribution pattern of cholinergic neurons was similar to that found in the in vivo study. We could, therefore, identify the subdivisions of the tegmental pedunculopontine nucleus (i.e., pars compacta and pars dissipata) and the midbrain extrapyramidal area. As in the in vivo situation, glutamate immunoreactive neurons were also located in these areas. Approximately 10% of NADPH-diaphorase positive neurons in the tegmental pedunculopontine nucleus, were glutamate immunoreactive. In the substantia nigra, as in the in vivo, tyrosine hydroxylase immunoreactive (putative dopaminergic) neurons were identified predominantly in the substantia nigra pars compacta, and parvalbumin immunoreactive neurons (putative GABAergic) mainly in the substantia nigra pars reticulata. The subthalamic nucleus was ladened with glutamate immunoreactive neurons. NADPH-diaphorase stained axons originating from the tegmental pedunculopontine nucleus were traced into the substantia nigra and subthalamic nucleus. They were often in close apposition to tyrosine hydroxylase immunoreactive neurons in the substantia nigra. Parvalbumin immunoreactive fibers from the substantia nigra projected heavily to the midbrain extrapyramidal area, but only sparsely to the tegmental pedunculopontine nucleus and the subthalamic nucleus. These findings indicate that the tegmental pedunculopontine nucleus/midbrain extrapyramidal area, substantia nigra and subthalamic nucleus in the organotypic culture have retained a basic morphological organization and connectivity similar to those seen in the in vivo situation. Therefore, this preparation could be a useful model to conduct further studies to investigate functional circuits among the structures represented.     

慢性肾病患者细胞因子测定的临床意义

目的：探讨了慢性肾病患者血清IL-6、IL-8、IL-10和IL-18水平的变化及意义。方法：分别应用放射免疫分析和酶联法对32例慢性肾病患者进行了血清IL-6、IL-8、IL-10和IL-18测定,并与35名正常健康人作比较。结果：慢性肾病患者血清IL-6、IL-8、IL-10和IL-18水平显著地高于正常人组（P〈0.01）,经治疗6个月后与正常人组比较仍有差异（P〈0.05）。结论：检测慢性肾病患者血清IL-6、IL-8、IL-10和IL-18水平的变化对疾病的预后观察具有重要的临床价值。     

Comparison of ethanol versus formalin fixation on preservation of histology and RNA in laser capture microdissected brain tissues

Although RNA can be retrieved from formalin-fixed, paraffin-embedded (FFPE) tissues, the yield is low, and the RNA is fragmented. Recent advances in gene expression profiling underscore the importance of identifying a fixative that preserves histology and mRNA. We demonstrated that, for immersion fixation of brains, 70% ethanol is superior to formalin for mRNA preservation. RNA yield from ethanol-fixed tissues was 70% of the yield from fresh frozen specimens, but only a negligible quantity was recovered from formalin-fixed tissues. RNA from ethanol-fixed brains showed integrity comparable to RNA from fresh frozen tissues, and RT-PCR using RNA from ethanol-fixed tissues was consistently successful. RNA from FFPE tissues composed of low-molecular weight fragments, and their use in RT-PCR failed repeatedly. The yield and quality of RNA from ethanol-fixed brains were unaffected after immersion at 4 degrees C for 2 weeks. In a blinded comparison to FFPE tissues, ethanol-fixed specimens were judged to show comparable histology and superior immunostaining. After laser capture microdissection (LCM), we failed to recover mRNA from FFPE tissues but retrieved mRNA from ethanol-fixed tissues for RT-PCR and cDNA microarray analysis. We conclude that 70% ethanol preserves RNA integrity and is suitable for expression profiling of brain tissues by LCM and cDNA microarray.     

神经肌肉电刺激联合Kegel锻炼在产后盆底功能障碍性疾病中的应用

目的 探讨神经肌肉电刺激联合Kegel锻炼在产后盆底功能障碍性疾病(FPFD)中的应用效果。方法 选择2019年1月—2020年12月本院接诊的90例产后FPFD患者,按随机数字表法分为研究组(45例)与对照组(45例)。对照组行单纯Kegel锻炼,在此基础上,研究组行神经肌肉电刺激干预。比较两组康复效果、盆底Ⅰ类和Ⅱ类肌肌力μV、肌纤维收缩时间、最大阴道内压以及压力性尿失禁、性功能障碍发生率。结果 研究组康复总有效率为95.56%,高于对照组的82.22%,差异有统计学意义(χ2=4.050,P=0.044);两组干预3个月后盆底Ⅰ类肌肌力、Ⅱ类肌肌力、肌纤维收缩时间以及最大阴道内压明显高于干预前,差异有统计学意义(P<0.05),研究组盆底Ⅰ类肌肌力为(4.212±0.351)μV、Ⅱ类肌肌力为(4.983±0.508)μV、Ⅰ类肌肌纤维收缩时间为(4.383±0.456)s、Ⅱ类肌肌纤维收缩时间(4.191±0.494)s、最大阴道内压为(83.282±4.157)cmH2O,高于对照组的(2.023±0.315)μV、(2.314±0.451)μV、(3.264±0.418)s、(3.053±0.412)s、(73.355±4.260)cmH2O,有统计学差异(t=31.421、26.626、12.342、11.970、11.201,P均<0.001);研究组干预后压力性尿失禁发生率为4.44%、性功能障碍发生率为35.56%,低于对照组的22.22%、57.78%,差异有统计学意义(χ2=6.154、4.464,P=0.013、0.035)。结论 神经肌肉电刺激联合Kegel锻炼能够有效增强产后FPFD患者盆底肌力,延长肌纤维。     

柴胡加龙骨牡蛎汤治疗冠状动脉粥样硬化性心脏病合并焦虑抑郁研究进展

冠状动脉粥样硬化性心脏病（CHD）是全球常见的慢性病之一,焦虑和抑郁是其发生不良预后事件的潜在与关键危险因素。柴胡加龙骨牡蛎汤（CLMT）首见于《伤寒论》,为治疗少阳病兼心神逆乱证的经典名方,具备和解少阳、镇惊安神之功效。目前机制研究表明CLMT能通过调控相关信号通路、抑制相关炎症因子表达、改善氧化应激损伤、调节神经递质水平、抑制下丘脑-垂体-肾上腺轴亢进、促进骨髓间充质干细胞动员、抑制血小板活化等多途径对CHD合并焦虑抑郁发挥作用。临床研究表明CLMT对CHD合并焦虑抑郁导致的心绞痛、失眠等症状具有显著改善作用,可有效减轻患者负性情绪、改善中医证候积分、降低炎症因子水平等,且与西医常规治疗相比不良反应少,安全性较高。该文通过归纳整理近15年来中国知网（CNKI）、万方（Wanfang）、维普（VIP）、PubMed等数据库关于CLMT治疗CHD合并焦虑抑郁的文献,对其进行了机制及临床研究的综述,以期为CLMT指导CHD合并焦虑抑郁的进一步研究提供参考。     

3D打印技术在脊柱侧凸矫形中的应用效果分析

目的探讨3D打印技术在脊柱侧凸矫形中的应用效果。方法 76例脊柱侧凸患者随机分为两组各38例。两组均实施后路小切口微创分期术,对照组行常规CT或X线辅助手术治疗,观察组行术前3D打印技术辅助手术治疗。比较两组的手术效果以及并发症。结果观察组的置钉准确率高于对照组,平均置钉时间短于对照组(P <0.05)。术后,观察组的终末融合后侧凸主侧凸冠状位Cobb角低于对照组,初次平均矫正率高于对照组(P <0.05)。两组的并发症发生率无统计学差异(P>0.05)。结论术前应用3D打印技术辅助治疗脊柱侧凸,可有效提升手术效果,更好地恢复脊柱生理弯曲,提高矫形成功率。     

深圳市急性缺血性脑卒中复发的危险因素及风险评估

目的探讨急性缺血性脑卒中(AIS)复发的危险因素及复发风险评估。方法通过调查深圳市某三级医院历史病案数据资料,回顾性研究2011—2017年收治新发住院AIS病例及其复发情况共1779例(年龄≥18岁),基于多因素cox回归模型评估深圳市AIS复发的影响因素。结果高血压(HR=2.862)、饮酒史(HR=1.002)、NIHSS≥4分(HR=2.868)和Essen≥3分(HR=2.997~4.743)是AIS患者复发的高危预测因素(P<0.05)。结论高血压、饮酒史、NIHSS及Essen评分高均是AIS复发的危险因素,尽早对AIS患者进行筛查和强化管理是预防复发的关键。     

菏泽地区新生儿甲基丙二酸血症的 筛查及基因突变分析

目的 分析甲基丙二酸血症(MMA)患儿的临床表型、基因突变类型以及不同类型治疗效果,为该病的产前诊断提供科学依据。方法 利用串联质谱技术对菏泽市2015年5月-2019年12月出生的210 319名新生儿进行筛查,结合尿气相色谱质谱检测及二代测序技术,将确诊的88例患儿分为单纯型MMA患儿和MMA合并同型半胱氨酸血症,进行相应治疗,并采用配对样本t检验对患儿治疗前后进行比较分析。结果 88例MMA患儿中79例为MMA合并同型半胱氨酸血症,9例为单纯型MMA,49例患儿行基因测序,其中MUT基因突变位点13个,包括3个未报道突变:c.389G>A:1963C>T、c.2009G>T、c.1233_1235delCAT;MMACHA基因突变位点20个,包括5个未报道突变:c.481C>T、c.568dupT、c.57delT、c.471G>A、c.IVS2+149C>T。78例MMA合并同型半胱氨酸血症患儿治疗后较治疗前血中丙酰肉碱(C3)值和尿中甲基丙二酸值显著下降,差异有统计学意义(P<0.05)。结论 新生儿遗传代谢病筛查能对MMA早发现、早诊断、早治疗,并降低其死亡率和致残率。基因检测有助于MMA分型诊治,不同基因型的临床表型以及对治疗反应不同。新发突变位点,不仅丰富了我国MMA患儿基因突变谱,而且为先证者家系提供产前诊断。     

HPLC法测定口服5—氨基水杨酸制剂后血浆和尿中的药物及其代谢物

目的建立测定血浆和尿样中5-氨基水杨酸(5-ASA)及代谢物乙酰-5-氨基水杨酸(Ac-5-ASA)浓度的HPLC方法,并进行5-ASA缓释片Pentasa的人体药动学研究.方法使用荧光检测器,以丙酰-4-氨基水杨酸为内标,用衍生化法使样品中的5-ASA丙酰化,甲醇沉淀蛋白后上清液直接进样.色谱柱为PhenomenexLunaTMC18,流动相为0.1mo1/L乙酸溶液乙腈三乙胺(460400.4,V/V/V)的混合液.测定6位健康志愿者口服1000magPentasa后血药浓度和尿药浓度.结果血浆中5-ASA及代谢物的线性范围为0.01～10μg/ml,尿样中为0.2～200μg/ml,血浆和尿中药物与代谢物的回收率在95.3%～106.2%之间,日内日间相对标准差均在052%～9.22%范围内.Pentasa口服后5-ASA和Ac-5-ASA的血药浓度在3～4h内达到峰值,分别为1.55和3.11μg/rl,AUC分别为6.90和26.32μg/(ml@h),60h内尿中排泄了口服剂量37.1%的药物.结论方法简便,灵敏度和准确度高,可用于5-ASA制剂的药物动力学研究.