射频消融术联合无水酒精注射术治疗对老年肝癌的疗效及对肝功能和免疫功能的影响

目的探讨射频消融术(RFA)联合无水酒精注射术(PEIT)治疗老年肝癌的疗效及对患者肝功能、免疫功能的影响。方法选择老年肝癌患者60例,根据接受治疗方式分为实验组及对照组,实验组30例行RFA+PEIT,对照组30例行RFA。对比分析两组完全消融率、一般不良反应,治疗前后肝功能、免疫指标的变化。结果治疗后1个月实验组及对照组完全消融率分别为73. 3%、46. 7%,差异有统计学意义(P0. 05)。两组术后出现发热、腹痛、腹胀、肝区不适等不良反应,持续3～10 d,经内科积极对症治疗,上述症状可缓解,组间比较差异无统计学意义(P0. 05)。两组治疗后1 w谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBIL)较治疗前均明显升高,差异有统计学意义(P0. 05);但经内科对症治疗后1个月AST、ALT、TBIL与治疗前水平差异无统计学意义(P0. 05)。治疗后1个月中性粒细胞/淋巴细胞比值(NLR)较治疗前明显降低,差异有统计学意义(P0. 05);但两组间比较差异无统计学意义(P0. 05)。结论 RFA联合PEIT治疗老年肝癌安全、有效、仅引起短暂的肝脏损伤、明显改善机体免疫抑制状态。     

光照疗法预防ICU患者谵妄的系统评价

目的系统评价光照疗法预防ICU患者谵妄的效果。方法计算机检索中英文数据库关于光照疗法预防ICU患者谵妄的随机对照试验文献,根据纳入和排除标准筛选文献,并进行资料提取和质量评价,使用RevMan5. 3软件进行Meta分析。结果共纳入7项随机对照试验文献。结果显示,光照组谵妄发生率显著低于对照组(P 0. 01),可以改善患者睡眠质量、帮助患者恢复昼夜节律。结论光照疗法对降低ICU患者谵妄发生率,对帮助患者恢复正常昼夜节律、改善睡眠质量方面有一定效果。     

CFP10-ESAT6融合蛋白用于结核分枝杆菌感染诊断ELISA方法的初步研究

目的 制备结核分枝杆菌CFP10-ESAT6融合蛋白,探讨CFP10-ESAT6融合蛋白在结核分枝杆菌免疫诊断中的应用价值。方法 PCR扩增得到CFP-10、ESAT6基因片断,将其先后克隆入pET-28a表达载体。优化表达条件、用镍亲和层析的方法纯化带His标签的重组CFP10-ESAT6融合蛋白(rCFP10-ESAT6)。制备兔多克隆抗体,建立rCFP10-ESAT6为抗原的酶联免疫吸附试验(ELISA)方法,以健康者血清为对照,检测170例结核患者血清的抗体。结果 重组质粒 pET28a-CFP10-ESAT6靶基因测序结果与预计设计完全一致。融合蛋白在E.coli BL21(DE3)工程菌中均为可溶性表达,表达量占菌体总蛋白的40%。利用金属螯合亲和层析直接纯化重组蛋白,纯度达到95%以上。Western blot分析表明,重组蛋白能与结核患者血清发生特异性免疫结合反应,与健康者血清不发生反应。CFP10-ESAT6的兔多克隆抗体的效价为1∶8 000,CFP10-ESAT6作为包被抗原的检测结核病人血清中特异性抗体的间接ELISA最佳包被浓度为0.002 μg/mL,患者血清的最佳稀释度为1∶500。检测结果与临床诊断的符合率,ELISPOT>ELISA(rCFP10-ESAT6)>ELISA(kit)。结论 CFP10-ESAT6融合蛋白具有较高的抗原特异性和免疫反应性,有可能成为结核病免疫学诊断的特异抗原,对结核的诊断具有重要参考价值。     

泽泻醇B抑制C3a介导的人肾小管上皮细胞间充质转分化的实验研究

目的 探讨泽泻醇B能否抑制C3a介导的肾小管上皮细胞间充质转分化(epithelial-mesenchymal transition,EMT)。方法 将体外培养的人肾小管上皮细胞(HK-2)分别用5 ng/mL转化生长因子β(transforming growth factor-β,TGF-β)、0.1 μmol C3a和0.1 μmol C3a加10 μmol泽泻醇B进行干预。分别采用RT-PCR、Western blot和细胞免疫荧光法检测HK-2细胞C3、α-平滑肌肌动蛋白（α-SMA）和上皮钙黏蛋白（E-cadherin） mRNA及蛋白表达。结果 经C3a刺激后,HK-2细胞C3 mRNA和蛋白表达明显增加(P<0.01),α-SMA mRNA及蛋白表达明显增加(P<0.01),E-cadherin mRNA及蛋白表达明显减少(P<0.01)。与经外源性C3a干预组比较,经泽泻醇B干预后,HK-2细胞α-SMA mRNA及蛋白表达明显减少(P<0.01),E-cadherin mRNA及蛋白表达明显增加(P<0.05)。结论 外源性C3a能诱导肾小管上皮细胞发生EMT,泽泻醇B可抑制C3a诱导的EMT。     

玻璃体腔重复注射抗血管内皮生长因子单克隆抗体bevacizumab对糖尿病大鼠视网膜的毒性观察

目的 观察玻璃体腔重复注射抗血管内皮生长因子(VEGF)单克隆抗体bevacizumab(商品名Avastin)对糖尿病大鼠视网膜的毒性作用.方法 40只健康成年雄性Sprague-Dawley大鼠随机分为正常组(A组)和糖尿病组,分别为10、30只.糖尿病组采用链脲佐菌霉素(STZ)尾静脉注射方法制作糖尿病动物模型.随机选取10只作为糖尿病视网膜病变(DR)组(B组),不作任何处理;其余20只大鼠左眼为实验组(C组),玻璃体腔注射25 mg/ml的bevacizumab 3 μ1,共注射3次,每次间隔10 d;右眼为实验对照组(D组),不给予任何处理.末次注射后20 d,采用闪光视网膜电图(F-ERG)对各组大鼠行视网膜功能检测;溴化乙锭(EB)染色视网膜铺片,荧光显微镜观察各组大鼠视网膜血管变化情况;苏木精-伊红(HE)染色,光学显微镜观察大鼠视网膜形态学变化;免疫组织化学染色法观察大鼠视网膜各层Thy-1及VEGF阳性表达情况.结果 F-ERG检测显示,A、B、C、D 4组暗适应a、b波潜伏期,暗适应b波振幅及振荡电位(Ops)总振幅比较,差异均有统计学意义(F=33.165,36.162,19.955,23.243;P值均=0.000);A、B、C、D4组暗适应a波振幅比较,差异无统计学意义(F=0.097,P=0.961).荧光显微镜观察发现,A组大鼠视网膜血管走行良好,B组大鼠视网膜血管走行纡曲、扩张,C组大鼠视网膜血管走形规则、变细,D组大鼠视网膜可见微血管瘤.光学显微镜观察发现,A组大鼠视网膜层次结构整齐分明,B组大鼠视网膜各层细胞结构排列紊乱,C组大鼠视网膜各层细胞排列整齐,D组大鼠视网膜各层细胞排列不整齐.免疫组织化学染色发现,Thy-1阳性表达主要位于神经节细胞层(GCL),极少数位于内丛状层、内核层.VEGF阳性表达主要定位于GCL,少量位于神经纤维层、内核层及视网膜色素上皮层.结论 玻璃体腔重复注射bevacizumab对糖尿病大鼠视网膜有一定毒性作用.

Abstract：

Objective To observe the retinal toxicity of repeated intravitreal injection with bevacizumab(Avastin)in diabetic rats.Methods Forty male Sprague Dawley(SD)rats were randomly divided into normal group(Group A,10 rats)and diabetes mellitus group(30 rats).The rats in diabetes mellitus group were induced with streptozotocin injection for diabetic retinopathy model.And then randomly divided into diabetic retinopathy(DR)group(Group B,10 rats),the rats were not intervened;the left eyes of the other 20 rats were intravitreal injected with bevaeizumab 3 μ1(25 mg/m1)for 3 times as experimental group(Group C);the right eyes of the 20 rats were not intervened as experimental control group(Group D),20 days after last intravitreal injection,retinal function was measured by Flicker Electroretinogram (F-ERG);retinal vascular pattern was determined by fluorescence microscopy of ethidium bromide(EB)stained retinal flat mounts;retinal morphological changes were determined by light microscope on hematoxylin-eosin (HE) stained sections;Thy-1 and VEGF expression was measured by immunohistochemistry staining.Results F-ERG showed that-the differences of a-and b-waves-the b-wave amplitude and the Ops-wave amplitude in the implicit time between group A,B,C and D were significant (F=33.165,36.162,19.955,23.243;P=0.000);the differences of a-wave amplitude between group A,B,C and D was not significant(F=0.097,P=0v961).Retinal blood vessel pattern was normalin Group A;retinal vascular vessels were tortuous and irregularly expanded in Group B:retinal vascular vessels of Group C were regular and thinner than Group A;microaneurysm were showed in Group D.Light microscope displayed that the layers of the rat retina of Group A were regular,the retinal architectures of Group B were irregular,the retinal layers were regular in Group C,the retinal layers were irregular in Group D.Immunohistochemistry staining discovered that Thy-1 and VEGF were mainly expressed in ganglion cell layer(GCL).Conclusion Repeated intravitreal injection of bevacizumab iS toxic tO retina of diabetes mellitus rats.     

玻璃体腔重复注射抗血管内皮生长因子单克隆抗体bevacizumab对糖尿病大鼠视网膜的毒性观察

Objective To observe the retinal toxicity of repeated intravitreal injection with bevacizumab(Avastin)in diabetic rats.Methods Forty male Sprague Dawley(SD)rats were randomly divided into normal group(Group A,10 rats)and diabetes mellitus group(30 rats).The rats in diabetes mellitus group were induced with streptozotocin injection for diabetic retinopathy model.And then randomly divided into diabetic retinopathy(DR)group(Group B,10 rats),the rats were not intervened;the left eyes of the other 20 rats were intravitreal injected with bevaeizumab 3 μ1(25 mg/m1)for 3 times as experimental group(Group C);the right eyes of the 20 rats were not intervened as experimental control group(Group D),20 days after last intravitreal injection,retinal function was measured by Flicker Electroretinogram (F-ERG);retinal vascular pattern was determined by fluorescence microscopy of ethidium bromide(EB)stained retinal flat mounts;retinal morphological changes were determined by light microscope on hematoxylin-eosin (HE) stained sections;Thy-1 and VEGF expression was measured by immunohistochemistry staining.Results F-ERG showed that-the differences of a-and b-waves-the b-wave amplitude and the Ops-wave amplitude in the implicit time between group A,B,C and D were significant (F=33.165,36.162,19.955,23.243;P=0.000);the differences of a-wave amplitude between group A,B,C and D was not significant(F=0.097,P=0v961).Retinal blood vessel pattern was normalin Group A;retinal vascular vessels were tortuous and irregularly expanded in Group B:retinal vascular vessels of Group C were regular and thinner than Group A;microaneurysm were showed in Group D.Light microscope displayed that the layers of the rat retina of Group A were regular,the retinal architectures of Group B were irregular,the retinal layers were regular in Group C,the retinal layers were irregular in Group D.Immunohistochemistry staining discovered that Thy-1 and VEGF were mainly expressed in ganglion cell layer(GCL).Conclusion Repeated intravitreal injection of bevacizumab iS toxic tO retina of diabetes mellitus rats.     

山东省胶东地区居民肠道寄生虫感染及相关认知行为状况调查

目的 目的 了解山东省胶东地区肠道寄生虫感染及相关认知行为现状, 为制定现阶段相应的防治策略提供科学依 据。方法 方法 按照分层抽样法, 选择胶东地区6个县的18个村作为调查点。采用改良加藤厚涂片法 （Kato?Katz） 检测调查点 ≥ 3岁常住居民粪便中的常见肠道寄生虫虫卵, 12岁以下儿童以透明胶纸肛拭法检查蛲虫卵。每调查点随机抽取50户家 庭, 采用结构式问卷调查家庭基本情况及居民寄生虫病防治知识知晓和卫生行为形成情况等。结果 结果 粪检6 163人, 肠道 寄生虫总感染率6.91%, 其中鞭虫、 蛔虫、 钩虫感染率分别为6.56%、 0.62%、 0.21%; 12岁以下儿童蛲虫感染率为0.51%; 未检 测到华支睾吸虫、 带绦虫等其他虫卵。人群寄生虫病防治知识知晓率为49.54%; 饭前洗手、 便后洗手、 生吃瓜果蔬菜洗净、 下地干农活不光脚、 不喝生水等健康行为形成率分别为97.78%、 91.95%、 88.81%、92.42%、 86.48%。结论 结论 胶东地区人群 肠道寄生虫感染水平较低, 但地区间差异较大; 寄生虫病防治知识知晓率不高, 但卫生行为形成情况较好。应加强健康教 育及重点人群服药, 积极推进农村改水改厕工程, 尽快降低肠道寄生虫病的危害。     

准分子激光原位角膜磨镶术术后早期应用卡替洛尔滴眼液对屈光状态的影响

目的 评估准分子激光原位角膜磨镶术（LASIK）术后早期应用盐酸卡替洛尔滴眼液对屈光状态及眼压的影响。 设计 前瞻性比较性病例系列。研究对象 2009年11月-2011年9月北京同仁医院行LASIK手术的近视患者32例（32眼）。 方法 试验组15眼LASIK术后第1周开始使用2%盐酸卡替洛尔滴眼液每日2次,低中度近视患者持续1个月,高度近视患者持续1.5个月。对照组17眼术后不使用2%盐酸卡替洛尔滴眼液。术前、术后1、3、6个月进行显然验光、Oculyzer眼前节测量系统、眼压等检查。主要指标 等效球镜度、角膜后表面高度、眼压。结果 试验组术后1、3、6个月时等效球镜度分别为（-0.150±0.742）、（-0.170±0.595）和（-0.525±0.618）D;对照组分别为（-0.258±0.581）、（-0.290±0.657）和（-0.459±0.591）D（P均＞0.05）。试验组术后1、3、6个月时角膜后表面高度分别为（7.47±2.326）、（6.60±3.158）和（5.86±2.610）μm;对照组分别为（6.59±3.355）、（7.35±3.622）和（7.33±2.992）μm（P均＞0.05）。试验组术后1、3、6个月眼压分别为（7.80±0.941）、（8.07±1.534）、（8.70±1.337） mm Hg;对照组分别为（9.35±2.827）、（9.59±2.717）、（8.73±1.580）mm Hg。术后1个月时试验组和对照组眼压有统计学差异（P=0.045）,余时间点均无统计学差异。结论 LASIK术后早期应用盐酸卡替洛尔滴眼液通过降低眼压可能对屈光状态具有稳定作用。（眼科,2013,22：49-52）     

透骨消痛胶囊含药血清对软骨细胞外基质表达的影响**◆

背景：软骨细胞代谢异常引起细胞外基质降解和修复失衡是骨性关节炎的重要病理变化。透骨消痛胶囊具有补肾柔肝、活血祛风的功效,临床实验证实其对防治骨性关节炎有较好疗效。 目的：观察透骨消痛胶囊含药血清对软骨细胞外基质表达的影响。 方法：取SD大鼠膝关节软骨建立体外培养的软骨细胞,第3代软骨细胞同步化后进行干预。50只SD大鼠抽签法随机分为5组,用药量按照人体与动物药物等效剂量换算,空白组：生理盐水进行灌胃;对照组：壮骨关节丸水溶液灌胃;实验组：透骨消痛胶囊水溶液按0.145,0.290,0.580 mg/(g•d)进行灌胃。各组均连续给药3 d,采血前禁食12 h,末次给药1 h后腹主动脉采血,制备血清。 结果与结论：Ⅱ型胶原免疫组织化学染色可见透骨消痛胶囊实验组Ⅱ型胶原表达强于空白组及对照组;透骨消痛胶囊实验组CollagenⅡ、蛋白聚糖、Aggrecan mRNA基因表达明显升高(P < 0.01),Cathepsin K mRNA基因表达明显降低(P < 0.01)。提示透骨消痛胶囊含药血清能上调软骨细胞CollagenⅡ、蛋白聚糖、Aggrecan mRNA基因表达,下调Cathepsin K mRNA基因表达,促进细胞外基质合成,调控细胞外基质和软骨细胞之间的动态平衡。关键词：透骨消痛胶囊;骨性关节炎;含药血清;软骨细胞;细胞外基质 doi:10.3969/j.issn.1673-8225.2012.21.004