毛囊性扁平苔藓1例

患者男,60岁。双小腿散在分布红斑和丘疹伴瘙痒1年余。皮肤科情况:双小腿见散在分布绿豆至胡豆大淡紫红色扁平斑块和丘疹,上覆少许鳞屑,部分可见Wickham纹。皮损组织病理示:表皮显著角化过度,毛囊口扩张,毛囊角栓,毛囊漏斗部基底细胞液化变性、颗粒层增厚,其下方真皮层大量淋巴细胞和组织细胞浸润。诊断:毛囊性扁平苔藓。口服阿维A20mg,1次/d。现随访中。     

Two polymorphisms in NEDD4L gene and essential hypertension in Chinese Hans - a population-based case-control study

Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) gene may play an important role in the development of hypertension by regulating the amiloride-sensitive epithelial sodium channel for sodium reabsorption. Recently, a functional polymorphism located at the last nucleotide of exon 1 (rs4149601) of the NEDD4L gene were found to be associated with hypertension both in African Americans and whites, and a "flip-flop" association with hypertension was found in two white samples for a polymorphism located at intron 13 (rs3865418). In this study, we aimed at examining the role of these two variants on essential hypertension in Chinese Hans. In a population-based association study, we observed significantly higher prevalence of T allelic frequencies (p = 0.023) in hypertensives than normotensives. In logistic regression analysis, the stronger association was found under the additive model with an odds ratio of 1.31 (1.04-1.67) for T allele (p = 0.025). The association remained significant (p = 0.039) with an odds ratio of 1.29 (1.01-3.66) when adjusting for age and sex. We also constructed an ANCOVA factorial model by using clinical parameters as the dependent variable for rs3865418 polymorphisms. A significantly higher diastolic blood pressure was observed at rs3865418 in the dominant model for the T allele (p = 0.009). The positive association still exist after controlling age and sex (p = 0.013). For rs4149601 polymorphism, however, we did not observe a positive association with hypertension by implicating either logistic regression models or ANCOVA models. Thus, our results support rs3865418 but not rs4149601 polymorphism of NEDD4L gene implicated in the prevalence of hypertension in Chinese Hans.     

超声评价微泡诱导超声空化联合血凝酶增强兔VX2肝癌微波热消融作用

目的 采用二维灰阶超声、CDFI和CEUS评价微泡诱导超声空化联合血凝酶对兔VX2肝癌微波热消融的增强作用。方法 将32只VX2肝癌荷瘤新西兰大白兔随机分为生理盐水组（空化假辐照+生理盐水）、血凝酶组（空化假辐照+生理盐水+血凝酶）、空化组（超声空化+微泡）和联合组（超声空化+微泡+血凝酶）4组,每组8只,分别给予相应空化治疗后行微波热消融治疗,并在治疗前后分别行二维灰阶超声、CDFI和CEUS检查,观察治疗前后超声表现,测量并比较肿瘤和消融区体积。结果 治疗前4组间肿瘤体积差异无统计学意义（P>0.05）,治疗后4组间消融区体积总体差异有统计学意义（P<0.001）;两两比较,联合组消融区体积大于其他3组（P均<0.05）,空化组消融区体积大于生理盐水组和血凝酶组（P均<0.05）,生理盐水组与血凝酶组体积差异无统计学意义（P>0.05）。治疗前肿瘤均可见丰富血流信号;消融后联合组肿瘤实质内CEUS均未显示增强,生理盐水组、血凝酶组和空化组部分肿瘤实质消融区边缘可见少量残余活性组织,呈典型"快进快出"表现,与CDFI显示的点状血流信号相对应。结论 微泡诱导超声空化联合血凝酶可增强兔VX2肝癌微波热消融效果。     

Receptor for advanced glycation endproduct modulators: a new therapeutic target in Alzheimer’s disease

Introduction: Reduction in the deposition of amyloid β (Aβ) has been the primary target for Alzheimer’s disease (AD) therapeutics recently, but in clinical trials this approach has generally been unsuccessful. A common feature of AD pathology is a complex inflammatory component that could be a target for treatment. One feature of this inflammation has been the involvement of the receptor for advanced glycation endproducts (RAGE), whose ligands include advanced glycation-endproduct-modified proteins as well as lipids and Aβ, which are found at elevated levels in AD brains.

Areas covered: In this article, the authors describe the key features of RAGE and how it could have a role in AD pathogenesis. They also summarize experimental animal and clinical data that demonstrate the therapeutic effect of RAGE inhibition and consider what these findings mean for human disease.

Expert opinion: RAGE has multiple ligands, including Aβ, that are increased in AD brains. Inhibiting RAGE-ligand interactions without activating receptor signaling can reduce multiple pathological pathways relevant for AD. Several RAGE inhibitors and modulators are now being tested as therapeutics for AD. Recent Phase II studies have established the good safety and tolerability of TTP448 with some evidence of positive benefit at lower dose. This suggests that further studies are required.     

Dichorionic twin pregnancy with sirenomelia and chromosomal anomaly in 1 fetus: A case report

Rationale:Sirenomelia is a rare congenital malformation that threatens fetal survivals. The cases in which twin with sirenomelia and chromosomal abnormality have been seldomly reported. We reported a dichorionic twin case in which one twin had sirenomelia, the other twin had a normal phenotype, and they had different chromosomal abnormalities.Patient concerns:The abnormal twin was found at 22 weeks by ultrasound. The sirenomelia fetus was complicated with a thoracic stenosis, enlarged rectum without anal opening, the absence of bilateral kidneys, a single umbilical artery, a single lower limb, the abnormal curvature of spine, double outlet of right ventricle, which were the indicatives of the chromosome detection.Diagnosis:The copy number variation of the sirenomelia fetus was detected as a deletion of 4.8Mb in 11p11.12-11q11. The co-twin was found with del(Y)(q11.223q11.23), which was as the same as his father''s. The mother had normal chromosome. The parents had normal phenotypes. It was firstly reported a microdeletion with sirenomelia fetus.Interventions:There was no specific treatments for the twins.Outcomes:Intrauterine death of the sirenomelia fetus was found at 27 weeks and postnatal death after inevitable abortion happened to the co-twin.Lessons:Prenatal ultrasound was responsible for recognizing sirenomelia, and the detailed ultrasound scanning and chromosome detection should be done for the co-twin. The etiology of sirenomelia remains unclear, and genetic detection is also necessary for its pathogenesis research.     

Evaluation of adalimumab biosimilar candidate (HS016) in Chinese patients with active ankylosing spondylitis based on a health survey: sub-analysis of a phase 3 study

Clinical Rheumatology - The equivalence of the biosimilar HS016 to adalimumab (Humira) for the treatment of active ankylosing spondylitis (AS) patients has been previously validated. The aim was to...     

贵州地区汉族居民糖尿病患病情况及相关危险因素研究

目的 了解贵州地区汉族居民空腹血糖水平,分析糖尿病相关危险因素。方法 采用多阶段整群抽样方法,选取20～80岁汉族居民进行调查。调查内容包括问卷调查、体格检查和实验室检测。比较城乡不同年龄、性别人群空腹血糖水平和糖尿病相关危险因素。结果 共纳入研究对象2 967人,城镇居民空腹血糖平均值高于农村(5.21 mmol/L vs. 5.03 mmol/L,P< 0.001),男性高于女性(5.23 mmol/L vs. 5.09 mmol/L,P=0.003),血糖水平有随年龄增长的趋势(P< 0.001)。城镇居民糖尿病标化患病率为6.01%(粗率7.45%),其中男性显著高于女性(P< 0.001),随年龄增长患病率升高。农村居民标化患病率为3.47%(粗率3.77%),性别差异无统计学意义,随年龄增长患病率升高。相同年龄性别下,≥40岁城镇居民患病率高于农村居民。糖尿病患者中知晓率为56.59%,治疗率为84.47%,控制率为41.38%。多因素分析显示,男性发病风险高于女性、年龄≥40岁发病风险升高、有糖尿病家族史、经常进行身体锻炼、高血压、高甘油三酯者糖尿病的发病风险增加。结论 贵州汉族居民糖尿病患病率较高,城乡患病率差异大,半数以上糖尿病患者治疗后血糖未达到控制水平,糖尿病知晓率、治疗率及控制率仍需进一步提高。     

2012-2014年广东省哨点医院诺如病毒GII.4 Sydney变异株流行状况及暴发疫情特征分析

目的：分析2012年1月至2014年6月广东省哨点医院诺如病毒GII.4 Sydney变异株流行状况,以及由诺如病毒GII.4 Sydney变异株感染引起的暴发疫情特征。方法2012年1月至2014年6月在广东省选取22家医院的门诊科室为监测哨点,将采集的腹泻病例粪便样本（共10750份）送至市级CDC,进行病毒核酸提取及诺如病毒核酸检测,所有阳性样本递送至广东省CDC,并按照随机数字法抽取了855份进行诺如病毒基因分型,共成功测序样本690份。采用χ2检验比较不同年龄组、不同时期内腹泻病例诺如病毒感染情况。通过广东省突发公共卫生事件管理信息系统,收集2012年1月至2014年6月广东省13起由诺如病毒GII.4 Sydney变异株感染引起的社区暴发疫情数据,进行社区流行病学分析。结果2012年8月首次检出诺如病毒GII.4 Sydney变异株,2012年11月检出比例为13/15。2012年11月至2013年1月（T1时期）,各月份中腹泻病例诺如病毒感染阳性率分别为23.8%（100/421）、15.9%（61/383）、19.2%（95/495）,2013年11月至2014年1月（T2时期）,各月份中腹泻病例诺如病毒感染阳性率分别为17.0%（90/529）、8.7%（37/426）、11.2%（46/409）,均低于T1时期（χ2值分别为6.65、9.93、10.74,P值分别为0.010、0.002、0.001）。T1时期内≥15、<15岁组腹泻病例诺如病毒感染阳性率分别为26.3%（143/543）、14.9%（113/756）（χ2=25.90,P<0.001）;T2时期≥15、<15岁组阳性率分别为10.1%（52/516）、14.3%（121/848）（χ2=5.09,P=0.024）。13起暴发疫情中,食源性传播占10/13。结论广东省2012年8月首次检出诺如病毒GII.4 Sydney变异株,2012年11月起呈现社区流行,流行1年后,强度降低;由诺如病毒GII.4 Sydney变异株引起的暴发疫情主要以食源性传播为主。     

EB病毒潜伏膜蛋白LMP2A对人鼻咽癌细胞增殖与迁移特性的影响

目的:制备重组慢病毒载体pLMP2A,并检测其在人鼻咽癌细胞CNE1的表达情况及潜伏膜蛋白2A(latent membrane protein 2A,LMP2A)对人鼻咽癌细胞CNE1增殖?迁移?侵袭的影响?方法:利用DNA重组技术将EB病毒编码的LMP2A基因克隆到慢病毒表达载体plv-GFP中,通过酶切?测序验证,将重组慢病毒载体pLMP2A与包装质粒pdelta-8.91?pVSVG共转染人胚肾上皮细胞株293T,包装重组慢病毒LV-LMP2A,并感染人鼻咽癌细胞CNE1,经单克隆筛选后,用RT-PCR?免疫荧光和Western blot检测LMP2A在人鼻咽癌细胞CNE1的表达,CCK8法检测LMP2A对人鼻咽癌细胞CNE1增殖的影响,划痕实验?Transwell侵袭实验检测LMP2A对人鼻咽癌细胞CNE1迁移和侵袭的影响?结果:酶切及测序结果表明,成功制备了重组慢病毒载体pLMP2A;RT-PCR?Western blot?免疫荧光结果显示筛选出的细胞克隆能高表达EBV-LMP2A,CCK8结果显示LMP2A能促进人鼻咽癌细胞CNE1增殖,划痕实验结果显示LMP2A能促进人鼻咽癌细胞CNE1迁移,Transwell侵袭实验结果显示LMP2A能提高人鼻咽癌细胞CNE1侵袭能力?结论:成功制备了慢病毒载体pLMP2A,包装的慢病毒能够成功感染人鼻咽癌细胞系CNE1,使LMP2A基因得以高表达,并发现LMP2A能够促进人鼻咽癌细胞株CNE1增殖?迁移?侵袭,为进一步探讨EB病毒在鼻咽癌中的发病机制及基因治疗奠定了基础?