实时心肌造影结合斑点追踪技术评价不同顿抑状态犬心肌微循环与收缩功能变化

目的:应用实时心肌造影技术(RT-MCE)和斑点追踪技术(STI),研究不同顿抑状态心肌的收缩功能和微循环的变化及相互关系,从影像可视化角度探讨顿抑心肌的生物学特征.方法:制作冠状动脉左前降支阻断后再灌注犬心肌顿抑模型,分为短顿抑组(阻断15 min)、长顿抑组(阻断45 min)和假手术组(不阻断),分别于阻断前、再灌注即刻、再灌注10、30、60、90、120 min进行MCE和STI检查.实验结束后,心肌标本行透射电镜检查.结果:再灌注即刻,长顿抑组和短顿抑组缺血心肌的径向应变和A·β均低于基础状态及假手术组,差异具有统计学意义(P＜0.01);随再灌注时间的延长,长顿抑组和短顿抑组缺血心肌A·β值较再灌注即刻时增高;至再灌注后30 min,径向应变峰值进一步降低,再灌注60、90、120 min,径向应变峰值有所恢复.再灌注120 min时缺血心肌A·β值和径向应变峰值仍低于基础状态和假手术组.缺血心肌血流量(Y)与径向应变(X)呈线性关系,可拟合直线方程,其回归方程与相关系数为Y=0.443+49.64X,r=0.80,R2=0.64,P=0.031(长顿抑组);Y=-2.184+65.88X,r=0.78,R2 =0.60,P=0.039(短顿抑组).结论:STI能够反映心肌微循环血流情况.STI结合MCE能反映顿抑心肌生物学特征的动态变化     

超声与CT 联合诊断肾上腺占位病变的价值探讨

目的：探讨超声与C T联合应用诊断肾上腺占位性病变的价值。方法将病理证实的55例肾上腺肿瘤、2例囊肿及超声、C T随访确诊的13例肾上腺血肿,共70例占位性病变的超声与C T联合诊断作回顾性分析,并分别与超声、C T单项检查进行比较。结果70例肾上腺占位病变（嗜铬细胞瘤14例,髓样脂肪瘤13例,皮质腺瘤15例,皮质腺癌5例,淋巴瘤2例,转移性肿瘤6例,囊肿2例,血肿13例）,超声与C T联合应用定性诊断正确率达88．6％,而超声、C T 单项检查定性诊断正确率分别为62．8％、72．9％,联合应用与单项检查比较均有显著差异,与超声单项检查比较（χ2＝12．58,P＜0．05）,与C T单项检查比较（χ2＝5．55,P＜0．05）。结论超声与C T联合应用,可显著提高肾上腺占位性病变定性诊断正确率。     

Effect of Huanshuai Recipe Oral Liquid (缓衰口服液) on Renal Dysfunction Progression in Patients with Atherosclerotic Renal Artery Stenosis

Objective:To investigate the effect of Huanshuai Recipe Oral Liquid(缓衰口服液,HSR) on retarding the progression of renal dysfunction in patients with atherosclerotic renal artery stenosis(ARAS).Methods:A total of 52 ARAS patients with the Chinese medicine(CM) syndrome of qi deficiency and blood stasis,phlegm and dampness retention were recruited and randomly assigned into the treatment group(36 cases) and the control group(16 cases).Both groups received a basic treatment(high-quality low-protein diet,blood pressure control,lipid-lowering,correcting the acidosis,etc.).In addition,the treatment group received 20 mL HSR and the control group received placebo,3 times a day for 6 months.Renal function(serum creatinine,blood urea nitrogen and uric acid) and blood lipids(cholesterol,triglycerides and low density lipoprotein) were examined monthly.The estimated glomerular filtration rate(eGFR) and CM syndrome score were compared between groups.Results:After treatment,compared with the control group,the serum creatinine level,uric acid level and CM syndrome score of the treatment group were significantly decreased(P0.05 or P0.01),and the eGFR in the treatment group were significantly increased(P0.05).Conclusion:HSR can effectively improve the renal function and clinical symptoms of ARAS patients.     

Differential Family Experience of Palliative Sedation Therapy in Specialized Palliative or Critical Care Units

Context

No study has examined the varying family experience of palliative sedation therapy (PST) for terminally ill patients in different settings.

两种术式治疗早期慢性闭角型青光眼的远期疗效

目的：评价激光周边虹膜切除术和小梁切除术在治疗早期慢性闭角型青光眼的远期疗效。
　　方法：对98例102眼早期慢性闭角型青光眼患者,随机分为A组50例54眼行周边虹膜切除术和B组48例48眼行小梁切除术。追踪观察3~8a,比较两组术后视力、眼压、前房角、视野及杯/盘比值的变化情况。
　　结果：A 组视力下降24眼,眼压>21 mmHg (1 mmHg=0.133kPa)者22眼,房角粘连>180°21眼,视野缩小21眼,C/D扩大21眼;B组依次为10眼,5眼,4眼,4眼和4眼,两组比较差异有统计学意义(P<0.05)。
　　结论：早期慢性闭角型青光眼手术治疗,可取得良好的疗效,远期疗效小梁切除术明显优于虹膜周边切除术。     

广东省某地区不同年龄段人群镉负荷水平研究

目的探究广东省某地区不同年龄段人群镉负荷水平,利用基准剂量法评估不同年龄段人群尿NAG及尿β2MG相应的尿镉参考剂量,以此对不同年龄段人群尿镉可接受阈值进行研究。方法对该地区开展基于大样本人群调查的环境流行病学研究,采集当地常住居民的尿液样本,共获得872例(男性375例,女性497例)有效样本。并以我国环境镉污染健康危害区判定标准值为肾功能损害发生临界值,应用BMDS软件对不同年龄段人群进行尿镉基准剂量估算。结果以尿NAG为效应指标的BMDL值为低年龄组4.25μg/g肌酐,高年龄组4.05μg/g肌酐;以尿β2MG为效应指标的BMDL值为低年龄组1.70μg/g肌酐,高年龄组1.58μg/g肌酐。结论在镉污染健康风险评价中,尿β2MG比尿NAG更为敏感,高年龄组人群尿镉可接受阈值低于低年龄组。在长期镉暴露过程中,高年龄组人群可能比低年龄组人群更容易发生肾功能损害。     

Dimethyl fumarate induces necroptosis in colon cancer cells through GSH depletion/ROS increase/MAPKs activation pathway

Background and Purpose

Dimethyl fumarate (DMF) is a newly approved drug for the treatment of relapsing forms of multiple sclerosis and relapsing-remitting multiple sclerosis. Here, we investigated the effects of DMF and its metabolites mono-methylfumarate (MMF and methanol) on different gastrointestinal cancer cell lines and the underlying molecular mechanisms involved.

Experimental Approach

Cell viability was measured by the MTT or CCK8 assay. Protein expressions were measured by Western blot analysis. LDH release, live- and dead-cell staining, intracellular GSH levels, and mitochondrial membrane potential were examined by using commercial kits.

Key Results

DMF but not MMF induced cell necroptosis, as demonstrated by the pharmacological tool necrostatin-1, transmission electron microscopy, LDH and HMGB1 release in CT26 cells. The DMF-induced decrease in cellular GSH levels as well as cell viability and increase in reactive oxygen species (ROS) were inhibited by co-treatment with GSH and N-acetylcysteine (NAC) in CT26 cells. DMF activated JNK, p38 and ERK MAPKs in CT26 cells and JNK, p38 and ERK inhibitors partially reversed the DMF-induced decrease in cell viability. GSH or NAC treatment inhibited DMF-induced JNK, p38, and ERK activation in CT26 cells. DMF but not MMF increased autophagy responses in SGC-7901, HCT116, HT29 and CT26 cancer cells, but autophagy inhibition did not prevent the DMF-induced decrease in cell viability.

Conclusion and Implications

DMF but not its metabolite MMF induced necroptosis in colon cancer cells through a mechanism involving the depletion of GSH, an increase in ROS and activation of MAPKs.     

Do the fragments from decomposed ZIF-8 greatly affect some of the intramolecular proton-transfer of thymine? A quantum chemical study

The intramolecular proton-transfer processes of thymine were investigated by the density functional theory method. It is shown that the mutation from keto (T) to enol (T′) form is affected by zeolitic imidazolate framework-8 (ZIF-8) fragments such as single 2-methylimidazole neutral crystals (M), and negatively charged 2-methylimidazole ligands (M⁻). Results show that with the number (n) of water (w) molecules that assist proton-transfer increasing from 1 to 4, the order of the tautomeric energy barriers (in kcal mol⁻¹) is T-2w (16.3) < T-1w (17.6) < T-3w (17.8) < T-4w (20.5). In the presence of M, the order of energy barrier is MT-2w (16.6) < MT-1w (17.7) < MT-3w (18.9) < MT-4w (20.8). M⁻ has a catalysis effect on the energy barrier and the order is M⁻T-2w (14.4) < M⁻T-3w (15.2) < M⁻T-1w (16.3) < M⁻T-4w (16.8). The attachment of the M⁻ fragment slightly promotes the proton-transfer processes in some instances. The characterization of the proton-transfer processes is helpful to understand the genotoxicity of ZIF-8 during drug delivery applications.

Investigations on whether fragments from decomposed ZIF-8 would affect the intramolecular proton-transfer of thymine by DFT modeling.     

藤草煎治疗脑出血卒中后抑郁39例临床观察

目的探讨藤草煎治疗脑出血后抑郁的疗效。方法选取脑出血合并抑郁患者72例,随机分为对照组和治疗组,对照组给予氟哌噻吨美利曲辛治疗,治疗组给予藤草煎汤剂口服,分别于入选时、治疗3个月时采用神经功能缺损评分(NIHSS)和汉密尔顿抑郁量表(HAMD)进行评价。结果治疗3个月时2组患者NIHSS评分和HAMD评分与治疗前比较均明显降低(P<0.05);治疗组NIHSS评分优于对照组,差异有统计学意义(P<0.05),HAMD评分与对照组比较差异无统计学意义(P>0.05)。结论藤草煎治疗脑出血后抑郁具有明显的临床疗效。