成人Still病诊疗进展

【摘要】 成人Still病是一类病因未明的全身炎症性疾病，临床表现多样，其诊断和治疗存在一定困难。近年来发现，血红素加氧酶1、钙网蛋白、炎症细胞因子、糖基化终末产物等新型标志物可对成人Still病的活动程度和严重程度进行全面评估，而新研发的生物制剂如肿瘤坏死因子抑制剂、白细胞介素1（IL-1）抑制剂、IL-6抑制剂、重组IL-18结合蛋白也有望用于治疗。本文主要综述成人Still病的诊断和治疗进展。     

中药治疗创伤后应激障碍的研究进展

创伤后应激障碍(PTSD)是指突发性、威胁性或灾难性生活事件导致个体延迟出现和长期持续存在的精神障碍,其临床表现以再度体验创伤为特征,并伴有情绪的易激惹和回避行为。PTSD的发生不仅伴随着行为学指标异常,机制研究表明还表现出神经生物学指标异常。PTSD的发生机制研究多集中在神经内分泌系统、中枢神经系统和免疫系统等方面,主要表现为应激激素、促炎细胞因子、神经递质、神经保护因子的水平异常。中药因其具有多靶点、多成分和多途径的特点,在治疗PTSD方面表现出了许多优势。当前研究表明,多种中药能够改善PTSD模型中动物行为异常、逆转神经生物学指标。其中很多中药复方已经应用于临床并且具有很好的疗效,因此中药治疗PTSD具有广阔的应用前景。但是,尚未有PTSD的专属治疗药物,且尚未完全厘清PTSD的机制。故本文对当前中药治疗PTSD的研究进行综述,并且从治疗的中药种类、作用机制、动物模型等角度,重点阐述PTSD的发生与治疗进展,以期为PTSD的治疗提供参考。     

Graph Convolutional Network Based on Manifold Similarity Learning

In the area of large-scale graph data representation and semi-supervised learning, deep graph-based convolutional neural networks have been widely applied. However, typical graph convolutional network (GCN) aggregates information of neighbor nodes based on binary neighborhood similarity (adjacency matrix). It treats all neighbor nodes of one node equally, which does not suppress the influence of dissimilar neighbor nodes. In this paper, we investigate GCN based on similarity matrix instead of adjacency matrix of graph nodes. Gaussian heat kernel similarity in Euclidean space is first adopted, which is named EGCN. Then biologically inspired manifold similarity is trained in reproducing kernel Hilbert space (RKHS), based on which a manifold GCN (named MGCN) is proposed for graph data representation and semi-supervised learning with four different kernel types. The proposed method is evaluated with extensive experiments on four benchmark document citation network datasets. The objective function of manifold similarity learning converges very quickly on different datasets using various kernel functions. Compared with state-of-the-art methods, our method is very competitive in terms of graph node recognition accuracy. In particular, the recognition rates of MGCN (Gaussian kernel) and MGCN (Polynomial Kernel) outperform that of typical GCN about 3.8% on Cora dataset, 3.5% on Citeseer dataset, 1.3% on Pubmed dataset and 4% on Cora_ML dataset, respectively. Although the proposed MGCN is relatively simple and easy to implement, it can discover local manifold structure by manifold similarity learning and suppress the influence of dissimilar neighbor nodes, which shows the effectiveness of the proposed MGCN.

     

基于机器学习的脑胶质瘤多模态影像分析

脑部胶质瘤是临床中常见的一种原发性脑肿瘤，具有复发率高、死亡率高以及治愈率低的特点。常规临床诊断主要依靠计算机断层扫描(CT)和磁共振成像(MRI)检查技术进行鉴别。随着成像技术和机器学习方法的不断发展，多模态影像智能分析技术已经逐步成为研究热点，在脑胶质瘤的病灶分割测量、肿瘤分级、预后生存周期预测和基因型辨别等方面具有重要的应用前景。本文重点介绍基于机器学习和多模态影像在脑胶质瘤临床辅助诊断和预后评估中的应用进展。     

膝骨关节炎患者关节滑液中IL-17水平与疾病严重程度的相关性

目的 探讨膝骨美节炎(KOA)患者美节滑液中IL 17的水平与疾病严重程度的相关性，为临床诊治KOA 提供新思路及新方法。方法 选取2017年1月?2018年12月南充市中心医院康复科收治的15。例膝骨美节炎患者作 为实验组，同时纳入30例健康志愿者作为对照组。实验组釆用视觉模拟量表(VAS)评价膝关节的疼痛程度，采用膝关 节学会评分系统(KSS)评价膝关节的功能及采用Kellgren Lawrence (KL)分级系统评价膝关节X线严重程度，通过 ELISA试验检测两组膝关节滑液中IL17的水平。采用Spearman相关分析KOA患者关节滑液中IL 17水平与膝关节 疼痛程度、膝关节功能及X线严重程度的相关性。结果 实验组关节滑液中IL17的水平明显高于对照组(P <0. 05). IL 17水平在滕美节炎KL分级之间比较，差异无统计学差异(P>0. 05)。IL 17的水平与膝关节VAS评分呈正相关 (P=0. 914,P<0.01),IL 17的水平与KSS呈负相关(P=—0. 847,P<0. 01), IL 17的水平与KL分级无相关性(r = 0.050,P= 0.545)。结论 IL 17可反应膝骨关节炎患者疼痛程度及功能损伤程度，但不能反映疾病的X线严重程度。 IL 17可作为一个生化指标反应膝关节炎疼痛程度及膝关节功能，临床通过减少关节滑液中IL 17,可能会减轻膝骨关 节炎患者的临床症状。     

The Associations of Dietary Inflammatory Potential With Musculoskeletal Health in Chinese Community-Dwelling Older People: The Mr. OS and Ms. OS (Hong Kong) Cohort Study

Inflammation, an important contributory factor of muscle and bone aging, is potentially modulated by diet. This study examined the associations of dietary inflammatory index (DII) score with musculoskeletal parameters and related disease outcomes in 3995 community-dwelling Chinese men and women aged ≥65 years in Hong Kong. DII score at baseline was estimated from a food frequency questionnaire. Bone mineral density (BMD) and muscle mass estimated by dual-energy X-ray absorptiometry (DXA), hand grip strength, gait speed, and chair stand test were measured at baseline, year 4, and year 14. The associations of DII score with the longitudinal changes of musculoskeletal parameters, and incidence of osteoporosis, sarcopenia, and fractures were examined by using general linear model, multinomial logistic regression model, and Cox proportional hazards regression model, respectively. After multiple adjustments, each tertile increase in DII score in men was associated with 0.37 (95% confidence interval [CI], 0.10–0.64) kg loss in grip strength and 0.02 (95% CI, 0.01–0.03) m/s loss in gait speed over 4 years. In men, the highest tertile of DII was associated with a higher risk of incident fractures, with adjusted and competing death adjusted hazard ratio (HR) (95% CI) of 1.56 (1.14–2.14) and 1.40 (1.02–1.91), respectively. In women, DII score was not significantly associated with any muscle-related outcomes or incidence of fracture, but a significant association between higher DII score and risk of osteoporosis at year 14 was observed, with the highest tertile of DII score having adjusted odds ratio (OR) (95% CI) of 1.90 (1.03–3.52). In conclusion, pro-inflammatory diet consumption promoted loss of muscle strength and physical function, and increased risk of fractures in older Chinese men. Pro-inflammatory diets had no significant association with muscle related outcomes but increased the long-term risk of osteoporosis in older Chinese women. © 2022 American Society for Bone and Mineral Research (ASBMR).     

生脉散防治心房纤颤的作用机制及网络药理学分析

目的:基于网络药理学方法探讨生脉散治疗心房纤颤的作用靶点和相关信号通路并探讨其作用机制。方法:运用中药系统药理学成分分析平台(bioinformatics analysis tool for molecular mechanism of TCM,BATMAN-TCM)数据库获取生脉散的化学成分及作用靶标基因,通过GeneCards,OMIM,DisGeNET数据库收集心房纤颤的靶标基因。将两者取交集后得到生脉散-心房纤颤靶基因交集,运用STRING构建蛋白质间相互作用网络,并将结果进行网络可视化展示。将药物-疾病交集基因导入DAVID6.8数据库,进行基因本体(gene ontology,GO)分析和基于京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Geomes,KEGG)通路富集分析。结果:生脉散干预房颤的有效活性成分159个,药物靶点与疾病靶点交集后获得206个共有靶点,PPI蛋白互作网络分析发现AKT1,TP53,PRKACA,IL-1B,TNF,INS,PPAR,RXR,F2,CACAN1C,PKC等是生脉散治疗房颤的核心靶点。GO富集分析确定了175个条目(P0.05),其中生物过程主要心脏传导调节心率、动作电位时膜去极化等;分子功能主要包括电压门控钙通道、类固醇激素受体活性、肾上腺素结合等,在细胞组成方面,主要包括钠、钾、钙通道复合物等。KEGG通路富集分析确定了100条相关信号通路,主要有cGMP/PKG信号通路,cAMP信号通路,血清素能突触,肾素分泌,钙信号通路等。结论:生脉散治疗心房纤颤具有多途径、多靶点作用的特点。该研究初步探讨了其作用的关键靶点及涉及的生物学过程和信号通路,为生脉散治疗心房纤颤后续的实验研究提供一定的参考。     

反复右美托咪定联合丙泊酚麻醉对成年大鼠学习记忆能力的影响

目的观察反复右美托咪定联合丙泊酚麻醉对成年大鼠学习记忆能力的影响。方法选取8周龄SD大鼠40只,雌雄不分,随机分为四组各10只:丙泊酚组(P组),右美托咪定组(D组),右美托咪定联合丙泊酚组(DP组),生理盐水组(NS组)。P组给予30 mg/kg的丙泊酚,D组给予30μg/kg的右美托咪定,DP组给予30 mg/kg的丙泊酚和30μg/kg的右美托咪定,NS组给予等量生理盐水,所有药物均采用尾静脉注射法,每日1次,连续5天,第6天起,选用Morris水迷宫进行行为学实验。结果在定位航行实验中,D组、DP组、NS组与P组比较,前4天的潜伏期差异有统计学意义(P<0.05),其中P组的潜伏期均明显长于DP组、D组、NS组(P<0.05);DP组、NS组与D组比较,前4天的潜伏期差异无统计学意义(P>0.05),且第2、3、4天三组的潜伏期均明显短于第1天(P<0.05);在空间探索实验中,各组间各项数据差异均无统计学意义(P>0.05)。结论右美托咪定对于在镇静剂量下丙泊酚麻醉所导致的成年大鼠的学习记忆功能的短暂损伤具有保护作用。