IL-6 receptor blockade ameliorates diabetic nephropathy via inhibiting inflammasome in mice

Background and ObjectiveInterleukin 6 (IL-6) has been identified as a key mediator in inflammation, immune responses and glucose metabolism. In this study, we assessed the effects of an IL-6 receptor antibody on diabetic nephropathy in a mouse model of type 2 diabetes mellitus.MethodsTwelve week old male db/db mice were treated with Tocilizumab (an IL-6 receptor antibody), normal IgG1 control antibody, insulin or normal saline for 12 weeks. Renal injury, inflammation and insulin resistance were assessed.ResultsDb/db mice treated with Tocilizumab exhibited reduced proteinuria and glomerular mesangial matrix accumulation compared to db/db + IgG controls. Additionally, Tocilizumab suppressed inflammatory response, oxidative stress and the IL-6 signaling pathway in the diabetic kidneys. It is noteworthy that blockade of IL-6 receptor blunted the activation of NLRP3 inflammasome partly through inhibition of IL-17A. Furthermore, insulin resistance assessed by glucose tolerance test, was ameliorated by Tocilizumab treatment.ConclusionsThe protective effects of an IL-6 receptor blockade against diabetic renal injury may be due to decreased insulin resistance and inhibition of the inflammasome.     

宫颈癌术前子宫动脉介入化疗效果的回顾性研究

目的总结并回顾性分析宫颈癌术前行子宫动脉介入化疗的疗效。方法对研究小组2001年1月至2009年12月收治的54例宫颈癌。患者行子宫动脉灌注化疗或化疗配合栓塞治疗,观察其疗效和毒副反应。介入治疗后2~3周行子宫根治术及盆腔淋巴结清扫术。结果 54例患者阴道流血、流液、腰骶部疼痛等症状均明显缓解,术前介入化疗的治疗有效率85.2%,介入治疗后手术率85.2%,3年生存率100%,5年生存率均为96.3%(52/54)。结论宫颈癌术前行子宫动脉介入化疗有助于提高手术切除率,减少复发和转移,提高5年生存率。     

甘露聚糖肽干预慢性自身免疫性荨麻疹的临床受益评价

目的:评价甘露聚糖肽在免疫紊乱性荨麻疹的有效性,探索其在免疫紊乱型荨麻疹免疫调节作用。方法:前瞻性,平行,随机对照试验,将186例自身免疫紊乱荨麻疹分为两组,其中对照组98例采用安慰剂给药(30mg/d),急性期处理应用咪唑斯丁(10mg/d),治疗组口服甘露聚糖肽(30mg/d),其他处理方式与对照组相似。于第四周评价临床疗效及自身抗体水平。结果:甘露聚糖肽组瘙痒评分[(0.9±0.1)vs(2.1±0.5)],风团大小评分[(0.2±0.7)vs(1.0±0.9)],显效率(59.1%vs 34.1%),非常满意率(71.5%vs 26.1%)均优于对照并具有统计学差异(P<0.05或P<0.01)。另外甘露聚糖肽治疗八周后,抗IgE,IgG,抗FcεRIα自身抗体阳性率显著下降,并具有显著的统计学差异(P<0.01)。而对照组无变化。结论:甘露聚糖肽可能通过降低自身抗体提高自身免疫性荨麻疹的临床疗效。     

经尿道精囊镜技术诊治血精的临床研究

目的 探讨经尿道精囊镜技术对顽固性血精的诊断和临床应用价值.方法 筛检2010年6月至2011年7月,对16例顽固性血精患者,年龄22~47岁,平均35.5±5.3岁;病程3~48个月,平均6.6±3.6个月,采用了经尿道精囊镜诊断和治疗.结果 手术全部成功,时间25~45 min,平均30.2±8.4 min,平均随访期为8.3个月(6～12个月),术后随访至今,仅1例精囊炎性出血患者术后3个月血精复发,治疗后半年内没有血精症状出现,视为治愈,本组治愈率为93.75%.结论 经尿道精囊镜检操作简单,创伤小,可作为顽固性血精的有效诊治方法.     

黄斑程序蓝/黄视野检查评估糖尿病性黄斑囊样水肿视功能的研究

目的 探讨黄斑程序蓝/黄视野检查在糖尿病性黄斑囊样水肿(cystoid macular edema,CME)诊断、预后判断及视功能评估中的作用.方法 收集糖尿病视网膜病变(diabetic retinopathy,DR)发生CME患者28例(28眼)(CME组),无CME患者24例(24眼)(NCME组),采用瑞士Octopus101型全自动视野计黄斑程序分别进行白/白视野(white-on-white perimetry,W/WP)和蓝/黄视野(blue-on-yellow perimetry,B/YP)检查,记录视野平均光敏感度(mean sensitivity,MS)值、平均缺损(mean defcct,MD)值等指标.结果 在W/WP检查中,NCME组MS值(26.23±2.71)dB显著大于CME组MS值(23.91±3.37)dB,差异有显著统计学意义(P＜0.01);NCME组MD值(1.99±1.27)dB显著小于CME组MD值(4.33±1.92)dB,差异也有显著统计学意义(P＜0.01).在B/YP检查中,NCME组MS值(20.08±2.16)dB显著大于CME组MS值(15.13±2.24) dB,差异有显著统计学意义(P＜0.01);NCME组MD值(6.63±2.30)dB显著小于CME组MD值(11.59±3.46)dB,差异有显著统计学意义(P＜0.01).W/WP检查MS(r=-0.357,P=0.009)、MD(r=-0.584,P＜0.01),与DR患者有无CME显著相关;B/YP检查MS(r=-0.753,P＜0.01)、MD(r=-0.645,P ＜0.01),也与DR患者有无CME显著相关.结论 视野检查尤其是黄斑程序B/YP是糖尿病性CME临床诊断、视功能评估的方法之一,可以作为DR常规检查项目,有利于CME的早期发现及疗效观察.     

视野与糖尿病视网膜病变相关性的研究

目的研究视野指数与糖尿病视网膜病变（DR）程度的关系,以评估视野在DR诊断和随访中的临床价值。方法将DR患者按照DR的国际新分型分成4组（1期DR为D0组,2期DR为D1组,3期DR为D3组,4期DR为D4组）,采用瑞士Octopus101型全自动视野计,分别对4组患者（共40例40只眼）以及正常对照组（12例12只眼）行白/白视野（W/WP）和蓝/黄视野（B/YP）检查。结果 W/WP检查中,D0组患者的平均光敏感度（MS）和平均缺损（MD）与对照组比较,差异无统计学意义（P〉0.05）;其余各组与对照组比较,差异有统计学意义（P〈0.05）。B/YP检查中,各组患者的MS和MD与对照组比较,差异均有统计学意义（P〈0.05）。W/WP检查与B/YP检查的MD与DR分级呈正相关（r=0.724,P=0.000;r=0.688,P=0.000）,MS与DR分级呈负相关（r=-0.819,P=0.000;r=-0.578,P=0.000）。结论视野缺损与DR程度呈正相关,即视野缺损随着DR程度的增加而增加;蓝/黄视野可提示糖尿病患者早期视功能改变,在DR早期诊断中有一定的临床应用价值。     

疏水性药物昔奈酸沙美特罗纳米粒-微粒系统的研制

目的:制备疏水性药物昔奈酸沙美特罗的纳米粒-微粒给药系统。方法:以壳聚糖为载体材料,采用离子交联法联合喷雾干燥工艺制备昔奈酸沙美特罗纳米粒-微粒给药系统,并考察其体外释药及沉降特性。结果:制得的纳米粒-微粒粉末外观较为圆整、规则,粒径分布主要集中在2～8μm范围内,堆密度和休止角分别为(217.28±1.47)mg/ml和(30.24±0.77)°,粉末流动性较好,包封率和载药量分别为(71.40±2.88)%和(7.67±0.31)%。昔奈酸沙美特罗纳米粒-微粒和昔奈酸沙美特罗原药在体外释放初期均表现出一定的突释效应(2h累积释药百分数达到50%以上),24h达到95%以上,其中昔奈酸沙美特罗纳米粒-微粒的体外释药速度与其原药相比较慢。微粒粉末的有效部位沉积百分比为22.07%。结论:本研究可以成功制得昔奈酸沙美特罗纳米粒-微粒给药系统,其载药量和包封率较高,体外释药可控,可吸入性良好,为进一步的载体修饰奠定了基础。     

Interaction between smoking and CYP2C19*3 polymorphism increased risk of lung cancer in a Chinese population

Cytochrome P450 (CYP) 2C19 is expressed in vascular endothelium and metabolizes arachidonic acid to biologically active epoxyeicosatrienoic acids (EETs), which play a crucial role in either the detoxification or inactivation of potential carcinogens, or the bioactivation of some environmental procarcinogens to reactive DNA-binding metabolites. And smoking is a major risk factor for lung cancer. The purpose of this study is to explore the relationship between the interaction of CYP2C19*3 polymorphism and smoking and lung cancer in a Chinese population. In a Chinese case-control study of lung cancer patients (n?=?420) and healthy controls (n?=?420), we investigated the roles of CYP2C19*3 polymorphism in lung cancer risk using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. We found that the frequency of CYP2C19 ^*3 (AG + AA) genotype was significantly higher in lung cancer patients than that in control subjects (14.28 % versus 4.76 %; P?<?0.001). Multivariable logistic regression analysis showed that after adjustment of other risk factors, the A allele of CYP2C19*3 remains significantly associated with lung cancer. We also found that there was a significant interaction between CYP2C19 ^*3 and smoking in increasing the risk for lung cancer (OR 5.121, 95 % confidence interval [CI] 4.321–10.124; P?=?0.001). The interaction between CYP2C19 ^*3 polymorphism and smoking plays an important role in the mechanism of lung cancer in Chinese population.     

Association study of CACNA1C polymorphisms with large artery atherosclerotic stroke in Chinese Han population

Aims Ischemic stroke (IS) is one of the most common diseases of neurology and the main cause of death and disability in Chinese population. CACNA1C was considered to be involved in the process of atherosclerosis, but there was little information about the association between genotypic polymorphisms of CACNA1C and ischemic stroke. Our study was designed to elucidate the relationship between four single-nucleotide polymorphisms (SNPs) variants in CACNA1C gene and the risk of large-artery atherosclerotic (LAA) stroke patients.

Methods A total of 384 subjects were enrolled in this study, including 192 LAA stroke cases and 192 healthy controls. And four SNPs variants in CNCNA1C gene were genotyped using in-house developed multiplex tagged-amplicon deep sequencing (TAm-Seq). Statistical analysis were conducted using χ2 test and binary logistic regression analysis.

Results We found one variant was significantly associated with LAA stroke in the allele models (rs10848683, p = 0.036, OR = 1.371, 95%CI: 1.021–1.841). And rs10848683 was also found to associate with LAA stroke under recessive model (p = 0.027, OR = 0.618, 95% CI: 0.403–0.947) after adjustment for gender and age. We also found that significant difference existed between haplotypes (rs229961-rs215976-rs216008-rs10848683) and LAA stroke (C-T-C-C, p = 0.017, OR = 2.265, 95%CI: 1.136–4.518; G-C-C-C, p = 0.046, OR = 1.891, 95% CI: 1.003–3.565; C-T-C-T, p = 0.001, OR = 0.256, 95%CI: 0.101–0.645).

Conclusion The results suggested that there was a potential association between CNCNA1C gene and the risk factor of LAA stroke in Chinese Han population.     

慢性肾功能衰竭的中医治疗现状

慢性肾功能衰竭虽然是个不可逆的过程,但只要积极治疗,保证残存肾单位功能正常,就可基本维持稳定的内环境,传统中医中药无论对患者症状的改善和微观病理状态的调节,都有较明显的疗效,从而避免了患者因透析所造成的痛苦和肾移植所带来的家庭负担。