Risk factors and a simple scoring system for predicting bowel resection in infants with NEC

Background and aimsWe intended to investigate the predictors for bowel resection in infants with necrotizing enterocolitis (NEC). We further developed a scoring system for better predicting bowel resection.MethodsA total of 207 infants who underwent surgical management at Children's Hospital, Chongqing Medical University between April 2008 and December 2020 were identified for the following investigation. Bowel resection was reviewed among the infants who underwent the procedure. Potential parameters related to bowel resection were explored using a multiple logistic regression method, and then a scoring system was developed.ResultsAmong the 207 patients who underwent operative intervention that were reviewed, 109 infants underwent bowel resection. Multivariate logistic regression analysis showed that birth weight, hypotension, neutropenia, pneumoperitoneum, acidosis, and intestinal wall thickness were predictors related to the occurrence of bowel resection. A 6-point scoring system was further developed based on the obtained total coefficient, and the infants could be divided into low-, moderate- and high-risk groups according to cut values of 7 and 13.ConclusionThe results of this study demonstrated that severe NEC features and low birth weight were associated with bowel resection. The risk scoring system could accurately separate infants that were suspected to have bowel loss during surgery.     

Effect of deuteration on the single dose pharmacokinetic properties and postoperative analgesic activity of methadone

Although methadone is effective in the management of acute pain, the complexity of its absorption-distribution-metabolism-excretion profile limits its use as an opioid of choice for perioperative analgesia. Because deuteration is known to improve the pharmacokinetic, pharmacodynamic and toxicological properties of some drugs, here we characterized the single dose pharmacokinetic properties and post-operative analgesic efficacy of d₉-methadone.The pharmacokinetic profiles of d₉-methadone and methadone administered intravenously to CD-1 male mice revealed that deuteration leads to a 5.7- and 4.4-fold increase in the area under the time-concentration curve and maximum concentration in plasma, respectively, as well as reduction in clearance (0.9 ± 0.3 L/h/kg vs 4.7 ± 0.8 L/h/kg). The lower brain-to-plasma ratio of d₉-methadone compared to that of methadone (0.35 ± 0.12 vs 2.05 ± 0.62) suggested that deuteration decreases the transfer of the drug across the blood-brain barrier. The estimated LD₅₀ value for a single intravenous dose of d₉-methadone was 2.1-fold higher than that for methadone. Moreover, d₉-methadone outperformed methadone in the efficacy against postoperative pain by primarily activating peripheral opioid receptors. Collectively, these data suggest that the replacement of three hydrogen atoms in three methyl groups of methadone altered its pharmacokinetic properties, improved safety, and enhanced its analgesic efficacy.     

针刺对肾血管性高血压大鼠的降压效应

目的　探讨针刺对肾血管性高血压大鼠的降压作用及其神经 -内分泌调节机制。方法　采用二肾一夹法制备高血压大鼠模型 ,测定实验各组大鼠血浆内皮素 (ET)、一氧化氮 (NO)含量和心率变异性 (HRV)的动态变化。结果　与模型组相比 ,针刺组血压 (BL 2 3:19.1± 1.1k Pa,ST36:18.1± 2 .5 k Pa)及 ET水平明显下降 (P<0 .0 1) ,其中针刺肾俞组血浆 ET水平 (91.3± 9.45 pg/ ml)较足三里组 (10 8.48± 13.0 6pg/ ml)下降更明显 (P<0 .0 5 ) ;针刺治疗组血浆 NO水平 (BL 2 3:5 0 .3±12 .7μmol/ ml,ST 36:49.71± 8.49μm ol/ m l)显著升高 (P<0 .0 5 )。足三里组针刺后 L F/ HF比值与模型组无明显差异 ,而肾俞组 L F/ HF值 (0 .5 7± 0 .13)明显低于模型组及足三里组 (0 .86± 0 .2 5 )。结论　针刺能降低肾血管性高血压模型大鼠动脉血压 ,肾俞与足三里两穴无明显差异 ,其作用机制可能与自主神经系统、NO及 ET参与的神经内分泌调节作用相关。     

百蕊草药材与标准汤剂量值传递规律研究及分析

目的 建立百蕊草Thesii Herba标准汤剂的UPLC特征图谱及其指标成分的含量测定方法;研究百蕊草药材与标准汤剂特征图谱的变化,并分析指标成分百蕊草素I在药材-标准汤剂的量值传递规律。方法 采用Waters Acquity UPLC BEH Shield RP18色谱柱（150 mm×2.1 mm,1.7μm）,流动相为乙腈-0.2%甲酸水溶液,梯度洗脱,体积流量0.4 mL/min,检测波长330、270 nm,柱温30℃,建立特征图谱与含量测定方法。以出膏率、含量及转移率、特征图谱共有峰传递数为主要评价指标,分析百蕊草标准汤剂的量值传递规律。结果 19批百蕊草药材、标准汤剂与各自的对照特征图谱相似度分别为0.986～1.000、0.989～1.000。百蕊草标准汤剂特征图谱标定6个共有峰,药材中的5个共有峰全部转移至标准汤剂并被指认,其中4个共有峰采用对照品比对确认,分别为5-O-阿魏酰奎宁酸（峰2）、4-O-阿魏酰奎宁酸（峰3）、百蕊草素I（峰5）、山柰酚-3-O-(2″-O-α-鼠李糖基-6″-O-丙二酰基)-β-葡萄糖苷（峰6）。19批标准汤剂的平均出膏率为27.45%...     

超声引导下经皮微波消融治疗恶性胸、腹壁肿瘤

目的 观察超声引导下经皮微波消融（MWA）治疗恶性胸、腹壁肿瘤的效果。方法 对11例恶性胸、腹壁肿瘤患者行超声引导下经皮MWA治疗,共治疗14个病灶,腹壁6个,胸壁8个;术后随访,观察治疗效果及不良反应。结果 11例超声引导下MWA治疗均成功,技术成功率100%。术后1个月8例治疗有效,3例肿瘤残存。2例术后出现局部疼痛,经对症治疗后缓解;1例局部脂肪液化,予局部消毒换药1个月后痊愈。未见气胸、肠道损伤、皮肤烧伤等严重并发症。4例术前合并病灶周围神经痛,术后疼痛得到有效控制。术后随访4~28个月,中位随访时间8个月;期间2例失访、2例死亡;至随访终点7例疗效较好,未见复发及转移。结论 超声引导下经皮MWA治疗恶性胸、腹壁肿瘤安全、有效。     

脾切除术治疗Wilson病合并脾亢患者的血液学改变及临床疗效

目的探索Wilson病（WD）合并脾功能亢进患者血液肝功能等指标与其脾脏大小相关性,及脾脏切除的临床疗效。方法回顾性分析2018年1月至2021年12月在安徽中医药大学神经病学研究所附属医院住院的63例行脾切除术的WD患者的临床资料,并收集行脾切除术前、后的病例资料,采用Spearman相关性分析脾切除前后血液肝功能等指标与脾脏大小相关性。结果采用Spearman相关性分析法得出脾脏厚度与PLT(r=-0.54,P<0.001)呈负相关,与PT(r=0.28,P=0.026)、SOD(r=0.28,P=0.028)、TBA(r=0.30, P=0.017)、TBIL(r=0.36, P=0.004)呈正相关。脾脏长度与PLT(r=-0.37,P=0.003)呈负相关、与TBA(r=0.28,P=0.025)呈正相关。WD患者脾切除后SOD、ALB、PLT水平较术前升高,PT以及TBIL水平较术前下降,差异有统计学意义（P<0.05）。结论脾切除术对WD合并脾亢患者的PLT下降具有改善作用,可部分改善肝脏的解毒、代谢、合成等功能指标,并对改善凝血功能具有积极影响。     

马钱子碱经皮给药对乳腺癌骨转移抑制机制的探讨

目的:探讨马钱子碱经皮给药对乳腺癌骨转移的抑制机制,为乳腺癌的治疗提供新的途径.方法:培养人乳腺癌细胞株MDA-MB-231,取对数生长期细胞制成单细胞悬液.20只雌性Balb/c-nu/nu裸鼠麻醉后,无菌条件下,局部骨内注射乳腺癌单细胞悬液0.2 mL,复制乳腺癌骨转移模型.20只荷瘤裸鼠随机分为马钱子碱高剂量组、中剂量组、低剂量组和模型组4组,分别给予20％(0.2 mg/g)、10％(0.1 mg/g)和5％(0.05 mg/g)浓度的马钱子碱膏(每日总剂量≤腹腔给药的半数致死量)和凡士林经皮给药,涂抹裸鼠的整个腹部和造模的部位,1 g/次,4次/d(每次间隔3 h),连续15 d.影像学观察骨转移情况;RT-PCR检测并比较各组肿瘤组织中,骨转移相关因子VEGF、COX-2和PTHrP的表达量.结果:胫骨的X射线表现,马钱子碱高剂量组和中剂量组的骨质破坏不明显,低剂量组和模型组的骨质破坏明显,甚至出现病理性骨折.RT-PCR结果显示,钱子碱高剂量组VEGF、COX-2和PTHrP mRNA的表达分别为25.30±0.90、20.63±0.73和25.56±0.54,马钱子碱中剂量组分别为24.10±0.73、20.49±0.76和25.74±0.48,马钱子碱低剂量组分别为25.27±0.75、21.02±0.65和25.65±0.44,模型组分别为24.09±0.74、21.14±0.66和25.75±0.39.与模型组比较,马钱子碱各剂量组VEGF、COX-2和PTHrP mRNA的表达量随着马钱子碱剂量的增加逐渐下降,差异均有统计学意义,P＜0.05.结论:马钱子碱经皮给药能抑制裸鼠乳腺癌骨转移瘤的生长,减轻骨损伤,其机制可能是通过调控VEGF、COX-2和PTHrP的表达而抑制乳腺癌骨转移瘤的生长.     

TEC酪氨酸蛋白激酶在肝癌组织中高表达并参与肝癌耐药

目的 研究TEC酪氨酸蛋白激酶在肝癌组织中的表达及其与肝癌耐药之间的关系,为肝癌临床治疗提供线索。方法 Real-time PCR、Western blot及免疫组织化学法检测癌旁、肝癌组织及肝癌细胞系中TEC mRNA、TEC蛋白表达水平;狭线杂交法检测肝癌组织中TEC mRNA表达水平;MTT检测细胞存活率。构建TEC真核表达载体,经脂质体介导法转染肝癌细胞;RNA干扰技术敲低肝癌细胞中TEC。免疫共沉淀技术检测TEC磷酸化活化水平。结果 18例肝癌组织中,TEC mRNA和蛋白水平显著高于癌旁组织（P<0.001）;48例肝癌组织中,TEC高表达组对化疗药物的耐受能力明显高于TEC低表达组;上调TEC表达水平后,HepG2细胞对化疗药物的耐受性增加;用化疗药物处理肝癌细胞株HepG2,其TEC表达水平增加,并伴随有ERK磷酸化水平升高。 结论 TEC在肝癌组织中的高表达促进了肝癌的耐药,且可能与ERK磷酸化水平升高有关。     

天麻道地产区的形成与变迁

天麻在我国已有2 000多年应用历史,为名贵中药材。天麻产地最早的记载为魏晋时期《吴普本草》所述的山东泰山和河南嵩山,并一直以山东泰安及其周边地区为道地产区,但从民国开始天麻产地发生了较大变化,道地产区向西迁移到西南地区。因此该文通过文献考证和实地走访调查,探讨分析了天麻道地产区的形成过程与产地变迁情况,介绍了天麻人工栽培历史和当前主流产地,并从自然、社会、交通、人文和种质资源方面分析了天麻道地产区形成和产地变迁的原因,从而为天麻质量评价和栽培生产研究提供参考。