大黄素甲醚对大鼠脑缺血再灌注损伤的拮抗作用

目的：探讨大黄素甲醚对脑缺血再灌注后IL-1β含量和ICAM-1及caspase-3表达的影响。 方法： 91只SD大鼠随机分为正常组（normal），假手术组（sham），模型组（model），大黄素甲醚大剂量（PHD）及小剂量(PLD)组。采用线栓法复制大鼠右侧大脑中动脉脑缺血再灌注模型，用放射免疫法测定病变侧脑组织IL-1β的含量，用免疫组织化学方法测定ICAM-1和caspase-3表达的变化，并进行组织病理学观察。 结果： Model组再灌注6 h病变侧IL-1β含量明显升高且达高峰，再灌注24 h病变侧ICAM-1、caspase-3表达明显升高，中性粒细胞附壁浸润明显；大黄素甲醚PHD组再灌注12 h、24 h病变侧IL-1β、ICAM-1和caspase-3表达明显低于model组相应时段(P<0.05或P<0.01)，中性粒细胞附壁浸润较少。 结论： 大黄素甲醚可降低脑缺血再灌注后IL-1β、ICAM-1和caspase-3水平，减轻脑缺血再灌注损伤。     

调和营卫法联合戊酸雌二醇片对围绝经期综合征的临床疗效及对性激素水平的影响

目的 观察调和营卫法对围绝经期综合征的治疗效果,并分析性激素水平的变化.方法 采用随机数字表法将2016年11月至2017年12月在南充市中心医院就诊符合纳排标准的60例围绝经期综合征分成两组(n=30):对照组采用常规戊酸雌二醇片每天1次,每次2 mg,晚餐后半小时口服;研究组在对照组的基础上采用桂枝汤加减方每天1剂,水煎分3次口服治疗.均连续用药3个月.比较两组治疗后临床症状改善总有效率、Kupperman评分、血清促卵泡激素(FSH)、雌二醇和促黄体素的水平变化.同时观察两组病人不良反应及肝肾功能变化.结果 两组按疗程治疗后,研究组临床症状改善总有效率96.7％明显高于对照组76.7％(P=0.023).与治疗前相比,治疗后两组Kupperman评分显著下降(P<0.05),研究组明显低于对照组.与治疗前相比,治疗后两组血清雌二醇浓度明显增高,血清促卵泡激素、促黄体素明显降低(P<0.05),但两组之间差异无统计学意义(P>0.05).结论 调和营卫法联合戊酸雌二醇片治疗围绝经期综合征,可提高病人临床疗效及改善血清性激素水平.     

Cell-derived biomimetic nanocarriers for targeted cancer therapy: cell membranes and extracellular vesicles

Nanotechnology provides synthetic carriers for cancer drug delivery that protect cargos from degradation, control drug release and increase local accumulation at tumors. However, these non-natural vehicles display poor tumor targeting and potential toxicity and are eliminated by the immune system. Recently, biomimetic nanocarriers have been widely developed based on the concept of ‘mimicking nature.’ Among them, cell-derived biomimetic vehicles have become the focus of bionics research because of their multiple natural functions, such as low immunogenicity, long circulation time and targeting ability. Cell membrane-coated carriers and extracellular vesicles are two widely used cell-based biomimetic materials. Here, this review summarizes the latest progress in the application of these two biomimetic carriers in targeted cancer therapy. Their properties and performance are compared, and their future challenges and development prospects are discussed.     

推拿疗法辅助治疗小儿神经性尿频脾肾气虚型37例临床观察

目的观察济生肾气丸联合推拿疗法治疗小儿神经性尿频脾肾气虚型的临床疗效。方法选取2018年9月至2019年10月于浙江中医药大学附属温州中西医结合医院推拿科就诊的神经性尿频脾肾气虚型患儿80例,按随机数字表法分为对照组和治疗组,各40例。治疗期间,对照组脱落1例,治疗组脱落3例,最终实际完成76例(对照组39例,治疗组37例)。对照组给予济生肾气丸小蜜丸口服,治疗组在对照组治疗方法的基础上给予推拿疗法,2组均连续治疗14 d后统计疗效。结果对照组总有效率为76.9%(30/39),治疗组为97.3%(36/37),2组比较,差异有统计学意义(P<0.05)。2组在治疗过程中均未见不良反应发生。结论济生肾气丸联合推拿疗法治疗小儿神经性尿频脾肾气虚型疗效显著,且无明显不良反应,值得临床推广应用。     

Clinical study on effect of Chinese herbal medicine for supplementing kidney and Qi and activating blood circulation in treating intrauterine growth retardation of fetus

Ｉｎｔｒａｕｔｅｒｉｎｅｇｒｏｗｔｈｒｅｔａｒｄａｔｉｏｎ（ＩＵＧＲ）ｏｆｆｅｔｕｓｉｓｏｎｅｏｆｔｈｅｍａｉｎｃａｕｓｅｓｏｆｐｅｒｉｎａｔａｌｍｏｒｔａｌｉｔｙａｎｄｍｏｒｂｉｄｉｔｙ．ＴｈｅｐｒｅｖｅｎｔｉｏｎａｎｄｔｒｅａｔｍｅｎｔｏｆＩＵＧＲｉｓａｎｉｍｐｏｒｔａｎｔｓｕｂｊｅｃｔｉｎｔｈｅｆｉｅｌｄｏｆｐｅｒｉｎａｔｏｌｏｇｙ．ＩｎＣｈｉｎａ,ｔｒｅａｔｍｅｎｔｏｆｔｒａｄｉｔｉｏｎａｌＣｈｉｎｅｓｅｍｅｄｉｃｉｎｅ（ＴＣＭ）ｂａｓｅｄｏｎＳｙｎｄｒｏｍｅＤｉｆｆｅｒｅｎｔｉａｔｉｏ…     

Study on molecular mechanism of liver yang ascending syndrome in hypertension

ＬｉｖｅｒＹａｎｇＡｓｃｅｎｄｉｎｇＳｙｎｄｒｏｍｅ（ＬＹＡＳ）ｉｓｔｈｅｐｒｉｎｃｉｐａｌＳｙｎｄｒｏｍｅ ｔｙｐｅｏｆＬｉｖｅｒｄｉｓｏｒｄｅｒｉｎＴＣＭ,ｍｏｓｔｌｙｓｅｅｎｉｎｈｙｐｅｒｔｅｎｓｉｏｎ,（1）ａｎｄｉｔｓｐａｔｈｏｐｈｙｓｉｏ ｌｏｇｉｃａｌｂａｓｉｓｈａｓｂｅｅｎｄｅｅｐｌｙｓｔｕｄｉｅｄ,（2,3）　ｔｈｏｕｇｈｔｈｅｓｔｕｄｙｏｆｍｏｌｅｃｕｌａｒｌｅｖｅｌｏｎｔｈｉｓＳｙｎｄｒｏｍｅｈａｓｎｏｔｂｅｅｎｓｅｅｎ．Ｔｈｉｓｓｔｕｄｙ,ｏｎｔｈｅｂａｓｉｓｏｆｐｒｅｖｉｏ…     

四逆汤对兔髂动脉球囊损伤病变区TGF-β1表达的影响

目的:通过球囊损伤兔髂动脉造成动脉损伤的模型，观察四逆汤对损伤后动脉内膜的保护和修复作用以及对转化生长因子β1（TGF-β₁）的影响。 方法:雄性新西兰兔24只，随机分为对照组、模型组、四逆汤治疗组（四逆汤组），每组8只。对照组给予普通饲料，模型组和四逆汤组给予高脂饮食。饲养2周后模型组、四逆汤组兔行髂动脉内膜剥脱术。术后4周处死各组实验兔，采用ELISA方法检测血清TGF-β₁水平；HE染色观察髂动脉内膜增生情况，通过免疫组化观察TGF-β₁蛋白在血管壁的表达；采用RT-PCR方法检测血管壁TGF-β₁ mRNA的表达。 结果:病理观察可见对照组兔髂动脉管腔和管壁厚度正常，管壁光滑；模型组的管壁明显增厚、管腔明显狭窄，内膜增厚；而治疗组管壁增厚较轻，管腔狭窄较轻，内膜增厚程度减轻。对照组兔血清TGF-β₁水平明显低于模型组和四逆汤组，四逆汤组又明显低于模型组（P<0.05）。免疫组化发现对照组兔髂动脉内膜TGF-β₁的染色灰度和染色阳性面积比明显小于模型组和四逆汤组，而四逆汤组TGF-β₁的染色灰度和染色阳性面积比明显小于模型组（P<0.05）。对照组兔髂动脉TGF-β₁ mRNA表达明显低于四逆汤组和模型组，而四逆汤组TGF-β₁ mRNA的表达少于模型组（P<0.05）。 结论:四逆汤可减轻兔髂动脉剥脱术后的内膜增生和血管的狭窄, 其机制可能与抑制髂动脉损伤后内膜TGF-β₁的基因和蛋白的表达，减少TGF-β₁的产生有关。     

前动力蛋白2介导躯体疼痛的外周与中枢神经敏化

前动力蛋白2(prokineticin 2,PK2) 是新近发现的一种趋化因子,通过与受体PKR1和PKR2结合,参与机体多种生理功能。PK信号通路是近年来新发现的组织损伤和神经损伤后疼痛发生和维持的重要调节通路,其在调节伤害性事件方面起着关键作用,是众多疾病的潜在治疗靶点。PKRs的激活可以引起痛觉感受,参与痛觉感受器对不同刺激的敏感性。PK系统（PKs和PKRs）是在免疫细胞中参与炎症发生和疼痛传递的重要环节。PK2通过激活初级传入神经元上的PKR1和PKR2参与调节痛觉感知,在大鼠初级感觉神经元中,PK2还通过PKC信号通路增强门控离子通道电流,抑制γ-氨基丁酸(GABA)激活电流,敏化嘌呤核苷酸P2受体(P2X)。本文围绕PK2在躯体疼痛中的研究进展进行述评,以期在未来的研究中,有望找到以PK信号通路为靶点的炎性疼痛治疗的新药。     

Predictive Accuracy of Frailty Tools for Adverse Outcomes in a Cohort of Adults 80 Years and Older: A Decision Curve Analysis

ObjectivesTo compare the predictive performance of 3 frailty identification tools for mortality, hospitalization, and functional decline in adults aged ≥80 years using risk reclassification statistics and decision curve analysis.DesignPopulation-based, prospective cohort.SettingBELFRAIL study, Belgium.Participants560 community-dwelling adults aged ≥80 years.MeasurementsFrailty by Cardiovascular Health Study (CHS) phenotype, Longitudinal Aging Study Amsterdam (LASA) markers, and Groeningen Frailty Indicator (GFI); mortality until 5.1 ± 0.25 years from baseline and hospitalization until 3.0 ± 0.25 years; and functional status assessed by activities of daily living at baseline and after 1.7 ± 0.21 years.ResultsFrailty prevalence was 7.3% by CHS phenotype, 21.6% by LASA markers, and 22% by GFI. Participants determined to be frail by each tool had a significantly higher risk for all-cause mortality and first hospitalization. For functional decline, only frail by GFI had a higher adjusted odds ratio. Harrell 's C-statistic for mortality and hospitalization and area under receiver operating characteristic curve for functional decline were similar for all tools and <0.70. Reclassification statistics showed improvement only by LASA markers for hospitalization and mortality. In decision curve analysis, all tools had higher net benefit than the 2 default strategies of “treat all” and “treat none” for mortality risk ≥20%, hospitalization risk ≥35%, and functional decline probability ≥10%, but their curves overlapped across all relevant risk thresholds for these outcomes.Conclusions and ImplicationsIn a cohort of adults aged ≥80 years, 3 frailty tools based on different conceptualizations and assessment sources had comparable but unsatisfactory discrimination for predicting mortality, hospitalization, and functional decline. All showed clinical utility for predicting these outcomes over relevant risk thresholds, but none was significantly superior. Future research on frailty tools should include a focus on the specific group of adults aged ≥80 years, and the predictive accuracy for adverse outcomes of different tools needs a comprehensive assessment that includes decision curve analysis.     

Gualoupi (Pericarpium Trichosanthis) injection in combination with convention therapy for the treatment of angina pectoris: a Meta-analysis

OBJECTIVE

To use a Meta-analysis to review the efficacy and safety of Gualoupi (Pericarpium Trichosanthis) injection (PTI) in the treatment of angina pectoris.