糖尿病周围神经病变疼痛机制研究进展

痛性糖尿病周围神经病变（DPN）表现为对多数镇痛药物的抵抗。最近许多研究表明，背根神经节（DRG）钠离子通道、丝裂原激活蛋白激酶、一氧化氮、蛋白激酶C、去甲肾上腺素等在DPN疼痛信号转导和痛觉调制方面发挥重要作用。现就DPN疼痛的分子机制及治疗前景作一探讨。     

甲状腺单发结节367例临床分析

目的总结评价4a来该医院对甲状腺单发结节诊断及治疗体会。方法回顾性分析367例甲状腺单发结节的。临床资料。结果367例中，甲状腺单发结节经病理组织学证实甲状腺癌58例，良性疾患309例。336例获随访，随访率达91.5％。随访时间为6个月～4a。喉返神经损伤2例，未出现术后甲状腺功能低下。结论术前细针穿刺活检结合彩色超声检查对甲状腺单发结节良恶性鉴别有帮助，甲状腺单发结节恶性率较高（15．8％），应积极手术治疗。     

妥洛特罗两种透皮贴剂临床药动学特性及其对临床疗效的可能影响

目的 评价妥洛特罗两种透皮贴剂和口服片剂的临床药动学特性及其对临床疗效的影响.方法 健康受试者分别单次接受2 mg妥洛特罗透皮贴剂A、贴剂B或口服1 mg盐酸妥洛特罗片剂,采血测试受试者不同时间点的血药浓度,并计算药动学参数.结果 贴剂A、贴剂B和片剂达峰时间(T<,max>)分别为(9.5±2.1)、(24.7±5.4)和(1.5±0.6)h;峰浓度(C<,max>)分别为(1.13±0.4)、(0.271±0.262)和(1.70±0.56) ng/mL.结论 两种贴剂药动学参数存在差异,有可能对临床疗效产生影响.预期贴剂A具有良好的临床疗效.     

血糖水平对急性脑出血预后的影响

目的探讨急性脑出血患者血糖水平与预后的关系。方法随机选择100例急性脑出血患者,分别测空腹血糖,按血糖水平分为正常血糖组(53例)和高血糖组(47例),观察血糖水平与脑出血近期预后的关系。结果有55.32%的急性脑出血病人血糖增高,血糖升高对脑出血急性期的病情及近期预后有重要影响,此类病人并发症多,预后差,死亡率高。结论血糖水平可作为预测急性脑出血病情及近期预后的指标,急性脑出血病人血糖高者预示急性期预后不良。     

改良气压止血带保护衬垫的制作及临床应用

目的研制一种改良气压止血带保护衬垫,探讨使用进口止血带时,检测其止血效果及止血带损伤情况。方法将160例使用气压止血带的患者随机分成实验组和对照组各80例,对照组在气压止血带受压处垫治疗巾保护,实验组使用改良气压止血带保护衬垫。比较两组止血效果及止血带损伤情况。结果两组止血效果及止血带损伤情况比较,差异有统计学意义(P0.05),按照手术时止血效果及放气后出现的止血带损伤进行综合判断,实验组效果好于对照组。结论使用改良气压止血带保护衬垫能获得更好的止血效果并降低了止血带损伤情况,提高了手术医生的满意度。     

Whole liver CT texture analysis to predict the development of colorectal liver metastases—A multicentre study

ObjectivesCT texture analysis has shown promise to differentiate colorectal cancer patients with/without hepatic metastases.AimTo investigate whether whole-liver CT texture analysis can also predict the development of colorectal liver metastases.Material and methodsRetrospective multicentre study (n = 165). Three subgroups were assessed: patients [A] without metastases (n = 57), [B] with synchronous metastases (n = 54) and [C] who developed metastases within ≤24 months (n = 54). Whole-liver texture analysis was performed on primary staging CT. Mean grey-level intensity, entropy and uniformity were derived with different filters (σ0.5–2.5). Univariable logistic regression (group A vs. B) identified potentially predictive parameters, which were tested in multivariable analyses to predict development of metastases (group A vs. C), including subgroup analyses for early (≤6 months), intermediate (7–12 months) and late (13–24 months) metastases.ResultsUnivariable analysis identified uniformity (σ0.5), sex, tumour site, nodal stage and carcinoembryonic antigen as potential predictors. Uniformity remained a significant predictor in multivariable analysis to predict early metastases (OR 0.56). None of the parameters could predict intermediate/late metastases.ConclusionsWhole-liver CT-texture analysis has potential to predict patients at risk of developing early liver metastases ≤6 months, but is not robust enough to identify patients at risk of developing metastases at later stage.     

Genetic analysis of 17 Y-STR loci in Han and Korean populations from Jilin Province,Northeast China

In this study, 17 Y chromosomal short tandem repeats (Y-STRs) were analyzed in 302 male individuals from the Chinese Han and Korean populations of Jilin Province. The haplotype diversities of two populations reached 0.99969 and 0.99874, respectively. The Jilin Han and Korean populations differed from each other significantly. The Jilin Han population showed no significant difference from almost any other Han population, but it did show significant differences from most other Chinese ethnic populations. The haplotype frequencies in the Jilin Korean population studied here showed significant differences from all reference populations in earlier reports. These data provide a reference for the Y-STR database in Jilin Province, and they may be valuable for population genetic analysis.     

海洛因依赖并发癫痫大发作30例临床分析

目的:探讨海洛因依赖伴癫痫大发作的特点、原因及临床治疗对策。方法:对海洛因依赖自愿戒毒者中伴癫痫大发作30例资料进行回顾性分析。结果:海洛因依赖伴癫痫大发作30例的滥用时间5年以上23例(76.67%);静脉注射者(86.67%)多于烫吸者(13.33%),(χ2=13.204,P<0.01);伴有多药滥用史27例,以BZD类药为多(90%);有苯丙胺类滥用史13例(43.3%)。对BZD类药物依赖者,给予同类药物替代递减治疗,可减少癫痫大发作的发生(χ2=8.919,P<0.01)。结论:海洛因依赖伴癫痫大发作可能与海洛因、多药滥用、静脉注射方式、滥用时间等因素有关,多药滥用者突然停用BZD类药物、减量过快可能诱发癫痫大发作的发作。     

Valproic acid transport in the choriocarcinoma placenta cell line JEG-3 proceeds independently of the proton-dependent transporters MCT1 and MCT4

Medication therapy is the first line of treatment in the management of epilepsy. Fetal exposure to valproic acid (VPA), an antiepileptic drug, poses an elevated risk of teratogenicity in early pregnancy. Some studies have reported that monocarboxylate transporters (MCTs) may be involved in the placental transport of VPA. However, it has not been determined which MCTs contribute to VPA transport into the placenta. Therefore, the aim of this study was to determine how MCTs contribute to VPA transport into the placenta using the human placenta choriocarcinoma cell line JEG-3. VPA uptake was investigated using JEG-3 cells and radiolabeled VPA. MCT expression in JEG-3 cells was detected using RT-PCR and western blotting. Knockdown of MCTs was carried out using siRNAs. VPA uptake into JEG-3 cells was pH- and concentration-dependent, and described by using the Michaelis–Menten equation (K_m = 0.95 ± 0.17 mM; V_max = 19.3 ± 1.21 nmol/mg protein/15 s). MCT1 and MCT4 expression was found in JEG-3 cells, and typical MCT inhibitors significantly inhibited VPA uptake into JEG-3 cells. However, knockdown of MCT1 and MCT4 did not alter VPA uptake. In conclusion, VPA transport is mediated by a proton-dependent transporter in JEG-3 cells, but not by MCT1 and MCT4.