低分子肝素预防脑出血后静脉血栓的安全性研究

目的探讨脑出血患者抗凝预防静脉血栓栓塞时颅内血肿体积变化及相关安全性。方法回顾性分析脑出血或脑出血合并脑室出血的患者,均在入院7 d内予以注射低分子肝素,并在用药7 d后复查头颅CT。计算患者低分子肝素治疗前后CT上的颅内血肿体积的变化,血肿体积的计算使用ABC/2法,脑室出血量的计算使用手绘出血区域方法。结果共入选64例,平均年龄65岁,美国国立卫生研究院卒中量表（NIHSS）评分中位值为10.6,基线时血肿体积平均为（24.3±22.3）ml,低分子肝素治疗前后CT检查上的颅内血肿体积变化为（-4.35±10.5）ml,仅有1例的血肿体积增大。经分析,自发性脑出血患者发病7 d内给予低分子肝素预防深静脉血栓并不导致颅内血肿的增大。结论在脑出血伴/不伴脑室出血的急性期,给予皮下注射低分子肝素预防静脉血栓栓塞不导致颅内血肿的增大。     

猪肝细胞与骨髓间充质干细胞最适共培养体系的建立

目的：建立猪肝细胞与骨髓间充质干细胞（MSCS）最适宜共培养体系,为生物人工肝的构建提供理想的细胞来源。方法：抽取中华实验猪（n=3）髂前上棘骨髓,采用密度梯度离心法分离单个核细胞,贴壁传代培养至第3代;采用原位两步胶原酶法分离猪肝细胞后与MSCS按1∶1,2∶1,5∶1和10∶1的比例混合培养,观察各组共培养肝细胞形态和功能的变化水平。结果：所获肝细胞纯度>99%,存活率>95%。共培养组肝细胞迅速黏附于MSCS表面,在三维空间呈球形聚集生长;肝细胞与MSCS间出现细胞连接,超微结构与正常肝细胞接近。肝细胞/MSCS 以2∶1共培养组的肝细胞清蛋白分泌水平、尿素合成能力和细胞色素P450为各组中之最佳,自第1天培养起均显著高于对照组（P<0.05）,并在第2天达到高峰,而且下降趋势较缓慢。结论：猪肝细胞/MSCS 按2∶1组成的最适共培养体系可最大程度地维持肝细胞功能,为构建功能性生物人工肝提供高效细胞材料。     

Familial cardiac myxoma with multifocal recurrences:a case report and review of the literature

We report a case of myxoma with multiple recurrences in both the atrium and ventricle in a 26-year-old woman five years after the surgical removal of left atrial myxoma.Her 52-year-old mother had a similar medical history.To our knowledge,this was the first familial case who suffered multifocal cardiac myxoma recurrences without any sign of the myxoma complex.Based on our understanding of the mechanism of recurrence,the approaches to prevent the recurrence,and markers to predict recurrence,we propose that m...     

与食管癌5-FU化疗效果相关分子标记的研究进展

不同个体的食管癌对氟尿嘧啶（Fluorouracil,5-FU）药物疗效存在差异。药物遗传学和药物基因组学的快速发展,使得分子标记指导下的食管癌个体化化疗成为可能,本文对食管癌5-FU疗效预测相关分子标记作一综述。     

利用PASS软件对我院住院患者用药医嘱的合理性分析

应用合理用药监测系统(PASS 软件)的"医院患者信息查询系统",回顾性监测我院2008年3月～2008年8月所有住院患者用药医嘱,并对监测结果进行了分析,结果表明,我院用药存在不合理之处主要表现为药物相互作用、用药剂量不合理等.PASS有助于提高临床合理用药水平,但该系统存在的不足方面有待不断完善.     

辅助性T细胞17及IL-17在支气管哮喘小鼠中的变化

目的:探讨辅助性T细胞17(Th17)及IL-17在支气管哮喘小鼠中的变化及意义.方法:将24只BABL/c小鼠随机分为哮喘组(12只)和正常对照组(12只).用卵清白蛋白(OVA)致敏和激发建立小鼠哮喘模型;行苏木精书红(HE)染色,观察肺组织炎症改变;流式细胞术检测脾脏单个核细胞中Th17细胞比例;酶联免疫吸附法(ELISA)检测支气管肺泡灌洗液(BALF)中卟17细胞相关细胞因子I[-17水平;并计数BALF中细胞总数、嗜酸粒细胞及中性粒细胞数.结果:哮喘组肺组织及气道周围的炎症改变较正常对照组显著增强.哮喘组脾脏中Th17细胞及BALF中IL-17水平均显著高于正常对照组(P均<0.01).哮喘组BALF中细胞总数及嗜酸粒细胞计数显著高于正常对照组(P均<0.01),结论:哮喘小鼠存在Th17细胞数量增多及其分泌的IL-17水平增高,IL-17可能通过促进嗜酸粒细胞在气道的聚集而参与炎症反应,Th17细胞可能在哮喘的发病中具有重要作用.     

Time in range as a useful marker for evaluating retinal functional changes in diabetic retinopathy patients

AIM: To elucidate the relationship between macular sensitivity and time in range (TIR) obtained from continuous glucose monitoring (CGM) measures in diabetic patients with or without diabetic retinopathy (DR). METHODS: This was a cross-sectional study including 100 eyes of non-DR patients and 60 eyes of DR patients. An advanced microperimetry was used to quantitate the retinal mean sensitivity (MS) and fixation stability in central macular. TIR of 3.9-10.0 mmol/L was evaluated with CGM. Pearson coefficient analysis and multiple linear regression analysis were used to assess the correlation between TIR and retinal sensitivity. RESULTS: In a comparison of non-DR patients, significant differences (P<0.05) were found in HbA1c, TIR, coefficient of variation (CV), standard deviation of blood glucose (SDBG) and mean amplitude of glucose excursion (MAGE) values in DR patients. Besides, those DR patients had significantly poor best-corrected visual acuity (BCVA, logMAR, P=0.001). In terms of microperimetry parameters, retinal mean sensitivity (MS) and the percentages of fixation points located within 2° and 4° diameter circles were significantly decreased in the DR group (P<0.001, P<0.001, P=0.02, respectively). The bivariate contour ellipse area (BCEA) encompassing 68.2%, 95.4%, 99.6% of fixation points were all significantly increased in the DR group (P=0.01, P=0.006, P=0.01, respectively). Correlation analysis showed that MS were significantly correlated with HbA1c (P=0.01). TIR was positively correlated with MS (r=0.23, P=0.01). SDBG was negatively correlated with MS (r=-0.24, P=0.01) but there was no correlation between CV and MAGE with MS (P>0.05). A multivariable linear regression analysis was performed to prove that TIR and SDBG were both independent risk factors for MS reduction in the DR group. CONCLUSION: TIR is correlated with retinal MS reduction in DR patients, suggesting a useful option for evaluating DR progression.     

Inhibition of phosphodiesterase-4 suppresses HMGB1/RAGE signaling pathway and NLRP3 inflammasome activation in mice exposed to chronic unpredictable mild stress

Inhibition of phosphodiesterase-4 (PDE4) produces robust anti-inflammatory and antidepressant-like effects in multiple animal models. However, the detailed mechanisms have not been well studied. Receptor for advanced glycation endproducts (RAGE) and inflammasome activation are implicated in the etiology of depression. Here, we aimed to investigate the involvement of RAGE and nucleotide-binding domain (NOD)–like receptor protein 3 (NLRP3) inflammasome in the antidepressant-like effects of PDE4 inhibition in mice. We found that inhibition of PDE4 by roflupram (ROF, 0.5, and 1.0 mg/kg, i.g.) exerted antidepressant-like effects in mice subjected to chronic unpredictable mild stress (CUMS). Simultaneously, ROF inhibited CUMS-induced microglial activation and restored the morphology of microglial cells in the hippocampus, as evidenced by reduced total process length, area, volume, number of branching points, number of terminal points and total sholl intersections of microglia. ROF also decreased the expression of ionized calcium-binding adapter molecule-1 and the level of interleukin-1β. Western blot analysis showed that PDE4 inhibition suppressed the high-mobility group box 1 protein (HMGB1)/RAGE signaling pathway, as the levels of HMGB1, RAGE, toll-like receptor 4, phosphorylated p38 mitogen-activated protein kinase, and nuclear factor κ-B were decreased in both hippocampus and cortex in mice after treatment with ROF. Moreover, ROF also attenuated the protein levels of NLRP3, the apoptosis-associated speck-like protein containing (ASC), and cysteine-requiring aspartate protease-1 (Caspase-1), which are key proteins in the NLRP3-mediated inflammasome signaling pathway. In summary, these results demonstrate that the down-regulation of HMGB1/RAGE signaling pathway and inflammasome suppression possibly contribute to the antidepressant-like effects of PDE4 inhibitors. And, ROF has potential as a candidate drug in the treatment of depression.