类固醇致胃黏膜损伤大鼠胃黏膜COX-2、iNOS水平变化及其意义

目的研究类固醇激素对胃黏膜的损伤作用及其可能的机制。方法采用泼尼松龙皮下注射制备大鼠胃黏膜损伤模型,泼尼松龙剂量40mg/kg,给药4d,计算溃疡指数,免疫组化方法检测胃黏膜诱生型一氧化氮合酶(iNOS)水平,RT-PCR方法检测大鼠胃黏膜环氧化酶异构酶-2(COX-2)mRNA的表达。结果40mg/kg泼尼松龙可引起胃黏膜显著出血性损伤,实验组大鼠溃疡指数中位数(44.5)明显高于空白组(0),P<0.01;COX-2基因表达增强(0.41±0.09)与空白组(0.06±0.03)比较差异有统计学意义(P<0.01);iNOS染色积分为(47±7)与空白组(16±3)比较差异有统计学意义(P<0.01)。结论泼尼松龙皮下注射,将引起胃黏膜损伤,可能与上调COX-2、iNOS表达有关。     

p21和PCNA在星形细胞瘤中的表达和相互关系

目的探讨p21蛋白和增殖细胞核抗原(PCNA)在星形细胞瘤中的表达和相互关系,以及p21阳性表达率与患者预后之间的关系。方法对63例幕上星形细胞瘤标本及8例正常对照标本,采用链霉菌抗生物素蛋白过氧化酶连接法染色观察,测定其p21、PCNA阳性率,并换算成标记指数(LI),比较不同级别肿瘤及不同临床影响因素者之间的差异。结果低级别星形细胞瘤中p21的LI明显低于高级别肿瘤(58.072±14.424VS26.630±5.570,P=0.00999)。PCNA的LI也随着肿瘤级别的升高而增强,低级别与高级别之间的差异也有统计学意义(40.192±11.407VS23.493±5.487,P=0.00134)。p21与PCNA呈正相关(r=0.672,P<0.01)。结论p21可能参与了星形细胞瘤的发生发展。p21和PCNA在星形细胞瘤中的表达呈正相关,在一定程度上提示p21强阳性的患者预后较差。     

HPLC测定四方蒿中总木犀草素苷的含量

 目的建立用反相高效液相色谱法测定四方蒿提取浸膏中主要黄酮苷(木犀草素)含量的方法。方法以ODS C₁₈柱为分析柱,PH 2.0磷酸缓冲液-四氢呋喃-异丙醇(70:30:5)为流动相,检测波长为360nm结果该黄酮水解后的苷元——木犀草素线性关系良好,在高、中、低浓度的日内精密度分别是2.82%,3 41%,5.17%;日间精密度分别是2.56%,5.46%,6.87%; 标准曲线线性0.999 9;检测限为50ng·mL^-1,定量限为(2.40±0.13)μg·mL^-1,方法回收率为高、中、低分别是101.28%, 105.58%,95.56%。结论木犀草素苷含量为(3.12±0.15)% 此法操作简便,准确率、灵敏度高。     

视网膜黄斑分支静脉阻塞视力损害的原因分析

目的探讨视网膜黄斑分支静脉阻塞的视网膜受累范围、并发症与视力损害的关系.方法对64例64只眼分别行荧光素眼底血管造影及90D Volk检眼镜检查,观察视网膜黄斑分支静脉阻塞发生的部位.结果视网膜黄斑分支静脉阻塞患者的阻塞点位于黄斑区上下血管弓的动静脉交叉处,且以靠近视乳头上的第一分支静脉好发;并发症中最多见的是黄斑囊样水肿.结论黄斑囊样水肿对视力损害最严重,但视网膜黄斑分支静脉阻塞的视网膜受累范围小,并发症较少,故视力预后较好.     

红曲对去势大鼠血清激素水平、骨密度和骨生物力学影响

目的:研究红曲对去势大鼠血清激素水平、骨密度和骨生物力学影响,并探讨其作用机理.方法:取12周龄的雌性wistar大鼠40只,其中30只打开腹腔去除双侧卵巢,逐层缝合,另10只予以单纯打开腹腔不切除卵巢.将大鼠分为A组(模型组)、B组(红曲治疗组)、C组(阳性对照组)、D组(假手术组)四组,饲养12周后,分别予以生理盐水、红曲水提液、α-D3水溶液及生理盐水灌胃.灌胃12周后,活杀各组动物,以双能X线、骨密度测定仪测定骨密度.取血清用放免法测定血清中骨钙素、降钙素.通过三点弯曲试验,记录载荷--变形曲线,测定骨生物力学指标.结果:经过12周的红曲水提液灌胃治疗,明显提高了去势大鼠的血清激素水平、骨密度,并能改善去势大鼠的骨力学性能.结论:红曲可提高去势大鼠骨密度值,改善骨的生物力学性能.推测其作用可能是通过改变血清激素水平来实现的.     

龙胆泻肝汤治疗湿热瘀阻型类风湿关节炎疗效观察

采用龙胆泻肝汤治疗湿热瘀阻型类风湿关节炎46例,并与运用西药治疗者加以比较.结果表明,龙胆泻肝汤对治疗湿热瘀阻型类风湿关节炎具有一定的疗效和较少的毒副作用,认为其机理主要与抗炎、改善血液循环及免疫调节有关.     

Genotoxicity and antileishmanial activity evaluation of Physalis angulata concentrated ethanolic extract

Antileishmanial in vitro tests, as well as Ames and micronucleus assays were performed with a concentrated ethanolic extract of Physalis angulata (EEPA)ResultsEEPA did not present mutagenic effect in Salmonella typhimurium strains at concentration reaching 3000 μg/plate and did not induce mutagenic effects after two oral administrations with a 24 h interval at a dose level of 2000 mg/kg. EEPA presented antileishmanial activity and presented an IC₅₀ value of 5.35 ± 2.50 μg/mL and 4.50 ± 1.17 μg/mL against Leishmania amazonensis and Leishmania braziliensis promastigotes, respectively. In the cytotoxicity test against macrophages, the EEPA had a LC₅₀ of 6.14 ± 0.59 μg/mL. Importantly, the IC₅₀ against L. amazonensis intracellular amastigotes was 1.23 ± 0.11 μg/mL.ConclusionEEPA extract is non-mutagenic and presented a promising pharmacological effect against Leishmania parasites.     

ICU机械通气患者意外拔管的原因分析及对策

对2008年1月至2010年6月,在ICU发生意外拔管的16例气管插管病人的临床资料进行了总结分析。结果导致意外拔管的相关因素有:缺乏有效的固定、未使用镇静剂、未使用适当的肢体约束及护患沟通不良等。因此,对人工气道的患者应高度重视,重在预防,做到正确固定,充分沟通,适当镇静和肢体约束,是有效的护理措施。     

Immune response to hepatitis B vaccination among people with inflammatory bowel diseases: A systematic review and meta-analysis

IntroductionThe response rate to hepatitis B virus (HBV) vaccination in patients with inflammatory bowel disease (IBD) is low and varies markedly. We performed a systematic review and meta-analysis to determine the response rate to HBV vaccination and identified the factors predictive of an immune response.MethodsWe searched PubMed, Cochrane Library, and Embase databases, and reviewed the titles and abstracts of studies on the efficacy of HBV vaccination in IBD patients performed through July 2016. Anti-HBs levels > 10 IU/L was considered to be an effective immune response. The primary outcome measure was the response rate to HBV vaccination after series completion, and the secondary outcome was identification of factors at baseline predictive of an immune response.ResultsThirteen studies including 1688 patients were eligible for inclusion. Based on a random-effects model, the pooled rate of a response to HBV vaccination among patients with IBD was 61% (95% confidence interval [CI]: 53–69). Young age (mean difference [MD]: −5.7; 95% CI: −8.46, −2.95) and vaccination during disease remission (relative risk [RR]: 1.62; 95% CI: 1.15–2.29) were associated with a positive response to HBV vaccination. In addition, no immunosuppressive therapy was predictive of an immune response compared to immunomodulatory (RR: 1.33; 95% CI: 1.08–1.63) or anti-tumor necrosis factor-α (anti-TNF-α) (RR: 1.57; 95% CI: 1.19–2.08) therapy.ConclusionsBased on this meta-analysis, only three of five IBD patients will show a serological response to HBV vaccination. Vaccination should be performed at the time of IBD diagnosis, during disease remission, or before starting immunosuppressive therapy.     

高龄备孕妇女常见妇科疾病及处理

目前高龄备孕,尤其是超过40岁甚至45岁的超高龄人群备孕皆在增多,妇产科医生面临的除高龄所带来的高危产科外,如何最优化处理此类人群的妇科疾病同样是项巨大挑战。高龄孕妇常见妇科疾病如子宫肌瘤、卵巢囊肿、宫颈上皮内瘤变、瘢痕憩室等,临床关注的焦点在于能否妊娠、孕前是否需手术、手术治疗对妊娠影响以及尽少破坏生育功能的手术技巧等方面。文章结合相关文献,对上述问题进行阐述。