重组人粒细胞集落刺激因子促进兔手术联合化疗后的切口愈合

目的 评价重组人粒细胞集落刺激因子(rhG-CSF)对手术同时使用化疗的兔切口感染程度及血管内皮生长因子(VEGF)和肿瘤坏死因子(TNF-α)的影响.方法 新西兰大白兔24只,随机分为3组,空白组单纯进行手术,常规换药；对照组和治疗组均于手术前当日给予表阿霉素静脉输注,常规换药,治疗组换药时涂抹重组人粒细胞集落刺激因子.于手术后第7天观察切口愈合等级,进行病理检查,通过免疫组化检测各组VEGF表达水平,酶联免疫吸附法检测TNF-α水平.结果 使用重组人集落刺激因子后切口愈合情况及等级均优于对照组(P＜0.05),VEGF表达水平升高,而TNF-α与对照组相比无明显差别.结论 重组人粒细胞集落刺激因子可以提高切口部位VEGF表达水平,对手术同时使用化疗的切口有促进愈合作用.     

Prognostic predictive value of TLR4 polymorphisms in Han Chinese population with hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac disease and is an important cause of sudden death in patients of all ages. The aim of this study was to find out whether Toll-like receptor-4 (TLR4) polymorphism is associated with HCM. To explore the association between TLR4 gene polymorphisms and HCM, 486 HCM patients and 214 healthy controls were enrolled in a case–control study of Chinese Han population. Two single nucleotide polymorphisms (SNPs) in the promoter region of TLR4 gene, ?728G > C (rs11536865) and ?2081G > A (rs10983755), were genotyped by PCR restriction fragment length polymorphism (PCR-RFLP). The associations between TLR4 SNPs and overall survival (OS) of HCM patients were analyzed by the Kaplan–Meier estimation method and Cox proportional hazards regression analysis. Serum TLR4 level was determined by ELISA. Our results showed that the C allelic frequency of ?728G > C and A allelic frequency of ?2081G > A were higher in HCM patients than those in controls (P < 0.001). The ratios of genotype frequencies for both SNPs were associated with HCM susceptibility under three genetic models (P < 0.01). Two SNPs were also associated with the OS in HCM patients (P < 0.001). The CC genotype of ?728G > C and AA genotype of ?2081G > A were associated with poor prognosis of HCM (P < 0.001). Moreover, HCM patients had a higher serum TLR4 level compared with the controls (242.6 pg/ml versus 135.7 pg/ml, P = 0.027). In addition, significant associations were observed between CC genotype of ?728G > C or AA genotype of ?2081G > A and plasma TLR4 level (P < 0.01). The results of this study indicated that TLR4 polymorphisms may be a genetic susceptibility factor for HCM in the Han Chinese population.     

��˾ƥ��/����������þ��������΢�轺�Ҽ����Ʊ�����ҩ������

??OBJECTIVE To prepare compound aspirin and esomeprazole magnesium enteric-coated pellet capsules and evaluate the drug release in vitro/in vivo. METHODS The aspirin pellet cores were prepared by using extrusion-spheronization method, and the esomeprazole magnesium-containing drug pellets were prepared with fluidized bed. By using fluidized bed coating method, the two kinds of drug-containing pellets were respectively coated with enteric layer to obtain enteric-coated pellets. After determining the loading capacity by measuring drug content, the two kinds of drug-containing pellets were filled into No.1 capsules. In vitro release was evaluated by measuring release percentage. The in vivo release behavior was evaluated by determination of pharmacokinetic parameters in rats. RESULTS The cumulative release percentage of the two drugs was less than 5% in 2 h in 0.1 mol??L^-1 hydrochloric acid solution. The cumulative release percentage of aspirin was more than 70% in 45 min in pH 6.8 PBS and it was more than 80% in 30 min for esomeprazole magnesium. Aspirin was metabolized to salicylic acid in plasma and its main pharmacokinetic parameters were as follows:t_1/2=9.47 h, MRT_0-??=14.43 h, t_max=3.00 h, ??_max=51.34 mg??L^-1, AUC _0-24=703.39 mg??h??L^-1, AUC _0-??=860.52 mg??h??L^-1. The pharmacokinetic parameters for esomeprazole magnesium were as follows:t_1/2=3.72 h, MRT_0-??=7.44 h, t_max=1.50 h, ??_max=2.71 mg??L^-1, AUC_0-24=11.89 mg??h??L^-1, AUC_0-??=13.79 mg??h??L^-1. CONCLUSION The formulation of compound enteric-coated pellet capsules is reasonable, and the preparation technology has good reproducibility. The drug release is located in the intestinal tract, thus esomeprazole magnesium can antagonize the gastrointestinal side effects of aspirin and aspirin can produce better antithrombotic effect .     

A possible significant role of zinc and GPR39 zinc sensing receptor in Alzheimer disease and epilepsy

Zinc the essential trace element, plays a significant role in the brain development and in the proper brain functions at every stage of life. Misbalance of zinc (Zn²⁺) ions in the central nervous system is involved in the pathogenesis of numerous neurodegenerative disorders such as Alzheimer's disease, Depression, and Epilepsy. In brain, Zn²⁺ has been identified as a ligand, capable of activating and inhibiting the receptors including the NMDA-type glutamate receptors (NMDARs), GABA_A receptors, nicotinic acetylcholine receptors (nAChRs), glycine receptors (glyR) and serotonin receptors (5-HT3). Recently GPR39 has been identified as a zinc-specific receptor, widely expressed in brain tissues including the frontal cortex, amygdala, and hippocampus. GPR39, when binding with Zn²⁺ has shown promising therapeutic potentials. This review presents current knowledge regarding the role of GPR39 zinc sensing receptor in brain, with a focus on Alzheimer’s disease and Epilepsy. Although the results are encouraging, further research is needed to clarify zinc and GPR39 role in the treatment of Alzheimer's disease and Epilepsy.     

人工智能技术在临床医疗中的应用概述

随着科技的进步和电子计算机技术的飞速发展,人工智能技术应运而生,并已进入人们日常生活的方方面面,在为人们带来便捷的同时,也逐渐改变着人们传统的生活及工作模式。近年来,人工智能技术、互联网和大数据医疗正在以惊人的速度渗透于医学相关的各个领域,这必将对医学发展带来新一轮的革新,重新赋予医疗活动更多的可能。目前,人工智能技术在医学领域的应用范围较广,可涉及医疗活动全过程,包括院前管理、院中诊疗和院后康复等等,在医学临床的各个科室也都能见到人工智能的运用。本文结合国内外人工智能技术在医疗实践中的研究和应用现状,主要围绕人工智能技术在临床医疗实践中的智能诊断、智能诊疗、智能随访、智能门诊急诊全程辅助诊疗系统、智能重症监护、智能医疗机器人、智能健康管理和疾病管理、智能约诊、智能院内就医流程引导等方面的应用做一概述。     

羞怯对网络交往的影响:自我意识的中介作用

目的:考察自我意识在大学生羞怯与网络交往关系中的中介作用。方法:采用大学生羞怯量表、自我意识量表和大学生网络交往问卷对781名大学生进行考察。结果:1羞怯与自我意识、网络交往总分显著正相关(r=0.483,0.260;P0.01);自我意识与网络交往总分显著正相关(r=0.261,P0.01);2羞怯通过自我意识的完全中介效应(△χ~2=5.43,△df=1,△χ~2/△df=5.436.63)对大学生网络交往产生影响,羞怯对大学生网络交往没有直接效应。结论:自我意识在大学生羞怯与网络交往关系中起到中介作用。     

潍坊市城区双向转诊制度实施情况及政策建议

目前,在社区卫生服务双向转诊制度实施中还面临很多障碍,要使双向转诊制度落到实处,真正发挥它应有的作用,仍然存在许多不尽人意的地方。文章通过从政府及其有关部门角度、患者角度、医疗保险机构角度、媒体角度等多方面,提出了促进双向转诊的主要措施。     

小儿肺炎支原体感染肺外器官的临床分析

目的 探讨肺炎支原体(MP)感染肺外器官的临床特征、疗效及预后.方法 对某院148例MP感染患儿的临床表现、实验室检验结果和疗效进行回顾性分析和总结.结果 148例中76例(51.35％)肺外器官受累,受累部位除呼吸道症状还包括消化、泌尿、血液、心血管和神经系统及皮肤黏膜损害.结论 MP感染可以引起机体多系统损害,少数以肺外表现为首发症状,阿奇霉素为重要药物,预后较好.