帕米磷酸钠和降钙素对人工关节磨损微粒引起单核细胞分泌溶骨性因子的影响

目的　探讨帕米磷酸钠和降钙素防治人工关节松动的可能性。方法　采集人体外周血 ,分离单核细胞 ,分组培养。实验分 4组 ,第 1组 :仅单核细胞 ,为对照组 ;第 2组 :单核细胞及微粒 ,为微粒组 ;第 3组 :单核细胞、微粒及帕米磷酸钠 (阿可达 ) ,为阿可达组 ;第 4组 :单核细胞、微粒及降钙素 (密钙息 ) ,为密钙息组。培养 48h后 ,检测细胞上清液中肿瘤坏死因子 (TNF) α、白细胞介素 (IL) 1和IL 6的含量。结果　微粒组的细胞上清液中溶骨性因子含量明显高于对照组 (P <0 .0 1) ;而阿可达组和密钙息组的溶骨性因子含量明显低于微粒组 (P <0 .0 1)。结论　阿可达和密钙息能有效地抑制微粒刺激单核巨噬细胞分泌溶骨性因子 ,从而间接抑制破骨细胞的活性。     

自发免疫耐受大鼠移植肝内调节性T细胞的生物学特性

目的研究大鼠肝移植后自发免疫耐受的形成与移植肝内CD4~ CD25~ 调节性T细胞(Tr细胞)的关系。方法按供、受者不同将实验分为3组。急性排斥组:DA大鼠为供者,LEW大鼠为受者;自发耐受组:LEW大鼠为供者,DA大鼠为受者;同基因组:供、受者均为DA大鼠。各组均建立大鼠原位肝移植模型。分别在肝移植术后4、7、14、30和90 d时采用密度梯度离心法分离移植肝内淋巴细胞,免疫磁珠分离(MACS)法分选出CD4~ CD25~ Tr细胞;用流式细胞术(FCM)检测细胞纯度,同时分析CD4~ CD25~ Tr细胞比例的变化;体外细胞增殖试验研究CD4~ CD25~ Tr细胞对CD4~ CD25~-T细胞的免疫抑制作用。结果肝移植早期,急性排斥组和自发耐受组移植肝内CD4~ CD25~ Tr细胞比例均明显增加,其中急性排斥组增加更为明显;移植后4 d左右,两组CD4~ CD25~ Tr细胞比例开始下降,急性排斥组的下降幅度较大;移植后30 d,自发耐受组受者的移植肝内CD4~ CD25~ Tr细胞比例达到第2次高峰,约在移植后90 d时下降至正常生理水平。移植后7 d左右,急性排斥组受者均因发生排斥反应而死亡,而自发耐受组受者均存活。此外,CD4~ CD25~ Tr细胞能有效抑制CD4~ CD25~-T细胞的增殖。结论CD4~ CD25~ Tr细胞是一种具有特异免疫调节功能的T细胞亚群,其主动的免疫抑制功能可能是诱导大鼠肝移植自发免疫耐受的机制之一。     

交叉韧带重建手术中可吸收挤压螺钉的应用

目的探讨交叉韧带重建术中可吸收挤压螺钉的使用方法和疗效。方法总结53例交叉韧带重建病例使用可吸收挤压螺钉的情况，在术中、术后并发症、术后康复、膝关节功能状况等方面进行回顾性分析。结果三例出现韧带切割现象。两例股骨侧螺钉拧入后导引针无法拔出。一例挤压螺钉断裂。术后Lysholm评分平均92.4±4．1。结论交叉韧带重建术中使用可吸收挤压螺钉固定的方法固定牢固，术后恢复快，利于早期康复。     

基于柯式四级评估法的南京市浦口区基层卫生人员培训效果及影响因素分析

目的 采用柯氏四级评估法,系统评价南京市浦口区基层卫生人员的培训效果,为基层卫生人员在职培训方案设计提供依据。方法 通过问卷调查浦口区所有基层医疗卫生机构在岗工作人员的基本情况、培训现况和培训效果,共收集有效问卷428份。采用SPSS 16.0软件进行统计分析,二元或有序Logistic回归筛选相关因素。结果 反映评估中,49.6%（192/387）的人认为参加培训很有意义;学习评估中,51.4%（220/428）的人了解本专业的前沿知识;行为评估中,40.3%（156/387）的人广泛应用了培训的内容;结果评估中,41.3%（177/428）的人表示自己的工作质量非常高。培训频率、时长、专业类别和职称是培训效果的影响因素。结论 总体来看,基层卫生人员培训效果并不理想。提高培训的频率、加强卫生人员对培训重要性的认知、延长培训时长可以有效增强培训效果。     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

胃泌素对大鼠胃粘膜环氧合酶及生长因子表达的影响

目的：探讨胃泌素对大鼠胃粘膜环氧合酶（COX）及生长因子表达的影响。方法：雄性SD大鼠皮下注射胃泌素1 μg/kg、10 μg/kg或100 μg/kg，Western blot和免疫组化检查胃粘膜COX-1、COX-2、肝细胞生长因子（HGF）和肝素结合表皮生长因子样生长因子（HB-EGF）表达。评价胃泌素受体拮抗剂YM022对COX-1、COX-2、HGF和HB-EGF表达的影响。结果：胃泌素剂量依赖性地增加大鼠胃粘膜COX-2和HB-EGF表达，而对COX-1和HGF表达无明显影响；YM022阻断胃泌素诱导的COX-2和HB-EGF表达。 结论： 胃泌素调节大鼠胃粘膜COX-2和HB-EGF蛋白表达，提示COX-2和HB-EGF参与与胃泌素相关联的胃粘膜增生和胃癌等的发病过程。     

编码N端截短的IκBα突变体重组腺病毒的构建与鉴定

目的：通过去除N端丝氨酸32/36磷酸化位点，获得人胎盘组织IκBα突变体（IκBαM）基因，构建其复制缺陷型重组腺病毒（AdIκBαM），并进行体外表达和活性检测。方法:PCR定点克隆IκBαM基因（203-1 003 bp），亚克隆至pShuttle和pGEM-T，进行PCR、双酶切、DNA测序和同源性分析。将重组质粒pShuttle-IκBαM中含CMV启动子、IκBαM cDNA和PolyA信号的表达单元定向插入Ad5腺病毒载体，构建成重组腺病毒AdIκBαM，再经脂质体介导共转染293细胞进行包装。Western blotting检测AdIκBαM在293细胞中蛋白表达情况，电泳迁移率实验观察AdIκBαM抑制佛波酯诱导的ECV304细胞核因子κB（NF-κB）激活的作用。结果:成功克隆长801 bp的新型IκBαM基因，与GenBank中登陆的IκBα基因（接受号M69043）相应核苷酸序列一致。所制备的AdIκBαM滴度为4.0×1012 pfu/L。AdIκBαM介导IκBαM基因在293细胞中表达，并以剂量依赖性方式显著抑制佛波酯诱导的ECV304细胞NF-κB活化 。结论：AdIκBαM有效介导IκBαM基因表达并特异性抑制NF-κB活性，有望应用于哮喘的基因治疗。     

Association between bariatric surgery and anemia

ObjectivesSeveral studies have recently conducted to investigate the link between anemia and bariatric surgery (BS). The results from these studies, however, were inconsistent. Therefore, a meta-analysis was conducted to determine whether BS for weight loss is a risk factor for anemia.MethodsStudies were identified relevant papers published a cutoff date of May 2022 for meta-analysis by searching four electronic databases (PubMed, EMBASE, Web of Science and Cochrane Library). Pairs of authors conducted title and abstract, full-text assessment, data extraction and risk of bias assessment, and quality of articles. Random-effects models were used to estimate the pooled effect size and evaluated the overall quality of evidence. The sources of heterogeneity were assessed with I². The Newcastle-Ottawa scale (NOS) was used to assess the methodologic quality of selected studies. The publication bias was assessed using funnel plots and Egger's test statistics.ResultsIn all, eight studies comprising 3150 patients were finally included in the final study analysis. Of these, pooled analysis of eight studies detecting association between anemia and BS for weight loss yield a statistically significant correlation (SMD ?1.12 (?1.46—?0.78, I² = 93%). Subgroup analyses were performed according to postoperative follow-up time and operation method. Before 24 months postoperatively, no patient had a significant decrease in hemoglobin. More than 24 months after BS, patients show a significant reduction in hemoglobin. In addition, the hemoglobin level was not changed after sleeve gastrectomy (SG) and adjustable gastric banding (AGB) (SMD ?0.19 (?1.04—0.67, I² = 0% for SG; SMD ?0.30 (?0.82—0.22 for AGB), but the hemoglobin level was significantly reduced after Roux-en-Y gastric bypass (RYGB) (SMD ?1.19 (?1.52—?0.87, I² = 94.2%).ConclusionThis current meta-analysis found that at 24 months after RYGB, the patient's hemoglobin level was significantly reduced, increasing the risk of anemia. Therefore, attention should be paid to the occurrence of anemia after BS. A large, placebo-controlled, multi-center study is needed to clarify the role of BS for weight loss in this patient anemia.     

Penetration moxibustion for postpartum subinvolution of uterus: Two case reports and mechanism analysis: 透灸法成功治疗产后子宫复旧不良:两则病例报告及机制分析

This article introduced the application of penetration moxibustion in successfully treating two cases of postpartum subinvolution of uterus. The main complaint of one case was increasing volume of abnormal vaginal bleeding for five days after delivery. The bleeding stopped after the patient received 7 times treatment of warming needle and penetration moxibustion on Zhōngjí (中极CV3), Guānyuán (关元CV4) and Qìhăi (气海CV6). The other case complained about persistent abdominal pain for 15 days, which was worsening for the recent 2 days. The symptom of abdominal pain was relieved after the penetration moxibustion was applied on CV4, CV6 and Zǐgōng (子宫 EX-CA1) for 5 times for the case. Penetration moxibustion can relieve abdominal pain during the postpartum period, accelerate lochia discharge, and recovery of menstrual and uterine cavity. Àiyè (艾叶 Artemisiae Argyi Folium) was proved to have antibacterial, hemostatic, and analgesic effects. The warming function and radiation features of moxibustion can help to alleviate spasm of the smooth muscle in the uterus and enhance the metabolism of the uterine tissue by expanding microvessels and improving the circulations of both blood and lymph. It can also activate cells in the uterine tissue by increased temperature in order to enhance the decomposition and elimination of pathological wastes, such as inflammation and hematoma. In addition, it can also relieve pelvic pain by inhibiting neuronal excitability.