西比灵对沙鼠脑缺血后脑内转化生长因子βⅠ型、Ⅱ型受体基因表达的影响

目的　研究西比灵对沙鼠脑缺血再灌注后脑内转化生长因子 βⅠ型、Ⅱ型受体 (TβRⅠ、Ⅱ )基因表达的影响。方法　制作沙鼠脑缺血再灌注模型 ,实验前给沙鼠喂食西比灵。在缺血再灌注 6小时、1天、3天、7天 ,用原位杂交法检测脑内TβRⅠ、ⅡmRNAs的表达 ,并与其他各组比较。 结果　各组沙鼠脑组织的神经元和胶质细胞胞浆均有TβRⅠ、ⅡmRNAs阳性表达。西比灵治疗组中缺血再灌注 6小时、1天、3天TβRⅠ、ⅡmRNAs表达较脑缺血组稍高 ,但无明显差异 (P >0 0 5 ) ,7天时同脑缺血组相比TβRⅠmRNAs的表达下降(P <0 0 1) ,而TβRⅡmRNAs表达增高 (P <0 0 1)。 结论　西比灵能抑制缺血再灌注后TβRⅠmRNAs的过度表达 ,避免TβRⅠ和ⅡmRNAs表达比例失调 ,可能有利于转化生长因子 β(TGFβ)的信号传递 ,有利于抵御脑缺血再灌注造成的脑损伤     

翼状胬肉的不同术式对创面上皮修复及复发率的影响

目的 :比较不同手术方法治疗原发性翼状胬肉对角膜创面上皮修复及其复发率的影响。方法 :对 78例 (82眼 )原发性翼状胬肉分别行显微切除联合角膜缘上皮移植术 (2 6例 2 8眼 )、羊膜移植术 (2 4例 2 6眼 ) ,和肉眼直视下的翼状胬肉结膜下转位移植术 (McReynoldtransplantation) (2 8例 ,2 8眼 )。术后用 1%荧光素钠染色法 ,观察角膜创面上皮修复速度 ,并随访 6～ 12个月 ,平均 8 5个月。结果 :显微切除联合角膜缘上皮移植、羊膜移植和肉眼直视下的结膜下转位移植术后 ,角膜创面平均上皮修复时间分别为 6 2 5、7 73和 8 5 0天 ,前者分别与后二者比较 ,差异有显著性 (P <0 0 5和 0 0 1)。随访观察 ,羊膜移植组和结膜下转位移植组分别有 2眼 (7 7% )和 5眼 (17 9% ) ,术后 2周角膜创面仍未完全上皮化 ,最后导致复发 ,而角膜缘上皮移植组无 1眼复发。结论 :显微切除联合角膜缘上皮移植或羊膜移植术治疗原发性翼状胬肉 ,可以显著促进角膜创面上皮修复 ,提高治疗效果 ,降低复发率 ,尤其以角膜缘上皮移植术疗效更佳。     

血栓性血小板减少性紫癜患者血管内皮细胞标志物和溶血参数的动态分析及其临床意义

目的动态洲定血栓性血小板减少性紫癜(TIP)患者发病过程巾血管内皮细胞标忠物——凝血酶渊节蛋白(TM)、血管内发生长因子(VEGF)的浓度、微血管病性溶血性贫血相关参数的变化．并分析其临床意义方法对3例TTP患者进行了血管性血友病因0子(VWF)裂解蛋白酶活性分析，外周血涂片连续动态计数破碎红细胞百分率；用Westem印迹分析结合灰度扫捕测定血浆TM水平；血浆VEGF水平用ELlsA法进行分析；对1例存在视力损害的TTP患者行眼底血管荧光造影，以寻找微血管血栓形成的可能证据结果3例TTP患者均有vWF裂解不令，发病时外周血涂片破碎红细胞百分分率分别为1．65％、2．50％、3．32％，均值为2．49％，破碎红细胞百分率随病情好转而逐渐下降TTP患者血浆TM和VEGF水平与正常人卡甘比在发病时均明显升高，并与TTP病情严重程度存存相关性，1例TTP患者眼底荧光造影存在眼底微小血管微血栓形成结论vwF裂解蛋白酶活性降低有助于TTP的肯定性诊断，缸浆TM、VEGF水平以及外周血破碎红细胞百分率的动态测定有助于反映TTP患者病情严重程度及对治疗反应的评价选择性眼底荧光造影对TTP微血管栓形成的判定有一定的临床价值。     

地塞米松联合恩丹西酮对手术后病人自控镇痛相关恶心呕吐的影响

目的　观察地塞米松联合恩丹西酮对手术后病人自控镇痛 (PCA)所致恶心呕吐的防治效果。方法　随机将 2 0 0例在连续硬膜外麻醉下行下肢手术的患者分为四组 :对照 (C)组于手术切皮前 (T1)和手术结束时 (T2 )分别静脉注射生理盐水 2ml;地塞米松 (D)组于T1、T2 时分别注射地塞米松 10mg和生理盐水 2ml;恩丹西酮 (O)组于T1、T2 时分别注射生理盐水 2ml和恩丹西酮4mg ;地塞米松 +恩丹西酮 (D +O)组于T1、T2 时分别注射地塞米松 10mg和恩丹西酮 4mg。术毕均行病人自控静脉芬太尼镇痛 (PCIFA)。观察术后 2 4h内病人镇痛效果、镇静评分和恶心呕吐发生情况。结果　 5例患者因故退出此观察。组间镇痛效果、镇静评分无明显差异。C组恶心呕吐发生率为 5 2 1% ,明显高于D组 (33 3% )和O组 (32 7% ) ,P <0 0 5 ;D +O组恶心呕吐发生率为16 0 % ,与C组比较 ,P <0 0 1,与D组和O组比较 ,P <0 0 5 ;各处理组恶心程度均小于对照组 ,P <0 0 5 ;D +O组呕吐程度低于C组 ,P <0 0 5。结论　地塞米松与恩丹西酮单独应用均能有效地减少手术后PCIFA相关的恶心呕吐 ,减轻恶心程度 ;两药联合应用进一步降低患者的恶心呕吐发生率和呕吐的程度     

沙美特罗/丙酸氟替卡松干粉剂和丙酸氟替卡松气雾剂治疗支气管哮喘的疗效比较

目的：比较吸入沙美特罗/丙酸氟替卡松（SM/FP）干粉剂和单用丙酸氟替卡松（FP）气雾剂治疗轻中度哮喘患者的临床疗效.方法：将60例哮喘患者随机分为两组,A组吸入SM/FP,每次50μg/100μg,bid,B组吸入FP,每次125μg,bid.测定两组患者治疗前、治疗后1个月和4个月后晨间呼气峰流速（mPEF）,第1秒用力呼气容积占预计值百分比（FEV1%pre）、第1秒用力呼气容积占用力肺活量百分比（FEV1/FVC）和哮喘症状评分.结果：两组各项指标均有好转,治疗后1个月A组mPEF,FEV1%pre,症状评分较B组改善明显,第4个月两组之间各项指标均有差异（P＜0.05）.结论：联合吸入低剂量糖皮质激素和β2受体激动剂较单一吸入激素效果好.     

扩张性心肌病患者内皮依赖性和内皮非依赖性血管舒张功能受损的研究

目的　研究扩张性心肌病 (扩心病 )患者内皮依赖性 (简称血管内皮功能 )和内皮非依赖性血管舒张功能是否受损。方法　采用高分辨血管外超声法测定 40例扩心病患者和 42例无扩心病对照组肱动脉血流介导的血管内皮功能和舌下含服硝酸甘油( 0 5mg)后内皮非依赖性血管舒张功能。结果　扩心病患者血流介导性的肱动脉舒张 [( 2 3 2± 2 10 ) % ]较对照组 [( 7 87± 4 15 ) % ]明显降低 (P <0 0 1) ,含服硝酸甘油后的肱动脉舒张 [( 16 89± 11 5 7) % ]也较对照组 [( 2 2 83± 6 93 ) % ]明显受损 (P <0 0 5 )。结论　扩心病患者外周血管内皮功能和内皮非依赖性血管舒张功能均受损     

NDUFA4L2 expression predicts poor prognosis in clear cell renal cell carcinoma patients

Background: NDUFA4L2 is overexpressed in VHL-deficient cell lines and neuroblastoma. The clinical significance of NDUFA4L2 in clear cell renal cell carcinoma (ccRCC) has not been well studied. Therefore, we evaluated the prognostic value of NDUFA4L2 in ccRCC patients.

Methods: In our study, NDUFA4L2 expression in 86 cases of ccRCC and adjacent normal tissues was monitored by immunohistochemistry, semi-quantitative RT-PCR, and Western blot analyses. The relationship between NDUFA4L2 expression and the clinical features of ccRCC was assessed.

Results: The results showed that NDUFA4L2 protein expression was found to be higher in ccRCC tissues 81.4% (70/86) than in normal tissues 26.7% (23/86) (p?=?0.021). The average level of NDUFA4L2 mRNA expression was found to be 122.23?±?6.018 and 21.34?±?1.036 in ccRCC tissue and adjacent normal tissue (p?Conclusions: Our study has provided the significant clinical relevance of NDUFA4L2 in ccRCC and suggested that ccRCC patients with NDUFA4L2 overexpression may be suitable as a potential therapeutic target for ccRCC patients.     

Allele polymorphism and haplotype diversity of MICA/B in Tujia nationality of Zhangjiajie,Hunan Province,China

Previous studies indicate the distribution of major histocompatibility complex class I chain-related genes A (MICA) and B (MICB) alleles and haplotypes varies widely between different ethnic populations and geographic areas. It is meaningful to investigate allelic frequencies and establish a genetic database. In this study, we firstly reported the polymorphic variation of MICA/B in 187 healthy, unrelated Tujia individuals in Zhangjiajie region, China. Using polymerase chain reaction-sequence specific priming (PCR-SSP) and sequencing-based typing (PCR-SBT), we identified eight MICA-sequence alleles, four MICA-short tandem repeat variants, and 13 MICB variants, of which MICA¹008:04 (29.41%), MICA¹A5 (29.68%), MICA¹A5.1 (29.68%) and MICB¹005:02 (39.57%) were the most frequent. Linkage disequilibrium analysis further revealed MICB¹005:02-MICA¹019 (13.10%) and MICB¹002-MICA¹008:04 (9.89%) as the most common two-locus haplotypes. Data comparison by neighbor-joining dendrograms and principal component analysis to verify allelic frequencies in other Chinese and Asia ethnic groups showed that the Zhangjiajie Tujias were genetically closer to the Guangdong Han population, based on MICA loci variability. Our results provide new information about the MICA/B gene polymorphism in Chinese Tujia population, which will form the basis for future studies on the potential role of MICA/B in allogeneic organ transplantation and disease susceptibility in related ethnic groups.     

Impact of HCV genotype on treatment regimens and drug resistance: a snapshot in time

The introduction of highly potent direct‐acting antivirals (DAAs) has revolutionized hepatitis C virus treatment. Nevertheless, viral eradication worldwide remains a challenge also in the era of DAA treatment, because of the high associated costs, high numbers of undiagnosed patients, high re‐infection rates in some risk groups and suboptimal drug efficacies associated with host and viral factors as well as advanced stages of liver disease. A correct determination of the HCV genotype allows administration of the most appropriate antiviral regimen. Additionally, HCV genetic sequencing improves our understanding of resistance‐associated variants, either naturally occurring before treatment, acquired by transmission at HCV infection, or emerging after virological failure. Because treatment response rates, and the prevalence and development of drug resistance variants differ for each DAA regimen and HCV genotype, this review summarizes treatment opportunities per HCV genotype, and focuses on viral genetic sequencing to guide clinical decision making. Although approval of the first pan‐genotypic DAA‐only regimen is expected soon, HCV genetic sequencing will remain important because when DAA therapies fail, genotyping and resistance testing to select a new active DAA combination will be essential. Copyright © 2016 John Wiley & Sons, Ltd.