丹酚酸B镁对兔急性心梗再灌注后无复流心肌损伤的保护作用

目的 评价丹酚酸B镁（salvianolic acid B,Sal-B）对兔急性心肌梗死再灌注后心肌损伤的保护作用。方法 新西兰大白兔40只随机分成4组,即假手术组、心肌缺血再灌注（myocardial ischemia/reperfusion,MI/R）、再灌注低剂量组（Sal-B20 mg·kg^-1组）、再灌注高剂量组（Sal-B 60 mg·kg^-1组）,每组10只。假手术组只开胸不结扎,其余3组结扎左室缘支90 min,切断结扎线120 min,建立MI/R模型。各组分别于结扎左心室缘支前5 min、结扎后90 min、再灌注120 min时取血,检测肌酸激酶同工酶（CK-MB）、心肌肌钙蛋白I （cTnI）,并评估缺血范围、无复流范围及梗死区心肌范围。结果 结扎90 min后,MI/R组、Sal-B 20 mg·kg^-1组和Sal-B 60 mg·kg^-1组3组之间CK-MB、cTnI水平差异无统计学意义。再灌注120 min后,Sal-B 60 mg·kg^-1组的血清CK-MB、cTnI水平显著低于MI/R组、Sal-B 20 mg·kg^-1组,差异有统计学意义（P<0.05）。各组染色所测的冠脉结扎区心肌缺血范围基本一致。与MI/R组、Sal-B 20 mg·kg^-1组比,Sal-B 60 mg·kg^-1组可以显著减少无复流面积（P<0.05）和梗死面积（P<0.05）,MI/R组和Sal-B 20 mg·kg^-1组之间差异无统计学意义。结论 Sal-B 60 mg·kg^-1能在一定程度上减轻心肌细胞结构损伤,缩小心肌梗死面积,减轻无复流的发生。     

The organochlorine p,p′-dichlorodiphenyltrichloroethane induces colorectal cancer growth through Wnt/β-catenin signaling

Dichlorodiphenyltrichloroethane (DDT), an organochlorine pollutant, is associated with several types of cancer. However, the relationship between DDT and colorectal cancer is uncertain. In this study, the impact of p,p′-DDT on colorectal cancer growth was evaluated using both in vitro and in vivo models. Our results indicated that the proliferation of human colorectal adenocarcinoma DLD1 cells was significantly promoted after exposed to low concentrations of p,p′-DDT ranging from 10⁻¹² to 10⁻⁷ M for 96 h. Exposure to p,p′-DDT from 10⁻¹⁰ to 10⁻⁸ M led to upregulation of phospho-GSK3β (Ser9), β-catenin, c-Myc and cyclin D1 in DLD1 cells. RNA interference of β-catenin inhibited the proliferation of DLD1 cells stimulated by p,p′-DDT. Inhibiting of estrogen receptors (ERs) had no significant effect on the action of p,p′-DDT. Treatment with p,p′-DDT induced production of intracellular reactive oxygen species (ROS) and inhibited superoxide dismutase (SOD) activity in DLD1 cells. Treatment with N-acetyl-L-cysteine (NAC), a ROS inhibitor, suppressed the induction of Wnt/β-catenin signaling and DLD1 cell proliferation by p,p′-DDT. Moreover, in a mouse xenograft model, 5 nmol/kg p,p′-DDT resulted in increased tumor size, oxidative stress and Wnt/β-catenin signaling. These results indicated that low concentrations of p,p′-DDT promoted colorectal cancer growth through Wnt/β-catenin signaling, which was mediated by oxidative stress. The finding suggests an association between low concentrations of p,p′-DDT exposure and colorectal cancer progression.     

基于文献数据挖掘中药复方治疗支气管扩张伴感染的用药规律*

目的基于文献数据挖掘的方式,收集近20年文献中治疗支气管扩张伴感染的中药复方,探讨支气管扩张伴感染的中医用药规律。方法 将收集所得83个处方,运用频数分析、聚类分析、关联规则进行数据挖掘,探讨其潜在的用药规律。结果 频数分析显示共涉及药物140味,使用频次≥10次的中药有29味;聚类分析反映了清肺祛痰消痈、祛瘀止血、益气养阴的治疗方法;关联规则体现清热补虚为本病的基本方法,重视消痈排脓。结论 支气管扩张的基本病机为本虚标实,在清热祛痰排脓的同时,要兼顾益气养阴、活血化瘀。     

Spectrum-effect relationships between UPLC fingerprints and bioactivities of crude secondary roots of Aconitum carmichaelii Debeaux (Fuzi) and its three processed products on mitochondrial growth coupled with canonical correlation analysis

Ethnopharmacological relevance: The crude secondary roots of Aconitum carmichaelii Debeaux (Fuzi), together with its processed products, including Yanfuzi, Heishunpian and Paofupian, are commonly applied in clinic using for thousands of years, such as collapse, syncope, rheumatic fever, painful joints and various tumors.Aim of the study: To explore the different effects of Fuzi and its processed products on energy metabolism, with mitochondria as the model with the aim of guiding the clinical use of Fuzi and its products. fingerprints of Fuzi, Yanfuzi, Heishunpian and Paofupian were established by Ultra-high Performance Liquid Chromatography (UPLC) and effects of Fuzi and its processed products on rat’s liver׳s mitochondrial metabolism were studied by microcalorimetry. Spectrum-effect relationships between UPLC fingerprints and energy metabolism of mitochondria were investigated using canonical correlation analysis (CCA).Results: Because of their inherent differences in chemical compositions, the main activities of energy metabolism of mitochondria were different among Fuzi and its processed products. The potential bioactivity sequence of the tested products was Fuzi>Heishunpian>Paofupian>Yanfuzi. Results of CCA showed that compounds mesaconitine, benzoylaconitine, and benzoylhypacoitine might be the principal active components.Conclusion: Altogether, this work provides a general model of combination of UPLC and microcalorimetry to study the spectrum-effect relationships of Fuzi and its processed products which can offer some references for detecting principal components of traditional Chinese medicine on bioactivity to mitochondrial growth.     

颈椎前路术后早期硬膜外血肿形成的原因及防治

目的:探讨颈椎前路术后早期硬膜外血肿形成的原因及防治措施.方法:2005年6月至2011年12月,行颈椎前路手术的患者1 452例,术后发生硬膜外血肿5例,男4例,女1例;年龄33～55岁,平均46.4岁;脊髓型颈椎病3例,脊髓型颈椎病伴C6椎体血管瘤1例,颈椎后纵韧带骨化症1例.回顾分析5例硬膜外血肿出现的时间、临床表现、症状持续时间及手术处理对神经功能恢复的影响.结果:5例患者均出现在术后24 h内,平均症状持续时间4 h(2～7 h),表现为进行性加重的脊髓功能损害,均行急诊手术处理,术后患者脊髓功能均有不同程度地恢复,1例患者在第1次血肿清除术后5h再次出现血肿压迫而行第2次血肿清除术;术后平均随访13.8个月(6～18个月),至末次随访时神经功能均恢复良好,无硬膜外血肿复发.结论:颈椎前路术后24 h内,特别是术后6～8 h,是硬膜外血肿发生的高峰,应严密监测患者神经功能变化;早期出现的进行性加重的脊髓功能损害是硬膜外血肿的主要临床表现;MRI检查可以明确硬膜外血肿的诊断,并可以精确定位血肿位置和范围,有助于硬膜外血肿的有效清除.硬膜外血肿一旦确诊必须第一时间行手术治疗,如果处理及时患者脊髓功能恢复良好.     

降钙素原、C反应蛋白在社区获得性肺炎细菌感染的诊断价值

目的：探讨血清降钙素原（PCT）及C反应蛋白（CRP）在社区获得性肺炎（CAP）中的诊断价值。方法回顾性分析明确诊断为肺部疾病的患者122例,分为细菌感染组54例和非细菌感染组68例,并根据重症肺炎诊断标准,将细菌感染组分为重症肺炎18例,轻中症肺炎36例。记录并比较所有患者入院24 h内的血常规、PCT、CRP、病原学等指标,并描绘ROC曲线进行分析。结果 PCT及CRP在CAP患者中的水平高于非细菌感染的患者（t分别=3.62、7.25,P＜0.05）。重症组的PCT和CRP水平明显高于轻中症组（t分别=2.37、2.65,P均＜0.05）。 ROC曲线分析显示,所有患者PCT和CRP的ROC曲线下面积分别为0.89和0.88,PCT和CRP诊断CAP细菌感染的最佳诊断阈值分别为0.09μg/L、29.27 mg/L。重症细菌感染组PCT和CRP的ROC曲线下面积分别为0.80和0.74,PCT和CRP诊断重症细菌感染的最佳诊断阈值分别为0.17μg/L、85.17 mg/L,此时PCT、CRP的灵敏度分别为88.89%、66.67%,特异度分别为66.65%、80.55%,PCT对重症细菌感染具有高度灵敏度,在重症细菌感染中的敏感性较CRP高,特异性未见明显优势。结论CAP患者的PCT及CRP水平较非细菌感染肺疾病患者高;PCT联合CRP对诊断细菌性肺炎及重症细菌感染性肺炎具有更高的特异性,有助于提高诊断的准确性。     

LC-MS法筛选强骨饮对绝经后骨质疏松症患者全血差异蛋白的研究

目的 应用LC-MS法筛选分析经强骨饮治疗的绝经后骨质疏松症患者（postmenopausal osteoporosis,PMOP）和未经治疗的绝经后骨质疏松症患者全血差异蛋白,探索强骨饮治疗绝经后骨质疏松症的作用机制。方法 采用液相色谱-串联质谱联用测定法分别对7例经强骨饮治疗后的绝经后骨质疏松症患者（治疗组）及8例未经治疗的绝经后骨质疏松症患者（对照组）全血蛋白进行检测,并对差异蛋白质进行定量分析,筛选出差异蛋白,进行生物信息学分析。结果 分析治疗组与对照组患者全血筛选出的91个差异蛋白, 以差异倍数大于1.2 倍作为显著上调、小于0.83作为显著下调,确认有 31个蛋白表达显著上调,60个蛋白表达显著下调。对所有差异蛋白进行GO功能注释分析,发现上调的差异蛋白主要位于细胞质内,而有22 %的下调蛋白在细胞外,有 1个细胞骨架蛋白。差异蛋白参与的主要细胞活动为单一生物过程、细胞代谢过程等,分子功能主要为催化活性、分子功能调节剂和结构分子活动等。结论 LC-MS法能有效筛选出强骨饮治疗的PMOP患者和未经治疗的PMOP患者全血中的差异蛋白,强骨饮治疗PMOP的作用机制是一个由多种蛋白质分子参与的结果,其关键的靶标和具体的调控机制尚需进一步的研究探讨。     

Tele-yoga in the management of ankylosing spondylitis amidst COVID pandemic: A prospective randomized controlled trial

PurposeAnkylosing spondylitis (AS) signficantly affect day to day activities contributing to signficant disability. Patients with AS often report to have psychological problems and poor quality of life (QoL). This study investigates the effect of a three-month tele-yogic intervention on disease activity, functional index, inflammatory markers, quality of life and mental health measures in patients with AS.MethodsOne hundred and twenty AS patients were assigned to either the yoga intervention group (YG) or the control group (CG). The YG (n = 57) received a 60-min structured yoga module online for 3 months in addition to standard medical care. The CG participants (n = 52) received only standard care during the same period. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis-Quality of Life (ASQOL) and psychological and inflammatory biomarkers were assessed at baseline and after three months.ResultsYG showed significant improvement in BASDAI (p = 0.001), anxiety (p = 0.0004), and depression (p = 0.001) at three months compared to baseline. The CG showed no significant change in similar outcome measures. At three months, the intervention resulted in a significant improvement in BASDI (−0.79; 95% CI (−1.3, to −0.29); p = 0.0021), BASFI (−0.86, 95% CI (−1.59, to −0.14); p = 0.0193), anxiety (−0.42, 95% CI (−0.84 to −0.01), p = 0.0468), and AS-QoL (−3.37; 95% CI (−5.21 to 1.53); p = 0.0004) compared to the CG.ConclusionsThe present study suggests that yoga helps improve pain, functional index, and mental health in patients with AS. Tele-yoga intervention is feasible and effective in treating AS.     

不寐从胆论治

不寐从胆论治古往今来鲜有系统阐述。本文从中医经典入手,分析“胆”的功能及经络输布等生理基础,并结合古代医案及临床效案,系统探究不寐从胆论治的理论基础,以窥不寐证从胆论治之义。