激素性股骨头缺血坏死MRI诊断的实验研究

目的：建立股骨头缺血坏死(ANFH)动物模型，将磁共振成像(MRI)表现与组织病理学结果对照，探讨早期ANFH的病理变化和删表现的病理学基础。方法：成年新西兰兔36只，随机均分成三组。A组：为正常对照组，静脉注射生理盐水。B、C组为实验组，B组：单纯静脉注射地塞米松10mg／kg／d连续7天，间隔两周再重复一次。C组；马血清与激素共用，先静脉注射马血清10g／kg，间隔2周再重复一次；继之重复B组给药。之后4、8、16、26周后分别从3组随机各取3只，先拍X线平片再进行删，然后取双侧股骨头做组织病理检查。结果：实验组兔股骨头第8周T1WI信号强度明显降低，T2WI呈不均匀高信号，对应病理改变为骨髓水肿，骨髓腔内少量出血和少量骨细胞坏死。16、26周T1WI信号强度增高，病理显示骨髓脂肪细胞肥大并融合成大泡状，大量骨细胞坏死，骨小梁变细、中断。16、26周兔股骨头X线平片示骨质稀疏，骨小梁模糊。C组上述变化较B组显著。结论：1．采用马血清和肾上腺皮质激素共用，比单纯用肾上腺皮质激素更易诱导出较典型的ANFH动物模型。2．删能够较全面反映早期激素性ANFH的病理变化。     

年龄相关性白内障术后发生感染性眼内炎的病原学特点及相关因素

目的：探究年龄相关性白内障手术后发生感染性眼内炎的病原学特点及相关因素与预防。

方法：回顾性分析本院2016-01/2018-01收治的1 365例年龄相关性白内障患者,统计患者感染性眼内炎发生情况,并分析感染性眼内炎病原学特点及相关危险因素。

结果：患者28例发生感染性眼内炎,共检出病原菌36株,其中表皮葡萄球菌9株(25.00%),铜绿假单胞菌9株(25.00%),芽孢杆菌8株(22.22%)。铜绿假单胞菌、芽孢杆菌对头孢唑林、头孢噻肟、阿莫西林具有较强的耐药性; 对头孢哌酮-舒巴坦、美罗培南的敏感性较高; 表皮葡萄球菌对青霉素、红霉素、阿奇霉素有较强的耐药性,对万古霉素、呋喃妥因、米诺环素的敏感性较高。Logistic多因素回归分析,年龄(≥70岁)、糖尿病、手术时间(≥15min)、术中玻璃体溢出是年龄相关性白内障术后发生感染性眼内炎的独立危险因素(P<0.05)。

结论：年龄相关性白内障手术后感染性眼内炎病原菌以表皮葡萄球菌、铜绿假单胞菌、芽孢杆菌多见。年龄(≥70岁)、糖尿病、手术时间(≥15min)、术中玻璃体溢出为年龄相关性白内障手术后发生感染性眼内炎的独立危险因素。     

Preoperative neutrophil-to-lymphocyte ratio is a more valuable prognostic factor than platelet-to-lymphocyte ratio for nonmetastatic rectal cancer

Several combinations of inflammatory factors, including neutrophil-to- lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been reported to be prognostic factors in various malignant tumors, including colorectal cancer (CRC). The aim of this study was to evaluate the prognostic value of NLR and PLR for patients with rectal cancer (RC) who underwent curative surgery. Data from patients who underwent curative resection for RC were retrospectively reviewed. The cutoff for NLR and PLR was defined as 2.3 and 144 by receiver operating characteristic (ROC) curve. Overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan-Meier method. Multivariable Cox regression model was used to evaluate the independent prognostic significance of variables. A total of 140 patients were eligible in the study. High NLR (> 2.3) and high PLR (> 144) both predicted lower OS and DFS according to Kaplan-Meier method. But in the multivariable Cox regression model, only the high NLR retained significance for reduced OS and DFS. According to Chi-square test, patients with higher NLR had larger tumor size and higher pN-stage. While PLR was only associated with the pN-stage. High preoperative NLR was shown to be a negative independent prognostic factor in patients undergoing resection for nonmetastatic RC. It may be helpful as a factor to guide the postoperative therapies.     

Inhibition of endocan attenuates monocrotaline-induced connective tissue disease related pulmonary arterial hypertension

Connective tissue disease related pulmonary arterial hypertension (CTD-PAH) is characterized by vascular remodeling, endothelial dysfunction and inflammation. Endocan is a novel endothelial dysfunction marker. The aim of the present study was to investigate the role of endocan in CTD-PAH. Monocrotaline (MCT)-induced PAH rats were used as the CTD-PAH model. Short hairpin RNA packed in a lentiviral vector used to inhibit endocan expression was intratracheally instilled in rats prior to the MCT injection. Endocan was found to be increased in the serum and lung of MCT-induced PAH rats. Short hairpin RNA mediated knockdown of endocan significantly decreased right ventricular systolic pressure, attenuated pulmonary remodeling and inflammatory responses in the lung. In the in vitro study, tumor necrosis factor-α (TNF-α) exposure caused increased endocan expression in the primary cultured rat pulmonary microvascular endothelial cells (RPMECs). Endocan knockdown inhibited the permeability increase and adhesion molecules secretion in RPMECs induced by TNF-α. In addition, TNF-α induced MAPK activation was blocked when endocan gene was knocked down. These data demonstrate that endocan may play an important role in the development of CTD-PAH. This study provides novel evidence to better understand the pathogenesis of CTD-PAH, which may be beneficial for the treatment of this disease.     

Aβ amyloid,cognition, and APOE genotype in healthy older adults

BackgroundOnly one study has investigated the relationship between cerebral β-amyloid (Aβ), apolipoprotein E (APOE) ɛ4 genotype, and cognition. Although significant relationships between cerebral Aβ and cognition were observed in ɛ4 carriers but not noncarriers, the magnitude of this relationship was not reported. Further, when demographic variables were controlled, the influence of APOE ɛ4 on the relationship between cerebral Aβ and cognition dissipated.MethodsIn 144 healthy older adults who had undergone amyloid scanning and APOE ɛ4 genotyping in the Australian Imaging, Biomarkers, and Lifestyle (AIBL) Flagship Study of Ageing, correlations were conducted to determine the magnitude of relationship between cerebral Aβ and cognition in ɛ4 carriers and noncarriers. Fisher’s Z was used to compare these correlations and Cohen’s q determined the magnitude of difference between correlations.ResultsCerebral Aβ was significantly associated with tasks of visual and verbal episodic memory in APOE ɛ4 carriers. This association was not observed in ɛ4 noncarriers. The relationship between cerebral Aβ and episodic memory in ɛ4 carriers was significantly different from that in ɛ4 noncarriers, and the magnitude of this difference was small to moderate.ConclusionsIn APOE ɛ4 carriers, there is a moderate negative relationship between cerebral Aβ and episodic memory. This suggests that increased cerebral Aβ may signify the onset of preclinical AD, especially in healthy older adults who are genetically at risk for AD.     

慢性烟曲霉暴露对支气管哮喘大鼠气道黏蛋白MUC5AC表达的影响

[目的]探讨慢性烟曲霉暴露对支气管哮喘(简称哮喘)大鼠气道黏蛋白MUC5AC表达的影响.[方法]将56只雄性Wistar大鼠按随机数字表法分为7组(每组8只):慢性哮喘(A)组、慢性哮喘+烟曲霉孢子吸入1周(B)、3周(C)和5周(D)组、慢性哮喘+生理盐水吸入(E)组、卵清白蛋白(OVA)致敏生理盐水激发(F)组和OVA致敏生理盐水激发+烟曲霉孢子吸入(G)组.测定各组大鼠基础气道阻力和应用乙酰胆碱后气道阻力变化率,RT-PCR测定肺组织MUC5AC mRNA的表达,免疫组织化学染色测定各组大鼠气道上皮细胞MUC5AC的表达,酶联免疫吸附(ELISA)法测定BALF中IL-13水平,肺组织切片过碘酸雪夫染色(PAS)观察气道上皮杯状细胞增生程度.[结果]B、C和D组大鼠肺组织MUC5AC mRNA(MUC5AC mRNA/β-actin mRNA)(分别为1.9±0.4、2.3±0.6、2.9±0.8)、气道上皮细胞MUC5AC表达(A值)(分别为278±58、566±64、891±80)、BALF上清液IL-13[分别为(96±16)、(136±22)、(197±34)μg/L]及杯状细胞/上皮细胞面积(分别为16％±5％、23％±7％、36％±9％)均高于A、E、F及G组(均P＜0.05);C和D组大鼠气道阻力变化率(分别为61.91％±5.26％、84.69％±6.38％)均高于A、E、F及G组(均P＜0.05).B、C和D组哮喘大鼠MUC5AC的A值及MUC5AC Mma/β-actin mRNA与气道上皮杯状细胞增生程度(PAS染色区面积/上皮细胞面积)呈正相关(r值分别为0.578和0.614,均P＜0.05),与气道反应性(Raw变化率)呈正相关(r值分别为0.638和0.564,均P＜0.05).[结论]慢性烟曲霉暴露可上调哮喘大鼠气道上皮黏蛋白MUC5AC的表达,促进杯状细胞增生,加重气道高反应.     

Perirenal fat associated with microalbuminuria in obese rats

Purpose

To determine whether perirenal fat is associated with increased urinary albumin excretion and whether perirenal fat affects renal vascular endothelial function in obese rats.

Methods

Wistar rats were randomly divided into normal and obesity group, which were fed with normal and high-fat diet, respectively. Blood and urine samples were collected. Endothelial function of the aorta was determined by measuring endothelium-dependent vasodilatation. Renal tissues were collected for CD34 immunohistochemistry and free fatty acids (FFA) measurement. Levels of glomerular nitric oxide (NO) and reactive oxygen species (ROS) were measured.

Results

After 24 weeks, plasma FFA, high-sensitivity C-reactive protein, and malondialdehyde levels were elevated and were significantly higher in renal venous blood than in jugular venous blood in obese rats. Urinary albumin/creatinine ratio, glomerular CD34 expression, glomerular ROS level, and renal cortex FFA levels were higher in obese rats. Endothelial dysfunction was more severe in the infra-renal aorta than in the thoracic aorta in obese rats. Plasma adiponectin and glomerular NO levels were lower in obese rats.

Conclusion

Perirenal fat is associated with increased urinary albumin excretion in obese rats. The mechanism may be renal vascular endothelial dysfunction caused by increased oxidative stress and activation of inflammatory molecular pathways due to elevated FFA and low adiponectin levels.     

Prognostic impact of lncRNA-ATB expression in malignant solid tumors: A meta-analysis

PurposeNumerous studies have reported the prognostic role of lncRNA-ATB high expression in solid tumours, but its prognostic effect is still uncertain. Therefore, the purpose of this meta-analysis was to further comprehensively verify the prognostic role of the lncRNA-ATB high expression in solid tumours.MethodsA literature search was performed using the electronic platforms to obtain relevant research studies published up to 31 May 2019. Confidence intervals of research endpoints in each study were extracted and merged. All data analysis was performed using Stata12.0 software.ResultsA total of 2120 patients with solid cancers in 14 studies were enrolled in our meta-analysis eventually. The analysis results revealed that high expression of lncRNA-ATB was related to lower OS (HR:1.46, P < 0.001), shorter DFS(HR:1.73, P < 0.001), and earlier RFS (HR:2.67, P < 0.001). Besides, the high expression of lncRNA-ATB has a considerable risk of lymph node metastasis (OR:2.13, P = 0.017)and perineural invasion (OR:1.58, P = 0.018).ConclusionsMeta-analysis showed that the high lncRNA-ATB expression was a poor prognostic marker in multiple cancer types. The high expression of lncRNA-ATB symbolizes the high risk of lymph node metastasis and perineural invasion in cancer patients.     

不同时机应用格拉司琼对预防全身麻醉术后恶心呕吐的影响

目的 探讨不同时机应用格拉司琼对预防全身麻醉术后恶心呕吐的影响。方法 选择择期气管插管全身麻醉手术的患者48例，按应用格拉司琼的不同时间将患者随机分为三组：A组：麻醉诱导完毕即刻；B组：麻醉诱导完毕后1h；C组：术毕拔出气管导管后。记录术后24h内恶心呕吐的发生情况。结果 术后恶心发生率及术后呕吐发生率在A组与B组间比较差异均无统计学意义（P〉0．05）。C组的术后恶心发生率及术后呕吐发生率明显低于A组与B组（P〈0．05）。结论 格拉司琼在预防术后恶心呕吐时，建议在术毕应用。     

前哨淋巴结活检对预测早期乳腺癌腋窝淋巴结状态的价值

目的研究前哨淋巴结活检术（sentinel lymph node biopsy,SLNB）对判断早期乳腺癌腋窝淋巴结状态应用的可行性及其预测的准确性。方法本组选择临床检测腋窝淋巴结阴性的原发性早期乳腺癌患者76例,按癌瘤长径分组,用术中在原发肿瘤周围注射亚甲蓝（美蓝）的方法定位腋窝前哨淋巴结并对其进行活检,随后行腋窝淋巴结清扫（axillary lymphnode dissection,ALND）。术后对全部淋巴结行连续切片病理检查。结果76例患者有69例检测到前哨淋巴结,成功率90.79%.69例检测到的前哨淋巴结中65例准确地判断了腋窝淋巴结转移状态,SLN预测腋窝淋巴结状态的假阳性率、假阴性率、敏感性、准确性分别为0,12.50%,87.50%,94.20%.结论SLNB基本能准确地判断早期乳腺癌腋窝淋巴结状态,故能指导cN0期乳腺癌腋窝淋巴结清扫范围。