中医医院现代化建设的思考

从中医现代化建设方面提出了几个注意的问题:强化改革开放意识,转变旧的封闭观念;重视医、教、研协同发展;加快传统科室的改造;加速陈旧设备的更新;基础设施建设应具有超前意识;开展对外交流,引进与输出相结合。     

当归四逆汤化学成分、药理作用和临床应用的研究进展及质量标志物（Q-Marker）的预测分析

当归四逆汤（Danggui Sini Decoction,DSD）是治疗血虚寒厥证的代表方剂,具有温经散寒、养血通脉等功效,临床多用于治疗冠心病、心绞痛、雷诺氏征、糖尿病周围神经病变、痛经、膝骨关节炎等疾病。在对DSD化学成分、药理作用和临床应用研究进展进行综述的基础上,依据中药质量标志物（quality marker,Q-Marker）“五原则”对其Q-Marker进行预测分析。结果提示阿魏酸、藁本内酯、肉桂酸、桂皮醛、芍药苷、芍药内酯苷、甘草苷、甘草酸和细辛脂素可作为DSD的Q-Marker,为DSD及其相关制剂的质量控制等后续研究提供参考。     

柿叶总黄酮对急性肝损伤小鼠肝组织的保护作用

目的探讨柿叶总黄酮(PLF)对四氯化碳(CCl 4)诱导的小鼠急性肝损伤的保护作用。方法采用CCl 4肝损伤模型,测定小鼠血清中谷丙转氨酶(ALT)和谷草转氨酶(AST)的含量及肝组织中超氧化物歧化酶(SOD)、脂质过氧化物丙二醛(MDA)、还原型谷胱甘肽(GSH)和肿瘤坏死因子-α(TNF-α)的含量,HE染色观察肝脏组织病理形态学的改变。结果PLF高、中、低剂量组均能降低肝损伤小鼠ALT和AST的含量,提高肝组织SOD和GSH含量,降低MDA和TNF-α含量,并能改善肝组织的病理损伤程度。结论PLF对CCl 4所致的小鼠肝损伤有较好的保护作用,其作用机制可能与提高小鼠的抗脂质氧化能力有关。     

Single nucleotide polymorphisms of HER2 related to osteosarcoma susceptibility

Aims: The purpose of this study was to investigate the correlation between single necleotide polymorphisms (SNPs) of human epidermal growth factor receptor-2 (HER2) gene with osteosarcoma susceptibility in Chinese Han population. Methods: 90 patients with osteosarcoma and 100 healthy controls who were frequency-matched with the former by age and gender were enrolled for a case-control study. 5 SNPs of HER2, namely rs2952155, rs1810132, rs2952156, rs1136201 and rs1058808, were tested by Sequenom time of flight mass spectrometry technique. The linkage disequilibrium and haplotype were analyzed using haploview software. The risk intensity of osteosarcoma was expressed by odds ratio (OR) with 95% confidence interval (CI) which was calculated by chi-squared text. Hardy-Weinberg equilibrium (HWE) was also evaluated by chi-squared text. Results: HER2 gene rs1136201 and rs1058808 polymorphisms were associated with the increased risk of osteosarcoma (P=0.04 and 0.02, respectively). Allele G in rs1136201 was 1.67 higher risk for osteosarcoma in cases than the control group (OR=1.67, 95% CI=1.11-2.51) and G allele of rs1058808 polymorphism also significantly increased osteosarcoma susceptibility (OR=2.06, 95% CI=1.27-3.22). The haplotype analysis showed that haplotype C-T-G-G might be a susceptible haplotype to osteosarcoma (OR=1.74, 95% CI=1.01-3.00). HWE test was eligible in controls (P>0.05). Conclusion: HER2 gene rs1136201 and rs1058808 polymorphisms and haplotype C-T-G-G may be related to osteosarcoma susceptibility in Chinese Han population, indicating that the interaction of gene polrmorphism plays an role in osteosarcoma risk.     

祛湿通络方对肺炎支原体感染的RAW264.7细胞TNF-α、IL-6表达的影响

[目的]观察祛湿通络方含药血清对肺炎支原体(MP)感染的RAW264.7细胞肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)表达的影响。[方法] 1)祛湿通络方含药血清的制备:SD大鼠随机分为空白对照组、中药低、中、高剂量组、阿奇霉素组,各组均连续给药7 d。2)MP感染的RAW264.7细胞炎症模型建立:模型组和各给药组分别加入MP菌液100μL,空白对照组加入100μL DMEM完全培养液,置于培养箱中培养2 h。3)酶联免疫吸附(ELISA)法检测祛湿通络方对MP感染的RAW264.7细胞TNF-α、IL-6表达的影响。[结果]与空白对照组比较,MP感染的RAW264.7细胞TNF-α、IL-6的分泌均显著上升(P0.05);与模型组比较,各给药组对TNF-α、IL-6均有不同程度的下调作用(P0.05),其中阿奇霉素组对TNF-α、IL-6的调节作用最优,中药低、中、高剂量组呈现剂量依赖性。[结论]祛湿通络方对MP感染的RAW264.7细胞TNF-α、IL-6的高表达具有下调作用,且呈剂量依赖性,这可能是祛湿通络方减轻炎症反应的机制之一。     

降钙素原与白介素-6与急性心力衰竭继发肺部感染的关系

目的观察分析血清降钙素原（PCT）与白介素-6（IL-6）与急性心力衰竭（心衰）并发肺部感染中的关联性。方法：将急性心衰患者184例分别于发病后第1、2、3、5天抽取静脉血,检测血清IL-6、PCT的变化,同时依据患者临床肺部感染评分及痰培养结果将患者分为单纯心衰组与心衰并发肺部感染组,分析两组患者IL-6、PCT动态变化的意义。结果：心衰发生后第1、2天单纯心衰组与并发肺部感染组炎性反应指标较正常值明显增高。单纯心衰组发生后第2天PCT达到高峰,第3、5天PCT明显下降,降低幅度大于50％。但第3天单纯心衰组有59％患者血清PCT≥2．0 μg／L;而继发肺部感染组第1、2天血清PCT水平也表现明显升高,两组比较,差异无统计学意义。但第3天及第5天患者血清PCT水平持续升高或下降幅度〈30％。IL-6的动态变化：单纯心衰组发生后IL-6缓慢上升,第3天白IL-6达到高峰,持续升高至第5天下降不明显;而肺部感染组各时点观察IL-6水平持续升高,两组比较,差异无统计学意义。结论：急性心衰发生后,血清PCT水平的动态变化与继发肺部感染有关联。     

Selenoprotein S expression in the rat brain following focal cerebral ischemia

Recent studies on cerebral ischemic stroke have demonstrated the importance of the inflammatory response. Ongoing inflammatory insults have been implicated as a secondary mechanism underlying neuronal injury induced by ischemia, and anti-inflammatory strategies have gained considerable interest. Selenoprotein S (SelS), which is an endoplasmic reticulum resident protein, is known to promote cell survival by regulating inflammation. Moreover, SelS has been shown to be responsive to ischemia in cultured astrocytes. A Finnish report revealed that a variation in the SelS gene locus is associated with a higher predisposition to ischemic stroke in humans, suggesting a crucial role for SelS in protection against brain ischemia. However, the time-course of SelS expression following cerebral ischemia in vivo remains unknown. In the present study, we show, for the first time, differential SelS expression from 3 h to 7 days after reperfusion in rats with transient focal cerebral ischemia induced by a 1-h middle cerebral artery occlusion. We found that the SelS protein level decreased in the ischemic core 3–7 days after reperfusion. Furthermore, SelS expression was upregulated in the ischemic penumbra adjacent to the ischemic core 3–7 days after reperfusion and is matched by reactive astrogliosis. Thus, we propose that the upregulation of Sels represents a reaction of astrocytes against inflammatory stimuli, and the findings of this study open a new chapter in the research of the interrelationships between SelS and cerebral ischemic stroke.     

The propagation mechanisms of extracellular tau in Alzheimer’s disease

Journal of Neurology - Tubulin-associated unit (tau) is an important microtubule-associated protein. The abnormal intracellular aggregation of tau has been strongly associated...     

3D手术视频系统在PDR合并牵拉性视网膜脱离手术中的应用

目的：评价3D手术视频系统在增生性糖尿病视网膜病变(PDR)合并牵拉性视网膜脱离(TRD)玻璃体切除术中的应用效果。

方法：回顾性分析2018-08/2019-03于我院行25G微创玻璃体切除术的PDR合并局部TRD(无牵拉性视网膜裂孔)患者32例38眼的临床资料,根据术中采用的观察系统进行分组,试验组16例19眼采用3D手术视频系统手术,对照组16例19眼采用传统显微镜手术。记录两组患者手术时间、术中医源性视网膜裂孔和硅油注入情况。术后至少随访6mo,观察最佳矫正视力及术后并发症发生情况。

结果：试验组术中发生医源性视网膜裂孔1眼,硅油注入1眼; 术后视网膜均完全复位; 术后1d玻璃体出血4眼,2～4wk后自行吸收; 术后2wk内发生高眼压6眼,药物治疗均能控制; 术后6wk后玻璃体再出血2眼; 术后6mo最佳矫正视力0.3以上者15眼。对照组术中发生医源性视网膜裂孔4眼,硅油注入5眼; 术后视网膜均完全复位; 术后1d玻璃体出血6眼,2～4wk后自行吸收; 术后2wk内发生高眼压5眼,药物治疗均能控制; 术后6wk后玻璃体再出血3眼; 术后6mo最佳矫正视力0.3以上者14眼。所有患者手术均顺利完成,均无眼内炎等严重并发症发生,但试验组手术时间明显短于对照组(37.3±4.8min vs 41.2±5.1min,P=0.020)。

结论：3D手术视频系统在PDR合并TRD玻璃体切除术中的应用能够缩短手术时间,提高手术效率。     

糖化血红蛋白检测在2型糖尿病诊断中的应用效果

目的对2型糖尿病诊断中糖化血红蛋白检测的作用进行探究。方法于2019年4月—2020年3月选择该院收治的确诊为2型糖尿病的患者50例纳入研究,将其作为甲组。同时选择同一时期的健康人员50名作为乙组。对两组实施糖化血红蛋白检测,比较两组的糖化血红蛋白水平,从而分析在2型糖尿病诊断中糖化血红蛋白检测的价值。结果甲组的糖化血红蛋白水平(8.8±1.2)%、空腹血糖水平(10.6±1.3)mmol/L和餐后2 h血糖水平(15.3±5.5)mmol/L均明显高于乙组糖化血红蛋白水平(5.1±0.6)%、空腹血糖水平(4.8±0.4)mmol/L和餐后2 h血糖水平(6.6±1.3)mmol/L,差异有统计学意义(t=19.500、27.345、10.885,P<0.05)。结论在2型糖尿病的诊断中,应用糖化血红蛋白检测具有重要的参考价值,能够为临床诊断提供重要的参考依据。