高龄股骨转子间骨折两种治疗方法的临床观察

目的:探讨手术治疗高龄股骨转子间骨折的安全性、合理性。方法:股骨转子间骨折患者65例,其中采用动力髋螺钉(DHS)治疗32例,男14例,女18例;年龄65~79岁,平均(70.6±2.3)岁;EvansⅠ型2例,Ⅱ型7例,Ⅲ型15例,Ⅳ型8例。采用单边外固定支架治疗33例,男14例,女19例;年龄68~90岁,平均(74.2±3.8)岁;EvansⅠ型3例,Ⅱ型15例,Ⅲ型11例,Ⅳ型1例,Ⅴ型3例。临床观察包括术中出血量、手术时间、骨折愈合时间、术后并发症及髋部运动功能等。结果:所有病例均获随访,时间1~34个月,平均19个月。两组手术时间、术中出血量、术后并发症发生率差异有统计学意义(P<0.05)。平均愈合时间DHS组为(13.0±2.7)周,外固定支架组为(12.3±3.0)周,差异无统计学意义。Sanders髋关节功能评价:DHS组优19例,良6例,可3例,差2例;外固定支架组优12例,良8例,可8例,差5例。两组优良率差异有统计学意义(P<0.05)。结论:围手术期外固定支架组较DHS组安全简便,术后疗效DHS组优于外固定支架组。     

miR-146a-5p regulates autophagy and NLRP3 inflammasome activation in epithelial barrier damage in the in vitro cell model of ulcerative colitis through the RNF8/Notch1/mTORC1 pathway

Ulcerative colitis (UC) is a chronic inflammatory disease affecting the colon that can be influenced by microRNAs (miRNAs). This study aims to investigate the impact of miR-146a-5p on lipopolysaccharide (LPS)-induced Caco-2/HT-29 cell autophagy and NLRP3 inflammasome activation and the underlying mechanism, with the aim of identifying potential therapeutic targets. We used LPS to establish Caco-2/HT-29 cell models and measured cell viability by CCK-8. The levels of miR-146a-5p, RNF8, markers of NLRP3 inflammasome activation and autophagy, proteins involved in the Notch1/mTORC1 pathway, and inflammatory factors were assessed by RT-qPCR, Western blot, and ELISA. Intestinal epithelial barrier function was evaluated by measuring transepithelial electrical resistance. Autophagic flux was measured using tandem fluorescent-labeled LC3. miR-146a-5p was highly-expressed in LPS-induced Caco-2/HT-29 cells, and autophagy flux was blocked at the autolysosomal stage after LPS induction. Inhibition of miR-146a-5p suppressed NLRP3 inflammasome activation, reduced intestinal epithelial barrier damage, and facilitated autophagy inhibition in LPS-induced Caco-2/HT-29 cells. The autophagy inhibitor NH4Cl partially nullified the inhibitory effects of miR-146a-5p inhibition on NLRP3 inflammation activation. miR-146a-5p targeted RNF8, and silencing RNF8 partly abrogated the action of miR-146a-5p inhibition on promoting autophagy and inhibiting NLRP3 inflammasome activation. miR-146a-5p inhibition suppressed the Notch1/mTORC1 pathway activation by upregulating RNF8. Inhibition of the Notch1/mTORC1 pathway partially nullified the function of silencing RNF8 on inhibiting autophagy and bolstering NLRP3 inflammasome activation. In conclusion, miR-146a-5p inhibition may be a potential therapeutic approach for UC, as it facilitates autophagy of LPS-stimulated Caco-2/HT-29 cells, inhibits NLRP3 inflammasome activation, and reduces intestinal epithelial barrier damage by upregulating RNF8 and suppressing the Notch1/mTORC1 pathway.     

Identification of peptides presented through the MHC-II of dendritic cells stimulated with Mycobacterium avium

Mycobacterium avium (M. avium) represents a species of concern, because of its ability to modulate the host’s innate immune response, and therefore influence trajectory of adaptative immunity. Since eradicative response against mycobacteria, and M. tuberculosis/M. avium, relies on peptides actively presented on a Major Histocompatibility complex-II (MHC-II) context, we assessed paradoxical stimulation of Dendritic Cell resulting on immature immunophenotype characterized by membrane minor increase of MHC-II and CD40 despite of high expression of the pro-inflammatory tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) in supernatants. Identification of M. avium leucine rich peptides forming short α-helices shutting down Type 1T helper (Th1), contribute to the understanding of immune evasion of an increasingly prevalent pathogen, and may provide a basis for future immunotherapy to infectious and non-infectious disease.     

强力增忆汤对脑疲劳伴记忆力下降影响的临床研究

目的观察强力增忆汤治疗脑疲劳伴记忆力下降的临床疗效。方法将152例脑疲劳伴记忆力下降患者随机分为治疗组与对照组,每组76例。对照组予柏子养心丸口服,治疗组予强力增忆汤口服。两组疗程均为10周,观察临床疗效,比较临床症状评分及记忆力相关指标的变化情况。结果 1治疗组、对照组临床总有效率分别为93.42%和82.89%;组间临床疗效比较,差异有统计学意义(P0.05)。2治疗前后组内比较,两组中的各分项指标及总积分均显著下降,差异有统计学意义(P0.05)。组间治疗后比较,治疗组各分项及总积分的下降较对照组更加显著(P0.05)。3治疗前后组内比较,治疗组记图、再认、联想、理解、背数评分及总分、MQ评分均显著增加(P0.05),对照组联想、理解、背数评分及总分、MQ评分显著增加(P0.05)。组间治疗后比较,治疗组记图、再认、总分及MQ评分的增加程度比对照组更加显著(P0.05)。结论强力增忆汤治疗脑疲劳伴记忆力下降的疗效满意,可缓解脑疲劳,增强记忆力。     

两种方法治疗不稳定性股骨转子间骨折的疗效比较

目的比较股骨近端防旋髓内钉(PFNA)与联合加压交锁髓内钉(InterTan)治疗不稳定性股骨转子间骨折的临床疗效。方法将124例不稳定性股骨转子间骨折患者按照内固定方法分为PFNA组(60例)和InterTan组(64例)。比较两组患者的手术时间、术中出血量、C臂机透视次数、住院时间、骨折愈合时间、术后并发症、术后髋关节功能评分。结果两组患者均获得随访,时间5~22个月。手术时间、术中出血量、C臂机透视次数PFNA组均短(少)于InterTan组(P<0.001)。住院时间、骨折愈合时间及术后髋关节功能评分两组比较差异均无统计学意义(P>0.05)。术后并发症InterTan组少于PFNA组(P<0.05)。结论PFNA手术创伤小,时间短,出血量更少,更适合一般状况差、手术耐受能力差的患者;InterTan稳定性好,术后并发症少,更利于不稳定骨折的固定及术前运动能力好的患者。     

中西医结合治疗糖尿病周围神经病变疗效观察

目的:观察中西医结合治疗糖尿病周围神经病变的效果。方法:治疗组在对照组治疗的基础上,加用中药辨证施治及中药足浴,对照组采用常规治疗联合甲钴胺静滴。结果:治疗组和对照组总有效率分别为91.11%和57.14%,经统计学处理有显著性差异(P<0.05)。结论:中西医结合治疗糖尿病周围神经病变效果显著。     

对中医“男胞”——前列腺生理功能再认识

认为前列腺应归属于男胞范畴 ,探讨了男胞与女胞的相似之处 ,强调了男胞兼具藏泻二性应与女胞一样属于奇恒之腑。本文还从多方位论及前列腺的生理功能与冲、督、任、肝经、肾经的关系 ,以及前列腺与全身其他脏器如膀胱、肝、肾等的生理病理方面的密切联系 ,以充实男胞藏象理论     

补肺定喘方联合吉非替尼治疗晚期肺腺癌临床研究

目的观察补肺定喘方联合吉非替尼治疗晚期肺腺癌临床疗效和不良反应。方法 76例晚期肺腺癌随机分为治疗组和对照组,各38例,治疗组采用补肺定喘方联合吉非替尼方案,对照组采用口服吉非替尼方案,30d为一周期。结果治疗组有效率为42.11%,对照组为39.47%,两组比较无明显统计学意义(P>0.05);皮疹发生率、胃肠道反应治疗组均明显低于对照组,两组有明显统计学意义(P<0.05);治疗组在细胞免疫功能均显著高于对照组,两组比较有明显统计学意义(P<0.05)。结论补肺定喘方联合吉非替尼治疗晚期肺腺癌疗效确切,明显减轻不良反应,增强免疫功能,提高患者生存质量,延长生存期。     

Effect of Electroacupuncture on Expression of p53 Protein in Cerebral Cortex of Rats with Global Cerebral Ischemia/Reperfusion Injury

Objective: To observe the effect of electroacupuncture (EA) on expression of p53 protein in cerebral cortex of senile rats with global cerebral ischemia/reperfusion (IR) injury and to explore its mechanism. Methods: The cerebral IR injury rat model was established referring to Pulsinelli 4-vessel occlusion method. Thirty-six SD rats were randomly and evenly divided into the control group, the IR group and the IR plus EA (IR-EA) group. The animals in the control group were subjected to electrocauterization of vertebral arteries in bilateral flank orifice alone with the general carotid arteries unoccluded. To rats in the IR-EA group, immediately and 24h, 48h, 72h after cerebral IR, EA treatment on bilateral acupoint "Zusanli" (ST36) was applied once a day, lasting for 60 minutes. After the final treatment, all the rats were sacrificed and their brains were taken to examine p53 protein expression by the immunohistochemical method. Results: Cells with positive p53 immunoreactivity in the cerebral cortex of