兔的右室流出道室性心动过速对交感神经的影响

目的 探讨兔的右室流出道室性心动过速(室速)与交感神经的关系.方法 兔20只随机分为室速组和对照组,每组10只,通过将电极放置右室流出道心外膜,以180次/分频率起搏构建室速模型,对照组不予起搏,待120 min后立即取出左右流出道及左心尖游离壁心肌组织.用免疫组化方法检测酪氨酸羟化酶(tyrosine hydroxy...     

针刺足运感区结合局部电针围刺治疗中风后尿失禁的临床观察

[目的]观察针刺足运感区结合局部电针围刺与常规针刺、常规针刺联合足运感区治疗中风后尿失禁的临床疗效差异。[方法]将90例患者随机分为治疗组、对照1组和对照2组,每组30例,治疗组予针刺足运感区结合膀胱体表相应投影区域电针围刺;对照1组参照全国高等中医药院校"十三五"规划教材《针灸治疗学》中有关"尿失禁"的治疗选穴;对照2组在对照1组的基础上联合足运感区针刺,每日上午行神经内科常规治疗,每日下午行中风后尿失禁的临床治疗,每次30 min,每周连续治疗6次,6次为1个疗程,疗程间休息1 d,共2个疗程。观察3组治疗前后尿失禁程度、尿失禁临床症状评分及日常生活活动能力量表(ADL)评分,并比较3组患者的临床疗效。[结果] 3组患者治疗后尿失禁程度、尿失禁临床症状评分及ADL评分均较前改善(均P0.05),治疗组对尿失禁程度及尿失禁临床症状评分的改善较其他两组更明显(P0.05),且治疗组和对照2组的ADL评分明显优于对照1组(P0.05)。治疗组总有效率为93.3%(30/28),优于对照1组76.7%(30/23)和对照2组83.3%(30/25,P0.05)。[结论]针刺足运感区结合局部电针围刺治疗中风后尿失禁疗效显著。     

绝经后骨质疏松症免疫反应相关基因的鉴定及其中药活性成分的筛选

目的 采用生物信息学方法 识别绝经后骨质疏松症中免疫反应相关的基因,并探讨其作用机制和筛选靶向中药活性成分。方法 在基因表达数据库（GEO）中检索“postmenopausal osteoporosis”,下载基因数据集GSE230665,通过R软件中的“limma”数据包获取差异表达基因,使用David工具对差异基因进行基因本体（GO）功能富集分析并筛选出免疫反应相关的关键基因,然后对关键基因进行GO功能富集分析和京都基因与基因组百科全书（KEGG）通路富集分析。采用STRING平台和Cystoscope软件建立蛋白相互作用（PPI）网络,用MCODE和CytoNCA插件识别重要基因簇模块和核心基因。在CTD数据库搜索“postmenopausal osteoporosis”对核心基因进一步筛选并搜索靶向核心基因的中药活性成分,并在PubChem数据库中搜索中药活性成分的3D结构,Autodock4软件进行分子对接,以及探索核心基因与绝经后骨质疏松症的相互作用。结果 在绝经后骨质疏松症中筛选出43个关键基因,GO富集分析显示主要参与涉及正向调节炎症反应、白细胞介素（IL）-12的产生...     

肾移植术后尿路上皮癌发病特点的文献统计分析

目的 统计分析国内肾移植尿路上皮癌患者的发病率、发病特点,提高临床工作中对此类疾病的认识。方法 检索目前从2005~2017年的国内权威中文数据库中国知网全文数据库和万方全文数据库,分别按照发病率、发病年龄、性别、发病部位、发病时间、马兜铃酸肾病的影响等方面收集统计数据,分析其临床意义。结果 文献统计肾移植术后尿路上皮癌的发病率约1.17~2.27%,高于普通人群中的发病率;发病年龄45~56岁;女性发病率64.93%,高于男性35.07%,差异有统计学意义（P＜0.05）;原上尿路发病率50.81%,高于膀胱49.19%,,移植肾同侧发病率70.80%,高于对侧为29.20%,差异无统计学意义（P＞0.05）;发病时间的分布主要在肾移植术后1~16.8个月内;相应文献报道马兜铃酸肾病是肾移植术后尿路上皮癌发病和复发的危险因素。结论 具有马兜铃酸肾病病史的女性患者是肾移植术后尿路上皮癌发生的高危人群,对高危患者的诊断和治疗应该更加重视,改进治疗方案,做到早发现早治疗。     

肾移植术后感染性腹泻的诊疗分析

肾移植是挽救晚期慢性肾衰竭患者的最佳方式,与长期透析比较可使患者获得更长久的生存率,但由于术后需要长期服用免疫抑制剂和相对较长时间的抗生素,极易容易引起肠道菌群紊乱和肠道感染,导致腹泻的发生。本文着重回顾了有关肾移植受者感染性腹泻的现有文献,对肾移植后感染性腹泻的研究进展进行了总结,并希望为临床能寻找到高效可靠的移植后感染性腹泻的评估方法提供一定的思路。     

王铁良老师临床治疗肾脏病常用处方经验总结

王铁良教授是黑龙江省中医药科学院主任医师,黑龙江中医药大学博士生导师,全国第二、三、四、五批名老中医药专家学术经验继承工作指导老师,是我国著名中医肾病专家。从事中医临床四十余载,本着＂勤求古训,博采众方,融中西医各家之长＂的原则,尤其治疗肾系疾病疗效显著,现将其治疗肾脏疾病行之有效的常用处方做一简要归纳及总结。     

Overall survival and PD-L1 expression in patients with recurrent or metastatic head and neck cancer treated with nivolumab

ObjectiveOur facility measures programmed cell death ligand 1 (PD-L1) expression in all patients before administering nivolumab. The aim of the present study is to clarify the association between overall survival (OS) and PD-L1 expression.Patients and MethodsSubjects in this study were 52 patients with R/M-HNC cancer (45 men, 7 women) administered nivolumab in our facility between June 1, 2017 and January 31, 2019. Mean age was 62.2 years (median, 65 years; range, 28–81 years). Histopathological type was squamous cell carcinoma (SCC) in 48 cases, and non-SCC in 4 cases. We set OS as the primary endpoint and progression-free survival (PFS), overall response rate (ORR), association of OS and PD-L1 expression and association of PFS and PD-L1 expression as secondary endpoints. The cut-off for PD-L1 expression was set using the receiver operating characteristic (ROC) curve. We compared OS, PES and ORR using this PD-L1 cut-off for all patients and for the SCC group. OS and PFS were calculated using Kaplan-Meier methods. The log-rank test was used for statistical analysis, with values of p < 0.05 taken as significant. For PD-L1 immunohistochemistry assays, Dako 28-8 antibody was used.ResultsIn the all-patients group, median OS was 9.6 months and 1-year OS rate was 40.4%. Median PFS was 4.0 months and 1-year PFS rate was 37.8%. The cut-off value of PD-L1 expression for OS was 40% for all patients and the SCC group. When PD-L1 expression was ≥40%, OS was significantly better in both all patients and the SCC group (p = 0.004, 0.007). The cut-off value of PD-L1 expression for PFS was also 40%. When PD-L1 expression was ≥40%, PFS was better in all patients and the SCC group (P = 0.003, 0.009). In the all-patients group, ORR was 19.2% and disease control rate (DCR) was 44.2%. When PD-L1 expression was ≥40%, ORR was 44.4% and DCR 83.3%.ConclusionIn the present study, when PD-L1 expression was high (≥40%), OS was significantly better (p = 0.004). This finding has not been reported in other research on R/M-HNC. PFS and ORR were also better with high PD-L1 expression. Regarding patterns of progression with a PD-L1 expression cut-off of 40%, hyperprogression was significantly more frequent for PD-L1 expression <40% (p = 0.039). Therefore, high PD-L1 expression could offer a predictor of prognosis and efficacy for nivolumab. The present findings may prove useful in considering treatment strategies.