柚皮苷抑制小鼠气囊模型中PMMA颗粒诱导的骨溶解

目的 :通过3-甲基腺嘌呤(3-methyladenine,3-MA)对多发性创伤模型大鼠进行预处理,探讨自噬在多发性创伤后急性肺损伤中的作用。方法:4月龄成年雄性SD大鼠45只,体重250~300 g,按照随机数字表随机分为3组:假手术组,对照组及3-MA组。假手术组仅在颅骨相应位置钻孔;3-MA组及对照组均采用液压打击器及自制骨折打击器制备股骨干骨折合并脑损伤模型,且分别于造模前1 h给予10 mg/kg的3-MA或等量生理盐水。各组大鼠于术后48 h分别采用实时荧光定量PCR检测肺部LC-3Ⅱ及Beclin-1的表达;ELISA法检测肺部炎症因子TNF-α、IL-6的浓度;HE染色观察肺部的组织病理学改变。结果:术后48 h,对照组大鼠肺部LC-3Ⅱ及Beclin-1的m RNA水平明显高于假手术组(P<0.01),而3-MA组上述基因的表达显著低于对照组(P<0.01);术后48 h,对照组大鼠肺部的TNF-α及IL-6浓度明显高于假手术组,3-MA组上述因子的浓度显著低于对照组(P<0.01)。3-MA组大鼠肺组织病理评分显著低于对照组(P<0.01)。3-MA组大鼠肺组织病理评分显著低于对照组(P<0.01)。结论:自噬可以加重股骨干骨折合并脑损伤后的急性肺损伤,而采用其抑制剂3-MA进行预处理可以降低细胞自噬水平,进而减轻肺部的损害。     

CD25抗体在单倍型干细胞移植后肠道急性GVHD治疗中的应用

目的 观察CD25抗体(巴利昔单抗)治疗单倍型造血干细胞移植(HSCT)后发生肠道Ⅲ～Ⅳ度急性移植物抗宿主病(aGVHD)的疗效.方法 2004年10月至2009年9月北京军区总医院20例单倍型HSCT后发生肠道Ⅲ～Ⅳ度aGVHD的患者,男13例,女7例,于确诊肠道aGVHD当日给予巴利昔单抗治疗,同时使用甲泼尼龙1 mg·kg-1·d-1静脉点滴,巴利昔单抗分别在第1、4天静脉点滴,每次的剂量是20 mg,如果肠道aGVHD无改善,第2周再重复使用,分析治疗疗效,观察输注相关的不良反应和巨细胞病毒(CMV)感染情况.结果 20例患者中完全缓解10例,部分缓解为5例,总有效率75.0%.使用巴利昔单抗后1～12 d,患者肠道aGVHD症状开始缓解,平均取得缓解时间为7 d.随访时间6～64个月,中位随访时间25个月.在完全缓解的10例中8例持续完全缓解无aGVHD复发;2例aGVHD复发患者,再次用巴利昔单抗取得缓解.9例生存,最长存活64个月,其中4例患者停用糖皮质激素,另外5例用低剂量糖皮质激素维持.Kaplan-Meier生存计算2年无病生存率为47.5%.结论 巴利昔单抗治疗单倍型HSCT后发生的肠道Ⅲ～Ⅳ度aGVHD疗效显著,未增加白血病复发和感染率.     

Analysis of cancer pain in hospitals in Beijing, China

Objective

This study aimed to survey the characteristics and treatments of cancer pain in Beijing hospitals, China.

Methods

At 20:00 on December 22, 2009, there conducted a questionnaire survey in 2238 patients with malignant tumors of 26 hospitals in Beijing, and the survey results were statistically analyzed.

Results

The 531 cases in 2238 patients had pained and 121 cases (22.79%) had outbreak pain with one week. At 20:00 on December 22, 2009, 199 cases (38%) in the above-mentioned 531 pain patients suffered the moderate to severe pain (pain scores ≥ 4). The number of pain (pain scores ≥ 4) patients in the consecutive three days from December 20 to December 22 were 150.

Conclusion

In the 531 cancer pain patients of the surveyed hospitals, 38% of the patients were not satisfied with the pain control. Doctors believed that the main reason for pain not controlled was the non-standard treatment, but patients considered to be afraid of addiction.     

神经营养素-3基因非病毒载体转染的嗅鞘细胞移植促进脊髓损伤大鼠轴突再生及功能恢复

目的将神经营养素-3（neurotrophin-3,NT-3）基因转染的嗅鞘细胞（olfactory ensheathing glia,OEG）移植到脊髓损伤大鼠体内,以期促进大鼠胸脊髓损伤的恢复。方法将自行构建的质粒pcDNA3．1（＋）-NT3,应用脂质体介导的方法导入体外培养的OEG,将其移植入急性脊髓损伤大鼠体内,连续观察12周,与接受单纯OEG移植和空白质粒转染OEG移植及无OEG移植的脊髓损伤大鼠进行比较。结果pcDNA3.1（＋）-NT3转染的OEG移植后能在体内长期存活,表达NT-3基因,并较对照组更能促进脊髓损伤区轴突的再生和后肢功能的恢复。结论OEG是脊髓损伤基因治疗较好的受体细胞。转染OEG移植后可以在体内较长时间存活。能明显促进急性脊髓挫伤神经纤维再生和功能恢复的作用,为基因修饰嗅鞘细胞在脊髓损伤治疗的应用提供了实验和理论依据。     

乙型肝炎病毒前S1抗原、HBeAg及HBV-DNA检测相关分析及临床意义

目的探讨HBV感染者血清中HBV-M、HBV-DNA、HBeAg与HBV PreS1抗原的关系，为临床诊治提供有益的参考。方法采用ELISA法和荧光定量聚合酶链反应技术分别检测了288份血清中的前S1抗原、HBcAg、HBeAg和HBV-DNA。结果前S1抗原与HBV—DNA在HBV感染者血清中具有良好的平行关系，其阴／阳符合率均大于86．1％，两者之间无显著性差异（P〈0．05）。HBV—DNA和HBV PreS1抗原阳性率均高于HBeAg，具有显著性差异（P〉0．05）。结论HBV PreS1抗原与HBV-DNA检出阳性率高度相关，HBV PreS1抗原比HBeAg更能精确地反映HBV在人体内的感染和复制情况，动态监测HBV PreS1抗原的变化对临床判断乙肝治疗效果有重要价值。     

复方中药体外保护肝细胞的机制

目的探讨复方中药制剂体外保护肝细胞的机制.方法用MTT法、荧光染色、透射电镜、DNA琼脂糖凝胶电泳及流式细胞术等方法观察不同浓度中药复方制剂(包括黄芩、黄柏、板蓝根、山豆根等)抑制TNF-α+Act-D诱导正常大鼠肝细胞凋亡的作用,并检测各组清蛋白的分泌结果自组中药复方制剂能明显改善肝细胞的凋亡状况,出现了典型的形态学和生化学改变,但存在药物浓度上的差异.中药组(0.2,2 mg.L-1)的凋亡率(10.4%±1.2%,13.9±0.4%)低于凋亡模型组(vs17.4%±1.9%,n=3,P＜0.05),中药组(20mg.L-1)的凋亡率(18.30%±1.15%)与凋亡模型组相比没有显著性差异(P＞0.05).除此之外,自组中药复方制剂还促进肝细胞清蛋白的分泌,但存在作用时间和药物浓度的交互作用.结论复方中药制剂能够抑制正常肝细胞凋亡并促进其清蛋白分泌.     

【In Press】Effect of anti-VEGF treatment on retinopathy of prematurity in Zone II Stage 3+

AIM: To assess the effect of intravitreal ranibizumab injection for retinopathy of prematurity (ROP) in Zone II Stage 3+. METHODS: Data was collected from ROP patients with Zone II Stage 3+ who had intravitreal ranibizumab injections between October 2014 and January 2017 at the department of Ophthalmology in our hospital. No prior laser or other intravitreal therapy was done. Fundus examination was performed prior to the intervention and at each follow-up visit. Gestational age at birth, birth weight, sex, ROP zone, ROP stage, post menstrual age (PMA) at treatment, and follow-up period were recorded. The final clinical status of the retina was noted for each patient. The primary outcome measures included ROP recurrences requiring re-treatment, complete or incomplete peripheral vascularization RESULTS: Eighty-six eyes of 46 premature infants with Zone II Stage 3+ROP were enrolled in the study. The mean gestational age at birth was 28.18±1.67wk (range: 25 to 33wk) and the mean birth weight was 1070.57±226.85 g (range: 720.00 to 1650.00 g). The mean PMA at treatment was 38.32±2.99wk (range: 32.29 to 46.00wk). Seventy-one eyes (82.56%) were treated successfully with intravitreal ranibizumab as monotherapy. Fifteen eyes (17.44%) developed recurrent disease. The mean interval between the treatment and retreatment was 5.96±3.22wk (range: 1.86 to 11.71wk). All eyes vascularized into zone III at the end of the study and among them 62 eyes (72.1%) achieved complete vascularization. CONCLUSION: Intravitreal ranibizumab injection is an effective treatment in patients with zone II stage 3+ ROP. More patients with longer follow-up duration are mandatory to confirm the safety and efficacy of this treatment.     

The imbalance between regulatory and IL-17-secreting CD4T cells in multiple-trauma rat

Background

It has been well recognised that a deficit of numbers and function of CD4⁺CD25⁺Foxp3⁺cells (Treg) is attributed to the development of auto-immune diseases, inflammatory diseases, tumour and rejection of transplanted tissue; however, there are controversial data regarding the suppressive effect of Treg cells on the T-cell response in auto-immune diseases. Additionally, interleukin-17 (IL-17)-producing cells (Th17) have a pro-inflammatory role. The balance between Th17 and Treg may be essential for maintaining immune homeostasis and has long been thought as one of the important factors in the development/prevention of auto-immune diseases, inflammatory diseases, tumour and rejection of transplanted tissue, but their role in multiple trauma remains unclear.

Objective

This study aims to investigate whether an imbalance of Treg and Th17 effector cells is characteristic of rats suffering from multiple trauma.

Methods and subjective

Sixty Sprague-Dawley (SD) rats were randomly divided into three groups. The control group (n = 20, group I) no received procedures (normal). The sham group (n = 20, group II) only received anaesthesia, cannulation and observation. The bilateral femoral shaft fractures with haemorrhagic shock groups (n = 20, group III). Rats in groups II and III were killed at the end of 4 h after models were established. Peripheral blood samples were collected for assessment of Treg cells, Th17 cells and cytokines (IL-17, IL-6, IL-2, transforming growth factor beta (TGF-β)) and intestine tissue was collected for intestine histological analysis.

Results

We observed decreased Treg/Th17 ratios in CD4⁺T cells in rats with multiple trauma and a strong inverse correlation with disease activity (intestinal histological scores).

Conclusion

We suggest a role for immune imbalance in the pathogenesis and development of multiple trauma. The alteration of the index of Treg/Th17 cells likely indicates the therapeutic response and progress in the clinic.     

提壶揭盖法治疗妇科病的应用探讨

朱丹溪首创提壶揭盖法,原指通过宣通肺气,达到通调水道以利小便的目的,是古人运用"意象思维"、"援物比类"的思维方式,也是临床上一种朴素直观的思维方式,亦是一种行之有效的中医特色治疗方法。用于临床疑难、复杂疾病,常常起桴鼓之效。笔者试着将该法用于多种妇科疾病的治疗,亦有良效。从病因病机探讨提壶揭盖与妇科病的关系,通过经行浮肿、产后缺乳、妊娠小便不通等典型病例分析,对"提壶揭盖"在妇科疾病治疗中的应用进行了初探。