山茱萸饮片与市售配方颗粒的含量对比

目的:以传统汤剂为基准,比较山茱萸中药饮片与市售配方颗粒中指标性成分的含量差异。方法:收集8批合格的山茱萸饮片和A、B、C 3个厂家的配方颗粒各5批,采用高效液相色谱(HPLC)法测定山茱萸传统汤剂和配方颗粒中莫诺苷、马钱苷的含量,并计算总含量转移率、出膏率。结果:8批山茱萸传统汤剂的指标性成分总含量均值、转移率均值、出膏率均值分别为2.09%,80.3%,68.7%;3个厂家的配方颗粒指标性成分总含量在0.24%～0.57%之间,理论转移率在20.2%～47.3%之间,出膏率在16.7%～30.0%之间。结论:山茱萸配方颗粒的含量、转移率、出膏率测定结果远低于传统汤剂,二者不具有质量一致性。     

地佐辛用于无痛气管镜检查40例临床观察

目的 评价地佐辛在无痛气管镜检查中应用的有效性和安全性.方法 拟行无痛气管镜检查的患者80例,采用随机数字表法分为地佐辛观察组(D组)和舒芬太尼对照组(S组),每组40例.两组患者均行喉罩通气下无痛气管镜检查,D组地佐辛0.1 mg·kg-1,S组舒芬太尼0.2μg·kg-1,静脉滴注,麻醉诱导.观察两组患者麻醉诱导期呛咳反应发生情况;记录麻醉开始前(T0),喉罩置入后即刻(T1),术中(T2),以及术后(T3)的平均动脉压(MAP)、心率(HR)和脉搏氧饱和度(SpO2);记录两组患者气管镜检查持续时间、停药后患者苏醒时间和术后恶心呕吐的发生情况.结果 两组患者各时点血流动力学均较稳定;S组患者诱导期有3例出现轻微的呛咳反应,D组无一例出现呛咳;两组患者苏醒时间[(184.45±22.34)s比(182.57±18.72)s]比较差异无统计学意义(t=0.027,P=0.978).结论 地佐辛可以安全有效的用于无痛气管镜检查,对循环影响较小,无呛咳反应,不增加恶心呕吐发生率,不延长苏醒时间.     

Gray matter atrophy and corresponding impairments in connectivity in patients with anti-N-methyl-D-aspartate receptor encephalitis

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune disease that is commonly accompanied by cognitive impairment and various neurological and psychiatric symptoms, advanced image analyses help explore the pathogenesis of this disease. Therefore, this study aimed to explore specific structural and functional alterations and their relationship with the clinical symptoms of anti-NMDAR encephalitis. In this study, twenty-two patients with anti-NMDAR encephalitis after the acute stage and 29 controls received cognitive assessments and magnetic resonance imaging. Grey matter atrophy was measured using voxel-based morphometry, and functional alterations in abnormal regions were subsequently investigated using resting state functional connectivity (RSFC). Finally, correlation analyses were performed to explore the associations between imaging alterations and cognitive assessments. The patients demonstrated significant gray matter atrophy in the bilateral triangle part of the inferior frontal gyrus (triIFG.L and triIFG.R) and right precuneus, decreased RSFC between triIFG.L and bilateral Heschl gyrus (HES), decreased RSFC between triIFG.R and HES.R, decreased RSFC between right precuneus and left cerebellum, and increased RSFC between triIFG.R and left superior frontal gyrus. Further correlation analyses showed that the gray matter volume in triIFG.R and decreased RSFC between triIFG.L and HES.R were associated with decreased memory scores, whereas decreased RSFC between triIFG.R and HES.R was marginally correlated with the disease course in patients. In conclusion, this study suggests that cognitive impairments in patients with anti-NMDAR encephalitis may be mainly associated with gray matter atrophy and abnormal RSFC in the triIFG. These findings provide new insights into anti-NMDAR encephalitis pathogenesis and help explore potential treatments.

     

调节自噬提高人肝癌Bel-7402/FU细胞株对5-氟尿嘧啶的敏感性

目的：探讨细胞自噬对肝癌Bel-7402／FU细胞5-氟尿嘧啶敏感性的影响。方法：选取Bel-7402、Bel-7402／FU细胞株,分为对照组、5-氟尿嘧啶组、自噬抑制剂3-甲基腺苷组以及5-氟尿嘧啶＋3-甲基腺苷组,MTT法了解抑制细胞自噬对肝癌5-氟尿嘧啶IC50值的影响;流式细胞术检测抑制细胞自噬对细胞凋亡的影响;GFP-LC3质粒转染观察细胞浆中GFP-LC3分布情况。结果：Bel-7402细胞株与Bel-7402／FU细胞株5-氟尿嘧啶IC50值分别为4．66、68．14μg／mL,凋亡率分别为13．809／6、1.09％。3-甲基腺苷联合5-氟尿嘧啶作用后Bel-7402细胞株与Bel-7402／FU细胞株的氟尿嘧啶IC50值分别为4．31、29．44μg／mL,凋亡率分别为13．82％、6．86％。在3-甲基腺苷作用下,Bel-7402／5-FU细胞株5-氟尿嘧啶诱导的点状样GFP-LC3的细胞数量减少。结论：抑制细胞自噬可降低Bel-7402／FU对5-氟尿嘧啶IC50值,诱导细胞凋亡,从而有效地逆转Bel-7402／FU对5-氟尿嘧啶耐药。     

新诊断2型糖尿病合并恶性肿瘤的危险因素分析

目的分析新诊断2型糖尿病(T2DM)合并恶性肿瘤的临床特点以及影响因素,为临床防治提供依据。方法选择病程小于1年的新诊断T2DM患者合并恶性肿瘤40例(肿瘤均在诊断糖尿病后检出)为病例组,同时选择年龄、性别、糖尿病病程、体重指数(BMI)及居住环境匹配的T2DM无恶性肿瘤患者40例作为对照组。两组糖尿病患者均未应用降糖调脂药物治疗。问卷调查糖尿病家族史、饮酒、吸烟、饮茶等生活习惯,并测定血糖、血脂水平,分析肿瘤的临床特点以及危险因素。结果 (1)病例组中,男性以消化系统恶性肿瘤构成比最高,为47.5%(19/40);女性则以雌激素依赖肿瘤(乳腺癌,子宫内膜癌)构成比最高,为40.0%(16/40)。(2)Spearman相关分析显示恶性肿瘤与饮茶、胆固醇水平呈负相关(r值分别为-0.22,-0.24,均P<0.05),与HbA1C、糖尿病家族史呈正相关(r值分别为0.25,0.24,均P<0.05)。(3)多因素非条件Logistic回归分析发现,糖尿病家族史、HbA1C为恶性肿瘤的危险因素(OR分别为1.52,3.85,均P<0.05),饮茶、高胆固醇则是保护性因素(OR值分别为0.79,0.86,均P<0.05)。结论高血糖与恶性肿瘤密切相关,新诊断T2DM特别是伴有糖尿病家族史患者,应加强消化道肿瘤(男性)、乳腺癌及子宫内膜癌(女性)的筛查。     

A combination of Sinomenine and Methotrexate reduces joint damage of collagen induced arthritis in rats by modulating osteoclast-related cytokines

ObjectiveTo analyze the combination therapy of Sinomenine (SIN) and Methotrexate (MTX) in rheumatoid arthritis (RA), we herein demonstrated the combination effect of SIN and MTX on collagen-induced arthritis (CIA) in rats through their modulation on osteoclast-related cytokines.MethodsCIA was induced by the immunization of type II collagen (CII) in SD rats. SIN and MTX were administrated alone or in combination after the onset of arthritis. Arthritis index and histological analysis were used to evaluate the effect of treatments. Effects of SIN and MTX on expression of receptor activator of NF-κB ligand (RANKL) and osteopontin (OPN) in synovial tissues were assayed by immunohistochemistry. RANKL, osteoprotegerin (OPG), IL-6, IL-17 and matrix metalloproteinases (MMPs) in rat serum were measured by ELISA. The expression of osteoclast-related cytokines in fibroblast-like synoviocytes (FLS) from RA patients was assayed by RT-PCR.ResultsSIN and MTX combination additively reduced the inflammatory symptoms and joint damage in CIA. Combination of SIN and MTX significantly repressed synovial RANKL and OPN production. SIN and MTX exhibited complementary and synergistic effect upon down-regulating RANKL, IL-6, IL-17 and MMPs in rat serum. SIN and MTX also modulated the expression of RANKL and OPG in RA-FLS.ConclusionSIN and MTX have additive effects, decreasing inflammation and joint damage in CIA rats by modulating osteoclast-related cytokines. These results are indicative of the combined effect of SIN and MTX for anti-arthritic treatment in RA.     

肥胖者网膜脂肪组织中脂联素、肿瘤坏死因子α mRNA表达及其与胰岛素抵抗相关性的研究

19例肥胖者和24例非肥胖者的网膜脂肪研究显示，肥胖者脂联素（APN）基因表达降低，肿瘤坏死因子α（TNF-α）基因表达增加，两者表达呈负相关。肥胖、胰岛素抵抗为网膜脂肪APN、TNF-α基因表达的独立影响因素。     

Chicoric acid alleviates lipopolysaccharide-induced acute lung injury in mice through anti-inflammatory and anti-oxidant activities

Acute lung injury (ALI) is a severe clinical disease with high mortality rates. Chicoric acid (CA), an active component extracted from traditional Chinese medicine, was suggested to have anti-inflammatory and anti-oxidant activities. Inflammation and oxidative damage are implicated in the pathogenesis of ALI. In this study, we explored the protection effect of CA on LPS-induced ALI, and further discussed the possible molecular mechanisms. The results showed that CA could significantly improve the histological changes of LPS-induced acute lung injury. In addition, CA not only decreased LPS-stimulated protein leakage and lung wet/dry ratio but also reduced inflammatory cell infiltration, myeloperoxidase (MPO) activity and the generation of pro-inflammatory cytokines in bronchoalveolar lavage fluid (BALF). Meanwhile, CA lessened the reactive oxygen species (ROS) generation, and malondialdehyde (MDA) formation, and decreased glutathione (GSH) and superoxide dismutase (SOD) depletion, which were caused by LPS challenge. Furthermore, CA dramatically inhibited LPS-stimulated MAPK and NLRP3 activation and increased the expression of NAD (P) H: quinone oxidoreductase (NQO1), and dismutase (SOD), glutamate-cysteine ligase catalytic/modifier (GCLC/GCLM) subunit and heme oxygenase-1 (HO-1), as well as its upstream genes nuclear factor-erythroid 2-related factor 2 (Nrf2), which might be central to the protective effects of CA. In conclusion, these data indicated that the protective effects and mechanisms of CA on LPS-induced ALI and provided new insights for its application.     

Development of frailty measurement tools using administrative health data: A systematic review

ObjectivesFrailty is an increasingly common health condition and is seen more often due to the ageing population. This study reviews the evidence on the development and validation of these automated frailty measurement tools.DesignSix databases: PubMed, EMBASE, MEDLINE, CINAHL, Scopus, and Web of Science were electronically searched. Selected studies must have developed and validated a new frailty measurement tool using administrative health data and published results in a peer-reviewed, English-language journal. Selected studies were synthesized narratively.Setting and participantsThe review focused on large scale studies using administrative health data in developed countries. Participants included older people aged 65 years and above.MeasuresThe main measures of review studies include discrimination power and the prediction ability of adverse health outcomes; performance against established frailty measures; and validation records.ResultsFive studies were selected for narrative synthesis after screening the full-text. All frailty measurement tools in the selected five studies produced strong discrimination power with C-statistics ranging from 0.61−97. Two studies were independently validated in studies by other authors or conducted in other locations; one study developed an early prediction model, and no study has been applied in practice.Conclusions and implicationsAutomated frailty measurement tools using administrative health data are still in the early development stage with five tools developed since 2016. Selected studies have strong prediction of adverse health outcomes. Future studies should include validation and refinement of these tools in other countries and assessment of their clinical utility and capacity to inform cost-effective policy and practice.