Toxic epidermal necrolysis following morbilli-parotitis-rubella vaccination

We present the first reported case of toxic epidermal necrolysis (TEN) caused by morbilli-parotitis-rubella (MPR) vaccine. A 13-year-old girl developed TEN 7 days after she received live, attenuated, triple MPR vaccine. The history of drug intake and any illness was negative. At admission the patient was acutely ill with high fever. The whole body was erythematous. The epidermis was wrinkled and the Nikolsky sign was positive. Numerous erosions were present on the lips and genital region. On the seventh day of illness, the eruption involved 80% of the skin. Systemic corticosteroid therapy was not employed. The skin and mucosal defects completely epithelized by the end of the third week of illness. Mild keratoconjunctivitis sicca remained because of permanent cup cell damage.     

Sizing a trial to alter the trajectory of health behaviours: methods, parameter estimates, and their application

Group-randomized trials often involve repeat observations on the same participants. When there are no more than two observations from each participant, standard mixed-model regression methods for a pretest-posttest design can be used. When there are more than two observations from each participant, random coefficients models may be useful. This paper describes the random coefficients analysis appropriate to data from an extended nested cohort design and presents the methods for power analysis and sample size calculations based on that analysis. We provide estimates for the parameters required for those calculations for a number of adolescent health behaviours. We also show how the estimates can be used to plan a future trial.     

Females Are Not Proportionally Smaller Males: Relationships Between Radius Anthropometrics and Their Sex Differences

Background: Distal radius fracture reduction by internal fixation is most commonly achieved using volar locking plates (VLPs). Many standard VLP designs make little point contact with radius anatomy, and most postsurgical complications following fixation are attributed to poor implant fit. Sex differences may require consideration in implant design, as females more commonly require VLP removal. Therefore, the purpose of this research was to determine whether the relationships between measures of radius shape are proportional between the sexes. Methods: Three-dimensional radius bone geometries were created from 40 male and 34 female (mean age = 72.04 years) forearm computed tomographic scans in Mimics (Materialise NV, Leuven, Belgium). Eleven measures of radius shape were collected from each scan. Principal components analysis was performed on these measures to determine which shape variables account for the greatest differences in radius shape among individuals and between the sexes. Results: Principal component scores representing isometric radius size separated the sexes. Six anthropometric measures significantly correlated with isometric radius size for all specimens, whereas 3 and 1 measures significantly correlated with isometric radius size in males and females, respectively. Conclusions: Anthropometrics of male and female radii vary by different proportions. Using anthropometrics from both sexes to create a single implant system may not result in optimal patient fit for either sex.     

A strategy of screening and binding analysis of bioactive components from traditional Chinese medicine based on surface plasmon resonance biosensor

Elucidating the active components of traditional Chinese medicine (TCM) is essential for understanding the mechanisms of TCM and promote its rational use as well as TCM-derived drug development. Recent studies have shown that surface plasmon resonance (SPR) technology is promising in this field. In the present study, we propose an SPR-based integrated strategy to screen and analyze the major active components of TCM. We used Radix Paeoniae Alba (RPA) as an example to identify the compounds that can account for its anti-inflammatory mechanism via tumor necrosis factor receptor type 1 (TNF-R1). First, RPA extraction was analyzed using an SPR-based screening system, and the potential active ingredients were collected, enriched, and identified as paeoniflorin and paeonol. Next, the affinity constants of paeoniflorin and paeonol were determined as 4.9 and 11.8 μM, respectively. Then, SPR-based competition assays and molecular docking were performed to show that the two compounds could compete with tumor necrosis factor-α (TNF-α) while binding to the subdomain 1 site of TNF-R1. Finally, in biological assays, the two compounds suppressed cytotoxicity and apoptosis induced by TNF-α in the L929 cell line. These findings prove that SPR technology is a useful tool for determining the active ingredients of TCM at the molecular level and can be used in various aspects of drug development. The SPR-based integrated strategy is reliable and feasible in TCM studies and will shed light on the elucidation of the pharmacological mechanism of TCM and facilitate its modernization.     

低浓度氯喹保护成年小鼠视网膜神经节细胞抵抗N-甲基-D-天冬氨酸的兴奋性毒性作用

目的:观察不同浓度氯喹对N-甲基-D-天冬氨酸(NMDA)损伤模型小鼠RGC的保护作用及可能调控机制。方法:健康雄性C57/BL6小鼠54只,随机分为氯喹低浓度组、氯喹高浓度组、PBS对照组,每组均为18只。氯喹低浓度组、氯喹高浓度组小鼠分别按体重10、100 mg/kg剂量腹腔注射氯喹;PBS组小鼠腹腔注射等体积PBS。腹腔注射1次/d,连续2d后,氯喹低浓度组、氯喹高浓度组小鼠左眼玻璃体腔注射5 nmol/L NMDA,对侧眼注射等体积PBS。建模后7d,视网膜铺片RGC染色,计数RGC存活数目;建模后9、10d,分别行视动反应和ERG检查;建模后11 d,行视网膜免疫荧光染色检测各组小鼠视网膜胶质纤维酸性蛋白(GFAP)荧光表达和实时荧光定量PCR(RT-PCR)检测各组小鼠视网膜GFAP、TNF-α、IL-6 mRNA表达。各组间RGC密度、视敏度、光负性反应(PhNR)波振幅比较采用单因素方差分析。结果:建模后7d,与PBS对照组小鼠RGC密度比较,氯喹低浓度组显著升高,差异有统计学意义(F=54.41,P<0.01);氯喹高浓度组降低,但差异无统计学意义(F=1.18,P>0.05)。氯喹低浓度组小鼠视敏度、PhNR波振幅均高于PBS对照组,差异有统计学意义(F=9.10、17.60,P<0.05、<0.01)。氯喹低浓度组小鼠视网膜GFAP绿色荧光表达明显少于PBS对照组、氯喹高浓度组,差异有统计学意义(F=23.66,P<0.05)。低浓度氯喹组小鼠视网膜GFAP(F=110.20)、IL-6(F=167.60)、TNF-α(F=17.78)mRNA表达较高浓度氯喹组、PBS对照组显著下降,差异有统计学意义(P<0.010、<0.001、<0.010)。结论:低浓度氯喹对NMDA损伤所致RGC丢失有保护作用,其作用机制可能与抑制胶质细胞活化与炎症反应有关;高浓度氯喹会加重RGC凋亡。     

小鼠眼血管内皮生长因子家族基因相关性研究

目的比较小鼠眼VEGF家族VEGFA、VEGFB和VEGFC之间功能和作用途径的异同。方法利用Genenetwork数据库中BXD小鼠眼基因数据作为模板,采用基因表达水平、基因间比较、相关基因间的比较、基因表达数量性状基因座(eQTL)等多种方法和统计策略,对BXD重组小鼠近交系群体的眼全基因组表达谱数据中VEGF家族VEGFA、VEGFB和VEGFC的分子通路或潜在功能的异同进行比较和研究。结果矩阵比较结果显示,VEGFC的2个探针之间呈强正相关(r=0.732,P<0.01);VEGFA 1420909与VEGFC 1440739、VEGFA 1451959与VEGFB 1451803、VEGFC 1419417与其他5个基因、VEGFA 1451959与VEGFC 1419417/VEGFC 1439766、VEGFB 1451803与VEGFC 1439766均呈弱相关性(P<0.05);VEGFA 1420909与除VEGFC 1440739之外的4个基因、VEGFA 1451959与VEGFC 1440739、VEGFB 1451803与VEGFA 1420909/VEGFC 1419417/VEGFC 1440739之间无相关性(P>0.05)。在VEGF各基因的相关Top50基因的对比分析中,BXD小鼠眼中VEGFA、VEGFB和VEGFC之间除个别相关基因存在弱关联外,其他大部分基因并不存在较显著的相关性。eQTL分析结果显示,VEGF基因各探针中eQTL分别定位于不同的染色体上。结论小鼠眼VEGF家族中VEGFA、VEGFB和VEGFC之间表达水平和正负相关性各不相同,这些基因可能通过不同的途径发挥其作用。     

中药活性成分直接作用靶点鉴定研究方法及应用

中药因其确切的临床疗效受到越来越多的关注。随着对中药活性成分的深入研究,现已发现很多具有独特活性和药效的潜在创新药物。然而,如何进一步对其药效机制进行挖掘、发现全新的机制和靶点,成为创新中药研究的关键。中药活性成分靶点鉴定一直是研究者们所探寻的重要课题。随着化学生物学技术尤其是化学蛋白组学技术的发展,越来越多的方法被建立并用于中药活性成分的靶点鉴定。简单来说,这些方法大致可被分为标记法和非标记法。标记法是通过将中药活性成分改造为活性探针,进而探寻它们的作用靶标蛋白;而非标记法主要是基于中药活性成分和靶标蛋白结合后会影响靶标蛋白的热稳定性等生物物理性质从而识别可能的作用靶点。主要针对这2大类靶点鉴定方法进行归纳整理,从方法原理、大致操作流程、应用、优缺点等方面进行阐述,为中药活性成分靶点鉴定提供一定的参考,以期助力中药创新研究。     

胃癌发病关键基因调控网络构建及其靶向治疗中药活性成分筛选研究

目的 通过生物信息学方法分析与胃癌发病密切相关的基因调控网络,探讨其在胃癌预后中的价值,并进一步挖掘靶向治疗胃癌的中药活性成分。方法 通过GEO数据库获取GSE103236胃癌芯片数据,对芯片数据进行均一化处理,分析胃癌组织与正常胃组织的差异表达基因（differentially expressed genes,DEGs）;应用Metascape数据库对DEGs进行基因本体论（genetic ontology,GO）和京都基因与基因组百科全书（Kyoto encyclopedia of genes and genomes,KEGG）通路分析;通过String数据库构建DEGs蛋白交互作用网络;采用Cytohubba筛选关键基因,分析关键基因表达程度与患者的预后及免疫细胞浸润的相关性;运用CTD数据库筛选能靶向作用于关键DEGs的中药活性成分。结果 共获得45 015个胃癌组织与正常组织的DEGs,其中显著性DEGs 176个。它们与细胞周期过程调控、丝裂原活化蛋白激酶（mitogen activated protein kinases,MAPK）级联调控等生物过程密切相关,集中于细胞外区域、细胞外泌体等细胞组分,主要参与胰岛素样生长因子结合、Wnt蛋白结合等细胞功能。KEGG分析发现显著性DEGs主要参与环磷酸酰胺（cyclic adenosine monophosphate,cAMP）信号通路、磷脂酰肌醇3-激酶/蛋白激酶B（phosphatidylinositide 3-kinases/protein kinase B,PI3K/Akt）信号通路、癌症转录失调、p53信号级联等信号通路。筛选出TIMP1、SPP1、APOE、APOB、FGA、FGG、CYR61、IGFBP1、CHGB、SCG3 10个关键基因。这些基因表达异常均与免疫细胞的大范围浸润存在极高的相关性,其中TIMP1、IGFBP1、CYR61、FGG、APOE、APOB 6个关键基因的异常表达显著影响患者的生存率。进一步挖掘出桦木酸、长春新碱、丹参酮等30个可能靶向治疗胃癌的中药活性成分。结论 筛选出10个与胃癌发病密切相关的核心基因,并分析了这些核心基因与胃癌患者预后及免疫细胞浸润的相关性;挖掘出30个可能用于胃癌靶向治疗的中药活性成分;研究结果可为胃癌生物标志物的筛选、胃癌的防治及预后分析提供思路和参考。     

基于斑马鱼模型的补骨脂毒性相关成分群的高效辨识研究

目的基于斑马鱼模型结合相关分析高效辨识补骨脂毒性成分群。方法采用高效液相色谱法测定7个产地18个批次补骨脂中4个香豆素类、4个黄酮类和补骨脂酚的含量。以斑马鱼(6 dpf)死亡率、脏器中毒形态、半数致死浓度(lethal concentration 50,LC_(50))值为指标,采用斑马鱼模型评价18个批次补骨脂水煎液的毒性。将各类成分的含量分别与斑马鱼LC_(50)值进行相关分析,辨识毒性成分群,并通过对代表成分的斑马鱼毒性评价进行验证。结果不同产地18个批次补骨脂水煎液中香豆素类、黄酮类、补骨脂酚的含量差异较大,4个香豆素类成分、黄酮成分(新补骨脂异黄酮)和补骨脂酚含量最大值分别是最小值的3.47～5.60、5.30、6.47倍。斑马鱼毒性评价结果显示18个批次补骨脂水煎液对斑马鱼毒性差异较大,其中LC_(50)最大值是最小值的7.2倍。毒性与成分含量相关分析结果表明,斑马鱼毒性与黄酮类成分、补骨脂酚的相关性较好(R~2分别为0.623 4、0.587 8),与香豆素类成分的相关性较低(R~2为0.187 7)。各类代表成分的毒性评价结果表明,补骨脂酚和3个黄酮成分(补骨脂甲素、新补骨脂异黄酮、补骨脂乙素)是补骨脂致毒的关键成分,香豆素类成分的安全性相对较好。结论斑马鱼模型可高效、灵敏反映不同批次补骨脂毒性的差异,通过毒性与成分含量的相关分析,能够快速发现补骨脂中毒性相关成分群,为从中药复杂体系快速发现毒性及其相关物质提供依据。     

基于GC-MS技术及网络药理学探讨醒脑静注射液入脑成分抗脑缺血损伤的作用机制

目的基于气相色谱-质谱联用技术(gas chromatography-mass spectrometry,GC-MS)、网络药理学及分子对接技术识别并探究醒脑静注射液入脑成分及其治疗脑缺血损伤的作用机制,为其药效物质基础研究提供参考依据。方法调研文献获取醒脑静入脑成分并采用GC-MS技术对其入脑成分进行补充,在此基础上,利用中药系统药理学数据库与分析平台(traditional Chinese medicine systems pharmacology database and analysis platform,TCMSP)和Swiss数据库对醒脑静注射液入脑成分进行靶点预测;同时通过CTD、OMIM、Gene Cards等数据库获取脑缺血靶点;进一步利用Omic Share平台对药物与脑缺血共有靶点进行基因本体(gene ontology,GO)、京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)通路富集分析;采用String数据库和Cytoscape 3.7.2软件构建蛋白互作(protein-protein interaction,PPI)网络图及"入脑成分-脑缺血靶点-通路"网络图,并对入脑成分与核心靶点进行分子对接验证。结果鉴定出龙脑、麝香酮、樟脑、莪术二酮等13种醒脑静注射液入脑成分;通过网络药理学技术得到93个醒脑静注射液治疗脑缺血的作用靶点,包括MPO、PPARG、HMOX1、MMP2等。通路富集分析表明神经营养蛋白信号通路(neurotrophin signaling pathway)、雌激素信号通路(estrogen signaling pathway)及血管内皮生长因子信号通路(vascular endothelial growth factor signaling pathway)等可能是醒脑静注射液发挥抗脑缺血损伤的主要途径。通过分子对接技术验证得出代表性成分(栀子苷、莪术二酮、麝香酮)与治疗脑缺血潜在靶点具有较好的亲和。结论明确了醒脑静注射液的入脑成分,预测了入脑成分治疗脑缺血损伤的作用机制并初步验证了其靶点,为深入阐明醒脑静注射液的药效物质基础及作用机制提供了实验及理论依据。