皮肤原位再生复原技术结合可调脉宽倍频Nd∶YAG激光治疗黄褐斑的临床疗效观察

目的 观察皮肤原位再生复原技术结合可调脉宽倍频Nd∶YAG激光治疗黄褐斑的临床疗效,并总结临床经验.方法 应用皮肤原位再生复原技术结合可调脉宽倍频Nd∶YAG激光治疗黄褐斑380例,根据评定标准对治疗结果进行评价.结果 380例黄褐斑患者经治疗后基本治愈272例,显效57例,好转51例,无效0例,有效率86.58%.结论 皮肤原位再生复原技术结合可调脉宽倍频Nd∶YAG激光治疗黄褐斑疗效确切,该技术值得临床推广.     

姜黄素激活Nrf2抗氧化系统缓解百草枯诱导的胰岛素抵抗

目的：观察姜黄素是否具有改善百草枯（ paraquat,PQ）所致氧化应激诱导的胰岛素抵抗作用并探讨其改善胰岛素抵抗的效应机理。方法将实验小鼠随机分成对照组（ Control组）,百草枯组（ PQ组）以及PQ加姜黄素组（ Cur组）。 PQ和Cur组连续腹腔注射百草枯7天造模成功后。 Cur组继续Cur灌胃干预。7天后,取胰岛素敏感组织肌肉,用蛋白免疫印迹方法（ Western blot,WB）检测蛋白水平和磷酸化变化,并检测脂质过氧化指标MDA。结果在PQ诱导的小鼠胰岛素抵抗模型中,姜黄素可改善小鼠葡萄糖耐量并对抗 PQ 所致的胰岛素信号蛋白 PKB－Ser473磷酸化损害;姜黄素还可明显降低肌肉MDA水平,激活小鼠Nrf2系统,促进Nrf2核转位和NQO－1的表达,同时能增强IкBα的水平,缓解氧化应激及炎症反应。结论姜黄素通过增强内源性Nrf2系统功能和胰岛素信号水平,对抗PQ诱导的氧化应激,是其缓解胰岛素抵抗的重要机理。     

姜黄素对阿尔茨海默病细胞模型miRNA106a的影响

目的探讨阿尔茨海默病(Alzheimer’s disease,AD)中姜黄素与miR-106a的关系。方法将PC12细胞随机分为5组:正常对照组(PC12细胞组),模型组(PC12细胞与浓度为4μg/mL的Aβ1-42共培养24h),anti-miR-106a组(造模成功后转染anti-miR-106a),姜黄素组(造模成功后加姜黄素,终浓度为20μmol/L)、共同作用组(anti-miR-106a加入姜黄素)。RT-PCR检测miR-106a的含量;Western blotting检测APP的含量。结果 RT-PCR结果显示,与正常对照组相比,模型组和anti-miR-106a组miR-106a含量均明显降低(P<0.05),而姜黄素组明显升高(P<0.05)。Western blotting结果显示,与正常对照组相比,模型组(P<0.05)和anti-miR-106a组(P<0.01)APP明显增加,姜黄素组APP比模型组明显降低(P<0.05)。结论姜黄素可通过正性调节miR-106a而参与AD的治疗。     

Lower anticoagulation for mechanical heart valves: experience with the ATS bileaflet valve

Background: The design of the bileaflet ATS (ATS Medical Inc., Minneapolis, USA) mechanical valve incorporates an open pivot at the hinge mechanism. Total washout of the blood at the pivot area was observed using 3-D computational fluid dynamics modelling. This phenomenon could make the valve less vulnerable to clot formation in patients without major thromboembolic risk factors.

Methods: From January 1993 to June 1999, 286 consecutive patients had the ATS valve inserted in the aortic position. Patients were divided into two groups. Group 1 comprised all patients in regular sinus rhythm with good left ventricular function (144 patients). Group 2 included patients in non-sinus rhythm and/or with large hypocontractile left ventricles (142 patients). The anticoagulation regime in group 1 was used to obtain an international normalised ratio (INR) between 1.5 and 2.5. This contrasts with our regular aim to maintain the INR strictly between 2.5 and 3.5 for all mechanical valves, as achieved in group 2.

Results: The follow-up period (99% completeness) ranged from 18 to 84 months. Survival (Kaplan-Meier) was 97 and 98% and 92 and 81% at 1 and 5 years in group 1 and group 2, respectively (P = 0.12). Log rank analysis failed to detect a statistical difference in thromboembolism or bleeding between both groups (P > 0.05). However, trends were in favour of group 1. Univariate analysis selected poor ventricular function and an ‘erratic’ INR value (P = 0.002) as risk factors for death. The sole independent risk factor for bleeding was the use of aspirin (P = 0.025).

Conclusions: The excellent group 1 data and outcome encouraged us to continue our low intensive anticoagulation regime and perhaps should be regarded as a new concept for treatment of selected mechanical valve patients.     

Functional tricuspid regurgitation secondary to aortic annular abscess: An unusual presentation of infective endocarditis

An unusual case of aortic annular abscess is presented, in which the patient presented with features of gross tricuspid regurgitation. There was no direct involvement of the tricuspid valve. Tricuspid regurgitation disappeared following surgical repair of the annular abscess. The present case also illustrates the utility of trans-oesophageal echocardiography in establishing the diagnosis and planning surgical intervention.     

Anti-thrombotic, anti-platelet and fibrinolytic therapy: current management of acute myocardial infarction

Significant advances in the treatment of patients with acute myocardial infarction (MI) have been obtained in recent times. In particular, thrombolytic therapy has been shown to preserve ventricular function and improve survival in patients with acute MI. Therapies now include third-generation thrombolytic agents, percutaneous transluminal coronary angioplasty (PTCA) and intracoronary stenting, and new anti-thrombotic therapies including anti-platelet treatment with glycoprotein (GP) IIb/IIIa inhibition and direct anti-thrombin agents. This review will focus on the use of GP IIb/IIIa antagonists and thrombin inhibitors as adjunctive therapies to thrombolytic treatment of patients with acute MI.     

响应曲面法优化姜黄素包合物的制备

目的:探讨姜黄素羟丙基β-环糊精包合物curcumin HP-β-cyclodextrin inclusion complex,CUR-HP-β-CD)的包合工艺。方法:以包合物的产率为考查指标,考查温度、搅拌时间、乙醇浓度对产率的影响。采用响应曲面法对实验进行设计,采用饱和水溶液法制备包合物,通过紫外扫描和差示扫描量热法对包合物进行验证。结果:制备姜黄素羟丙基β-环糊精包合物的最佳条件为乙醇浓度为40%,饱和温度50℃,反应时间4 h。紫外扫描和差示扫描量热法证明了所得产物为包合物;结论:本工艺适用于制备姜黄素羟丙基β-环糊精包合物。     

Curcumin prevents the non-alcoholic fatty hepatitis via mitochondria protection and apoptosis reduction

Background: Non-alcoholic fatty hepatitis (NASH) is highly prevalent, mitochondria damage is the main pathophysiological characteristic of NASH. However, treatment for mitochondria damage is rarely reported. Methods: NASH model was established in rats, the protective effects of curcumin were evaluated by histological observation; structure and function assessments of mitochondria; and apoptotic genes expression. Results: NASH rats treated with curcumin displayed relatively slight liver damage when compared with NASH livers. The average mitochondrial length and width of NASH (12.0 ± 3.2 and 5.1 ± 1.1 micrometers) were significantly longer than that of normal (6.2 ± 2.1 and 2.1 ± 1.5 micrometers) and NASH treated with curcumin (7.4 ± 1.2 and 3.2 ± 1.5 micrometers) rats. The average malondialdehyde (MDA) and 4-hydroxy nonyl alcohol (HNE) levels in liver homogenates of NASH rats (4.23 ± 0.22 and 19.23 ± 2.3 nmol/Ml) were significantly higher than these in normal (1.32 ± 0.12 and 3.52 ± 0.43 nmol/mL) and NASH treated with curcumin (1.74 ± 0.11 and 4.66 ± 0.99 nmol/mL) rats. The expression levels of CytC, Casp3 and Casp8 of the NASH livers were significantly higher than normal and NASH treated with curcumin rats livers. Conclusion: Our data demonstrated that curcumin prevents the NASH by mitochondria protection and apoptosis reduction and provided a possible novel treatment for NASH.