度普利尤单抗治疗特应性皮炎引起“度普利尤单抗面部红斑”1例

患者女，65岁，全身皮肤对称红斑、丘疹伴瘙痒9个月。9个月前患者躯干、四肢出现黄豆大小丘疹、红斑伴瘙痒，就诊于当地医院，诊断为“湿疹”，予氯雷他定、西替利嗪口服，外用糠酸莫米松乳膏治疗，皮疹反复发作并逐渐增多，干燥、瘙痒加重，影响患者睡眠……     

原发性肝癌患者手术切除术后早期复发影响因素分析

目的:探究原发性肝癌患者手术切除术后早期复发影响因素分析。方法:对广州市番禺区中医院2017年2月-2019年2月收治的原发性肝癌患者98例进行回顾性分析,依据各项临床指标分析手术切除术后早期复发的影响因素。结果:原发性肝癌患者经由手术切除后出现复发的可能性较高,同时手术切缘有残留、包膜不完整、肿瘤结节、心理因素、甲胎蛋白、血管侵犯、肝硬化及肿瘤直径等均是影响原发性肝癌手术期后再复发的高危因素。结论:原发性肝癌通常具有术后复发的生物学特性,依据对手术切除术之后早期复发因素的分析,对手术风险与治疗方案进行充分评估,同时要求患者进行定期复查及随访等工作,可对患者手术成功以及并发症的防治等均具有积极意义。     

Hisense计算机辅助系统辅助腹腔镜精准手术治疗儿童肾上腺区巨大肿瘤

目的探讨计算机辅助手术系统(computer-aided system,CAS)对于腹腔镜手术切除肾上腺巨大肿瘤(瘤体直径≥5 cm)的指导价值。方法回顾性分析青岛大学附属医院2015年9月至2018年6月收治的13例肾上腺区巨大肿瘤病例,13例术前均完善相关辅助检查并行Hisense CAS三维重建,依据三维重建结果指导完成腹腔镜手术。结果13例肾上腺区巨大肿瘤患儿术前和术中在Hisense CAS三维重建结果的指导下均顺利完成腹腔镜手术。术后病理检查:神经母细胞瘤7例,节细胞性神经母细胞瘤2例,节细胞神经瘤1例,嗜铬细胞瘤2例,肾上腺皮质癌1例。结论Hisense计算机辅助系统能够清晰显示肿瘤位置及其与周围重要脏器结构的毗邻关系,可用于指导手术治疗儿童肾上腺区巨大肿瘤。     

Expression and effect of sodium-potassium-chloride cotransporter on dorsal root ganglion neurons in a rat model of chronic constriction injury

Sodium-potassium-chloride cotransporter 1 (NKCC1) and potassium-chloride cotransporter 2 (KCC2) are associated with the transmission of peripheral pain.We investigated whether the increase of NKCC1 and KCC2 is associated with peripheral pain transmission in dorsal root ganglion neurons.To this aim,rats with persistent hyperalgesia were randomly divided into four groups.Rats in the control group received no treatment,and the rat sciatic nerve was only exposed in the sham group.Rats in the chronic constriction injury group were established into chronic constriction injury models by ligating sciatic nerve and rats were given bumetanide,an inhibitor of NKCC1,based on chronic constriction injury modeling in the chronic constriction injury + bumetanide group.In the experiment measuring thermal withdrawal latency,bumetanide (15 mg/kg) was intravenously administered.In the patch clamp experiment,bumetanide (10 μg/μL) and acutely isolated dorsal root ganglion neurons (on day 14) were incubated for 1 hour,or bumetanide (5 μg/μL) was intrathecally injected.The Hargreaves test was conducted to detect changes in thermal hyperalgesia in rats.We found that the thermal withdrawal latency of rats was significantly decreased on days 7,14,and 21 after model establishment.After intravenous injection of bumetanide,the reduction in thermal retraction latency caused by model establishment was significantly inhibited.Immunohistochemistry and western blot assay results revealed that the immune response and protein expression of NKCC1 in dorsal root ganglion neurons of the chronic constriction injury group increased significantly on days 7,14,and 21 after model establishment.No immune response or protein expression of KCC2 was observed in dorsal root ganglion neurons before and after model establishment.The Cl^– (chloride ion) fluorescent probe technique was used to evaluate the change of Cl^– concentration in dorsal root ganglion neurons of chronic constriction injury model rats.We found that the relative optical density of N-(ethoxycarbonylmethyl)-6-methoxyquinolinium bromide (a Cl^– fluorescent probe whose fluorescence Cenintensity decreases as Cl– concentration increases) in the dorsal root ganglion neurons of the chronic constriction injury group was significantly decreased on days 7 and 14 after model establishment.The whole-cell patch clamp technique revealed that the resting potential and action potential frequency of dorsal root ganglion neurons increased,and the threshold and rheobase of action potentials decreased in the chronic constriction injury group on day 14 after model establishment.After bumetanide administration,the above indicators were significantly suppressed.These results confirm that CCI can induce abnormal overexpression of NKCC1,thereby increasing the Cl^– concentration in dorsal root ganglion neurons;this then enhances the excitability of dorsal root ganglion neurons and ultimately promotes hyperalgesia and allodynia.In addition,bumetanide can achieve analgesic effects.All experiments were approved by the Institutional Ethics Review Board at the First Affiliated Hospital,College of Medicine,Shihezi University,China on February 22,2017 (approval No.A2017-169-01).     

知母饮片炮制前后黄酮类和皂苷类成分变化研究

目的:测定知母饮片炮制前后3个黄酮类和2个皂苷类成分变化。方法:采用高效液相色谱-紫外检测法(HPLC-UV)测定3个黄酮类成分,色谱柱为岛津Intetsil ODS-3(4.6 mm×250 mm,5μm),流动相为乙腈-0.2%冰醋酸,梯度洗脱,进样量20μL,流速1.0 mL/min,柱温30℃;采用高效液相色谱-蒸发光散射检测法(HPLC-ELSD)测定2个皂苷类成分,色谱柱为岛津Intetsil ODS-3(4.6 mm×250 mm,5μm),流动相为乙腈-0.2%冰醋酸,梯度洗脱,进样量10μL,流速1.0 mL/min,氮气流量2.5 mL/min,蒸发温度80℃。结果:知母饮片炮制后知母皂苷BⅡ、新芒果苷、芒果苷含量下降,知母皂苷AⅢ含量上升,异芒果苷含量相对稳定。结论:知母饮片炮制后部分知母皂苷BⅡ会转化成知母皂苷AⅢ,新芒果苷、芒果苷会转化成其他成分,异芒果苷结构相对稳定,不易转化成其他成分。     

肝阴虚证证候特点及辨证用药规律的文献研究

目的:为进一步深入研究和探讨肝阴虚证候的本质,本文分析和整理肝阴虚证的病因病机、证候表征、证候属性疾病及遣方选药的规律。方法:运用检索文献并进行频数统计的方法,检索查阅1960年9月1日至2019年1月10日中国知网中医临床研究文献。结果:肝阴虚证的病因病机为肝失疏泄,气机郁滞,化火伤阴,阴液亏虚,失于濡养;证候辨证要点主要为脉弦细数,舌红少津,头晕目眩,五心烦热,口咽干燥,两目干涩;证候临床属性疾病有肝炎、肝硬化、肝纤维化、肝癌;临床上治疗肝阴虚证使用处方主要为一贯煎、补肝汤、四物汤、芍药甘草汤,临床高频使用中药为生地黄、白芍、枸杞、当归、麦冬。结论:本文对于肝阴虚证的证候特点以及辨证用药规律做出系统的总结与归纳,将有关肝阴虚证的论述联系起来,形成统一的整体,为揭示肝阴虚证的本质与临床上形成较为成熟的肝阴虚证治疗方案提供参考。     

RPV‐modified epirubicin and dioscin co‐delivery liposomes suppress non‐small cell lung cancer growth by limiting nutrition supply

Chemotherapy for non‐small cell lung cancer (NSCLC) is far from satisfactory, mainly due to poor targeting of antitumor drugs and self‐adaptations of the tumors. Angiogenesis, vasculogenic mimicry (VM) channels, migration, and invasion are the main ways for tumors to obtain nutrition. Herein, RPV‐modified epirubicin and dioscin co‐delivery liposomes were successfully prepared. These liposomes showed ideal physicochemical properties, enhanced tumor targeting and accumulation in tumor sites, and inhibited VM channel formation, tumor angiogenesis, migration and invasion. The liposomes also downregulated VM‐related and angiogenesis‐related proteins in vitro. Furthermore, when tested in vivo, the targeted co‐delivery liposomes increased selective accumulation of drugs in tumor sites and showed extended stability in blood circulation. In conclusion, RPV‐modified epirubicin and dioscin co‐delivery liposomes showed strong antitumor efficacy in vivo and could thus be considered a promising strategy for NSCLC treatment.     

HPV检测原发灶不明颈淋巴结转移癌的诊断作用初探(附6例报告)

目的 初步探讨HPV检测在诊断原发灶不明的颈淋巴结转移性鳞癌中的价值。方法 收集复旦大学附属肿瘤医院6例首诊为原发灶不明的颈淋巴结转移性鳞癌,最终确诊为HPV相关口咽鳞癌,分析确诊过程。结果 首诊时6例患者均被确诊为颈淋巴结转移性鳞癌,且p16表达阳性和HPV-16亚型阳性,而EBER表达阴性。经全面检查均未发现明显的原发病灶。随后对其中4例予同侧扁桃体盲检(2例)和切除(2例),病理均证实为扁桃体鳞癌。另2例分别在随访第149天、545天MRI检查发现同侧口咽侧壁和舌根增厚伴强化,经活检分别证实为扁桃体鳞癌、舌根鳞癌。结论 对于原发灶不明的HPV阳性颈淋巴结转移性鳞癌,应高度怀疑原发病灶来源于口咽部位的可能性,特别是扁桃体和舌根部位。