肝硬化患者的视网膜血管特征及其可能的诊断价值

目的 分析肝硬化患者的视网膜血管特征,并探讨视网膜血管参数在肝硬化中的诊断价值和眼底检查作为肝硬化筛查手段的可行性。方法 将90例确诊为肝硬化的患者和93名同期体检健康人员分别设为肝硬化组与对照组。使用眼底照相机和自动化图像分析系统对入组个体进行眼底图像采集和视网膜血管参数测量,包括视网膜血管管径、血管弯曲度、血管分支夹角和血管分形维数。比较2组各视网膜血管参数,采用受试者工作特征(ROC)曲线分析各视网膜参数单独和联合诊断肝硬化的效能。结果 与对照组相比,肝硬化组具有更宽的视网膜血管管径、更大的血管分支夹角和更小的血管分形维数(P均< 0.05)。视网膜血管管径、视网膜血管分形维数及两者联合诊断肝硬化的ROC曲线下面积分别为0.869(95%CI 0.820 ~ 0.919)、0.780(95%CI 0.713 ~ 0.847)和0.901(95%CI 0.860 ~ 0.942)。结论 肝硬化患者的视网膜血管系统发生了明显改变。视网膜血管管径和血管分形维数对肝硬化具有一定的诊断价值,诊断效能较佳,两者联合具有更高的诊断价值。眼底检查或可为肝硬化的便捷筛查和无创诊断带来更多的可能性。     

Cold‐inducible RNA‐binding protein (CIRP) in inflammatory diseases: Molecular insights of its associated signalling pathways

Cold‐inducible RNA‐binding protein (CIRP) was previously identified as an intracellular stress‐response protein, which can respond to a variety of stress conditions by changing its expression and regulating mRNA stability through its binding site on the 3′‐UTR of its targeted mRNAs. Recently, extracellular CIRP (eCIRP) was discovered to be present in various inflammatory conditions and could act as a pro‐inflammatory factor. Genetic studies have demonstrated a key role for eCIRP in inflammatory conditions that led to the importance of targeting eCIRP in these diseases. Currently, the underlying mechanism of eCIRP‐induced inflammation is under intensive investigation and several signalling pathways are being explored. Here, we epitomized various signalling pathways that mediate the pro‐inflammatory effects of CIRP and also recapitulated all the CIRP‐derived peptides that can block the interaction between CIRP and its receptors in inflammatory setting.     

基于网状Meta分析探索6种中成药治疗糖尿病肾病氧化应激反应的疗效＊

目的 基于网状Meta分析的方法对不同中成药治疗糖尿病肾病氧化应激反应的有效性及安全性进行评估。方法 计算机检索中国期刊全文数据库（CNKI）、万方数据库（WanFang）、维普数据库（VIP）、SinoMed数据库、PubMed数据库、Cochrane Library数据库等国内外数据库，检索时间均为建库至2020年2月。首先按预先制定的纳入与排除标准进行文献筛选和资料提取。然后采用Cochrane系统5.3推荐的偏倚风险评价工具对纳入的RCTs进行质量评估。紧接着采用Gemtc软件进行数据分析，采用STATA14.0软件进行绘图。结果 最终纳入关于中成药改善DN患者氧化应激水平的随机对照试验（RCT）共计30篇，涉及6种中成药，8种治疗方案，总计3354例患者，其中治疗组1693例，对照组1661例。网状Meta分析结果显示，SOD指标共产生7个直接比较和21个间接比较，其中，百令胶囊、黄葵胶囊、金水宝颗粒、糖脉康颗粒、益肾化湿颗粒联合常规治疗的疗效优于西医常规治疗，且差异具有统计学意义；中成药疗效排序结果为：益肾化湿颗粒 > 雷公藤多甙片联合黄葵胶囊 > 雷公藤多甙片 > 百令胶囊 > 黄葵胶囊 > 金水宝颗粒 > 糖脉康颗粒；MDA指标共产生7个直接比较和21个间接比较，百令胶囊、黄葵胶囊联合常规治疗的疗效较西医常规治疗更好，且差异具有统计学意义；8种治疗方案疗效排序结果为：雷公藤多甙片联合黄葵胶囊 > 雷公藤多甙片 > 黄葵胶囊 > 百令胶囊 > 益肾化湿颗粒 > 糖脉康颗粒 > 金水宝颗粒；UAER指标共产生5个直接比较和11个间接比较，其中黄葵胶囊联合西医常规治疗在减少UAER方面优于西医常规治疗，中成药之间排序为：黄葵胶囊 > 金水宝颗粒 > 百令胶囊 > 益肾化湿颗粒 > 糖脉康颗粒。结论 在西医常规基础上辅于中成药的治疗方案较单纯西医常规治疗方案，在提高血清SOD水平，降低血液中MDA含量方面明显优于后者。此外，由于涉及不同的中成药的RCTS中的研究数量及质量存在差异，本研究的中成药排序结果有待进一步RCT临床试验验证。     

新生儿单肺通气的麻醉管理(附20例报告)

目的探讨新生儿食管端端吻合手术中单肺通气(OLV)麻醉的可行性和安全性.方法对20例日龄4h～17d、体重1.5～3.2kg的食管闭锁及气管食管瘘患儿,快速诱导后,在正气管插入单腔气管导管,右侧开胸,使术侧肺脏压迫萎陷造成左侧单肺通气(OLV).术中连续监测心率(HR)、动脉压(ABP)、心电图(ECG)、脉搏血氧饱和度(SpO2)、呼气末CO2分压(PETCO2)、体温(T);记录诱导前后OLV10min、OLV30min,术毕的SpO2、PETCO2、HR值,比较各时段呼吸循环参数变化.结果全部患儿单肺通气后SpO2均有下降,经适当处理,14例患儿SpO2维持在95%以上.3例患儿应用呼气末正压通气(PEEP),可维持SpO2在94%以上.另3例患儿在暂停手术操作、恢复双肺通气后,SpO2恢复正常.与诱导后相比,PETCO2在单肺通气后10min及30min分别为(30.2±3.6)、(29.5±4.8)mmHg,显著低于诱导后的(35.1±0.6)mmHg(P＜0.05).HR在单肺通气后各时段呈显著降低趋势(P＜0.05).结论采用正气管插管技术,应用合理的呼吸管理,适当的麻醉用药,新生儿单肺通气行类似于食管端端吻合手术是安全可行的.     

Resveratrol relieves particulate matter (mean diameter < 2.5 μm)‐induced oxidative injury of lung cells through attenuation of autophagy deregulation

Oxidative stress and inflammation are critically implicated in ambient fine particulate matter (mean diameter < 2.5 μm; PM_2.5)‐induced lung injury. Autophagy, playing a crucial role in various physiopathological conditions, modulates cellular homeostasis and stress adaptation. Resveratrol is a phytoalexin that exerts potent antioxidant effects on cardiopulmonary diseases. To date, the mechanisms by which resveratrol protects against PM_2.5 remain to be elucidated. In the present study, we investigated the effect of resveratrol on PM_2.5‐induced oxidative injury. The potential role of nuclear factor erythroid‐2‐related factor 2 and autophagy in this progress was explored. Human bronchial epithelial cells were treated with PM_2.5 and the cytotoxicity and oxidative stress markers were determined. The results showed that PM_2.5 decreased cell viability and elevated the level of lactate dehydrogenase. The levels of malondialdehyde and reactive oxygen species were increased by PM_2.5 exposure. PM_2.5 also induced a significant increase of the inflammatory cytokines including interleukin (IL)‐6, IL‐8, IL‐1β and tumor necrosis factor α. Meanwhile, PM_2.5 triggered autophagy formation and alteration of the nuclear factor erythroid‐2‐related factor 2 pathway. Furthermore, human bronchial epithelial cells were co‐treated with PM_2.5 and resveratrol in the presence or absence of 3‐methylamphetamine, an inhibitor of autophagic formation. It was revealed that resveratrol intervention abolished PM_2.5‐induced oxidative injury partially through the suppression of autophagy deregulation. Findings from this study could provide new insights into the molecular mechanisms of pulmonary intervention during PM_2.5 exposure.     

Targeted delivery of hyaluronic acid-coated solid lipid nanoparticles for rheumatoid arthritis therapy

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease. Long-term, high-dose glucocorticoid therapy can be used to treat the disease, but the fact that the drug distributes systemically can give rise to severe adverse effects. Here we develop a targeted system for treating RA in which the glucocorticoid prednisolone (PD) is encapsulated within solid lipid nanoparticles (SLNs) coated with hyaluronic acid (HA), giving rise to HA-SLNs/PD. HA binds to hyaluronic receptor CD44, which is over-expressed on the surface of synovial lymphocytes, macrophages and fibroblasts in inflamed joints in RA. As predicted, HA-SLNs/PD particles accumulated in affected joint tissue after intravenous injection into mice with collagen-induced arthritis (CIA), and HA-SLNs/PD persisted longer in circulation and preserved bone and cartilage better than free drug or drug encapsulated in SLNs without HA. HA-SLNs/PD reduced joint swelling, bone erosion and levels of inflammatory cytokines in serum. These results suggest that encapsulating glucocorticoids such as PD in HA-coated SLNs may render them safe and effective for treating inflammatory disorders.     

The anti-tumor effect of pachymic acid on osteosarcoma cells by inducing PTEN and Caspase 3/7-dependent apoptosis

Pachymic acid (PA) is a lanostane type triterpenoid isolated from Poria cocos, which possesses an anti-tumor effect in breast cancer, prostate cancer, lung cancer, and bladder cancer cells. In this study, we investigated the effect of PA on the growth and apoptosis of human immortalized cell line (HOS) and primary osteosarcoma cells by a Cell Counting Kit-8 (CCK-8) and Annexin V and propidium iodide (PI) staining, respectively. Western blot was used to measure the expression of cleaved Caspase 3, PTEN, and AKT, as well as the AKT phosphorylation. The Caspase 3 activity was determined using the Caspase-3 Colorimetric Assay Kit. From the results, PA significantly reduced cell proliferation in a concentration- and time-dependent manner. PA also induced cell apoptosis in a dose-dependent fashion. PA treatment led to increased Caspase 3 activation and PTEN expression, as well as reduced AKT phosphorylation. Moreover, Ac-DEVD-CHO (a Caspase 3/7 inhibitor) pre-treatment or PTEN knockdown partially blocked the effects of PA on cell proliferation and apoptosis. Caspase 3/7 inhibitor had an additive effect with PTEN knockdown. Collectively, our results suggested that induction of apoptosis by PA was mediated in part by PTEN/AKT signaling and Caspase 3/7 activity. This study provides evidence that PA might be useful in the treatment of human osteosarcoma.     

New resilience instrument for patients with cancer

Objective

Resilience is an important concept in the cancer literature and is a salient indicator of cancer survivorship. The aim of this study is to develop and validate a new resilience instrument that is specific to patients with cancer diagnosis (RS-SC) in Mainland China.

Methods

First, a resilience framework was constructed for patients with cancer diagnosis. Second, items were formulated based on the framework to reflect different aspects of resilience. Third, two rounds of expert panel discussion were performed to select important and relevant items. Finally, two cross-sectional studies were conducted to evaluate the psychometric properties of this instrument.

Results

Fifty-one items were generated based on the resilience framework and the final 25-item RS-SC resulted in a five-factor solution including Generic Elements, Benefit Finding, Support and Coping, Hope for the Future and Meaning for Existence, accounting for 64.72% of the variance. The Cronbach’s α of the RS-SC was 0.825 and the test–retest reliability was 0.874.

Conclusion

The RS-SC is a brief and specific self-report resilience instrument for Chinese patients with cancer and shows sound psychometric properties in this study. The RS-SC has potential applications in both clinical practice and research with strength-based resiliency interventions.

     

A-40926混合物中B0组分的分离纯化

目的 开发一种高纯度A-40926混合物中B0组分(以下简称A-40926 B0)的分离纯化工艺。方法 采用中压色谱系统,以聚合物微球为载体,A-40926 B0的收率为指标,筛选聚合物微球的类型,优化洗脱条件。结果 型号为UniPS30-300的微球为最佳层析介质,上样量为10mg(每毫升填料),洗脱剂依次为体积分数30%,45%的乙醇溶液,流速为1.5BV/h(BV：层析柱体积);所得产品纯度大于95%,层析总收率大于75%。结论 此种高纯度A-40926 B0的分离纯化方法简单易行,收率稳定,适于工业化生产。