辛伐他汀对急性呼吸窘迫综合征的治疗效果研究

目的 探讨辛伐他汀治疗急性呼吸窘迫综合征患者的临床疗效及安全性。方法 将2018 年1 月～2019 年7月至我院治疗的88 例高ARDS 患者纳入研究，随机均分为实验组与对照组，每组各44 例。两组患者在常规治疗之外，实验组接受每日80 mg 辛伐他汀给药，对照组接受每日80 mg 安慰剂给药。研究持续28 d，治疗前后使用Murray 肺损伤评分评估患者肺损伤程度，检测治疗后患者血浆IL-6、TNF-α 和hs-CRP 含量，统计研究期间两组患者不良反应率。并使用辛伐他汀处理EC 细胞，检测S1PR1 蛋白和KLF2 蛋白的表达。结果 治疗后，两组患者Murray 肺损伤评分均显著下降（P＜0.05），且实验组改善幅度大于对照组；治疗后，实验组患者Murray 肺损伤评分、血浆IL-6/TNF-α 和hs-CRP 均显著低于对照组（P＜0.05）；治疗期间，两组间总不良反应率比较，差异无统计学意义（P=0.534）。辛伐他汀处理后，EC 细胞中的S1PR1 和KLF2 的表达均显著提高。结论 辛伐他汀治疗能够显著改善ARDS 患者肺损伤和炎症反应，具有良好的安全性，可能是通过与KLF2 相关的机制，增加S1PR1 的表达来增强内皮屏障功能，从而降低血管通透性的增加。     

应用Fast-fix 360全内缝合技术修复半月板Ramp区损伤的临床研究

目的探讨应用Fast-fix 360全关节内缝合技术修补半月板Ramp区损伤的方法和疗效。方法2016年10月至2018年4月,中部战区总医院骨科足踝与运动医学中心使用Fast-fix 360缝合技术修补经镜下确诊为内侧半月板Ramp区损伤病人15例,其中男14例,女1例,平均年龄为23.6岁,病人均合并前交叉韧带(anterior cruciate ligament,ACL)断裂,均予以一期行ACL自体腘绳肌单束重建,6例合并外侧半月板损伤亦同期处理。术后行膝关节标准化功能康复。收集病例手术时间、术中出血量、术后并发症情况;术前、术后半年、术后1年的Lysholm膝关节评分、国际膝关节评分委员会(International Knee Documentation Committee,IKDC)评分;术后半年、1年分别复查患膝关节MRI,评估Ramp区损伤修复情况。结果病人随访13~26个月(平均17.8个月)。手术时间为(90.8±21.4)min,术中出血量为(50.5±10.6)ml。术后2例病人移植肌腱供区伤口浅表感染,经延长换药后均愈合;无伤口深部感染及膝关节感染;未出现腘窝血管神经损伤情况。术后半年及1年的Lysholm膝关节评分、IKDC评分均显著高于术前,差异均有统计学意义(P均<0.05)。术后半年MRI评估Ramp区的愈合率为73.3%,术后1年其愈合率提高至86.7%。结论使用Fast-fix 360全关节内缝合技术修补半月板Ramp区损伤,同时一期重建ACL,可获得较满意的临床疗效,方法简单、手术时间短,可作为半月板Ramp区损伤的一种常规修复方法。     

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).     

鼻咽癌放疗导致海马损伤及认知功能障碍研究进展

放射性认知功能障碍是鼻咽癌患者放疗后常见并发症,主要与神经发生障碍、胶质细胞损伤、血管损伤和细胞因子表达异常有关。随着医学的进步,功能磁共振可以提示认知障碍的早期病变,屏蔽海马及药物治疗(美金刚、多奈哌齐、贝伐单抗等)等方法可改善放射性认知障碍。本文总结了放射性认知障碍的发病机制、影像学、放疗剂量学和治疗方法。     

Effects of sildenafil on inflammatory injury of the lung in sodium taurocholate-induced severe acute pancreatitis rats

BackgroundInflammatory response and acute lung injury (ALI) occur in sodium taurocholate-induced severe acute pancreatitis (SAP). Because sildenafil has anti-inflammatory, anti-oxidant and immune-modulating effects, we investigated its effect on inflammatory and lung injury in sodium taurocholate-induced SAP-associated ALI rat lung.MethodsSodium taurocholate-induced SAP rats received sildenafil (100 mg/kg) or not and were compared to age-matched normal control animals. We evaluated inflammatory response by detecting the expression of inflammatory factors including IL-1β, IL-6 and TNF-α, and detected the level of lung injury through histopathological evaluation. Moreover, we also tested the protein expression of PCNA, P21, Bcl-2 and Bax in the lung.ResultsSildenafil administration rats had a low level of lung injury and inflammation. In addition, sildenafil significantly increased the expression of proliferation-related markers and decreased the expression of apoptosis-related markers in lung tissue.ConclusionsSildenafil administration may attenuate inflammation and lung injury by promoting proliferation and suppressing apoptosis in SAP rats.     

Irgm1 knockout indirectly inhibits regeneration after skeletal muscle injury in mice

Immunity-related GTPase family M1 protein (lRGM1) plays an important role in host resistance to infection, immune inflammation, and tumors, and it is expressed in various tissues and cells, including the central nervous system, cardiovascular system, bone marrow-derived cells, glioma, and melanoma. However, the effect of IRGM1 in the muscles has not been reported to date. In this study, Irgm1^−/− mice were used to evaluate the effect of lrgm1 on regeneration after skeletal muscle injury. The tibialis anterior muscle in Irgm1^−/− mice was poorly repaired after BaCl₂-induced injury, whereas lrgm1 knockout itself had no significant effect on the differentiation of myoblasts. However, the microenvironment of Irgm1^−/− mice with a high interferon-gamma level inhibited the differentiation of myoblasts in vivo. These results suggest that lrgm1 knockout indirectly inhibits skeletal muscle regeneration after injury, providing new insights into the biological function of IRGM1.     

代谢组学在肾脏疾病中的研究进展

目前肾脏疾病的准确诊断最终仍需要肾穿刺活检技术。代谢组学可以定性和定量分析生物机体包括系统、器官或细胞在受到外界因素影响下引起的内源性代谢产物的变化；肾脏疾病的发生发展会受到生物体内外多种因素的影响，与机体代谢异常密切相关，表现为各类代谢产物的变化。近年来，代谢组学为肾脏疾病的研究做出了很多贡献，本文就代谢组学在肾脏疾病中的研究进展作以综述，希望为肾脏病发生发展及诊断提供新的研究思路和方向。     

基于国家专利的中药复方治疗化学性肝损伤用药规律研究

目的分析国家专利治疗化学性肝损伤的组方用药规律,为新药研发及相关专利的申请提供参考。方法以国家知识产权局中国专利公布公告网站收录的授权专利为资料来源,使用Microsoft Excel 2018建立数据库,对中药频次与分类进行统计分析;采用SPSS Statistic 21.0和SPSS Modeler 15.0对高频中药(频次≥10)进行性味归经分析、系统聚类分析、关联度与网络分析。结果纳入专利100项,涉及中药186味,以葛根最为常见;高频中药15味,药味以甘为主,药性以温、平为主,多归脾、肝经;聚类分析得到7组中药组合;二项、三项和四项关联规则分别为6、24、2项,各项组合分别为6、16、2项;核心药物为葛根、五味子、丹参、甘草、山楂、枸杞子、黄芪、柴胡、姜黄和枳椇子。结论中药复方治疗化学性肝损伤常用补虚、解表、化瘀、活血、渗湿及利水药;临证多采用疏肝理气之剂,适当伍以柔润之品。     

蒙药治疗肝损伤的实验研究进展

随着蒙医药临床与实验科学的快速发展，关于肝损伤的实验研究也逐渐增多，其研究内容从最初的药物对实验动物生化指标的影响发展到组织病理形态学改变以及分子生物，免疫蛋白测定等。本文章通过查阅与总结从1992年至今关于蒙药治疗肝损伤实验研究，总结多种蒙药复方、单药及其提取物对不同模型导致肝损伤的作用及影响，为蒙药治疗肝损伤的进一步研究发展提供最初的信息资源。