维生素B12和叶酸干预对绝经后骨质疏松症妇女的骨代谢及同型半胱氨酸水平的影响

目的观察叶酸和维生素B12对绝经后骨质疏松症妇女的骨代谢及同型半胱氨酸水平的影响。方法 80例绝经后骨质疏松症妇女参加研究。所有参与者随机接受叶酸和维生素B12(n=40)或安慰剂(n=40)治疗。在干预前的基线及干预后3个月和6个月,测量两组患者血清同型半胱氨酸、维生素B12和骨代谢标志物的水平。结果治疗前,两组患者血清同型半胱氨酸、维生素B12和骨代谢标志物水平比较差异无统计学意义(P0.05)。治疗后,两组患者同型半胱氨酸均下降,但比较差异无统计学意义(P0.05)。6个月后各组间血清维生素B12、骨钙素、CTX的变化均有显著改变且差异有统计学意义(P0.05)。结论绝经后骨质疏松症妇女补充叶酸和维生素B12可以一定程度改善同型半胱氨酸及骨代谢指标水平。     

Melatonin safeguards against fatty liver by antagonizing TRAFs‐mediated ASK1 deubiquitination and stabilization in a β‐arrestin‐1 dependent manner

Melatonin has been previously shown to prevent nonalcoholic fatty liver disease (NAFLD), yet the underlying mechanisms are poorly understood. Here, we identified a previously unknown regulatory action of melatonin on apoptosis signal‐regulating kinase 1 (ASK1) signaling pathway in the pathogenesis and development of NAFLD. Although melatonin administration did not alter food intake, it significantly alleviated fatty liver phenotypes, including the body weight gain, insulin resistance, hepatic lipid accumulation, steatohepatitis, and fibrosis in a high‐fat diet (HFD)‐induced NAFLD mouse model (in vivo). The protection of melatonin against NAFLD was not affected by inactivation of Kupffer cell in this model. In NAFLD mice liver, ASK1 signal cascade was substantially activated, evidence by the enhancement of total ASK1, phospho‐ASK1, phospho‐MKK3/6, phospho‐p38, phospho‐MKK4/7, and phospho‐JNK. Melatonin treatment significantly suppressed the ASK1 upregulation and the phosphorylation of ASK1, MKK3/6, MKK4/7, p38, and JNK. Mechanistically, we found that lipid stress triggered the interaction between ASK1 and TNF receptor‐associated factors (TRAFs), including TRAF1, TRAF2, and TRAF6, which resulted in ASK1 deubiquitination and thereby increased ASK1 protein stability. Melatonin did not alter ASK1 mRNA level; however, it activated a scaffold protein β‐arrestin‐1 and enabled it to bind to ASK1, which antagonized the TRAFs‐mediated ASK1 deubiquitination, and thus reduced ASK1 protein stability. Consistent with these findings, knockout of β‐arrestin‐1 in mice partly abolished the protection of melatonin against NAFLD. Taken together, our results for the first time demonstrate that melatonin safeguards against NAFLD by eliminating ASK1 activation via inhibiting TRAFs‐mediated ASK1 deubiquitination and stabilization in a β‐arrestin‐1 dependent manner.     

MicroRNA-214 promotes chronic kidney disease by disrupting mitochondrial oxidative phosphorylation

1. Download : Download high-res image (301KB)
2. Download : Download full-size image

     

人为提高儿童肱骨髁上骨折外侧克氏针出针点的可行性及置针经验分析

目的初步探讨人为提高儿童肱骨髁上骨折外侧克氏针出针点的可行性及其相应的置入方法。方法本研究分为两个阶段。第一阶段:收集2016年3月至2016年12月中国医科大学附属盛京医院161例儿童伸直型肱骨髁上骨折外侧针构型病例术中透视图像中最外侧针的出针点和入针点位置,测量最外侧针冠状面和矢状面钢针角度。第二阶段(2017年1月至2017年12月)基于第一阶段的研究结果,由中国医科大学附属盛京医院两名小儿骨科医生尝试人为提高最外侧针的出针位置(预期组),另外两名外科医生继续按照常规流程置针(对照组),对两组各项治疗参数进行比较。结果第一阶段参与回顾性研究的161例患者中,47例(29.2%)最外侧针出针点位于骨干-干骺端交界区(metaphyseal-diaphyseal junction,MDJ)上边界线以上,其中40例最外侧针(85.1%)由肱骨小头骨化中心(ossific nucleus of the capitellum,ONC)外侧或骨化中心外1/3置入(正位像),于骨化中心后1/3或骨化中心后方置入(侧位像)。冠状面和矢状面钢针平均角度分别为58.4°和90.5°。第二阶段,预期组中有47例(65.3%,47/72)患者的最外侧针出针点位于MDJ上边界线以上,而对照组中仅32例(36%,32/89)出针点位于MDJ上边界线以上。两组比较差异有统计学意义(χ2=16.134,P<0.05)结论在单纯外侧针构型中,人为提高最外侧针出针点可行。钢针路径位于正位像肱骨小头骨化中心外侧、外1/3及侧位像在肱骨小头后方或后1/3位置时更容易获得高位的出针点。     

Effect of different modeling time on intestinal bacteria in letrozole induced PCOS rats

Objective: The differences of ovarian morphology, reproductive hormones, glucose and lipid metabolism and intestinal bacteria in rats with polycystic ovary syndrome (PCOS) induced by triazole were compared. Method: Eighteen 21 SPF female SD rats were randomly divided into group A (3-week group), group B (5-week group) and group D (control group) by random number table.Group A received letrozole + CMC-Na mixture by gavage in the first 3 weeks and CMC-Na solution by gavage in the last 2 weeks, group B received letrozole + CMC-Na mixture by gavage for 5 weeks, and group D received CMC-Na solution by gavage for 5 weeks, and all three groups of rats were fed with normal diet.At the end of gavage, the body weight of rats in each group was observed, the histological changes of ovaries were observed by hematoxylin-eosin (HE) staining, the serum levels of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), total cholesterol (TC), triglyceride (TG), fasting blood glucose (Glu), fasting insulin (FINS) and lipopolysaccharide (LPS) were measured by enzyme-linked immunosorbent assay (ELISA), and the LH/FSH ratio and insulin resistance index (HOMA IR) were calculated; the intestinal bacteria of rats were detected by 16S rRNA technique. Result: 1. Comparison of ovary histomorphology: Under light microscope, multiple luteum and oocytes were observed in mature follicles in group D, and granulosa cells were orderly arranged and multilayered, without cystic dilated follicles. There were no mature follicles in the ovarian tissues of group A and GROUP B. The follicles were irregular in structure and more cystic dilated follicles were visible. The number of granular cells in some follicles decreased or even disappeared. 2. Comparison of sex hormone levels: compared with group D, T level in group B was significantly increased (P < 0.001), and T level in group A had an upward trend (P > 0.05); The LH/FSH levels in group A and B were significantly increased (P < 0.001; P < 0.001). Compared with group A, E2 in group B was significantly decreased (P < 0.05) and T was significantly increased (P < 0.01). 3. Comparison of glucose and lipid metabolism levels: Compared with group D, TC levels in groups A and B were significantly increased (P < 0.01; P < 0.01). Compared with group A, TG in group B was significantly increased (P < 0.05). There were no significant differences in Glu, FINS and HOMA-IR levels among all groups. 4. Comparison of LPS levels: Compared with group D, the serum LPS levels of rats in groups A and B were significantly increased (P < 0.001; P < 0.01). 5. Intestinal flora analysis and comparison: At the phylum level, compared with group D, the abundance of Firmicutes in group B increased (P < 0.01), Firmicutes in group A showed an upward trend (P > 0.05), and the abundance of Bacteroidetes in groups A and B decreased (P < 0.05). At the genus level, compared with group D, Lactobacillus in group B increased (P < 0.01). The results of LEfSe analysis showed that there were differences in the composition of various intestinal bacteria among the three groups (LDA > 3).Conclusion: The phenotype of PCOS rats was related to the length of modeling, and the phenotypic characteristics of PCOS in rats at 5 weeks of modeling were more typical than those in rats at 3 weeks of modeling; PCOS can cause changes in intestinal flora, and the changes in the structure of intestinal flora between groups are related to different modeling duration.     

锁骨钩钢板内固定术后钢板钩与肩峰匹配性影像学研究

目的通过测量锁骨钩钢板内固定术后患者影像学资料，分析发生肩峰骨侵蚀的原因是否与钢板钩-肩峰匹配度相关。 方法回顾性分析2015年8月1日至2018年8月31日期间在上海市浦东医院骨科就诊的210例患者的影像学资料，210例患者均因肩锁关节脱位或锁骨远端骨折行锁骨钩钢板内固定治疗，其中男110例、女100例；年龄24~76岁，平均（44.60±8.75）岁；肩锁关节脱位70例，锁骨远端骨折140例。测量术后及终末随访患者肩锁关节正位X线片相关数据，按锁骨钩钢板术后是否发生肩峰骨侵蚀，将纳入患者分为3组：无骨侵蚀组（A组）、伴钢板钩移位骨侵蚀组（B组）、不伴移位的骨侵蚀组（C组），分别测量钢板钩-肩峰的匹配度（β），统计分析术后发生肩峰骨侵蚀与钢板钩-肩峰匹配度之间的关系。 结果纳入研究的210例患者术后随访24~64周，平均（32.0±6.5）周。A组患者115例，B组患者54例，C组患者41例。A组匹配度β（3.72±0.48）mm与B组β¹（6.91±0.84）mm比较差异有统计学意义（P<0.05）；A组匹配度β（3.72±0.48）mm与C组β²（5.88±0.65）mm比较差异有统计学意义（P<0.05）；B组匹配度β¹（6.91±0.84）mm与C组β²（5.88±0.65）mm比较差异有统计学意义（P<0.05）。 结论锁骨钩钢板内固定术后是否发生肩峰骨侵蚀与钢板钩-肩峰匹配度β存在明显相关性，钢板钩与肩峰之间的匹配度越好，β值越小，发生肩峰骨侵蚀的可能性更小。     

新冠疫情背景下组织学与胚胎学网络教学的实施及教学反思*

2020年1月,突发的新冠肺炎疫情给我国经济社会发展带来巨大的挑战,能否将信息技术和网络教学完美融合,确保网络教学的质量,是摆在每一位教育工作者面前的问题[1].按照国家关于新型冠状病毒肺炎疫情防控工作部署要求,遵循"停课不停教、停课不停学"的原则,在2020年春季学期面向本校中医学、针灸推拿学、临床医学等专业开设组织学与胚胎学课程的网络教学.组织学与胚胎学是医学院校中非常重要的专业基础课,与现代医学及生命科学相互交叉与渗透,该学科研究的是正常人体的微观结构及功能,具有教学内容多、知识点繁杂、专业术语多、教学学时偏少、学生学习难度较高等特点[2].     

依据CLSI EP9-A3评价两种方法学检测糖类抗原242的可比性

目的评价两种方法学检测糖类抗原242(CA242)结果的可比性,以评估磁微粒化学发光法检测CA242是否能够满足临床的需求。方法根据美国临床和实验室标准协会(CLSI)新指南EP9-A3文件要求,收集2018年1-7月首都医科大学附属北京康复医院和北京大学首钢医院肿瘤患者检测剩余的新鲜血清标本100例,以Fujirebio Diagnostics AB的酶联免疫法为参比方法,安图生物的磁微粒化学发光法为评估方法,对2种方法检测CA242的结果进行方法学比对和偏移评估。选择Passing-Baklok回归方法进行线性拟合,采用Wilcoxon符号秩检验及Spearman相关分析。结果在4.31~295.63 U/ml范围内,2种方法学的CA242检测结果具有较好的相关性(r=0.991,截距0.652)。参比方法和评估方法比较,差异无统计学意义[(53.75±6.69)U/ml比(56.11±6.86)U/ml,t=0.246,P=0.806]。将CA242的医学决定水平25.00 U/ml代入选取的最佳回归模型拟合方程,计算得到的相对偏移3.52%,<1/2TEa±12.5%(TEa为国家卫生健康委临床检验中心室间质量评审允许总误差),满足要求。结论安图生物的磁微粒化学发光法和Fujirebio Diagnostics AB酶联免疫法检测CA242结果具有可比性,满足临床需要。