伸筋易骨法调节兔膝关节周围软组织张力影响软骨形态的研究

[目的] 评价伸筋易骨法对膝关节周围软组织张力及软骨形态的影响，以探讨其对膝关节骨性关节炎（KOA）的治疗作用。[方法] 选择6~8月龄雌性健康新西兰大耳白兔50只，随机分为5组。其中模型组、推拿组、玻璃酸钠组采用Hulth造模法模拟KOA，正常组、假手术组不做干预。造模成功后，推拿组予伸筋易骨法治疗3周，玻璃酸钠组予局部关节内注射每周1次，共3周，模型组不予任何治疗。治疗结束后，测试股直肌、股二头肌张力，并取软骨组织进行HE染色后光镜下进行形态学观察，并进行Markin评分。分析推拿组与其余4组的异同。[结果] 模型组较正常组，股直肌FDD值和S值显著降低（P<0.05），股二头肌FDD值和S值显著升高（P<0.05）。推拿组和玻璃酸钠组相较于模型组的股直肌FDD值和S值均显著升高（P<0.05））；推拿组和玻璃酸钠组相较于模型组股二头肌的FDD值和S值均显著降低（P<0.05）。推拿组和玻璃酸钠组相较于模型组，Mankin’s评分比较有统计学意义（P<0.05）。[结论] 伸筋易骨法可以显著增加关节周围肌肉的肌力、调节组织张力、改善关节活动功能，对保护膝关节周围软组织功能具有重要意义。     

RG108 调控 TFPI-2 甲基化/TMPRSS4 表达对 NSCLC 细胞增殖和凋亡的影响

目的：探讨RG108对人非小细胞肺癌（non-small cell lung cancer, NSCLC）A549和H1299细胞增殖、凋亡的影响及其可能的作用机制。方法：体外培养A549和H1299细胞，经不同浓度RG108处理后，采用MTT法、流式细胞术分别检测细胞增殖率、细胞周期和凋亡水平；qPCR和Western blotting（WB）法检测细胞内TFPI-2 mRNA和蛋白的表达及TMPRSS4的表达量，以甲基化特异性PCR和比色法检测细胞中TFPI-2启动子区域甲基化的状态和程度；分别采用siRNA-TFPI-2和pcDNA3.0-TMPRSS4质粒敲减TFPI-2或过表达TMPRSS4，然后检测细胞增殖率及凋亡率的变化。结果：RG108处理后，A549和H1299细胞的增殖率显著降低（均P<0.05）、细胞周期阻滞于G1/S期（均P<0.05）而凋亡率显著增加（均P<0.01），细胞中TFPI-2 mRNA及蛋白表达水平均显著升高（P<0.01和P<0.05），同时细胞中TFPI-2启动子区域甲基化程度显著降低（均P<0.05）、TMPRSS4的表达也明显减少（P<0.05）。沉默TFPI-2表达后，A549和H1299细胞的增殖水平显著增加（均P<0.05），而转染pcDNA3.0-TMPRSS4质粒则显著降低细胞的凋亡率（均P<0.05）。结论：RG108能够通过抑制TFPI-2甲基化负向调控TMPRSS4表达进而抑制A549和H1299细胞的增殖，并促进其凋亡。     

萆苓祛痛方对糖尿病痛风大鼠骨骼肌组织SIRT3蛋白表达及URAT1 mRNA的影响

目的:探讨萆苓祛痛方对糖尿病痛风大鼠骨骼肌组织去乙酰化酶3(SIRT3)蛋白表达及尿酸盐转运体1(URAT1) mRNA的影响。方法:选择健康雄性大鼠40只,除正常组外,其余组予高脂饲料喂养并联合小剂量链脲佐菌素(STZ)溶液40 mg·kg-1腹腔注射1次,以血糖≥16. 7 mmol·L-1,为糖尿病模型。4 d后关节腔注射5%尿酸钠溶液1次,诱导痛风模型,模型成功后,分为萆苓祛痛方组(萆苓组,10 g·kg-1),吲哚美辛组(5 mg·kg-1),吡格列酮组(10 mg·kg-1),均连续给药21 d,正常组、模型组予等量生理盐水;采用蛋白免疫印迹法(Western blot)测定骨骼肌组织SIRT3蛋白表达;实时荧光定量聚合酶链式反应(Real-time PCR)检测骨骼肌组织URAT1 mRNA表达,并进行病理检查,取血测定血糖(GLU),血尿酸(UA)及C反应蛋白(CRP)含量。结果:与正常组比较,模型组GLU,UA及CRP明显升高(P 0. 01);与模型组比较,萆苓组、吡格列酮组血糖下降(P 0. 05);各药物组UA及CRP明显下降(P 0. 01)。与正常组比较,模型组骨骼肌SIRT3蛋白表达量显著降低(P 0. 01);与模型组比较,萆苓组骨骼肌SIRT3蛋白表达量显著提高(P 0. 01),与西药组比较无明显差异;条带图的结果同样显示,与正常组比较,模型组表达亮度明显减弱,药物组表达亮度明显增强;与正常组比较,模型组关节组织URAT1 mRNA相对表达量明显升高(P 0. 01);与模型组比较,各药物组URAT1 mRNA相对表达量显著下调(P 0. 01)。电泳图同样提示,正常组表达亮度减弱,模型组表达亮度显著增强,萆苓组、西药组表达亮度明显减弱。关节病理提示,与正常组比较,模型组大鼠关节病理损伤严重,可见大量炎细胞浸润及纤维增生,滑膜细胞变性、坏死。与模型组比较,萆苓祛痛方关节病变程度明显减低,见少量炎细胞浸润,滑膜上皮轻度增生。结论:具有泻浊解毒通络作用的萆苓祛痛方可显著提高糖尿病痛风大鼠骨骼肌组织SIRT3的蛋白表达量,下调URAT1 mRNA的表达量,减轻骨骼肌组织病理损伤,减低血清炎症因子CRP的含量,降低模型大鼠的血糖、血尿酸水平,有保护关节功能的作用。     

造口护理辅助用品在大便失禁患者中的应用

目的观察造口护理辅助用品(皮肤保护膜、造口护肤粉、改良一件式造口袋)对大便失禁相关性皮炎(IAD)的防治效果。方法选择2017年3月-2018年2月本院神经外科大便失禁患者31例作为观察组,使用造口护理辅助用品进行护理;采用回顾性对照方法,将2016年3月-2017年2月本院神经外科具有同质性的大便失禁患者30例作为对照组,使用氧化锌软膏联合一次性护理垫。观察两组患者IAD的发生时间、发生率、严重程度及治疗有效率。结果观察组患者IAD发生时间明显长于对照组,Ⅰ度皮炎4例,无Ⅱ、Ⅲ度皮炎发生,对照组Ⅰ度皮炎10例,Ⅱ度3例、Ⅲ度1例,观察组IAD的发生率为12.90%,明显低于对照组46.67%,严重程度明显轻于对照组,IAD治疗有效率达100.00%,较对照组42.86%明显提高,两组比较,均P<0.05,差异有统计学意义。结论大便失禁患者使用造口护理辅助用品可预防或延缓IAD发生,减轻IAD严重程度,提高IAD治疗效果。     

CDC25B and CDC25C overexpression in nonmelanoma skin cancer suppresses cell death

Non‐melanoma skin cancer frequently results from chronic exposure to ultraviolet (UV) irradiation. UV‐induced DNA damage activates cell cycle arrest checkpoints through degradation of the cyclin‐dependent kinase activators, the cell division cycle 25 (CDC25) phosphatases. We previously reported increased CDC25A in nonmelanoma skin cancer, but CDC25B and CDC25C had not been previously examined. Consequently, we hypothesized that increased expression of CDC25B and CDC25C increases tumor cell proliferation and skin tumor growth. We found that CDC25B and CDC25C were increased in mouse and human skin cancers. CDC25B was primarily cytoplasmic in skin and skin tumors and was significantly increased in the squamous cell carcinoma (SCC), while CDC25C was mostly nuclear in the skin, with an increased cytoplasmic signal in the premalignant and malignant tumors. Surprisingly, forced expression of CDC25B or CDC25C in cultured SCC cells did not affect proliferation, but instead suppressed apoptosis, while CDC25C silencing increased apoptosis without impacting proliferation. Targeting CDC25C to the nucleus via mutation of its nuclear export sequence, however, increased proliferation in SCC cells. Overexpression of CDC25C in the nuclear compartment did not hinder the ability of CDC25C to suppress apoptosis, neither did mutation of sites necessary for its interaction with 14‐3‐3 proteins. Analysis of apoptotic signaling pathways revealed that CDC25C increased activating phosphorylation of Akt on Ser⁴⁷³, increased inhibitory phosphorylation of proapoptotic BAD on Ser¹³⁶, and increased the survival protein Survivin. Silencing of CDC25C significantly reduced Survivin levels. Taken together, these data suggest that increased expression of CDC25B or CDC25C are mechanisms by which skin cancers evade apoptotic cell death.     

猪小肠黏膜下层脱细胞修复补片修复手部软组织缺损的效果分析

目的 对比应用新型再生可降解生物材料猪小肠黏膜下层脱细胞修复补片(SIS)与植皮术在修复手部软组织缺损的治疗效果.方法 2017年12月至2018年12月,共收治手部软组织缺损36例,根据缺损面积与治疗方法分为两组:补片组21例,软组织缺损面积2.0 cm×1.5 cm^9.0 cm×3.5 cm,平均5.3 cm×2.1 cm,采用SIS治疗;植皮组15例,软组织缺损面积9.0 cm×4.0 cm^16.0 cm×9.0 cm,平均12.0 cm×8.5 cm,采用中厚皮片植皮治疗.观察两组治疗方法促进软组织缺损愈合的效果,记录术后14 d、21 d、28 d、3个月创面区愈合情况,并随访评估创面区愈合后的外观、色泽、弹性、感觉恢复与部分肌腱外露的治疗效果.结果 本组36例均获随访,随访时间3~10个月,平均5个月.两组创面均完全愈合,外观、色泽接近,皮肤弹性及感觉均恢复良好.补片组感觉恢复优14例(66.6%),良5例(23.8%),差2例(9.6%);植皮组感觉恢复优9例(60.0%),良4例(26.0%),差2例(14.0%).创面愈合效果补片组优14例,良5例,差2例;植皮组愈合优9例,良4例,差2例.结论 SIS能快速、有效的刺激机体再生出表皮组织,并且新生的表皮经过生长与周围皮肤颜色无明显差异,无明显瘢痕增生,是一种手部小面积浅表软组织缺损的理想修复材料.     

丹参注射液对带蒂皮瓣移植修复术后成活率及预后的影响

目的:探讨丹参注射液对带蒂皮瓣移植修复术后成活率及预后的影响。方法:将68例接受带蒂皮瓣移植修复术的患者简单随机分成观察组与对照组各34例。对照组给予术后常规治疗,观察组在此基础上加用丹参注射液治疗,持续给药1周。随访3～12个月,比较两组患者术后皮瓣成活率、皮瓣肿胀程度、凝血指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平变化及并发症发生率。结果:观察组患者皮瓣成活率为97.06%,明显高于对照组的76.47%,差异有统计学意义(P<0.05)。观察组术后7 d皮瓣肿胀程度明显轻于对照组,差异有统计学意义(P<0.05)。观察组患者术后3 d的PT、APTT、FIB水平[(17.84±2.45)s、(35.38±3.14)s、(2.24±0.17)g/L]均明显低于对照组患者[(23.07±2.69)s、(41.56±3.34)s、(2.79±0.32)g/L],差异有统计学意义(P<0.05)。观察组患者术后伤口感染、瓣下积液、动静脉危象的总并发症率为8.82%,明显低于对照组的29.41%,差异有统计学意义(P<0.05)。结论:丹参注射液能提高带蒂皮瓣移植修复术后成活率,减轻术后皮瓣肿胀程度,改善凝血指标,降低血管危象、皮瓣坏死等并发症风险。     

Management of Non-melanoma Skin Cancer in Transplant Recipients

Transplant recipients have a significantly higher risk of developing non-melanoma skin cancers compared with the general population and squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are the most common post-transplant malignancies. Although in the general population BCC outnumbers SCC 4:1, in transplant patients this ratio is reversed and SCC is more common, with a 65- to 250-fold increased incidence. As patients in immunosuppressed states are living longer after transplants, the incidence of skin cancer in this population continues to increase. The skin cancers in transplant patients also tend to be more aggressive, with higher morbidity and mortality. Preventive strategies play an important role in transplant recipients given their increased frequency of developing both premalignant and malignant skin lesions. Sun protection and regular skin cancer screening are critical. In addition, chemoprophylaxis with systemic retinoids, nicotinamide and capecitabine can significantly reduce the development of new skin cancers. Topical 5-fluorouracil, imiquimod, photodynamic therapy and cyclooxygenase inhibitors have all been investigated in transplant patients for the treatment of field cancerisation. Adjusting the immunosuppressive regimen is also an important adjuvant therapeutic strategy for managing skin cancers in transplant recipients and requires integrated multidisciplinary care with the entire transplant team. This article reviews the epidemiology of non-melanoma skin cancer in transplant patients, discusses the prevention strategies and highlights the management and treatment strategies of both field cancerisation and non-melanoma skin cancers.     

Effects of ambient particulate matter on vascular tissue: a review

ABSTRACT

Fine and ultra-fine particulate matter (PM) are major constituents of urban air pollution and recognized risk factors for cardiovascular diseases. This review examined the effects of PM exposure on vascular tissue. Specific mechanisms by which PM affects the vasculature include inflammation, oxidative stress, actions on vascular tone and vasomotor responses, as well as atherosclerotic plaque formation. Further, there appears to be a greater PM exposure effect on susceptible individuals with pre-existing cardiovascular conditions.     

B cell and B cell-related pathways for novel cancer treatments

B cells are recognized as the main effector cells of humoral immunity which suppress tumor progression by secreting immunoglobulins, promoting T cell response, and killing cancer cells directly. Given these properties, their anti-tumor immune response in the tumor micro-environment (TME) is of great interest. Although T cell-related immune responses have become a therapeutic target with the introduction of immune checkpoint inhibitors, not all patients benefit from these treatments. B cell and B cell-related pathways (CCL19, −21/CCR7 axis and CXCL13/CXCR5 axis) play key roles in activating immune response through humoral immunity and local immune activation via tertiary lymphoid structure (TLS) formation. However they have some protumorigenic works in the TME. Thus, a better understanding of B cell and B cell-related pathways is necessary to develop effective cancer control. In this review, we summarize recent evidences regarding the roles of B cell and B cell-related pathways in the TME and immune response and discuss their potential roles for novel cancer treatment strategies.