热咳散治疗痰热内蕴型哮喘患儿的临床研究

目的:探讨痰热内蕴型哮喘婴幼儿西医常规治疗基础上使用自拟热咳散治疗的临床疗效，为其临床应用提供理论依据。方法:选取2017年3月至2018年9月中山市中医院收治的痰热内蕴型哮喘婴幼儿112例作为研究对象，根据治疗方式的不同分为对照组与观察组，每组56例。对照组采用常规治疗，观察组在对照组基础上加用自配热咳散，比较2组患儿肺功能指标（FEF25%、FEF50%、IgE）；血清生化指标（IL-6、TNF-α、CRP、Cal-3）和C-ACT和MARS-A评分的差异。结果:对照组FEF25%、FEF50%显著低于观察组，对照组IgE含量显著高于观察组，差异均有统计学意义（P<0.05）。2组患儿治疗有效率和治疗效果构成差异有统计学意义（P<0.05）。治疗后观察组IL-6、TNF-α、CRP、Cal-3含量低于对照组，观察组C-ACT评分、MARS-A评分高于对照组，差异均有统计学意义（P<0.05）。结论:相比于西医常规治疗的治疗手段，在其基础上连用自拟热咳散的治疗效果更佳，患者症状改善时间也相对较短。     

Population Prevalence of the Posttraumatic Stress Disorder Subtype for Young Children in Nationwide Surveys of the British General Population and of Children in Care

ObjectivePosttraumatic stress disorder (PTSD) is a debilitating condition that when left untreated can have severe lifelong consequences for psychological, social, and occupational functioning. Initial conceptualizations of PTSD were centered on adult presentations. However, the instantiation of developmentally appropriate PTSD in young children (PTSD-YC) criteria, tailored to preschool (6 years old and younger) children, represents an important step toward identifying more young children experiencing distress. This study explored population-level prevalence of PTSD-YC indexed via an alternative algorithm for DSM-IV PTSD (AA-PTSD).MethodRepresentative population data were used to test whether application of AA-PTSD criteria, relative to the DSM-IV PTSD algorithm, increased identification of 5- to 6-year-old children with clinical needs in both the general population (n = 3,202) and among looked after children (ie, in Britain, foster children are called looked after children [more commonly referred to as children in care].) (n = 137), in whom the risk of mental health issues is greater.ResultsNotably, no 5- to 6-year-old children in the general population sample were diagnosed with PTSD using adult-based DSM-IV criteria. In contrast, AA-PTSD prevalence was 0.4% overall, rising to 5.4% in trauma-exposed children. In looked after children, overall PTSD prevalence rose from 1.2% when applying adult-based DSM-IV criteria to 14% when using AA-PTSD criteria. Of trauma-exposed looked after children, 2.7% met criteria for DSM-IV PTSD compared with 57.0% when applying AA-PTSD criteria. In both samples, use of the alternative algorithm to index PTSD-YC criteria markedly increased identification of children experiencing functional impairment owing to symptoms.ConclusionResults demonstrate the utility of the PTSD-YC diagnosis beyond at-risk and treatment-seeking samples. Use of PTSD-YC criteria substantially improves identification of 5- to 6-year-old children burdened by PTSD at the population level.     

基于生物信息学筛选肝细胞癌年轻患者特有关键枢纽基因及其临床意义

目的：运用生物信息学方法筛选年轻肝细胞癌（hepatocellular carcinoma，HCC）患者特有的关键枢纽基因（Hub gene），并探索其生物学和临床意义。方法:从GEO芯片数据集GSE45267获取年轻（确诊HCC时年龄≤40岁）和年老（确诊HCC 时年龄>40岁）组的HCC组织及正常肝组织数据信息，通过GEO2R和Venn图工具筛选两组的HCC组织相对正常肝组织差异表 达基因（differentially expressed gene，DEG），运用STRING和Cytoscape软件构建年轻组特有差异表达基因的蛋白互作网络并筛 选关键Hub基因及显著模块。利用GEPIA数据库对关键基因进行验证，并通过Kaplan–Meier分析相关HCC患者总生存期。最 后应用DAVID对年轻组特有基因及年轻与年老组共有DEGs进行GO富集分析和KEGG通路分析比较。结果：筛选出年轻组特 有117个上调、179个下调DEGs，构建PPI网络选取出10个连接度最高的基因为Hub基因，其中7个Hub基因集中于第一模块。 GEPIA验证与Kaplan–Meier生存分析提示TYMS、CDC6、BUB1、TPX2、OIP5、KIF23等6个表达上调的Hub基因可能与年轻HCC 癌患者的不良预后相关。功能富集分析显示年轻HCC特有DEGs主要参与ATP结合等生物学过程，并主要富集到了细胞周期S 期；年轻与年老组共有DEGs主要参与环氧酶P450、细胞分裂等生物学过程，并主要富集到细胞周期G2/M期。结论:本研究鉴定 出6个在年轻HCC患者肿瘤组织中特有的显著上调且提示预后不良的Hub基因，可能成为年轻HCC患者潜在的治疗和预后预 测靶点。