患者报告结局在人类免疫缺陷病毒感染临床研究与实践中的应用进展

得益于高效抗反转录病毒治疗的发展,人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染已成为可控的慢性疾病,患者对生命质量的要求日益增高,临床也逐渐向"以患者为中心"的诊疗新模式发展,以优化HIV感染者的长期管理。其中,以患者主观感受为导向的患者报告结局作为一类新的评价指标,有助于临床工作者将HIV感染者的治疗需求、对健康的偏好和价值取向纳入临床决策,进而提升患者的满意度。然而在我国HIV领域中,患者报告结局尚未得到广泛应用。本研究对患者报告结局的基本概念和内容进行阐述,并结合文献资料综述其在国内外HIV感染临床研究及实践中的进展,以期为患者报告结局在我国HIV领域中的普及和发展提供参考。     

Increased intracranial hemorrhage of mechanical thrombectomy in acute ischemic stroke patients with atrial fibrillation

Journal of Thrombosis and Thrombolysis - The impact of atrial fibrillation (AF) on outcomes of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) is controversial, and with a paucity of...     

医学本科生在儿外科实习中的困惑和解决策略

实习是医生从理论步入实战最重要的经历。2014年国家七部委联合出台《意见》:进入临床工作的住院医师要求本科必须取得毕业证、规培证、执业证才有资格。也就是本科毕业后必须进行为期3年的规范化培训才有资格进入临床。这种教学模式对医学本科生实习心态波动很大。对是否考研,如何选择就业充满困惑,尤其是面对难度高、收入低、稀缺小专业或者不喜欢的专业,抵触、焦虑、逃避成了学生最常见反应。他们认为是浪费自己读书时间,耽误考研,以至于学生和代教教师在实际工作中普遍表现得敷衍、懈怠。如何改善现状和帮助学生走出困境,不仅需要医院深化教学改革,同时政府行为、政策也亟待完善或改革。     

Identification of key genes and pathways in discoid lupus skin via bioinformatics analysis

Discoid lupus erythematosus (DLE) is the most common skin manifestation of lupus; however, the molecular mechanisms underlying DLE remain unknown. Therefore, we aimed to identify key differentially expressed genes (DEGs) in discoid lupus skin and investigate their potential pathways.To identify candidate genes involved in the occurrence and development of the disease, we downloaded the microarray datasets {"type":"entrez-geo","attrs":{"text":"GSE52471","term_id":"52471"}}GSE52471 and {"type":"entrez-geo","attrs":{"text":"GSE72535","term_id":"72535"}}GSE72535 from the Gene Expression Database (GEO). DEGs between discoid lupus skin and normal controls were selected using the GEO2R tool and Venn diagram software (http://bioinformatics.psb.ugent.be/webtools/Venn/). The Database for Annotation, Visualization, and Integrated Discovery (DAVID), Enrichr, and Cytoscape ClueGo were used to analyze the Kyoto Encyclopedia of Gene and Genome pathways and gene ontology. Protein-protein interactions (PPIs) of these DEGs were further assessed using the Search Tool for the Retrieval Interacting Genes version 10.0.Seventy three DEGs were co-expressed in both datasets. DEGs were predominantly upregulated in receptor signaling pathways of the immune response. In the PPI network, 69 upregulated genes were selected. Furthermore, 4 genes (CXCL10, ISG15, IFIH1, and IRF7) were found to be significantly upregulated in the RIG-I-like receptor signaling pathway, from analysis of Enrichr and Cytoscape ClueGo.The results of this study may provide new insights into the potential molecular mechanisms of DLE. However, further experimentation is required to confirm these findings.     

香萱益神方对血管性痴呆模型大鼠神经元凋亡机制研究

目的:探讨香萱益神方治疗血管性痴呆(VD)模型大鼠认知功能作用及其对神经元凋亡机制的研究。方法:两血管阻断法建立VD大鼠模型,给予中药方香萱益神方灌胃治疗6周,分别于造模后、中药喂养6周后进行Morris水迷宫行为学检测,测试大鼠认知行为能力改变,行为学测试结束后,检测VD模型大鼠海马中海马组织脑源性神经营养因子(BDNF)表达水平的变化。结果:香萱益神方治疗6周后,血管性痴呆大鼠模型学习记忆能力得到改善,上调脑内海马组织神经营养因子水平,海马神经元凋亡率下降。结论:香萱益神方是治疗血管性痴呆的有效方剂,可以有效改善VD大鼠模型认知行为功能的障碍情况,起到减少海马神经元细胞凋亡,诱导海马神经元细胞修复的作用。香萱益神方可能是通过激活BDNF相关通路,起到保护海马神经元的作用。