开喉剑喷剂（儿童型）治疗小儿疱疹性咽峡炎疗效观察

目的：观察开喉剑喷雾剂(儿童型)治疗小儿疱疹性咽峡炎的疗效。方法将76例疱疹性咽峡炎患儿,随机分为对照组和治疗组各38例,两组皆选用α1b干扰素肌肉注射治疗及症治疗,治疗组在此基础上加用开喉剑喷雾剂（儿童型）,观察临床症状、体征消退时间。结果开喉剑喷雾剂治疗小儿疱疹性咽峡炎治疗组与对照组比较差异有统计学意义(P＜0.05)。结论开喉剑喷雾剂是治疗小儿疱疹性咽峡炎的有效方法。     

Acyclovir-resistant herpes simplex encephalitis in a patient treated with anti-tumor necrosis factor-α monoclonal antibodies

Herpes simplex virus is the most common cause of severe sporadic encephalitis. We report a case of herpes simplex type 1-encephalitis in a 50-year-old woman receiving anti-tumor necrosis factor-α monoclonal antibodies adalimumab. Although she was an acyclovir naïve patient, a mixed viral population (wild-type and acyclovir-resistant bearing a thymidine-kinase mutation) was identified in the cerebrospinal fluid. The virus in cerebrospinal fluid evolved and a second thymidine-kinase mutant virus emerged. Combined foscavir and acyclovir treatment resolved the herpes simplex encephalitis. To our knowledge, this is the first report of acyclovir-resistant herpes simplex encephalitis in a patient treated with adalimumab.     

Superior mesenteric artery syndrome and disseminated tuberculosis: “Double troubleˮ

Superior Mesenteric Artery (SMA) Syndrome is a rare condition characterized by compression of the third part of the duodenum between the aorta and superior mesenteric artery due to decreased angle between these two vessels due to loss of intervening pad of fat. Tuberculosis is one of the causes, and its association with it is rare. However, SMA syndrome with significant gastrointestinal symptoms in TB poses a greater challenge in management, particularly in dissemination. Strong clinical suspicion, timely diagnosis and appropriate antituberculosis therapy are the keys to successful management.     

塞来昔布对膝关节炎大鼠肿瘤坏死因子α信号通路及关节滑膜细胞的影响*

目的：探究塞来昔布对膝关节炎大鼠肿瘤坏死因子α（ TNF-α）信号通路及关节滑膜细胞的影响。方法： SD大鼠随机分为模型组、假手术组和治疗组,治疗组大鼠制作膝关节炎模型后给予塞来昔布进行治疗。通过 TUNEL 法、qRT-PCR 法、CCK-8 法、免疫印迹等方法检测3 组大鼠滑膜细胞凋亡情况、TNF-α mRNA表达含量、 TNF-α 蛋白含量、关节炎指数及细胞增殖情况。结果：模型组、治疗组、假手术组关节滑膜细胞凋亡率分别为 89.38%、46.84%、13.68%。模型组与假手术组、治疗组相比较,细胞凋亡率显著升高,治疗组细胞凋亡数量多 于假手术组。假手术组、治疗组细胞增殖OD值比模型组高,差异具有统计学意义,假手术组关节滑膜细胞的增 殖数量最多,模型组关节滑膜细胞的增殖数量最少,治疗组关节滑膜细胞的增殖情况比假手术组相比明显减少。 与假手术组、治疗组比较,模型组关节滑膜细胞中TNF-α 蛋白表达水平显著上升,治疗组TNF-α 蛋白表达水平较 假手术组明显升高。与假手术组、治疗组比较,模型组TNF-α mRNA含量显著升高,治疗组TNF-α mRNA表达 量较假手术组明显升高。治疗组和模型组大鼠关节炎指数相近,随着给药时间的增加,治疗组大鼠膝关节炎情况 逐渐好转,而未服用药物的模型组大鼠病情逐渐恶化。结论：塞来昔布胶囊治疗膝关节炎大鼠效果显著,能够显 著降低TNF-α 信号通路的表达水平,改善关节滑膜细胞的凋亡情况。     

鼠神经生长因子对急性脑出血患者肿瘤坏死因子-α、血清基质金属蛋白酶-9和超氧化物歧化酶水平的影响

目的探讨鼠神经生长因子(NGF)对急性脑出血患者肿瘤坏死因子-α(TNF-α)、血清基质金属蛋白酶-9(MMP-9)和超氧化物歧化酶(SOD)水平的影响。方法选择急性脑出血患者64例,随机分为研究组和对照组。两组患者均予以控制血压、血糖和颅内压,营养脑细胞、止血、给氧及维持酸碱平衡等治疗。研究组在此基础上加用NGF 20μg肌肉注射,1次/d,连用2周。观察并比较两组患者治疗前后TNF-α、MMP-9和SOD水平的变化,并观察两组的临床疗效和不良反应。结果治疗2周后,两组患者血清TNF-α、MMP-9水平均较治疗前明显下降,血清SOD活性较治疗前明显上升,且研究组下降或上升幅度明显大于对照组(P<0.05);同时两组患者神经功能缺损评分均有明显下降(P<0.05或P<0.01),且研究组下降幅度较对照组更明显(P<0.05),研究组临床总有效率明显高于对照组(χ2=6.56,P<0.05)。两组患者治疗期间均未出现明显药物不良反应。结论 NGF治疗急性脑出血安全有效,作用机制与降低血浆炎症因子水平、减轻血脑屏障破环和改善氧自由基代谢密切相关。     

外源性ghrelin在大鼠重症急性胰腺炎并肾损伤中的作用

目的：探讨外源性ghrelin在大鼠SAP肾损伤中的作用及机制。方法72只Wistar大鼠随机分为假手术组（SO组,n=24）、重症急性胰腺炎模型组（SAP组,n=24）和ghrelin干预组（G组,n=24）。 SAP组、G组均用3.5%牛磺胆酸钠（1ml/kg）按胰胆管逆行注射法制成重症急性胰腺炎模型,G组在制模前30min和制模后3h腹腔内注射ghrelin（10nmol/kg）,SO组、SAP组于相同时间注射等量生理盐水,各实验组大鼠于制模后6h、12h和24h分批取材。光学显微镜下对胰腺和肾脏组织进行病理学评分,全自动生化仪检测血清淀粉酶,酶联免疫吸附法检测血清IL-6、TNF-α、肌酐。结果①SAP组6h、12h、24h血清淀粉酶、肌酐、TNF-α、IL-6,胰腺及肾脏病理评分均较同时间点SO组升高,差异有统计学意义（P<0.05）;②G组6h、12h、24h血清淀粉酶、肌酐、TNF-α、IL-6,胰腺及肾脏病理评分均较同时间点SAP组下降,差异有统计学意义（P<0.05）,但均较同时间点SO组升高,差异有统计学意义（P<0.05）。结论外源性ghrelin通过降低TNF-α、IL-6的水平,减轻炎症反应来减轻SAP的严重程度,同时保护肾脏的生理功能。     

Early pregnancy induced expression of prostaglandin E2 receptors EP2 and EP4 in the ovine endometrium and regulated by interferon tau through multiple cell signaling pathways

Prostaglandin E2 (PGE₂) plays pleiotropic roles at fetal-maternal interface during establishment of pregnancy. The objectives of the study were to: (i) determine regulation of PGE2 receptors EP1, EP2, EP3, and EP4 in the endometrium during the estrous cycle and early pregnancy; and (ii) understand endometrial epithelial and stromal cell-specific hormonal regulation of EP2 and EP4 in sheep. Results indicate that: (i) early pregnancy induces expression of EP2 and EP4 but not EP1 and EP3 proteins in the endometrium on days 12-16 compared to that of estrous cycle; (ii) intrauterine infusion of interferon tau (IFNT) increases expression of EP2 and EP4 proteins in endometrium; and (iii) IFNT activates distinct epithelial and stromal cell-specific JAK, EGFR, ERK1/2, AKT, or JNK signaling module to regulate expression of EP2 and EP4 proteins in the ovine endometrium. Our results indicate a role for EP2 and EP4-mediated PGE₂ signaling in endometrial functions and establishment of pregnancy in ruminants.     

肿瘤坏死因子-α抗体对梗阻性黄疸大鼠肾脏IP3R表达的影响

目的研究肿瘤坏死因子-α(TNF-α)单克隆抗体对梗阻性黄疸大鼠肾功能的影响及机制。方法将60只雄性SD大鼠随机分成假手术组、模型组、干预组,采用胆总管结扎(CBDL)造梗黄模型,干预组于结扎后第2周开始腹腔注射TNF-α单克隆抗体[0.1 mg/(kg.2d)]。并于干预后1、2、3、4周麻醉动物,假手术组与5周模型组动物同批麻醉,留取肝和肾组织。采用HE染色确定模型建立情况,通过Western blot方法检测1,4,5-三磷酸肌醇受体(IP3R)的含量,免疫组织化学方法检测IP3R在肾组织的表达。结果 HE染色显示模型组和干预组肾间质有炎性细胞浸润,干预组较轻。免疫组化和Western blot显示模型组肾组织IP3R蛋白表达较多,干预组略下降,但均明显高于假手术组(P<0.05)。结论梗阻性黄疸时肾小球前小动脉平滑肌细胞内的IP3R蛋白的表达增强,而TNF-α单克隆抗体干预治疗可减轻IP3R表达增强的程度,部分减轻肾功能损害的发生。