UPLC-MS/MS测定人痰液中异烟肼、吡嗪酰胺和左氧氟沙星的浓度

目的建立超高效液相色谱串联质谱法(UPLC-MS/MS)同时检测痰液中3种药物异烟肼(isoniazid,INH)、左氧氟沙星(levofloxacin,LFX)和吡嗪酰胺(pyrazinamide,PZA)浓度的方法,冒在为实现临床个体化用药提供帮助。方法痰液样品离心后经甲醇/乙腈蛋白沉淀法预处理后进样液质联用仪进行分析。实验采用的流动相A为含0.1%甲酸的水溶液,流动相B为含0.1%甲酸的乙腈;流速0.35mL·min^-1;采用ACQUITY UPLAC HSS T31.8μm column(2.1mm×100mm,Waters公司)分离;采用电喷零电离源,采用多反应监测(multiple reaction monitoring,MRM)模式对待测物进行正离子扫描检测。此外,本试验盲态收集5例患者的痰液,用该法进行定量分析。结果测得痰液中INH、PZA和LFX分别在48~6000 ng·mL^-1(r=0.9988)、480~60000 ng·mL^-1(r=0.9993)、120~15000 ng·mL^-1(r=0.9995)内表现出良好的线性关系。INH、PZA和LFX 3种药物的日内和日间精密度均低于15%,且3种药物的提取回收率均处于97.21%~107.80%之间。7例受试者体内均检测到药物INH,质量浓度分别为44.74、120.1、301.5、481、595.5、1220及1570 ng·mL^-1;PZA的质量浓度分别为104.2、6273.34和3185 ng·mL^-1;1例受试者检出LFX,质量浓度为199.86 ng·mL^-1。结论本试验建立了痰液中INH、PZA及LFX的检测方法,具有灵敏度高、测定结果准确、快速等诸多优点,可以应用于临床治疗药物的监测。     

活性多酚化合物LM49对RAW264.7巨噬细胞极化的影响

目的初步探讨LM49(2,4'三羟基-5,2'-二溴二苯甲酮)对脂多糖(LPS)联合干扰素γ(IFN-γ)诱导的小鼠单核巨噬细胞(RAW264.7)M1/M2极化的影响及其调控机制。方法四曱基偶氮唑蓝(MTT)法测定LM49对细胞活力的影响;流式细胞术、实时荧光定量聚合酶链反应(PCR)和Westem-blot法测定LM49(5,10,20μmol·L^-1)与LPS/INF-γ共同作用于RAW264.7细胞后,巨噬细胞亚型标志物的表达情况及对核因子(NF)-κB和JAK/STAT信号通路的影响。结果与LPS/INF-γ造模组相比,LM49显著抑制CD16/32^+细胞数及诱导型一氧化氮合酶(iNOS)、白细胞介素(IL)4和肿瘤坏死因子(TNF)-αmRNA的表达,升高CD206^+细胞数及Arg-1和IL-10 mRNA的表达,且降低巨噬细胞M1/M2的比值;Westem-blot法验证LM49可显著降低TLR4、Myd88、NF-κB和STAT1蛋白的表达量,同时抑制p-JAK2和p-STATl蛋白磷酸化水平。结论LM49通过抑制TLR4-Myd88-NF-κB和JAK2-STAT1信号通路,抑制巨噬细胞Ml型极化及促进巨噬细胞M2型极化,调节巨噬细胞M1/M2的平衡。     

穴位埋线对肾虚血瘀型子宫内膜异位症患者IL-1β、TNF-α、VEGF和MMP-2水平的影响

目的:基于PI3K/Akt/mTOR信号通路,探讨穴位埋线疗法治疗肾虚血瘀型子宫内膜异位症的临床疗效及对IL-1β、TNF-α、VEGF和MMP-2等相关信号通路下游细胞因子的水平的影响。方法:选取肾虚血瘀型子宫内膜异位症的门诊和住院患者86例,按照随机数字表法随机分为穴位埋线组和西药组,西药组口服孕三烯酮胶囊(内美通),穴位埋线组在西药组的基础上采用穴位埋线进行治疗,治疗3个月后观察两组患者的临床疗效和IL-1β、TNF-α、VEGF、MMP-2等相关信号通路下游细胞因子的水平。结果:治疗后穴位埋线组总有效率93.02%(40/43),西药组总有效率83.72%(36/43),两组比较差异无统计学意义(P>0.05)。治疗3个月后,穴位埋线组和西药组的VAS评分、血清IL-1β、TNF-α、VEGF和MMP-2水平均较治疗前改善(P<0.01),但穴位埋线组较西药组改善更为明显(P<0.05或P<0.01)。治疗过程中,西药组不良反应发生率为18.60%(8/43),穴位埋线组不良反应发生率为4.65%(2/43),两组不良反应发生率比较,差异有统计学意义(P<0.05)。结论:穴位埋线可以显著改善子宫内膜异位症患者的临床症状和体征,并能显著降低孕三烯引起的不良反应,可见穴位埋线疗法可以作用PI3K/Akt/mTOR信号通路,通过改善通路下游的IL-1β、TNF-α、VEGF和MMP-2水平,发挥治疗子宫内膜异位症的作用。     

五味子醇甲对APP/PS1小鼠学习记忆和NF-κB p65的影响

目的研究五味子醇甲(SCH)对APP/PS1双转基因痴呆小鼠行为学和NF-κB p65的影响。方法将35只APP/PS1双转基因痴呆小鼠随机分为模型(APP/PS1)组、五味子醇甲(SCH+APP/PS1)组;另以同背景同月龄的C 57 BL/6 J阴性小鼠为空白(WT)组。SCH+APP/PS1组给予SCH悬浊液灌胃(2.6 mg·kg^-1·d^-1),模型组和空白组给予等量蒸馏水灌胃。各组灌胃30 d进行Mirror水迷宫空间探索试验后取材。HE染色法观察皮层及海马CA1区神经细胞的形态结构。运用DCFH-DA法检测脑组织活性氧(ROS)含量。Western印迹检测法检验磷酸化核转录因子(NF-κB p65,pp65)的表达。结果与APP/PS 1组相比,APP/PS 1+SCH组有效区停留距离及时间明显延长,差异有统计学意义(P<0.05,P<0.01);APP/PS 1+SCH组穿越有效区次数和平台区停留距离增加,均差异有统计学意义(P<0.01)。APP/PS 1+SCH组HE染色观察皮层有部分神经细胞萎缩、减少,较APP/PS1组明显好转,海马细胞排列整齐度尚可、较均匀。与APP/PS1组相比,APP/PS1+SCH组能降低ROS含量,差异有统计学意义(P<0.05)。APP/PS 1+SCH组皮层及海马pp65蛋白相对表达量下调(P<0.05,P<0.01)。结论SCH可能通过降低ROS含量和抑制pp65保护脑组织形态结构和提高APP/PS1鼠空间探索记忆能力。     

Chronological Changes in Neutrophil/lymphocyte Ratio in Advanced Gastric Cancer Patients Treated with Nivolumab: a Report of Nine Cases

Background: Nivolumab has been approved for use in advanced gastric cancer (GC) after third-line chemotherapy in Japan. However, it remains difficult to predict favorable nivolumab response before treatment. Methods: We evaluated the clinical course with a focus on the chronological changes in neutrophil/lymphocyte ratio (NLR) throughout the chemotherapy and assessed the relationship between nivolumab response and chronological changes in NLR before nivolumab administration. Results: We experienced nine cases who received nivolumab monotherapy for unresectable advanced or postoperative recurrent GC. Nivolumab was used as third-line chemotherapy in all patients, and partial response (PR) and stable disease (SD) were observed in two patients each. Nivolumab treatment resulted in progressive disease (PD) in five patients. In patients with PR or SD, changes in the NLR tended to correspond to the response of target metastatic lymph nodes to first- and second-line chemotherapy. In the four cases with PR or SD following nivolumab, ∆NLRresponses that was the difference in the degree of decline during the most effective pretreatment chemotherapy were 1.39, 0.73, 1.62, and 1.22. However, the patients with PD showed lower ∆NLRresponses, at 0.66, 0.66, 0.25, 0.13, and -0.05 in the five cases. Mean ∆NLRresponses in the patients with PR or SD and patients with PD were 1.17 and 0.33, respectively (P = 0.0008). Conclusions: We experienced nine GC cases treated with nivolumab and assessed the association between chronological NLR changes throughout chemotherapy and tumor response to nivolumab. Changes in NLR during pretreatment chemotherapy might predict tumor response to nivolumab monotherapy in patients with advanced GC.     

Solid‐type poorly differentiated adenocarcinoma of the stomach: Deficiency of mismatch repair and SWI/SNF complex

ARID1A, one of the subunits in SWI/SNF chromatin remodeling complex, is frequently mutated in gastric cancers with microsatellite instability (MSI). The most frequent MSI in solid‐type poorly differentiated adenocarcinoma (PDA) has been reported, but the SWI/SNF complex status in solid‐type PDA is still largely unknown. We retrospectively analyzed 54 cases of solid‐type PDA for the expressions of mismatch repair (MMR) proteins (MLH1, PMS2, MSH2, and MSH6), SWI/SNF complex subunits (ARID1A, INI1, BRG1, BRM, BAF155, and BAF170) and EBER, and mutations in KRAS and BRAF. We analyzed 40 cases of another histological type of gastric cancer as a control group. The solid‐type PDAs showed coexisting glandular components (76%), MMR deficiency (39%), and complete/partial loss of ARID1A (31%/7%), INI1 (4%/4%), BRG1 (48%/30%), BRM (33%/33%), BAF155 (13%/41%), and BAF170 (6%/2%), EBER positivity (4%), KRAS mutation (2%), and BRAF mutation (2%). Compared to the control group, MMR deficiency and losses of ARID1A, BRG1, BRM, and BAF155 were significantly frequent in solid‐type PDAs. Mismatch repair deficiency was associated with the losses of ARID1A, BRG1, and BAF155 in solid‐type PDAs. In the MMR‐deficient group, solid components showed significantly more frequent losses of ARID1A, BRG1, BRM, and BAF155 compared to glandular components (P = .0268, P = .0181, P = .0224, and P = .0071, respectively). In the MMR‐proficient group, solid components showed significantly more frequent loss of BRG1 compared to glandular components (P = .012). In conclusion, solid‐type PDAs showed frequent losses of MMR proteins and the SWI/SNF complex. We suggest that loss of the SWI/SNF complex could induce a morphological shift from differentiated‐type adenocarcinoma to solid‐type PDA.     

基于JAK2/STAT3信号通路探讨大黄素保护AR42J胰腺腺泡细胞损伤的作用机制

目的基于JAK2/STAT3信号通路探讨大黄素保护AR42J胰腺腺泡细胞损伤的作用机制。方法将AR42J细胞以1×10~5/mL铺于6孔板,分为对照组、雨蛙素组(雨蛙素10~(-8) mol/L)、大黄素组(终浓度0.25、0.5、1.0mg/L),通过碘-淀粉比色法淀粉酶(AMS)试剂盒测定细胞上清淀粉酶活力水平,确定雨蛙素刺激AR42J胰腺腺泡细胞损伤的收样时间;ELISA法检测TNF-α活力;Western blot法分析JAK2/STAT3通路相关蛋白的表达情况。结果①与对照组比较,雨蛙素组中的AMS、TNF-α、JAK2/STAT3通路相关蛋白表达量显著提高,差异有统计学意义(P0.05)。②与雨蛙素组比较,大黄素各干预组可显著降低雨蛙素诱导的胰腺腺泡细胞损伤的淀粉酶活力、TNF-α含量、JAK2和STAT3的mRNA相对表达量,差异有统计学意义(P0.01)。③大黄素0.5、1.0 mg/L干预组的作用优于0.25 mg/L干预组,差异有统计学意义(P0.001)。结论大黄素能够减轻雨蛙素诱导的胰腺腺泡细胞损伤,其作用机制可能与调控JAK2/STAT3信号通路有关。     

Cinnamaldehyde suppresses NLRP3 derived IL-1β via activating succinate/HIF-1 in rheumatoid arthritis rats

Cinnamaldehyde (CA) is an essential component of cinnamon (Cinnamomum cassia Presland), which is often used as a flavoring condiment in beverages, pastries, perfumes, etc. Cinnamon is also used as herbal medicine in China and Southeast Asia to treat rheumatoid arthritis. However, the molecular mechanism is unclear. In this study, we aim to investigate its anti-inflammatory effects against Rheumatoid arthritis (RA) using activated macrophages (Raw246.7) in vitro and adjuvant arthritis rats (AA) in vivo. The results demonstrated that CA significantly reduced synovial inflammation in AA rats, possibly due to suppression of the expressions of pro-inflammatory cytokines, especially the IL-1β. Further investigation found that CA also suppressed the activity of HIF-1α by inhibiting the accumulation of succinate in cytoplasm. As we know, the reduction of HIF-1α nucleation slows down IL-1β production, because HIF-1α activates the expression of NLRP3, which is involved in the assembly of inflammasome and processing of IL-1β. In addition, CA also inhibited the expression of the succinate receptor GPR91, which in turn inhibited the activation of HIF-1α. In conclusions, our results suggested that CA might be a potential therapeutic compound to relieve rheumatoid arthritis progress by suppressing IL-1β through modulating succinate/HIF-1α axis and inhibition of NLRP3.     

Extending multilevel spatial models to include spatially varying coefficients

Multilevel models have long been used by health geographers working on questions of space, place, and health. Similarly, health geographers have pursued interests in determining whether or not the effect of an exposure on a health outcome varies spatially. However, relatively little work has sought to use multilevel models to explore spatial variability in the effects of a contextual exposure on a health outcome. Methodologically, extending multilevel models to allow intercepts and slopes to vary spatially is straightforward. The purpose of this paper, therefore, is to show how multilevel spatial models can be extended to include spatially varying covariate effects. We provide an empirical example on the effect of agriculture on malaria risk in children under 5 years of age in the Democratic Republic of Congo.     

Risk factors of rib metastases in nasopharyngeal carcinoma patients with rib 99mTc- MDP foci on whole-body bone scansCSCD

Objective To investigate the correlation of rib 99mTc-MDP foci on whole-body bone scan with clinical variables and rib metastases in nasopharyngeal carcinoma(NPC) patients, and to screen the risk factors of rib metastases. Methods We retrospectively reviewed 312 NPC patients with rib 99mTc-MDP foci on wholebody bone scan. Chi-square test and logistic regression were performed to evaluate the correlation between clinical variables and rib metastases. Results In all 312 NPC patients, rib metastases were associated with T stage, skull base bone invasion, other bone metastasis, number of rib foci, lateral localization on rib and foci type (P<0.01), and the risk factors of rib metastasis included skull base bone invasion, other bone metastases, lateral localization on rib and foci type (P<0.05). In 176 patients with pure rib foci, rib metastases were closely related to T stage, skull base bone invasion, other bone metastasis, number of rib foci and lateral localization on rib (P<0.05), while only lobar distribution (P=0.029) was the effective risk factor. In 198 patients with single rib focus, rib metastases were affected by skull base bone invasion and foci type (P<0.01), while only foci type (P=0.000) was the effective risk factor. In all 566 rib foci, uptake level and localization on rib were the effective risk factors of rib metastases(P<0.01). Conclusion In NPC patients with rib foci on whole body bone scan, the effective risk factors of rib metastases include skull base bone invasion, other bone metastases, lateral localization on rib, foci type, uptake level and anterior and posterior localization on rib. Follow up should be the main way for the pure rib foci on unilateral ribs. For multiples rib foci on bilateral ribs or single rib focus combined with other bones foci, additional image modalities should be required to exclude bone metastasis. © 2020, CHINA RESEARCH ON PREVENTION AND TREATMENT. All rights reserved.