乙酰谷酰胺对酒精中毒昏迷患者的急救效果和血清β-EP、氧化应激指标的影响

目的探讨乙酰谷酰胺对酒精中毒昏迷患者的急救效果和血清β内啡肽(β-EP)、氧化应激指标的影响。方法选择2017年1月-2019年3月成都市第三人民医院蒲江医院接诊的115例酒精中毒昏迷患者,通过随机数表法分为观察组60例和对照组55例。两组入院后均给予常规治疗,对照组在此基础上给予盐酸纳洛酮注射液治疗,观察组在对照组基础上,联合乙酰谷酰胺注射液治疗。比较两组临床疗效、临床症状恢复时间、肝功能、血清β-EP、氧化应激指标和清醒后不适症状。结果观察组总有效率明显高于对照组(P<0.05);两组体温正常时间比较差异无统计学意义(P>0.05),观察组苏醒时间、生命体征稳定时间明显短于对照组(P<0.05);治疗后,观察组肝功能指标谷草转氨酶(AST)、谷丙转氨酶(ALT)、γ-谷氨酰转肽酶(γ-GT)明显低于对照组(P<0.05);观察组血清β-EP、丙二醛(MDA)明显低于对照组,超氧化物歧化酶(SOD)明显比对照组高(P<0.05);观察组头晕头痛、恶心呕吐、乏力、胸闷发生率均明显低于对照组(P<0.05)。结论在常规治疗基础上,联合乙酰谷酰胺对酒精中毒昏迷患者急救疗效显著,且可有效改善肝功能及血清β-EP、氧化应激指标的表达,减少清醒后不适症状的发生率,值得应用推广。     

The spatial cerebral damage caused by larger infarct and β-amyloid toxicity is driven by the anatomical/functional connectivity

Large cerebral infarctions are major predictors of death and severe disability from stroke. Conversely, data concerning these types of infarctions and the affected adjacent brain circuits are scarce. It remains to be determined if the co-morbid concurrence of large infarct and β-amyloid (Aβ) toxicity can precipitate the early development of dementia. Here, we described a dose-dependent effect of a unilateral striatal injection of vasoconstrictive endothelin-1 (ET-1) along with Aβ toxicity on CNS pathogenesis; driven by the anatomical and functional networks within a brain circuit. After 21 days of treatment, a high dose (60 pmol) of ET-1 (E60) alone caused the greatest increase in neuroinflammation, mainly in the ipsilateral striatum and distant regions with synaptic links to the striatal lesion such as white matter (subcortical white matter, corpus callosum, internal capsule, anterior commissure), gray matter (globus pallidus, thalamus), and cortices (cingulate, motor, somatosensory, entorhinal). The combined E60 + Aβ treatment also extended perturbation in the contralateral hemisphere of these rats, such as increased deposition of amyloid precursor protein fragments associated with the appearance of degenerating cells and the leakage of laminin from the basement membrane across a compromised blood–brain barrier. However, the cerebral damage induced by the 6 pmol ET-1 (E6), Aβ and E6 + Aβ rats was not detrimental enough to injure the complete network. The appreciation of the causal interactions among distinct anatomical units in the brain after ischemia and Aβ toxicity will help in the design of effective and alternative therapeutics that may disassociate the synergistic or additive association between the infarcts and Aβ toxicity.     

加味逍遥散联合三维适形放疗对原发性肝癌患者血清生长因子及免疫功能的影响

目的:观察加味逍遥散联合三维适形放疗对原发性肝癌(PLC)患者血清肝细胞生长因子(HGF)、转化生长因子-β1(TGF-β1)及免疫功能的影响。方法:选取90例PLC患者为研究对象,按照随机数字表法分为观察组和对照组,每组45例。对照组采用经肝动脉化疗栓塞术(TACE)联合三维适形放疗治疗,观察组在对照组基础上联合加味逍遥散治疗。对比2组中医证候疗效和实体瘤疗效,观察治疗前后血清HGF、TGF-β1及免疫功能指标的变化,记录不良反应发生情况。结果:观察组中医证候改善率97.78%,高于对照组的77.78%,差异有统计学意义(P<0.05)。观察组实体瘤疗效有效率略高于对照组,差异无统计学意义(P>0.05)。与治疗前比较,治疗后2组HGF水平均升高(P<0.05),TGF-β1水平均降低(P<0.05),观察组2项指标水平升高或降低幅度均大于对照组(P<0.05)。与治疗前比较,治疗后2组CD3^+、CD4^+、CD4^+/CD8^+、自然杀伤细胞(NK细胞)值均升高(P<0.05),观察组以上4项指标值均高于对照组(P<0.05)。2组治疗过程中均无严重不良反应发生。结论:加味逍遥散联合三维适形放疗治疗PLC可提高临床疗效,改善患者的免疫功能,调节机体血清相关因子。     

针刺华佗夹脊穴和督脉穴对强直性脊柱炎患者血清中HMGB1和β-CTX水平及病情活动度的影响

目的:探讨与分析针刺华佗夹脊穴和督脉穴对强直性脊柱炎患者血清中HMGB1和β-CTX水平以及病情活动度的影响。方法:抽取2015年7月—2018年7月本院收治的100例确诊为强直性脊柱炎的患者,随机分为2组,对照组采用柳氮磺胺吡啶片口服治疗,研究组采用针刺督脉穴和华佗夹脊穴的方式进行治疗,每10天为1个疗程,3个疗程后比较两组患者治疗前后血清中HMGB1和β-CTX水平以及病情活动度的改善情况。结果:两组患者的病情活动度比较无明显差异(P>0.05),而接受不同治疗后,两组患者的病情活动度均有一定改善,并且研究组患者病情改善明显优于对照组(P<0.05);治疗前两组患者β-CTX及HMGB1水平无明显区别(P>0.05),治疗后研究组β-CTX及HMGB1水平改善情况显著优于对照组(P<0.05)。结论:针刺华佗夹脊穴和督脉穴能够有效改善患者血清中HMGB1和β-CTX水平,较好改善患者的病情活动度,值得推广使用。     

β-arrestin1在炎-癌转化中的研究进展

β-arrestin1(ARRB1)作为β-arrestin（ARRB）家族成员，是一类具有多种生物学功能的细胞内支架蛋白。其参与调控G蛋白偶联受体（G protein-coupled receptor，GPCR）和非GPCR介导的信号通路。ARRB1与炎症和癌症密切相关，不仅参与炎症形成，而且通过多种方式调节炎癌转化的进程。因此对ARRB1的生物学特性及其在炎癌转化中作用的研究，将有助于揭示其对人类肿瘤进程干预的潜在价值。     

Faster bone union progression and less sclerosis at the osteotomy margin after medial opening-wedge high tibial osteotomy using highly porous β-tricalcium phosphate granules versus allogeneic bone chips: A matched case–control study

BackgroundThis study compared bone union progression using highly porous (80% porosity) β-tricalcium phosphate (β-TCP) granules or allogeneic bone chips in the gap created by medial opening-wedge high tibial osteotomy (MOWHTO).MethodsThe study population consisted of 54 patients who received MOWHTO with locking plate fixation: 27 patients using highly porous β-TCP granules, and 27 age- and sex-matched patients using allogeneic bone chips. Bone union progression was evaluated 1, 3, 6, and 12 months postoperatively. The presence of radiographic sclerosis at the osteotomy margin was also assessed.ResultsAmong all patients, the highest degree of bone union observed 12 months postoperatively was grade 4. As postoperative time passed, bone union progression of highly porous β-TCP granules increased linearly and was statistically significant compared with that of cancellous allogeneic bone chips (P = 0.014). The presence of radiographic sclerosis at the osteotomy margin was significantly less common in the β-TCP group than in the allograft group (P = 0.003) and was the strongest predictor of delayed progress of bone union (odds ratio = 6.16, P = 0.006).ConclusionsPatients who underwent MOWHTO using highly porous β-TCP granules had faster new bone remodeling, less radiographic sclerosis at the osteotomy margin, and no inferior clinical outcome compared with allogeneic bone chips, as determined at the 1-year follow up. The presence of radiographic sclerosis at the osteotomy margin in patients undergoing MOWHTO using allogeneic bone or synthetic bone substitute may indicate delayed progress of bone union.     

Composite intestinal adenoma-microcarcinoid: An update and literature review

Composite intestinal adenoma-microcarcinoid (CIAM) is a rare intestinal lesion consisting of conventional adenoma and small, well differentiated carcinoid [microcarcinoid (MC)] at its base. The incidence of CIAM is 3.8% in surgically resected colorectal polyps. While its pathogenesis is unknown, studies support the role of Wnt/β-catenin pathway in the tumorigenesis of CIAM. CIAMs have been primarily reported in the colon wherein they present as polyps with well-defined margins, similar to conventional adenomatous polyps. MC is usually found in adenomatous polyps with high-risk features such as large size, villous architecture, or high grade dysplasia. Histologically, the MC component is often multifocal and spans 3.9 to 5.8 millimeters in size. MC is usually confined within the mucosa but occasional CIAM cases with MC extending to the submucosa have been reported. MC of CIAM demonstrates bland cytology and inconspicuous proliferative activity. The lesional cells are positive for synaptophysin and 60% to 100% of cases show nuclear β-catenin positivity. MC poses a diagnostic challenge with its morphologic and immunohistochemical resemblance to both benign and malignant lesions, including squamous morules/metaplasia, adenocarcinoma, squamous cell carcinoma, sporadic neuroendocrine tumor and goblet cell adenocarcinoma. CIAM is an indolent lesion with a favorable outcome. Complete removal by polypectomy is considered curative. Awareness and recognition of this rare entity will help arrive at correct diagnosis and improve patient care. Currently, CIAM is not recognized as a subtype of mixed neuroendocrine-non-neuroendocrine neoplasm by WHO.