MicroRNA-181c provides neuroprotection in an intracerebral hemorrhage model

Apoptosis is an important factor during the early stage of intracerebral hemorrhage.MiR-181 c plays a key regulatory role in apoptosis.However,whether miR-181 c is involved in apoptosis of prophase cells after intracerebral hemorrhage remains unclear.Therefore,in vitro and in vivo experiments were conducted to test this hypothesis.In vivo experiments:collagenase type VII was injected into the basal ganglia of adult Sprague-Dawley rats to establish an intracerebral hemorrhage model.MiR-181 c mimic or inhibitor was injected in situ 4 hours after intracerebral hemorrhage.Neurological functional defects(neurological severity scores)were assessed 1,7,and 14 days after model establishment.Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling and western blot assay were conducted 14 days after model establishment.In vitro experiments:PC12 cells were cultured under oxygen-glucose deprivation,and hemins were added to simulate intracerebral hemorrhage in vitro.MiR-181 c mimic or inhibitor was added to regulate miR-181 c expression.3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay,luciferase reporter system,and western blot assay were performed.Experimental results revealed differences in miR-181 c expression in brain tissues of both patients and rats with cerebral hemorrhage.In addition,in vitro experiments found that miR-181 c overexpression could upregulate the Bcl-2/Bax ratio to inhibit apoptosis,while inhibition of miR-181 c expression could reduce the Bcl-2/Bax ratio and aggravate apoptosis of cells.Regulation of apoptosis occurred through the phosphoinositide 3 kinase(PI3 K)/Akt pathway by targeting of phosphatase and tensin homolog deleted on chromosome ten(PTEN).Higher miR-181 c overexpression correlated with lower neurological severity scores,indicating better recovery of neurological function.In conclusion,miR-181 c affects the prognosis of intracerebral hemorrhage by regulating apoptosis,and these effects might be directly mediated and regulated by targeting of the PTEN\PI3 K/Akt pathway and Bcl-2/Bax ratio.Furthermore,these results indicated that miR-181 c played a neuroprotective role in intracerebral hemorrhage by regulating apoptosis of nerve cells,thus providing a potential target for the prevention and treatment of intracerebral hemorrhage.Testing of human serum was authorized by the Ethics Committee of China Medical University(No.2012-38-1)on February 20,2012.The protocol was registered with the Chinese Clinical Trial Registry(Registration No.ChiCTR-COC-17013559).The animal study was approved by the Institutional Animal Care and Use Committee of China Medical University(approval No.2017008)on March 8,2017.     

泽泻化学成分及药理作用研究进展

泽泻为我国传统中药,广泛应用于中医临床复方及多种中成药中。目前从泽泻中分离到了220余个化合物,包括三萜、倍半萜、二萜、糖类、含氮化合物、苯丙素、黄酮、甾体等。药理学研究表明泽泻醇提物、水提物及一些单体类成分具有利尿、抗结石及肾脏保护、降血脂及保肝、降血糖、抗癌、抗氧化损伤、抗炎、抗补体等作用。该文对近五十年来泽泻的化学成分和药理作用进行了全面系统的整理,以期为泽泻的深入研究和开发利用提供理论依据。     

Epigenetic priming with decitabine followed by low dose idarubicin and cytarabine in acute myeloid leukemia evolving from myelodysplastic syndromes and higher-risk myelodysplastic syndromes: a prospective multicenter single-arm trial

Patients with acute myeloid leukemia (AML) evolving from myelodysplastic syndrome (MDS) or higher-risk MDS have limited treatment options and poor prognosis. Our previous single-center study of decitabine followed by low dose idarubicin and cytarabine (D-IA) in patients with myeloid neoplasms showed promising primary results. We therefore conducted a multicenter study of D-IA regimen in AML evolving from MDS and higher-risk MDS. Patients with AML evolving from MDS or refractory anemia with excess blasts type 2 (RAEB-2) (based on the 2008 WHO classification) were included. The D-IA regimen (decitabine, 20 mg/m² daily, days 1 to 3; idarubicin, 6 mg/m² daily, days 4 to 6; cytarabine 25 mg/m² every 12 hours, days 4 to 8; granulocyte colony stimulating factor [G-CSF], 5 μg/kg, from day 4 until neutrophil count increased to 1.0 × 10⁹/L) was administered as induction chemotherapy. Seventy-one patients were enrolled and treated, among whom 44 (62.0%) had AML evolving from MDS and 27 (38.0%) had RAEB-2. Twenty-eight (63.6%) AML patients achieved complete remission (CR) or complete remission with incomplete blood count recovery (CRi): 14 (31.8%) patients had CR and 14 (31.8%) had CRi. Six (22.2%) MDS patients had CR and 15 (55.6%) had marrow complete remission. The median overall survival (OS) was 22.4 months for the entire group, with a median OS of 24.2 months for AML and 20.0 months for MDS subgroup. No early death occurred. In conclusion, the D-IA regimen was effective and well tolerated, representing an alternative option for patients with AML evolving from MDS or MDS subtype RAEB-2.     

High infiltration of mast cells is associated with improved response to adjuvant chemotherapy in gallbladder cancer

Recent studies have reported that tumor‐infiltrating mast cells (TIM) play an important role in tumor regression, but the effect of TIM in gallbladder cancer (GBC) remains unclear. The present study aims to investigate the prognostic value of TIM in GBC patients and its responsiveness to gemcitabine‐based adjuvant chemotherapy (ACT). A total of 298 GBC patients from Zhongshan Hospital were recruited for this study. TIM infiltration was measured by immunohistochemical staining. Accumulation of TIM is significantly associated with prolonged overall survival in GBC patients. The benefit from gemcitabine‐based ACT was superior among patients with high infiltration of TIM with GBC. Multivariate analysis identified TIM infiltration as an independent prognostic factor for overall survival. A heatmap showed that TIM‐activated gene signatures were positively correlated with CD8+ T cells' gene signatures. Gene set enrichment analysis (GSEA) suggested that TIM was related to multiple T cell‐related processes and signaling pathways, including the interferon gamma signaling pathway and the leukocyte migration signaling pathway. It was confirmed that CD8+ T cell infiltration was positively correlated with high TIM infiltration in tissue microarray (TMA), suggesting that TIM infiltration was linked to the immune surveillance in GBC. TIM can be used as an independent prognostic factor and a predictor of therapeutic response of gemcitabine‐based ACT in GBC patients, which may mediate immune surveillance by recruiting and activating CD8+ T cells in GBC.     

盐酸氨溴索联合排痰仪与大剂量盐酸氨溴索联合支气管镜对老年重症肺炎疗效的Meta分析

目的比较正常剂量盐酸氨溴索联合排痰仪与大剂量盐酸氨溴索联合支气管镜在治疗老年重症肺炎中的临床疗效。方法通过计算机检索PubMed、The Cochrane Library、Web of Science、CNKI、万方数据库、维普数据库和中国生物医学文献服务系统,搜索国内外公开发表的有关盐酸氨溴索联合排痰仪与大剂量盐酸氨溴索联合支气管镜治疗老年重症肺炎的相关文章,检索时限从建库起到2019年5月。分别由两名作者根据文献纳入和排除标准对文献进行筛选以及数据提取,使用RevMan 5.3软件进行Meta分析。结果经筛选后共有27篇文献最终被纳入分析。Meta分析结果表明,大剂量盐酸氨溴索联合支气管镜治疗能减少患者ICU住院时间(MD=-1.84,95%CI:-2.21～-1.48)、呼吸机使用时间(MD=-3.93,95%CI:-4.17～-3.69)、治疗期间死亡率(O^R=0.42,95%CI:0.33～0.53)、急性生理学与慢性健康状况(APACHEⅡ)评分(MD=-0.67,95%CI:-1.05～-0.29)、多器官功能衰竭(MOF)发生率(O^R=0.41,95%CI:0.32～0.53)、C反应蛋白(CRP)浓度(MD=-10.35,95%CI:-11.29～-9.41)以及血清降钙素原(PCT)浓度(MD=-0.37,95%CI:-0.40～-0.33),增加患者动脉血氧分压(PaO_2)(MD=4.85,95%CI:3.83～5.86)、经皮动脉血氧饱和度(SpO_2)(MD=6.47,95%CI:5.65～7.29)和氧合指数(OI)(PaO_2/FiO_2)(MD=31.88,95%CI:29.21～34.54)。结论大剂量使用盐酸氨溴索联合支气管镜治疗老年重症肺炎是安全可行的,且与常规治疗方法相比,在所测指标中均具有一定的优势,有望成为治疗老年重症肺炎的优先选择。     

The prognostic significance of ΔSUVmax assessed by PET/CT scan after 2 cycles of chemotherapy in patients with classic Hodgkin’s lymphoma

Annals of Hematology - The objective of this study is to investigate the prognostic value of the percentage change of maximum standardized uptake value (ΔSUVmax) assessed by PET/CT scan after...     

关节镜联合关节牵张成形术治疗踝关节创伤性关节炎

目的对比分析单纯关节镜手术与关节镜手术联合Ilizarov外固定架关节牵张术治疗踝关节创伤性关节炎的临床疗效。 方法纳入2016年10月至2018年4月聊城市中医医院收治的早中期踝关节创伤性关节炎患者30例，排除非创伤性关节炎和终末期踝关节炎。其中接受单纯踝关节镜手术者纳入对照组(n＝15)，接受关节镜手术联合Ilizarov外固定架关节牵张成形术者纳入研究组(n＝15)，术后随访6个月，对比分析两组患者的治疗效果：疼痛视觉模拟评分(VAS)、踝关节功能评分(Kofoed评分)以及生活质量的变化。计数资料比较采用卡方或Fisher精确检验，计量资料比较采用独立样本t检验。 结果研究组治疗有效率大于对照组(χ²＝7.214，P<0.05)，术后疼痛视觉模拟评分明显低于对照组(t ＝10.342，P<0.05)，Kofoed评分高于对照组(t ＝10.452，P<0.05)；研究组生活质量显著高于对照组(P<0.05)。 结论关节镜手术联合关节牵张成形术对早中期踝关节创伤性关节炎较单纯关节镜手术短期效果更好，可成为临床治疗中的一种选择，但远期效果尚需进一步研究。     

基于病证结合的肝硬化诊治理论探讨与临床实践

肝硬化病因多种、病情复杂,目前单纯的中医或西医方法均不足以满足临床需求,需要中西医结合,以提高临床疗效。肝硬化的病证结合诊治是中西医结合的具体体现,诊断上宜据病分证,即依据西医病名,明确肝硬化的病因分类、程度分期及其并发证等,而后根据主症表现而中医辨证分型。我们发现肝硬化的中医证型与疾病分期有关,可进一步研究分期辨证与据因辨证的中医证候特征。治疗上,当中西结合、优势互补,我们观察证实西医病因治疗与中医辨证治疗相结合,可提高肝硬化疗效。但需注意具体病因肝硬化的病证结合治疗策略,如中西药物序贯或同时治疗,更要强调研究过程的规范性与疗效评价的可靠性。以优化疗效显著、宜于推广的肝硬化中西医结合诊疗方案,发现中医药的特色优势作用,促进提高肝硬化的诊疗水平。