针刀配合整脊疗法治疗糖耐量异常76例临床观察

目的观察针刀配合整脊疗法治疗糖耐量异常(IGT)的疗效。方法采用随机平行对照方法,将152例门诊患者按随机数字表方法随机分为两组,对照组、治疗组各76例。对照组与治疗组同采用健康教育及饮食与运动指导等基础治疗,治疗组在基础治疗上又加用针刀、整脊疗法,每周1次,4周为1疗程,治疗1疗程。观测空腹血糖(FBG)、糖耐量试验餐后2 h血糖(P2hBG),随访半年,判定疗效,观察2型糖尿病(T2DM)发生率。结果治疗组总有效率82.89%,T2DM发生率11.84%。对照组总有效率61.84%,T2DM发生率26.32%。治疗组疗效优于对照组(P<0.01);FBG、P2hBG降低程度,治疗组优于对照组(P<0.01)。结论针刀配合整脊能降低IGT向T2DM的转化率,并能降低血糖。     

Inhibitory Effects of Mild Hyperthermia plus Docetaxel Therapy on ER（＋/-） Breast Cancer Cells and Action Mechanisms

Summary： The purpose of this study was to verify that a combination of mild hyperthermia and do- cetaxel chemotherapy produces synergistic antitumor effects and to explore the action mechanisms of this treatment approach. The effects of docetaxel on the proliferation of cells from the estrogen receptor （ER）-positive human breast cancer cell line MCF-7 and the ER-negative human breast cancer cell line MDA-MB-453 were examined by 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide （MTT） assay, and effective experimental concentrations of docetaxel were determined. The effects of mild hy- perthermia plus docetaxel therapy on apoptosis rate in the MCF-7 and MDA-MB-453 human breast cancer cell lines were analyzed by using flow cytometry with Annexin-V fluorescein isothiocyanate （FITC）/propidium iodide （PI） staining. The effects of these combined treatments on cell cycle progres- sion in the MCF-7 and MDA-MB-453 human breast cancer cell lines were examined by using flow cy- tometry. The effects of these combined treatments on the expression of apoptosis-related proteins and proteins in the mitogen-activated protein kinase （MAPK） pathways were analyzed by using Western blotting. The effects of these combined treatments on the expression of the heat shock protein 70 （HSP70） and the multi-drug resistance （MDR） gene product P-glycoprotein （Pgp） were examined by using Western blotting. The results showed that the half-maximal inhibitory concentration （IC50） of do- cetaxel for MCF-7 and MDA-MB-453 cells was 19.57±1.12 and 21.64±2.31 gmol/L respectively. Mild hyperthermia with docetaxel therapy could increase apoptosis rate in the MCF-7 and MDA-MB-453 cells. Apoptosis rate in MCF-7 and MDA-MB-453 cells was increased from （23.66±3.59）% and （18.51±3.17）% in docetaxel treatment group to （47.12±6.73）% and （55.16±7.42）% in mild hyperthermia plus docetaxel group, indicating that the mild hyperthermia and docetaxel therapeutic approaches exhib- ited significant synergistic antitumor effects. Treatments of mild hyperthermia plus docetaxel induced G2/M cell cycle arrest in the MCF-7 and MDA-MB-453 cells. Western blotting demonstrated that pro- teins in the MAPK pathway were expressed at higher levels in docetaxel-treated cells following mild hypothermia than those in cells treated with docetaxel alone. As compared with blank control group, cells from the mild hyperthermia plus docetaxel group exhibited significantly decreased B-cell lym- phoma 2 （Bcl-2） protein expression but slightly increased Bcl-2-associated X protein （Bax） expression. Western blotting results revealed that HSP70 and Pgp expression levels were significantly increased following mild hypothermia. It was concluded that treatments of mild hyperthermia plus docetaxel in- hibited the proliferation of human breast cancer cells, promoted apoptosis of breast cancer cells, and produced synergistic antitumor effects.     

术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.     

术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房颤动

目的 前瞻性的评估术前低剂量胺碘酮预防非体外循环冠状动脉旁路移植术后心房纤颤(房颤)的安全性、耐受性和有效性. 方法 将200例择期行非体外循环冠状动脉旁路移植手术(OPCAB)治疗的冠状动脉粥样硬化性心脏病患者随机分成研究组和对照组.对照组100例,术前给予常规药物和安慰剂;研究组100例,术前给予常规药物和低剂量胺碘酮,术后两组均用常规药物.结果 研究组的房颤发生率(15%)、房颤时最大心室率(126.0±20.8)次/min,房颤持续时间(8.0±8.6)h均低于对照组的房颤发生率((41%),(χ2=16.766,P=0.000]、房颤时最大心室率((150.0±25.6)次/min,t=0.478,P=0.017]以及房颤持续时间[(12.0±9.6)h,t=0.439,P=0.019].本实验结果 显示研究组药物不良反应的发生较对照组差异无统计学意义(P均0.05).结论 术前预防性应用低剂量胺碘酮能安全有效减少房颤发生率,缩短房颤持续时间,并能降低术后房颧最大心室率,减轻临床症状.     

2015年九市7岁以下儿童龋齿调查及与体格生长的相关性分析

目的 了解九市7岁以下儿童患龋现状及患病率30年变化趋势,分析龋病与体格生长的关系。方法 以“2015年中国九市儿童体格发育调查”中乳牙已萌出的6月~7岁儿童为研究对象,龋齿和体格生长情况通过横断面调查获得。应用独立样本t检验比较有无龋病的儿童体格指标差异。利用1985、1995年调查数据分析患龋率的长期变化。结果 1)患龋率随年龄增长而增加,从6~12月组的0.2%至1岁组的0.9%,6~7岁组增至45.7%;2)郊区儿童患龋率高于城区,北部和南部地区高于中部地区;3)3岁以内有无龋病两组儿童的身长、体重、体质量指数(BMI)差别无统计学意义(P>0.05),而3岁以上患龋组体格指标均低于无龋组;4)1985-2015年三十年间,城郊患龋率均呈下降趋势,如城区6~7岁组从1985年的68.1%降至2015年的43.2%。结论 7岁以下儿童患龋率随年龄增长而增加,存在明显城郊和地区差异。龋病对体格生长的影响在3岁以后较明显。九市儿童患龋率三十年间呈明显下降趋势。     

人子宫内膜细胞中 miRNAs 的表达及功能分析

摘要： 目的 探索微小 RNAs （miRNAs, miR） -125b、 miR-30b 和 miR-424 在子宫内膜中的表达及功能。方法 收 集自然周期患者（增殖期和分泌期）和促排卵周期患者（高孕组和非高孕组）的子宫内膜标本, 体外分离培养子宫内 膜上皮细胞和间质细胞, 并用免疫荧光验证。实时定量 PCR 检测 miR-125b、 miR-30b 和 miR-424 的表达。结果 增 殖期, 间质细胞中 miR-125b、 miR-30b 和 miR-424 的表达高于上皮细胞; 分泌期, 间质细胞中 miR-125b 和 miR-424 的表达仍高于上皮细胞, 而 miR-30b 的表达低于上皮细胞。上皮细胞中, 分泌期 miR-125b、 miR-30b 和 miR-424 的 表达显著高于增殖期, 而间质细胞中 3 种 miRNAs 的表达差异无统计学意义。HCG 日高孕组上皮细胞中 miR-125b 的表达高于非高孕组, 间质细胞中 miR-30b 的表达高于非高孕组。miR-125b、 miR-30b 和 miR-424 的靶基因功能 分析发现, 其涉及的生物过程主要有细胞迁移、 运动、 细胞间黏附连接等, 主要富集的信号通路包括胰岛素信号通 路、 VEGF 信号通路、 MAPK 信号通路、 焦点黏附和 Wnt 信号通路。结论 miR-125b、 miR-30b 和 miR-424 在子宫内 膜不同细胞类型、 不同时期和 HCG 日高孕酮患者中的表达存在差异, 可能参与子宫内膜容受性的调节。     

2014年江苏省农村中小学卫生调查

摘要:目的　客观评价2014年江苏省农村中小学环境卫生现状。方法　按照简单随机抽样的方法从江苏省全部13个省辖市中选取13个县（市、区）,65个乡镇,130所中小学,780个班级。调查学校供水情况、学校卫生保健和传染病管理情况、教室环境卫生情况和学生健康档案。结果　2014年,参与调查的130所中小学中,学校卫生专业技术人员配备率较低（30.77%）;参与调查的780间中小学教室中,教室前排课桌前缘距前方黑板水平距离合格率较低（19.23%）,小学的教室2种不同高低型号或可调式课桌椅配备率（55.64%）高于初中（43.59%）;在收集到的522份学生健康档案中,初中生近视和沙眼阳性率（49.17%,2.44%）高于小学生（23.72%,1.59%）,小学生龋齿、肥胖与营养不良阳性率（22.29%,9.92%）高于初中生（7.43%,8.74%）,以上比较差异均有统计学意义（P＜0.01）。结论　2014年,江苏省农村中小学的环境卫生状况总体较好,但学校卫生专业技术人员配备率、教室内部的合理布局,中小学生近视、沙眼的预防是需要进一步重视的问题。     

冠心病患者血浆脂蛋自水平与冠脉病变相关性研究

目的通过实验室检测血浆脂蛋白水平,初步探讨这些因素与冠状动脉狭窄程度的关系,从而为冠心病的临床诊断和治疗及预后的评估提供一种便捷有效的检验指标。方法所有研究对象均于入院次日清晨取空腹12小时静脉血,通过实验室全自动生化仪分别以氧化酶法测定LP（a）生化指标。结果经T检验显示,CHD组Lp（a）水平明显高于非CHD组（P〈0．05）,Lp（a）危险因素的Logistic分析可见Lp（a）为冠心病的独立危险因素。结论血浆Lp（a）浓度与冠状动脉粥样硬化疾病存在相关性,水平升高是其独立危险因子,也是心肌梗死的预测因子。     

外泌体作为药物递送系统的研究进展

外泌体是一种由细胞分泌的直径约40-100 nm的盘状囊泡,具有天然脂质双分子层,其内包含了复杂的RNA和蛋白质.大多数细胞在正常及病理状态下均能产生外泌体,这些外泌体主要存在于体液中,在细胞间物质运输和信号交流中发挥着重要作用.作为天然内源性纳米级载体,外泌体具有毒性小、稳定性好、、渗透性好、靶向归巢性强、能透过血脑...