全身性遗传疾病对角膜移植排斥的影响

角膜移植为治疗角膜盲的主要手段，而角膜移植排斥则是决定角膜植片存活时间和病人术后视力的关键。角膜得益于其特殊的眼前节“免疫赦免”状态，使得角膜移植能够在众多器官移植中享有极低的排斥率，然而排斥反应发生的风险依然存在。当机体处于遗传物质异常的特殊状态时，宿主将通过宏观调控“免疫赦免”状态对植片的保护作用或受体对移植物排异产生的有害作用，延迟或促进角膜移植排斥反应的发生，进而影响移植物的存活时间和透明度。该文综述与角膜移植排斥相关的多种全身性遗传疾病，总结全身性遗传疾病对角膜移植排斥的影响，浅析其发生的病理生理学机制以及诊疗的特殊性。     

胰腺导管腺癌CT、MR相关研究进展

胰腺导管腺癌（pancreatic ductal adenocarcinoma，PDAC）是最常见的胰腺恶性肿瘤，其恶性程度高，患者生存率低。CT、MR是PDAC诊断最常用的影像检查，其不仅可以帮助PDAC进行诊断、鉴别，还能通过特殊序列来提供相应功能参数。此外，影像组学可以挖掘更多的影像信息供临床医生分析、预测患者术后生存率。CT、MR对于PDAC临床治疗具有重要的指导意义，故本文对PDAC相关CT、MR进展进行综述。     

国医大师段富津教授验案四则浅析

本文选取国医大师段富津教授上世纪九十年代书写的典型验案四则,对疾病病机及方药配伍进行浅析。     

胃肠道间质瘤诊断方法的研究进展

胃肠道间质瘤（gastrointestinal stromal tumor，GIST）是起源于胃肠道间叶组织的肿瘤，由于GIST存在恶性潜能，且多数GIST患者无明显临床症状，所以GIST的早期发现、诊断和治疗显得尤为重要。GIST通常在内窥镜、超声内镜（endoscopic ultrasound，EUS）检查中发现。GIST的诊断取决于形态学和免疫组织化学染色，因此组织样本的充足性是其关键。近年来，新的成像技术的应用和分子生物学的发展提高了GIST的诊断准确率，并为GIST的预后及辅助治疗提供了依据。     

黄芪多糖提取工艺、化学结构及药理作用的研究进展

黄芪多糖（Astragalus polysaccharides,APS）是黄芪的重要活性成分之一,随着黄芪在临床上的使用越来越广泛,学者对APS的提取工艺、化学结构及药理作用的研究也愈来愈深入。不同的提取工艺对APS的含量和纯度均会产生不同程度的影响,进而对其药理作用的发挥也会有所影响。APS具有调节免疫、抗肿瘤、降血糖、抗衰老和抗炎等药理作用。在全面查阅并梳理文献资料的基础上,对APS的提取工艺、化学结构及药理作用进行综述,并对APS的研究前景进行展望,以期对APS的进一步开发利用和研究提供有效的理论支持。     

三主体双轨道交互式护理对老年慢性阻塞性肺疾病患者应用及效果评价

目的 探究三主体双轨道交互式护理对老年慢性阻塞性肺疾病(COPD)患者的应用效果。 方法 选取2013年12月-2015年12月期间哈尔滨医科大学附属第一医院门诊确诊的老年COPD患者132例,按照单纯随机抽样的方式分为干预组和对照组;对照组患者采用常规化的护理方法,即患者在出院后,进行电话回访一次,提供给患者相应的自我管理知识和宣传教育,干预组患者采用三主体双轨道交互式护理干预模式,构建以老年COPD患者及医院专科护士为主体的医院延续护理干预轨道和以老年COPD患者及社区护士为主体的社区干预轨道,增强三主体双轨道的交互作用;三主体双轨道交互式护理在老年COPD患者应用及效果评价参考2组患者生活质量各维度评分、预后3个月后焦虑自评量表(SAS)/抑郁自评量表(SDS)评分以及干预效果、满意度等数据。 结果 干预后实验组患者和对照组患者的总体健康得分分别是61.6±4.6、53.6±3.7,实验组患者得分高于对照组,实验数据差异具有统计学意义(P<0.01);干预后实验组患者显效33例、有效28例、无效5例,对照组显效23例、有效17例、无效26例,实验组的干预效果优于对照组,实验数据差异具有统计学意义(P<0.01);干预后实验组患者和对照组患者的满意度分别为97.0%、72.7%,实验组患者满意度高于对照组,实验数据差异具有统计学意义(P<0.01)。 结论 三主体双轨道交互式护理干预模式激发患者的主观能动性,改善患者的心理状态,提高患者的生存质量,具有重要的推广价值。      

不同针法分期治疗肩关节周围炎90例

ObjectiveTo observe the clinical efficacy of different acupuncture modalities in the treatment of adhesive capsulitis a tthrough different clinical stages.MethodsNinety patients of adhesive capsulitis weregraded in three different stages based on clinical presentations. Patients in painful stage were treated with silver needles once every 5to 7 days for two courses; patients in adhesive stage were given acupotomy treatment every 7 to 10 days for two courses; while patients in recovery stage were treated with acupuncture with warm needles by moxibustion on tendon knots, once a day 10 times in a course, for two courses of treatment. The disease scores were compared between all groups before and after the treatment, and clinical efficacy was evaluated after the treatment.ResultsThe disease scores in patients of all three stages were higher after treatment, and the differences were statistically significant (all P < 0.05). Among 90 patients with adhesive capsulitis, 32 cases were clinically under controlled, 37 cases claimed remarkably effective, 18 were effective, and 3 ineffective cases, thus the total effective rate for this stage-based treatment is 96.7%.ConclusionFor adhesive capsulitis,different acupuncture modalities targeting patients in different clinical stages were feasible and effective, the disease scores of patients were significantly improved.     

Long non-coding RNA TPTEP1 exerts inhibitory effects on hepatocellular carcinoma by impairing microRNA-454-3p-mediated DLG5 downregulation

BackgroundHepatocellular carcinoma (HCC) is usually diagnosed at late stages, making it the second cause of malignancy-related death across the world. Long noncoding RNAs (lncRNAs) are of significance to tumorigenesis, highly suggestive of their functional roles as novel biomarkers for cancer therapy. The current study investigated the specific role of lncRNA TPTE pseudogene 1 (TPTEP1) in HCC.MethodsExpression of lncRNA TPTEP1, microRNA-454-3p (miR-454-3p) and discs large homolog 5 (DLG5) was determined in tissues samples from the recruited patients with HCC. Cell proliferation, migration and invasion assays were performed to determine effects of lncRNA TPTEP1, miR-454-3p and DLG5 on the malignant phenotype of tumor cells. Finally, the mouse HCC model was also established to disclose the tumor suppressor effects of lncRNA TPTEP1 in vivo.ResultsLncRNA TPTEP1 was downregulated both in HCC cells and tissues, and played a negative regulatory role in HCC cell proliferation, migration and invasion. Mechanistically, lncRNA TPTEP1 competitively bound to miR-454-3p, thereby upregulating its endogenous target DLG5. Moreover, lncRNA TPTEP1 hindered activation of the protein kinase B signaling pathway, causing inhibited malignant phenotypes of HCC cells. Also, lncRNA TPTEP1 suppressed tumor growth and extrahepatic metastasis (lung) via miR-454-3p/DLG5 axis.ConclusionTaken together, this research revealed a concrete mechanism of lncRNA TPTEP1 in HCC.     

急性淋巴细胞白血病患儿甲氨蝶呤转运蛋白及代谢酶基因多态性的研究进展

大剂量甲氨蝶呤治疗儿童急性淋巴细胞白血病的疗效及不良反应具有明显的个体差异。大剂量甲氨蝶呤治疗反应的多样性与甲氨蝶呤相关转运蛋白如溶脂载体转运蛋白、ABC转运蛋白以及甲氨蝶呤代谢相关酶如亚甲基四氢叶酸还原酶、二氢叶酸还原酶、胸腺嘧啶核苷酸合成酶、氨基咪唑胺甲酰转移酶等密切相关。本文就甲氨蝶呤代谢途径,甲氨蝶呤转运蛋白及代谢酶基因多态性对其疗效、不良反应的影响作一综述。