基于太赫兹时域光谱技术的名贵动物药材龟甲的真伪品鉴别

目的： 建立一种利用太赫兹时域光谱和多种化学计量学方法鉴别龟甲真伪的新方法。方法： 选用正品乌龟和伪品红耳彩龟的腹甲进行实验,先用经典的性状鉴别、显微鉴别方法比较两种样品的典型性状特征,后利用太赫兹时域光谱仪测得样品的光谱信息,对样品谱图进行平滑处理和基线校准,并运用化学计量方法进行数据分析以区分正品和伪品龟甲。结果： 性状鉴别结果显示完整正、伪品龟甲样品仅有细微差异,且其碎片或粉末基本无差异;显微鉴别未在两种样品中发现明显的特征差异性结构;两种样品的太赫兹时域光谱曲线图经快速傅里叶变换滤波器平滑滤波处理、正交偏最小二乘法判别分析处理后呈现显著差异。结论： 利用太赫兹时域光谱技术结合正交偏最小二乘法判别分析可以实现龟甲真伪品的精准鉴别。     

胆道镜辅助Glission蒂横断法在腹腔镜左半肝切除治疗左肝内胆管结石的应用

目的：　探讨腹腔镜下胆道镜辅助Glisson蒂法解剖性左半肝切除治疗左肝内胆管结石的可行性。方法：　回顾性分析2016年12月至2020年2月中国人民解放军西部战区总医院全军普外中心采用腹腔镜下胆道镜辅助Glisson蒂法解剖性左半肝切除处置的10例左肝内胆管结石患者的临床资料。结果：　10例患者中男性4 例,女性6 例;年龄45~68 岁;10例患者均手术成功,手术时间245（200,320） min,术中出血300（200,650） mL,术中左肝蒂在胆道镜引导下采用一次性切割吻合器离断,离断位置良好,无一例出现保留侧胆管损伤,无一例出现大出血和胆漏;无一例出现中转开腹;术后不良事件轻微,1例患者出现轻微漏胆,1例出现少量胸腔积液,Clavien-Dindo并发症分级均为Ⅱ级,经保守治疗后痊愈;恢复流质饮食时间90~102 h,术后住院时间8~13 d,住院费用为（4.02±0.36）万元。结论：　腹腔镜下胆道镜辅助Glisson蒂法解剖性左半肝切除治疗左肝内胆管结石在器械、技术保障下是安全、可行的,且不会增加患者住院费用。     

不同频率神经肌肉电刺激对ARDS相关性ICU-AW小鼠肌肉萎缩防治及临床意义

目的 不同频率下神经肌肉电刺激(neuromuscular electrical stimulation,NMES)在ARDS相关性ICU获得性衰弱(ICU-acquired weakness,ICU-AW)中的作用及机制。方法 健康雄性C57BL/6小鼠88只随机分为11组,每组8只。分为:空白对照组(C1)、气管内注入无菌水组(C2)、ICU-AW模型组(ICU-AW)、ICU-AW+AMPK激动剂A-769662组(ICU-AW-A)、ICU-AW+A-769662溶剂对照组(ICU-AWV)、NMES 20 Hz组(ICU-AW-20)、NMES 40 Hz组(ICU-AW-40)、NMES 60 Hz组(ICU-AW-60)、NMES80 Hz组(ICU-AW-80)、ICU-AW-40+AMPK抑制剂Compound C组(ICU-AW-40-C)、ICU-AW-40+Compound C溶剂对照组(ICU-AW-40-V)。检测小鼠四肢抓力和存活状态,7 d后收集小鼠肺组织和腓肠肌标本,采用HE染色观察肺和肌肉病理学变化,采用western blot以及qRT-PCR的方...     

柚皮苷激活Maxi K对糖尿病心脏的保护作用

目的探讨柚皮苷(naringin, NA)通过激活大电导钙激活钾离子通道(the large conductance Ca;activated K;channels, Maxi K)对糖尿病心肌病的保护作用。方法高脂饲料喂养SD大鼠,随后腹腔注射链脲佐菌素(streptozotocin, STZ)建立糖尿病大鼠模型。造模后随机分为模型组(DCM),柚皮苷治疗组(NA),柚皮苷+Maxi K特异性抑制剂治疗组(NA+PAX),每组8只大鼠。治疗组大鼠连续给药12周,定期检测血糖。结束后观察大鼠心功能、形态及纤维化改变;并检测心脏Maxi K的α及β亚基变化。结果超声显示NA可部分恢复大鼠心功能,而特异性阻断Maxi K后,NA对心脏的保护作用明显下降;纤维化分析显示NA治疗后可降低大鼠胶原蛋白及纤连蛋白表达,该作用可被PAX部分逆转;而Western blot结果显示Maxi Kα及β亚基在DCM组表达下降,NA治疗后无明显改变。结论柚皮苷通过促进细胞膜表面Maxi K通道开放而非增加其表达产生对糖尿病大鼠的心脏保护作用。     

阈下抑郁症评估工具在老年人中的应用现状

随着老龄化进程加速,我国老年抑郁症患病形势十分严峻。阈下抑郁症被认为是抑郁症的“临床前”阶段,与健康人相比,可能导致更高的自杀风险、疾病负担和功能损害。正确识别与评估阈下抑郁症对提高老年心理健康水平、实现健康老龄化具有深刻意义。本文对老年人阈下抑郁症的概念、国内外的评估工具进行综述,分析比较了不同工具的内容、测验方法、适用范围,以助相关临床工作者恰当选用。     

ZDHHC9 promotes colon tumor growth by inhibiting effector T cells

Zinc finger DHHC-type palmitoyltransferase 9 (ZDHHC9) has been reported to play an important role in the occurrence and development of several types of cancer. However, its effects on colon cancer growth remain unclear. Using Gene Expression Profiling Interactive Analysis and Tumor Immune Estimation Resource, data obtained from The Cancer Genome Atlas were analyzed, and the results showed that ZDHHC9 was highly expressed in colon cancer and that patients with higher ZDHHC9 expression levels had a worse prognosis. Inhibition of ZDHHC9 expression promoted the proliferation of colon cancer cells in vitro but decreased their growth in vivo. Additionally, inhibition of ZDHHC9 expression in cancer cells enhanced CD8⁺ T cell-mediated cytotoxicity in vitro and increased CD8⁺ T infiltration and activation in vivo. Furthermore, ZDHHC9 promoted IFN-γ-induced JAK/STAT1 activation and upregulated programmed death-ligand 1 (PD-L1) expression in colon cancer cells. In conclusion, the present findings showed that ZDHHC9 promoted colon cancer growth by upregulating the expression of PD-L1 and inhibiting the function of CD8⁺ T cells.     

Clinical course and outcomes of COVID-19 patients with chronic obstructive pulmonary disease: A retrospective observational study in Wuhan,China

Information about coronavirus disease 2019 (COVID-19) patients with pre-existing chronic obstructive pulmonary disease (COPD) is still lacking. The aim of this study is to describe the clinical course and the outcome of COVID-19 patients with comorbid COPD.This retrospective study was performed at Wuhan Huoshenshan Hospital in China. Patients with a clear diagnosis of COVID-19 who had comorbid COPD (N = 78) were identified. COVID-19 patients without COPD were randomly selected and matched by age and sex to those with COPD. Clinical data were analyzed and compared between the two groups. The composite outcome was the onset of intensive care unit admission, use of mechanical ventilation, or death during hospitalization. Multivariable Cox regression analyses controlling for comorbidities were performed to explore the relationship between comorbid COPD and clinical outcome of COVID-19.Compared to age- and sex-matched COVID-19 patients without pre-existing COPD, patients with pre-existing COPD were more likely to present with dyspnea, necessitate expectorants, sedatives, and mechanical ventilation, suggesting the existence of acute exacerbations of COPD (AECOPD). Greater proportions of patients with COPD developed respiratory failure and yielded poor clinical outcomes. However, laboratory tests did not show severer infection, over-activated inflammatory responses, and multi-organ injury in patients with COPD. Kaplan–Meier analyses showed patients with COPD exhibited longer viral clearance time in the respiratory tract. Multifactor regression analysis showed COPD was independently correlated with poor clinical outcomes.COVID-19 patients with pre-existing COPD are more vulnerable to AECOPD and subsequent respiratory failure, which is the main culprit for unfavorable clinical outcomes. However, COPD pathophysiology itself is not associated with over-activated inflammation status seen in severe COVID-19.     

Rasal2在肺动脉平滑肌细胞增殖及迁移中的作用机制

目的 探讨Ras蛋白激活类似物2(Rasal2)调控肺动脉平滑肌细胞(PASMCs)增殖与迁移的作用机制。方法 提取慢性-低氧小鼠肺动脉组织以及使用低氧条件刺激PASMCs,检测Rasal2表达变化。体外沉默Rasal2后检测各组哺乳动物雷帕霉素靶蛋白复合体1(mTORC1)下游效应分子S6、4EBP1的蛋白磷酸化变化,Ki-67免疫荧光染色与Transwell分析检测各组细胞增殖与迁移能力变化。使用胰岛素恢复mTORC1活性,检测各组增殖与迁移能力变化。结果 与常氧小鼠(Normoxic)相比,慢性低氧组小鼠(CH-PH)肺动脉Rasal2 mRNA[(2.57±0.15)和(1.02±0.09),P<0.001]和蛋白[(2.18±0.36)和(0.97±0.14),P<0.001]表达显著升高。与常氧组(Normoxic)细胞相比,低氧组(Hypoxic)细胞处理12、24 h后Rasal2 mRNA[(2.41±0.20)、(2.86±0.24)和(1.03±0.12);均P<0.001]和蛋白[(2.50±0.32)、(2.79±0.38)和(1.13±0....     

Extensive analysis of the molecular biomarkers excision repair cross complementing 1, ribonucleotide reductase M1, β-tubulin III,thymidylate synthetase,and topoisomerase IIα in breast cancer: Association with clinicopathological characteristics

Excision repair cross complementing 1 (ERCC1), ribonucleotide reductase M1 (RRM1), β-tubulin III (TUBB3), thymidylate synthetase (TYMS), and topoisomerase IIα (TOP2A) genes have been shown to be associated with the pathogenesis and prognosis of various types of carcinomas; however, their roles in breast cancer have not been fully validated. In this study, we evaluated the correlations among these biomarkers and the associations between their expression intensity and the clinicopathological characteristics to investigate whether the above genes are underlying biomarkers for patients with breast cancer.Ninety-seven tissue specimens collected from breast cancer patients. The expression levels of these biomarkers were measured by the multiplex branched DNA liquidchip (MBL) technology and clinicopathological characteristics were collected simultaneously.The expression levels of ERCC1, TUBB3, TYMS, and TOP2A were significantly associated with the characteristics of menopausal status, tumor size, lymph node metastasis, hormone receptor status, triple-negative status, Ki-67 index, and epidermal growth factor receptor. The expression intensity of ERCC1 negatively associated with that of TUBB3 and TYMS, and positively associated with that of RRM1. The expression intensity of TOP2A positively associated with that of TYMS. Hierarchical clustering analysis and difference test indicated that breast cancer with higher levels of TUBB3, TYMS, and TOP2A, as well as lower levels of ERCC1 and RRM1 tended to have higher histological grade and Ki-67 index.Our studies showed that ERCC1, TYMS, TUBB3, and TOP2A may be potential biomarkers for prognosis and individualized chemotherapy guidance, while there may be interactions between ERCC1 and RRM1, or TUBB3, or TYMS, as well as between TOP2A and TYMS in pathogenesis and development of breast cancer.     

Association Between Lipid Profiles and Left Ventricular Hypertrophy: New Evidence from a Retrospective Study

ObjectiveTo explore the association between lipid profiles and left ventricular hypertrophy in a Chinese general population.MethodsWe conducted a retrospective observational study to investigate the relationship between lipid markers [including triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL-cholesterol, apolipoprotein A-I, apolipoprotein B, lipoprotein[a], and composite lipid profiles] and left ventricular hypertrophy. A total of 309,400 participants of two populations (one from Beijing and another from nationwide) who underwent physical examinations at different health management centers between 2009 and 2018 in China were included in the cross-sectional study. 7,475 participants who had multiple physical examinations and initially did not have left ventricular hypertrophy constituted a longitudinal cohort to analyze the association between lipid markers and the new-onset of left ventricular hypertrophy. Left ventricular hypertrophy was measured by echocardiography and defined as an end-diastolic thickness of the interventricular septum or left ventricle posterior wall > 11 mm. The Logistic regression model was used in the cross-sectional study. Cox model and Cox model with restricted cubic splines were used in the longitudinal cohort.ResultsIn the cross-sectional study, for participants in the highest tertile of each lipid marker compared to the respective lowest, triglycerides [odds ratio (OR): 1.250, 95%CI: 1.060 to 1.474], HDL-cholesterol (OR: 0.780, 95%CI: 0.662 to 0.918), and lipoprotein(a) (OR: 1.311, 95%CI: 1.115 to 1.541) had an association with left ventricular hypertrophy. In the longitudinal cohort, for participants in the highest tertile of each lipid marker at the baseline compared to the respective lowest, triglycerides [hazard ratio (HR): 3.277, 95%CI: 1.720 to 6.244], HDL-cholesterol (HR: 0.516, 95%CI: 0.283 to 0.940), non-HDL-cholesterol (HR: 2.309, 95%CI: 1.296 to 4.112), apolipoprotein B (HR: 2.244, 95%CI: 1.251 to 4.032) showed an association with new-onset left ventricular hypertrophy. In the Cox model with forward stepwise selection, triglycerides were the only lipid markers entered into the final model.ConclusionLipids levels, especially triglycerides, are associated with left ventricular hypertrophy. Controlling triglycerides level potentiate to be a strategy in harnessing cardiac remodeling but deserve to be further investigated.