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1.
熊磊教授以理脾为本,将治痰贯穿始终。根据小儿脾常不足、肾常虚、肝常有余的生理特点,癫痫发作期治疗主以涤痰开窍,辅以理气健脾,同时配合活血化瘀通窍与平肝息风潜阳。主要选方为柴芍温胆汤、天麻钩藤饮、桃红四物汤加减;缓解期则以补肾养肝为主,兼以健脾化痰,主要选方为杞菊地黄丸合定痫丸加减,取得较好临床疗效。 相似文献
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背景:原发性线粒体病具有高度的临床和遗传异质性,其中周围神经是线粒体病的常见受累器官之一。
目的:总结COX20基因变异相关周围神经病的临床表型及遗传学特征。
设计:病例系列报告。
方法:回顾性收集2018年5月至2020年5月复旦大学附属儿科医院诊治的COX20基因变异相关周围神经病患儿的临床资料,总结其临床表现、基因检测结果及治疗效果,并以“COX20”、“线粒体复合物Ⅳ缺乏症(Complex Ⅳ deficiency)”为关键词检索中英文数据库。检索时间均为从建库至2021年12月。总结已报道COX20基因变异与临床表型的关系。
主要结局指标:临床表型和COX20基因变异位点。
结果:4例患儿纳入分析,男、女各2例,其中3例自幼运动发育落后。4例均在儿童期起病,均以行走不稳为首发症状。肌电图均提示多发性周围神经损害改变,感觉神经轴索受累为主。4例患儿均携带COX20基因复合杂合变异,包括错义变异2个,无义变异和移码变异各1个,其中移码变异c.262delG(p.E88Kfs*35)尚未见报道。文献复习目前共报道COX基因变异18个家系22例患儿(包括本文病例),起病中位年龄为5(1.0~17)岁,22例均以行走困难或步态不稳起病,11例(50.0%)有精神运动发育迟滞,病程中14例(63.6%)出现构音障碍,14例(63.6%)出现肌力下降和/或足部畸形,8例(36.4%)出现共济失调,6例(27.3%)出现肌张力障碍,5例(22.7%)存在认知倒退等。21例患儿行神经传导及肌电图检查,19例(90.5%)提示多发性周围神经病变。头颅(18例)及脊髓(10例)MR检查提示,脊髓萎缩4例(40%),小脑萎缩4例(22.2%)。9例患儿已无法独立行走,丧失独立行走能力中位年龄为10(7~21)岁。目前共报道9个变异位点,4种变异类型,其中错义变异5个,剪切变异2个,无义变异和移码变异各1个。
结论:COX20基因变异患者多早期起病,以周围神经系统病变为主要表现,可合并构音障碍、共济失调、肌张力障碍、认知倒退等,病情逐渐进展,致残率高。COX20基因变异类型以错义变异最常见。 相似文献
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Noninvasive imaging of cardiac fibrosis is important for early diagnosis and intervention in chronic heart diseases. Here, we investigated whether noninvasive, contrast agent-free MRI T2-mapping can quantify myocardial fibrosis in preclinical models of aging and pressure overload. Myocardial fibrosis and remodeling were analyzed in two animal models: (i) aging (15-month-old male CF-1 mice vs. young 6- to 8-week-old mice), and (ii) pressure overload (PO; by transverse aortic constriction in 4- to 5-month-old male C57BL/6 mice vs. sham-operated for 14 days). In vivo T2-mapping was performed by acquiring data during the isovolumic and early diastolic phases, with a modified respiratory and ECG-triggered multiecho TurboRARE sequence on a 7-T MRI. Cine MRI provided cardiac morphology and function. A quantitative segmentation method was developed to analyze the in vivo T2-maps of hearts at midventricle, apex, and basal regions. The cardiac fibrosis area was analyzed ex vivo by picro sirius red (PSR) staining. Both aged and pressure-overloaded hearts developed significant myocardial contractile dysfunction, cardiac hypertrophy, and interstitial fibrosis. The aged mice had two phenotypes, fibrotic and mild-fibrotic. Notably, the aged fibrotic subgroup and the PO mice showed a marked decrease in T2 relaxation times (25.3 ± 0.6 in aged vs. 29.9 ± 0.7 ms in young mice, p = 0.002; and 24.3 ± 1.7 in PO vs. 28.7 ± 0.7 ms in shams, p = 0.05). However, no significant difference in T2 was detected between the aged mild-fibrotic subgroup and the young mice. Accordingly, an inverse correlation between myocardial fibrosis percentage (FP) and T2 relaxation time was derived (R2 = 0.98): T2 (ms) = 30.45 – 1.05 × FP. Thus, these results demonstrate a statistical agreement between T2-map–quantified fibrosis and PSR staining in two different clinically relevant animal models. In conclusion, T2-mapping MRI is a promising noninvasive contrast agent-free quantitative technique to characterize myocardial fibrosis. 相似文献
7.
Yuxiang Ma Wenfeng Fang Hongyun Zhao Sai Praneeth Bathena Amol Tendolkar Jennifer Sheng Li Zhang 《The oncologist》2021,26(4):e549-e566
Lessons Learned
- The overall safety profiles of ipilimumab 3 mg/kg and 10 mg/kg administered every 3 weeks, were consistent between Chinese patients with solid tumors in the current study and patients from previous U.S. ipilimumab monotherapy studies. No new safety signals were identified.
- The mean systemic exposures to ipilimumab (assessed by first dose area under the curve during the dosing interval and maximum serum concentration) were numerically lower in the Chinese patient population than in U.S. patients for both 3 mg/kg and 10 mg/kg doses; however, the range of serum concentrations in the Chinese and U.S. populations overlapped (3 mg/kg and 10 mg/kg), suggesting that ipilimumab pharmacokinetics was ethnically insensitive in this study.
8.
Bortezomib is a novel proteasome inhibitor, which has been successfully used to treat mantle cell lymphoma and multiple myeloma. However, the direct effects of bortezomib on acute promyelocytic leukaemia (APL) have not been fully investigated. In the present study, the WST-8 assay, western blotting, flow cytometry, monodansylcadaverine staining and transmission electron microscopy were performed. It was demonstrated that bortezomib treatment induced a time- and dose-dependent decrease in the viability of NB4 cells. Bortezomib treatment induced cell apoptosis in NB4 cells, as assessed by Annexin V/propidium iodide analysis, and the detection of cleaved caspase-3, cleaved poly(ADP-ribose) polymerase, Bax and Bcl-2 expression. Furthermore, bortezomib treatment induced autophagy in NB4 cells, as indicated by autophagosome formation, p62 degradation, LC3-I to LC3-II conversion and formation of acidic autophagic vacuoles. Notably, autophagy induced by bortezomib was initiated prior to apoptosis. Inhibition of autophagy by knocking down Beclin-1 expression increased bortezomib-induced apoptosis in NB4 cells. Therefore, the present study revealed that the combination of bortezomib and autophagy inhibition may be a potential treatment strategy for APL. 相似文献
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采用文献复习和实证研究经验的方法对《医疗质量管理办法》中涉及的医疗质量概念及相关问题进行探讨。《医疗质量管理办法》中的医疗质量的定义存在重大缺失,没有涉及医疗服务的结果,特别是患者安全。医疗质量的定义应与国际相关权威机构保持一致,应高度重视医疗服务的结果,特别是患者安全。 相似文献