Prenatal exposure to di-n-butyl phthalate (DBP) differentially alters androgen cascade in undeformed versus hypospadiac male rat offspring

This study was to compare the alterations of androgen cascades in di-n-butyl phthalate (DBP)-exposed male offspring without hypospadias (undeformed) versus those with hypospadias. To induce hypospadias in male offspring, pregnant rats received DBP via oral gavage at a dose of 750 mg/kg BW/day during gestational days 14–18. The mRNA expression levels of genes downstream of the androgen signaling pathway, such as androgen receptor (AR) and Srd5a2, in testes of undeformed rat pups were similar to those in controls; in hypospadiac rat pups these levels were significantly lower than those of control pups. In contrast, both undeformed and hypospadiac rats had decreased serum testosterone levels, reduced mRNA expression of key enzymes in the androgen synthetic pathway in the testes, and ablated genes of developmental pathways, such as Shh, Bmp4, Fgf8, Fgf10 and Fgfr2, in the genital tubercle (GT) as compared to those in DBP-unexposed controls, albeit hypospadiac rats had a more severe decrement than those of undeformed rats. Although other possibilities cannot be excluded, our findings suggest that the relatively normal levels of testosterone-AR-Srd5a2 may contribute to the resistance to DBP toxicity in undeformed rats. In conclusion, our results showed a potential correlation between decreased testosterone levels, reduced mRNA expression of AR and Srd5a2 and the occurrence of hypospadias in male rat offspring prenatally exposed to DBP.     

微小RNA在新生儿缺血缺氧性脑病中的表达

微小RNA(miRNA)是一类高度保守的内源性小分子RNA。miRNA主要通过选择性结合mRNA调控基因表达。目前研究结果表明，中枢神经系统存在大量miRNA，并参与神经细胞的正常生长、发育，以及组织损伤修复、肿瘤发生、神经退行性变等多种病理、生理过程。笔者拟就新生儿缺血缺氧性脑病(HIE) miRNA谱系的最新研究进展进行阐述，探讨其miRNA特异性表达，对新生儿HIE诊断和预后判断的意义，旨在为该病的相关诊治研究提供参考。     

中西医结合促排卵治疗肾精不足型多囊卵巢综合征不孕症的临床观察

目的观察育肾通络颗粒联合氯米芬促排卵治疗肾精不足型多囊卵巢综合征(PCOS)不孕症的临床疗效。方法纳入62例肾精不足型PCOS不孕症患者,随机分为治疗组(31例)和对照组(31例)。两组患者均在月经周期或孕酮撤退性出血第5天开始口服枸橼酸氯米芬片,连服5 d;在此基础上,治疗组患者于经净后予育肾通络颗粒口服,对照组患者予育肾通络颗粒模拟剂口服,直至排卵期。两组疗程均为3个月经周期。评价两组的临床疗效,比较两组患者的妊娠情况及中医证候积分,通过阴道超声监测患者的排卵情况和排卵期子宫内膜厚度,比较两组未妊娠患者治疗前后的睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)水平及LH/FSH比值。结果①治疗后,治疗组和对照组的总有效率分别为96.8%和90.3%,两组临床疗效差异具有统计学意义(P0.05),治疗组疗效优于对照组。②治疗组和对照组患者的排卵率分别为91.5%和75.9%,治疗组患者的排卵率高于对照组(P0.05)。③治疗过程中,治疗组患者的妊娠率为54.8%,对照组患者的妊娠率为35.5%,两组妊娠率比较,差异无统计学意义(P0.05)。④治疗后,治疗组患者的中医证候积分明显降低(P0.01),且治疗组患者的积分明显低于对照组(P0.01)。⑤在治疗的第1、第2、第3月经周期中,治疗组患者的排卵期子宫内膜厚度较对照组均明显增厚(P0.01)。⑥治疗后,两组未妊娠患者的T、LH水平及LH/FSH比值较治疗前均明显降低(P0.05),且治疗组患者的LH/FSH比值低于对照组(P0.05)。结论育肾通络颗粒联合氯米芬治疗肾精不足型PCOS不孕症具有协同作用,可明显提高患者的排卵率,改善中医证候,增加子宫内膜厚度,改善性激素水平,其总体临床疗效优于单用氯米芬治疗。     

尿毒症相关性不安腿综合征的发病机制研究进展

尿毒症是继发性不安腿综合征最常见的病因之一，但相关机制尚未完全阐明。在尿毒症相关性不安腿综合征的发病机制中，间脑多巴胺能神经元受损所致的功能障碍、铁缺乏对运动障碍的直接调控及通过影响多巴胺能系统的间接调控、持续性的血液透析所致的静息状态、对硫铵代谢的影响等扮演重要角色。此外，周围神经病变、钙磷不平衡、基因、毒素刺激等因素可能也参与了尿毒症相关性不安腿综合征的发生与发展。     

某社区2019年第二类疫苗接种疑似预防接种异常反应监测结果

目的了解某社区第二类疫苗接种及疑似预防接种异常反应(AEFI)情况。方法通过查询疫苗出入库系统和中国免疫规划信息管理系统,对2019年该社区第二类疫苗使用及AEFI报告情况进行分析。结果2019年,该社区接种门诊共接种第二类疫苗21种7449剂,接种数最多的是13价肺炎疫苗(784剂)。接种数居前6位的依次为13价肺炎疫苗、ACYW135群流脑多糖疫苗、轮状病毒疫苗、百白破-IPV-HIB五联疫苗、手足口EV71疫苗、九价人乳头瘤疫苗。累计报告AEFI病例94例,发生率为1.26%;一般反应占96.81%,异常反应占3.19%。报告AEFI疫苗共12种,报告发生率居前6位的分别为13价肺炎疫苗、百白破-IPV-HIB五联疫苗、百白破-IPV-HIB四联疫苗、手足口EV71疫苗、九价HPV疫苗、AC结合流脑疫苗。结论第二类疫苗品种接种量均有所增加,AEFI报告发生率有所波动,需加强监测。     

Expression of co-inhibitory molecules B7-H4 and B7-H1 in Epstein-Barr virus positive diffuse large B-cell lymphoma and their roles in tumor invasion

To investigate the relationship between immunoregulatory molecules B7-H4 and B7-H1 in Epstein-Barr positive diffuse large B-cell lymphoma (EBV⁺DLBCL). Immunohistochemistry was used to detect the expression of B7-H4 and B7-H1 in tumor tissues of 13 patients with EBV⁺DLBCL. The expression levels of B7-H4 and B7-H1 in four diffuse large B-cell lymphoma cell lines (SU-DHL-4, SU-DHL-10, SU-DHL-6, Pfeiffer) were analyzed by flow cytometry. Transwell invasion assays were conducted to observe the invasive ability of cell lines. B7-H4 and B7-H1 were expressed in 84.62% and 100% tumor specimens of EBV⁺DLBCL. The overexpression of B7-H4 and B7-H1 was found in 46.15% and 23.08% tumor samples of EBV⁺DLBCL. There was a medium negative correlation between the expression levels of B7-H4 and B7-H1 (r = -0.667, P = 0.013, spearman rank correlation). The expression levels of B7-H1 in four diffuse large B-cell lymphoma cell lines were positively correlated with their invasive ability, whereas the expression levels of B7-H4 were not. Here, we provide evidence for the negative relationship between B7-H4 and B7-H1 in EBV⁺DLBCL. The expression of B7-H1 in EBV⁺DLBCL appears to be the dominant factor which affects tumor aggressiveness. When B7-H1 expression weakens, the molecule B7-H4 may become the dominant factor of prognosis in patients with EBV⁺DLBCL.     

高中生睡眠质量现状及影响因素分析

  目的  研究高中生睡眠质量现状及影响因素, 为有针对性地改善高中生睡眠质量提供依据。  方法  2020年在中国4个区域(上海、青海、澳门、河南)招募各年级高中生4 793名, 问卷收集人口统计学信息、睡眠情况、精神状况、生活习惯等信息, 采用描述性统计和Logistic回归方法分析高中生睡眠质量及影响因素。  结果  高中生睡眠障碍检出率为24.2%, 睡眠时间 < 7 h/d者占71.4%。单因素分析显示, 人际关系敏感、抑郁、焦虑症状、学习压力、家庭压力、人际关系压力对高中生睡眠障碍影响有统计学意义(χ2值分别为1 147.98, 1 228.35, 1 032.54, 371.05, 497.61, 475.39, P值均 < 0.01)。咖啡浓茶、饮酒、吸烟(包括二手烟)、电子产品使用、晚睡、睡前饮食、不良睡眠环境、父母患睡眠障碍与高中生睡眠障碍发生呈正相关, 规律运动与高中生睡眠障碍发生呈负相关(χ2值分别为160.28, 127.73, 108.02, 113.27, 470.91, 340.95, 72.02, 155.53, 116.30, 76.96, 28.75, 12.89, P值均 < 0.05)。  结论  高中生睡眠质量有待改善。学校及家长应注意高中生的心理健康及生活习惯, 帮助高中生提升睡眠质量, 顺利成长。     

The Use of Lipoprotein-Associated Phospholipase A2 in a Chinese Population to Predict Cardiovascular Events

Objective To explore associations between lipoprotein-associated phospholipase A2(Lp-PLA2) and the risk of cardiovascular events in a Chinese population, with a long-term follow-up.Methods A random sample of 2,031 participants(73.6% males, mean age = 60.4 years) was derived from the Asymptomatic Polyvascular Abnormalities Community study(APAC) from 2010 to 2011. Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay(ELISA). The composite endpoint was a combination of first-eve...     

药源性运动障碍的特点与诊治进展

探讨药源性运动障碍的致病机制、疾病种类与特点和诊治进展,以提高对该类疾病的认识及诊治水平。使用检索词"药源性""运动障碍""迟发性综合征""帕金森""肌张力障碍""肌阵挛"等在Pubmed、万方数据、中国知网等数据库中检索相关文献,并结合临床治疗经验,进行文献复习。目前药源性运动障碍致病机制并不十分明确,但对症治疗基本有效。药源性运动障碍治疗控制难度大,容易诱发其他不良反应,因此预防显得尤为重要。