Venetoclax alone or in combination with other regimens treatment achieve deep and sustained remission of relapsed/refractory chronic lymphocytic leukemia: a meta-analysis

Clinical and Experimental Medicine - Recently, the use of novel targeted drugs significantly improved the overall response rate (ORR) and survival of patients with relapsed/refractory chronic...     

针刺配合推拿、跌打追风酒外敷治疗肩周炎的临床疗效分析

目的:探寻肩周炎患者临床有效的治疗方法。方法:从我院2018年治疗的肩周炎患者中随机抽取80例,采取双盲筛选法将其均分为对照组与观察组各40例,分别接受针刺治疗及针刺+推拿+跌打追风酒外敷治疗,对比两组临床效果。结果:观察组总有效率、治疗满意度均显著高于对照组(P<0.05)。结论:针刺+推拿+跌打追风酒外敷联合治疗方案可有效改善肩周炎患者的临床症状,促使患者早日恢复,值得临床广泛推广运用。     

带中心孔植入式透镜（V4c-ICL）矫正高度近视的视觉质量研究

目的　观察高度近视患者植入带中心孔植入式透镜（implantable collamer lens，ICL）后的临床疗效和视觉相关的生活质量。方法　前瞻性病例研究。选取我院诊断为高度近视，并植入V4c-ICL患者25例（50眼）为研究对象。术前及术后1个月、3个月、6个月分别检查患者屈光状态，裸眼远、中、近视力，最佳矫正远视力，远视力矫正下中、近视力，双眼视力，眼压，角膜内皮细胞密度（corneal endothelial cell density，ECD），并进行国家眼科研究所视功能问卷-25（national eye institute-visual function questionnaire，NEI-VFQ-25）调查及评分。结果　高度近视患者植入V4c-ICL后不同时间球镜、柱镜、等效球镜（spherical equivalent，SE）度较术前均明显降低（F=884.35、17.15、810.25，均为P＜0.05）；术后不同时间裸眼远、中、近视力，最佳矫正远视力，远视力矫正下中、近视力和双眼视力较术前均明显改善（F=604.47、878.13、713.92、22.25、5.33、6.90、16.51，均为P＜0.05）。术前及术后随访期间眼压、ECD无明显变化（F=0.07、1.53，均为P＞0.05）；术后NEI-VFQ-25评分较术前明显提高（F=21.76，P＜0.05）。结论　高度近视患者植入V4c-ICL后屈光不正得到矫正、短期内屈光稳定，随访期间远、中、近视力明显提高，视觉相关的生活质量明显改善。V4c-ICL植入术治疗高度近视安全、有效。     

安全感在护士评价恐惧与情绪表达冲突中的中介作用

目的调查护士安全感、评价恐惧及情绪表达冲突现状,探讨安全感在护士评价恐惧与情绪表达冲突中的中介作用,为护士有效应对情绪表达提供依据。方法采用安全感量表、正面评价恐惧与负面评价恐惧量表及情绪表达冲突问卷对161名护士进行调查。结果护士的安全感总分(53.84±12.44)分;正面评价恐惧总分(31.78±15.27)分、负面评价恐惧总分(24.89±7.48)分;情绪表达冲突总分(96.26±23.20)分。安全感在正面评价恐惧与情绪表达冲突之间起完全中介作用,在负面评价恐惧与情绪表达冲突之间起部分中介作用。结论护士的安全感、情绪表达冲突处于中等水平,存在着对正面评价及负面评价的恐惧。安全感在护士评价恐惧与情绪表达冲突中起到中介作用。可通过提升安全感及正确对待负面评价,以降低评价恐惧对情绪表达冲突的影响。     

Protective activities of ellagic acid and urolithins against kidney toxicity of environmental pollutants: A review

Oxidative stress and inflammation are two possible mechanisms related to nephrotoxicity caused by environmental pollutants. Ellagic acid, a powerful antioxidant phytochemical, may have great relevance in mitigating pollutant-induced nephrotoxicity and preventing the progression of kidney disease. This review discusses the latest findings on the protective effects of ellagic acid, its metabolic derivatives, the urolithins, against kidney toxicity caused by heavy metals, pesticides, mycotoxins, and organic air pollutants. We describe the chelating, antioxidant, anti-inflammatory, antifibrotic, antiautophagic, and antiapoptotic properties of ellagic acid to attenuate nephrotoxicity. Furthermore, we present the molecular targets and signaling pathways that are regulated by these antioxidants, and suggest some others that should be explored. Nevertheless, the number of reports is still limited to establish the efficacy of ellagic acid against kidney damage induced by environmental pollutants. Therefore, additional preclinical studies on this topic are required, as well as the development of well-designed clinical trials.     

Aprepitant exerts anti-fibrotic effect via inhibition of TGF-β/Smad3 pathway in bleomycin-induced pulmonary fibrosis in rats

Bleomycin is a well-recognized antineoplastic drug. However, pulmonary fibrosis (PF) is considered to be the principal drawback that greatly limits its use. Here, we sought to investigate ability of the neurokinin receptor 1 blocker, aprepitant, to prevent PF caused by bleomycin. Male adult Wistar rat groups were given a single intratracheal injection of bleomycin, either alone or in combination with aprepitant therapy for 3 or 14 days. Collagen deposition and a rise in transforming growth factor beta (TGF-β) immunoreactivity in lung tissue serve as evidence of bleomycin-induced PF. The serum levels of lactate dehydrogenase, alkaline phosphatase, and total antioxidant improved after aprepitant therapy.Additionally, it reduced the protein expressions of interferon alpha, tumor necrosis factor alpha, and lung lipid peroxidation. Moreover, aprepitant treatment led to an increase in the antioxidant indices glutathione, glutathione peroxidase, and catalase. Aprepitant is postulated to protect against bleomycin-induced PF by decreasing TGF-β, phosphorylating Smad3, and increasing interleukin 37, an anti-fibrotic cytokine, and G Protein-coupled Receptor Kinase 2. Aprepitant for 14 days considerably exceeded aprepitant for 3 days in terms of improving lung damage and having an anti-fibrotic impact. In conclusion, aprepitant treatment for 14 days may be used as an adjuvant to bleomycin therapy to prevent PF, mostly through inhibiting the TGF-/p-Smad3 fibrotic pathway.     

miR-148a 靶向HMGB3抑制非小细胞肺癌细胞迁移、侵袭和增强顺铂抗肿瘤效应的机制研究

目的:探讨miR-148a靶向HMGB3抑制非小细胞肺癌细胞迁移和侵袭的作用机制。方法:采用RT-qPCR和Western blot检测非小细胞肺癌组织和癌旁组织标本中miR-148a和HMGB3相对表达水平；以A549、H1299细胞为研究对象，Transwell和MTT法分别检测过表达miR-148a、敲低HMGB3和DDP干预对细胞迁移、侵袭及细胞活力的影响；TargetScan在线预测、双荧光素酶报告基因实验和Western blot验证miR-148a与HMGB3的靶向关系；miR-148a过表达或敲减HMGB3并联合DDP，Transwell和MTT法检测细胞迁移、侵袭和细胞活力。结果:非小细胞癌组织中miRNA-148a表达明显下调（P<0.05），HMGB3在mRNA和蛋白水平表达均明显上调（P<0.05），miR-148a与HMGB3表达呈负相关（r=-0.856 8，P<0.000 1）；过表达miR-148a或敲低HMGB3能明显抑制细胞迁移和侵袭（P<0.05），过表达miR-148a或敲低HMGB3联合DDP干预，细胞活力明显下降（P<0.05）；TargetScan在线预测、双荧光素酶报告基因实验和Western blot检测表明miR-148a能调控HMGB3表达。结论:miR-148a在非小细胞肺癌组织中表达下调，HMGB3是miR-148a的靶基因，过表达miR-148a能抑制HMGB3表达从而抑制非小细胞肺癌细胞A549、H1299迁移和侵袭并增强顺铂抗肿瘤效应。     

CT引导下不同路径经皮肺穿刺活检诊断胸膜下结节

目的探讨CT引导下不同路径经皮肺穿刺活检(PTNB)诊断胸膜下结节的价值。方法 147例胸膜下结节患者接受CT引导下PTNB,根据穿刺针与胸膜角度分为长路径组(穿刺针与胸膜角度≤50°,83例)与短路径组(穿刺针与胸膜角度50°,64例),比较两组诊断准确率、单次穿刺成功率及术后出血、气胸等并发症,分析两组中直径≤10 mm、10～20 mm、≥20 mm结节之间调针次数、穿刺时间、患者气胸及出血发生率的差异。结果 2组诊断准确率、单次穿刺成功率及气胸、出血发生率差异均无统计学意义(P均0.05)。长路径组对于直径≤10 mm及10～20 mm结节的调针次数及穿刺时间均短于短路径组(P均0.05)。结论 CT引导下不同路径PTNB对胸膜下结节均具有较高诊断准确率。对直径20 mm胸膜下结节建议长路径穿刺。     

雅安市社区在管严重精神障碍患者现状研究

目的了解雅安市社区在管严重精神障碍患者的现况,为改进雅安市严重精神障碍管理治疗工作提出可行性建议。方法采用分层随机抽样的方法,抽取雅安市纳入社区管理的严重精神障碍患者1 002例,采用重性精神疾病管理随访表调查患者规范管理情况、服药情况、居家稳定情况以及肇事肇祸情况。结果完成有效问卷803份,雅安市社区在管严重精神障碍患者规范管理率为93. 03%(95%CI:91. 30%~94. 80%),服药率为65. 13%(95%CI:61. 80%~68. 40%),规律服药率为50. 44%(95%CI:47. 00%~53. 90%),居家稳定率为90. 78%(95%CI:88. 80%~92. 80%)。肇事肇祸发生率为4. 61%(95%CI:3. 20%~6. 10%)。结论雅安市严重精神障碍患者规范管理率、规律服药率达到国家标准,服药率尚未达到国家标准,居家稳定率较高,肇事肇祸率较低。