The usefulness of measuring n-butyric acid concentration as a new indicator of blood decomposition in forensic autopsy

In forensic medicine, although various alcohols have been reported as indicators of decomposition in collected blood, no studies have examined short-chain fatty acids as indicators. In this study, the blood n-butyric acid concentration was quantified, and the association between n-butyric acid and decomposition was investigated to determine whether the detection of n-butyric acid could be a new indicator of decomposition. Among the forensic autopsies performed from 2016 to 2018 in our laboratory, the cases were divided into decomposed (n = 20) and non-decomposed (n = 20) groups based on macroscopic findings. Blood samples collected at the time of autopsy were derivatized with 3-nitrophenylhydrazine hydrochloride after solid-phase extraction. The n-butyric acid concentration was measured using liquid chromatography–tandem mass spectrometry. In addition, ethanol and n-propanol were measured using a gas chromatography-flame ionization detector. There was a significant difference (p < 0.01) in the concentrations of n-butyric acid between the decomposed and non-decomposed groups (0.343 ± 0.259 [0.030–0.973] and 0.003 ± 0.002 [0.001–0.007] mg/mL, respectively). In the decomposed group, n-butyric acid was detected at high concentrations, even in cases where n-propanol was low. These results suggest that n-butyric acid is more likely to be an indicator of blood decomposition than n-propanol.     

复方丹参滴丸对老年冠心病患者血流变学、血脂及炎性反应递质的影响

目的：探究复方丹参滴丸对老年冠心病患者血流变学、血脂及炎性反应递质的影响。方法：选取2015年1月至2017年12月海南省人民医院收治的老年冠心病患者154例作为研究对象，按照随机数字表法随机分为对照组和观察组，每组77例。对照组采用常规西药治疗，观察组在此基础上加服复方丹参滴丸。比较治疗前后2组患者的血流变学、血脂、炎性反应递质和疗效。结果：观察组治疗有效率为92.21%，明显高于对照组治疗有效率79.22%，差异有统计学意义（P<0.05）。治疗后，2组总胆固醇（TC）、三酰甘油（TG）和低密度脂蛋白（LDL）水平均升高，差异有统计学意义（P<0.05），且观察组高于对照组，2组差异有统计学意义（P<0.05）。2组血流变学指标、高密度脂蛋白（HDL）、IL-6和TNF-α水平治疗后均降低（P<0.05），且观察组降低更明显，差异有统计学意义（P<0.05）。结论：复方丹参滴丸联合常规西药治疗冠心病患者，能够调节脂代谢，降低炎性反应，改善血流变学。     

石斛合剂对高脂高糖糖尿病大鼠心肌细胞Ca^2+代谢的影响

目的以糖尿病心肌病大鼠为研究对象,探讨石斛合剂对糖尿病心肌病心肌细胞Ca^2+代谢的影响。方法 Wistar大鼠24只,取5只作为正常组,余19只采用高脂高糖饮食联合链脲佐菌素腹腔注射进行糖尿病心肌病造模。成模后,随机分为模型组、二甲双胍组、石斛合剂组。二甲双胍组、石斛合剂组分别予二甲双胍、石斛合剂灌胃,正常组、模型组予生理盐水灌胃。4周后,测空腹血糖,取左心室心肌组织进行组织病理学观察和心肌细胞内游离钙(MyoCa^2+)浓度测定,Western blot法检测肌浆网Ca^2+-ATP酶(SERCA2a)、L型钙通道α1C亚单位蛋白(CACNA1C)蛋白表达,RT-PCR法测定SERCA2a mRNA表达。结果石斛合剂组心肌纤维较模型组、二甲双胍组排列整齐,断裂较少。与正常组比较,模型组血糖、心肌细胞MyoCa^2+含量和CACNA1C蛋白表达明显升高(P<0.01,P<0.05),SERCA2a mRNA和蛋白表达明显降低(P<0.01)。与模型组比较,石斛合剂组血糖、心肌细胞MyoCa^2+含量和CACNA1C蛋白表达明显降低(P<0.01,P<0.05),SERCA2a mRNA和蛋白表达明显升高(P<0.01,P<0.05);二甲双胍组血糖明显降低(P<0.01)。与二甲双胍组比较,石斛合剂组心肌细胞MyoCa^2+含量明显降低(P<0.01,P<0.05),血糖、SERCA2a mRNA和蛋白表达明显升高(P<0.05)。结论石斛合剂通过提高SERCA2a mRNA和蛋白表达,加快摄取Ca^2+的速率,降低细胞质Ca^2+负荷,缓解钙超载,最终达到维持糖尿病心肌病钙稳态的作用,有效维持心肌细胞的正常收缩舒张功能;其降糖作用不是预防糖尿病心肌病的主要机理,而在于抑制CACNA1C蛋白表达,抑制钙诱导钙释放过程。     

Molecular profiling of ctDNA in pancreatic cancer: Opportunities and challenges for clinical application

Pancreatic ductal adenocarcinoma (PDAC) is predicted to become the second leading cause of cancer-related mortality within the next decade, with limited effective treatment options and a dismal long-term prognosis for patients. Genomic profiling has not yet manifested clinical benefits for diagnosis, treatment or prognosis in PDAC, due to the lack of available tissues for sequencing and the confounding effects of low tumour cellularity in many biopsy specimens. Increasing focus is now turning to the use of minimally invasive liquid biopsies to enhance the characterisation of actionable PDAC tumour genomes. Circulating tumour DNA (ctDNA) is the most comprehensively studied liquid biopsy analyte in blood and can provide insight into the molecular profile and biological characteristics of individual PDAC tumours, in real-time and in advance of traditional imaging modalities. This can pave the way for identification of new therapeutic targets, novel risk variants and markers of tumour response, to supplement diagnostic screening and provide enhanced scrutiny in treatment stratification. In the roadmap towards the application of precision medicine for clinical management in PDAC, ctDNA analyses may serve a leading role in streamlining candidate biomarkers for clinical integration. In this review, we highlight recent developments in the use of ctDNA-based liquid biopsies for PDAC and provide new insights into the technical, analytical and biological challenges that must be overcome for this potential to be realised.     

液体活检在结直肠癌诊断中的应用进展

结直肠癌(Colorectal cancer,CRC)作为全球第三大常见癌症,是导致人类死亡的重要原因之一。目前针对CRC的诊断手段仍在不断完善,液体活检作为一种新兴的无创活检组织检查技术,受到广泛关注。液体活检主要对生物源液体特定成分进行分析,其中主要包括循环肿瘤细胞、循环肿瘤DNA、细胞游离DNA、外泌体、肿瘤相关血小板及循环肿瘤相关微粒等。本文就以上生物源液体特定成分在CRC诊断中的最新应用研究进行综述。     

Matrine,oxymatrine, and compound Kushen injection from the roots of Sophora flavescens: an overview of their anticancer activities

In the present review, we updated current information on the chemistry, contents, and anticancer properties of matrine (MT), oxymatrine (OMT), and compound Kushen injection (CKI). The anticancer properties were focused on lung, breast, and liver cancer cells because they are most susceptible. Sources of information were from Google, Google Scholar, PubMed, PubMed Central, Science Direct, PubChem, J-Stage, Directory of Open Access Journals (DOAJ), and China National Knowledge Infrastructure (CNKI). Reference was also made on botanical websites, such as Flora of China and World Flora Online. MT and OMT are dominant quinolizidine alkaloids from the roots of Sophora flavescens (Kushen) of the family Fabaceae. Against lung, breast, and liver cancer cells, MT and OMT inhibit cell proliferation; induce cell cycle arrest, apoptosis, and autophagy; restrict angiogenesis; and inhibit cell metastasis, invasion, and migration. The processes involve various molecular targets and signaling pathways. CKI is a traditional Chinese medicine (TCM) composed of root extracts of S. flavescens and Smilax glabra (Baituling) of the family Smilacaceae. With MT and OMT as major components, CKI has been approved for the treatment of cancer in China more than 20 years ago. In recent years, systematic reviews and meta-analysis have been undertaken to evaluate the anticancer effects of CKI. When CKI is used alone and in combination with chemotherapy of western medicine, there is much to be learned concerning their interactions besides their individual and integrated efficacy. Some perspectives of MT, OMT, and CKI are discussed, and their suggestions for future research are provided.     

激光联合复方血栓通胶囊治疗糖尿病视网膜病变合并黄斑水肿的疗效观察

目的:分析糖尿病视网膜病变合并黄斑水肿联合采用激光与复方血栓通胶囊治疗的临床疗效。方法:选取我院2017年1月—2019年1月收治的200例糖尿病视网膜病变合并黄斑水肿患者为研究对象,随机分为两组。对照组单独行激光治疗,观察组于对照组基础上联合复方血栓通胶囊治疗,对比两组临床疗效、治疗前后IL-6(白介素-6)、VEGF(血管内皮生长因子)、NOS(血清一氧化氮合成酶)水平变化情况。结果:对照组总有效率(68.00%,68/100)较观察组总有效率(98.00%,98/100)更高(P<0.05);与对照组对比,观察组治疗后NOS水平更高,IL-6、VEGF水平更低(P<0.05)。结论:糖尿病视网膜病变合并黄斑水肿联合采用激光与复方血栓通胶囊治疗的临床疗效显著,值得推广。     

复方番石榴制剂治疗超重肥胖2型糖尿病的疗效分析

【目的】评价复方番石榴制剂治疗超重肥胖2型糖尿病的临床疗效。【方法】将120例超重肥胖2型糖尿病患者随机分为治疗组和对照组各60例,治疗组给予口服二甲双胍肠溶片及复方番石榴制剂治疗,对照组给予口服二甲双胍肠溶片治疗,疗程均为12周。观察2组治疗前后腰围(WC)、体质量指数(BMI)、空腹血糖(FBG)、餐后2h血糖(P2hBG)、糖化血红蛋白(HbA1c)、胆固醇(TC)、甘油三酯(TG)、游离脂肪酸(FFA)等的变化情况,评估复方番石榴制剂的临床疗效。【结果】(1)中医证候总疗效:治疗后,治疗组的总有效率为95.00%,优于对照组的70.00%,差异有统计学意义(P0.01)。(2)治疗后,治疗组的WC和BMI均较治疗前显著下降(P0.01),而对照组均无明显下降(P0.05),治疗组对WC和BMI的下降作用均优于对照组(P0.05)。(3)治疗后,2组FBG、P2hBG、HbA1c、TC、TG、FFA水平均较治疗前显著改善(P0.05),且治疗组对上述各项指标的改善作用均优于对照组(P0.05)。(4)安全性评价:除治疗组有3例患者出现轻度的胃部不适感,未予特殊处理后自行缓解外,其余患者均未发现不良反应。【结论】复方番石榴制剂联合二甲双胍治疗超重肥胖2型糖尿病,疗效确切,可有效降糖、降脂、减肥及改善中医证候。