血清Ⅰ\Ⅱ型胶原、TGF-β及BMP水平与绝经后女性骨关节炎、骨质疏松症患者疾病进展的关系

骨关节炎与骨质疏松是两种常见的慢性骨代谢异常导致的疾病。现代研究发现,在OA早期即可出现由骨代谢异常导致的软骨下骨损伤。本文就Ⅰ\Ⅱ型胶原、TGF-β、BMP水平与骨代谢的相关关系及其对OA、OP病程进展的影响,展开文献研究,兹以综述。     

重组人乳铁蛋白急性经口毒性试验和90天喂养试验

目的评价转基因奶牛乳腺生物反应器表达的重组人乳铁蛋白食用安全性。方法参照GB 15193.1—2014《食品安全国家标准食品安全性毒理学评价程序》进行小鼠急性经口毒性试验和大鼠90天亚慢性毒性试验。结果急性经口毒性试验观察期内各小鼠均未见任何毒性效应,判断重组人乳铁蛋白的小鼠急性经口LD5020 000 mg/kg;90天喂养试验结果表明,给予动物人体推荐剂量300倍的重组人乳铁蛋白,未观察到有害作用,大鼠的无明显损害作用剂量水平(NOAEL)为10.00g/(kg·d)。结论重组人乳铁蛋白属无毒级,无亚慢性毒性,无潜在的食用安全风险。     

补肾通络方对大鼠膝关节炎软骨中半胱氨酸天冬氨酸特异性蛋白酶3的调节

目的:观察补肾通络方对骨性关节炎大鼠模型膝关节软骨半胱氨酸天冬氨酸特异性蛋白酶3表达的调节作用。方法:实验于2005-05/2006-03在上海中医药大学动物中心实验室完成。将30只雄性清洁级SD大鼠抽签随机分为正常对照组、骨关节炎模型组、补肾通络方组,每组10只。造模方法:氯胺酮经腹腔注射,麻醉后纵行切开右膝部内侧皮肤,切断内侧副韧带,打开关节腔,切除内侧半月板,切断前后交叉韧带,缝合皮肤。干预方法:正常对照组随意放养,不做处理。补肾通络方药物组成:杜仲、山萸肉、熟地黄、秦艽、寄生、独活等,由上海中医药大学脊柱病研究所提供。自造模第2周开始灌药,2次/d,连续4周。骨性关节病模型组自造模第2周开始灌服等量生理盐水。干预4周后,拉颈处死动物。电镜观察细胞微观形态,免疫组化法检测关节软骨半胱氨酸天冬氨酸特异性蛋白酶3蛋白表达,阳性表达为棕黄色,主要存在于细胞浆内。用平均灰度值和平均吸光度对阳性信号进行量化。RT-PCR法检测半胱氨酸天冬氨酸特异性蛋白酶3mRNA的表达强度。结果:30只大鼠均进入结果分析,无脱失。①半胱氨酸天冬氨酸特异性蛋白酶3表达:骨性关节病模型组明显高于正常对照组,差异非常显著(平均灰度值:142.07±4.04,195.65±2.71,P<0.01;平均吸光度:0.25±0.01,0.12±0.01,P<0.01);补肾通络方组与骨性关节病模型组相比,差异非常显著[平均灰度值:167.62±2.70,142.07±4.04,P<0.01;平均吸光度:0.18±0.01,0.12±0.01,P<0.01]。②半胱氨酸天冬氨酸特异性蛋白酶3mRNA表达:骨性关节病模型组明显高于正常对照组,差异非常显著(3.16±0.26,0.19±0.03,P<0.01);补肾通络方组与骨性关节病模型组相比,差异非常显著(0.41±0.05,3.16±0.26,P<0.01)。结论:补肾通络方能够下调膝骨性关节炎半胱氨酸天冬氨酸特异性蛋白酶3的表达。     

体位改变对脑卒中卧床患者血流动力学的影响

目的:研究平卧位、站立位两种体位改变对脑卒中卧床患者心率、血压、左室排血功能、心肌收缩功能、心脏前负荷、后负荷等血流动力学参数的影响。方法:采用观察性研究方法,利用无创心输出量检测系统,监测30例脑卒中卧床患者和20例正常受试者在平卧位、站立位两种不同体位改变时的心率(HR)、平均动脉压(MABP)、心输出量指数(CI)、每搏输出量(SV)、心收缩力指数(CTI)、左心做功指数(LCWI)、前负荷率(EDFR)、外周血管阻力(SVR)。每个体位连续监测2min,取以上参数的平均值作为观察结果。结果:①平卧位时脑卒中卧床患者的SV、CTI较正常受试者显著下降(P0.01),HR显著上升(P0.01);②脑卒中卧床患者在不同体位下的比较:HR、SV、CI、CTI、LCWI均呈现平卧位站立位(P0.01),且站立位HR升高最大幅度10次/分左右(76.36±8.54 VS 86.12±12.57);SVR比较结果为平卧位站立位(P0.01);③正常受试者不同体位间的比较:HR表现为平卧位站立位(P0.01);SV表现为平卧位站立位(P0.01);CTI、LCWI、SVR比较无差别;④在平卧位→站立位变化时:HR在两组间均出现持续上升趋势;SV在正常受试者中呈下降趋势而脑卒中卧床患者却呈上升趋势。结论:脑卒中卧床患者心排量较正常人群下降,从平卧位到站立位的体位改变对脑卒中卧床患者心血管反应有明显的影响,而且这种体位改变是一种安全有效的辅助训练心功能的方法。     

420nm强脉冲光联合阿达帕林凝胶治疗中度寻常痤疮的疗效观察

目的探讨中度寻常痤疮患者联合使用420nm强脉冲光以及阿达帕林凝胶进行治疗的临床疗效。方法挑选我院收治的中度寻常痤疮患者100例进行随机分组,一组为治疗组(50例),联合使用420nm强脉冲光以及阿达帕林凝胶进行治疗,另一组为对照组(50例),单纯使用阿达帕林凝胶进行治疗。结果治疗8周后,治疗组有效率(88%)比对照组(40%)高,治疗组Ⅱ级的有效率(92.59%)比对照组Ⅱ级(56%)高,治疗组Ⅲ级的有效率(82.61%)也比对照组Ⅲ级(24%)高;差异均明显,均具有统计学意义(均P <0.05)。结论中度寻常痤疮患者联合使用420nm强脉冲光以及阿达帕林凝胶进行治疗的临床疗效显著,安全性高。     

尖锐湿疣皮损中Caspase 8与p-Akt的表达

目的 探讨Caspase 8与p-Akt在尖锐湿疣皮损中的表达及意义.方法 收集尖锐湿疣30例、宫颈癌20例、正常皮肤(包皮)20例,采用免疫组化检测以上组织中Caspase 8及p-Akt的表达及分布.结果 Caspase 8在尖锐湿疣皮损、宫颈癌、正常皮肤中阳性率分别为23.33%、80%、90%.Caspase 8在尖锐湿疣中的表达强度显著低于正常皮肤(P<0.01)和宫颈癌组织(P<0.001).p-Akt在尖锐湿疣皮损、宫颈癌组织、正常皮肤组织中的阳性率分别为93.33%、95%、90%.p-Akt在尖锐湿疣皮损的表达强度显著高于正常皮肤组织(P<0.001),低于宫颈癌组织(P<0.001).在尖锐湿疣皮损和正常皮肤组织中,Caspase 8与p-Akt的表达无相关性.在宫颈癌中,Caspase 8与p-Akt的表达存在显著的正相关(r=0.369,P<0.05).结论 Caspase 8的凋亡启动受抑制及p-Akt的抗凋亡作用可能参与了尖锐湿疣的发生发展.     

68例梅毒血清固定患者妊娠结局分析

目的:探讨孕前规范驱梅治疗的梅毒血清固定患者在孕期是否需要驱梅治疗。方法:回顾性分析我院2010~2013年无系统感染的梅毒血清固定育龄妇女的临床资料,按妊娠期是否接受驱梅治疗分为治疗组(A组)和未治疗组(B组),比较其妊娠结局的差异。结果:共收集了68例患者,A组46例,B组22例,两组患者足月产分别有44例(95.65%)和21例(95.45%),早产分别有2例(4.35%)和1例(4.55%),低体重儿两组各有1例(2.2%、4.5%),两组均无先天梅毒儿出生。两组在足月产、早产、低体重儿、先天梅毒儿发生率上,差异均无统计学意义(P值均0.05)。结论:孕前经过规范驱梅治疗的育龄妇女,如果没有合并系统感染,妊娠期在密切随访下可能无需予驱梅治疗。     

Treatment of 60 cases of senile herpes zoster by encircled acupuncture plus valaciclovir

To observe the clinical therapeutic effect and safety of local encircled acupuncture plus valaciclovir in treating senile herpes zoster.MethodsSixty senile patients with herpes zoster were divided into two groups.In acupuncture and medicine group,the patients were treated by encircled acupuncture plus valaciclovir.The needle was inserted about 0.8 cun away from herpes and to form an angle of 15°with the skin around the skin lesion.During treatment,valaciclovir was taken orally 300 mg every time,twice every day for successive 10 days.In westem medicine group,valaciclovir was taken orally 300 mg every time,twice every day for successive 10 days.ResultsThe time of stopping herpes,relieving pain andscabbing in acupuncture and medicine group was significantly lower than that in western group.ConclusionLocal encircled acupuncture plus valaciclovir in treating senile herpes zoster got effects quickly and could effectively shorten the course of disease and reduce the incidence rateofresidual neuralgia.     

几丁糖预防CO2激光声带切除术后声带粘连短期观察的实验研究

Objective To observe the effect of immediate topical application of chitosan on preventing anterior giottic stenosis (AGS) after microsurgical resection of both vocal fold with CO<,2> laser , including the anterior commissure, in a canine model. Methods Sixteen canine larynges were injured by microresecting procedure of both vocal folds with CO<,2> laser. The dogs were randomly divided into two groups, chitosan group and control group. The chitosan and isotonic sodium chloride solution(control) were used for 5 minutes immediately after surgery. One week after the initial surgery, three dogs in each group were randomly selected , ultrastructure of fibroblast were examined with transmission electronic microscope and expression of basic fibroblast growth factor(bFGF) and traansforming growth factor betal (TGF-β1) were evaluated by enzyme-linked immunosorbent assay(ELISA). Three weeks after surgery, the rest dogs' glottic web were lysed and repeatedly treated with chitosan and isotonic sodium chloride solution respectively. The glottic wound healing and AGS formation were examined every week, and all larynges were harvested and examined histologically six weeks after the initial surgery. Results Transmission electronic microscope examination of the ultrasmcture of fibroblast indicated that chitosan inhibited the proliferation of fibroblast. Chitosan increased the expression of bFGF and TGF-β1, and bFGF and TGF-β1 in chitosan group, which was significantly higher than that in control group (z = -2.887 and -2.005, P =0.002 and 0.041). Chitosan decreased the extent of AGS formation. Three weeks after the surgery, the AGS lesion in the control group affected mean 49% of the length of the vocal folds from the anterior commissure to the vocal process, while chitosan group affected mean 7%, which was significantly less than the extent of web formation in the control group, (z = - 2. 619, P = 0. 008). The grade of collagen content in chitosan group was significantly lower than that in control group (P = 0. 003). Conclusion Chitosan is effective in preventing AGS after CO<,2> laser cordectomy.