苦寒药与生物钟基因的关系研究进展＊

苦寒类中药善于清热燥湿以改善机体内环境稳态，目前在临床上被广泛应用于糖尿病、肥胖、炎症、菌群失调等慢性或代谢性疾病，而这些疾病往往都伴随着机体生物钟系统的失衡。改善生物钟失衡可能是苦寒药治疗这些疾病的作用机制之一，同时，在生物钟的调控下，机体新陈代谢及内分泌等行为的节律性波动也可能影响苦寒药的药效。既往对苦寒药在临床应用上的研究大部分集中于胃肠动力及激素等基础研究上，从生物钟基因的角度鲜有见到深入的研究与阐述。因此，本文从临床常用苦寒药对生物钟基因的影响及生物钟基因对苦寒药作用的影响两个方面探讨苦寒药的应用，同时分析二者之间的关系和归纳苦寒药影响生物钟基因共同的物质基础，以期为苦寒药作用多靶点以及指导临床合理用药和中药药性物质基础研究提供参考。     

ERAS理念在腹腔镜子宫内膜癌全面分期手术围手术期应用的效果分析

目的探讨加速康复外科(enhanced recovery after surgery，ERAS)在腹腔镜子宫内膜癌全面分期手术围手术期应用的安全性和有效性。 方法回顾性分析2017年2月至2018年10月54例在甘肃省人民医院行腹腔镜子宫内膜癌全面分期手术患者，ERAS组和对照组各27例。ERAS组采用加速康复理念行围手术期处理，对照组给予外科常规处理措施，比较2组的术中、术后恢复情况及术后并发症等方面的差异。 结果ERAS组患者的术后住院时间、首次通气时间、引流管放置时间及术后腹腔引流量均明显低于对照组，差异有统计学意义(P<0.05)；与对照组相比，ERAS组的术后并发症总发生率减少(P<0.05)。 结论ERAS技术用于腹腔镜子宫内膜癌全面分期手术围手术期优势突出，值得临床推广。     

Tumor‐associated macrophages promote bladder tumor growth through PI3K/AKT signal induced by collagen

The tumor microenvironment is associated with various tumor progressions, including cancer metastasis, immunosuppression, and tumor sustained growth. Tumor‐associated macrophages (TAMs) are considered an indispensable component of the tumor microenvironment, participating in the progression of tumor microenvironment remodeling and creating various compounds to regulate tumor activities. This study aims to observe enriched TAMs in tumor tissues during bladder cancer development, which markedly facilitated the proliferation of bladder cancer cells and promoted tumor growth in vivo. We determined that TAMs regulate tumor sustained growth by secreting type I collagen, which can activate the prosurvival integrin α2β1/PI3K/AKT signaling pathway. Furthermore, traditional chemotherapeutic drugs combined with integrin α2β1 inhibitor showed intensive anticancer effects, revealing an innovative approach in clinical bladder cancer treatment.     

手术室医辅人员任务智能分配的抢单模式管理

目的研发适用于手术室医辅人员任务分配管理的智能软件信息系统,并探讨其运行效果。方法将2018年3月试运行抢单信息系统的509台次手术设为实验组,对医辅人员运用抢单模式进行管理;对同期未实施的486台次同类手术设为对照组,运用常规管理模式;比较两组的运行效果。结果实验组应答时间和完成任务时间显著短于对照组,护士满意率显著提升(均P0.01)。结论抢单信息系统精准记录了医辅人员的工作量和时间节点,提高了工作效率和护理人员满意率,促进了后勤医辅人员的科学化、精细化管理。     

Wnt/β-catenin links oxidative stress to podocyte injury and proteinuria

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教育信息化2.0背景下网络教育的现状及对策思考——以陕西省为例

《教育信息化2.0行动计划》发布以来,全国各地积极推动教育信息化的发展,网络教育变得越来越普及。虽然网络教育在发展的过程中也越来越完善,但是还存在着一些问题。文章通过分析陕西省网络教育的现状,总结目前存在的问题并提出相应的对策,有助于更好地发展和完善网络教育,为教育信息化的发展提供借鉴。     

药品审评检查机构质量管理体系建设实践探索

目的:贯彻国务院强化质量管理、落实全国药监部门完善自身质量管理体系工作部署,梳理山东省药品审评检查机构质量管理体系建设情况,总结经验、查找不足,加强审评检查质量管理。方法:调研药品审评检查机构导入质量管理体系的现实意义,剖析山东省药品审评检查机构质量管理体系建设的实践经验,思考存在的问题。结果:行之有效的质量管理体系对药品审评检查机构规范化建设和药品审评检查发展起到了积极的推动作用。结论:药品审评检查机构推进质量管理体系建设,对规范自身建设、提高工作质量、降低业务风险、服务医药产业发展具有重要作用,也是必然要求,药品审评检查机构质量管理体系需要持续改进,逐渐与国际接轨。     

针刺联合艾灸对慢性盆腔炎患者炎性反应指标及中医症候积分的影响

目的:探究针刺联合艾灸对气滞血瘀型慢性盆腔炎性患者炎性反应指标及中医症候积分的影响。方法:选取2017年3月至2019年3月安徽中医药大学第二附属医院收治的气滞血瘀型慢性盆腔炎性患者60例作为研究对象,将其按照随机数字表法分为观察组和对照组,每组30例。2组患者均行常规抗炎治疗,对照组在此基础上加用针刺治疗,观察组在对照组治疗基础上加用艾灸治疗,对比治疗前后2组白细胞计数、中医证候积分及不良反应情况。结果:观察组的临床治疗有效率明显优于对照组(P<0.05);分组治疗后观察组中医症候积分均明显低于对照组及治疗前(P<0.05);治疗后观察组RBC明显低于对照组和治疗前(P<0.05);治疗期间观察组不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。结论:针刺联合艾灸可显著提高慢性盆腔炎性的治疗效果,改善患者中医证候、减轻炎性反应,且治疗安全性高,值得临床推广应用。     

The effect of acetylation on the protein stability of BmApoLp‐III in the silkworm,Bombyx mori

Acetylation is an important, reversible posttranslational modification to a protein. In a previous study, we found that there were a large number of acetylated sites in various nutrient storage proteins of the silkworm haemolymph. In this study, we confirmed that acetylation can affect the stability of nutrient storage protein Bombyx mori apolipophorin‐III (BmApoLp‐III). First, the expression of BmApoLp‐III could be upregulated when BmN cells were treated with the deacetylase inhibitor panobinostat (LBH589); similarly, the expression was downregulated when the cells were treated with the acetylase inhibitor C646. Furthermore, the increase in acetylation by LBH589 could inhibit the degradation and improve the accumulation of BmApoLp‐III in BmN cells treated with cycloheximide and MG132 respectively. Moreover, we found that an increase in acetylation could decrease the ubiquitination of BmApoLp‐III and vice versa; therefore, we predicted that acetylation could improve the stability of BmApoLp‐III by competing for ubiquitination and inhibiting the protein degradation pathway mediated by ubiquitin. Additionally, BmApoLp‐III had an antiapoptosis function that increased after LBH589 treatment, which might have been due to the improved protein stability after acetylation. These results have laid the foundation for further study on the mechanism of acetylation in regulating the storage and utilization of silkworm nutrition.