不同剂量阿托伐他汀钙对急性冠脉综合征患者经皮冠状动脉介入术治疗后血清sCD40 L、sCD146的影响

目的探讨不同剂量阿托伐他汀钙对急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)治疗后疗效、血脂及血清可溶性CD40配体(s CD40L)、可溶性CD146(s CD146)的影响。方法选取2017年5月-2018年5月于我院接受PCI手术治疗的ACS患者90例,随机分为对照组和观察组,各45例。对照组术后每晚予口服阿托伐他汀钙20 mg,研究组术后每晚予口服阿托伐他汀钙40 mg,均维持治疗1个月。比较两组患者治疗有效率、不良反应发生率及治疗前后血脂〔总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)〕和血清s CD40L、s CD146水平变化。结果治疗后,观察治疗有效率(75. 6%)高于对照组(51. 1%)(P0. 05);两组TC、TG、LDL-C及血清s CD40L、s CD146水平较治疗前均降低(P0. 05),且观察组降低幅度大于对照组(P0. 05)。观察组心绞痛、肾功能不全、心功能减弱等不良反应发生率(6. 6%)低于对照组(17. 8%)(P0. 05)。结论 ACS患者PCI术后服用高剂量阿托伐他汀钙可显著提高临床治疗效果,有效降低患者血脂和血清s CD40L、s CD146水平,且不增加不良反应。     

MR扩散张量成像评价脑室旁白质软化症脑性瘫痪患儿认知功能的研究

目的 探讨MR DTI及白质纤维束成像(FT)在评价脑室旁白质软化症(PVL)脑性瘫痪患儿认知功能中的应用价值,为揭示PVL患儿认知功能障碍的可能神经基础提供帮助.方法 选取46例临床确诊为脑性瘫痪的PVL患儿,同时选择足月无窒息史的健康儿童16名进行对照研究.应用发育商(DQ)评价患儿认知功能,根据DQ值将患儿分为轻(11例)、中(19例)、重度(16例)认知障碍组.对受试儿童进行常规MRI及DTI检查,计算各组患儿主要白质纤维束各向异性分数(FA)值,患儿组与对照组间进行非配对t检验,各认知障碍组及对照组组间比较采用单因素方差分析.结果 与对照组相比,患儿组左侧皮质脊髓束(患儿组:0.476 ±0.064;对照组:0.531±0.064),双侧内囊前肢(患儿组:左侧0.357±0.050,右侧0.370±0.040;对照组:左侧0.405±0.081,右侧0.405±0.036),双侧内囊后肢(患儿组:左侧0.483±0.044,右侧0.485±0.046;对照组:左侧0.546±0.091,右侧0.547±0.083),双侧弓状束(患儿组:左侧0.367±0.069,右侧0.363±0.064;对照组:左侧0.433±0.097,右侧0.421±0.091),双侧丘脑后辐射(患儿组:左侧0.390±0.059,右侧0.382±0.047;对照组:左侧0.459±0.067,右侧0.446±0.064),双侧前扣带束(患儿组:左侧0.362±0.056,右侧0.345±0.056;对照组:左侧0.423±0.057,右侧0.417±0.080),双侧上纵束(患儿组:左侧0.323±0.050,右侧0.341±0.056;对照组:左侧0.426±0.102,右侧0.416±0.092)及胼胝体压部(患儿组:0.535±0.090;对照组:0.606±0.060)的FA值显著减低,差异有统计学意义(t值为2.037 ～3.745,P值均＜0.05);随认知障碍程度的加重,所有纤维束的FA值逐渐下降,各认知障碍组及对照组进行组间比较发现双侧皮质脊髓束、内囊前肢、内囊后肢、左侧弓状束、双侧丘脑后辐射、前扣带束、上纵束及胼胝体压部的FA值差异有统计学意义(F值为3.021 ～7.146,P值均＜0.05).进一步两两比较显示,以上纤维束的FA值在对照组与重度认知障碍组间比较,差异均有统计学意义(P值均＜0.05).结论 PVL患儿认知功能障碍与脑内广泛白质纤维束损伤有关,DTI及FT在评价PVL患儿认知功能方面有较高的应用价值.     

磁敏感加权成像定量测量在鉴别诊断帕金森病和血管性帕金森综合征中的应用

目的 探讨在磁敏感加权成像(SWI)上测量脑内锥体外系各核团相位值对帕金森病(PD)和血管性帕金森综合征(VPS)的诊断及鉴别诊断价值.资料与方法 在SWI上对20例PD患者(PD组)、20例VPS患者(VPS组)和20例正常对照者(对照组)脑内锥体外系各核团进行相位值测量,并进行比较.结果 PD组较VPS组及对照组黑质致密带(SNc)、苍白球(GP)、壳核(PUT)相位值均明显降低(P＜0.01);VPS患者与对照组比较,差异无统计学意义(P＞0.05).PD组SNc、GP及PUT相位值在早期即已经降低,随病情加重其相位值进一步降低(P＜0.01);中晚期其黑质网状带(SNr)相位值降低(P＜0.05).VPS组在早中期各感兴趣区相位值均无明显变化,仅在晚期SNc、PUT、尾状核(CN)及SNr、GP相位值轻度降低(SNc、PUT、CN:P＜0.01;SNr、GP:P＜0.05).双侧红核(RN)比较,差异均无统计学意义(P＞0.05).结论 应用SWI测量脑内锥体外系各核团相位值对PD和VPS的评估具有临床诊断价值.     

IL-10基因单核苷酸多态性与急性淋巴细胞白血病易感性的相关性研究

Objective To observe the relationship of IL-10 gene single nucleotide polymorphism and the susceptibility to ALL. Methods The bone marrow and peripheral blood samples from 115 ALL patients and 323 healthy controls were collected in Peking University First Hospital and Beijing Dao-pei Hospital from January 2007 to December 2009. The DNA were extracted from all samples. The primers of -819C/T and -592A/C in the promoter region of IL-10 gene were designed for the PCR. The restrictive fragment length polymorphism of IL-10 gene was analyzed by using restrictive enzyme Msl Ⅰ and HpyCH4 Ⅲ.Sequencing was done in part of these samples to confirm the results of PCR. The differences of genotypes and allele ratio of -819 and -592 sites were analyzed between the ALL patients and healthy controls. Real-time quantitative PCR was performed to detect the EB virus (EBV) infection and the expression of BCR/ABL fusion gene. The differences of genotypes and allele ratio of -819 and -592 sites were analyzed between the positive and negative group. Results The genotype ratios of -819CC, -819TT, - 819CT, -592AA,- 592CC and - 592AC were 14. 8% ( 17/115 ), 45.2% ( 52/115 ), 40. 0% ( 46/115 ), 43.5% ( 50/115 ),16. 5% ( 19/115 ), 40. 0% ( 46/115 ) in ALL patients, and were 9. 9% ( 32/323 ), 16. 4% ( 53/323 ),73.7% ( 238/323 ), 11.8% ( 38/323 ), 15.5% ( 50/323 ), 72. 8% ( 235/323 ) in the healthy controls,respectively. The genotypes of -819 and -592 sites had statistically significant differences between the two groups(x2 values were 46.000 and 54.550, all P ＜ 0. 05 ). The allele ratio of -819T and -592A were (65.2%, 150/230) and (63.5%, 146/230) in ALL patients, while they were 53.5% (344/646) and 48. 1% (311/646)in the healthy controls. There were statistically significant differences between the two groups (x2 values were 9. 877 and 15.986, all P ＜ 0. 05 ). The EBV DNA were detected in 42 ALL patients,among which 22 were positive and 20 were negative. The genotype ratios of -819CC, -819TT, -819CT,-592AA, - 592CC, - 592AC in EBV positive group were 9. 1% ( 2/22 ), 40. 9% ( 9/22 ), 50. 0%(11/22) ,31.8% ( 7/22 ), 13.6% ( 3/22 ), 54. 5% ( 12/22 ), while they were 35.0% ( 7/20 ), 45.0%(9/20) ,20. 0% (4/20) ,35.0% (7/20) ,45.0% (9/20) ,20. 0% (4/20) in the EBV negative group. The genotypes of -819 and -592 sites showed no statistical differences between the two groups( all P ＞ 0. 05 ).The BCR/ABL fusion gene were detected in 36 ALL patients, among which 20 were positive and 16 were negative. The genotype ratios of - 819CC, - 819TT, - 819CT, - 592AA, - 592CC, - 592AC in BCR/ABL positive group were 0% (0/20) ,45.0% (9/20) ,55.0% ( 11/20), 45. 0% (9/20) ,5.0% (1/20) ,50. 0%( 10/20), while they were 18. 8% ( 3/16 ), 50. 0% ( 8/16), 31.3% ( 5/16 ), 50. 0% ( 8/16 ), 18. 8%(3/16), 31.3 % (5/16)in the BCR/ABL negative group. The genotypes of -819 and -592 sites showed no statistical differences between the two groups ( all P ＞ 0. 05 ). Conclusion The population with - 819TT and - 592AA genotype of IL-10 gene shows susceptibility to ALL.     

肿瘤相关成纤维细胞外泌体miRNA-656-3p调控喉癌生长侵袭及丹参酮ⅡA对其调控研究

目的研究喉癌肿瘤相关成纤维细胞(CAFs)外泌体表达下调的miRNA-656-3p对喉癌细胞生长和侵袭能力的影响以及丹参酮ⅡA对其调控作用。方法将CAFs外泌体miRNA-656-3p表达上调,制备外泌体上清,检测其对喉癌细胞体外增殖、侵袭能力及细胞周期的影响。检测中药提取物丹参酮ⅡA是否具有类似的上调CAFs外泌体miRNA-656-3p表达的作用,其作用后的CAFs外泌体上清是否具有类似的抑制喉癌增殖和侵袭能力的功效。结果过表达miR-656-3p的CAFs外泌体上清能抑制喉癌细胞的体外增殖和侵袭能力,抑制CCND2的表达,并将喉癌细胞阻滞在G0/G1期。而丹参酮ⅡA也可以上调CAFs外泌体中miR-656-3p的表达水平,其作用后的CAFs外泌体能发挥类似的抑制喉癌细胞体外增殖和侵袭的功效。结论喉癌CAFs外泌体miRNA-656-3p的表达下调促进喉癌细胞的生长和侵袭能力,丹参酮ⅡA可上调CAFs外泌体miR-656-3p的表达,通过后者抑制喉癌细胞的生长和侵袭能力。     

3.0TMR磁敏感加权成像测量帕金森病患者基底节区体积

目的 应用3.0T磁共振SWI分析帕金森病患者基底节区体积的变化,探讨其诊断帕金森病的价值。方法 采用3.0T MRI对40例早期、中晚期帕金森病患者和年龄匹配的20名正常人进行扫描,分别测量尾状核、壳核及苍白球的体积,并与Hoehn & Yahr分级及病程行相关性分析。结果 早期、中晚期帕金森病患者壳核体积较正常人分别下降10.79%(P＜0.05)和22.66%(P＜0.05),中晚期患者较早期患者下降13.31%(P＜0.05)。中晚期患者苍白球体积较正常人下降11.65%(P＜0.05),较早期患者下降8.51%(P＜0.05)。帕金森病患者壳核体积与Hoehn & Yahr分级呈负相关 (r=－0.987, P＜0.001),与病程无相关性。结论 MRI体积测量技术能为帕金森病的辅助诊断提供一定帮助。     

中医药治疗复发性口腔溃疡研究近况

为了解中医药治疗复发性口腔溃疡的研究近况,通过查阅近5年有关于本病的文献资料,经分析、归纳、整理,从内治法、外治法、针灸疗法、联合疗法方面进行综述,发现中医依靠其辨证论治、整体与局部相结合等优势,在减少本病发病次数、提高疗效等方面发挥了积极作用,值得临床进一步推广研究。     

急性咽炎中医药治疗近况

目的:了解急性咽炎中医药治疗近况。方法:查阅近10年有关中医药治疗急性咽炎的文献资料,从内治法、外治法、针灸疗法、内外并治法和其他疗法五个方面进行综述。结果:发现中医药治疗急性咽炎方法多,效果好。结论:中医药治疗急性咽炎有其独特优势,有较大的临床推广价值。     

SWI鉴别帕金森病和帕金森综合征的研究进展

帕金森病(PD)和帕金森综合征(PDS)是神经系统中两种不同的疾病,两者在临床或病理上常出现交叠,早期病变的部位和症状多样,使得两者间鉴别困难。磁敏感加权成像作为一种新的磁共振成像技术在这两种疾病诊断中的作用越来越显著。     

雀啄灸红外治疗仪治疗特发性耳鸣临床研究

目的:观察雀啄灸红外治疗仪与常规针刺、传统雀啄灸治疗特发性耳鸣的临床疗效。方法:将90例患者按就诊先后顺序分为观察组、对照1组、对照2组,每组30例。观察组采用雀啄灸红外治疗仪治疗,每穴照射20 min;对照1组采用常规针刺治疗,每穴留针20 min;对照2组采用传统雀啄灸治疗,每穴灸20 min。三组均取穴翳风、耳门、听宫,每周2次,连续治疗10次为1个疗程。通过THI分级、耳鸣严重程度分级及耳鸣疗效评估观察三组患者的临床疗效。结果:观察组、对照1组、对照2组在治疗前后耳鸣症状及体征均有缓解(P0.05),其中,观察组总有效率为86.67%,显著高于对照1组的60.00%、对照2组的63.33%(P0.05)。患者THI分级及耳鸣严重程度评估中,观察组明显低于对照1组、对照2组(P0.05)。结论:雀啄灸红外治疗仪疗效佳,优于普通针刺及传统雀啄灸,缓解耳鸣严重程度及焦虑情绪可能与其治疗效果有关,使用便捷且安全系数高,值得作为新的治疗手段并推广应用。