氟哌噻吨美利曲辛在胃食管反流性咳嗽治疗中的作用

目的观察氟哌噻吨美利曲辛在治疗胃食管反流性咳嗽(GERC)中的作用。方法收集2012年10月—2013年11月确诊GERC者73例,将其中焦虑、抑郁患者分为A、B组,无焦虑抑郁患者,定为C组,A组28例,B组24例,C组21例。B组、C组患者进行常规抗反流治疗,A组加用氟哌噻吨美利曲辛片治疗。治疗12周后评估患者GERD-Q量表及咳嗽症状积分变化。结果 3组治疗第4、8、12周后GERD-Q积分、咳嗽症状积分较治疗前均有所下降(P<0.01,P<0.05);治疗第4、8、12周后GERD-Q量表评分、咳嗽症状积分降低程度A、C组均高于B组(P<0.01,P<0.05),A、C组间无统计学差异(P>0.05);A、C组总有效率明显高于B组(P<0.05),A、C组间无统计学差异(P>0.05)。结论埃索美拉唑、莫沙必利联合氟哌噻吨美利曲辛片治疗伴有焦虑、抑郁状态GERC患者,具有价格低廉、疗效确切、服用方便、不良反应少等优点。     

同病异证H22肝癌小鼠肿瘤组织细胞凋亡通路基因差异表达的特征

目的:观察昆明种H22肝癌小鼠邪毒壅盛证与气虚证肿瘤组织细胞凋亡通路基因表达特征,探讨中医同病异证发生的物质基础。方法:采用小鼠计量化辨证方法,筛选出瘤早期邪毒壅盛证与气虚证同病异证H22肝癌小鼠,采用Affymetrix GeneChip Mouse Exon 1.0 ST Array检测肿瘤组织细胞凋亡通路相关基因表达的特征。结果:依据KEGG数据库细胞凋亡通路,筛选出芯片数据中匹配的33个基因,发现(1)TNF-α和IL-1依赖的细胞凋亡信号通路总体上不利于邪毒壅盛证小鼠肿瘤细胞的凋亡;(2)IL-3依赖的细胞凋亡信号通路总体上反似有利于邪毒壅盛证小鼠肿瘤细胞凋亡;而(3)线粒体介导的细胞凋亡信号通路,邪毒壅盛证小鼠一致表达下调,提示不利于其细胞凋亡。结论:邪毒壅盛肝癌小鼠肿瘤细胞恶性增殖程度高,可能与线粒体介导的细胞凋亡信号通路系列相关基因表达轻度抑制有关。     

幽门螺杆菌尿素酶B亚单位Th表位的免疫学特性研究

采用MHC限制性分析、ELISA方法、淋巴细胞增殖实验等方法研究幽门螺杆菌(Hp)尿素酶B亚单位(UreB)的H- 2~d限制性Th表位U_(546-561)、U_(229-244)、U_(237-251)的免疫学特性。发现抗I-E~d抗体能够抑制U_(546-561)对CD4~+T淋巴细胞的刺激,抗I-A~d抗体能够抑制U_(229-244)、U_(237-251)对CD4~+T淋巴细胞的刺激作用。U_(229-244)、U_(229-244)能刺激CD4~+T淋巴细胞分泌IL-4和IL-10,U_(237-251)刺激CD4~+T淋巴细胞分泌IFN-γ、IL-2,且U_(546-561)、U_(229-244)、U_(237-251)三个表位肽免疫BALB/c小鼠能够引起针对各自免疫多肽和rUreB的CD4~+T细胞应答。结果表明U_(546-561)为I-E~d限制性Th2表位,U_(229-244)为I-A~d限制性Th2表位、U_(237-251)为I-A~d限制性Th1表位。三个表位之间具有协同刺激效应,可以用于Hp表位疫苗的研究。     

Acoustic triggered nanobomb for US imaging guided sonodynamic therapy and activating antitumor immunity

We fabricated an ultrasound activated ‘nanobomb’ as a noninvasive and targeted physical therapeutic strategy for sonodynamic therapy and priming cancer immunotherapy. This ‘nanobomb’ was rationally designed via the encapsulation of indocyanine green (ICG) and perfluoropentane (PFP) into cRGD peptide-functionalized nano-liposome. The resulting Lip-ICG-PFP-cRGD nanoparticle linked with cRGD peptide could actively targeted ID8 and TC-1 cells and elicits ROS-mediated apoptosis after triggered by low-intensity focused ultrasound (LIFU). Moreover, the phase change of PFP (from droplets to microbubbles) under LIFU irradiation can produce a large number of microbubbles, which act as intra-tumoral bomber and can detonate explode tumor cells by acoustic cavitation effect. Instant necrosis of tumor cells further induces the release of biologically active damage-associated molecular patterns (DAMPs) to facilitate antitumor immunity. More important, the ‘nanobomb’ in combination with anti-PD-1checkpoint blockade therapy can significantly improve the antitumor efficacy in a subcutaneous model. In addition, the liposomes may also be used as an imaging probe for ultrasound (US) imaging after being irradiated with LIFU. In summary, the US imaging-guided, LIFU activated ROS production and explosion ‘nanobomb’ might significantly improve the antitumor efficacy and overcome drug resistance through combination of SDT and immunotherapy, we believe that this is a promising approach for targeted therapy of solid tumor including ovarian cancer.     

Sleep‐disordered breathing in heart failure patients with different etiologies

BackgroundThe prevalence of sleep‐disordered breathing (SDB) is closely related to the severity of heart failure (HF), and the severity of HF is different in patients with HF of different etiologies. Hypothesis: This study aimed to explore the prevalence of SDB in patients with HFof different etiologies.MethodsHospitalized HF patients were consecutively enrolled. All patients underwent portable overnight cardiorespiratory polygraphy. Patients were divided into five groups according to the etiology of HF: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB and clinical data was compared among the five groups.ResultsIn total, 248 patients were enrolled in this study. The prevalence of SDB in HF was 70.6%, with the prevalence of obstructive sleep apnea (OSA) at 47.6% and central sleep apnea (CSA) at 23.0%. Patients were divided into five groups: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB among the five groups was 75.3%, 81.4%, 77.8%, 51.9%, and 58.5% (p = .014), respectively. The prevalence of OSA among the five groups was 42.7%, 72.1%, 36.1%, 37.0%, and 49.1% (p = .009), whereas the CSA was 32.6%, 9.3%, 41.7%, 14.8%, and 9.4% (p < .001), respectively.ConclusionsSDB is common in HF patients. The prevalence and types of SDB varied in HF with different etiologies, which may be related to the different severities of HF. SDB was highly prevalent in patients with ischemic, hypertensive, and myocardial HF. Hypertensive HF patients were mainly complicated with OSA, while myocardial HF patients were mainly complicated with CSA. Both conditions were highly prevalent in ischemic HF patients. The prevalence of SDB was relatively low in valvular and arrhythmic HF patients, and OSA was the main type.     

Microstructure and Friction Properties of CoCrFeMnNiTix High-Entropy Alloy Coating by Laser Cladding

To enhance the friction and wear properties of 40Cr steel’s surface, CoCrFeMnNi high-entropy alloy (HEA) coatings with various Ti contents were prepared using laser cladding. X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS) were used to characterize the phase composition, microstructure, and chemical composition of the samples. The findings demonstrated that the CoCrFeMnNiTi_x HEA coatings formed a single FCC phase. Fe₂Ti, Ni₃Ti, and Co₂Ti intermetallic compounds were discovered in the coatings when the molar ratio of Ti content was greater than 0.5. The EDS findings indicated that Cr and Co/Ni/Ti were primarily enriched in the dendrite and interdendrite, respectively. Ti addition can effectively enhance the coating’s mechanical properties. The hardness test findings showed that when the molar ratio of Ti was 0.75, the coating’s microhardness was 511 HV0.5, which was 1.9 times the hardness of the 40Cr (256 HV0.5) substrate and 1.46 times the hardness of the CrCrFeMnNi HEA coating (348 HV0.5). The friction and wear findings demonstrated that the addition of Ti can substantially reduce the coating’s friction coefficient and wear rate. The coating’s wear resistance was the best when the molar ratio of Ti was 0.75, the friction coefficient was 0.296, and the wear amount was 0.001 g. SEM and 3D morphology test results demonstrated that the coating’s wear mechanism changed from adhesive wear and abrasive wear to fatigue wear and abrasive wear with the increase in Ti content.     

小脑发育不良性节细胞瘤与Cowden综合征:6例临床分析

目的分析小脑发育不良性节细胞瘤（LDD）的临床、影像学和病理学特征,探讨LDD与Cowden综合征（CS）之间的关系。方法回顾6例LDD患者的临床、影像学和病理学资料,根据国际CS协会（ICC）标准体检,并与1例CS患者比较。结果患者发病年龄23-56岁,平均39岁,常见症状为颅内压增高、小脑征及颅神经麻痹表现。CT示后颅等密度和低密度占位,部分钙化,MRI表现为特征性的“虎纹征”;病理特征为小脑层状结构紊乱,颗粒细胞和浦肯野细胞减少,而异常神经节细胞增多。患者术后预后多良好。随访到的5例LDD患者中3例（60％）符合CS诊断标准,1例CS患者未合并LDD。结论LDD为小脑的少见良性病变,MRI为最佳影像学诊断手段,全切手术为首选治疗方法。LDD可能为CS在中枢神经系统的表现。     

Displaced proximal humerus fractures treated with ORIF via the deltoid interfascicular approach vs the deltopectoral approach: A prospective case-control study

Background:The purpose of this study was to evaluate the clinical outcomes and complications of displaced proximal humeral fractures treated with proximal humeral internal locking system (PHILOS) plate fixation via a deltoid interfascicular (DI) vs a deltopectoral (DP) approach.Methods:This prospective case-control study was conducted with patients admitted to our hospital from May 2015 to June 2018 who suffered from unilateral displaced proximal humerus fractures. Patients were treated with PHILOS plate fixation via a DI (DI group) or DP approach (DP group). The clinical outcomes and complication data were collected for comparison between the 2 groups. The patients were followed up at 3, 6, and 12 months; and every 6 months thereafter. The patients’ functional recoveries were evaluated according to the normalized Constant-Murley score, range of motion of the shoulder (flexion, abduction, external/internal rotation) and disabilities of the arm, shoulder and hand score.Results:A total of 77 patients, followed for an average of 15 ± 2.2months (range, 12–21), were enrolled (36 in DI group and 41 in DP group) for final analysis. No significant differences in age, sex, affected side, fracture type, injury mechanism or time from injury to operation were found between the 2 groups (all P > .05). The incision length, intra-operative blood loss, and duration of operation in the DI group were significantly less than those in the DP group, respectively (all P < .05). The functional outcomes assessed by the normalized Constant-Murley score and range of motion of flexion and internal rotation in the DI group were superior to those in the DP group at 3 and 6months after the operation (P < .05); however, no significant differences were observed at the 12-month and subsequent follow-ups (all P > .05). There was no significant difference in the range of shoulder external rotation and abduction during the postoperative follow-ups (P > .05). At the last follow-up, the mean disabilities of the arm, shoulder, and hand score was 14.0 (6.6) points in the DI group and 14.4 (6.9) points in the DP group (P = .793). Complications occurred in 1 patient in the DI group and 8 patients in the DP group (P = .049).Conclusion:The current study demonstrates that DI approach is a safe and effective alternative for the treatment displaced proximal humerus fractures. The DI approach rather than DP approach was recommended when lateral and posterior exposure of the proximal humerus is required, especially when fixed with PHILOS plate.     

链霉菌多糖的免疫学活性研究

目的 研究链霉菌多糖(SMP)对正常小鼠和免疫抑制模型小鼠的免疫调节活性.方法 通过混合淋巴细胞培养方法检测SMP对正常小鼠脾脏淋巴细胞增殖作用的影响,用酸性α-醋酸萘酯酶染色法观察免疫抑制小鼠模型外周血中T淋巴细胞的变化,以及流式细胞仪检测免疫抑制模型小鼠脾细胞中T细胞亚群Lyt2 和L3T4 的比例变化.结果 SMP可以明显促进混合淋巴细胞的增殖,并对免疫抑制模型小鼠T淋巴细胞的抑制有保护作用,还可以调节模型小鼠CD4 /CD8 的比值至正常水平.结论 SMP具有调节免疫功能的作用.