方祝元效方治验——养心舒脉方

1 养心舒脉方 组 成:党参12 g,麦冬12 g,五味子6 g,生炙黄芪(各)15 g,玉竹12 g,百合15 g,莪术6 g,牡丹皮6 g,丹参15 g. 功 效:益气养阴,活血舒脉. 主 治:胸痹、心悸(气阴两虚、瘀热内结证). 用 法:每日1剂,水煎,早晚分服. 方 解:方中党参、生炙黄芪健脾益气生津,皆为补气...     

黄春林运用仙芪地黄汤加减治疗慢性肾病经验

黄春林教授认为脾肾气虚、湿瘀内阻是慢性肾脏疾病的常见病机,益气健脾补肾、祛湿活血是慢性肾脏疾病的治疗大法,在古方六味地黄丸的基础上自拟仙芪地黄汤为基本方,加减治疗多种慢性肾脏疾病,临床疗效良好。该文对其运用仙芪地黄汤加减治疗慢性肾脏疾病的临床经验进行了初步的总结。     

破骨细胞分化在颞下颌关节骨关节炎发生中的作用

目的 探究破骨细胞分化在颞下颌关节骨关节炎(TMJOA)发生中的作用.方法 构建小鼠TMJOA模型,Micro-CT观察TMJOA发生发展过程中髁突骨质变化,苏木素伊红(HE)染色观察TMJOA关节组织学结构变化,抗酒石酸酸性磷酸酶(TRAP)组织染色观察TMJOA关节组织中破骨细胞的存在情况.收集TMJOA患者滑液,...     

Intraoperative choroidal detachment during small-gauge vitrectomy: analysis of causes,anatomic, and visual outcomes

IntroductionTo investigate the incidence and causes of intraoperative choroidal detachment (CD) during small-gauge vitrectomy, as well as the anatomic and visual outcomes.MethodsWe retrospectively reviewed the medical records of 1026 consecutive patients who underwent small-gauge vitrectomy from June 2017 to December 2018 at Zhongshan Ophthalmic Centre, Guangzhou, China. Data on the presence, location, and extent of intraoperative CD and its relationship to the infusion cannula were collected. Patient demographic characteristics and postoperative anatomic and visual outcomes were also assessed.ResultsA total of six cases were found to have intraoperative CD, including two with serous CD, three with limited haemorrhagic CD, and one with CD caused by inadvertent perfusion of gas during air/fluid exchange. Retraction of the infusion cannula and acute ocular hypotony were found to be the main causes of intraoperative CD in five out of the six cases. The best-corrected visual acuity of all cases significantly improved after the surgery.ConclusionThe incidence of intraoperative CD during small-gauge vitrectomy is low; the predominant causes are retraction of the infusion cannula and acute ocular hypotony. Immediate awareness and timely closure of the incision may contribute to a better surgical prognosis.Subject terms: Uveal diseases, Diseases     

Correction of RNA splicing defect in β654-thalassemia mice using CRISPR/Cas9 gene-editing technology

β⁶⁵⁴-thalassemia is a prominent Chinese subtype of β-thalassemia, representing 17% of all cases of β-thalassemia in China. The molecular mechanism underlying this subtype involves the IVS-2-654 C→T mutation leading to aberrant β-globin RNA splicing. This results in an additional 73-nucleotide exon between exons 2 and 3 and leads to a severe thalassemia syndrome. Herein, we explored a CRISPR/Cas9 genome editing approach to eliminate the additional 73-nucleotide by targeting both the IVS-2-654 C→T and a cryptic acceptor splice site at IVS-2-579 in order to correct aberrant β-globin RNA splicing and ameliorate the clinical β-thalassemia syndrome in β⁶⁵⁴ mice. Gene-edited mice were generated by microinjection of sgRNA and Cas9 mRNA into one-cell embryos of β⁶⁵⁴ or control mice: 83.3% of live-born mice were gene-edited, 70% of which produced correctly spliced RNA. No off-target events were observed. The clinical symptoms, including hematologic parameters and tissue pathology of all of the edited β⁶⁵⁴ founders and their offspring were significantly improved compared to those of the non-edited β⁶⁵⁴ mice, consistent with the restoration of wild-type β-globin RNA expression. Notably, the survival rate of gene-edited heterozygous β⁶⁵⁴ mice increased significantly, and live-born homozygous β⁶⁵⁴ mice were observed. Our study demonstrated a new and effective gene-editing approach that may provide groundwork for the exploration of β⁶⁵⁴-thalassemia therapy in the future.     

以循证为基础的阶梯式心理护理对乳腺癌化疗患者负性心理的影响研究

目的 探讨以循证为基础的阶梯式心理护理(SCM)对乳腺癌化疗患者负性心理的影响.方法 采取方便抽样的方法,将76例乳腺癌化疗患者随机分为对照组和观察组各38例.对照组实施乳腺癌常规心理护理和出院后随访,观察组在对照组措施的基础上实施阶梯式心理干预措施,包括1周观察评估、2周指导性自我管理、4周一对一健康指导、4周专业心...     

Effect of Killed PRRSV Vaccine on Gut Microbiota Diversity in Pigs

Porcine reproductive and respiratory syndrome virus (PRRSV) is one of the most economically important pathogens affecting the global swine industry. Vaccination is still a main strategy for PRRSV control; however, host factors associated with vaccine efficacy remain poorly understood. Growing evidence suggests that mucosa-associated microbiomes may play a role in the responses to vaccination. In this study, we investigated the effects of a killed virus vaccine on the gut microbiome diversity in pigs. Fecal microbial communities were longitudinally assessed in three groups of pigs (vaccinated/challenged with PRRSV, unvaccinated/challenged with PRRSV, and unvaccinated/unchallenged) before and after vaccination and after viral challenge. We observed significant interaction effects between viral challenge and vaccination on both taxonomic richness and community diversity of the gut microbiota. While some specific taxonomic alterations appear to be enhanced in vaccinated/challenged pigs, others appeared to be more consistent with the levels in control animals (unvaccinated/unchallenged), indicating that vaccination incompletely protects against viral impacts on the microbiome. The abundances of several microbial taxa were further determined to be correlated with the level of viral load and the amount of PRRSV reactive CD4⁺ and CD8⁺ T-cells. This study highlights the potential roles of gut microbiota in the response of pigs to vaccination, which may pave the road for the development of novel strategies to enhance vaccine efficacy.     

干扰素调节因子 5、粒细胞 -巨噬细胞集落刺激因子在细菌性肺炎病儿血清中的表达及预后价值

目的探讨干扰素调节因子 5(interferon regulatory factor 5,IRF5)、粒细胞 -巨噬细胞集落刺激因子( granulocyte-macrophage colony-stimulating factor,GM-CSF)在细菌性肺炎病儿血清中的表达变化及疾病预后价值。方法选取 2019年 4月至 2021年 5月中国人民解放军联勤保障部队第九二八医院收治的细菌感染性肺炎病儿 96例作为细菌组,同期非细菌感染性肺炎病儿 88例作为非细菌组,另外选取健康体检儿童 96例为对照组,收集检测三组病儿基本临床资料。检测血清中 IRF5、GM-CSF及其组间差异;采用 Pearson法分析细菌性肺炎病儿血清 IRF5、GM-CSF水平与病情指标的相关性;应用受试者操作特征曲线(ROC曲线)分析 IRF5、GM-CSF及二者联合预测细菌性肺炎预后的价值。结果细菌组血清 IRF5水平［(38.85±13.86)ng/L］显著高于非细菌组［( 11.15±4.37)ng/L］和对照组［( 10.76±1.55)ng/L］,且重症组高于轻症组( P<0.05);细菌组血清 GM-CSF水平［(54.73±16.56)ng/L］显著低于非细菌组［(246.73±28.94)ng/L］和对照组［(250.64±55.67)ng/L］,且重症组低于轻症组( P<0.05)。重症组气促、吐沫、三凹征、肺部明显湿啰音比例、 C反应蛋白( C-reactive protein,CRP)、白细胞水平显著高于轻症组、非细菌组(P<0.05)轻症组、非细菌组 CRP水平显著高于对照组( P<0.05),非细菌组 CRP水平显著高于对照组( P<0.05)。血清 IRF5水平与 CRP、,白细胞、临床肺部感染评分( clinical pulmonary infection score,CPIS)均呈正相关( r=0.34、0.36、0.41,P<0.05)血清 GM-CSF水平与 CRP、白细胞、 CPIS均呈负相关( r=-0.40、-0.32、-0.45,P<0.05)。预后不良组血清 IRF5水平高于预后良好,组,血清 GM-CSF水平低于预后良好组( P<0.05)。 ROC曲线显示, IRF5、GM-CSF对预后预测的 AUC分别为 0.90、0.87,二者联合对预后预测的 AUC为 0.96,明显高于二者单独诊断,(Z联合 vs.IRF5=2.86,P=0.004;Z联合 vs.GM-CSF =2.24,P=0.025),其灵敏度、特异度分别为 90.32%、90.77%。结论细菌性肺炎病儿血清 IRF5水平升高, GM-CSF水平降低,二者在评估病情进展及疾病预后预测方面具有较高的价值。     

利妥昔单抗治疗难治性激素耐药型肾病综合征的疗效和安全性

目的:探讨利妥昔单抗(RTX)治疗儿童难治性激素耐药型肾病综合征(SRNS)的疗效和安全性。方法:回顾性分析2013年9月至2018年3月东部战区总医院儿科收治并接受RTX治疗的10例难治性SRNS患儿的临床资料。结果:10例患儿发病年龄(4.47±2.75)岁,男女各5例;5例(50%)肾活检为局灶节段性肾小球肾炎,...