丹田降脂丸联合辛伐他汀对慢性脑供血不足患者血脂及血清超敏C反应蛋白的影响

目的 观察丹田降脂丸和辛伐他汀联合治疗对慢性脑供血不足患者血脂及超敏C反应蛋白(hs-CRP)水平的影响.方法 将114例慢性脑供血不足患者随机分为对照组、辛伐他汀组、联合组.对照组给予常规治疗;辛伐他汀组在常规治疗基础上加用辛伐他汀片20 mg,每日1次口服;联合组在常规治疗基础上加用丹田降脂丸2 g,每日2次、辛伐他汀片20 mg每日1次口服.3组分别测血脂、hs-CRP水平浓度.结果 治疗后联合组、辛伐他汀组总胆固醇(TC)、低密度脂蛋白(LDL-C)、hs-CRP水平均明显下降,与对照组相比有统计学意义(P<0.05),联合组较辛伐他汀组TC、LDL-C下降水平无明显差异(P>0.05),联合组较辛伐他汀组hs-CRP、TG下降和高密度脂蛋白(HDL-C)升高水平有明显差异(P<0.05).治疗期间无明显不良反应发生.结论 丹田降脂丸和辛伐他汀联合治疗可有效改善慢性脑供血不足患者的血脂水平,降低血清hs-CRP,有效抑制炎性反应,延缓动脉粥样硬化斑块的形成及发展.     

脑肠互动与针刺治疗功能性胃肠病的相关性

功能性胃肠病是临床上常见的消化系统疾病,也是针刺治疗的优势病种.近年来的研究表明,脑肠轴功能失调是功能性胃肠病发病的重要原因,而针刺对脑肠轴的调节作用是其治疗功能性胃肠病的主要着眼点.随着脑功能成像技术的发展和脑肠肽研究的进展,功能性胃肠病与中枢神经系统及脑肠肽代谢相关性的研究日益增多.针灸作为传统中医疗法的一部分,治疗功能性胃肠病疗效显著,被广泛运用于临床.大量研究显示,针刺既能调节中枢神经系统,也能调控脑肠肽代谢.本文拟从中枢神经系统、脑肠肽代谢两方面,探讨脑肠互动与针刺治疗功能性胃肠病的相关性.     

主动脉夹层症状与原发破口位置、撕裂范围关系的探讨

目的:探讨主动脉夹层首发症状与内膜原发破口位置和撕裂范围的关系。方法:回顾性总结931例主动脉夹层患者的首发症状、疼痛部位、是否有转移性疼痛、撕裂范围等情况,分析不同症状与原发破口和撕裂范围的关系。结果:疼痛占夹层首发症状的91.2%,其中以胸痛(40.3%)、胸背痛(25.9%)和腹痛(11.7%)最多见,17.6%的患者合并有转移性疼痛。表现为无痛(包括晕厥、胸闷、气短)或仅为胸痛症状的患者以A型夹层多见(均P0.05)。而以背痛、腹痛、腰痛等为首发症状的多见于B型夹层(均P0.05),且此类患者的内膜撕裂终点多位于腹主动脉及以下血管,而首发症状为头、颈或咽喉部疼痛的患者夹层撕裂范围多局限于胸降主动脉。结论:主动脉夹层症状呈多样性特点,首发症状与原发破口位置和撕裂范围之间存在规律性,此有助于对急诊疑似主动脉夹层进行初步的诊断。     

MicroRNA‐181a,a potential diagnosis marker,alleviates acute graft versus host disease by regulating IFN‐γ production

Allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is a valuable therapeutic strategy for a wide variety of diseases. Acute graft‐versus‐host disease (aGVHD) is a major complication in up to 75% of allo‐HSCT. The absence of a reliable predicative marker for aGVHD onset prevents preemptive treatment and impedes widespread and successful application of this therapy. In this study we found that after allo‐HSCT, the levels of miR‐181a were reduced significantly prior to the onset of aGVHD. More importantly, the degree of its reduction correlated with the severity of aGVHD. Mechanistically, miR‐181a affects the function of T lymphocytes by down‐regulating IFN‐γ in a dose‐dependent manner. Meanwhile, we confirmed that miR‐181a can effectively preserve the anti‐leukemic effect in vitro. Using a murine allo‐HSCT model, we demonstrated that murine miR‐181b, the human miR‐181a homolog, served as an effective predictor of aGVHD. Moreover, expression of this microRNA ameliorated the severity of aGVHD. Collectively, these results show that the level of miR‐181a may serve as a reliable marker for the diagnosis and prognosis the onset of aGVHD. Am. J. Hematol. 90:998–1007, 2015. © 2015 Wiley Periodicals, Inc.     

心脏再生的研究新进展

心肌梗死后容易发生心衰、恶性心律失常甚至猝死等而威胁患者生命,有效改善心梗患者心功能促进心肌再生已经成为研究的热点。目前促进心肌再生的方法可大体概括为干细胞法诱导心肌增殖,微小核糖核酸诱导心肌再生,调控心肌细胞增殖有关的通路及细胞周期因子诱导心肌增殖,调节心肌细胞微环境诱导心肌增殖。虽然这些方法的研究都取得了一定的进展,但许多机制并未明确,也有诸多问题没有解决,还需要更深入的研究,随着心脏再生的研究,这一领域必将带来振奋人心的结果。     

Different patterns of association between white matter microstructure and plasma unsaturated fatty acids in those with high risk for psychosis and healthy participants

BackgroundDisrupted white matter (WM) microstructure has been commonly identified in youth at clinical high risk (CHR) for psychosis. Several lines of evidence suggest that fatty acids, especially unsaturated fatty acids (UFAs), might play a crucial role in the WM pathology of early onset psychosis. However, evidence linking UFA and WM microstructure in CHR is quite sparse.AimsWe investigated the relationship between the plasma UFA level and WM microstructure in CHR participants and healthy controls (HC).MethodsPlasma fatty acids were assessed and diffusion tensor imaging (DTI) data were performed with tract-based spatial statistics (TBSS) analysis for 66 individuals at CHR for psychosis and 70 HC.ResultsBoth the global and regional diffusion measures showed significant between-group differences, with decreased fractional anisotropy (FA) but increased mean diffusivity (MD) and radial diffusivity (RD) found in the CHR group compared with the HC group. On top of that, we found that in the HC group, plasma arachidic acid showed obvious trend-level associations with higher global FA, lower global MD and lower global RD, which regionally spread over the corpus callosum, right anterior and superior corona radiata, bilateral anterior and posterior limb of the internal capsule, and bilateral superior longitudinal fasciculus. However, there were no associations between global WM measures and any UFA in the CHR group. Conversely, we even found negative associations between arachidic acid levels and regional FA values in the right superior longitudinal fasciculus and right retrolenticular part of the internal capsule in the CHR group.ConclusionsCompared with the HC group, CHR subjects exhibited a different pattern of association between WM microstructure and plasma UFA, with a neuroprotective effect found in the HC group but not in the CHR group. Such discrepancy could be due to the excessively upregulated UFAs accumulated in the plasma of the CHR group, highlighting the role of balanced plasma-membrane fatty acids homeostasis in WM development.     

两种不同剂型非诺贝特(力平脂D○R)降脂作用的临床研究

高脂血症是冠心病的重要原因之一,用饮食控制,适当运动等措施如不见效,则应考虑药物疗法.作为新一代的苯氧芳酸类/降脂药非诺贝特(力平脂D○R),于1975年开始应用于临床以来,广为欢迎.本文旨在对两种不同剂型的非诺贝特降脂效果,安全性、预防心脏性事件发生的进行比较研究.