Early diagnosis of psoriatic arthritis among psoriasis patients: clinical experience sharing

Clinical Rheumatology - The early detection of psoriatic arthritis (PSA) poses a challenge to rheumatologists, even when their diagnosis is aided by sonography. In order to facilitate early...     

Sleep apnea and risk of deep vein thrombosis: a non-randomized, pair-matched cohort study

BackgroundPatients with sleep apnea have been reported to be associated with increased prevalence of deep vein thrombosis (DVT) in some papers, which were criticized for either a small sample size or lack of a prospective control. Our study strived to explore the relationship of sleep apnea and the subsequent development of DVT using a nationwide, population-based database.MethodsFrom 2000 to 2007, we identified a study cohort consisting of newly diagnosed sleep apnea cases in the National Health Insurance Research Database. A control cohort without sleep apnea, matched for age, sex, comorbidities, major operation, and fractures, was selected for comparison. The 2 cohorts were followed-up, and we observed the occurrence of DVT by registry of DVT diagnosis.ResultsOf the 10,185 sampled patients (5680 sleep apnea patients vs. 4505 control), 40 (0.39%) cases developed DVT during a mean follow-up period of 3.56 years, including 30 (0.53%) from the sleep apnea cohort and 10 (0.22 %) from the control group. Subjects with sleep apnea experienced a 3.113-fold (95% confidence interval, 1.516-6.390; P = .002) increase in incident DVT, which was independent of age, sex, and comorbidities. Kaplan-Meier analysis also revealed the tendency of sleep apnea patients toward DVT development (log-rank test, P = .001). The risk of DVT was even higher in sleep apnea cases who needed continuous positive airway pressure treatment (hazard ratio 9.575; 95% confidence interval, 3.181-28.818; P <.001).ConclusionSleep apnea may be an independent risk factor for DVT.     

肝动脉化疗栓塞术中注入重组人血管内皮抑制素治疗中晚期肝癌的疗效及安全性分析

目的：观察重组人血管内皮抑制素经肝动脉灌注联合TACE治疗中晚期肝癌的近期及远期疗效。方法将64例中晚期肝癌患者分为对照组（n=30例),仅予以TACE治疗,和观察组（n=34例）,在行TACE治疗时,同时经肝动脉注入重组人血管内皮抑制素,比较两组近、远期疗效,观察治疗前后肿瘤直径、KPS评分及AFP变化,分析两组毒副反应。结果观察组治疗总有效率（64.7%）明显高于对照组（43.3%,P<0.05）;两组患者治疗后肿瘤直径[（4.0±1.2） cm和（4.9±1.3） cm]较治疗前[（6.7±2.0） cm和（6.6±2.2） cm]明显缩小（P<0.05）,KPS评分明显升高[（92.5±9.8）对（76.1±4.5）和（84.8±8.6）对（75.2±3.4）,P<0.05],AFP明显降低[（547.2±160.7）μg/L对（1275.3±316.8）μg/L和（558.5±176.4）μg/L 对（1218.8±337.9）μg/L,P<0.05],且观察组肿瘤直径[（4.0±1.2） cm、KPS评分（92.5±9.8）较对照组缩小（4.9±1.3） cm或升高（84.8±8.6）更为显著,P<0.05];两组毒副反应比较差异无显著性（P>0.05）;随访1年,观察组患者病死率（5.9%）和肝外转移率（14.7%）明显低于对照组患者（16.7%和26.7%, P<0.05）。结论在行TACE治疗时加用重组人血管内皮抑制素治疗中晚期肝癌患者可明显提高近期及远期疗效,缩小肿瘤直径和改善KPS评分,且不会加重毒副反应。     

改良构建大鼠单侧输尿管梗阻肾间质纤维化模型

文题释义：肾盂积液：输尿管完全或不完全梗阻时,由于尿液无法正常排出体外而导致肾盂积液。慢性肾盂积液引起的肾脏损伤是不可逆的,可由多种上尿路梗阻性疾病诱发,导致肾盂肾盏扩大,肾小管与肾小球结构与功能丧失,进而肾组织萎缩。 肾间质纤维化：是各种慢性肾病发展至终末期的共同病理特征,以肾小管间质瘢痕硬化为特征,最终导致肾脏组织功能完全丧失。该过程受到转化生长因子β、成纤维细胞生长因子、内分泌等信号通路的调控,肾间质纤维化动物模型是研究相关药物药理机制的重要模型。 背景：传统的大鼠单侧输尿管梗阻手术方法,可以在较短的时间内(一两周)导致动物梗阻侧肾脏发生肾间质纤维化,但具有术后并发症较多、死亡率较高的缺点。 目的：优化并改良大鼠单侧输尿管梗阻手术操作,降低动物术后的并发症发生率,提高存活率,检测改良单侧输尿管梗阻方法建模大鼠的病理生理指标,为功能药理学基础研究提供背景数据支持。 方法：①取20只雄性SD大鼠,随机分为4组,分别进行传统单侧输尿管梗阻方法结扎、改良单侧输尿管梗阻方法结扎、不游离输尿管结扎、开腹腔但不结扎输尿管(假手术组)操作,术后14 d时比较组间大鼠肾间质纤维化成模率、死亡率、术后并发症发生率的差异;②另取28只SD大鼠,雌雄各半,随机分为改良组与假手术组,采用尿液分析、血细胞分析、血液生化分析方法,检测两组大鼠的生理指标,并通过苏木精-伊红染色与Masson染色法,观察改良组大鼠术后14,21 d时的肾脏组织病理学结果。 结果与结论：①与不游离输尿管结扎组大鼠相比,传统单侧输尿管梗阻组和改良单侧输尿管梗阻组大鼠的成模率高;②在单侧输尿管梗阻手术操作过程中,采用输尿管中段双结扎、中间不剪断的改良方法与传统方法相比,操作更简便易行,手术开创更小,肾间质纤维化成模快、成模率较高,动物术后死亡率与并发症发生率均低;③改良组与假手术组相比,术后14 d时的尿素氮、谷草转氨酶、白蛋白等血液生化指标差异有显著性意义(P < 0.05),其梗阻侧肾脏的组织病理切片苏木精-伊红染色与Masson染色结果均可见典型的肾间质纤维化病理特征。 ORCID: 0000-0001-7823-2897(孙杰) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

立体定向移植骨髓间充质干细胞改善血管性大鼠的学习记忆能力

背景:大量的实验证明将骨髓间充质干细胞移植到复制的中枢神经系统疾病大鼠模型后,能迁移到损伤部位,表达神经细胞的潜在特性并且提高神经功能。目的:验证骨髓间充质干细胞对拟人类血管性痴呆模型大鼠学习记忆障碍的改善作用。方法:分离SD大鼠骨髓间充质干细胞,于细胞移植前掺入10mg/L的BrdU进行标记。建立Wistar大鼠血管性痴呆样学习记忆障碍动物模型,随机分为模型组、假手术组与移植组。移植组致伤后第14天,通过立体定向途径移植骨髓间充质干细胞到大鼠海马,假手术组给予等量生理盐水,模型组大鼠不做处理。采用Morris水迷宫检测大鼠空间学习记忆能力。损伤后第90天处死大鼠,观察海马组织有无Brdu+神经元特异性烯醇化酶、Brdu+胶质纤维酸性蛋白免疫组织化学双染阳性细胞,并且观察从侧脑室到海马是否存在神经元前体细胞的标志Doublecortin(DCX)吻侧迁移流。结果与结论:①移植组大鼠采用Morris水迷宫检测大鼠空间学习记忆能力逃避潜伏期及跨越平台次数优于模型组及假手术组(P<0.05)。②移植组大鼠海马组织及其周围可见免疫组织化学双染阳性细胞,但未见从侧脑室到海马关于神经元前体细胞的标志Doublecortin(DCX)吻侧迁移流。结果提示,骨髓间充质干细胞移植可以促进脑损伤大鼠的神经功能的恢复,其机制可能与移植细胞分化为神经元样和神经胶质细胞样细胞,并分泌或促进宿主分泌神经营养因子有关。     

Effect of Bacillus subtilis,Enterococcus faecium,and Enterococcus faecalis supernatants on serotonin transporter expression in cells and tissues

BACKGROUND Bacillus subtilis(B.subtilis),Enterococcus faecium(E.faecium),and Enterococcus faecalis(E.faecalis)are probiotics that are widely used in the clinical treatment of irritable bowel syndrome(IBS).Whether the supernatants of these three probiotics can improve gastrointestinal sensation and movement by regulating the serotonin transporter(SERT)expression needs to be clarified.AIM To investigate whether B.subtilis,E.faecium,and E.faecalis supernatants can upregulate SERT expression in vitro and in vivo.METHODS Caco-2 and HT-29 cells were stimulated with probiotic culture supernatants for 12 and 24 h,respectively.A male Sprague-Dawley rat model of post-infectious irritable bowel syndrome(PI-IBS)was established and the rats were treated with phosphate-buffered saline(group A)and three probiotics culture supernatants(groups B,C,and D)for 4 wk.The levels of SERT were detected by quantitative PCR and western blotting.RESULTS The levels of SERT at post-treatment 12 and 24 h were significantly elevated in Caco-2 cells treated with B.subtilis supernatant compared with those in the control group(aP<0.05).Those levels were markedly upregulated in Caco-2 cells stimulated with E.faecium and E.faecalis supernatants at 24 h(aP<0.05).In addition,SERT expression in groups B,C,and D was significantly higher than that in group A in the 2nd wk(aP<0.05).Increased SERT expression was only found in group D in the 3rd wk(aP<0.05).However,there was no significant difference in SERT expression between the groups in the last week(P>0.05).CONCLUSION The supernatants of B.subtilis,E.faecium,and E.faecalis can upregulate SERT expression in intestinal epithelial cells and the intestinal tissues in the rat model of PI-IBS.