吴茱萸碱衍生物纳米粒的多功能性药效学研究

目的:研究吴茱萸碱丁酰基衍生物(evodiamine butyryl derivative,EAB)和吴茱萸碱丁酰基衍生物固体脂质纳米粒(evodiamine butyryl derivative-loaded lipid nanoparticles,EABLN)在大鼠体内的多功能性药效学行为。方法:采用薄膜超声法制备EABLN,对制剂的外观、粒径、电位和包封率进行检测。将32只SD雄性大鼠随机分为正常组、模型组、EAB治疗组、EABLN治疗组,每天监测大鼠的体质量变化。治疗组先连续口服灌胃给药治疗1周后,再口服灌胃次黄嘌呤并皮下注射氧嗪酸钾后成功造就了大鼠的高尿酸血症模型,检测血清中尿酸(uric acid,UA)、血肌酐(serum creatinine,CR)、尿素氮(usea nitrogen,BUN)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、低密度脂蛋白(low density lipoprotein,LDL)、高密度脂蛋白(high density lipoprotein,HDL)、谷丙转氨酶(alanine ami...     

合肥市856名学龄前儿童睡眠问题分析

目的 分析合肥市学龄前儿童睡眠问题,为改善儿童睡眠健康提供依据。方法 合肥市妇幼保健计划生育服务中心于2018年4～6月采用儿童睡眠习惯问卷对合肥市瑶海区、新站区856名3～6岁儿童家长进行调查,观察比较学龄前儿童就寝时间及夜间睡眠时间,分析学龄前儿童睡眠问题及其危险因素。结果 合肥市学龄前儿童平均每日就寝时间为21：39,夜间睡眠时间为（9.72±0.62）h。23.01%儿童就寝时间晚于22：00,61.45%儿童夜间睡眠时间<10 h。总体睡眠问题发生率为790名（92.29%）,以睡眠焦虑774名（90.42%）、就寝习惯不良757名（88.43%）、睡眠持续时间不规律580名（67.76%）、白天嗜睡576名（67.29%）最常见,儿童与家人同床睡眠率高达667名（77.92%）。同床睡眠是儿童睡眠质量不良的独立危险因素（OR=11.288,P<0.001）。结论 合肥市学龄前儿童睡眠习惯不良较为普遍,应引起家长和社会重视。     

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目的 探讨急性肠系膜血管供血不全的诊断和治疗。方法 对1972年11月至1999年10月经治的20例急性肠系膜血管供血不全的临床资料进行回顾性分析。结果 该病多为高龄，常伴有心血管疾病和发生绞窄性肠梗阻，病死率很高（本组为45%）。结论 充分认识该病，选用恰当的检查技术，早期诊断，及时手术，是提高急性肠系膜血管供血不全治疗效果的关键。     

Smad7 inhibits fibrotic effect of TGF-Beta on renal tubular epithelial cells by blocking Smad2 activation

It has been shown that transforming growth factor-beta (TGF-beta) is a potent mediator in renal fibrosis and that Smad proteins are critical intracellular mediators in TGF-beta signaling. It is here reported that TGF-beta mediates renal fibrogenesis in tubular epithelial cells (TEC) in association with the activation of Smad2 and that overexpression of Smad7 blocks this fibrotic process. Using a normal rat kidney tubular epithelial cell line (NRK52E), it was determined that TGF-beta1 induces Smad2 phosphorylation and nuclear localization in both a dose- and time-dependent manner. The activation of Smad2 was evident at 5 min (20%), peaked at 15 to 30 min (85%), and declined to baseline levels by 2 h (5 to 10%). This was associated with de novo expression of collagens I, III, and IV and the transformation of TEC into a "myofibroblast" phenotype with de novo expression of alpha-smooth muscle actin (alpha-SMA) and with the loss of E-cadherin (>50%). To investigate a negative regulatory role of Smad7 in renal fibrosis, the Smad 7 gene was stably transfected and its expression was tightly controlled by doxycycline into NRK52E cells. Overexpression of Smad7 induced by doxycycline results in marked inhibition of TGF-beta-induced Smad2 activation (90% downward arrow) with the prevention of collagen synthesis and myofibroblast transformation. Thus, Smad2 activation occurs in the fibrogenic response of TEC to TGF-beta, and this process is blocked by overexpression of Smad7. This indicates that Smad signaling is a key pathway of TGF-beta-mediated renal fibrosis and suggests that treatments targeting the inactivation of Smad2 by overexpression of Smad7 may provide a new therapeutic strategy for renal fibrosis.     

股腘动脉粥样硬化病变腔内治疗的疗效分析

目的评价股腘动脉硬化病变腔内治疗的近期临床疗效。方法回顾性分析2008年1月～2009年6月收治的55例(57条患肢)TASCC型股腘动脉病变患者的临床资料,其中50例(52条患肢)施行经皮血管腔内球囊成形术和支架植入术,应用踝/肱指数(ABI)、Fontaine分期、保肢率和通畅率综合评估治疗效果。结果腔内治疗技术成功率91.2%,围手术期死亡率5.3%,截肢率3.5%。腔内治疗明显提高患肢足背动脉AB(I0.38±0.17vs0.68±0.39,P0.01)和胫后动脉的AB(I0.41±0.18vs0.72±0.50,P0.05)。重症下肢缺血(CLI)的患肢数由治疗前的36条(63.2%)减少至治疗后的19条(36.5%),差异具有统计学意义(P0.01)。平均随访(11.4±6.4)个月,随访期足背动脉和胫后动脉ABI分别为0.48±0.38和0.61±0.47,与术前和术后相比,差异均有统计学意义(P0.05);随访期CLI的患肢数(12条,29.3%)与治疗前(36条,63.2%)比较,差异有统计学意义(P0.05),与治疗后(19条,36.5%)比较,差异无统计学意义(P0.05)。结论腔内治疗TASCC型股腘动脉硬化病变创伤小,近期临床疗效满意。     

老年人生活质量评价指标的研究现状与思考

阐述了老年人生活质量的概念,老年人生活质量的评价指标体系包括客观评价指标、主观评价指标及主客观结合评价指标。在此基础上,思考构建了一套能全面反映老年人生活质量的主、客观相结合的综合生活质量指标体系,该指标体系包含生命健康系统、经济与消费系统、人居环境系统、交通状况系统、社会支持系统、社会保障系统、公共安全系统、医疗卫生系统、文化休闲系统九大系统。该指标体系重视老年人的主客观生活感受,能更全面地评价老年人的生活质量。     

甲状腺乳头状癌淋巴结转移规律的研究

目的探讨甲状腺乳头状癌淋巴结转移的规律,为临床行选择性颈淋巴结清扫术提供依据。方法回顾性分析华中科技大学附属协和医院乳腺、甲状腺外科中心2003年6月至2006年6月间行甲状腺癌根治＋颈淋巴结清扫术,且颈清扫的淋巴结数目大于8枚的83例甲状腺乳头状癌临床资料。结果甲状腺乳头状癌最容易转移至Ⅵ区（单侧甲癌72.3%,双侧甲癌88.9%）,其次是Ⅲ、Ⅳ区（单侧甲癌57.9%,双侧甲癌50%～66.7%）,Ⅴ区和Ⅰ区较少发生淋巴结转移（单侧甲癌0%～20.1%,双侧甲癌25%～33.3%）。侵犯甲状腺包膜（88%）和滤泡亚型（85.7%）的甲状腺癌容易发生颈淋巴结转移。良性病变局部恶变（27.3%）和包膜型（25%）甲状腺癌,较少发生颈淋巴结转移。甲状腺上极的肿瘤可以先出现颈外侧区淋巴结转移。结论甲状腺乳头状癌的淋巴结转移的研究有助于确定选择性颈淋巴结清扫术范围,建议甲状腺乳头状癌常规清扫Ⅵ区淋巴结,肿瘤位于甲状腺下极者需清扫对侧下极淋巴结;对于肿瘤位于甲状腺上极的患者,应增加清扫Ⅱ、Ⅲ区的淋巴结。对风险较高的滤泡亚型及侵犯包膜的甲状腺乳头状癌清扫范围要更大,应清扫Ⅱ～Ⅵ区淋巴结。     

肝移植术中门静脉阻断前后血液成分变化的研究

目的 研究肝移植术中门静脉阻断前后血液成分变化及临床意义。方法 32例肝病患者于静吸复合全麻下行无转流原位肝移植术。常规麻醉监测，并放置Swan-Ganz导管检测心输出量，无肝前期、无肝期给予抑肽酶输注，通过输液、给予去甲肾上腺素及多巴胺，维持无肝期平均动脉压〉70mmHg，心输出量指数〉2.5L·min^-1·m^-2。分别于门静脉阻断即刻、门静脉开放即刻采集门静脉血液测定电解质、血气及炎性细胞因子浓度（肿瘤坏死因子tumor necrosis factor alpha，TNF-α；白介素Interleukin-6，IL-6）。结果 阻断前、后血钙、血镁浓度均明显低于正常值。无肝期后门静脉血钾、乳酸、TNF-α及IL-6浓度显著升高（P〈0.05）；门静脉血血氧分压显著降低（P〈0.05），但仍超过40mm Hg。与C级患者相比，A级患者门静脉阻断前后血乳酸、IL-6的净变化量增加；门静脉血氧分压、二氧化碳分压净变化值呈下降趋势。结论 无肝期门静脉阻断后，其血液成分发生明显变化，开放循环前门静脉放血可能具有重要临床意义，Child A级患者门静脉开放前放血意义可能更大；但对心、肺功能影响的意义还有待探索。     

类风湿关节炎致自发性手指肌腱断裂的临床分析

目的探讨类风湿关节炎致自发性手指肌腱断裂的临床特点和治疗效果。方法对8例自发性手指肌腱断裂的患者（均有3～8年类风湿关节炎的病史），其中2例拇长伸肌腱断裂，采用示指固有伸肌腱转位修复；3例环、小指指伸肌腱断裂，采用环指指伸肌腱与中指指伸肌腱端侧编织缝合，示指固有伸肌腱移位修复小指固有伸肌腱；2例中、环、小指指伸肌腱断裂，采用冷冻异体指伸肌腱移植修复。1例拇长屈肌腱断裂，采用环指指浅屈肌腱转位修复。结果术后局部滑膜和肌腱组织送病理检查均显示为慢性炎症伴局灶性坏死。术后随访6个月～7年，未见肌腱再次断裂，优良率为100％。结论多根肌腱同时断裂是类风湿关节炎致自发性手指肌腱断裂的常见特点，手术采用肌腱转位或异体肌腱移植术，疗效确切。     

Upregulation of type I interleukin−1 receptor after traumatic spinal cord injury in adult rats

Post-traumatic inflammation response has been implicated in secondary injury mechanisms after spinal cord injury (SCI). Interleukin-1 (IL-1) is a key inflammatory mediator that is increasingly expressed after SCI. The action of IL-1 is mediated through its functional receptor, type I interleukin-1 receptor (IL-1RI). However, whether this receptor is expressed after SCI remains to be elucidated. In the present study, the temporospatial expression of IL-1RI was detected in rats that received a moderate contusive SCI (a 10 g rod dropped at a height of 12.5 mm) at the ninth to tenth thoracic vertebral level using a widely used New York University impact device. Our study demonstrated that IL-1RI was slightly increased at 4 h post-injury compared to the normal or sham-operated controls, reached the peak at 8 h at mRNA level (4.44-fold, P<0.01) and 1 d at protein level (2.62-fold, P<0.01). IL-1RI remained at its elevated levels for a relatively long duration (4 h–7 days). Spatially, IL-1RI was observed throughout the entire length of a 10 mm-long cord segment containing the injury epicenter. Colocalization of IL-1RI was found in neurons, oligodendrocytes, astrocytes, and activated microglia. Our results suggest that the elevated expression of IL-1RI after SCI may contribute to posttraumatic inflammation responses of IL-1.