以“芪英三两三”组方经验为指导治愈顽固慢性再生障碍性贫血1例

慢性再生障碍性贫血属于临床血液系统常见疾病之一，发病率呈逐年升高趋势，病程长，易反复，对患者的生活质量形成严重影响。姜苗教授认为慢性再生障碍性贫血不仅与肾虚相关，且与脾胃升降功能联系密切，强调从脾论治，抓住“虚”“瘀”“毒”3个病理因素，活用“芪英三两三”组方加减，健脾益肾，化瘀解毒。文章以完全治愈1则顽固慢性再障合并继发血小板减少病案为例，探讨姜教授治疗慢性再生障碍性贫血思路及用药方案。     

仙花活骨丹颗粒含药血清对血管内皮细胞增殖及黏附分子表达的影响

目的以血清药理学方法观察仙花活骨丹颗粒对血管内皮细胞增殖及黏附分子表达的影响,探讨仙花活骨丹颗粒治疗股骨头缺血性坏死的药理学机制。方法建立人脐静脉内皮细胞体外培养模型,将ECV304细胞与仙花活骨丹颗粒不同剂量含药血清一起培养,MTT法观察细胞增殖情况,同时对细胞黏附分子表达进行测定。结景仙花活骨丹颗粒舍药血清处理24h后能不同程度促进血管内皮细胞ECV304的增殖（P〈0．05）,中剂量12h、48h、72h增值最明显（P〈0．01）;但72h较48h增值情况又有所下降。含药血清组CD54（ICAM-1）表达明显较空白对照组增多（P〈0．05）。中剂量组CD54（ICAM-1）表达呈高峰,而大剂量组CD54（ICAM-1）表达又有所降低。中剂量仙花活骨丹颗粒是促进的最佳浓度。结论仙花活骨丹颗粒能够促进内皮细胞的增殖以及细胞粘附分子的表达。     

Clinical significance and correlation of miR-200c and P-gp expression in gastric cancer and the effects on multidrug resistance

BackgroundPoor prognosis is common in gastric cancer patients due to multidrug resistance (MDR)-induced recurrence and metastasis. In the present study, we investigated the expression of microRNA (miR)-200c in gastric cancer tissues and cell lines and its relationship with the expression of the drug resistant gene ABCB1, which encodes P-glycoprotein (P-gp).MethodsThe basic characteristics of 102 patients with gastric cancer were reviewed. Real time-polymerase chain reaction (PCR), immunohistochemistry, and Western blot were employed to detect the expression levels of miR-200c and P-gp in gastric carcinoma tissues and cell lines. The correlation of miR-200c messenger RNA (mRNA) level with clinicopathological characteristics and P-gp protein expression were analyzed. SGC7901/vincristine (VCR) cells were transfected with miR-200c mimics or a specific small interfering RNA (siRNA) targeting the ABCB1 gene. The methyl thiazolyl tetrazolium (MTT) assay and flow cytometry were used to determine the role of miR-200c and ABCB1 on the viability and apoptosis of gastric carcinoma cell lines.ResultsThe level of miR-200c in carcinoma tissues was significantly lower than that in adjacent tissues, and the expression level of P-gp in carcinoma tissues was obviously higher than that in adjacent tissues (P<0.01, P=0.029). The expression levels of miR-200c and P-gp were associated with the malignant characteristics of gastric cancer, and patients with high expression of miR-200c or negative expression of P-gp had a better prognosis (P=0.006, P=0.022). MiR-200c negatively regulated the ABCB1 gene in gastric cancer cell lines. MiR-200c overexpression and ABCB1 down-regulation increased the sensitivity of SGC7901/VCR cells to VCR and reversed MDR by promoting cell apoptosis.ConclusionsThe expression level of miR-200c decreases in gastric carcinoma tissues and drug-resistant gastric cancer SGC7901/VCR cells. Overexpression of miR-200c may enhance the sensitivity of SGC7901/VCR cells to VCR by regulating the expression of P-gp.     

A cross-sectional study of obstructive sleep apnea in patients with colorectal cancer

BackgroundThe association between colorectal cancer (CRC) and obstructive sleep apnoea (OSA) has been attracting increasing attention. several studies had confirmed that OSA increases the risk of CRC onset. However, the findings of studies on the morbidity of OSA in patients with CRC were unclear. Therefore, this study aimed to investigate the morbidity of OSA in patients with CRC as well as the association between the clinicopathological characteristics of OSA and CRC.MethodsA total of 414 patients with a pathological diagnosis of CRC from 1 January, 2020 to 30 December, 2020 were included in this study. Demographic characteristics, clinical information, and tumor characteristics of participants were collected; sleep was monitored using a wearable oximeter and via sleep quality questionnaire. The oxygen desaturation index (ODI) was used to classify OSA severity so that the diagnostic criteria for OSA were set based on the ODI as 0–5 (normal) and ≥5 (abnormal). After correcting for confounding factors, a logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the factors affecting the tumor lymph node stage (N stage).ResultsA total of 402 patients with CRC were included in this study, including 225 (55.97%) men and 177 (44.03%) women. The mean ODI value of participants was 3.40±8.17. The morbidity of OSA among the patients with CRC having ODI ≥5 was 16.17%. A comparison between the normal and abnormal ODI value groups revealed that the high proportion of abnormal ODI was related to higher N stage (P<0.05). Logistic regression analysis revealed a correlation of ODI values and age to the N stage. Specifically, CRC patients with an abnormal ODI had a higher risk of lymph node metastasis compared to those with normal ODI (OR =1.915, 95% CI: 1.025 to 3.579). Moreover, patients with CRC aged ≥65 years had a higher risk of lymph node metastasis compared to those aged <65 years (OR =2.190, 95% CI: 1.163 to 4.125).ConclusionsCRC patients with abnormal ODI are susceptible to OSA. Additionally, abnormal ODI and age ≥65 years are relevant factors for the N2 stage.     

心电图机数字处理技术及其在临床教学中的应用

根据目前临床心电图教学的特点与需要,用微机信号数字处理技术改进普通心电图机,使其成为一种方便实用的临床心电图教学专用仪器.在通用计算机和普通心电图机的硬件基础上,制作、编制相应的硬件电路和教学应用软件,实现两者的联机和辅助临床教学功能.增加普通心电图机本身所不具备的诸多临床教学项目,如心电图记忆显示监护和心电向量图检测功能,提高图形的描记质量,方便图形数据的快速存取,建立并不断扩充临床心电图库,解决学生误操作所导致的仪器损坏、软件纠正左右手反接误操作等问题, 便于学生理解的心电图、心电向量图相互转换、图形同屏显示和额面导联体系心电图(F导联心电图)等.系统尚有价格低廉,组装容易,操作简便,易于推广等优点.     

食管失弛缓症的外科治疗

本文报告了我科手术治疗食管失弛缓症56例体会。56例中贲门肌层切开加膈肌瓣成形10例;贲门成形加胃底折叠28例;贲门肌层切开加部分胃底折叠18例。术后并发肌层切开部粘膜下积血1例,食管裂孔疝2例。全组无术后死亡及因复发而需再次手术病例。手术的总优良率96％(54/56)。文中还就治疗中的几个争论问题及疗效评价等进行了讨论。     

两种喂养方法对早期新生儿体重的影响

本文研究母乳与混合喂养对早期新生儿体重的影响，结果生理性体重下降在母乳喂养无混合喂养儿显著（Ｐ＜０．００１）。二者均在５日龄内结束生理性体重下降，且在５日龄净增体重都＞５０ｇ，二者相近。比中国１２城市足月适于胎龄新生儿的生理性体重下降期在１０ｄ内显著缩短。     

血管内超声和血流储备分数测定在冠状动脉临界病变治疗中的作用

目的 比较血管内超声检查(IVUS)和血流储备分数测定(FFR)在指导冠状动脉临界病变治疗中的临床效果.方法 将94例行冠状动脉造影提示冠状动脉临界病变的患者分为IVUS组和FFR组,分别接受IVUS或FFR检查,并以此为依据指导冠状动脉介入治疗.在IVUS组中,如MLA＜4 mm2或冠状动脉狭窄虽不足,但IVUS显示为不稳定斑块,则行冠状动脉介入治疗(PCI);在FFR组中,以FFR＜0.75作为行冠状动脉支架置入术的指征.术后随访6个月,比较两组患者心血管不良事件的发生情况.结果 (1)两组患者病史等一般信息及冠状动脉造影情况差异无统计学意义(P＞0.05).(2) IVUS组行介入治疗的比例高于FFR组(P＜0.01).(3)两组间不良事件的发生情况差异无统计学意义(P＞0.05).结论 IVUS和FFR检查均可用于指导冠状动脉临界病变的介入治疗,受准确性的限制IVUS不能取代FFR检查的地位.     

幽门螺杆菌刺激胃癌细胞株SGC-7901分泌白细胞介素-8过程中核因子κB的作用

目的　探讨胃上皮细胞在幽门螺杆菌 (Hp)刺激下分泌白细胞介素 8(IL 8)的过程中 ,核因子 κB(NF κB)的作用。方法　电穿孔法将I κBαM(NF κB抑制蛋白 )基因转染入SGC 790 1中 ,β半乳糖苷酶分析转染效率 ,Western印迹分析I κB基因的表达。将不同浓度的Hp活菌、灭活菌及液体培养上清分别与稳定转染I κB的胃癌细胞株SGC 790 1及其空白质粒对照共同孵育 ,凝胶电泳迁移率变迁分析 (EMSA)和NF κB荧光素酶报告基因分析检测不同时间细胞内NF κB的激活 ,ELISA法检测不同时间细胞上清中IL 8的水平。结果　得到了稳定表达I κB的SGC 790 1细胞 ,命名为SGC790 1 I κB细胞 ,其空白质粒对照命名为SGC790 1 neo。Hp活菌刺激的SGC790 1 neo在 2h和 4h时可检测到明显的NF κB激活 ,灭活菌和液体培养上清刺激下无激活 ;Hp活菌、灭活菌和培养上清刺激下SGC 790 1 I κB内均无NF κB激活。 4h时 ,2× 10 7Hp/ml的Hp活菌刺激下即可检测到SGC790 1 neo内明显的IL 8分泌 ,并有时间 剂量依赖效应 ;灭活菌和液体培养上清无此作用。Hp活菌、灭活菌和液体培养上清均不能刺激SGC790 1 I κB产生IL 8。结论　Hp诱导胃上皮细胞分泌IL 8依赖于NF κB的激活。     

冠心病患者血浆肾上腺髓质素浓度的变化

测定了48例冠心病(CHD)患者血浆肾上腺髓质素(Adm)的放免活性,结果示31例急性心肌梗塞(AMI)患者发病后即刻血浆Adm水平升高达峰值(118.4±9.49pg/ml),峰值较对照组(46.46±3.55pg/ml)增加1.5倍(p<0.001),第3天开始逐渐下降,第28天恢复至对照组水平,即刻血浆Adm与内皮素(ET)水平呈正相关(γ=0.9003,p<0.001);5例心绞痛(AP)发作时血浆Adm明显升高(101.7±10.15pg/m1),其值较对照组增加1.1倍p<0.001),AP缓释后2至3天恢复到正常水平;12例病情稳定的陈旧性心肌梗塞(OMI)患者血浆Adm轻度增高(70.55±10.99pg/ml);实验性心梗大鼠血浆Adm水平明显升高(p<0.001)。以上提示在血管壁及内皮细胞受损或(和)被激活后,多种血管活性肽的合成、释放及降解失衡,Adm释放增加,对维持机体循环的自身调节具有有益的保护作用。