复方苦参洗剂外用对皮肤毒性的实验研究

为观察复方苦参洗剂对家兔及豚鼠皮肤的毒性作用,本研究用家兔进行皮肤急性毒性实验和皮肤刺激性实验,用豚鼠进行皮肤过敏性实验。结果显示,用复方苦参洗剂外涂于家兔完整皮肤和破损皮肤均未发生急性毒性反应和刺激反应。豚鼠皮肤也未发生过敏性反应。结果表明,复方苦参洗剂是安全的外用制剂,可在临床上推广应用。     

运脾颗粒对脾虚型慢传输型便秘小鼠SP和VIP含量的影响

为观察运脾颗粒对脾虚型慢传输型便秘小鼠肠道传输功能及结肠组织中P物质（sP）和血管活性肠肽（VIP）含量的影响,探讨运脾颗粒治疗脾虚型慢传输型便秘的药效与机制,为该药治疗便秘提供科学依据。采用复合造模法建立小鼠脾虚型慢传输型便秘模型,将小鼠分为空白对照组（A组）、模型对照组（B组）、麻仁对照组（c组）、运脾颗粒大剂量组（D组）、运脾颗粒中剂量组（E组）、运脾颗粒小剂量组（F组）,分别灌服相应药物,末次灌胃后测量肠道墨汁推进率;按放射免疫试剂盒方法分别测出结肠组织匀浆中SP、VIP的含量。结果显示,运脾颗粒能明显提高小鼠肠道传输功能,D组效果优于C组（P〈0．05）。运脾颗粒可明显增加便秘模型小鼠结肠组织中SP及VIP的含量,D、E、F组均优于c组（P〈O．05）,D组最明显（P〈0．01）。结果表明,运脾颗粒能明显提高小鼠肠道传输功能,且各项指标均优于C组（P〈0．05）,其机制可能是通过升高慢传输型便秘小鼠结肠中SP及VIP的含量来提高肠道传输功能。     

股骨转子间骨折3种内固定方法的疗效比较

目的探讨不同内固定治疗股骨转子间骨折的临床疗效。方法 97例股骨转子间骨折患者按治疗方法分为3组:动力髋螺钉固定组(A组)37例,解剖锁定钢板固定组(B组)36例,Gamma钉固定组(C组)24例。分析各种方法的疗效及优缺点。结果手术时间:A组为(102±19)min,B组为(75±15)min,C组为(71±11)min;A组与B、C组比较差异均有统计学意义(P<0.01),B组与C组比较差异无统计学意义(P>0.05)。出血量:A组为(501±134)ml,B组为(212±38)ml,C组为(198±31)ml;A组与B、C组比较差异均有统计学意义(P<0.01),B组与C组比较差异无统计学意义(P>0.05)。术中X线暴露次数:A组为(7±3)次,B组为(8±3)次,C组为(8±2)次;3组间两两比较差异无统计学意义(P>0.05)。术后髋关节功能Harris评分优良率:A组83.78%,B组88.88%,C组87.50%。结论 Gamma钉具有手术耗时少、术中X线透视时间短、创伤小、术后内固定稳定性强、并发症少、骨折愈合快、患肢功能恢复快等优点,可以作为治疗股骨转子间骨折优选内固定方法;解剖锁定钢板结合微创技术治疗股骨转子间骨折也有较大的适用范围;动力髋螺钉操作简单,适宜应用于无严重骨质疏松的A1型和A2转子间骨折。     

无体模法定量CT测量椎体骨密度的可信度及重复性研究

[目的] 评价无体膜定量CT测量腰椎骨密度(BMD)的观察者内及观察者间一致性和可重复性。 [方法] 将31例患者的腰椎螺旋CT扫描数据传输至工作站进行骨密度测量。由3位经过培训的脊柱外科医生独立进行腰椎BMD测量,每位观察者对患者均测量2次。观察者内或观察者间的差异用重复测量的方差分析比较,一致性分析用组内相关系数(ICC)描述。观察者间的可靠性分析用Cronbach"s alpha系数描述。 [结果] 观察A 2次测得腰椎BMD为(67.14±26.71) mg/cc和(66.37±26.69) mg/cc,两者间差值率为(4.22±2.55)%(P=0.12, ICC=0.995);观察者B 2次测量的BMD为(68.89±29.37) mg/cc和(68.54±28.98) mg/cc, 差值率为(5.08±3.83)% (P=0.56, ICC=0.994);观察者C 2次测量的BMD为(69.31±26.72) mg/cc和(69.83±27.90) mg/cc, 差值率为(4.16±3.03)% (P=0.31, ICC=0.995)。 3个观察者所测腰椎BMD的值分别是(66.76±26.66)、(68.71±29.13)、(69.57±27.28) mg/cc ( P=0.15, ICC=0.957, Cronbach"s alpha系数 =0.985)。[结论] 无体膜QCT测量腰椎BMD具有较高的一致性和可重复性。     

miRNA与热应激的关系及检测方法进展

热应激是机体长期暴露在热环境中无法充分将体内的热散出而导致机体温度失衡的一种状态。随着miRNA检测技术的进步,许多学者发现,热应激会导致miRNA的表达量发生变化。miRNA可以通过结合其靶基因,抑制miRNA靶基因的表达,从而在调控机体生命活动和抗热应激中发挥重要作用。     

纳米硫化镉呼吸道亚慢性暴露对雄性大鼠的生殖毒性

目的探讨纳米硫化镉(CdS)对大鼠睾丸的氧化损伤及对精子的影响。方法 32只雄性清洁级SD大鼠随机分为对照组(蒸馏水)、10 mg/kg、20 mg/kg和30 mg/kg的纳米CdS组,每组8只。采用肺灌注方法染毒,2次/周,持续染毒12周。计算睾丸脏器系数,测定睾丸组织中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)活力和丙二醛(MDA)含量,观察精子数量、畸形率、活动度和睾丸的病理学变化。结果与对照组相比,30 mg/kg染毒组精子数量、精子活动度降低,10、20、30 mg/kg染毒组精子畸形率增高(P<0.05)。与对照组相比,30 mg/kg染毒组的大鼠睾丸SOD、GSH-Px活力降低(P<0.05),10、20、30 mg/kg染毒组的大鼠睾丸MDA含量增高(P<0.05)。染毒组生精小管内生精细胞脱落,层次减少,各级生精细胞排列紊乱,管内生精细胞疏松、排列紊乱、上皮变薄,管腔内可见脱落的精子细胞。结论纳米硫化镉经呼吸道染毒可致大鼠睾丸病理改变,氧化损伤,并且引起精子数量减少,活动度降低,畸形率增加。     

维生素A、D、E水平与儿童反复呼吸道感染相关性研究

目的 分析儿童反复呼吸道感染(RRTI)与患儿血清维生素A、D、E水平的相关性,为临床防治提供理论依据。方法 2017年1-12月采集在广西壮族自治区人民医院儿科就诊的6个月~15岁儿童资料,选取171例RRTI儿童为RRTI组,156例为正常对照组。采用高效液相色谱法测定两组儿童血清维生素A和E水平,采用化学发光法检测血清维生素D₃水平。比较RRTI组和正常对照组维生素A、D₃、E水平的差异。结果 RRTI组平均血清维生素A水平为(0.30±0.06)mg/L,维生素D₃水平为(72.41±25.59)nmol/L,维生素E水平为(8.90±2.32)mg/L,均低于正常组的(0.39±0.07)mg/L、(84.84±29.96)nmol/L和(9.72±2.61)mg/L,差异均有统计学意义(P<0.01)。维生素A、D₃缺乏率和不足率、维生素E的不足率在RRTI组均高于正常对照组,差异有统计学意义(P<0.05)。Logistic回归分析提示维生素A水平低(<0.3 mg/L)(OR=19.225,95%CI:9.136~40.453)和维生素D₃缺乏(<50 nmol/L)(OR=2.891,95%CI:1.186~7.044)使得儿童患RRTI的风险增高。结论 维生素A和维生素D₃的亚临床水平缺乏可能与儿童RRTI相关,及时给予补充有助于儿童RRTI的防治。     

新冠肺炎疫情下中医风湿科治疗策略

以结缔组织病为主体的风湿病都是慢性疾病,需要长期持续性治疗。新型冠状病毒肺炎(COVID-19)流行期间,为了控制传染源,切断传播途径,全国各地均实行交通管制,风湿病患者复诊困难。医师无法判断患者病情控制的水平,无法了解服药后是否已产生不良反应,故而难以为患者提供全面的治疗建议。作为补救措施,可通过加患者微信开展网络咨询服务,开展函诊,快递药物。风湿病患者大都是新型冠状病毒的易感人群,医师需要为患者做更多的健康教育工作。虽然不能当面指导,但可以通过电话、微信等途径向患者反复宣教如何防范病毒感染。已经感染新型冠状病毒肺炎的风湿病患者,要在呼吸科和风湿科医师的协同指导下开展治疗。     

Comparable survival outcome between transplantation from haploidentical donor and matched related donor or unrelated donor for severe aplastic anemia patients aged 40 years and older: A retrospective multicenter cohort study

This retrospective multicenter cohort study aimed to compare the outcome of haploidentical hematopoietic stem cell transplantation (HID-HSCT) with matched sibling donor (MSD) and unrelated donor (URD) transplantation in severe aplastic anemia (SAA) patients 40 years of age and older. With a median follow-up time of 17.6 months, 85 consecutive patients were enrolled in the study, and the median patient age was 45 years (40, 58). The cumulative engraftment rates of neutrophil and platelet were 98.8 ± 0.0% and 92.9 ± 0.1%. The cumulative incidences of Grade 2-4 acute graft-versus-host disease (aGvHD) and chronic graft-versus-host disease (cGvHD) at 3 years were 14.1 ± 0.1% and 17.3 ± 0.2%. The 3-year estimated overall survival (OS) and failure-free survival (FFS) were 91.2 ± 3.2% and 89.7 ± 3.5%. In multivariate analysis, the only factor associated with inferior survival was an ECOG score ≥2. HID-HSCT was associated with a higher incidence of GvHD, but the difference of 3-year estimated OS between HID group and the other two cohorts was not significant (86.7 ± 6.4% for HID vs 92.1% ± 4.4% for MSD and 100% for URD, P = .481). HID-HSCT might be a feasible alternative option for selected SAA patients aged 40 years and older without a matched donor.     

Effects of SKF83959 on the excitability of hippocampal CA1 pyramidal neurons： a modeling study

Aim： 3-Methyl-6-chloro-7,8-hydroxy-1-（3-methylphenyl）-2,3,4,5-tetrahydro-1H-3-benzazepine （SKF83959） have been shown to affect several types of voltage-dependent channels in hippocampal pyramidal neurons. The aim of this study was to determine how modulation of a individual type of the channels by SKF83959 contributes to the overall excitability of CA1 pyramidal neurons during either direct current injections or synaptic activation.
Methods： Rat hippocampal slices were prepared. The kinetics of voltage-dependent Na^＋ channels and neuronal excitability and depolarization block in CA1 pyramidal neurons were examined using whole-cell recording. A realistic mathematical model of hippocampal CA1 pyramidal neuron was used to simulate the effects of SKF83959 on neuronal excitability.
Results： SKF83959 （50 μmol/L） shifted the inactivation curve of Na^＋ current by 10.3 mV but had no effect on the activation curve in CA1 pyramidal neurons. The effects of SKF83959 on passive membrane properties, including a decreased input resistance and depolarized resting potential, predicted by our simulations were in agreement with the experimental data. The simulations showed that decreased excitability of the soma by SKF83959 （examined with current injection at the soma） was only observed when the membrane potential was compensated to the control levels, whereas the decreased dendritic excitability （examined with current injection at the dendrite） was found even without membrane potential compensation, which led to a decreased number of action potentials initiated at the soma. Moreover, SKF83959 significantly facilitated depolarization block in CA1 pyramidal neurons. SKF83959 decreased EPSP temporal summation and, of physiologically greater relevance, the synaptic-driven firing frequency.
Conclusion： SKF83959 decreased the excitability of CA1 pyramidal neurons even though the drug caused the membrane potential depolarization. The results may reveal a partial mechanism for the drug’s anti-Parkinsonian effects and may also suggest that SKF83959 has a potential antiepileptic effect.