攻毒扶正法对非酒精性脂肪性肝炎大鼠肝组织内Th1/Th2类细胞因子的影响

目的:观察攻毒扶正法对非酒精性脂肪性肝炎(NASH)大鼠Th1/Th2类细胞因子免疫反应的影响。方法:用高脂饲料与四氯化碳(CCl4)制备NASH大鼠模型,分别用乙肝清热解毒颗粒、乙肝养阴活血颗粒、辛伐他丁溶液进行灌胃,用药4周后取材。ELISA法测定肝组织TNF-α、IFN-γ、IL-4、IL-6含量。结果:与正常组相比,模型组肝组织中TNF-α、IL-4、IL-6含量增高,IFN-γ含量降低,差异有统计学意义(P<0.01)。各治疗组对TNF-α、IL-4、IL-6有负向调节作用,可使其含量降低,对IFN-γ有正向调节作用,并能整体调节Th1/Th2的紊乱状态。结论:在NASH大鼠体内Th1/Th2类细胞因子网络紊乱,攻毒扶正法可对其进行调节。     

Factors influencing the diagnostic accuracy and management in acute surgical patients

AIM:To evaluate the diagnostic accuracy(DA) in acute surgical patients admitted to a District General Hospital.METHODS: The case notes of all acute surgical patients admitted under the surgical team for a period of two weeks were reviewed for the data pertaining to the admission diagnoses, relevant investigations and final diagnoses confirmed by either surgery or various other diagnostic modalities. The diagnostic pathway was recorded from the source of referral [general practitioner(GP), A and E, in-patient] to the correct final diagnosis by the surgical team. RESULTS: Forty-one patients(23 males) with acute surgical admissions during two weeks of study period were evaluated. The mean age of study group was 61.05 ± 23.24 years. There were 111 patient-doctor encounters. Final correct diagnosis was achieved in 85.4% patients. The DA was 46%, 44%, 50%, 33%,61%, 61%, and 75% by GP, A and E, in-patient referral, surgical foundation year-1, surgical senior house officer(SHO), surgical registrar, and surgical consultant respectively. The percentage of clinical consensus diagnosis was 12%. Surgery was performed in 48.8% of patients. Sixty-seven percent of GP-referred patients, 31% of A and E-referred, and 25% of the in-patient referrals underwent surgery. Surgical SHO made the most contributions to the primary diagnostic pathway.CONCLUSION: Approximately 85% of acute surgical patients can be diagnosed accurately along the diagnostic pathway. Patients referred by a GP are more likely to require surgery as compared to other referral sources. Surgical consultant was more likely to make correct surgical diagnosis, however it is the surgical SHO that contributes the most correct diagnoses along the diagnostic pathway.     

化痰与活血方对非酒精性脂肪肝氧应激的影响

目的:观察化痰方与活血方对非酒精性脂肪肝(NAFLD)大鼠氧应激损伤的影响,探讨两方在NAFLD治疗中的作用。方法:制备NAFLD大鼠模型,同时用化痰方和活血方对模型进行干预,并与西药组(二甲双胍+罗格列酮)进行对照,设置正常组、模型组、西药组、化痰方组、活血方组及合方组共6组,检测肝组织CYP450及CYP2E1活性,测定SOD、MDA。结果:模型组的CYP450和CYP2E1活性增强(P<0.05),SOD活性下降(P<0.05),MDA含量升高(P<0.01);所有中药组均能降低CYP2E1活性(P<0.05),而西药组能降低CYP450活性(P<0.05);化痰方与活血方能够提高SOD活性(P<0.01),降低MDA含量。结论:NAFLD大鼠存在明显的氧应激和脂质过氧化损伤情况,化痰方与活血方均能不同程度地调节NAFLD大鼠的氧应激水平,改善脂质过氧化,对NAFLD具有确切的防治作用。     

青岛市1300名吸毒者HIV和梅毒螺旋体感染状况及相关因素分析

目的调查吸毒人群HIV和梅毒螺旋体感染的状况,并探讨引起感染的相关因素。方法回顾性分析1300名新进看守所的吸毒人员的人口学资料和行为学资料,检测其HIV、梅毒螺旋体感染情况,分析其病原体感染现状,归纳总结出感染的相关因素。结果吸毒人群中HIV、梅毒螺旋体感染发生率远较正常人群高(P<0.05),吸毒人群中共用针具者、危险性行为者上述病原体感染率均较无上述危险因素的同质人群为高(P<0.05,OR>3)。结论吸毒者人群中HIV、梅毒螺旋体感染发生率远较正常人群高,共用针具、危险性行为有可能是其感染高发的原因。     

Copy number changes of the microcephalin 1 gene (MCPH1) in patients with autism spectrum disorders

Autism spectrum disorder (ASD) represents a set of neurodevelopmental disorders with a strong genetic aetiology. Chromosomal rearrangements have been detected in 5–10% of the patients with ASD, and recent applications of array comparative genomic hybridisation (aCGH) are identifying further candidate regions and genes. In this study, we present four patients who implicate microcephalin 1 ( MCPH1) in band 8p23.1 as an ASD susceptibility gene. Patient 1 was a girl with a syndromic form of autistic disorder satisfying the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Oligonucleotide aCGH (oaCGH) showed that she had a classic inv dup del(8)(qter-> p23.1::p23.1-> p21.2) containing at least three candidate genes; MCPH1 and DLGAP2 within the 6.9-Mb terminal deletion and NEF3 within the concomitant 14.1-Mb duplication. Three further patients with MCPH1 copy number changes were found using single-nucleotide polymorphism (SNP) array analysis in a cohort of 54 families with ASD patients. Our results show that ASD can be a component of the classical inv dup del(8) phenotype and identify changes in copy number of MCPH1 as a susceptibility factor for ASD in the distal short arm of chromosome 8.     

自我效能理论在癌症疼痛病人护理中的应用

目的探讨自我效能理论在癌症疼痛病人护理中的效果。方法将80例癌症疼痛病人随机分为实验组和对照组,实验组在常规治疗和护理的基础上增加自我效能的干预措施,对照组只接受常规的治疗和护理,比较两组患者入院时和入院15 d后的自我效能感（GSES）和生活质量（QOL）评分的差异。结果两组患者入院15 d后的自我效能感差异有统计学意义（t=5.12,P〈0.01）,实验组的自我效能感高于对照组;两组患者生活质量评分经过入院15 d的治疗和护理后评分均升高,两组总体生活质量比较,差异有统计学意义（t=3.72,P〈0.01）,总体生活质量评分比较,也有显著差异。结论自我效能理论可以作为癌症疼痛病人护理的理论依据,对临床护理工作具有很大的指导意义,在促进疾病康复的同时达到提高护理质量的目的 。     

腹壁皮下脂膜炎样T细胞淋巴瘤1例报道并文献复习

目的:探讨皮下脂膜炎样T细胞淋巴瘤(subcutaneous panniculitis-like T-cell lymphoma,SPTCL)的临床病理特征、诊断与鉴别诊断。方法:对1例SPTCL行HE染色和免疫组织化学标记,抗体为CD3、CD45RO、CD20、CD79a、CD4、CD8、CD30、CD56、CD68、TIA-1等。结果:患者表现为发热、左中腹至左腹股沟区红肿,辅助检查提示贫血、白细胞和血小板减少、肝功能异常、肝脾肿大。镜检:肿瘤位于皮下组织,呈脂膜炎样生长,瘤细胞围绕单个脂肪细胞呈花环状排列,瘤细胞小至中等大,偶见散在的大细胞,核碎裂和核分裂象易见,并可见肿瘤性坏死、出血和脂肪坏死以及组织细胞反应。免疫表型:瘤细胞表达CD3、CD8、CD45RO、CD30、TIA-1,而CD4、CD20、CD79a、CD56、CD68阴性。患者从发病到死亡仅2月余。结论:SPTCL是一种罕见的原发于皮下脂肪组织的细胞毒T细胞淋巴瘤,一般预后较好,伴有嗜血细胞综合征和其他症状者预后可能较差。     

Texture analysis on parametric maps derived from dynamic contrast-enhanced magnetic resonance imaging in head and neck cancer

AIM: To investigate the merits of texture analysis on parametric maps derived from pharmacokinetic modeling with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) as imaging biomarkers for the prediction of treatment response in patients with head and neck squamous cell carcinoma (HNSCC).METHODS: In this retrospective study, 19 HNSCC patients underwent pre- and intra-treatment DCE-MRI scans at a 1.5T MRI scanner. All patients had chemo-radiation treatment. Pharmacokinetic modeling was performed on the acquired DCE-MRI images, generating maps of volume transfer rate (K^trans) and volume fraction of the extravascular extracellular space (v_e). Image texture analysis was then employed on maps of K^trans and v_e, generating two texture measures: Energy (E) and homogeneity.RESULTS: No significant changes were found for the mean and standard deviation for K^trans and v_e between pre- and intra-treatment (P > 0.09). Texture analysis revealed that the imaging biomarker E of v_e was significantly higher in intra-treatment scans, relative to pretreatment scans (P < 0.04).CONCLUSION: Chemo-radiation treatment in HNSCC significantly reduces the heterogeneity of tumors.     

苦参碱抗肿瘤机制的分子生物学研究进展

苦参碱属于我国纯天然生物碱类药物之一,其药理作用广,特别在抗肿瘤方面越来越受到人们的关注。大量的研究表明其可通过抑制肿瘤细胞的增殖,诱导肿瘤细胞的凋亡,阻滞细胞周期的进展,抑制端粒酶的活性,逆转肿瘤细胞的耐药性,抑制肿瘤细胞的转移作用,抑制肿瘤血管的生成,提高对化疗药物的敏感性等发挥抗肿瘤作用。本文就苦参碱的上述抗肿瘤机制研究进展作一综述,为苦参碱的进一步开发与应用提供理论依据。