硫酸镁、硝苯地平和酚妥拉明治疗妊高症

目的探讨对妊娠高血压综合征患者给予硫酸镁联合硝苯地平以及酚妥拉明治疗的临床效果。方法抽取医院在2018年2月-2019年2月所接收的156例妊娠高血压综合征患者,将其按照数字随机表的方法分为单纯组和联合组,每组分别为78例。单纯组给予单纯的硫酸镁进行治疗,联合组在单纯组给予硝苯地平以及酚妥拉明进行联合治疗,比较患者的治疗效果。结果联合组的治疗有效率显著高于单纯组,治疗前血压水平差异无统计学意义(P>0.05),治疗后联合组的收缩压和舒张压水平均低于单纯组,P<0.05,两组差异有统计学意义。结论对妊娠高血压综合征患者给予硫酸镁联合硝苯地平和酚妥拉明进行联合治疗,有效改善患者的血压水平。     

m6A结合蛋白IGF2BP1在肝细胞癌中的基因调控网络分析

目的 分析m6A阅读器胰岛素样生长因子2-mRNA结合蛋白1（insulin-like growth factor 2 mRNA-binding protein 1，IGF2BP1）在肝细胞癌（hepatocellular carcinoma，HCC）中的表达水平及其对HCC患者预后的影响，并探讨IGF2BP1在HCC发生发展中的作用及其潜在机制。方法 基于5对HCC癌及相应癌旁组织mRNA-seq数据和TCGA数据库LIHC的mRNA-seq数据综合分析IGF2BP1在HCC中的表达情况，同时利用TCGA数据库中343例HCC患者的临床随访资料分析IGF2BP1表达水平对HCC患者总生存期的影响。基于TCGA数据库筛选IGF2BP1的共表达mRNA，并利用m6Avar在线网站预测mRNA的m6A位点及其RNA结合蛋白等信息，最终构建IGF2BP1的基因调控网络。结果 IGF2BP1基因在HCC中表达上调（log2FC HCC转录组数据=10.684，P<0.001；log2FC TCGA-LIHC数据集=7.032，P<0.001）。生存分析显示IGF2BP1低表达的HCC患者中位生存时间为5.84年，IGF2BP1高表达患者为4.44年，高表达患者总生存期缩短（P=0.011）。22个差异表达的mRNA与IGF2BP1存在靶向结合关系，并与其表达水平呈正相关。其中，HMGA2等15个高表达mRNA的HCC患者总生存期缩短。HMGA2、PEG10、CEP55、RHO、CDC6和KIF23基因中的潜在m6A甲基化位点位于mRNA 3'UTR端的miRNA结合区域。结论 IGF2BP1在HCC中高表达且导致患者总生存期缩短。IGF2BP1可能通过m6A甲基化及miRNA抑制作用的方式上调mRNA的表达，促进HCC发生并导致不良预后。     

行政诉讼的裁判基准研究——以契税客体内含的私法规则为中心

契税客体是契税行政法律关系变动的基础,法院审理契税行政诉讼案件的裁判基准源自对契税客体的判定。在税法理论上,契税客体有债权行为说和物权行为说两种观点,两种学说下的法律后果完全相反。法院审理契税案件的核心任务是维护契税立法的稳定性。通过对现行契税立法条文的目的解释和民法客体理论检视,可以发现立法对契税客体采债权行为说。面对契税立法缺漏,法院应当恪守"债权行为说",并援引私法规则形成契税行政诉讼的裁判基准。对于房屋预售引发的滞纳金争议,法院应居中将"合同签订日"扩张解释为"竣工验收备案日"做出裁判。对于合同解除引发的退税争议,法院应当依据交易是否已成立来确定税局应否退税。     

水针疗法联合清热祛毒汤治疗寻常型银屑病(血热证)的疗效及其作用机制分析

目的观察分析水针疗法联合清热祛毒汤治疗寻常型银屑病(血热证)的疗效及其作用机制。方法选择2018年8月—2019年7月在我院接收治疗的112例寻常型银屑病患者作为分析对象,采取随机分组的办法将其分为对照组56例和研究组56例,对照组患者采取水针疗法治疗,研究组在对照组的基础上联合清热祛毒汤治疗。比较分析2组患者的疗效;治疗前后的中医证候评分、皮肤病生活质量指数(DLQI)评分;治疗前后皮损面积、浸润、鳞屑、红斑等评分;治疗前后肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、血管内皮生长因子(VEGF)水平变化情况。结果研究组患者治疗总有效率89.29%明显高于对照组73.21%(P<0.05);治疗前,2组患者的中医证候评分、DLQI评分、皮损面积、浸润、鳞屑、红斑等评分及TNF-α、IL-6、VEGF等水平比较(P>0.05);研究组患者治疗后的中医证候评分与DLQI评分明显低于治疗前(P<0.05);研究组患者治疗后的皮损面积、浸润、鳞屑、红斑等评分明显低于对照组(P<0.05);研究组患者治疗后的TNF-α、IL-6、VEGF等水平明显低于对照组(P<0.05)。结论对寻常型银屑病患者采取水针疗法联合清热祛毒汤治疗的疗效显著,能有效改善中医证候表现,提高生活质量,减轻皮损程度,降低炎症反应,其作用机制可能与炎症因子水平、皮损血管增生相关。     

余尚贞以六戊年麦门冬汤治疗高血压经验浅析

高血压病为临床最常见的慢性病,余尚贞根据多年临床经验辨证,结合开、阖、枢理论,以太阴阳明升降不和为病机,从太阴阳明入手论治高血压病,结合五运六气选方六戊年麦门冬汤,临床治疗多例,疗效甚佳。开、阖、枢理论源于内经,是对人体三阴三阳经生理功能、病理特点及其相互关系的概括,我们可从中窥得开、阖、枢理论之部分面貌,比如对太阴、阳明经的了解,并拓展中医在治疗高血压病方面的治疗思路。     

医用粘胶相关性皮肤损伤的文献计量学分析

目的: 应用文献计量学方法,分析国内外医用粘胶相关性皮肤损伤（Medical adhesive-related skin injuries,MARSI）文献的研究主题和热点。方法: 检索Cochrane Library、PubMed、EMbase、Web of science、sinoMed、CNKI、Wanfang、VIP等数据库MARSI相关文献,检索时限为建库至2019年5月。采用SPSS 22.0 软件进行文献计量分析,利用gCLUTO统计对国内外高频主题词进行聚类分析。结果: 共纳入论文103篇,其中外文文献占总文献量的27.18%,中文文献占总文献量的72.82%。聚类分析将国内外高频主题词聚为4大类,依次为皮肤损伤及损伤类型、相关危险因素、风险评估及风险管理、护理干预措施。结论: MARSI仍是国内外研究的热点,其发病机制研究仍处于探索阶段,目前尚缺乏有效的预防策略,研究领域较局限。在今后的研究中,应加强MARSI预防的研究、注重多学科合作。     

在生物化学教学中培养医学生的科研创新能力

在教学过程中潜移默化培养医学生的科研创新能力，是实践新时代医学教育改革新理念的有益探索。生物化学是医学生的重要专业基础课程之一，探讨在生物化学教学过程中通过多种教学方法培养学生对科研的兴趣，同时，结合科研新进展，开拓学生的视野，培养学生的创新思维，提高医学生科研创新能力的思路。     

Characterization of two pigeon paramyxovirus type 1 isolates in China

For over three decades, there has been a continuing panzootic caused by a virulent variant avian paramyxovirus type 1 strain, the so-called pigeon paramyxovirus type 1. It is found primarily in racing pigeons, but it has also spread to wild birds and poultry. In this study, two pigeon paramyxovirus type 1 strains, SD12 and BJ13, obtained from diseased pigeons in China, were characterized. Phylogenetic analysis based on complete sequences allowed characterization of both strains as genotype VI, class II. Further phylogenetic analysis of a 374-nucleotide section of the fusion gene showed that SD12 fell into lineage VIbii-d and BJ13 into VIbii-f. The deduced amino acid sequence of the cleavage site of the fusion protein confirmed that both isolates contained the virulent motif ¹¹²K/RRQKR↓F¹¹⁷ at the cleavage site. Nevertheless, the values of intracerebral pathogenicity indices showed the SD12 isolate to be a velogenic strain and BJ13 isolate to be a mesogenic strain. The SD12 isolate was further investigated via clinical observation, RNA detection, histopathology and viral serology in experimentally infected 3-week-old chickens. It showed a mild pathological phenotype in chickens, with viral replication restricted to a few tissues. The molecular mechanism for the SD12 isolate to have a virulent motif but low levels of virulence for chickens requires further study.     

Neuronal protein-tyrosine phosphatase 1B hinders sensory-motor functional recovery and causes affective disorders in two different focal ischemic stroke models

Ischemic brain injury causes neuronal death and inflammation. Inflammation activates protein-tyrosine phosphatase 1B (PTP1B). Here, we tested the significance of PTP1B activation in glutamatergic projection neurons on functional recovery in two models of stroke: by photothrombosis, focal ischemic lesions were induced in the sensorimotor cortex (SM stroke) or in the peri-prefrontal cortex (peri-PFC stroke). Elevated PTP1B expression was detected at 4 days and up to 6 weeks after stroke. While ablation of PTP1B in neurons of neuronal knockout (NKO) mice had no effect on the volume or resorption of ischemic lesions, markedly different effects on functional recovery were observed. SM stroke caused severe sensory and motor deficits (adhesive removal test) in wild type and NKO mice at 4 days, but NKO mice showed drastically improved sensory and motor functional recovery at 8 days. In addition, peri-PFC stroke caused anxiety-like behaviors (elevated plus maze and open field tests), and depression-like behaviors (forced swimming and tail suspension tests) in wild type mice 9 and 28 days after stroke, respectively, with minimal effect on sensory and motor function. Peri-PFC stroke-induced affective disorders were associated with fewer active (FosB⁺) neurons in the PFC and nucleus accumbens but more FosB⁺ neurons in the basolateral amygdala, compared to sham-operated mice. In contrast, mice with neuronal ablation of PTP1B were protected from anxiety-like and depression-like behaviors and showed no change in FosB⁺ neurons after peri-PFC stroke. Taken together, our study identifies neuronal PTP1B as a key component that hinders sensory and motor functional recovery and also contributes to the development of anxiety-like and depression-like behaviors after stroke. Thus, PTP1B may represent a novel therapeutic target to improve stroke recovery. All procedures for animal use were approved by the Animal Care and Use Committee of the University of Ottawa Animal Care and Veterinary Service (protocol 1806) on July 27, 2018.Key Words: adhesive removal test, anxiety, depression, elevated plus maze, forced swimming test, Iba1, interleukin-1β, microglia, open field test, tail suspension test, tumor necrosis factor-α

Chinese Library Classification No. R453; R741; R364.5