中药对高尿酸血症患者肠道菌群影响的研究进展

高尿酸血症是痛风发病的重要病理基础,可引发痛风性关节炎、痛风石、痛风性肾病,引起关节破坏、肾功能损伤等并发症。人体内约1/3的尿酸通过肠道代谢,近年来研究发现肠道菌群与高尿酸血症密切相关。中药在降尿酸方面具有显著的疗效性和良好的安全性,可能与肠道菌群的调节有关。运用转录组学、代谢组学及宏基因组学等测序技术分析口服中药后肠道微生物多样性、种群结构及基因表达的变化,阐述中药与肠道菌群的相互作用机制是目前研究的重要方向。本综述总结了该领域最新研究进展,展望了未来的研究趋势。     

益肾化瘀解毒方对连续不卧床腹膜透析腹膜炎患者血清HMGB-1和hs-CRP水平的影响

目的观察益肾化瘀解毒方对连续不卧床腹膜透析（CAPD）腹膜炎患者微炎症状态的影响及其可能作用机制。方法选取60例正在行CAPD治疗且中医辨证为肾虚浊瘀内停证的腹膜炎患者,随机分为治疗组与对照组各30例,两组均进行常规治疗,治疗组加用益肾化瘀解毒方口服,每日1剂,4周为1个疗程,连续治疗2个疗程。评价临床疗效并观察两组患者中医证候积分,检测血清高迁移率族蛋白1（HMGB-1）和超敏C-反应蛋白（hs-CRP）水平。结果治疗组临床疗效有效率为83.34%,对照组为46.67%,治疗组疗效优于对照组（P<0.01）。治疗组治疗后中医证候积分、HMGB-1、hs-CRP均较治疗前显著降低,且均低于对照组（P<0.05或P<0.01）。结论益肾化瘀解毒方能有效改善CAPD腹膜炎患者微炎症状态,其机制可能与降低患者血清HMGB-1和hs-CRP水平有关。     

Preadsorption of radiolabeled monoclonal antibodies to liver and spleen tissues leads to higher tumor-to-normal-tissue ratios

This study addresses the impact of background activity on the use of radioimmunoconjugates for radioimmunodiagnosis and radioimmunotherapy. Since the liver and the spleen represent organs with preferential nonspecific uptake, we exposed radiolabeled (iodinated and Indium-111 labeled) preparations of monoclonal antibodies to a suspension of fresh liver and spleen cells at physiological temperature and compared their immunoreactivity, in vivo biodistribution, and tumor targeting to those of the same radiolabeled proteins without prior adsorption to this suspension. The biodistribution studies were performed under conditions of high background activity, i.e., shortly after the injection (1 hour) and using a high dose of the protein. Preadsorption of radiolabeled monoclonal antibodies results in a significant decreased uptake in certain normal tissues, i.e., greater contrast between normal and tumor tissues, as demonstrated by the quotient of the two target-to-nontarget ratios (exposed/unexposed antibody) which was greater than one for most of the tissues examined.     

Diagnosis and Management of Right-Sided Heart Failure in Subjects Supported With Left Ventricular Assist Devices

Right ventricular failure (RVF) is a cause of major morbidity and mortality in the left ventricular assist device (LVAD) population. Many LVAD candidates have clinical or subclinical right ventricular (RV) dysfunction, and the perioperative period is fraught with insults that may provoke reactive pulmonary vascular hypertension and acute or chronic development of RVF. Thus, preoperative patient optimization using diuretics, pulmonary vasodilators, and inotropes to reduce RV wall stress and improve contractility is critical. An assessment of the LVAD candidate’s risk for developing postoperative RVF is also key, especially in the destination therapy population for whom good options for long-term RV support currently are lacking. Intraoperatively, various pharmacologic and surgical interventions are available to reduce RVF risk. This review discusses RVF diagnosis and management strategies in subjects undergoing LVAD implantation.     

Gender Differences in the Clinical Characteristics and Atrioventricular Nodal Conduction Properties in Patients With Atrioventricular Nodal Reentrant Tachycardia

Gender Differences in Patients With AVNRT. Introduction: The detailed electrophysiological characteristics of the gender differences associated with atrioventricular nodal reentrant tachycardia (AVNRT) have not been clarified. This study investigated the gender‐related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation. Methods and Results: A total of 2,088 consecutive AVNRT patients (men/women 869/1,219) who underwent catheter ablation were enrolled in this study. We evaluated the gender differences in their electrophysiological characteristics. Women had a significantly younger age of onset, higher incidence of multiple jumps, shorter AH interval, atrial effective refractory period (ERP), anterograde fast pathway ERP, anterograde slow pathway ERP, and retrograde slow pathway ERP, and longer ventricular ERP than men. The incidence of baseline ventriculoatrial dissociation was lower in women than in men. Women needed less isoproterenol/atropine to induce AVNRT. No gender differences in the radiation exposure time, procedure time, complication rate, acute success rate, or second procedure rate were noted. Both typical and atypical AVNRT were more predominant in women. In the patients with atypical AVNRT, there was no significant gender difference in incidence of baseline ventriculoatrial dissociation; however, the retrograde slow pathway ERP was significantly shorter in women than in men. Women of premenopausal age (≤50 years old) had a significantly higher incidence of anterograde multiple jumps and a retrograde jump phenomenon, and a shorter anterograde slow pathway ERP and retrograde slow pathway ERP than those of women over 50 years old. Conclusion: Gender differences in the anterograde and retrograde AV nodal electrophysiology were noted in the patients with AVNRT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1114‐1119)     

上臂内侧扩张皮瓣修复面部瘢痕挛缩

目的探讨上臂内侧扩张皮瓣面部瘢痕挛缩的方法及效果。方法采用上臂内侧扩张皮瓣修复面部瘢痕挛缩17例。结果本组皮瓣面积(10 cm×8 cm)~(15 cm×9 cm),移植皮瓣全部成活。7例随访3个月~5年,皮瓣外形良好,色泽与面部皮肤相近,供瓣区遗留瘢痕较小。结论上臂内侧扩张皮瓣修复面部瘢痕挛缩效果良好,虽所需时间长,且需强迫体位固定,但仍不失为面部整形修复的可选之法。