葛根素对油酸致大鼠急性肺损伤组织中核因子-κB表达的影响

摘 要 目的:观察核因子 κB（NF-κB）在油酸致大鼠急性肺损伤时肺组织中的表达变化,探讨葛根素对急性肺损伤的保护作用及其可能机制。方法: 24只大鼠随机分为3组：对照组（Control）、油酸组（OA）、葛根素预处理组（Pue）。Control组大鼠尾静脉注射生理盐水0.1 ml·kg^-1;OA组大鼠尾静脉注射油酸0.1 ml·kg^-1;Pue组大鼠在注射油酸前30 min腹腔注射葛根素30 mg·kg^-1。光镜下观察肺组织病理形态学改变,免疫组织化学染色技术观察NF-κB在肺组织中的表达变化。结果 Pue组较OA组肺组织损伤情况明显减轻。OA组肺组织NF-κB的阳性表达（0.39±0.07）与Conrtol组（0.12±0.04）相比显著增加（P<0.05）;应用葛根素后肺组织NF-κB的阳性表达（0.24±0.05）明显减少,但仍高于Conrtol组（P<0.05）。结论 葛根素可能通过抑制NF-κB的表达减轻急性肺损伤时肺组织的炎症反应。     

方宝华主任医师调治癫痫病经验

方宝华,主任医师,上海中医药大学客座教授.早年毕业于上海中医专门学校,深受孟河丁氏学派熏陶,并承丁济万先生亲授内科诸病,深得其奥妙.从医六十余载,学验俱丰,饮誉沪上.     

Exploring the mechanism of Buyang Huanwu decoction in the treatment of lumbar disc herniation based on network pharmacology and molecular docking

Buyang Huanwu decoction (BYHWD), as one of the traditional Chinese medicine formulas, is widely used in the clinical treatment of lumbar disc herniation (LDH) with curative effect. It has the characteristics of multi-component, multi-target, and mutual synergy, but the mechanism of action is often unclear. It needs some research to explore the molecular mechanism of BYHWD in the treatment of LDH based on network pharmacology and molecular docking. Screen the active compounds of BYHWD and predict drug-related gene/protein targets, which could determine the specific target of BYHWD in the treatment of LDH. Construct the “Drugs-Compounds-Targets” network and search for the core targets. Use Gene Ontology functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis, and molecular docking verification to explore the possible molecular mechanism. Eighty-two effective compounds and 666 targets of BYHWD, 187 targets for LDH treatment, and 20 core candidate targets were excavated. A total of 3414 entries were identified by Gene Ontology enrichment analysis, 173 related signal pathways were identified by Kyoto Encyclopedia of Genes and Genomes enrichment analysis, and 5 core compounds were identified by molecular docking, which had a good affinity with core genes STAT3, JUN, AKT1, MAPK1, RELA, and PIK3CA. BYHWD may play the role of analgesic and improving function by synergistic anti-inflammatory and analgesic compounds, regulating cell metabolic differentiation, regulating immunity, and anticoagulation. BYHWD in the treatment of LDH may play a role in analgesia and improve function through multiple signaling pathways, including PI3K-Akt, mitogen-activated protein kinase, tumor necrosis factor, and interleukin-17. The PI3K-Akt signaling may be one of the key mechanisms.     

糖尿病大鼠早期视网膜神经节细胞凋亡机制的探讨

目的：探讨糖尿病大鼠模型早期视网膜神经节细胞(retinal ganglion cells,RGCs)凋亡的机制。

方法：SD大鼠60只,随机分为对照组(CON)及糖尿病组(DM),糖尿病组一次性腹腔注射1% STZ诱发糖尿病鼠模型,两组于第4,8,12wk分别行HE、透射电镜及TUNEL法检测RGCs的凋亡情况,并应用激光共聚焦显微镜检测RGCs内钙离子浓度的变化。

结果：糖尿病组第8wk开始出现RGCs数量减少、细胞排列紊乱的病理改变,第12wk更为明显。糖尿病组透射电镜下可见第4wk时RGCs出现线粒体肿胀; 第8wk时RGCs内肿胀的线粒体更为明显、数目增多,染色质边集于核膜周边,部分细胞体积缩小、细胞器减少; 第12wk时出现RGCs体积变小,甚至出现细胞核断裂。TUNEL阳性RGCs最早于糖尿病组第4wk时出现,随病程延长凋亡的阳性细胞逐渐增多,凋亡指数与同期对照组相比,差异有统计学意义(P<0.01)。糖尿病组第8,12wk时RGCs内钙离子浓度明显高于同期对照组,差异显著(P<0.01); 糖尿病组第8wk与第12wk比较,升高差异亦有统计学意义(P<0.05)。

结论：糖尿病早期出现了视网膜神经节细胞的凋亡,其机制可能与细胞内钙离子浓度升高有关。     

CA125与子宫内膜抗体测定用于诊断子宫内膜异位症

测定了４２例妇女血清和腹腔液ＣＡ＿（１２５）及子宫内膜抗体（ＥＭＡｂ）水平，其中经腹腔镜诊断为子宫内膜异位症者２８例（观察组），无子宫内膜异位症者１４例（对照组）。结果表明：观察组血清ＥＭＡｂ的吸光度为０．４４±０．１３，明显高于对照组的０．３４±０．０７，但两组间血清ＣＡ＿（１２５）差异无显著性；两含用于诊断的敏感性分别为７１．４３％和８２．１４％，特异性为５７．２１％和５７．１４％。两组腹腔液中ＥＭＡｂ差异无显著性；两组腹腔液ＣＡ＿（１２５）和ＥＭＡｂ水平均明显高于血清。     

雷公藤单体对大鼠睾丸间质细胞及支持细胞毒性与其抗生育作用不相关

本文用体外培养的睾丸间质细胞和支持细胞筛选了２２种从雷公藤根、皮中分离、纯化的单体，并选择其中对两种细胞杀伤作用强、弱不同的化合物ＴＷ－９，ＴＷ－５，ＴＷ－２８和ＴＷ－２７进行抗生育试验以及体外杀精试验。结果发现对两种细胞毒性作用最弱的ＴＷ－１９对大鼠有明显的抗生育作用；而毒性作用较强的ＴＷ－５，ＴＷ－２８和最强的ＴＷ－２７则无明显的抗生育作用。然而这四种化合物的体外杀精强度则依次为：ＴＷ－２７，ＴＷ－５，ＴＷ－１９，ＴＷ－２８。与它们的抗生育作用不相关。     

丹参酮ⅡA磺酸钠治疗冠心病心绞痛随机对照试验的Meta分析

目的 根据现有临床研究评价丹参酮ⅡA磺酸钠治疗冠心病心绞痛的有效性及安全性.方法 通过PubMed、中国生物医学文献数据库、中国期刊全文数据库、万方数据库检索丹参酮ⅡA磺酸钠治疗冠心病心绞痛的随机对照临床试验文献,采用Cochrane协作网专用软件RevMan 4.2进行Meta分析.结果 共有29篇文献,2 712例患者符合纳入标准.所有试验根据Jadad评分均〈3分,无双盲试验.＂倒漏斗＂图显示不对称,提示存在一定的发表偏倚.治疗组在改善心绞痛症状总有效率及显效率均显著优于对照组（P〈0.01）,合并RR值分别为1.23（95%CI1.19～1.28）,1.37（95%CI1.27～1.47）;心电图疗效总有效率及显效率亦显著优于对照组（P〈0.01）,合并RR值分别为1.33（95%CI1.23～1.43）,1.48（95%CI1.28～1.72）.试验未发现严重的副反应.结论 在西药常规治疗基础上合用丹参酮ⅡA磺酸钠可进一步改善冠心病心绞痛的临床症状及心电图缺血改变,但由于存在发表性偏倚及文献质量偏低,尚需更严格的循证医学证据.     

Full-Endoscopic versus Minimally Invasive Lumbar Interbody Fusion for Lumbar Degenerative Diseases : A Systematic Review and Meta-Analysis

ObjectiveAlthough full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. MethodsWe systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. ResultsFour retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669–35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941–41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. ConclusionRelative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.     

Prior statin and short‐term outcomes of primary intracerebral hemorrhage: From a large‐scale nationwide longitudinal registry

IntroductionThe relationship between statins and intracerebral hemorrhage outcomes is unclear.AimWe aimed to compare the in‐hospital mortality and evacuation of intracranial hematoma rates in patients with primary intracerebral hemorrhage between prior statin users and nonusers.ResultsThe final study population included 66,263 patients. Multivariable logistics analyses showed that prior statin use was not associated with in‐hospital mortality for primary intracerebral hemorrhage (adjusted odd ratio 0.78, 95% CI 0.61–1.01), but reduced the proportion of patients undergoing evacuation of intracranial hematoma (adjusted odd ratio 0.70, 95% CI 0.61–0.82). Propensity score matching analyses yielded similar results.ConclusionPrior statin use was not associated with in‐hospital mortality but did reduce evacuation of intracranial hematoma rates.