白藜芦醇抑制胃癌细胞株MKN45增殖的机制研究*

目的 通过研究白藜芦醇抑制胃癌MKN45细胞增殖及对丝裂原活化蛋白激酶(MEK)/细胞外信号调节激酶（ERK）信号通路的影响,探讨白藜芦醇抗胃癌的作用机制。方法 体外常规培养胃癌MKN45细胞,将细胞分为对照组、MEK/ERK信号通路抑制剂PD98059组（PD98059组）、白藜芦醇低剂量组（100?μmol/L）、 白藜芦醇高剂量组（400?μmol/L）。各组细胞处理1、2和4?h后,MTT法检测细胞增殖抑制率,Western blotting法检测Ras、Raf、MEK、ERK1/2蛋白的表达,细胞免疫化学法检测Ras、Raf、MEK、ERK1/2蛋白荧光强度的变化。结果 与对照组比较,PD98059组、白藜芦醇低剂量组和白藜芦醇高剂量组细胞在处理1、2和4?h后,细胞增殖受到抑制（P?<0.05）,且呈时间剂量依赖性;PD98059组、白藜芦醇低剂量组和白藜芦醇高剂量组细胞Ras、Raf、MEK和ERK1/2表达下降,差异有统计学意义（P?<0.05）,且白藜芦醇的作用呈剂量依赖性（P?< 0.05）;MEK和ERK1/2蛋白主要定位于细胞质中,且PD98059组、白藜芦醇低剂量组和白藜芦醇高剂量组细胞ERK1/2的荧光强度均减弱。结论 白藜芦醇呈剂量依赖性抑制胃癌细胞株MKN45的增殖,可能与抑制MEK/ERK信号通路,减弱Ras、Raf、MEK和ERK1/2的表达有关。     

胃窦部超声指导下妇科腹腔镜手术患者术前 口服10% 葡萄糖溶液的临床应用

目的 研究在胃窦部超声指导下妇科腹腔镜手术患者术前2 h 口服4 ml/kg、10% 葡萄糖溶液的 临床应用。方法 选取2019 年1 月—2019 年8 月延安大学附属医院拟在全身麻醉下行腹腔镜手术的妇科患 者60 例作为研究对象,根据随机数字表法分为口服糖水组和常规禁饮组,每组30 例。常规禁饮组术前常规 禁食、禁饮8 ～ 12 h ;口服糖水组常规禁食,术前2 h 口服4 ml/kg、10% 葡萄糖溶液。进入手术室后先用超 声测量2 种不同体位下的胃窦部横截面积（CSA）：半卧位为CSA1,右侧卧位为CSA2。应用公式计算胃容量（GV） 及单位体重胃容量（GV/W）。采用视觉模拟评分（VAS）分别在术前30 min 与术前3 h 对所有患者行口渴感、 饥饿感及焦虑感评分,然后将不同时间的评分差值进行比较。记录两组术后首次排气及排便时间。结果 两 组CSA1、CSA2、GV1、GV2、GV1/W 及GV2/W 等胃超声测量数据比较,差异无统计学意义（P >0.05）。两组 术前30 min 与术前3 h 口渴感、饥饿感及焦虑感的VAS 评分差值比较,差异有统计学意义（P <0.05）。与常 规禁饮组比较,口服糖水组术后首次排气时间缩短（P <0.05）。结论 在胃窦部超声指导下妇科腹腔镜手术 患者术前2 h 口服4 ml/kg、10% 葡萄糖溶液安全可行,并且可以改善患者术前的主观不适感,缩短术后首次 排气时间,促进患者胃肠功能早期恢复。     

美罗培南配合免疫球蛋白治疗新生儿败血症的疗效及其对炎症因子的影响

目的?探讨新生儿败血症患儿实施美罗培南配合免疫球蛋白治疗的疗效及炎症水平变化。方法?选取2016年4月—2018年4月海南医学院第二附属医院收治的新生儿败血症患儿100例,以挂号就诊单病案号单、双数为基准,分为研究组和对照组。治疗组采用美罗培南+免疫球蛋白治疗,对照组采用美罗培南治疗,对比两组临床症状改善时间、临床疗效、炎症水平及临床指标。结果?研究组拒奶改善时间、体温改善时间、神经系统症状改善时间、血培养转阴时间及住院时间低于对照组（P?<0.05）,研究组总有效率高于对照组（P?<0.05）,研究组治疗前后白细胞介素-6、白细胞介素-1、高敏感C反应蛋白及肿瘤坏死因子-α的差值高于对照组（P?<0.05）,研究组治疗前后分化抗原3、分化抗原8、免疫球蛋白G及免疫球蛋白M的差值高于对照组（P?<0.05）。结论?新生儿败血症患儿实施美罗培南配合免疫球蛋白治疗的临床疗效显著,可明显改善机体炎症水平,值得借鉴。     

The co-inhibitory pathway and cellular immune imbalance in the progress of HBV infection

Objective

Chronic hepatitis B (CHB) affects 400 million people and is the most common cause of liver cirrhosis (LC) and hepatocellular carcinoma (HCC) worldwide. Cellular immune regulation plays an important role in determining the infection outcome. Co-signal molecules and Th17/Treg were studied to explore their association with the progression of HBV infection.

Methods

Ninety-four HBV-infected patients were categorized into three groups: 31 patients with LC caused by CHB, 30 with HCC caused by CHB and 33 with HCC caused by CHB. Co-signal molecules, Th17/Treg, and Stat3 and Stat5 were analyzed by flow cytometry.

Results

CHB patients who progressed to LC or HCC showed a significantly higher level of co-inhibitory molecules such as BTLA and PD-1, while there was no significant difference in co-stimulatory molecules among LC, HCC and CHB. Stat3 and Stat5 were significantly increased in LC and HCC compared to CHB patients.

Conclusion

Co-inhibitory molecules play more important roles than co-stimulatory molecules. Increased PD-1 and BTLA/HVEM inhibited immune cells and the immune process. At the same time activated Stat3 and Stat5 stimulate the key factors in differentiation of Th17 and Treg, thus leading to imbalanced expansion of Th17 and Treg; immune tolerance was induced and HBV persistent. This resulted in hepatic inflammation that progressed to cirrhosis and carcinoma.     

Role of immune dysfunction in pathogenesis of type 1 diabetes mellitus in children

Objective:To investigate the function of cytokines,chemokines,and regulatory T cells(Tregs)in the pathogenesis of Type 1 diabeles mellitus(T1DM)in children.Methods:A total of 35 children with T1DM and 30 healthy controls were enrolled in this study.Levels of serum cytokines(IL-1α,IL-6,IL-10,IL-12,and TNF-α)and chemokines(MIP-1α,MIP-1βand MCP-1)were detected by enzyme-linked immunosorbent assay.Peripheral blood mononuclear cells(PBMCs)were isolated and culture supernatant of phytohaemagglutinin(PHA)-stimulatcd PBMCs was subjecled to ELISA for levels of cytokines(IL-1α,IL-6,IL-10,IL-12 and TNV-α)in T1DM and control group.Furthermore,flow cytometty was used to determine the percentage of Tregs in PBMCs of two groups.Results:Levels of serum cytokines including IL-1α,IL-6,IL-10 andd TNF-αas well as chemokines,such as MIP-1αand MIP-1βin children with T1DM children were significantly higher than those in healthy controls(P0.05,respectively).PBMCs with PHA stimulation in T1DM group secreted more IL-1αand TNF-α(P0.05,respectively),but less IL-10(P0.05),as compared with control group.Furthermore,the proportion of CD4~+,CD25~+,Foxp3.Tregs in PBMCs isolated from children with T1DM was obviously lower than those in heathy controls(P0.05).Conclusions:Immune dysfunction.with uprcgulation of inflanunatory factors such as IL-1α.IL-6.TNF-αand MIP-1α.downregulation of IL-10 and Tregs,plays an important role in the pathogenesis of T1DM in children.     

Lyssaviruses and Bats: Emergence and Zoonotic Threat

The continued detection of zoonotic viral infections in bats has led to the microbial fauna of these mammals being studied at a greater level than ever before. Whilst numerous pathogens have been discovered in bat species, infection with lyssaviruses is of particular significance from a zoonotic perspective as, where human infection has been reported, it is invariably fatal. Here we review the detection of lyssaviruses within different bat species and overview what is understood regarding their maintenance and transmission following both experimental and natural infection. We discuss the relevance of these pathogens as zoonotic agents and the threat of newly discovered viruses to human populations.     

Differences in distribution and drug sensitivity of pathogens in lower respiratory tract infections between general wards and RICU

Background

Lower respiratory tract infections (LRTIs) are common among patients in hospitals worldwide, especially in patients over the age of 60. This study investigates the differences in distribution and drug sensitivity of pathogens in LRTIs.

Methods

The clinical and laboratory data of 4,762 LRTI patients in the general ward and respiratory intensive care unit (RICU) of Xiangya Hospital (Changsha) were retrospectively analyzed.

Results

The infection rate of Gram-negative bacteria was significantly higher than that of Gram-positive bacteria in both the general ward and RICU (P<0.05). The incidence of Gram-negative bacteria infection was significantly higher in the RICU than in the general ward (P<0.05), whereas the incidence of Gram-positive bacteria infection is less in the RICU than in the general ward (P<0.05). In the general ward, the incidence of Gram-negative bacteria infection significantly increased (P<0.05) over time, whereas the incidence of Gram-positive bacteria infection significantly decreased from 1996 to 2011 (P<0.05). In the RICU, the incidence of Gram-positive bacteria infection decreased, while Gram-negative bacteria infections increased without statistical significance (P>0.05). Staphylococcus pneumoniae and Staphylococcus aureus were found to be the predominant Gram-positive strains in the general ward (34.70-41.18%) and RICU (41.66-54.87%), respectively (P>0.05). Pseudomonas aeruginosa and Acinetobacter baumannii were the predominant gram negative strains in the general ward (19.17-21.09%) and RICU (29.60-33.88%), respectively (P>0.05). Streptococcus pneumoniae is sensitive to most antibiotics with a sensitivity of more than 70%. Staphylococcus aureus is highly sensitive to vancomycin (100%), linezolid (100%), chloramphenicol (74.36-82.19%), doxycycline (69.57-77.33%), and sulfamethoprim (67.83-72.46%); however, its sensitivity to other antibiotics is low and decreased each year. Sensitivity of Pseudomonas aeruginosa to most β-lactam, aminoglycoside, and quinolone group antibiotics decreased each year.

Conclusions

The distribution and drug sensitivity of LRTI pathogens exhibit a high divergence between the general ward and RICU. Streptococcus pneumoniae may not be the predominant pathogen in LRTIs in some areas of China.     

托伐普坦联合尿毒清颗粒治疗肾病综合征的临床效果

目的观察托伐普坦联合尿毒清颗粒治疗肾病综合征患者的临床效果。方法选择2017年8月-2018年12月四川省资阳市第一人民医院肾病内科诊治肾病综合征患者90例作为研究对象,依据随机数字表法将患者分为对照组(n=45)和观察组(n=45),入院后根据诊疗规范进行治疗,对照组给予托伐普坦,观察组在对照组基础上给予尿毒清颗粒,治疗1个月后,比较2组治疗前后的血肌酐、尿素氮、尿量、血红蛋白、血清白蛋白、钾离子和钙离子水平,记录不良反应发生情况。结果治疗1个月后,2组血肌酐与尿素氮水平均降低,且观察组降低幅度大于对照组(t/P=3.999/0.000、2.316/0.023);2组的尿量、血红蛋白和血清白蛋白均上升,且观察组上升幅度大于对照组(t/P=-11.320/0.000、-4.606/0.000、-3.068/0.003),2组治疗前后的钾、钙离子浓度均未发生明显变化(P>0.05);不良反应发生率比较差异亦无统计学意义(P>0.05)。结论使用托伐普坦联合尿毒清颗粒治疗肾病综合征患者,可以改善患者的肾功能,改善尿量和营养状态,稳定体内电解质水平,安全性良好。     

动脉化静脉皮瓣移植术后临床表现分型及其护理对策

目的：对动脉化静脉皮瓣移植术后的不同临床表现进行分型,以便采取针对性护理干预,改善其成活状况,提高皮瓣成活率。方法：收集2010年6月至2019年3月温州医科大学附属第二医院采用动脉化静脉皮瓣游离移植修复的所有临床病例资料,根据其术后皮瓣颜色、皮瓣张力、肿胀程度、水泡形成以及淤血等情况,采用个体化护理干预措施,以皮瓣最终成活状况作为最主要的观察评价指标,进行系统总结分析。结果：共收集64例,68个动脉化静脉皮瓣,根据其术后表现情况分为正常生理皮瓣型（NPF型,25例,27个）、水泡形成型（BF型,18例,18个）和淤血肿胀型（CS型,21例,23个）。其中,NPF型皮瓣全部成活,BF型皮瓣仅1个部分坏死,CS型皮瓣虽经积极保守治疗,有1个完全坏死和2个部分坏死。结论：动脉化静脉皮瓣移植术后临床表现差异较大,需根据不同的临床分型,加强护理观察,采取针对性术后护理干预措施,以提高其整体成活状况。