6-姜烯酚对急性肺损伤小鼠肺水肿的治疗作用及机制研究

目的：观察6-姜烯酚（6-SH）对脂多糖（LPS）诱导的急性肺损伤（ALI）小鼠肺水肿的治疗作用,探究可能的作用机制。方法：采用随机数字表法将40只无特定病原体（SPF）级Balb/c小鼠分为对照组、模型组、6-姜烯酚组、地塞米松组,每组10只。鼻腔滴注LPS构建ALI模型,对照组滴注等量生理盐水。30 min后,给予6-姜烯酚组灌胃（100 mg/kg）;地塞米松组给予腹腔注射（5 mg/kg）;对照组和模型组给予灌胃等量生理盐水,24 h后结束实验,收集样本。测定肺组织湿/干重比（W/D）和肺系数;收集支气管肺泡灌洗液（BALF）,测定白细胞计数和总蛋白浓度;观察肺组织病理学改变、计算病理评分;测定BALF上清液中肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）以及白细胞介素-6（IL-6）水平;检测肺组织中Toll样受体4/核因子κB/水通道蛋白（TLR4/NF-κB/AQPs）信号通路相关蛋白表达水平。结果：与对照组比较,模型组肺组织损伤明显,病理评分、肺系数、W/D增加（P<0.01）,白细胞计数、总蛋白浓度及TNF-α、IL-1β、IL-6的水平升高（P<0.01）;与模型组比较,6-姜烯酚组的肺系数和W/D降低（P<0.01或P<0.05）,白细胞计数、总蛋白浓度以及TNF-α、IL-1β、IL-6的水平降低（P<0.01或P<0.05）,AQP1和AQP5的蛋白表达水平升高（P<0.01）,TLR4、MyD88、NF-κB p65以及p-NF-κB p65的表达水平降低（P<0.01或P<0.05）。结论：6-姜烯酚可能通过调控TLR4/NF-κB/AQPs信号通路发挥其抗炎作用和改善肺组织水液代谢与转运,有效缓解ALI小鼠的肺组织水肿。     

超声心动图评价室间隔升主动脉夹角与S状室间隔患者升主动脉弹性的相关性

目的 探讨应用超声心动图评价室间隔升主动脉夹角（Ao SA）与S状室间隔（SSIVS）患者升主动脉弹性的相关性。方法 选择2021年8月-2022年4月本院确诊为SSIVS的患者82例为研究对象,按Ao SA的测值分为A组（≥120°,42例)和B组（<120°,40例);另选取年龄、性别相匹配的40例健康志愿者为对照组。二维超声测量常规超声心动图参数;M型超声测量收缩期升主动脉内径（ASD）、舒张期升主动脉内径（ADD）;PW-TDI模式获得升主动脉前壁收缩期运动速度(S波)、舒张早期运动速度(E波)及舒张晚期运动速度(A波),比较各组人群的上述参数的差异,并评价Ao SA与SSIVS患者升主动脉弹性之间的相关性。结果 与对照组相比,A组与B组患者的高血压比例明显增高,bIVS、mIVS、Vlvot、ASD、ADD增加,S波、E波降低,差异有统计学意义（均P＜0.05）;与A组相比,B组bIVS、ASD增加,S波减低,差异有统计学意义（均P＜0.05）,其余参数比较差异无统计学意义（均P＞0.05）。Pearson相关分析显示,SSIVS患者的Ao SA与ASD、ADD呈负相关（r=-0.372、-0.325,P＜0.05）,与S波、E波呈正相关（r=410、0.329;P＜0.05）。结论 Ao SA与SSIVS患者升主动脉弹性相关,Ao SA越小升主动脉弹性功能越易受损,早期对Ao SA相对较小的SSIVS升主动脉弹性进行针对性评估,及时干预,有助于延缓并发症的发生     

Relationship of body fat and left ventricular hypertrophy with the risk of all-cause death in patients with coronary artery disease

BACKGROUNDLeft ventricular hypertrophy (LVH) is prevalent in obese individuals. Besides, both of LVH and obesity is associated with subclinical LV dysfunction. The study aims to investigate the interplay between body fat and LVH in relation to all-cause death in patients with coronary artery disease (CAD).METHODSIn this retrospective cohort study, a total of 2243 patients with angiographically proven CAD were included. Body fat and LV mass were calculated using established formulas. Patients were grouped according to body fat percentage and presence or absence of LVH. Cox-proportional hazard models were used to observe the interaction effect of body fat and LVH on all-cause death.RESULTSOf 2243 patients enrolled, 560 (25%) had a higher body fat percentage, and 1045 (46.6%) had LVH. After a median follow-up of 2.2 years, the cumulative mortality rate was 8.2% in the group with higher body fat and LVH, 2.5% in those with lower body fat and no LVH, 5.4% in those with higher body fat and no LVH, and 7.8% in those with lower body fat and LVH (log-rank P < 0.001). There was a statistically significant interaction between body fat percentage and LVH ( P interaction was 0.003). After correcting for confounding factors, patients with higher body fat and LVH had the highest risk of all-cause death (HR = 3.49, 95% CI: 1.40–8.69, P = 0.007) compared with those with lower body fat and no LVH; in contrast, patients with higher body fat and no LVH had no statistically significant difference in risk of death compared with those with lower body fat and no LVH (HR = 2.03, 95% CI: 0.70–5.92, P = 0.195). CONCLUSIONA higher body fat percentage was associated with a different risk of all-cause death in patients with CAD, stratified by coexistence of LVH or not. Higher body fat was significantly associated with a greater risk of mortality among patients with LVH but not among those without LVH.

Last 40 years have witnessed sharply rise of obesity prevalence at any age and gender around the world. In the concept of obesity transition, China has been classified into stage 2, which is characterized by a significant increase of obesity prevalence in adults surpassing that among children, and a narrowing distinction between sexes.^[1] In 2012, obesity prevalence in Chinese residents aged over 18 years old is 11.9%. About 13.5% of cardiovascular deaths were attributable to high body mass index in 2017; furthermore, the direct economic burden of overweight and obesity rose to 90.768 billion yuan (RMB), which is accounted for 4.5% of total health expenditure of China in 2010.^[2] Obesity, itself or concomitant with other comorbidities, contribute to a higher risk of incident coronary artery disease (CAD).^[3] Cardiac remodeling and functional changes are also prevailing phenomena in obese individuals. A meta-analysis showed that the prevalence of left ventricular hypertrophy (LVH) in obese individuals was 56%, ranging from 20% to 85% according to different criteria of LVH.^[4] In patients with coronary artery stenosis, LVH was associated with the presence of myocardial ischemia and the extent of involvement independent of traditional cardiovascular risk factors.^[5]With in-depth research on the pathogenesis heart failure with preserved ejection fraction, increasing weight has been given to the impact of obesity and LVH on cardiovascular system.^[6] Although we are well aware of the adverse effects of body fat on cardiovascular metabolism, for patients who have been diagnosed with CAD, the role of body fat may be heterogeneous.^[7,8] In other words, for those patients, some studies have reported the phenomenon of the obesity paradox, while other studies have observed the U-shaped curve between obesity and prognosis, and some studies have not observed the relationship between obesity and better clinical endpoints.^[8,9] It is very important to clarify the association between body fat and the prognosis among patients with CAD because it will determine how to guide them on weight management. Actually, physical activity can improve the cardiopulmonary function status of patients with cardiovascular disease. Therefore, identifying which patients with obesity have a worse prognosis and need to be focused on as target population to improve management and reduce the burden of disease is worthy of further observation. Since LVH is very closely related to adipose tissue and adverse cardiovascular events, it may play an important role in the risk stratification of patients with obesity concomitant with CAD.^[10] Previous studies demonstrated that the reaction of ventricular sarcomere contractility to increased calcium stimulation was substantially depressed in severely obese patients; furthermore, LVH and obesity had a superposition effect on regional LV dysfunction.^[11,12] In this study, we investigated the interplay relationship of body fat and LVH with the risk of all-cause death in patients with CAD.     

章念伟治疗慢性肾小球肾炎经验

慢性肾小球肾炎是一种变态反应性疾病,是慢性肾衰竭最常见的原发病,因此,及时治疗慢性肾炎,对阻止或延缓病情的发展、提高患者的生活质量至关重要。章念伟主任医师提出治疗慢性肾小球肾炎当以祛湿为主,活血化瘀,慎用补虚,平和用药,适时守方,于临床治疗可获得较好的疗效。     

辛弗林分离检测方法研究进展

通过查阅2000年以来相关文献,对辛弗林的分离提取、检测方法的研究进展进行归纳与综述.认为辛弗林具有广泛的医药、保健作用,其分离提取、含量检测手段在不断改进.     

全球化时代灾害医疗救援发展探讨

全球化正在深刻地影响世界各国灾害医疗救援的发展。为了进一步提高灾害医疗救援的整体成效，本文对全球化时代国际层面、国家层面、地区层面灾害医疗救援的组织、制度、训练、装备及技术建设进行了研究，提出了适应全球化趋势，对灾害医疗救援程序、阶梯、时段、急救技术、装备标准等共性内容进行规范，统一医疗救援程序、统一医疗救援标准等建议。     

超声造影联合超声引导下穿刺活检诊断乳腺癌前哨淋巴结转移的Meta分析

目的 系统评价超声造影联合超声引导下穿刺活检诊断乳腺癌前哨淋巴结转移的临床价值.方法 计算机检索中国知网(CNKI)、万方、中国生物医学文献数据库(CBM)、维普(VIP)、龙源期刊、医学库、国研数据库、PubMed、Embase、Cochrane图书馆、NEJM医学期刊,搜集2021年6月30日前关于超声造影联合超声...     

桃红四物汤抗血栓形成作用研究

目的探讨桃红四物汤的抗血栓作用。方法采用Chandler环血栓形成法测定体外血栓的湿质量、干质量和血栓长度,采用大鼠下腔静脉结扎血栓形成法观察静脉血栓湿质量及干质量,采用二磷酸腺苷（adenosine diphosphate,ADP）和肾上腺素致肺栓塞实验模型观察小鼠肺栓塞时间。结果桃红四物汤能显著降低体外血栓长度、湿质量和干质量,显著降低体内静脉血栓湿质量和千质量,显著缩短静脉注射ADP和肾上腺素所致小鼠肺栓塞时间。结论桃红四物汤具有较好的抗血栓作用,其作用环节可能与抑制血小板聚集有关。     

半夏种内各变异类型主要形态学性状比较研究

目的为半夏各变异类型提供形态学的鉴别和分类依据。方法系统观察并测量各变异类型主要形态学性状,采用多角形图比较其相似性和差异性程度。结果生殖器官中,各变异类型间各性状的差异性较小,但有一个变异趋势,即阔叶类型的雌雄花序长和宽,雌雄间隔,管部长和宽与其它类型相比,数值略小。营养器官中,以叶片长宽比值即叶形的变化最为明显,其它性状在各变异类型间相似。结论叶片长宽比值在各变异类型间差异显著,可作为各变异类型鉴别和分类的依据。     

侧脑室后角入路脉络丛神经内镜手术的相关解剖学研究

目的 通过解剖学研究为神经内镜下侧脑室脉络丛手术提供解剖学依据.方法 观察8例(16侧)固定成人尸头标本上的脉络丛形态及其供血动脉的走形,测量各部位脉络丛的宽度、到中线的距离及其供血动脉的管径,并确定侧脑室后角入路脉络丛手术的最佳穿刺点.结果 侧脑室内的大部分脉络丛集中在三角部和颞角;其脉络点、颞凸点和三角部至中线距离分别是(25.6±2.0)mm,(32.2±1.1)mm,(29.1±1.3)mm;脉络丛颞部、球部、体部宽度不同[(6.40+0.64)mm、(13.53±1.03)mm、(3.70±0.59)mm],差异有统计学意义(P<0.05);侧脑室脉络丛由根部血管供血,突出的脉络球由脉络丛前动脉外侧干供血:神经内镜下双侧脑室后角入路脉络丛手术的最佳穿刺点是枕外粗隆上5 cm、旁开3 cm,穿刺方向指向同侧眼球.结论 神经内镜下双侧脑事后角最佳穿刺点入路行脉络从手术有利于最大面积的烧灼脉络丛组织,手术中可烧灼或离断脉络丛前动脉外侧干以阻断颞部脉络丛外侧份及脉络丛球部供血,不会影响丘脑、室管膜下及颞叶等重要功能区域的血液供应.