丙泊酚对失眠患者睡眠周期性肢体活动的影响

目的观察丙泊酚持续输注对睡眠周期性肢体活动（PLMS）的抑制作用。方法对32例顽固性失眠患者在自由睡眠（自由睡眠组）和丙泊酚全身麻醉（丙泊酚组）两种情况下实施睡眠监测,观察脑电图以及肌电图改变。结果两组均有部分患者发生睡眠周期性肢体活动。两组之间的发病率和睡眠周期性肢体活动指数均无明显差异,睡眠周期性肢体活动期间患者脑电图无异常改变。结论临床浓度的丙泊酚对PLMS无明显抑制作用。     

Inhibited interleukin 35 expression and interleukin 35–induced regulatory T cells promote type II innate lymphoid cell response in allergic rhinitis

BackgroundInterleukin (IL)-35 and IL-35–producing regulatory T cells (iTr35) have been reported to inhibit T_H2 response in allergic rhinitis (AR). However, its effects on type II innate lymphoid cells (ILC2) are not well characterized.ObjectiveTo investigate the effect of IL-35 on ILC2 in AR.MethodsA total of 25 patients with AR and 20 controls were recruited. The expression and regulation of IL-35 receptor in ILC2 were analyzed by real-time polymerase chain reaction. The effect of IL-35 on ILC2 differentiation and cytokine production was analyzed by real-time polymerase chain reaction and enzyme-linked immunosorbent assay. In addition, iTr35 were cocultured with ILC2 to explore the effect of iTr35 on ILC2. The AR mice models were also established to confirm the role of IL-35 in vivo.ResultsThe patients with AR had decreased IL-35 expression and iTr35 proportion and increased ILC2 and type II cytokines compared with the controls. Notably, IL-35 inhibited ILC2 differentiation and type II cytokine production by regulating IL-12Rβ2 and gp130. IL-35 promoted the inducible costimulatory molecule expression by iTr35 and the inducible costimulatory molecule ligand expression by ILC2. IL-35–treated mice with AR presented decreased frequency and function of nasal ILC2.ConclusionIL-35 inhibited ILC2 responses directly or through mutual contact between iTr35 and ILC2 in AR, suggesting that IL-35 may be used as a potential treatment target in AR.     

Functional giant parathyroid cyst with high concentration of CA19-9 in cystic fluid

A 63-year-old man was admitted to our hospital for the evaluation of hypercalcemia and anterior neck mass. Laboratory findings revealed hypercalcemia, hypophosphatemia, and hypercalciuria, as well as elevated serum levels of parathyroid hormone (PTH) and alkaline phosphatase. Computerized tomography and magnetic resonance images showed that the mass contained a cystic area. Parathyroid scintigraphy using either 99mTc-sestamibi alone or 201Tl-chloride in conjunction with 99mTc-pertechnetate for thyroid image subtraction showed uptake of the radioactivity into the cyst wall, suggesting that the mass originated from the parathyroid. Fine needle aspiration biopsy revealed that the cyst fluid was serous and bloody with extremely high concentrations of both PTH and CA19-9. The patient was diagnosed as primary hyperparathyroidism caused by parathyroid cyst and cervical exploration was performed. The cyst was dissected away along with the right lobe of the thyroid gland. After tumor removal, serum calcium and PTH levels were normalized. Histological study showed that the tumor possessed malignant potential with capsular invasion as well as moderate cellular atypia with trabecular pattern in arrangement. Parathyroid cells in the wall of the cystic tumor were immunostained positively for CA19-9, suggesting that CA19-9 in the cyst fluid was produced from the cells.     

Extracts from rabbit skin inflamed by the vaccinia virus attenuate bupivacaine-induced spinal neurotoxicity in pregnant rats

Extracts from rabbit skin inflamed by the vaccinia virus can relieve pain and promote repair of nerve injury. The present study intraperitoneally injected extracts from rabbit skin inflamed by the vaccinia virus for 3 and 4 days prior to and following intrathecal injection of bupivacaine into pregnant rats. The pain threshold test after bupivacaine injection showed that the maximum possible effect of tail-flick latency peaked 1 day after intrathecal injection of bupivacaine in the extract-pretreatment group, and gradually decreased, while the maximum possible effect in the bupivacaine group continued to increase after intrathecal injection of bupivacaine. Histological observation showed that after 4 days of intrathecal injection of bupivacaine, the number of shrunken, vacuolated, apoptotic and caspase-9-positive cells in the dorsal root ganglion in the extract-pretreatment group was significantly reduced compared with the bupivacaine group. These findings indicate that extracts from rabbit skin inflamed by the vaccinia virus can attenuate neurotoxicity induced by intrathecal injection of bupivacaine in pregnant rats, possibly by inhibiting caspase-9 protein expression and suppressing nerve cell apoptosis.     

Paclitaxel‐based supramolecular hydrogel loaded with mifepristone for the inhibition of breast cancer metastasis

Breast cancer is the leading cause of cancer death among women and almost all of the breast cancer‐caused mortality is related to metastasis. It has been reported that glucocorticoid facilitates the metastasis of breast cancer in mice, and mifepristone can antagonize the effect of glucocorticoid. Paclitaxel is one of the important drugs in the treatment of breast cancer. Mifepristone combined with paclitaxel could be an effective strategy for inhibiting breast cancer metastasis. However, their inherent defects, in terms of short blood circulation half‐life and lack of tumor targeting, not only limit their effectiveness but also cause adverse reactions. Therefore, our aim is to explore a novel protocol against breast cancer metastasis, further optimize its therapeutic efficacy by a nanodelivery system, and explore its mechanism. Herein, a paclitaxel‐conjugated and mifepristone‐loaded hydrogel (PM‐nano) was prepared by self‐assembly. Its characterizations were studied. The antimetastatic effect was evaluated in vitro and in vivo and its mechanism was also explored by western blot assay. The resultant PM‐nano was developed with favorable water solubility and good biocompatibility. Moreover, PM‐nano displayed increased cell uptake properties and stimulated drug release in the tumor micro‐acidic environment. The PM‐nano was more effective in inhibiting the proliferation and metastasis of breast cancer than other groups in vitro and in vivo. The PM‐nano might inhibit metastasis through glucocorticoid receptor/receptor tyrosine kinase‐like orphan receptor 1 and MMPs. Taken together, PM‐nano showed superior antimetastatic effects against breast cancer and excellent biocompatibility in vitro and in vivo, providing a new option for limiting metastasis.     

经皮穴位电刺激辅助麻醉在腔镜肠癌根治术患者加速康复外科中的应用

目的：观察经皮电刺激足三里穴和内关穴对腹腔镜下肠癌根治术患者手术后康复情况的影响。方法：选择择期行腹腔镜下肠癌根治手术的患者50 例,随机分为2 组,研究组24 例（其中1 例未能完成全部试验）,对照组25 例;2 组麻醉方案相同,研究组手术前30 min 及术后第1 天、第2 天给予经皮电刺激足三里穴、内关穴治疗,对照组操作同研究组,但不开启电源;记录2 组患者手术时间、出血量、复苏室停留时间、肛门首次排气时间、有无术后非切口痛（肩痛、背痛、肋间肌疼痛等）、术后（4 h、12 h、24 h、48 h） 切口疼痛视觉模拟评分法（VAS） 评分,以及有无术后恶心呕吐（PONV）。结果：治疗后,研究组患者首次排气时间明显短于对照组,差异有统计学意义（P＜0.05）;而2 组患者手术时间、复苏室停留时间及出血量比较,差异无统计学意义（P＞0.05）。术后第1 天、第2 天,研究组无PONV 的病例明显多于对照组,差异均有统计学意义（P＜0.05）。经皮穴位电刺激干预后,研究组没出现非切口疼痛的病例明显多于对照组,差异有统计学意义（P＜0.05）。术后24 h、48 h,研究组疼痛VAS 评分较同组前一时间点明显下降,差异有统计学意义（P＜0.05）;且研究组VAS 评分明显低于对照组同时间点（P＜0.05）。结论：经皮电刺激足三里穴和内关穴可明显改善腹腔镜下肠癌根治术患者术后的镇痛效果,减少术后非切口痛的发生,改善术后恶心呕吐,提早排气时间,对加速术后康复有一定的促进作用。     

改良鼻中隔缝合在鼻中隔矫正术中的临床应用

目的 探讨改良鼻中隔缝合在鼻中隔矫正术中应用的可行性和安全性.方法 对比分析鼻中隔矫正术后应用鼻腔填塞通气管和不填塞而行改良鼻中隔贯穿缝合2种方法的效果.将60例行鼻中隔偏曲矫正术和下鼻甲骨折外移术的患者分为填塞组和缝合组,填塞组30例常规行鼻中隔矫正术和下鼻甲骨折外移术,术后行鼻腔通气管填塞支撑;缝合组30例在鼻中隔...     

血管紧张素Ⅱ1型受体基因A1166C多态性与高血压肾脏损害相关性研究

目的:探讨血管紧张素Ⅱ1型受体(AT1R)A1166C多态性与高血压、高血压肾脏损害的关系。方法:入选188例原发性高血压患者进行尿微量白蛋白和AT1R基因A1166C多态性测定。结果:AA基因型与AC基因型收缩压分别为(149·1±20·8)mmHg(1mmHg=0·133kPa)和(137·8±22·6)mmHg,2组间差异有显著性(P=0·013)。AC基因型携带者尿微量白蛋白尿异常者明显增多,差异有显著性(P=0·006)。结论:AT1R基因A1166C多态性可能与原发性高血压和高血压肾脏损害有关。     

Plasma lipids and osteoporosis in postmenopausal women

Many clinical studies have shown that osteoporosis is associated with atherosclerosis and cardiovascular death. Although both high plasma levels of low density lipoprotein cholesterol (LDL-C) and low plasma levels of high density lipoprotein cholesterol (HDL-C) are known to be risk factors for atherosclerosis, it is unclear whether such lipid derangements are also associated with the pathogenesis of osteoporosis. In this study, we evaluated the relationships between plasma levels of total C, LDL-C, HDL-C, or triglyceride (TG) versus bone mineral density (BMD) at the lumbar spine, femoral neck, radius, or total body as well as the presence of vertebral fractures in 214 Japanese postmenopausal women (age range, 47-86 years, mean 62.7). Multiple regression analysis was performed between BMD at each skeletal site versus each lipid level adjusted for age, years after menopause, body mass index (BMI), and %fat. Plasma LDL-C levels were significantly and inversely correlated with the absolute values of both one-third radial (1/3R) and distal radial (UDR) BMD (p<0.01), and tended to be inversely correlated with the absolute values of L-BMD (p=0.051). In contrast, plasma HDL-C levels were significantly and positively correlated with the absolute values of L, 1/3R and UDR BMD (p<0.05). On the other hand, plasma TG levels were significantly lower in women with vertebral fractures than in those without fractures (97.0+/-36.5 vs. 126.4+/-65.8 mg/dl, mean+/-SD, p<0.05). When multivariate logistic regression analysis was performed with the presence of vertebral fractures as a dependent variable and each lipid level adjusted for age, years after menopause, BMI, and %fat as independent variables, TG alone was selected as an index affecting the presence of vertebral fractures (odds ratio: 0.51, 95% confidential interval: 0.29-0.89 per SD increase, p<0.05). Our study showed that plasma LDL-C and HDL-C levels were inversely and positively correlated with both R- and L-BMD values, respectively, while low plasma TG levels were associated with the presence of vertebral fractures in postmenopausal women. Thus, plasma lipids might be related to bone mass and bone fragility, and might be the common factor underlying both osteoporosis and atherosclerosis.     

生脉二至方联合α-干扰素治疗慢性乙型肝炎的疗效观察

目的观察α-干扰素联合生脉二至方治疗慢性乙型肝炎的效果。方法治疗组40例与对照组联合利血生、复方益肝灵30例对照。结果治疗组能明显减少白细胞水平降低的发生率、可提高HBeAg/抗HBe转换率（两组相比有显著性差异,P〈0.05）。结论此方法可升高白细胞水平,提高HBeAg/抗HBe转换率。