肺动脉平滑肌细胞氧敏感钾通道与低氧性肺血管收缩

Lopez Barnc于1988年采用全细胞膜片钳技术发现了大鼠颈动脉体Ⅰ型细胞膜上对低氧敏感的钾（K^＋）通道,称为“氧敏感K^＋通道”（O2-sensitive K^＋ channels）。在肺动脉平滑肌细胞（PASMCs）巾亦存在此种离子通道。低氧时PASMCs的K^＋外向电流发生抑制,膜发生除极化,继而L^-型电压门控Ca^2＋通道开放,     

Diagnostic value of periostin in lung cancer‐related malignant pleural effusion

BackgroundPeriostin (POSTN) is an extracellular matrix protein that is overexpressed in lung cancer and is considered an effective diagnostic and prognostic biomarker for lung cancer. The purpose of this study was to investigate the diagnostic performance of POSTN and to further evaluate the diagnostic value of POSTN combined with carcinoembryonic antigen (CEA) and cancer ratio [CR: serum lactate dehydrogenase (LDH)/pleural effusion adenosine deaminase (PE ADA)] in lung cancer‐related malignant PE (MPE).MethodsA total of 108 patients with PE, including 54 with lung cancer and 54 with benign lung disease, were enrolled in this study. The POSTN levels of PE and serum were detected using an enzyme‐linked immunosorbent assay. Information on the expression of PE and serum CEA, serum LDH, and PE ADA was collected from medical records.ResultsThe levels of PE POSTN in MPE of patients with lung cancer were significantly higher than those in patients with benign PE (p < 0.0001). The receiver operating characteristic (ROC) curve indicated that the diagnostic sensitivity and specificity of PE POSTN for lung cancer‐related MPE were respectively 77.78% and 68.52% when the cutoff value was determined to be 53.45 ng/ml. The ROC curve analysis demonstrated that PE POSTN has a high diagnostic value in MPE associated with lung cancer [area under the curve (AUC) = 0.764], and the combination of PE POSTN, PE CEA, and CR can improve the diagnostic accuracy of lung cancer‐related MPE (AUC = 0.948).ConclusionPOSTN can be used as a potential marker for lung cancer‐related MPE diagnosis.     

Advances in biotechnological production of santalenes and santalols

Sandalwood essential oil has been widely used not only as natural medicines but also in perfumery and food industries, with sesquiterpenoids as its major components including(Z)-a-santalol and(Z)-bsantalol and so on. The mature heartwoods of Santalum album, Santalum austrocaledonicum and Santalum spicatum are the major plant resources for extracting sandalwood essential oil, which have been overexploited. Synthetic biology approaches have been successfully applied to produce natural products on large scale. In this review, we summarize biosynthetic enzymes of santalenes and santalols, including various santalene synthases(STSs) and cytochrome P450 monooxygenases(CYPs), and then highlight the advances of biotechnological production of santalenes and santalols in heterologous hosts, especially metabolic engineering strategies for constructing santalene-and santalol-producing Saccharomyces cerevisiae.     

闭合性胰腺损伤22例诊治分析

目的提高闭合性胰腺损伤的早期诊断水平,掌握好探查指征,合理选择手术方式.方法回顾性分析20年来22例闭合性胰腺损伤的诊治过程.结果闭合性胰腺损伤临床上均有不同程度的上腹疼痛、呕吐、腹膜刺激征,其中伴休克3例,早期血淀粉酶检查18例,15例阳性;尿淀粉酶12例,6例阳性,腹水淀粉酶检查6例,均为阳性,腹穿12例均为阳性.B超检查18例,确诊9例,CT检查10例,确诊8例.并发症发生率50%(11/22)死亡2例.结论早期诊断闭合性胰腺损伤主要依靠临床表现、诊断性腹腔穿刺、淀粉酶检查和B超及CT检查.各种辅助检查有一定的局限性,术前提高对胰腺损伤程度的认识,掌握好探查指征,合理选择手术方式,可以进一步降低并发症及死亡率.     

危重症患者肠内营养安全实施流程的构建

目的构建危重症患者肠内营养安全实施流程,确保肠内营养实施的安全性和有效性。方法以标准化作业为理论基础,在查阅相关文献的基础上,初步拟定危重症患者肠内营养安全实施流程;应用德尔菲专家咨询法,对16名专家进行2轮问卷咨询。结果经2轮专家咨询,构建了包括10个项目36个子项目的流程,2轮专家的积极系数均为100%,权威系数为0.8313、0.8860,子项目的协调系数分别为0.267、0.359。结论构建的危重症患者肠内营养安全实施流程合理、可靠,为肠内营养的实施提供了客观依据。     

Transforming brain signals related to value evaluation and self‐control into behavioral choices

The processes involved in value evaluation and self‐control are critical when making behavioral choices. However, the evidence linking these two types of processes to behavioral choices in intertemporal decision‐making remains elusive. As the ventromedial prefrontal cortex (vmPFC), striatum, and dorsolateral prefrontal cortex (dlPFC) have been associated with these two processes, we focused on these three regions. We employed functional magnetic resonance imaging during a delayed discounting task (DDT) using a relatively large sample size, three independent samples. We evaluated how much information about a specific choice could be decoded from local patterns in each brain area using multivoxel pattern analysis (MVPA). To investigate the relationship between the dlPFC and vmPFC/striatum regions, we performed a psychophysiological interaction (PPI) analysis. In Experiment I, we found that the vmPFC and dlPFC, but not the striatum, could determine choices in healthy participants. Furthermore, we found that the dlPFC showed significant functional connectivity with the vmPFC, but not the striatum, when making decisions. These results could be replicated in Experiment II with an independent sample of healthy participants. In Experiment III, the choice‐decoding accuracy in the vmPFC and dlPFC was lower in patients with addiction (smokers and participants with Internet gaming disorder) than in healthy participants, and decoding accuracy in the dlPFC was related to impulsivity in addicts. Taken together, our findings may provide neural evidence supporting the hypothesis that value evaluation and self‐control processes both guide the intertemporal choices, and might provide potential neural targets for the diagnosis and treatment of impulsivity‐related brain disorders.     

基于五味合化理论探讨辛宣苦泄配伍治疗哮喘机制

支气管哮喘是一种慢性炎症性气道疾病,隶属于中医治疗优势病种的哮病范畴,多因肺气的宣降失衡,冲逆咽喉而作哮鸣。五味合化,是指“辛、苦、酸、甘、咸”五味中药之间配伍合化出新功用的药性组方理论。辛味“能散”,苦味“能泄”,是中药五味理论的重要组成,且肺苦气上逆,食辛散之,食苦泄之,二味中药也占据了目前治疗哮病用药的大部分,辛宣苦泄的配伍亦是治疗哮病的主要组方思路,目前尚缺乏对辛苦合化治疗哮喘的中医理论和机制的深入分析。辛横行而宣散,苦直行而降泄,而且辛味和苦味的微观分子机制分别与瞬时受体电位通道(TRPs)和苦味受体(TAS2Rs)存在着密切的关系。Ca²⁺信号的调节作用已经在哮喘的过程中被发现,参与哮喘多种症状的发病机制。而定位于细胞膜上的Ca²⁺通道TRPs,及受体TAS2Rs已经被证实能够直接调节细胞内Ca²⁺信号,并且在哮喘的治疗过程中发挥作用。因此,辛宣苦泄功效的发挥可能是通过TRPs/TAS2Rs介导的Ca²⁺信号实现的。通过辛散宣肺,苦泄降肺的理论认识和现代研究,以期从中医理论和现代机制的角...     

急性心肌梗死再灌注治疗后早期ST段变化预测心肌微血管功能

目的 :评价急性心肌梗死直接经皮冠状动脉腔内成形术 (PTCA)和支架置入术后ST段变化与心肌微血管灌注之间的关系 ,探讨ST段变化预测心肌微血管功能的可行性。方法 :测量PTCA和支架置入术前及术后 1、5、10、2 0、3 0min及 12h内相关导联ST段抬高指数 (∑STI)。术后 12h内行静脉心肌声学造影 (MCE)。根据心肌灌注将 2 4例患者分为无再流者 8例 (MCE积分为 3分或 2分 ) ,再流者 16例(MCE积分为 1分 )。MCE图像用MCE图像分析软件进行定量分析。结果 :心肌梗死相关动脉成功重建后 ,16例患者危险区有再流 ,8例出现无再流现象 ;再流者 16例患者中 ,14例∑STI下降≥ 5 0 % ,而在无再流者 8例中只有 1例 (P =0 0 0 0 1) ;无再流者 7例在术后 10min内∑STI进一步抬高≥3 0 % ,而再流者仅有 2例 (P =0 0 0 3 )。∑STI变化预测心肌微血管灌注敏感性、特异性及准确性均为 87 5 % ,阳性预测值为 93 3 % ,阴性预测值为 77 8%。术后 2 0min的∑STI与标化A·β值存在显著的负相关 (γ =-0 881,P =0 0 0 0 1)。结论 :急性心肌梗死成功再灌注治疗后不同的ST段变化与心肌微血管灌注有关 ;急性心肌梗死再灌注治疗后早期ST段变化可预测心肌微血管功能。