TLR4受体与银屑病及过敏性紫癜皮肤病的研究进展

国内外研究表明TLR4在银屑病和过敏性紫癜患者中的体内表达上调。TLRs信号过度活化时,激活机体内炎症反应,导致炎性细胞大量浸润及细胞因子过度释放,可使体内Th1/Th2免疫应答失衡,干扰机体自身免疫耐受机制,导致免疫功能紊乱。本文对银屑病和过敏性紫癜的与TLR4介导的免疫研究进展进行了综述。     

酸性环境抑制CIK细胞对肝癌HepG2细胞的杀伤活性

目的 研究酸性环境对CIK（cytokine-induced killer, CIK）细胞杀伤肝癌HepG2细胞的影响。方法 利用IFN-γ、IL-2及CD3抗体诱导外周血单个核细胞获得CIK细胞。在pH6.5及pH7.4条件下将CIK细胞和荧光素酶标记的HepG2细胞（HepG2-luc）按不同的效靶比混合培养,用小动物活体成像系统检测HepG2-luc荧光强度并计算杀伤活性,用MTT法检测并计算杀伤活性。在pH6.5及pH7.4条件下,在含CIK条件培养液0、50%和100%的情况下培养HepG2细胞,流式细胞仪检测凋亡坏死的细胞比例。结果 pH7.4时CIK细胞对HepG2细胞的杀伤率明显高于pH6.5时。CIK条件培养液作用下,pH7.4时HepG2细胞的凋亡坏死比例明显高于pH6.5。结论 酸性环境明显抑制了CIK细胞对肝癌细胞HepG2的杀伤活性。     

头颈部CTA判断大脑中动脉区脑梗死患者供血动脉狭窄的价值

目的探讨头颈部计算机断层扫描血管成像（CTA）在判断大脑中动脉（MCA）区脑梗死患者血管狭窄程度以及与脑梗死程度的相关I生。方法对68例MCA区脑梗死患者进行头颈部CTA检查,分析受累血管狭窄程度及其与脑梗死程度的关系。结果68例中,颈内动脉（ICA）和MCA均正常者5例,单纯ICA狭窄共16例,其中轻度狭窄2例,中度狭窄4例,重度狭窄5例,闭塞5例;单纯MCA狭窄共41例,其中轻度狭窄6例,中度狭窄12例,重度狭窄18例,MCA闭塞5例;MCA合并ICA狭窄6例。ICA或MCA狭窄程度与脑梗死类型有关,狭窄程度越严重,梗死程度越严重（r=0.832,0．938,P〈0．05）。结论头颈部CTA在判断血管狭窄的同时,可预测患者脑梗死的程度,对脑梗死的临床诊断和治疗方案的选择具有重要的指导价值。     

Coupling of oxidative stress responses to tricarboxylic acid cycle and prostaglandin E2 alterations in Caenorhabditis elegans under extremely low-frequency electromagnetic field

Purpose: With all-pervasive presence of extremely low-frequency electromagnetic field (ELF-EMF) in modern life, ELF-EMF has been regarded as an essential factor which may induce changes in many organisms. The objective of the present study was to investigate the physiological responses of Caenorhabditis elegans (C. elegans) to 50?Hz, 3?mT ELF-EMF exposure.

Materials and methods: Worms were exposed to ELF-EMF from the egg stage until reaching the fourth larva (L4) stage. After exposure, expressions of the tricarboxylic acid (TCA) cycle enzymes were examined by qRT-PCR and western blot analysis. Two lipid metabolites were detected by GC-MS. Reactive oxygen species (ROS) level was detected by dichlorofluorescein staining and worm antioxidant system was investigated by enzymatic activity analysis, including detection of the superoxide dismutase and catalase (CAT) activity and the total antioxidant capacity (T-AOC).

Results: The TCA cycle enzyme, fumarase was found with decreased expression under ELF-EMF exposure. And arachidonic acid (ArA) and prostaglandin E₂(PGE₂) showed elevated concentrations, with increased expression of prostaglandin E₂ synthase (PGES-2) in ELF-EMF exposed worms. Significant elevation of ROS level was identified accompanied with the significant depression of T-AOC in response to ELF-EMF.

Conclusions: Our results suggested that exposure to 50?Hz, 3?mT ELF-EMF in C. elegans can elicit disruptions of the TCA cycle metabolism and PGE₂ formation, coupling ELF-EMF-induced oxidative stress responses. Our study probably will attract increasing attentions to the controllable application of ELF-EMF associated with health and disease.     

Evaluation of the Microcentrifuge Dissolution Method as a Tool for Spray-Dried Dispersion

Although using spray-dried dispersions (SDDs) to improve the bioavailability of poorly water-soluble compounds has become a common practice in supporting the early phases of clinical studies, their performance evaluation, whether in solid dosage forms or alone, still presents significant challenges. A microcentrifuge dissolution method has been reported to quickly assess the dissolution performance of SDDs. While the microcentrifuge dissolution method has been used in the SDD community, there is still a need to understand the mechanisms about the molecular species present in supernatant after centrifugation, the molecular nature of active pharmaceutical ingredients (APIs), as well as the impact of experimental conditions. In this paper, we aim to assess the effect of API and polymer properties on the dissolution behavior of SDDs along with centrifuging parameters, and for this, two poorly water-soluble compounds (indomethacin and ketoconazole) and two commonly used polymers in the pharmaceutical industry (PVP and HPMC-AS) were chosen to prepare SDDs. A typical microcentrifuge dissolution procedure as reported in the publication (Curatolo et al., Pharm Res 26:1419–1431, 2009) was followed. In addition, after separation of the supernatant from precipitation, some of the samples were filtered through filters of various sizes to investigate the particulate nature (particle size) of the supernatant. Furthermore, the centrifuge speed was varied to study sedimentation of API, SDD, or polymer particles. The results indicated that for the SDDs of four drug-polymer pairs, microcentrifuge dissolution exhibited varied behaviors, depending on the polymer and the drug used. The SDDs of indomethacin with either PVP or HPMC-AS showed a reproducible dissolution with minimum variability even after filtration and subjecting to varied centrifugation speed, suggesting that the supernatant behaved solution-like. However, ketoconazole-PVP and ketoconazole-HPMC-AS SDDs displayed a significant variation in concentration as the speed of centrifugation and the pore sizes of filters were altered, indicating that their supernatant was heterogeneous with the presence of particulates. In conclusion, microcentrifuge dissolution method was more suitable for indomethacin-PVP and indomethacin-HPMC-AS systems compared with ketoconazole-PVP and ketoconazole-HPMC-AS. Therefore, the use of microcentrifuge dissolution method depends on both compounds and polymers selected, which should be examined case by case.     

癫痫患儿疾病家庭负担的现状及影响因素研究

目的 了解癫痫患儿疾病家庭负担的现状及影响因素,为促进癫痫患儿的合理管理、减轻癫痫患儿疾病家庭负担提供依据。方法 采用方便抽样法,选取2021年1—12月于西安市儿童医院神经内科住院部治疗的315名癫痫患儿的父母作为研究对象。采用自制一般资料调查表、孕产期情况调查表、疾病相关信息调查表及疾病家庭负担量表（FBS）调查癫痫患儿及其父母的一般资料、孕产期情况、疾病情况及家庭负担现状。采用多重线性回归分析癫痫患儿疾病家庭负担的影响因素。结果 315名癫痫患儿父母的FBS总分为（17.95±11.36）分,家庭经济负担维度的标准化得分为1.0(0.8,1.6)分,70.48%(222/315)的癫痫患儿家庭经济负担为中度及以上。多重线性回归分析结果显示,父亲职业、家庭年收入、户外活动频率、有无合并症、发作频率、多药治疗是癫痫患儿疾病家庭负担的影响因素（P<0.05）。结论 癫痫患儿疾病家庭负担中,经济负担最重,为中等以上。父亲职业不稳定、家庭年收入低、有癫痫共患病、户外活动频率低、发作未得到有效控制、多种药物治疗的癫痫患儿家庭,需要得到更多的关注。     

头罩与面罩无创通气对呼吸衰竭患者临床疗效的Meta分析

目的 评价头罩与面罩无创通气方式对呼吸衰竭患者临床疗效的影响。 方法 通过检索文献数据库包括Medline(Pubmed)、Cochrane Library、Web of Science和万方数据、中国知网、中国生物医学文献数据库,根据纳入标准及剔除标准,筛选出比较头罩与面罩无创通气治疗呼吸衰竭的随机对照试验。提取数据,采用Cochrane协作网提供的“risk of bias”标准和Jadad评分体系进行文献质量评价。采用Review manager 5.1.0统计软件进行Meta分析。 结果 共纳入10篇随机对照试验,包括头罩组228例,面罩组223例。Meta分析显示,相比面罩,头罩可降低呼吸衰竭患者不耐受率(RR=0.18,95%CI:0.08~0.41,P<0.001),减少面部皮肤溃疡发生率(RR=0.19,95%CI:0.08~0.48,P<0.001)和胃肠胀气发生率(RR=0.15,95%CI:0.05~0.42,P<0.001),降低呼吸频率(MD=-3.01,95%CI:-4.87~-1.16,P=0.001)、气管插管率(RR=0.39,95%CI:0.26~0.59,P<0.001)和住院病死率(RR=0.59,95%CI:0.36~0.96,P=0.030),提高Ⅰ型呼吸衰竭患者氧合指数(MD=60.45,95%CI:20.44~100.46,P=0.003)。然而,在相同压力支持下,头罩降低Ⅱ型呼吸衰竭患者二氧化碳分压的能力低于面罩(MD=5.86,95%CI:3.64~8.08,P<0.001)。 结论 相比面罩,头罩可提高患者耐受性,减少不良反应,增加氧合作用,降低气管插管的风险,但在清除二氧化碳潴留方面无优势。     

肿块样病变的X线征象分析在早期乳腺癌诊断及鉴别诊断中的应用

目的:探讨肿块样病变的X线征象在鉴别早期乳腺癌与良性病变中的应用价值。方法:选择经病理证实的肿块型乳腺病变患者396例,肿块最大径在3 cm以内,其中早期乳腺癌组257例,良性病变组139例。全部病例于穿刺前或手术前行乳腺X线摄影检查。观察肿块的大小、形态、边缘、密度、肿块有无钙化、钙化的分布、肿块位置的深度和双侧乳腺腺体类型。结果:两组病例在肿块形态、肿块边缘、肿块密度、肿块伴钙化、钙化类型上存在差异,且差异具有统计学意义（P＜0.05）;两组病例在钙化分布、病灶深度及乳腺分型上差异无统计学意义（P＞0.05）;乳腺良性病变组病灶最大径中位数值小于早期乳腺癌组。结论:乳腺X线摄影在早期乳腺癌和乳腺良性病变的鉴别诊断上,尤其是对肿块样病变的鉴别诊断上,具有较高的临床应用价值。     

奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌的临床研究

目的观察奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌的疗效和不良反应。方法采用奥沙利铂130mg/m2,静滴2 h,第1天;亚叶酸钙(CF)200 mg/m2,静滴,连续5天;5_Fu 500 mg/m2,静滴4 h,连续5天,21天为1周期。结果35例患者中CR 1例,PR 13例,总有效率40.0%。主要的不良反应为消化道症状、骨髓抑制和感觉神经毒性。结论奥沙利铂联合氟尿嘧啶及亚叶酸钙治疗晚期胃癌疗效肯定,毒副作用较轻,值得推广应用。     

Non-selective pulmonary angiography for venous thromboembolism diagnosis, a better choice？

ObjectiveTo evaluate the efficiency of non-selective pulmonary angiography for pulmonary embolism diagnosis.Methods105 consecutive subjects diagnosed with limb deep venous thrombosis (DVT) by lower limb phlebography underwent non-selective pulmonary angiography.Results52.38% patients were diagnosed with pulmonary embolism, 21.9% with inferior vena cava thromboembolism, and 9.52% with pulmonary embolism combined with inferior vena cava thrombosis. Images obtained by non-selective pulmonary angiography had a good correlation with selective pulmonary angiography.ConclusionThe non-selective pulmonary angiography was a simplified, efficient and safe method for pulmonary embolism diagnosis. Large clinical trials are still needed to further evaluate the accuracy and safety of the non-selective method.