十味降糖胶囊葛根中葛根素的HPLC含量测定

目的建立HPLC法测定十味降糖胶囊中葛根素含量测定的方法。方法采用RP-HPLC法测定。用AgilentXDB C18色谱柱(250mm×4.6mm,5μm),以甲醇-磷酸盐溶液(20∶80)为流动相,流速为1mL.min-1,检测波长250nm,柱温为室温,进样量为10μL。结果葛根素保留时间约为27min左右,与其他峰的分离度大于2.0。葛根素的线性范围为0.024~0.476μg,r=0.9999,平均加样回收率为98.81%(n=5)。结论该方法简便快速,结果准确可靠,可用于十味降糖胶囊中葛根素的高效液相色谱法含量测定。     

肝细胞肝癌肝移植受者术后生存及肿瘤复发临床分析

目的比较符合米兰标准和杭州标准的肝细胞肝癌(HCC)肝移植受者术后生存及肿瘤复发情况,分析移植术后生存和肿瘤复发影响因素。 方法回顾性分析青岛大学附属医院器官移植中心2014年2月1日至2018年12月31日符合米兰标准和杭州标准的119例HCC肝移植受者临床资料。符合米兰标准受者79例(米兰标准组),超出米兰标准但符合杭州标准者受者40例(杭州标准组)。所有受者肝移植术后均规律随访,收集受者性别、年龄和手术时间等临床资料。无瘤生存时间以受者移植术后发现肿瘤复发转移为观察终点,累积生存时间以受者移植术后死亡为观察终点。采用Kaplan-Meier法绘制生存曲线,采用log-rank检验比较组间累积生存率和无瘤生存率。采用Cox比例风险模型进行影响累积生存时间和无瘤生存时间的单因素和多因素分析。P<0.05为差异有统计学意义。 结果截至2019年7月31日,119例受者术后中位随访时间为27个月(15～43个月),其中术后因肿瘤复发死亡11例复发转移27例。米兰标准组受者1、3和5年累积生存率分别为98.7%、90.2%和90.2%,杭州标准组分别为97.2%、73.9%和73.9%,差异均无统计学意义(χ²＝0.219、1.598和1.598,P均>0.05)。米兰标准组受者1、3和5年累积无瘤生存率分别为90.3%、82.1%和68.6%,杭州标准组分别为81.6%、56.0%和56.0%,两组受者术后1年和5年累积无瘤生存率差异均无统计学意义(χ²＝1.587和3.707,P均>0.05),3年累积无瘤生存率差异有统计学意义(χ²＝5.543,P<0.05)。多因素分析结果证实术前有无脉管癌栓是影响其累积生存率的独立危险因素,差异有统计学意义(HR＝0.159,P<0.05);术前有无脉管癌栓和病理分化类型是影响无瘤生存的独立危险因素,差异均有统计学意义(HR＝0.338和0.395,P均<0.05)。 结论符合杭州标准的HCC肝移植受者移植术后可获得较好的累积生存率及无瘤生存率,受者术前是否存在脉管癌栓及病理分化程度可以指导移植术后肿瘤复发的预防。     

Clinical assessment of a CMC/PEO gel to inhibit postoperative epidural adhesion formation after lumbar discectomy: a randomized, control study

Purpose

To evaluate effectiveness of carboxymethylcellulose/polyethylene oxide (CMC/PEO) gel in improving clinical outcomes after the first-time lumbar discectomy.

Method

Ninety-three patients with herniated lumbar disc at L4–L5 or L5–S1 were enrolled and randomized into two groups: CMC/PEO gel treatment group and control group. All the patients underwent laminotomy and discectomy by posterior approach. The preoperative and postoperative Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) scores for lower-back pain and leg pain were analyzed and compared between two groups at 30- and 60-day time points.

Results

No patient presented with any clinically measurable adverse event during surgery. There were no significant differences between the treated group and the control group on the preoperative ODI and VAS scores. In general, the ODI and VAS scores decreased in both groups at all the time points. At the 30-day time point, the VAS scores for back pain and leg pain and the ODI scores in treatment group were lower by 9.9 % (P = 0.0302), 27.0 % (P = 0.0002) and 16.3 % (P = 0.0007) than those in control group. And at the 60-day time point, the ODI and VAS scores further decreased in both groups. The VAS scores for leg pain in treatment group were lower by 4.5 % than that in the control group (P = 0.0149). However, no significant difference was detected between two groups on the ODI and VAS scores for back pain.

Conclusions

The results demonstrated that CMC/PEO gel is effective in reducing posterior dural adhesions in the spine with no apparent safety issues. It can improve patients’ postoperative clinical outcome.     

Viral IL-10 Gene Transfer Inhibits the Expression of Multiple Chemokine and Chemokine Receptor Genes Induced by Inflammatory or Adaptive Immune Stimuli

Previously we have shown that adenovirus-mediated gene transfer and expression of vIL-10 are able to prolong cardiac allograft survival, through the inhibition of the immune response to both alloantigen and adenoviral antigens. In the current study, we have defined further mechanisms of Ad.vIL-10-mediated prolongation of cardiac allograft survival. E1- and E3-deleted adenoviral vectors encoding beta-galactosidase or vIL-10 were transferred into grafts at the time of transplantation, chemokine and chemokine receptor expression were evaluated by a pathway-specific cDNA array, and the results were confirmed with real time RT-PCR on selected genes. Ischemic injury, alloantigen and adenovirus vector induced the expression of multiple pro-inflammatory chemokines in the grafts, which likely amplify allograft rejection. Most of these Th1-related chemokine genes were inhibited or down-regulated by Ad.vIL-10 administration, which may help to decrease leukocytic infiltration and improve graft survival. Among the potent Th1 type chemokines inhibited were the CXCR3 ligands CXCL9 and CXCL10, which could directly inhibit vector-mediated gene expression in myoblasts, although targeting CXCR3 or its ligands did not prolong allograft survival with vIL-10 gene transfer. Ad.vIL-10 administration also induced the expression of the Th2-associated chemokines eotaxin-2 and MIP-1 gamma, suggesting Th1 to Th2 immune deviation. These results demonstrated that the vIL-10 gene transfer inhibits chemokine expression, preventing stimulation of innate and adaptive immunity.     

降钙素基因相关肽对大鼠离体心脏的作用及机理探讨

本文利用离体大鼠心脏标本,观察降钙素基因相关肽(CGRP)对心脏活动的影响,并用双脉冲技术测定左心房功能不应期(FRP)和α、β受体阻断剂,前列腺素合成抑制剂对CGRP对心脏活动影响。结果表明:CGRP对心脏具有明显的正性变力和正性变时作用,正性变力作用可能与β受体有关,正性变时作用可能与Na~+内流有关。     

完全腹腔镜根治性全胃切除术后食管空肠三角吻合的近期疗效

目的探讨完全腹腔镜根治性全胃切除术中采用食管空肠三角吻合进行消化道重建的近期疗效。方法回顾性分析2013年7月至10月上海交通大学医学院附属瑞金医院收治的5例食管胃结合部腺癌和2例胃体癌患者的临床资料。7例患者进行术前评估后施行腹腔镜根治性全胃切除术,消化道重建采用完全腹腔镜下食管空肠三角吻合。术后每月门诊或电话随访,随访了解进食情况和有无胸骨后烧灼感等,随访时间截至2013年11月。结果7例患者均顺利完成完全腹腔镜根治性全胃切除和消化道重建。手术时间为（234±23）min,其中食管空肠三角吻合时间为（34±7）min,术中出血量为（153±32）mL,平均清扫淋巴结数目为（36±4）枚;术中用60mm钉仓7个。前3例患者消化道重建完成后行术中胃镜检查,吻合口通畅。7例患者术后恢复良好,术后第1天拔除胃管,术后肛门排气时间、进食流质时间以及半流质时间分别为（2．4±0．5）d、（4．0±0．6）d、（5．3±0．5）d,术后无吻合口出血、吻合口漏、吻合口狭窄、腹腔感染等手术相关并发症,无围手术期死亡。前3例患者术后第5天行上消化道造影,造影剂通过顺畅。术后病理分期：IA期3例、IB期2例、ⅡA期1例、ⅡB期1例。术后住院时间为（9．7±1．4）d。患者中位随访时间为3个月,一般情况良好,均可进食软性普通食物,无体质量减轻,无进食哽噎感和胸骨后烧灼感等症状。结论在腹腔镜胃癌根治术中进行食管空肠三角吻合安全可行。该术式吻合口大小不受食管和空肠内径限制,近期疗效满意。     

Assessing the mean strength and variations of the time-to-time fluctuations of resting-state brain activity

The time-to-time fluctuations (TTFs) of resting-state brain activity as captured by resting-state fMRI (rsfMRI) have been repeatedly shown to be informative of functional brain structures and disease-related alterations. TTFs can be characterized by the mean and the range of successive difference. The former can be measured with the mean squared successive difference (MSSD), which is mathematically similar to standard deviation; the latter can be calculated by the variability of the successive difference (VSD). The purpose of this study was to evaluate both the resting state-MSSD and VSD of rsfMRI regarding their test–retest stability, sensitivity to brain state change, as well as their biological meanings. We hypothesized that MSSD and VSD are reliable in resting brain; both measures are sensitive to brain state changes such as eyes-open compared to eyes-closed condition; both are predictive of age. These hypotheses were tested with three rsfMRI datasets and proven true, suggesting both MSSD and VSD as reliable and useful tools for resting-state studies.