Ⅱ、Ⅲ型Pilon骨折不同手术疗效分析

目的探讨Pilon骨折临床手术治疗方法。方法回顾性分析2008年1月至2011年6月在本院手术治疗的46例Pi-lon骨折（Ruedi-Allgower分型：Ⅱ型28例、Ⅲ型18例）患者,根据骨折类型以及软组织条件分别采用不同手术方法治疗,35例患者行切开复位内固定术治疗,11例患者行有限切开内固定结合外固定架治疗。结果根据Mazure评分标准,优16、良24、可5、差1。结论 Pilon骨折类型及踝部周围软组织情况对愈后影响最大;根据骨折具体情况、软组织条件、是否开放性骨折选择个体化的治疗方案是手术治疗Pilon骨折成功的关键。     

健康成人血浆内皮素测定与鼻粘膜微血管观察

鼻粘膜血管系统主要由表浅的静脉丛、深层的动脉系统及动静脉之间的毛细血管及静脉窦组成 ,在鼻生理及病理过程中起着重要的作用 ,它主要受局部释放的神经递质和神经肽调节。内皮素 ( endothelin,ET)是一类新发现的、具有强烈缩血管效应的 2 1个氨基酸的多肽 ,最初从猪的主动脉内皮细胞分离出来 [1] ,它有三种异构型 ,名为 ET- 1、ET- 2、ET- 3[2 ]。存在于血管内皮细胞主要是 ET- 1,它是迄今为止所知的最强的血管收缩物质之一。新近的研究发现ET- 1对家兔鼻粘膜血管有强烈而持久的收缩作用 [3] ,体外试验发现 ET- 1对人鼻粘膜血管产…     

Treatment with a JAK1/2 inhibitor ameliorates murine autoimmune cholangitis induced by IFN overexpression

The interferon (IFN) signaling pathways are major immunological checkpoints with clinical significance in the pathogenesis of autoimmunity. We have generated a unique murine model named ARE-Del, with chronic overexpression of IFNγ, by altering IFNγ metabolism. Importantly, these mice develop an immunologic and clinical profile similar to patients with primary biliary cholangitis, including high titers of autoantibodies and portal inflammation. We hypothesized that the downregulation of IFN signaling pathways with a JAK1/2 inhibitor would inhibit the development and progression of cholangitis. To study this hypothesis, ARE-Del^+/− mice were treated with the JAK1/2 inhibitor ruxolitinib and serially studied. JAK inhibition resulted in a significant reduction in portal inflammation and bile duct damage, associated with a significant reduction in splenic and hepatic CD4⁺ T cells and CD8⁺ T cells. Functionally, ruxolitinib inhibited the secretion of the proinflammatory cytokines IFNγ and TNF from splenic CD4⁺ T cells. Additionally, ruxolitinib treatment also decreased the frequencies of germinal center B (GC B) cells and T follicular helper (Tfh) cells and led to lower serological AMA levels. Of note, liver and peritoneal macrophages were sharply decreased and polarized from M1 to M2 with a higher level of IRF4 expression after ruxolitinib treatment. Mechanistically, ruxolitinib inhibited the secretion of IL-6, TNF and MCP1 and the expression of STAT1 but promoted the expression of STAT6 in macrophages in vitro, indicating that M1 macrophage polarization to M2 occurred through activation of the STAT6-IRF4 pathway. Our data highlight the significance, both immunologically and clinically, of the JAK/STAT signaling pathway in autoimmune cholangitis.     

加味柴芩承气汤治疗妊娠合并急性胰腺炎28例临床分析及文献复习

目的：观察加味柴芩承气汤治疗妊娠合并急性胰腺炎（APIP）的疗效。方法：回顾性分析28例APIP采用加味柴芩承气汤治疗的疗效,同时选取中国期刊全文数据库关于西医治疗APIP的文献43篇,共615例患者。结果：本组19例MAP好转出院;9例SAP1例死亡,2例行剖宫产术,其中1例同时行剖腹探查术,2例均好转出院;本组孕妇病死率3．57％;胎儿死亡3例,死亡率为10．71％。文献中615例患者,孕妇死亡36例,病死率5．85％。胎儿死亡94例,死亡率15．16％。采用加味柴芩承气汤治疗址口的孕妇及胎儿死亡率均低于西医治疗。结论：加味柴芩承气汤治疗APIP有一定疗效。     

Sigma‐2 Receptor Ligands and Their Perspectives in Cancer Diagnosis and Therapy

The sigma‐2 receptor is highly expressed in various rapidly proliferating cancer cells and regarded as a cancer cell biomarker. Selective sigma‐2 ligands have been shown to specifically label the tumor sites, induce cancer cells to undergo apoptosis, and inhibit tumor growth. Sigma‐2 ligands are potentially useful as cancer diagnostics, anticancer therapeutics, or adjuvant anticancer treatment agents. However, both the cloning of this receptor and the identification of its endogenous ligand have not been successful, and the lack of structural information has severely hindered the understanding of its physiological roles, its signaling pathways, and the development of more selective sigma‐2 ligands. Recent data have implicated that sigma‐2 binding sites are within the lipid rafts and that PGRMC1 (progesterone receptor membrane component 1) complex and sigma‐2 receptor may be coupled with EGFR (epidermal growth factor receptor), mTOR (mammalian target of rapamycin), caspases, and ion channels. Due to its promising applications in cancer management, there are rapidly increasing research efforts that are being directed into this field. This review article updates the current understanding of sigma‐2 receptor and its potential physiological roles, applications, interaction with other effectors, with special focuses on the development of sigma‐2 ligands, their chemical structures, pharmacological profiles, applications in imaging and anticancer therapy.     

64排螺旋CT多期增强扫描联合血管成像对肺内肿块的诊断价值

目的：探讨64排螺旋 CT 多期增强扫描联合血管成像（CTA）对肺内肿块的诊断价值。方法对265例经病理检查确诊的肺内肿块患者行64排螺旋 CT 多期增强扫描及 CT 血管成像,分析 CT 各个扫描期征象特点和 CTA 对肺内肿块血供的显示。结果肺癌主要由支气管动脉（BA）供血,部分可由体动脉供血,肺癌组供血动脉显示率显著高于良性病变组（P ＜0．05）。肺癌组 CT 增强峰值显著大于结核球组、炎性假瘤组及错构瘤组（P ＜0．05）,但与血管瘤组比较差异无统计学意义（P ＞0．05）。肺癌组与良性病变各组的增强动态曲线不同：肺癌组增强扫描后在肺动脉期无明显强化,主动脉期 CT 值迅速升高,120 s 形成强化高峰,延迟期缓慢下降;结核球组增强扫描后 CT 值缓慢上升,无明显峰值出现;炎性假瘤组增强扫描后在肺动脉期 CT 值逐渐升高,90 s 左右出现高峰;错构瘤组强化不明显;血管瘤增强扫描后在肺动脉期迅速强化,在15 s 左右达高峰,然后缓慢下降。结论64排螺旋 CT 多期增强扫描联合血管成像能有效鉴别肺内肿块的良、恶性,具有重要的临床价值。     

DLL4/Notch信号途径对A549细胞VEGF表达的影响

目的：研究Delta-like ligand 4（DLL4）与血管内皮生长因子（VEGF）在人肺腺癌A549细胞中的表达,以及DLL4对VEGF表达的影响。方法（1）用免疫组化检测DLL4与VEGF在A549细胞中的表达;（2）设计和化学合成靶向DLL4基因的小干扰RNA（siRNA）序列,用lipofectamineTM2000介导DLL4 siRNA转染人A549细胞;（3）提取细胞总RNA,进行反转录-聚合酶链反应（RT-PCR）扩增检测DLL4、VEGF mRNA;（4）用酶联免疫吸附试验（ELISA）检测A549细胞培养上清液中VEGF质量浓度。结果（1）DLL4、VEGF表达于A549细胞的细胞质内;（2）DLL4 siRNA可使DLL4沉默,同时,明显上调VEGF-A、VEGF-B、VEGF-C mRNA表达,差异有统计学意义（P＆lt;0.05）;（3）DLL4转染后,细胞培养上清液中VEGF质量浓度明显增加,差异有统计学意义（P＆lt;0.01）。结论阻断A549细胞中Notch通路可刺激VEGF过表达。     

The decreased expression of IKBKE in systemic lupus erythematosus

Clinical Rheumatology - The IKBKE has been proven to be associated with systemic lupus erythematosus (SLE) in a genome-wide association study (GWAS) conducted by our group. The objective of the...     

来氟米特治疗类风湿关节炎的Ⅱ期临床试验

目的：探讨来氟米特（leflunomide,LFM)治疗类风湿关节炎（rheumatoid arthritis,RA)的疗效和安全性。方法：与甲氨喋methoptrexate,MTX)对照，用随机双盲双模拟的研究方法将80例活动性RA患者随机分为2组，每组各40例，分别接受LFM每日20mg和MTX每周10mg口服，疗程24周，观察疗效和不良反应。结果：经治疗12周时LFM和MTX组的总有效率分别为77．5％和72．5％（P＞0．05），24周时分别为86．5％和83．3％（P＞0．05）；2组不良反应及发生率相近，分别为13．5％和25．0％，差异无显著性（P＞0．1），LFM组不良反应程度相对较轻。结论：LFM治疗RA的疗效肯定，但具有较好的耐受性。