中药通过细胞外信号调节激酶信号通路调控胃癌的研究进展

胃癌在我国发病率和死亡率较高,存在发现晚、5年生存率低的特点,手术切除仍然是临床治疗的主要方法。大鼠肉瘤蛋白(Ras)/迅速加速性纤维肉瘤蛋白(Raf)/丝裂原活化的细胞外信号调节激酶(MEK)/细胞外信号调节激酶(ERK)信号通路在调控细胞增殖、转移、凋亡等方面具有非常重要的作用,与胃癌的发生与发展密切相关。近年来,很多学者探索调控Ras/Raf/MEK/ERK信号通路治疗胃癌的作用机制,在信号转导机制研究、靶向抑制剂筛选、中医药治疗等方面取得大量成果,实验验证在胃癌的治疗中干预其信号传递具有良好的效果和应用前景。     

胃癌组织中KAl1、nm23及P53的表达及其临床意义

目的探讨正常胃黏膜、不典型增生胃黏膜及癌组织中KAI1、nm23及P53蛋白的表达.方法应用SP法免疫组化检测22例正常胃黏膜,65例不典型增生胃黏膜及74例胃癌组织中的KAI1、nm23及P53蛋白的表达.结果正常胃黏膜、不典型增生胃黏膜及胃癌组织中,KAI1和nm23阳性率呈降低趋势,组间差异性有统计学意义(x2=20.885,P＜0.001;x2=29.133,P＜0.05);P53蛋白阳性表达率呈增加趋势,组间差异性有统计学意义(x2=21.954,P＜0.001).Fisher精确概率检验显示在胃癌组中不同的浸润深度、有无淋巴结转移和脉管侵犯组内KAI1、nm23及P53组阳性表达率的差异性有统计学意义(x2=20.885,P＜0.001;x2=29.133,P＜0.05;x2=21.954,P＜0.001);而在年龄、性别组间的差异性无统计学意义.Spearman等级相关分析显示KAI1与nm23表达呈正相关(r=0.859,P＜0.05);KAI1与P53表达呈负相关(r=-0.859,P＜0.05),nm23与P53表达呈负相关(r=-0.874,P＜0.05).结论抑癌基因KAI1与nm23的缺失以及P53蛋白的过表达可能是胃癌发生、发展及浸润和转移的重要原因之一.     

联机血液透析滤过治疗单纯急性肾功能衰竭

目的比较联机血液透析滤过(OL-HDF)与间歇性血液透析(IHD)对单纯急性肾功能衰竭(ARF)患者的治疗效果。方法收集本院血液净化中心的单纯ARF患者61例,其中OL-HDF组(HDF组)28例,普通血液透析治疗(IHD组)33例,回顾性对比分析两组的临床资料、透析过程中并发症的发生率和肾功能恢复时间。结果HDF组IHD组透析中低血压的发生次数分别为(1.87±0.25)和(3.90±0.97),两组相比差异有显著性(P<0.05)、心律失常发生次数分别为(1.49±1.37)、(3.85±2.39)(P<0.01);肾功能开始恢复时间分别为(13.31±4.28)d和(23.78±7.43)d(P<0.05)。结论OL-HDF滤过在单纯ARF的治疗中效果优于IHD,并具有血流动力学稳定,可缩短住院时间的优点。     

马甲子对LPS刺激下人牙髓细胞炎性因子表达影响的初探

目的:研究马甲子提取物对体外培养HDPCs生长及对P.g-LPS诱导HDPCs合成分泌的炎症相关细胞因子IL-1β、IL-6及TNF-α的影响.方法:体外培养人牙髓细胞,建立炎症状态的体外HDPCs,检测不同浓度梯度马甲子提取物对HDPCs生长的影响,以及对炎症状态下的HDPCs各炎性因子mRNA表达及蛋白表达的影响....     

局部脑氧饱和度和肠道血氧饱和度对新生儿坏死性小肠结肠炎早期预警及手术治疗时机的指导价值

目的 研究局部脑氧饱和度(rcSO₂)和局部肠道血氧饱和度(rintSO₂)与新生儿坏死性小肠结肠炎(NEC)病情程度的关系,探讨rcSO₂和rintSO₂对NEC早期预警及手术干预时机的指导意义。方法 回顾性分析2021年3月至8月96例胎龄<32周早产儿临床资料,根据是否发生NEC分为三组：对照组49例,未发生NEC;疑似组14例,疑似发生NEC;NEC组33例,患有NEC。其中NEC组再根据是否手术分为两个亚组：手术组19例,非手术组14例。观察三组不同临床分期早产儿的rcSO₂和rintSO₂水平变化,Spearman相关性分析其与Bell分期的关系;利用受试者工作特征(ROC)曲线分析rcSO₂、rintSO₂预测NEC发生和手术时机的价值。结果 (1)疑似组和NEC组rcSO₂及不同监测部位rintSO₂水平均较对照组明显降低,NEC组降低幅度较为显著...     

俯卧位双镜联合微通道经皮肾镜同期治疗复杂性肾结石的有效性与安全性

目的:探讨俯卧位输尿管软镜联合微通道经皮肾镜同期治疗复杂性肾结石的有效性与安全性。方法:选取2017年7月至2019年3月于本院就诊的30例复杂性肾结石患者。其中15例患者一期均采取俯卧位输尿管软镜联合微通道经皮肾镜钬激光碎石术(双镜联合组),另外15例采取截石位单一微通道经皮肾镜钬激光碎石术治疗(对照组)。结果:双镜...     

Long‐Term Clinical Outcomes and Survivorship of Total Hip Arthroplasty for Pyogenic Arthritis: A Retrospective Cohort Study of 168 Hips

ObjectiveThe aim of the present study was to evaluate the 10‐year outcomes of cementless total hip arthroplasty (THA) in adult patients with the late sequelae of septic arthritis of the hip.MethodsWe followed 166 consecutive patients (168 hips) who underwent cementless THA between March 2001 and December 2011. There were 79 men and 87 women, with a mean age of 50.4 years (range 21–76 years) at the time of index THA, all of whom had hip osteoarthritis secondary to hip pyogenic infection. The average duration of follow up was 10.6 years (range 6.9–17.2 years). Preoperative and postoperative clinical ratings were evaluated, including the hip dysfunction and osteoarthritis outcome score (HOOS), the Harris hip score (HHS), range of motion, a 100‐point visual analog scale for hip pain, and the severity of limp and limb length discrepancy (LLD). The anteroposterior and lateral radiographs of the hip and full‐length view of the lower extremities were obtained to assess the position of the components, radiolucent lines, osteolysis, loosening of components, and heterotopic ossification. The intraoperative and postoperative complications were also recorded.ResultsThe mean HSS and hip pain score were 44.2 points (range 29–66 points) and 42.5 points (range 32–64 points), respectively, before the index surgery and significantly improved to 88.1 points (range 78–96 points) and 15.1 points (range 10–26 points), respectively, at final follow‐up examination. The HOOS and range of motion also improved significantly. The mean limb length discrepancy was reduced from 2.6 to 0.8 cm. The limp at last follow‐up examination was moderate in 3 cases because of hip osteoarthritis in the other limb, slight in 26, and absent in 137. A radiolucent line was observed in 12 hips (7.1%) around the acetabular or femoral components. A progressive radiolucent line around the undersized femoral stem in all zones was seen in 1 hip, resulting in aseptic loosening and breakage of the femoral component. There were 8 cases of intraoperative fracture, 7 cases of dislocation, and 7 cases of transient nerve palsy. Recurrence of infection occurred in 2 hips. Revision surgery was conducted in 2 hips because of isolated loosening of the acetabular cup and the femoral stem, respectively. Kaplan–Meier survival was 97% at 10 years, with revision for any reason with any component as an end‐point.ConclusionImproved surgical techniques and development of components with various sizes provided favorable results for cementless THA conducted for late sequelae of sepsis in these young and active patients. Although the incidence of complications was relatively high, the complications were treated successfully.     

早期股骨头坏死的非手术治疗现状

股骨头坏死作为骨科难治性疾病,对早期股骨头坏死患者可以采取非手术治疗。非手术治疗包括降脂药、抗凝剂、血管扩张剂、双膦酸盐、中医药等药物治疗以及物理治疗。药物治疗主要针对股骨头坏死的病因,可减轻疼痛,改善功能,延缓病程。体外震波和高压氧能改善微循环,促进血管修复,从而改善软骨下骨重建和预防股骨头塌陷。非手术治疗主要用于股骨头坏死的早期,对于其临床疗效,有待进一步研究。     

从火郁发之理论探析升降散治疗失眠症

自《黄帝内经》提出火郁发之理论以来,历代医家对此续有阐发。“火郁”二字重在“郁”字,有“郁”固当“发”,“发之”核心思想在于因势利导,给邪以出路。纵观“火郁发之”之病机,无非气血失衡,从心、肝入手,舒畅气机。火郁的治疗,宜因势利导,宣畅气机,使其外达。升降散其辨证运用的关键是气机失调,无论寒热虚实,只要是气机逆乱,都可采用升降散加减变化来调整脏腑功能气机,达到气血阴阳的协调。失眠症多因气机郁滞所致,因此从火郁发之论治升降散治疗失眠具有广泛的临床指导意义。