成人Moyamoya病的临床表现和影像学特征

目的 总结成人Moyamoya病(烟雾病)的临床表现特点.比较MRA与DSA在Moyamoya病诊断中的价值.方法 对经DSA或MRA确诊的8例成人Moyamoya病患者的临床及影像学资料进行回顾性分析.结果 脑卒中是本组Moyamoya病患者最常见的临床表现,缺血性卒中与出血性卒中发病各半.MRA与DSA检查显示所有患者均有颈内动脉或其分支狭窄或闭塞及脑底异常血管网形成,两者结果相符合.结论 对年轻无基础疾病的脑血管病患者,尤其反复TIA或卒中或头痛患者,应常规行MRI和MRA检查.DSA可清晰显示颅内、外侧枝循环状况,更有助于手术适应证的选择与预后评价.     

Effect of Leptospira interrogans outer membrane proteins LipL32 on HUVEC

Leptospira cause disease through a toxin-mediated process by inducing vascular injury, particularly a small-vessel vasculitis. Breakdown of vessel endothelial cell integrity may increase vessel permeability which is correlated with the changes of tight junction and/or apoptosis in vessel endothelial cells. The specific toxin responsible remains unidentified. In this study, we amplified outer membrane protein LipL32 from the genome of Leptospira interrogans serovar Lai, and it was subcloned in pET32a(+) vector to express thioredoxin(Trx)–LipL32 fusion protein in Escherichia coli BL21(DE3). The protein was expressed and purified, and Trx–LipL32 was administered to culture with human umbilical vein endothelial cells (HUVEC) to elucidate the role of leptospiral outer membrane proteins in vessel endothelial cell. The purified recombinant protein was capable to increase the permeability of HUVECs. And the protein was able to decrease the expression of ZO-1 and induce F-actin in HUVECs display thickening and clustering. Moreover, apoptosis of HUVEC was significantly accelerated. But the fusion partner had no effect in these regards. It is possible that LipL32 is involved in the vessel lesions.     

呼吸机治疗重症哮喘患者的临床护理分析

目的：总结呼吸机治疗重症哮喘患者的临床护理体会.方法：对呼吸机治疗重症哮喘患者临床资料进行统计分析.结论：临床统计资料得出经过正确使用呼吸机治疗重症哮喘患者,并配合科学系统的临床护理,能够保障患者度过危险期.     

IL-6启动子-174G/C基因多态性与冠心病关系研究

目的:在湖北汉族人群中研究IL-6基因启动子-174G/C多态性与冠心病的关系。方法:应用聚合酶链-限制性片段长度多态性(PCR-RFLP)方法检测50例冠心病患者和60名非冠心病对照人群IL-6启动子-174G/C多态性。结果:研究人群IL-6基因启动子-174只有GG和GC基因型,未见CC基因型,且基因型以GG为主(98.12%)。结论:IL-6启动子-174C等位基因在湖北汉族人群中的分布频率极低,对该类人群的冠心病易感性影响不大。     

Metabolic alterations in the visual pathway of retinitis pigmentosa rats: A longitudinal multimodal magnetic resonance imaging study with histopathological validation

Because retinitis pigmentosa (RP) has been shown to cause degenerative changes in the entire visual pathway, there is an urgent need to perform longitudinal assessments of RP-induced degeneration and identify imaging protocols to detect this degeneration as early as possible. In this study, we assessed a transgenic rat model of RP by using complementary noninvasive magnetic resonance imaging techniques, namely, proton magnetic resonance spectroscopy (¹H-MRS), to investigate the metabolic changes in RP. Our study demonstrated decreased concentrations and ratios to creatine (Cr) of N-acetylaspartate (NAA), glutamate (Glu), γ-aminobutyric acid (GABA), and taurine (Tau), whereas myo-inositol (Ins) and choline (Cho) were increased in the visual cortex of Royal College of Surgeons (RCS) rats compared with control rats (p < 0.05). Furthermore, with the progression of RP, the concentrations of NAA, Glu, GABA, and Tau, and the ratios of GABA/Cr and Tau/Cr significantly decreased over time, whereas the concentrations of Ins and Cho and the ratio of Ins/Cr significantly increased over time (p < 0.05). In addition, in RCS rats, NAA/Cr decreased significantly from 3 to 4 months postnatal (p < 0.001), and Cho/Cr increased significantly from 4 to 5 months postnatal (p = 0.005). Meanwhile, the ¹H-MRS indicators in 5-month postnatal RCS rats could be confirmed by immunohistochemical staining. In conclusion, with the progression of RP, the metabolic alterations in the visual cortex indicated progressive reprogramming with the decrease of neurons and axons, accompanied by the proliferation of gliocytes.     

口腔颌面外科规范化培训中开展课程思想政治教育的情况调查——以上海交通大学医学院附属第九人民医院为例

住院医师规范化培训是医学生毕业后教育的重要组成部分,起到了将医学理论和技能应用于临床服务的承前启后的重要作用,课程思政教育在住院医师规范化培训中具有重要意义。上海交通大学医学院附属第九人民医院口腔外科规培基地中从理论授课及临床实践等方面在学生中开展本学科的思政课程教育,并通过对本基地轮转的148名学生进行问卷调查,以了解本基地思政课程实施后学生满意度及对其临床意识、临床能力和职业价值观重塑的影响,以期为不断改进和进一步加强本基地的课程思政教育提供经验。     

基于市售样品质量考察的“猪腰”和“豆豉”女贞子比较

目的 对市售女贞子质量进行考察,比较“猪腰”和“豆豉”2种不同性状女贞子的水分、浸出物、有效成分含量等,以期为提高女贞子药材及饮片利用率提供依据。方法 采用2020年版《中华人民共和国药典》（以下简称《中国药典》）（一部）“女贞子”项下方法对市售女贞子的性状、水分、总灰分、醇溶性浸出物含量进行测定并进行薄层色谱法（TLC）检测;建立高效液相色谱法（HPLC）指纹图谱,对有效成分红景天苷、特女贞苷含量进行测定,流动相0.2%磷酸水溶液（A）-乙腈（B）梯度洗脱（0~70 min,92%~65%A）,检测波长程序为0~14 min,220 nm;14~70 min,225 nm。利用以上指标对2种不同性状女贞子进行综合比较。结果 13批市售女贞子除其中1批为抢青采收质量不符合规定外,其余12批均符合2020年版《中国药典》的相关规定,但存在2种不同性状的现象。对比2种不同性状的女贞子发现,猪腰女贞子水分、总灰分、浸出物含量、红景天苷及特女贞苷质量分数分别为2.22%~5.19%、3.91%~4.49%、32.56%~40.95%、0.073%~0.170%、1.45%~4.14%;豆豉女贞子水分、总灰分、浸出物含量、红景天苷及特女贞苷质量分数则分别为3.57%~5.61%、3.65%~4.44%、41.31%~46.70%、0.041%~0.067%、3.01%~4.20%。结论 豆豉女贞子浸出物、特女贞苷含量大部分高于猪腰女贞子,而红景天苷含量却低于猪腰女贞子,两者的水分、总灰分和TLC鉴别差别不大。建议若以提取红景天苷为主要目的,则选择猪腰女贞子;若以女贞子入药为主要目的,建议选择豆豉女贞子。     

局限期小细胞肺癌胸部放疗剂量分割现状

胸部放疗是局限期小细胞肺癌的重要治疗手段,与之相关的剂量分割存在一定争议。超分割放疗方案(2 次/d)作为前瞻性研究确立的标准方案,由于不良反应的发生和治疗的不便利,在临床实践中常常被其他治疗策略代替。另外在不可手术的淋巴结阴性的Ⅰ期小细胞肺癌中,立体定向消融放疗为部分高龄且预计难以耐受长疗程放疗的患者提供了新的选择。合适的剂量分割方案既可以保证治疗疗效,也能降低放疗相关急性及晚期损伤。本文将对目前局限期小细胞肺癌剂量分割研究现状进行阐述。