NT-3、NT-4和BDNF在面神经逆行转运的动力学比较

目的　研究神经营养素 3(NT- 3)、神经营养素 4(NT- 4)和脑源性神经营养因子 (BDNF)在面神经中的逆行转运动力学特点。方法　将新西兰兔一侧面神经干横切断后置入硅胶再生室 ,再将 1 2 5I标记的 NT- 3或NT- 4或 BDNF或人血清白蛋白 (HSA) (10μl/只 ,约 3.7MBq)注入再生室 ,在注药后于不同时刻取兔面神经干和脑干面神经运动核 ,测定其摄取率。利用 3P87动力学处理程序分析计算各标记物在面神经的动力学参数。结果　面神经逆行转运神经营养素的转运量 :NT- 3>BDNF>NT- 4(P <0 .0 5 ) ,转运速率 :NT- 4>NT- 3>BDNF (P <0 .0 5 )。结论　研究结果提供了神经营养素在面神经逆行转运的动力学特点。     

Effect of a Boarding Restriction Protocol on Emergency Department Crowding

PurposeAccess block due to the lack of hospital beds causes crowding of emergency departments (ED). We initiated the “boarding restriction protocol” that limits the time of stay in the ED for patients awaiting hospitalization to 24 hours from arrival. The purpose of this study was to determine the effect of the boarding restriction protocol on ED crowding.Materials and MethodsThe primary outcome was ED occupancy rate, which was calculated as the ratio of the number of occupying patients to the total number of ED beds. Time factors, such as length of stay (LOS), treatment time, and boarding time, were investigated.ResultsThe mean of the ED occupancy rate decreased from 1.532±0.432 prior to implementation of the protocol to 1.273±0.353 after (p<0.001). According to time series analysis, the absolute effect caused by the protocol was -0.189 (-0.277 to -0.110) (p=0.001). The proportion of patients with LOS exceeding 24 hours decreased from 7.6% to 4.0% (p<0.001). Among admitted patients, ED LOS decreased from 770.7 (421.4–1587.1) minutes to 630.2 (398.0–1156.8) minutes (p<0.001); treatment time increased from 319.6 (198.5–482.8) minutes to 344.7 (213.4–519.5) minutes (p<0.001); and boarding time decreased from 298.9 (109.5–1149.0) minutes to 204.1 (98.7–545.7) minutes (p<0.001). In pre-protocol period, boarding patients accumulated in the ED during the weekdays and resolved on Friday, but this pattern was alleviated in post-period.ConclusionThe boarding restriction protocol was effective in alleviating ED crowding by reducing the accumulation of boarding patients in the ED during the weekdays.     

可乐定和普萘洛尔对实验性肾性高血压糖尿病性心肌病的影响

可乐定和普萘洛尔治疗肾性高血压糖尿病性心肌病大鼠的心肌组织学改变,表明可乐定和普萘洛尔均使大鼠血压下降,体重恢复,心肌灶性坏死和纤维化减少。普萘洛尔组血管周围纤维化好转比可乐定组明显,可乐定组心肌纤维化改善较普萘洛尔组明显。其机制可能与抗交感紧张和减少儿茶酚胺对心肌损伤有关。     

Identification of a novel ene reductase from Pichia angusta with potential application in (R)-levodione production

Asymmetric reduction of electronically activated alkenes by ene reductases (ERs) is an attractive approach for the production of enantiopure chiral products. Herein, a novel FMN-binding ene reductase (PaER) from Pichia angusta was heterologously expressed in Escherichia coli BL21(DE3), and the recombinant enzyme was characterized for its biocatalytic properties. PaER displayed optimal activity at 40 °C and pH 7.5, respectively. The purified enzyme was quite stable below 30 °C over a broad pH range of 5.0–10.0. PaER was identified to have a good ability to reduce the C C bond of various α,β-unsaturated compounds in the presence of NADPH. In addition, PaER exhibited a high reduction rate (k_cat = 3.57 s⁻¹) and an excellent stereoselectivity (>99%) for ketoisophorone. Engineered E. coli cells harboring PaER and glucose dehydrogenase (for cofactor regeneration) were employed as biocatalysts for the asymmetric reduction of ketoisophorone. As a result, up to 1000 mM ketoisophorone was completely and enantioselectively converted to (R)-levodione with a >99% ee value in a space–time yield of 460.7 g L⁻¹ d⁻¹. This study provides a great potential biocatalyst for practical synthesis of (R)-levodione.

Asymmetric reduction of electronically activated alkenes by ene reductases (ERs) is an attractive approach for the production of enantiopure chiral products.     

不同级别小鼠来源的骨髓细胞对制备优势DC2的影响

目的探索不同级别小鼠来源的骨髓细胞对体外制备优势DC2细胞的影响。方法取SPF级和健康普通级C57BL/6小鼠股、胫骨骨髓细胞及脾细胞,设细胞因子诱导的实验组、低浓度GM-CSF对照组、无外源细胞因子对照组及脾细胞组。骨髓细胞采用GM-CSF,IL-4,Flt3L和SCF的不同细胞因子浓度和组合体外培养诱导。脾细胞培养2d去除大部分淋巴细胞,第3天采用流式细胞术4色荧光标记法分析细胞表型,骨髓细胞诱导的各组同样于第3天采用流式细胞术分析细胞表型,比较不同级别小鼠骨髓细胞所诱导的DC2细胞的表型和比例。结果SPF来源的小鼠骨髓细胞诱导的各组第3d在CD11c+的DC细胞群中CD8α+DC2所占比例及不成熟DC2的比例均高于普通级小鼠,显示普通鼠来源的骨髓细胞更倾向于产生成熟的DC,不易诱导产生高比例的不成熟的DC2。对两种动物脾细胞DC2的分析结果表明,普通鼠脾脏中CD8α-MHCⅡ+的成熟DC1比例为75.58%,远远超过SPF鼠的30.60%。结论小鼠的微生物级别可影响耐受性DC的诱导效果,采用SPF级小鼠来源的骨髓细胞体外制备优势DC2细胞效果优于普通级鼠,原因可能与普通鼠接触微生物较多,免疫系统更易于产...     

自体髓核移植接触神经根后大鼠诱发电位及神经显微结构的观察

目的:探索髓核移植接触神经根后对大鼠诱发电位及神经显微结构的影响。方法:20只SD大鼠随机分成2组,A组、B组分别取大鼠自体皮下筋膜脂肪及尾部的髓核组织,无压迫下放置在L4~5神经根周围。分别在术前、术后即刻、术后3天检测大鼠术侧诱发电位。3天时处死大鼠,进行神经根的病理切片观察。结果:A组大鼠感觉及运动诱发电位手术前后没有明显变化,B组诱发电位潜伏期延长。神经显微结构观察,A组少量炎性细胞浸润,B组神经外膜水肿、大量炎性细胞侵润,髓鞘水肿。结论:髓核接触神经根后可引起神经周围急性炎症病理改变,并引起神经传导功能的下降。     

酪氨酸激酶抑制剂在慢性粒细胞白血病治疗中的临床应用及最新进展

从二十世纪末至今,在肿瘤治疗领域有了很大的进展,作用于特异的致癌因素的分子靶向治疗已成为现实.     

在病理学教学中培养医学生临床思维能力的探讨

在病理学教学中通过溯因逆向推理和发散性思维培养,提高学生临床思维能力。     

Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study

Background  Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.

Methods  Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm³ for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.

Results  Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas—acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.

Conclusions  In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.

     

ERCC1､RRM1预测NSCLC患者GP方案化疗敏感性的对比研究

目的:对比切除修复交叉互补基因1(excision repair cross-complementing rodent repair deficiency,complementationgroup1,ERCC1)和核苷酸还原酶M1(ribonucleotide reductase M1,RRM1)低表达患者选择健择联合顺铂(gemcitabine andcisplatin,GP)方案和未经筛选经验性选用GP方案治疗晚期非小细胞肺癌(non-small-cell lung carcinoma,NSCLC)的临床疗效。方法:采用前瞻性的方法,根据组织标本是否适宜使用免疫组织化学方法检测分子标志物,在确诊为晚期NSCLC的患者中,ERCC1和RRM1低表达者归为A组,未经分子标志物检测的经验治疗者归为B组,经过4～6个周期的GP方案化疗,观察两组的疗效、无进展生存期(progressive-free survival,PFS)、总生存期(overall survival,OS)及化疗过程中的不良反应。结果:基于分子标志物结果选用GP方案较经验性选用GP方案有效率明显提高(χ2=5.377,P=0.02),PFS明显延长(P=0.03),差异有统计学意义;两组OS无显著性差异;不良反应无明显差异。结论:对ERCC1和RRM1低表达患者选择GP方案可以明显提高化疗有效率。