河北汉族人群 CYP1A2 C163A基因多态性研究

目的：探讨河北汉族人群细胞色素P4501A2（cytochrome P4501A2,CYP1A2）C163A基因多态性的分布情况。方法应用聚合酶链式反应－限制性酶切片段长度多态性（PCR‐RFLP）方法对210例河北汉族正常人进行CYP1A2 C163A基因多态性分析。结果河北汉族人群CYP1A2 C163A基因A和C等位基因的频率为：68．3％、31．7％。AA、AC、CC基因型频率分别为48．1％、40．5％、11．4％。符合 Hardy‐Weinberg 遗传平衡定律（χ2＝1．22,P＞0．05）,具有代表性。结论河北汉族人群CYP1A2基因存在C163A位点多态性。     

Effect of survivin on tumor growth of colorectal cancer in vivo

Survivin, a member of the inhibitor of apoptosis gene family regulates two critical processes in neoplastic transformation, namely, cell proliferation and apoptosis. This study aimed to detect the effect of survivin on tumor growth of colorectal cancer (CRC) in vivo. We found that inhibition of survivin by interference decreased the sizes and weights of xenografts in nude mice. The number of apoptotic cells of the shRNA survivin group was higher than that of the black group and the shRNA control group. The downregulated expression of survivin decreased the expression levels of bcl2 and ki67. Our results indicated that inhibition of survivin significantly enhanced the inhibition of tumor growth and induced apoptosis. Survivin is an attractive target for CRC treatment.     

祛风活络丸与制香片联合应用治疗骨关节炎

目的 探讨祛风活络丸与制香片联合应用治疗骨关节炎是否具有临床协同疗效。方法 选取2017年10月~2019年5月我院诊治的骨关节炎患者160例,采用随机数字表法分为祛风活络丸组、制香片组、祛风活络丸/制香片联合应用组和硫酸氨基葡萄糖组,每组各40例,治疗3个月后,对患者的疗效及不良反应进行评价与统计,观察各组X 线片和核磁共振表现、WOMAC骨关节炎指数和Lequesne疼痛与功能指数;并采用金正均法计算q值,评价祛风活络丸/制香片联合应用是否具有协同作用。结果 与单独给药组比较,祛风活络丸/制香片联合给药组患者X线片结果显示关节间隙狭窄减轻,骨赘减少,KL分级降低,MRI结果显示关节囊积液和水肿减少,软骨缺损减轻,Recht分级降低;WOMAC骨关节炎指数（P＜0.05）和Lequesne疼痛与功能指数显著降低（P＜0.01）;采用金正均法计算q值（q=125）,联合用药具有协同作用。同时,与硫酸氨基葡萄糖相比,联合用药组疗效相当但不良反应更少（P＜0.05）。结论 祛风活络丸与制香片联合应用治疗骨关节炎临床疗效优于单独给药,具有协同作用,与硫酸氨基葡萄糖疗效相当且副作用更少,可在临床推广应用。     

miR-93-3p对高糖诱导的肾小管上皮细胞损伤及炎症因子分泌的影响

目的 微小miRNA-93-3p（miR-93-3p）对高糖诱导的肾小管上皮细胞损伤及炎症因子分泌的影响。方法 体外培养肾小管上皮细胞,分为NC组、HG组、anti miR NC组、anti miR-93-3p组、HG+ miR NC组、HG+miR-93-3p组。采用实时荧光定量聚合酶链反应（qRT-PCR）检测miR 93 3p的表达;酶联免疫吸附（ELISA）法检测肿瘤坏死因子 α（TNF-α）、白细胞介素6（IL-6）水平;甲基噻唑基四唑（MTT）检测细胞增殖能力;流式细胞术检测细胞凋亡率;蛋白免疫印迹法（Western blot）检测细胞周期蛋白1（CyclinD1）、活化的含半胱氨酸的天冬氨酸蛋白水解酶3（C caspase-3）、磷酸化 磷脂酰肌醇激酶（p-PI3K）、磷酸化 蛋白激酶 B（p-AKT）表达量。结果 与NC组相比,HG组miR 93 3p的表达水平显著降低（P＜0.05）,细胞存活率显著降低（P＜0.05）,CyclinD1蛋白表达水平显著降低（P＜0.05）,而细胞凋亡率显著升高（P＜0.05）,C caspase 3、p PI3K、p AKT蛋白表达水平显著升高（P＜0.05）,TNF α、IL 6水平显著升高（P＜0.05）;与anti miR NC组相比,anti miR-93-3p组细胞存活率显著降低（P＜0.05）,细胞凋亡率显著升高（P＜0.05）,C caspase 3蛋白表达水平显著升高（P＜0.05）,TNF α、IL 6水平显著升高（P＜0.05）;与HG+ miR NC组相比,HG+miR 93 3p组细胞存活率显著升高（P＜0.05）,细胞凋亡率显著降低（P＜0.05）,CyclinD1蛋白表达水平显著升高（P＜0.05）,C caspase 3、p PI3K、p AKT蛋白表达水平显著降低（P＜0.05）,TNF α、IL 6水平显著降低（P＜0.05）。结论 miR 93 3p通过调控PI3K/AKT信号通路抑制高糖诱导的肾小管上皮细胞损伤及炎症因子分泌。     

退行性腰椎滑脱症的现代中医研究进展

文章在简要阐述现代中医对退行性腰椎滑脱症的病名、病因病机、中医分型的研究现状基础上,从现代中医治疗方面总结了退行性腰椎滑脱症的现代中医治疗研究进展。文章主要从以下几方面进行综述：现代中医手法治疗退行性腰椎滑脱症、中药治疗、中医针灸治疗、针刀治疗、拔罐、刮痧等其他综合治疗以及中医综合疗法治疗。文章以期为退行性腰椎滑脱症的现代中医治疗提供参考。     

阿托伐他汀联合曲美他嗪对冠心病患者的疗效及血脂水平的临床评价

目的 研究冠心病患者治疗中阿托伐他汀联合曲美他嗪对心绞痛改善情况和血脂水平的影响。方法 选取2015年11月-2017年12月就诊的149例冠心病患者作为研究对象,按随机数字表法分为对照组（n=71）和观察组（n=78）。对照组患者口服曲美他嗪20 mg、3次/d,观察组在对照组基础上口服阿托伐他汀20 mg、1次/d,8 d为1个疗程。对比两组患者平板运动试验、丙二醛（MDA）和超氧化物歧化酶（SOD）水平、血脂水平和临床疗效。结果 治疗后研究组的诱发心绞痛发作时间和运动持续时间明显高于对照组,心电图ST段下移1 mm时间明显低于对照组（P<0.05）;两组治疗后ST段下移1 mm时间、诱发心绞痛发作时间和运动持续时间等平板运动试验项目均明显高于同组治疗前（P<0.05）。两组治疗后MDA和SOD水平与各自治疗前对比均有统计学差异（P<0.05）;治疗后观察组患者MDA水平明显低于对照组,SOD水平明显高于对照组（P<0.05）。两组治疗后血脂水平与同组治疗前比较均有统计学差异,且观察组患者血脂水平明显低于对照组（P<0.05）。对照组患者总有效率为67.61%,观察组患者总有效率为93.59%,两组比较有统计学差异（P<0.05）。结论 在冠心病治疗中,阿托伐他汀联合曲美他嗪可明显抑制氧化应激损伤,改善心电图平板试验、改善血脂代谢,提高疗效,值得临床推广。     

炎症性肠病发生消化道狭窄的临床特点分析

目的探讨住院炎症性肠病(inflammatory bowel disease,IBD)患者发生消化道狭窄的临床特点。方法纳入2010年1月至2018年12月在中国人民解放军总医院第七医学中心住院诊治的IBD患者,对发生消化道狭窄患者的诊治过程和随访情况进行回顾性分析。结果发生消化道狭窄患者118例(23.14%),其中克罗恩病(Crohn’s disease,CD)、溃疡性结肠炎(ulcerative colitis,UC)和IBD类型待定(IBD unclassified,IBDU)的消化道狭窄发生率分别为59.02%、6.67%和34.25%,三者比较,差异有统计学意义(P<0.001)。病程0~10年的消化道狭窄发生率为25.06%,而病程>10年的发生率为14.29%,二者比较,差异有统计学意义(χ2=4.880,P=0.027)。发生消化道狭窄患者中,33.90%(40例)的患者经单纯药物治疗有效;55.93%(66例)的患者予以外科手术治疗,术后并发症发生率为18.46%(12例),10.61%(7例)的患者予以再次手术治疗。27.12%(32例)的患者予以内镜下治疗,内镜治疗有效率为81.25%(26例),18.75%(6例)的患者经内镜治疗无效后行外科手术治疗,内镜治疗术后并发症发生率为3.13%(1例)。结论消化道狭窄是IBD的严重并发症之一,CD的消化道狭窄发生率显著高于UC。有效的内科药物及营养治疗可降低消化道狭窄发生率、手术率。内镜治疗消化道狭窄具有较高的有效性、安全性,可有效避免外科手术的发生。     

Significance of IGFBP-4 in the Development of Fetal Growth Restriction

Background: Fetal growth restriction (FGR) is a leading cause of perinatal mortality and morbidity. Animal studies suggest dysregulation of IGF-binding protein (IGFBP)-4 is significant in the development of FGR, although human data are lacking. We postulated that IGFBP-4 is expressed at the maternal fetal interface and plays a role in regulating IGF bioavailability. Thus, maternal serum levels of IGFBP-4 may be associated with complications of abnormal placental growth and development including FGR. Methods: Circulating levels of IGFBP-4 and its protease, pregnancy-associated plasma protein-A (PAPP-A), were examined in healthy pregnancies. Their expression in villi and bed as possible sources of the circulating products were examined by immunohistochemistry. From the large Ottawa and Kingston (OaK) Birth Cohort, a nested case-control study was conducted to examine circulating levels of IGBP-4, PAPP-A, IGF-I, and IGF-II by Western blot in early gestation in 36 women who went on to develop FGR and 36 controls having normal-weight babies. Results: IGFBP-4 was elevated in early pregnancy compared with nonpregnant women and women in later pregnancy, consistent with the presence of abundant extravillous trophoblasts and decidual cells that highly expressed IGFBP-4. High expression of PAPP-A was observed in extravillous trophoblasts and decidual cells in early pregnancy but hardly detectable in the circulation at this time, suggesting maternal circulating PAPP-A originates more likely from syncytiotrophoblasts. Increased IGFBP-4 in the maternal circulation in early pregnancy was associated with the development of FGR [0.48 (0.28-0.74) in control vs. 1.22 (0.66-1.65) in FGR; odds ratio = 22 (95% confidence interval = 2.7-181)]. No difference was observed in circulating PAPP-A, IGF-I and IGF-II in the FGR vs. control group. Conclusion: Our findings support the role of IGFBP-4 in regulating IGF bioavailability and provide new clues for the prevention and treatment of FGR, raising the possibility of clinical use of IGFBP-4 as an early biomarker for this condition.