黄芩汤通过Nrf2信号通路对Caco-2细胞抗氧化应激作用的机制

目的：以Caco-2细胞为载体,结合基因干扰(RNAi)技术,通过体外实验进一步验证黄芩汤基于核因子E2相关因子2(Nrf2)通路发挥的抗氧化应激作用。方法：将处于对数生长期的Caco-2细胞,经siRNA转染,构建siRNA Caco-2细胞;将正常Caco-2细胞和siRNA Caco-2细胞与不同浓度的黄芩汤共同孵育后,提取RNA和蛋白,采用实时荧光定量聚合酶链式反应(Real-time PCR)和蛋白免疫印迹法(Western blot)技术检测血红素氧合酶-1(HO-1)、醌氧化还原酶1(NQO1)、谷胱甘肽巯基转移酶(GST)、接头蛋白Kelch样ECH相关蛋白1(Keap1)及Nrf2 mRNA和蛋白的表达;同时,采用比色法和探针法检测各组细胞中超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)的活力及丙二醛(MDA)、活性氧(ROS)的表达水平。结果：与空白组比较,仅有黄芩汤400 mg·L^-1组与萝卜硫素(SFN)组可降低正常Caco-2细胞内ROS、MDA含量(P<0.01);而黄芩汤各剂量组与SFN组细胞内SOD与GSH-Px...     

黄芩汤对溃疡性结肠炎小鼠肠道菌群的影响及肠黏膜屏障的保护作用机制

目的：研究黄芩汤对溃疡性结肠炎(UC)模型小鼠的药效,并探究黄芩汤在UC中是否能调节肠道菌群,发挥屏障保护作用。方法：雄性Balb/c小鼠按体质量随机分为正常组、模型组、黄芩汤高(20 g·kg^-1)、中(10 g·kg^-1)、低(5 g·kg^-1)剂量组、菌群干扰组、菌群干扰模型组、菌群干扰黄芩汤组(黄芩汤,20 g·kg^-1)。灌胃抗生素(杆菌肽200 mg·kg^-1、万古霉素200 mg·kg^-1)8 d构建菌群干扰模型,自由饮用3%葡聚糖硫酸钠(DSS)溶液7 d构建UC模型,黄芩汤给药治疗7 d。实验结束后处死小鼠,取血、结肠及粪便,苏木素-伊红(HE)染色观察结肠病变,酶联免疫吸附测定法(ELISA)检测血清白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)含量,实时荧光定量聚合酶链式反应(Real-time PCR)及蛋白免疫印迹法(Western blot)检测结肠组织中紧...     

治疗儿童呼吸系统疾病中成药的临床研究证据的概况性综述

目的：该研究使用概况性综述的方法,对治疗儿童呼吸系统疾病的中成药说明书信息及临床研究证据进行全面分析总结并报告。方法：通过检索2021年版《国家基本医疗保险、工商保险和生育保险药品目录》、2018年版《国家基本药物目录》、2020年版《中华人民共和国药典》（一部）,三大药品目录,获得治疗儿童呼吸系统疾病中成药;再检索中英文数据库获得相关文献,最后进行数据统计与可视化分析。结果：经筛选分析后,共纳入中成药52种。涉及9种剂型;主要组成为黄芩、苦杏仁、连翘等;功效以清热解表、止咳化痰等为主;主要治疗小儿风热感冒、咳嗽等;药物不良反应与禁忌证均只有19.23%(10/52)的中成药给与说明,其余均为尚不明确。纳入文献279篇,其中中文核心期刊文献277篇,英文科学引文索引扩展版（SCIE）2篇,包括随机对照研究253篇（含剂型/剂量比较6篇）、基于医院管理信息系统（HIS）数据的回顾性分析11篇、病例系列1篇、系统评价与Meta分析13篇（含网状Meta分析2篇）、经济学评价1篇。72.76%(203/279)的研究发表在中国科技核心期刊上;文献只涉及33种中成药,关于小儿肺热咳喘口服液的研...     

基于“阴火”理论探讨内皮细胞代谢重塑与肿瘤血管化关系及中医药干预思考

血管内壁的内皮细胞借助调节血管稳态、血管张力、细胞黏附、细胞增殖、凝血抗性、炎症因子等来响应机体的物理和化学信号,进而维持血管处于衡动稳定的状态。血管生成是肿瘤发生发展所需的关键条件,肿瘤血管化的病理模式为瘤体生长提供所需的营养和氧气,以促进其增殖。近年来,内皮细胞参与肿瘤血管渗入,驱动血管生成被认为是促进肿瘤转移的关键环节。血管内皮细胞可通过调控代谢重塑以满足肿瘤血管化过程中对物质和能量的需要,其异常的代谢特征使得其能更好地适应肿瘤微环境的变化,这种代谢的改变常被看作是肿瘤血管化进程的重要基础。中医“阴火”理论源自《黄帝内经》,原指“阴虚生内热”,属内伤之火范畴,后经历代医家推演变化,逐步形成“脾胃气虚-阴火上乘-气火失调”的病机认识。内皮细胞代谢重塑的发病过程是“阴火”病理表征的客观体现,而阴火造化生息、燔灼妄动之性又与肿瘤新生血管增生无制、亢变为害的疾病状态相吻合。脾胃亏虚与气机失衡的改变可致水谷精微不得布散,发生代谢障碍,停久为痰为瘀,与血脉相搏结,致使局部环境异化（肿瘤微环境形成）、脉道不利（内皮细胞代谢失衡）,异变形成肿瘤新生血管。在“阴火”证候要素指导下,围绕气与火的相关性,运用“扶正调气”的治法遣方用药,可调节内皮细胞代谢功能,达到机体相对平衡状态,进而抑制肿瘤血管新生。基于以上认识,该文围绕内皮细胞代谢重塑与阴火相关理论,阐发学术微旨,以期为中医药干预肿瘤血管化进程提供一定的理论支持。     

Internet Access and Nutritional Intake: Evidence from Rural China

Over the past 4 decades, China has experienced a nutritional transition and has developed the largest population of internet users. In this study, we evaluated the impacts of internet access on the nutritional intake in Chinese rural residents. An IV-Probit-based propensity score matching method was used to determine the impact of internet access on nutritional intake. The data were collected from 10,042 rural households in six Chinese provinces. The results reveal that rural residents with internet access have significantly higher energy, protein, and fat intake than those without. Chinese rural residents with internet access consumed 1.35% (28.62 kcal), 5.02% (2.61 g), and 4.33% (3.30 g) more energy, protein, and fat, respectively. There was heterogeneity in regard to the intake of energy, protein, and fat among those in different income groups. Moreover, non-staple food consumption is the main channel through which internet access affects nutritional intake. The results demonstrate that the local population uses the internet to improve their nutritional status. Further studies are required to investigate the impact of internet use on food consumed away from home and micronutrient intake.     

The Differential Effects of Social Media on Depressive Symptoms and Suicidal Ideation Among the Younger and Older Adult Population in Hong Kong During the COVID-19 Pandemic: Population-Based Cross-sectional Survey Study

BackgroundSocial media has become a ubiquitous part of daily life during the COVID-19 pandemic isolation. However, the role of social media use in depression and suicidal ideation of the general public remains unclear. Related empirical studies were limited and reported inconsistent findings. Little is known about the potential underlying mechanisms that may illustrate the relationship between social media use and depression and suicidal ideation during the COVID-19 pandemic.ObjectiveThis study tested the mediation effects of social loneliness and posttraumatic stress disorder (PTSD) symptoms on the relationship between social media use and depressive symptoms and suicidal ideation, as well as the moderation effect of age on the mediation models.MethodsWe administered a population-based random telephone survey in May and June 2020, when infection control measures were being vigorously implemented in Hong Kong. A total of 1070 adults (658 social media users and 412 nonusers) completed the survey. Structural equation modeling (SEM) and multigroup SEM were conducted to test the mediation and moderation effects.ResultsThe weighted prevalence of probable depression was 11.6%; 1.6% had suicidal ideation in the past 2 weeks. Both moderated mediation models of depressive symptoms (χ²₆₂=335.3; P<.05; comparative fit index [CFI]=0.94; nonnormed fit index [NNFI]=0.92; root mean square error of approximation [RMSEA]=0.06) and suicidal ideation (χ²₃₄=50.8; P<.05; CFI=0.99; NNFI=0.99; RMSEA=0.02) showed acceptable model fit. There was a significantly negative direct effect of social media use on depressive symptoms among older people (β=–.07; P=.04) but not among younger people (β=.04; P=.55). The indirect effect via PTSD symptoms was significantly positive among both younger people (β=.09; P=.02) and older people (β=.10; P=.01). The indirect effect via social loneliness was significant among older people (β=–.01; P=.04) but not among younger people (β=.01; P=.31). The direct effect of social media use on suicidal ideation was not statistically significant in either age group (P>.05). The indirect effects via PTSD symptoms were statistically significant among younger people (β=.02; P=.04) and older people (β=.03; P=.01). Social loneliness was not a significant mediator between social media use and suicidal ideation among either age group (P>.05).ConclusionsSocial media may be a “double-edged sword” for psychosocial well-being during the COVID-19 pandemic, and its roles vary across age groups. The mediators identified in this study can be addressed by psychological interventions to prevent severe mental health problems during and after the COVID-19 pandemic.     

阴沟肠杆菌对碳青霉烯类药物的耐药机制

 目的 研究耐碳青霉烯类阴沟肠杆菌分子流行病学特征和碳青霉烯耐药机制,为临床经验性用药及医院感染防控提供依据。方法 对某院2019年4—9月分离的耐碳青霉烯类阴沟肠杆菌进行菌种鉴定及药敏分析,mCIM联合eCIM试验筛选碳青霉烯酶,聚合酶链反应（PCR）方法检测碳青霉烯酶耐药基因,多位点序列分型（MLST）和脉冲场凝胶电泳（PFGE）进行分子流行病学特征分析。结果 8株耐碳青霉烯类阴沟肠杆菌中5株来自于重症监护病房（ICU）,对临床常用头孢类及加酶抑制剂药物均表现出高水平耐药的特性。所有菌株均携带金属β-内酰胺酶,7株为bla_NDM-1,1株为bla_IPM-4。MLST分子分型及PFGE同源性分析有6个ST序列类型,6个克隆群。ST596（3株）均为A群、ST121（1株）为C群、ST993（1株）为F群、ST91（1株）为E群、ST794（1株）为B群、ST88（1株）为D群。结论 该院耐碳青霉烯类阴沟肠杆菌主要来源于ICU,产金属酶bla_NDM-1β-内酰胺酶是其主要耐药机制。ST596 A群阴沟肠杆菌短时间内在ICU存在局部流行,应加强医院感染防控措施,遏制暴发流行。     

西昌市城区3~14岁儿童身高状况分析

目的 分析西昌市城区儿童身高的特点,为当地儿童健康发展提供参考。方法 2018年4-5月采用分层整群抽样法以西昌市城区19所学校3~14岁儿童作为研究对象。按照《中国儿童生长标准与生长曲线》的要求,统一测量儿童身高,并使用SPSS22.0软件进行数据分析。结果 西昌市城区的儿童中汉族男生3~6岁及9~11岁、彝族男生3~7岁及10~11岁、汉族女生3~7岁及9~10岁、彝族女生3~10岁的身高均高于全国标准(P<0.05);学龄前期男生汉族儿童身高高于彝族(P<0.05);在学龄期与青春期彝汉两个民族身高差异无统计学意义(P>0.05);男生身高在各年龄段均高于女生身高(P<0.05)。结论 西昌市儿童身高普遍高于全国标准身高,家长应重视身高在儿童生长发育中的作用。     

内镜下气囊扩张治疗贲门失驰缓症临床应用研究

目的 :探讨贲门失弛缓症患者食管动力学及气囊扩张的疗效。方法 :在内镜及X线监视下 ,用OTW气囊对 1 6例患者进行扩张 ,压力为 80～ 1 5 5kPa,维持 30s～1min ,反复 3～ 5次。对 7例患者在扩张前后使用瑞典产C—TD、PCPolyral压力测定仪作了下食管括约肌 (LES)压力、上食管括约肌 (UES)压力检测。结果 :1 6例患者临床症状显著改善 ,可进半流食和普食。 7例患者治疗前LES压力 (7 4± 1 4)kPa,扩张治疗LES压力 (3 4± 0 5 2 )kPa ,扩张治疗后LES压力较治疗前明显下降 (P <0 0 1 )。结论 :贲门失弛缓症存在明显食管动力障碍 ,气囊扩张疗效显著 ,采用渐进式气囊扩张方法 ,可避免食管穿孔的发生。     

健侧血管桥接背阔肌皮瓣修复小腿严重毁损伤14例报告

目的 :探索应用健侧胫后血管皮瓣蒂桥式携带背阔肌皮瓣游离移植修复对侧小腿严重毁损伤所致大面积皮肤软组织、骨缺损或外露 ,免除截肢所造成重大残废。方法 :临床治疗 14例 ,切取 12cm× 18cm -2 4cm× 38cm背阔肌皮瓣 ,通过暂借健侧胫后血管桥式携带修复小腿巨大缺损 ,断蒂时同时修复健侧胫后动脉。结果 :14例暂借桥式背阔肌皮瓣全部成功 ,3例皮瓣轻度感染 ,1例皮瓣下血肿 ,经及时处理均一期愈合。随访 1～ 8年 ,肌皮瓣外观饱满 ,质地均匀。远端肢体供血明显改善 ,最大限度的恢复功能 ,避免截肢残废。结论 :对于小腿巨大软组织骨缺损外露 ,应用暂借对侧胫后血管桥式携带背阔肌皮瓣移植修复是一种行之有效的好方法