王念孙释《广雅》医学词汇

三国时代魏张揖编著的《广雅》中收录有医学词汇,清代训诂大家王念孙所著的《广雅疏证》是《广雅》最好的注本,最注重以声音通训诂、系联同源词,以此对词义进行训释,沟通词际关系。以《广雅》中收录的医学词汇为语料,挖掘王念孙在《广雅疏证》中训释医词时所使用的破通假、系同源、沟通普通词汇与医学词汇等理论、方法,并结合王念孙在校勘《广雅》文本中存在的误字、脱文、衍文等问题时采用的校勘学方法,从中探索当今医学词汇研究可以借鉴的释词方法。     

不同临床分型的新型冠状病毒肺炎患者影像学表现

目的 探讨不同临床分型的新型冠状病毒肺炎（COVID-19）的影像学表现。方法 回顾性分析71例COVID-19患者的电子计算机断层扫描（computed tomography,CT）影像资料,分析普通型与重型及危重型患者的临床特点、影像学特点、优势分布以及出现好转时间,并进行统计学分析。结果 71例患者中,轻型12例,普通型45例,重型及危重型14例。临床表现方面,重型及危重型（6/14,42.9%;4/14,28.6%）伴乏力、胸闷及呼吸困难较轻型（0;0）及普通型（2/45,4.4%;0）明显,差异有统计学意义（P值分别为0.001,0.002）;普通型（30/45,66.7%）、重型及危重型（9/14,64.3%）C反应蛋白升高较轻型（2/12,16.7%）明显,差异有统计学意义（P=0.005）。CT表现,病变累及范围超过3个肺叶数：重型及危重型（13/14,92.9%）明显高于普通型（26/45,57.8%）;重型及危重型（12/14,85.7%）病变分布于两肺外周及中心多于普通型（20/45,44.4%）;病变表现为实变、病变内伴小叶间隔增厚,重型及危重型均多于普通型;以上表现两组相比,差异均有统计学意义（P值分别为0.036、0.007、0.004、0.002）。对22例患者进行随访,CT表现达高峰及病情出现好转多发生在发病10 d后（40.9%,45.5%）。结论 普通型与重型及危重型COVID-19患者胸部CT在发病部位、病变密度、实变程度等方面具有不同特征,多数COVID-19患者多在发病10 d后好转。     

Differential impairment patterns of the corticospinal tract segments in alcohol dependence

Abstract

Background: Previous studies have reported inconsistent findings regarding corticospinal tract (CST) changes in alcohol dependence. Here, we aimed to clarify this issue by examining the micro-structural integrity differences of distinct CST segments between alcohol-dependent patients and healthy controls.

Methods: Diffusion tensor imaging was performed in a total of 39 male individuals, including 19 alcohol-dependent patients and 20 age-matched healthy controls. CST was reconstructed using tractography and was divided into inferior and superior segments at the level of the lateral sulcus. Multiple diffusion measures of each segment were compared between two groups.

Results: For the bilateral whole CSTs, no diffusion measures showed significant between-group differences. However, compared to healthy controls, alcohol-dependent patients exhibited decreased FA and increased RD in the left-superior segment, increased FA and decreased RD/MD in the left-inferior segment, increased AD/MD in the right-superior segment, decreased RD/MD in the right-inferior segment.

Conclusions: These findings suggest that CST impairments may vary with the fibre arrangement patterns of its segments in alcohol dependence.

• Keypoints

• We reconstructed the CST using tractography based on DTI data and divided the CST into different segments in order to explore more detailed micro-structural integrity changes in alcoholisms.

• Alcohol-dependent patients showed decreased RD and MD for the bilateral inferior segments of the CSTs.

• The left-superior segment exhibited decreased FA and increased RD while the right one exhibited increased AD and MD.

• These findings suggest that CST impairments may vary with the fiber arrangement patterns of its segments in alcohol dependence.

• In future work, more elaborate segmentation schemes and lager samples should be used to test the reproducibility of our findings.

     

MiR-195 inhibits proliferation and growth and induces apoptosis of endometrial stromal cells by targeting FKN

MiR-195, which exhibits a proliferation-inhibiting role in different tumors, has been reported to be down-regulated in the ectopic endometrium. The aim of this study was to determine the impact of miR-195 on the biological characteristic of the endometrial stromal cells (ESCs). MiR-195 has been presumed to target the 3’-untranslated regions (3’-UTR) of Fractalkine (FKN), which also plays important roles in endometriosis. Fluorescence reporter assays showed that miR-195 effectively binds to the 3’-UTR of FKN. The normal ESCs showed a significant higher miR-195 expression than that of eutopic and ectopic ESCs associated with endometriosis, while the FKN expression showed opposite results. MiR-195 mimics inhibited proliferation and growth and induced apoptosis of eutopic ESCs, and these effects were abolished by FKN-siRNA. miR-195 could decrease the expression of survivin, matrix metalloproteinase-9 (MMP9) and up-regulate the expression of CD82, tissue inhibitor of metalloproteinase 1 (TIMP1) and TIMP2 of eutopic ESCs by targeting FKN. Our study has demonstrated for the first time that miR-195 plays important roles in regulating the functions of ESCs through targeting FKN. The information may be useful for developing a new therapeutic strategy for endometriosis.     

Effects of Different Dosages of Parathyroid Hormone-Related Protein 1–34 on the Bone Metabolism of the Ovariectomized Rat Model of Osteoporosis

Intermittent and low-dose parathyroid hormone (PTH) injection to stimulate bone formation has been used in the treatment of osteoporosis. The N-terminal fragment 1–34 of PTH is quite similar in structure and function to N-terminal PTH-related protein (PTHrP). PTH(1–34) and PTHrP also share a coreceptor, the PTH/PTHrP receptor. Therefore, some studies have suggested that PTHrP could effectively stimulate bone formation, similar to PTH. We used an ovariectomized (OVX) rat model of osteoporosis to study the effects of PTHrP(1–34) on bone metabolism by measuring bone mineral density (BMD), bone histomorphometrics, and biomechanical parameters. We found that subcutaneous injection of PTHrP(1–34) (40 or 80 μg/kg body weight every day) in OVX rats increased lumbar and femoral BMD, improved bone biomechanical properties, enhanced bone strength, and promoted bone formation. We selected 40 μg/kg as the preferred therapeutic dose of PTHrP(1–34) and investigated the effects of frequency of treatment (per 1, 2, 3, or 7 days) on bone metabolism in OVX rats. We found that injection of PTHrP(1–34) once per day or every other day significantly improved the BMD and strength of OVX rats. Serum calcium and phosphate levels in all treated rats did not vary significantly from control rats. Based on our results, intermittent low-dose PTHrP(1–34) injection promoted bone formation in OVX rats, suggesting a high potential for therapeutic use in osteoporosis patients.     

Evaluation of renal biopsies in type 2 diabetic patients with kidney disease: a clinicopathological study of 216 cases

Objectives

The outcome and the therapy of patients with diabetes mellitus (DM), diabetic nephropathy (DN), and non-diabetic renal disease (NDRD) are quite different, so the differential diagnosis is of considerable importance. To evaluate the usefulness of renal biopsy in type 2 diabetic patients, we examined the relationship between the clinical parameters and the histopathological findings in different age groups.

Methods

Renal biopsy specimens and clinical and laboratory data from 216 patients with type 2 DM were evaluated. According to their age, three groups were defined: 17–35 years (group I), 36–59 years (group II), and more than 60 years (group III).

Results

The study showed that, beside the duration of diabetes, other clinical parameters were not significantly different between the three groups. Chronic nephritic syndrome was the most common clinical manifestation in group I (44.1 %) and in group II (34.0 %). Among patients in group III, we found a high prevalence of chronic renal failure (34.3 %) and nephrotic syndrome (28.6 %). Consistent with the clinical manifestations, IgA nephropathy was the most common pathologic finding in group I (29.4 %) and in group II (34.7 %), whereas the most frequent abnormalities in group III were membranous nephropathy (25.7 %) and tubulointerstitial lesions (14.3 %). Overall, among these patients, 14 cases were diagnosed with DN (6.5 %), 179 with NDRD (82.9 %), while 23 had concurrent DN and NDRD (10.7 %).

Conclusions

Our results indicated that the clinical manifestations and pathologic findings in type 2 diabetic patients in different age groups have different features. This study emphasized the usefulness of renal biopsy for determining the pattern of renal damage and thus for the overall management of type 2 diabetic patients.     

高度近视白内障患者术后疗效的影响因素研究

目的 比较综合性医院眼科与眼科专科医院高度近视白内障患者术后视力,分析高度近视白内障患者术后视力的影响因素。方法 选择在复旦大学附属华东医院及复旦大学附属眼耳鼻喉科医院进行超声乳化白内障摘除合并人工晶状体植入手术的眼轴长度≥26 mm的高度近视患者77例(77眼)。术前记录患者眼部生物学特征及眼底相干光层析成像(OCT)情况,并按医院不同分为2组,比较2组术后视力,并分析术后最佳矫正视力(BCVA)与术前眼部特征的相关性。结果 眼耳鼻喉科医院收治的高度近视白内障患者更年轻、眼轴长度更长、合并的黄斑疾病更多(P<0.05)。所有患者术后视力均有提高(P<0.001),2家医院平均术后BCVA差异无统计学意义(P=0.805)。单因素分析显示,高度近视白内障患者术后BCVA(logMAR)与眼轴长度、光感受器内外节连接(IS/OS)不连续及合并黄斑牵引性疾病呈正相关,与黄斑中心凹视网膜厚度呈负相关(P<0.05)。逐步向后多元线性回归分析显示高度近视白内障术后BCVA的独立影响因素为眼轴长度、IS/OS连续性及术前BCVA。结论 超声乳化白内障摘除合并人工晶状体植入手术治疗高度近视白内障安全有效,其疗效受眼轴长度、IS/OS连续性及术前BCVA影响。     

有晶状体眼后房型人工晶状体植入治疗屈光不正的研究进展

屈光不正(refractive errors)是常见的眼科疾病,可以通过配镜、激光屈光手术等方法为患者进行矫正,但是这些方法对高度屈光不正、圆锥角膜等疾病的治疗有一定的局限性。有晶状体眼后房型人工晶状体(ICL)植入术是矫正屈光不正的主要方式之一,目前主要应用于矫正高度近视和散光,为探讨ICL植入术矫正低、中、高度近视及远视等的安全性和有效性,本文将会对ICL植入术矫正屈光不正的研究进展进行综述。     

不同屈光度近视青少年儿童黄斑区血管密度和视网膜厚度的比较

目的:通过光学相干断层扫描血管成像技术(OCTA)观察与比较不同屈光度近视青少年儿童黄斑区血管密度和视网膜厚度的变化,并探讨其相关性。方法:前瞻性横断面研究。纳入6~18岁青少年儿童115例230眼。根据等效球镜度数(SE)分为4组:正视组16例32眼,低度近视组47例94眼,中度近视组34例68眼,高度近视组18例36眼。RTVueXR扫描黄斑区6mm×6mm范围,系统自动分区,分为以黄斑中心小凹为中心,直径分别为1mm的中心凹(fovea)环、1~3mm的内环(parafovea)、3~6mm的外环(perifovea),且每个圆环被进一步划分为颞(T)、上(S)、鼻(N)、下(I)4个象限,定量分析各分区浅层、深层毛细血管密度和视网膜厚度。结果:正视、低度、中度和高度近视组黄斑区整体浅层毛细血管密度依次显著减低,分别为(44.4±3.5)%、(44.8±3.8)%、(44.3±3.8)%、(42.6±4.5)%(F=2.963,P=0.033),内环颞侧浅层毛细血管密度分别为(46.1±3.5)%、(46.8±5.1)%、(46.2±4.3)%、(43.8±5.5)%(F=3.436,P=0.018);四组黄斑区整体深层毛细血管密度随着近视度数增加亦显著降低,分别为(49.9±4.1)%、(48.4±4.7)%、(47.9±5.5)%、(45.3±4.7)%(F=4.806,P=0.003),外环深层毛细血管密度分别为(49±4.4)%、(47.2±5.2)%、(46.6±6)%、(43.6±5.1)%(F=5.495,P=0.001)。四组黄斑区整体视网膜厚度分别为293.9±12.9、295.5±13.0、290.9±12.0、284.5±10.7μm(F=6.606,P<0.001)。内环颞侧、鼻侧浅层毛细血管密度与SE呈正相关(r=0.221、0.219,P=0.001、0.001),外环颞侧、上方、鼻侧、下方深层毛细血管密度与SE呈正相关(r=0.172、0.200、0.250、0.296,P=0.011、0.003、<0.001、<0.001);黄斑区除中心凹外其余区域视网膜厚度与SE均呈正相关(P<0.05)。结论:随着青少年儿童近视度数的增加,黄斑区浅层毛细血管密度降低,以内环颞侧为甚;深层毛细血管密度降低,以外环范围内为甚;视网膜厚度降低,以内环和外环范围为甚。青少年儿童近视随着屈光度增加,会导致黄斑区结构和血流循环的变化,在高度近视眼中改变尤为显著。     

Electrospun fibers as a scaffolding platform for bone tissue repair

The purpose of the study is to investigate the effects of electrospun fiber diameter and orientation on differentiation and ECM organization of bone marrow stromal cells (BMSCs), in attempt to provide rationale for fabrication of a periosteum mimetic for bone defect repair. Cellular growth, differentiation, and ECM organization were analyzed on PLGA‐based random and aligned fibers using fluorescent microscopy, gene analyses, electron scanning microscopy (SEM), and multiphoton laser scanning microscopy (MPLSM). BMSCs on aligned fibers had a reduced number of ALP+ colony at Day 10 as compared to the random fibers of the same size. However, the ALP+ area in the aligned fibers increased to a similar level as the random fibers at Day 21 following stimulation with osteogenic media. Compared with the random fibers, BMSCs on the aligned fibers showed a higher expression of OSX and RUNX2. Analyses of ECM on decellularized spun fibers showed highly organized ECM arranged according to the orientation of the spun fibers, with a broad size distribution of collagen fibers in a range of 40–2.4 μm. Taken together, our data support the use of submicron‐sized electrospun fibers for engineering of oriented fibrous tissue mimetic, such as periosteum, for guided bone repair and reconstruction. © 2013 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 31:1382–1389, 2013