长春西汀治疗血管性痴呆的临床疗效观察

目的:探讨长春西汀对血管性痴呆(VD)疗效和作用机制。方法:96例VD患者随机分成长春西汀治疗组和胞二磷胆碱对照组,分别在治疗第10、21d进行简易精神状态评分(MMSE)和长谷川评分(1DS),同时测定与记忆有关的乙酰胆碱酯酶(AchE)的活性。结果:长春西汀治疗组患者第21d的MMSE和IDS评分均高于治疗前和一般治疗组(P＜0．01),且长春西汀治疗组VD患者的乙酰胆碱酯酶(AchE)活性降低和血浆乙酰胆(Ach)含量升高(P＜0．05)。结论:长春西汀治疗VD疗效肯定,其机制可能与胆碱能神经系统功能增强有关。     

实习医生对艾滋病病毒职业暴露知识知晓的调查与分析

目的了解实习医生对艾滋病病毒职业暴露知识知晓的情况,为防护知识培训提供依据,减少职业暴露的发生,并知晓发生暴露后的处理措施。方法采用问卷调查法,以整群抽样方式,分别于岗前培训前和培训后对558名即将进入临床医疗实习的学生进行调查。结果实习医生培训前后对艾滋病病毒职业暴露知识知晓率差异有统计学意义(P<0.01)。结论对实习医生进行岗前培训时有必要增加艾滋病病毒职业暴露知识的培训,以增加实习医生对职业暴露的防护能力和暴露后的及时应对。     

葛根芩连汤及其加减方改善2型糖尿病胰岛素抵抗作用研究进展

葛根芩连汤出自《伤寒杂病论》,为表里双解治疗协热下利的代表方剂,全方由葛根、黄芩、黄连、炙甘草配伍而成,四药合用可外疏内清,共达清热止利,表里同解之效。现临床上基于异病同治的原则将葛根芩连汤用于2型糖尿病（T2DM）的治疗,取得了良好的疗效。T2DM是一种以血糖水平升高为主要特征的慢性代谢性疾病,其病因和发病机制十分复杂,主要与遗传、生活方式、环境及饮食等因素相关。临床观察及实验研究显示,葛根芩连汤及其药效成分可有效防治T2DM。临床上常将葛根芩连汤加减应用或联合西药应用,其治疗效果明显优于单独使用西药。临床实践证实葛根芩连汤可以有效缓解T2DM患者临床症状,减轻胃肠道等不良反应,并减少并发症的发生。实验研究表明葛根芩连汤可通过调控胰岛传导通路及炎症信号通路、缓解氧化应激反应、调节肠道菌群等方式来增强患者胰岛功能,改善胰岛素抵抗,从而治疗T2DM。但目前关于葛根芩连汤通过改善胰岛素抵抗治疗T2DM的机制尚待进一步研究,故该文就葛根芩连汤改善T2DM胰岛素抵抗的临床及实验基础研究进展进行系统综述,以期为葛根芩连汤治疗T2DM作用机制的后续深入研究及其临床防治提供理论和数据参考。     

Application of Iron Tailings-Based Composite Supplementary Cementitious Materials (SCMs) in Green Concrete

How to treat the iron tailings of mining solid waste with high value is an urgent problem on a global scale. In recent years, the application of iron tailings in the building materials industry has attracted the attention of many scholars. The conversion of iron tailings into green building materials helps achieve carbon neutrality and high-value utilization of solid waste, and promotes sustainable development. Although iron tailings have been extensively studied as supplementary cementitious materials, the performance of concrete is not ideal due to its low activity. In this study, the hybrid supplementary cementitious materials system was prepared by iron tailings, phosphorus slag, and steel slag, and the effects of supplementary cementitious materials type, iron tailings content, iron tailings grinding time, and supplementary cementitious materials content on concrete performance were studied. The compressive properties, iron tailings properties, pore structure, interfacial transition zone, and element distribution of hydration products of concrete were tested by compressive strength tests, X-ray Diffractometer (XRD), X-ray Photoelectron Spectroscopy (XPS), Mercury Intrusion Porosimetry (MIP), Backscattering Electron Tests (BSE), and Energy Dispersive Spectrometer (EDS). The results show that further grinding improves the iron tailings activity. There is a synergistic mechanism between steel slag and phosphorus slag in the composite supplementary cementitious materials, which overcomes the low activity defect of iron tailings and produces concrete with a compressive strength exceeding 40 MPa. The composite supplementary cementitious materials can optimize the interfacial transition zone of the concrete interface and reduce the calcium–silicon ratio of the hydration products. However, it will deteriorate the pore structure of the concrete matrix, cause part of the concrete matrix to be damaged and lead to a loss of compressive strength, and the loss is acceptable. This work broadens the methods of comprehensive utilization of iron tailings and also provides a reference for a more detailed understanding of the properties of iron tailings-based concrete.     

苯那普利和缬沙坦联合应用对大鼠阿霉素肾病的影响

目的:探讨苯那普利和缬沙坦对大鼠阿霉素肾病的干预作用。方法:实验Wistar大鼠实行右肾切除手术,以阿霉素尾静脉注射造模,分别用苯那普利、缬沙坦及两者联合灌胃。用药后2～8周检测血、尿标本;透射电镜下观察肾形态学变化;用TUNEL法检测肾组织细胞凋亡。结果:与肾病组相比,3个干预组中的肌酐、尿素氮、尿蛋白、血压均降低,且差异显著;电镜下肾小球超微结构改善;凋亡细胞减少,差异显著。联合应用组与单用组差异显著。结论:苯那普利、缬沙坦及两者联合应用均可延缓阿霉素肾病肾小球硬化的进展,其机制可能与减少细胞的凋亡及肾超微结构的改善有关,两药联合应用效果更显著。     

Methods for monitoring cancer cell pyroptosis

Pyroptosis is a form of proinflammatory cell death that depends on the gasdermin family of proteins. The main features of pyroptosis are altered membrane permeability, cell swelling, membrane rupture, and the ability to mobilize a strong immune response. The relationship between pyroptosis and cancer has become a popular topic in immunological research. Multiple strategies for inducing pyroptosis in cancer cells have been developed for cancer therapy, including chemotherapy, small molecule drugs, and nanomedicines. In this review, we systematically discuss recent advances in research on the mechanisms of pyroptosis, and compare pyroptosis with apoptosis and necroptosis from several aspects. The development of various experimental systems has accompanied rapid progress in this field, but little consensus on monitoring pyroptosis is currently available. We focus on techniques commonly used to monitor pyroptosis, and describe future techniques that may be used to increase our knowledge in this field. Overall, the advancement of pyroptosis detection methods will help researchers to better investigate the relationships between pyroptosis and various cancers, and should provide insights into the use of these promising tools for cancer treatments.     

酸性微环境下大蒜素增强大鼠自然杀伤细胞的功能活性

目的 观察体外酸性培养环境下大蒜素对自然杀伤(NK)细胞功能活性的影响,并探讨其机制.方法 以pH 5.6、pH 6.5和pH 7.2的完全RPMI 1640培养基对大鼠脾脏CD3-NKR-P1+NK细胞进行悬浮培养,并给予30 mg/L浓度的大蒜素进行处理.酶联免疫吸附试验(ELISA)检测细胞培养液中干扰素(IFN)-γ的分泌水平,流式细胞仪检测NK细胞的增殖和凋亡率,乳酸脱氢酶法检测NK细胞的功能活性.结果 酸性培养环境下大鼠脾脏NK细胞的增殖能力明显下降,NK细胞功能活性明显受阻.在pH 7.2、pH 6.5和pH 5.6三种不同的培养条件下,大蒜素对NK细胞增殖率的影响表现为随培养环境的pH降低反而升高,以pH 5.6、培养16 h时达最高33.3%.与之相对应,NK细胞分泌的IFN-γ达(64.59±0.09)ng/L,较培养4 h时升高28%,且对小鼠淋巴瘤Yac-1细胞的杀伤活性也达到最高水平.结论 大蒜素可通过提高NK细胞IFN-γ分泌水平明显改善酸性培养环境下NK细胞的功能活性.

Abstract：

Objective To investigate the role of allicin on rat nature killer (NK) cell activity in vitro under acidic microenvironment, and its possible mechanism. Methods CD3- NKR-P1+ NK cells isolated from the rat spleen were cultured in the complete RPMI 1640 medium ( pH 5. 6, pH 6. 5, or pH 7. 2 respectively), and treated with allicin at final concentration of 30 mg/L. Enzyme linked immunosorbent assay (ELISA) was used to determine supernatant interferon (IFN)-γ levels. The percentage of NK cells proliferation and apopotosis was analyzed by flow cytometry. NK cell cytotoxicity toward YAC-1 tumor cells was detected by LDH release assay. Results Proliferation and cytotoxicity of NK cells were significantly suppressed by acidic microenvironment in vitro. Under the cultured condition of acidic pH below 7. 2, allicin seemed to promote NK cells proliferation, which reached to highest level of 33% at pH 5. 6 cultured for 16 h. Correspondingly, at pH of 5. 6, allicin induced a marked increase of IFN-γ concentration in the supernatant from (50. 07 ± 0. 38) (cultured for 4 h) to (64. 59 ± 0. 09) ng/L ( cultured for 16 h). The cytotoxicity of NK cells toward YAC-1 tumor cells was also found strongest under the condition of pH 5. 6 cultured for 16 h. Conclusion Allicin favored to enhance the cytotoxicity of NK cells under the acidic cultured condition, which might be related to the increase of IFN-γ production.     

儿童下肢截肢及其功能康复的流行病学与临床特征

目的 分析儿童下肢截肢及其康复的流行病学特点与临床特征,阐述儿童截肢的原因及截肢后并发症的情况。方法 选择2016年1月至2021年3月北京博爱医院收治的下肢截肢儿童51例,分析截肢原因与截肢后并发症的相关性。结果 创伤性截肢占58.82%,主要原因为交通事故(70%);疾病性截肢占41.18%,主要原因为先天性肢体畸形(80.95%)。创伤性截肢后发生残端并发症的可能性较预期更高(P <0.05);疾病性截肢后发生残端并发症的可能性较预期更低(P <0.05)。结论 交通事故是儿童创伤性截肢的主要原因,其临床特征是不良残端发生率高,主要原因是软组织异常,大部分病例需要通过残端修整术改善不良残端而达到装配假肢恢复行走的目的。先天性胫骨假关节是儿童疾病性截肢的主要原因,往往经历长期的保肢治疗后仍不能避免截肢的结局。     

逆行交锁髓内钉治疗股骨远端骨折

目的:评价应用逆行交锁髓内钉治疗股骨远端骨折的临床疗效。方法:回顾性分析2002年4月至2005年1月采用逆行交锁髓内钉内固定治疗32例股骨远端骨折的临床资料。结果:骨折愈合时间为2～12个月,平均4.5个月。伤肢膝关节屈曲度为75°～140°,平均118°。按Neer股骨髁上骨折疗效标准评价:优23例,良5例,中4例,优良率为87.5%。结论:应用逆行交锁髓内钉治疗股骨远端骨折疗效满意,具有操作简单、固定可靠、手术创伤小等优点。