西洋参茎叶皂苷对脑缺血大鼠细胞凋亡及caspase-3表达的影响

目的：研究西洋参茎叶皂苷对大鼠局灶性脑缺血损伤的保护作用及其机制。方法：采用大鼠大脑中动脉内栓线阻断法制备局灶性脑缺血损伤模型，通过HE染色、TUNEL、免疫组化及RT—PCR等方法，观察西洋参茎叶皂苷对脑缺血损伤大鼠脑组织形态学改变，细胞凋亡及半胱氨酸天冬氨酸蛋白酶（caspase）-3mRNA和蛋白表达的影响。结果：西洋参茎叶皂苷（100、50mg／kg，ig）均可明显改善脑缺血损伤所致的大鼠脑组织病理形态学改变，抑制神经细胞凋亡，降低促凋亡基因caspase-3mRNA和caspase-3蛋白的表达。结论：西洋参茎叶皂苷对大鼠局灶性脑缺血损伤具有保护作用，其作用机制可能与抑制caspase-3表达有关。     

Comparison of the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma: a retrospective cohort study

BackgroundThere is lack of studies on sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma (HCC). This study was to explore the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib failure in HCC patients.MethodsThis study was a retrospective, real-world study that included 50 HCC patients who received sequential regrafinib after sorafenib and lenvatinib failure. The safety and prognosis of two groups were compared.ResultsThe incidence of all grade and III/IV adverse events were 68% and 24%. According to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 and modified (m) RECIST standards, the objective response rates (ORRs) after receiving regorafenib were 14.0% and 22.0%, respectively. The disease control rates (DCRs) were 62.0% and 60.0%, respectively. Based on different first-line targeted drugs, 50 patients were divided into sorafenib (n=22) and lenvatinib group (n=28). There was no differences between two groups except age and bilirubin. And there was no differences in other treatments before or after regorafenib. The baseline between two groups was basically same and had good comparability. There was no difference in incidence of all grade and III/IV adverse events, ORR and DCR between two groups (P>0.05). On long-term prognosis, total overall survival (TOS) in sorafenib and lenvatinib group were 23.0 (95% CI: 15.1–30.9) vs. 29.7 (95% CI: 21.4–38.1) months. The difference was statistically significant (P=0.041). Besides, regorafenib overall survival (ROS) in sorafenib and lenvatinib group were 11.7 (95% CI: 7.1–16.3) vs. 15.9 (95% CI: 8.3–23.5) months. The difference was statistically significant ( P=0.045). The regorafenib progression-free survival (RPFS) was 5.6 (95% CI: 1.9–9.2) vs. 8.0 (95% CI: 5.1–10.9) months in sorafenib and lenvatinib group, respectively, and difference was not statistically significant (P=0.380).ConclusionsRegorafenib is an effective drug for second-line treatment of HCC, with fewer severe adverse events, ORR and DCR was 14–22% and 62–60%, respectively. Both TOS and ROS in lenvatinib group were better than those in sorafenib group. For HCC patients whose first-line targeted drug is lenvatinib, it is safe and effective to accept regorafenib after disease progresses.     

hs-CRP在急性脑梗死患者动态水平及预后的临床意义

目的：观察超敏C-反应蛋白（hs-CRP）在脑梗死患者的动态水平与其病情预示作用,了解hs-CRP同脑梗死患者病情关系。方法：收集126例脑梗死患者发病后72h内,第（4—7）d和第14d的血清进行超敏免疫比浊法测定hs-CRP。应用美国国立卫生研究院卒中量表（NIHSS）及Barthel指数（BI）记分法测定神经功能缺损评分。结果：脑梗死后72h血清hs-CRP浓度即开始升高,1周左右达高峰,至14d时接近对照组水平,并发多脏器功能衰竭者CRP水平最高。结论：hs—CRP是判断脑梗死病情轻重和预后的特异性指标,适时终止或减轻炎症反应损害,可以降低脑梗死的病死率及并发多脏器衰竭的危险。     

改良Ⅱ期法耳廓再造术

目的 探讨改良Ⅱ期法耳廓再造的方法并总结6年来的临床应用经验。方法 对146例（155耳）小耳畸形患者行耳廓再造术,手术分Ⅱ期进行。Ⅰ期：采用“U”形切口,切除残耳,在耳后分离合适的腔隙,置入肋软骨耳支架,耳垂向后转位衔接于再造的耳廓下方。6个月后行Ⅱ期手术：掀起耳廓,耳后置入软骨块,颞浅筋膜瓣转移覆盖后行中厚皮片移植术。结果 146例患者中141例（150耳）Ⅰ期术后恢复顺利,伤口愈合良好;5例（5耳）Ⅰ期术后4～6d出现皮瓣尖端坏死,范围约1.0 cm×1.5 cm,经换药后痊愈,未出现软骨外露、感染等;139例（147耳）Ⅱ期术后耳后移植皮片成活良好,7例（8耳）Ⅱ期术后出现耳后移植皮片部分成活不良,换药1周后愈合。146例患者随访94例（97耳）,失访52例（58耳）,随访时间为术后6个月至2年,随访病例均无感染、软骨吸收等并发症,再造耳廓结构清晰,耳颅角稳定。结论 改良Ⅱ期法耳廓再造手术操作相对简单,易于掌握,是耳廓再造的较为理想的方法之一。     

豚鼠膜迷路蛋白组成分析及免疫转印法检测感音神经性聋患者抗68kD抗体

比较了多种条件提取的豚鼠膜迷路蛋白，发现用十二烷基磺酸钠（ＳＤＳ）或ＴｒｉｔｏｎＸ－１００提取效率高，冻融法较超声粉碎法更可取。成功地建立了免疫转印（Ｗｅｓｔｅｒｎｂｌｏｔ）法，并初步运用于血清抗膜迷路蛋白抗体的检测。４２例不明原因感音神经性聋患者中１６例患者血清中抗６８ｋＤ抗体阳性，同时伴有ＩｇＧ、ＩｇＭ、ＩｇＡ升高。部分正常对照组血清中也存在该抗体，但反应弱，重复性差。     

基于知识元标引的中医古籍研究回顾与反思

回顾国内以往知识元研究,结合当前中医古籍知识元研究工作,探讨中医古籍研究的部分现存问题.中医古籍知识元研究工作重点在于知识元标引平台的研发以及中医基础理论的数据化处理.知识元的概念是文本中的词或短语;知识元的文本可以借助文言语法与知识图谱三元组概念进行数据提取;建立语义关系,即语义三元组的描述,可分为表达不同描述对象(...     

The dynamic changes of plasma neuropeptide y and neurotensin and their role in regulating cerebral hemodynamics in neonatal hypoxic-ischemic encephalopathy

Hypoxic-ischemic encephalopathy (HIE) is a common cause of neonatal encephalopathy and is one of the most important causes of neonatal death and disabilities, especially those infants with moderate to severe encephalopathy. However, the pathogenesis of HIE still remains unclear. The purpose of this study was to explore the dynamic changes in plasma neuropeptide Y (NPY) and neurotensin (NT) as well as their role in regulating cerebral hemodynamics in HIE patients. The plasma levels of NPY and NT in the umbilical artery and peripheral blood on the first, third, and seventh days after birth in 40 term infants with HIE and 40 healthy controls were measured using radioimmunoassay. On the first day of life, the blood samples were collected immediately when ultrasound examinations were finished. The ultrasound transducer was placed on the temporal fontanelle to detect the hemodynamic parameters of the middle cerebral artery, including peak systolic flow velocity, end-diastolic flow velocity, time-average mean velocity, pulsatility index, and resistance index (RI) in both groups were measured by pulse Doppler ultrasound in the first day after birth. The relationship between RI and NPY or NT was analyzed by linear regression analysis. NPY levels in umbilical blood ([mean +/- standard deviation] 615.5 +/- 130.7 ng/L) and first-day peripheral blood (355.9 +/- 57.4 ng/L) in neonates with HIE were significantly higher than those in normal newborns' blood (199.1 +/- 63.2 and 214.4 +/- 58.0 ng/L, respectively; P < 0.01). NPY levels in HIE neonates then declined to control levels on the third day after birth ( P > 0.05). However, the levels of plasma NT in umbilical blood and peripheral blood were much higher in the HIE group than those in normal newborns during the first week ( P < 0.01). The results of Doppler ultrasound examinations showed that cerebral blood flow velocity significantly decreased, whereas RI increased markedly in HIE patients compared with healthy controls ( P < 0.01). Linear regression analysis revealed that the RI was positively correlated with NPY levels ( R = 0.614; P < 0.01) and negatively correlated with NT levels ( R = -0.579; P < 0.01). The results of this study showed that there was a significant increase in plasma NPY and NT levels in HIE patients and this was strongly related to the severity of HIE, and the hemodynamic parameter RI was significantly correlated with NPY and NT. Therefore, we believe that the dynamic changes in plasma NPY or NT levels participate in the mechanisms of HIE by regulating cerebral hemodynamic changes after neonatal asphyxia occurs.     

三圆式站桩干预焦虑状态大学生诱发心率变异性效应的分析

目的通过分析心率变异性(HRV)时域和频域指标,探寻站桩功对焦虑状态的调节效应。方法以在校大学生志愿者(焦虑自评量表≥50分)为受试对象,按里1?1配比随机分为试验组和对照组,试验组进行为期10周、每周不少于5次的三圆式站桩功练习干预,对照组不进行任何干预。在站桩功干预开始前与完成后,分别采集2组HRV数据进行比较分析。结果站桩态,试验组窦性心搏间标准差(SDNN)、相邻正常窦性心搏间期差值的均方根(RMSSD)和相差50 ms以上相邻窦性心搏间期数占窦性心搏间期总数的百分比(PNN50)均较前升高,且试验前后差异具有统计学意义(P<0.05);对照组干预前后差异无统计学意义(P>0.05)。试验组标化低频功率(LFn)降低,标化高频功率(HFn)升高,且试验前后,LFn、HFn、LF/HF变化差异具有统计学意义(P<0.05);对照组各时段LFn、HFn、LF/HF变化差异无统计学意义。结论三圆式站桩功对练习者的HRV指标水平影响显著,具体表现为提高副交感神经活性、降低交感神经活性,且有益于自主神经的平衡。其对焦虑状态的缓解效应值得进一步研究。     

中国农村地区婴幼儿辅食添加状况

对较贫困农村地区 146 49名 4～ 2 4月龄婴幼儿的辅食添加情况进行分析 ,结果显示婴幼儿平均从出生后 6个月开始添加食物 ,约 1 3的婴幼儿在 4～ 6个月开始添加 ,有 16 4%的婴幼儿在 4个月以前就添加了谷类食物 ;大多数婴幼儿 (74 4% )从 7个月开始每天进食谷类食物 ,蔬菜水果类食物的摄入频率随着年龄的增加有所增加 ,但 1岁以后也只有 5 0 %的的婴幼儿能够每天食用蔬菜水果。蛋白质类食物的摄入频率较低 ,1岁以上婴幼儿能够每天食用的占 38% ,有 15 8%的婴幼儿从未添加过肉蛋类及豆制品类食物。农村地区的大多数婴幼儿是以母乳喂养的 ,但断奶以后只有 2 0 %的婴幼儿能够每天饮奶 ;婴幼儿的食物摄入情况受家庭食物状况的影响 ,随着年龄的增加 ,影响程度增加 ;婴幼儿辅食添加的状况直接影响婴幼儿的生长发育 ,长期不合理的喂养模式 ,就会造成营养不良。应通过营养教育 ,提高婴幼儿看护人的营养知识 ,及时合理地添加辅食对婴幼儿的生长发育非常重要。