中风文献的计量学分析

本文运用文献计量学方法 分析了由中国中医科学院中医药信息研究所研制开发的"中医临床数据库"(2001～2005)年的中风文献,分析了5年来中风文献的变化,研究了中风文献的主要作者、主要期刊和研究内容的变化和发展.     

Selenium substituted axitinib reduces axitinib side effects and maintains its anti-renal tumor activity

Axitinib is a potent vascular endothelial growth factor receptor (VEGFR) inhibitor, which has a strong inhibitory effect on the three isoforms of VEGFR 1–3. Having strong therapeutic efficacy, its broad use is limited by its side effects such as hypertension, proteinuria, cardiovascular damage, and liver and kidney dysfunction. Selenium compounds are broadly reported to have a good protective effect on cardiovascular disease, inflammation, infection, and immune function. In this study, a selenium substitute of axitinib was synthesized, and its anti-renal cell carcinoma activity and side effects were investigated. The results of the study indicated that Se-axitinib had potent antitumor activity on renal cell carcinoma (RCC), alleviated vascular hyperpermeability, and also alleviated axitinib-related side effects including hypertension, liver dysfunction and kidney dysfunction significantly. Therefore, we suggest that Se-axitinib could be a solution to the severe side effects of VEGFR inhibitors and provide evidence to improve the outcome of RCC treatment.

Se-axitinib is a selenium substitution of sulfur in axitinib, which reduced the side effect of VEGFR inhibitors and maintained the potent anticancer activity of the original drug.     

印迹基因Snrpn在人类卵母细胞及植入前胚胎mRNA表达

目的了解印迹基因Snrpn在人类卵母细胞和植入前胚胎的表达,以分析Snrpn基因表达对人类卵母细胞和早期胚胎发育的影响。方法采用单细胞巢式逆转录多聚酶链式反应(Single Cell Nested RT-PCR)方法,检测人类卵子和植入前各个阶段胚胎的印迹基因Snrpn mRNA表达情况。结果Snrpn在人类卵母细胞GV、MI、MII和植入前胚胎2、4、6、8细胞期都有表达,单卵母细胞扩增成功率为87.5%,单个胚胎为75.8%,平均扩增成功率为79.1%。单个卵母细胞和单个卵裂球扩增成功率无显著性差异(P>0.05),但单卵母细胞较单个卵裂球高。结论建立了比较稳定、可靠的单细胞巢式RT-PCR技术检测基因表达。印迹基因Snrpn在人类卵细胞和植入前胚胎的表达对卵子生长和胚胎发育有着重要意义,为早期胚胎阶段该基因表达正常图谱提供实验依据     

利培酮治疗难治性Tourette综合征对照观察

目的:探讨利培酮治疗难治性Tourette综合征(TS)的疗效和安全性。方法:对141例难治性TS患者,随机分为利培酮组(71例)和对照组(70例),进行8周的利培酮开放、对照研究。利培酮组以利培酮单药治疗,对照组以氟哌啶醇等单一或联合治疗。采用耶鲁抽动症状严重程度量表(YGTSS)Achenbach儿童行为量表(CBCL)、治疗中出现的症状量表(TESS),于治疗前、治疗4、8周对两组进行临床疗效及安全性评估。结果:两组症状均有改善。治疗第4周利培酮组有效率56.3%,明显高于对照组32.9%(χ2=8.212,P<0.01);利培酮组YGTSS总分(39.97±15.62)分较对照组(49.84±13.91)分显著为低(P<0.01)。治疗8周时利培酮组有效率为71.8%,明显高于对照组51.4%(χ2=6.357,P<0.05);利培酮组YGTSS总分(17.20±11.24)分明显低于对照组(24.97±10.74)分(P<0.05);减分率(76.55±14.73)%明显高于对照组(66.86±14.28)%(P<0.01)。治疗4周和8周,两组的CBCL总分均显著减少(P<0.05)。治疗4周和8周,利培酮组TESS分显著低于对照组(P<0.01)。结论:利培酮对难治性TS疗效肯定,不良反应较轻。     

基于金磁微粒标记技术的可目视化蛋白质芯片检测方法的建立

目的：应用金磁微粒标记蛋白质技术,建立可目视化蛋白质芯片检测体系,比较金磁微粒和胶体金标记蛋白质技术应用于蛋白质芯片检测效果的优劣。方法：将人IgG点制于环氧基修饰的玻片上,分别与金磁微粒和胶体金标记的羊抗人IgG温育,银染显色,肉眼观察并用普通扫描仪记录结果。结果：基于金磁微粒的蛋白质芯片人IgG最佳点样浓度为0．2mg／ml,37℃温育2h,银染10～15min,检测结果信噪比高;基于胶体金的蛋白质芯片人IgG最佳点样浓度为0．1mg／ml,37℃温育1h,银染15～20min．检测结果信噪比高。结论：金磁微粒标记蛋白质技术应用于蛋白质芯片的检测,具有和胶体金一致的可目视化检测效果。且其标记技术简单,标记的蛋白质可定量。     

ELISA法检测乙肝5项指标室内质控初探

目前,市县级医院普遍采用固相酶联免疫法（ELISA）检测乙肝5项指标,该法操作方便、快捷,特别适合大批标本的筛查。但由于ELISA方法学特点,批内批间的CV值较大。因此,做好该项检测的质量控制是保证结果真实可靠的基础。现就本室开展此项室内质控若干措施和体会报告如下。     

Allen试验与高频超声评价桡尺动脉侧支循环的对比研究

目的:判断高频超声桡动脉(RA)、尺动脉(UA)及手掌侧支循环的相关性及后两者在临床诊断中的准确性。方法:采用改良和量化SaO2-Allen试验方法,判断受试者手掌侧支循环建立时间。采用高频超声检测受试者RA受压迫前后,RA、UA、RA掌浅支和拇指动脉的血流动力学参数。结果:207例受试者的手掌侧支循环建立时间:量化SaO2-Allen试验坐位为7.34(Q2.5～Q97.5:4.35～13.22)s,卧位为7.30(Q2.5～Q97.5:3.63～13.22)s,改良Allen试验坐位为3.02(Q2.5～Q97.5:1.17～11.38)s,卧位为2.77(Q2.5～Q97.5:1.28～11.29)s;高频超声检测:以高频超声检测拇指动脉血流消失为异常标准,对量化SaO2和改良Allen试验进行受试者工作特征曲线分析,得出曲线下面积(AZ),量化SaO2-Allen试验AZ=0.52～0.53,改良Allen试验AZ=0.53～0.55。结论:与高频超声检测结果比较,量化SaO2和经典Allen试验诊断准确性较低。     

Evaluation of physician experience in achieving non-perfused volume ratio of high-intensity focused ultrasound ablation for uterine fibroids: a multicentre study

ObjectiveTo evaluate the effect of different levels of physician experience on the high-intensity focused ultrasound (HIFU) ablation of uterine fibroids and to provide a reference for the use of non-perfused volume ratio (NPVR) standards during training.MethodsThis prospective multicentre study enrolled patients with uterine fibroids. The effect of the physician’s level of experience on the outcomes under different NPVR standards and the learning curve of six centres without HIFU experience were analysed. The impact of patient demographic and clinical characteristics were also evaluated.ResultsA total of 1352 patients from 20 centres were included in the study. The median NPVRs were 92.00%, 88.10% and 92.86% in the no experience group, inexperienced group and experienced group, respectively. Posterior wall fibroids, lateral wall fibroids and fundus fibroids were inversely correlated with NPVR, while experienced physicians were positively correlated with NPVR. With NPVR ≥ 70% and NPVR ≥ 80% standards, physicians in the no experience group completed the learning curve on the 11th and 16th procedure, respectively. Physicians under a standard of an NPVR ≥ 90% did not complete the learning curve.ConclusionsNPVR ≥ 80% is a standard that is worth using for HIFU treatment of uterine fibroids.     

PRRSV Induces HMGB1 Phosphorylation at Threonine-51 Residue to Enhance Its Secretion

Porcine reproductive and respiratory syndrome virus (PRRSV) induces secretion of high mobility group box 1 (HMGB1) to mediate inflammatory response that is involved in the pulmonary injury of infected pigs. Our previous study indicates that protein kinase C-delta (PKC-delta) is essential for HMGB1 secretion in PRRSV-infected cells. However, the underlying mechanism in HMGB1 secretion induced by PRRSV infection is still unclear. Here, we discovered that the phosphorylation level of HMGB1 in threonine residues increased in PRRSV-infected cells. A site-directed mutagenesis study showed that HMGB1 phosphorylation at threonine-51 was associated with HMGB1 secretion induced by PRRSV infection. Co-immunoprecipitation (co-IP) of HMGB1 failed to precipitate PKC-delta, but interestingly, mass spectrometry analysis of the HMGB1 co-IP product showed that PRRSV infection enhanced HMGB1 binding to ribosomal protein S3 (RPS3), which has various extra-ribosomal functions. The silencing of RPS3 by siRNA blocked HMGB1 secretion induced by PRRSV infection. Moreover, the phosphorylation of HMGB1 at threonine-51 was correlated with the interaction between HMGB1 and RPS3. In vivo, PRRSV infection also increased RPS3 levels and nuclear accumulation in pulmonary alveolar macrophages. These results demonstrate that PRRSV may induce HMGB1 phosphorylation at threonine-51 and increase its interaction with RPS3 to enhance HMGB1 secretion. This finding provides insights into the pathogenesis of PRRSV infection.     

鹦鹉热衣原体肺炎 28例临床特征分析

目的分析经宏基因组二代测序技术(metagenopmic next generation sequencing,mNGS)确诊的 28例鹦鹉热衣原体肺炎病人的临床特点。方法回顾性分析 2019年 10月 1日至 2022年 4月 1日长沙市第一医院采用 mNGS诊断的 28例鹦鹉热衣原体肺炎病人的诊治情况。结果 28例病人中 10例为女性, 18例为男性,中位年龄 60岁; 27例病人有明确禽类接触史, 1例无。重症病例占 32.1%,多为有慢性阻塞性肺疾病(COPD)糖尿病、高血压、冠心病或尿毒症等基础疾病病人。临床表现包括发热(100%)、畏寒(28.6%)、咳嗽、咳痰(71.4%)、气促(53.6%)。、外周血中白细胞总数多在正常范围, 96.4%的病人中性粒细胞比例增高、淋巴细胞比例降低; 96.4%病人 PCT升高,所检测病人中 ESR和 CRP升高者达 100%;分别有 71.4%和 50%病人乳酸脱氢酶和肌酸激酶增高;有 82.1%的病人谷草转氨酶增高,有 78.6%的病人白蛋白降低。胸部 CT表现单侧病变 25例、其中右肺病变 19例,常见影像改变是斑片状阴影(78.6%)、大片实变(21.4%),26例伴有胸腔积液。治疗情况:单用氟喹诺酮类(莫西沙星或者左氧氟沙星)治疗 9例,单用多西环素治疗 2例;联合用药 13例,其中青霉素类(哌拉西林他唑巴坦或头孢哌酮舒巴坦钠)联用喹诺酮类有 10例,青霉素类联合多西环素 3例。有 2例病人初始选择青霉素类加喹诺酮类药物治疗无效,改用多西环素或联用多西环素后症状缓解。 28例病人均预后良好,无死亡病例。结论鹦鹉热衣原体肺炎病人的职业史、临床表现、实验室检查结果及肺部 CT具有一定的特点;临床对可疑病例应尽早行 mNGS检测,快速过渡到精准治疗,能明显改善预后。