健康教育及心理护理干预对肥胖型多囊卵巢综合征患者生活方式的影响研究

目的探讨健康教育及心理护理干预对肥胖型多囊卵巢综合征(PCOS)患者生活方式的影响。方法将100例肥胖型PCOS患者按照抽签方法随机均分为对照组与观察组各50例,对照组采用常规护理方法,观察组在此基础上采用健康教育及心理护理干预方法,比较2组护理干预前后生活方式的转变情况、生殖内分泌与脂肪代谢相关指标变化情况、心理状况变化情况以及护理干预后生活质量评分。结果 2组护理干预后生活方式(食用低脂食品、加强运动、禁烟/酒、自我疗养、合理用药、自测体重)较护理前均显著改善,且观察组改善程度大于对照组(P0.05);对照组护理干预前后生殖内分泌及脂肪代谢的相关指标(LH、T、LH/FSH、BMI、FINS及TG)水平差异均无统计学意义(P0.05),观察组护理干预前后上述指标差异均具有统计学意义(P0.05);2组护理干预前后SAS及SDS评分差异均具有统计学意义(P0.05),且护理干预后2组上述评分差异也均具有统计学意义(P0.05);根据SF-36生活质量评价标准,观察组生活质量评分显著高于对照组,差异具有统计学意义(P0.05)。结论与常规护理干预方式相比,健康教育及心理护理干预可改善肥胖型PCOS患者生活方式、心理状况及生活质量,应进行推广应用。     

类风湿性关节炎患者外周血HFLC检测的临床意义

目的探讨外周血高荧光强度淋巴细胞(HFLC)与类风湿性关节炎(RA)发作的关系。方法选取2013年3月至2014年7月在武警后勤学院附属医院就诊的RA患者91例,含活动期患者(ARA)39例,静止期患者(SRA)52例,并选择同期114例该院查体患者作为健康对照组(HC),采用Sysmex XE-5000检测外周血HFLC的两参数绝对计数(HFLC#)和占白细胞百分比(HFLC%),采用SIMENS BNII全自动免疫散射比浊仪检测C反应蛋白(CRP)、血清免疫球蛋白(IgA、IgG、IgM)、类风湿因子(RF)、抗链O(ASO)、补体(C3、C4)。结果 HC组[0.00(0.00~1.00)×109/L]和SRA组[0.00(0.00~1.00)×109/L]间HFLC差异无统计学意义(P0.05),但均明显低于ARA组[1.00(0.00~2.00)×109/L](P0.05)。ARA组HFLC%[0.10%(0.00%~0.22%)]明显高于HC组[0.00%(0.00%~0.14%)](P0.05)。ARA组中HFLC#与IgE、CRP为正相关(P0.05),HFLC%与RF正相关(P0.05)。HFLC#与HFLC%的ROC曲线下面积分别为0.637(P0.05)、0.632(P0.05),当HFLC%界值为0.14%时,灵敏度为46.15%,特异度为78.85%。结论 HFLC%与HFLC#可以反映RA的发作,虽然其诊断效能不高,但是由于这些参数获取经济、便捷,可以为RA发作的诊断提供新的观察指标,为指导下一步的检查和治疗提供帮助。     

Insulin suppresses IKs (KCNQ1/KCNE1) currents,which require β-subunit KCNE1

Abnormal QT prolongation in diabetic patients has become a clinical problem because it increases the risk of lethal ventricular arrhythmia. In an animal model of type 1 diabetes mellitus, several ion currents, including the slowly activating delayed rectifier potassium current (I_Ks), are altered. The I_Ks channel is composed of KCNQ1 and KCNE1 subunits, whose genetic mutations are well known to cause long QT syndrome. Although insulin is known to affect many physiological and pathophysiological events in the heart, acute effects of insulin on cardiac ion channels are poorly understood at present. This study was designed to investigate direct electrophysiological effects of insulin on I_Ks (KCNQ1/KCNE1) currents. KCNQ1 and KCNE1 were co-expressed in Xenopus oocytes, and whole cell currents were measured by a two-microelectrode voltage-clamp method. Acute application of insulin suppressed the KCNQ1/KCNE1 currents and phosphorylated Akt and extracellular signal-regulated kinase (ERK), the two major downstream effectors, in a concentration-dependent manner. Wortmannin (10^?6 M), a phosphoinositide 3-kinase (PI3K) inhibitor, attenuated the suppression of the currents and phosphorylation of Akt by insulin, whereas U0126 (10^?5 M), a mitogen-activated protein kinase kinase (MEK) inhibitor, had no effect on insulin-induced suppression of the currents. In addition, insulin had little effect on KCNQ1 currents without KCNE1, which indicated an essential role of KCNE1 in the acute suppressive effects of insulin. Mutagenesis studies revealed amino acid residues 111–118 within the distal third C-terminus of KCNE1 as an important region. Insulin has direct electrophysiological effects on I_Ks currents, which may affect cardiac excitability.     

聚乙二醇干扰素治疗低水平HBsAg慢性乙肝患者疗效

目的 分析聚乙二醇干扰素（PEg-IFNα-2a、PEg-IFNα-2b）治疗低水平HBsAg慢性乙型病毒性肝炎（CHB）的临床疗效。方法 采用回顾性研究,选取2017年1月1日—2019年1月1日于北京大学深圳医院感染性疾病科门诊就诊,HBsAg<500 IU/mL且开始使用聚乙二醇干扰素治疗的慢性乙型病毒性肝炎患者,分析在治疗第24周、第48周HBsAg清除率及相关疗效影响因素。结果 共纳入88例患者,在0~48周达到HBsAg清除有45例,其中应答组与未应答组性别、HBsAg基线水平差异有统计学意义（P<0.05）;达到HBsAg清除的45例中,24例使用PEg-IFNα-2a治疗,21例使用PEg-IFNα-2b治疗,两组HBsAg清除率差异无统计学意义（P=0.195）;治疗第24周时新增HBsAg清除患者25例,经多因素分析,基线HBsAg水平差异有统计学意义（OR=0.991,95%CI=0.983~1.000,P=0.042）;治疗第48周时新增HBsAg清除患者10例,经多因素分析,第24周HBsAg下降率有统计学意义（OR=1.063,95%CI=1.077~1.123,P=0.027）。结论 聚乙二醇干扰素治疗HBsAg<500 IU/mL慢性乙型病毒性肝炎患者HBsAg 清除率明显高于基线水平高者;PEg-IFNα-2a、PEg-IFNα-2b疗效无差异。治疗过程中第24周HBsAg下降幅度可预测治疗48周时HBsAg清除率。     

Analysis of the contribution of nasopharyngeal epithelial cancer cells to the induction of a local inflammatory response

Purpose

We investigated the local contribution of nasopharyngeal epithelial cancer cells to the inflammatory process.

Materials and methods

THP-1 monocytes were treated with phorbol 12-myristate 13-acetate to induce the production of differentiated macrophages (D-THP-1), which were subsequently activated by lipopolysaccharide (LPS) (10?ng/ml). The production of pro-inflammatory cytokines in D-THP-1 cells was detected by ELISA and qRT-PCR. The effects of conditioned media harvested from LPS-treated D-THP-1 cells were investigated with regard to cell proliferation (MTT), production of pro-inflammatory cytokines (ELISA) and activation of NF-??B and STAT3 (western blot) in the nasopharyngeal epithelial cancer cell line 5?C8F.

Results

LPS induced the production of the pro-inflammatory cytokines TNF-?? (875.1?±?68.31?pg/ml), IL-6 (42.2?±?5.32?pg/ml), IL-1?? (9.6?±?1.34?pg/ml) and IL-8 (19.3?±?3.47?pg/ml) in D-THP-1 cells significantly (P?P?P?P?Conclusions Nasopharyngeal epithelial cancer cells may play a significant role in maintaining and amplifying the inflammation process via activation of NF-??B and STAT3 pathway and through the local production of pro-inflammatory cytokines, which recruit and activate additional immune cells in the nasopharyngeal path and promote tumour progression.     

Melatonin prevents human pancreatic carcinoma cell PANC-1-induced human umbilical vein endothelial cell proliferation and migration by inhibiting vascular endothelial growth factor expression

Abstract: Melatonin is an important natural oncostatic agent, and our previous studies have found its inhibitory action on tumor angiogenesis, but the mechanism remains unclear. It is well known that vascular endothelial growth factor (VEGF) plays key roles in tumor angiogenesis and has become an important target for antitumor therapy. Pancreatic cancer is a representative of the most highly vascularized and angiogenic solid tumors, which responds poorly to chemotherapy and radiation. Thus, seeking new treatment strategies targeting which have anti‐angiogenic capability is urgent in clinical practice. In this study, a co‐culture system between human umbilical vein endothelial cells (HUVECs) and pancreatic carcinoma cells (PANC‐1) was used to investigate the direct effect of melatonin on the tumor angiogenesis and its possible action on VEGF expression. We found HUVECs exhibited an increased cell proliferation and cell migration when co‐cultured with PANC‐1 cells, but the process was prevented when melatonin added to the incubation medium. Melatonin at concentrations of 1 μm and 1 mm inhibited the cell proliferation and migration of HUVECs and also decreased both the VEGF protein secreted to the cultured medium and the protein produced by the PANC‐1 cells. In addition, the VEGF mRNA expression was also down‐regulated by melatonin. Taken together, our present study shows that melatonin at pharmacological concentrations inhibited the elevated cell proliferation and cell migration of HUVECs stimulated by co‐culturing them with PANC‐1 cells; this was associated with a suppression of VEGF expression in PANC‐1 cells.     

质子泵抑制剂治疗胃食管反流性咽喉炎的Meta分析

目的探讨质子泵抑制剂对胃食管反流性咽喉炎的治疗作用及其安全性,为胃食管反流性咽喉炎的临床治疗提供指导依据。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge databases、VIP、CNKI、CBM和WANFANG数据库,查找所有探讨质子泵抑制剂对胃食管反流性咽喉炎治疗作用的随机对照试验,检索时限均为建库至2012年3月2日。同时手检纳入文献的参考文献。按纳入排除标准由3名研究者独立进行RCT的筛选、资料提取和质量评价后,采用RevMan 5.1软件进行Meta分析,并采用GRADE系统进行证据质量评价。结果共纳入8个研究,591例患者。Meta分析结果显示:质子泵抑制剂治疗胃食管反流性咽喉炎的总体有效率[OR=7.79,95%CI(2.20,27.51),P<0.05]高于对照组,咳嗽症状缓解效率[OR=2.29,95%CI(0.83,6.35),P>0.05],与对照组比较差异不显著,内镜检查好转率[OR=18.83,95%CI(1.86,190.60),P<0.05],高于对照组。结论质子泵抑制剂对胃食管反流性咽喉炎的治疗作用较对照组明显;但因纳入研究较少、质量参差不齐、样本含量小、各研究方法变异性大,建议临床上审慎选择使用;需要更多高质量、大样本、多中心的随机对照试验进一步论证。