调神止痛法针刺治疗枕神经痛疗效观察

目的观察调神止痛法针刺治疗枕神经痛的疗效。方法以调神止痛法针刺治疗枕神经痛30例,并与常规针刺法治疗30例进行对照,观察两组疗效及对疼痛指数的影响。结果与结论观察组总有效率为93.3%,对照组为76.7%,观察组疗效明显高于对照组(P<0.05);观察组止痛效果优于对照组(P<0.05)。     

解郁透达化气法治疗肝郁血结型失眠症105例临床分析

目的探讨解郁透达化气法治疗肝郁血结所致失眠的临床疗效。方法对105例患者采用解郁透达化气法辨证论治,经2至4周治疗后观察临床疗效。结果105例患者中治愈11例,好转84例,未愈7例,总有效率达90.48%。结论解郁透达化气法治疗肝郁血结的失眠疗效良好。     

Berberine inhibits IFN-γ signaling pathway in DSS-induced ulcerative colitis

AimsThe potential signaling pathways and core genes in ulcerative colitis (UC) were investigated in this study. Furthermore, potential mechanisms of BBR in treating UC were also explored.MethodsExpression profiling by array of UC patients were obtained from Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were determined with the differential analysis. The biological functions of DEGs were analyzed through the Database for Annotation, Visualization and Integrated Discovery (DAVID). The Gene Set Enrichment Analysis (GSEA) was applied to analyze the expression differences between two different phenotype sample sets. Dextran sulfate sodium (DSS) was applied to establish UC model of mice and lipopolysaccharide (LPS) was utilized to induce inflammatory damage of NCM460 cells. Therapeutic effects of berberine (BBR) on disease performance, pathologic changes and serum supernatant indices were analyzed in vivo. To further investigate the potential mechanisms of BBR in treating UC, the expression of genes and proteins in vivo and in vitro were examined by RT-qPCR, immunohistochemical staining and western blotting.ResultsImmune-inflammatory genes were identified and up-regulated significantly in UC patients. In addition, IFN-γ signaling pathway and its core genes were significantly up-regulated in the phenotype of UC. All disease performance and the pathologic changes of UC in mice were evidently ameliorated by BBR treatment. The pro-inflammatory cytokines of serum, including CXCL9, CXCL1, IL-17 and TNF-α, in UC mice were significantly reduced by treatment of BBR. In terms of mechanisms of BBR in treating UC, the pro-inflammatory and immune-related genes, encoding IFN-γ, IRF8, NF-κB and TNF-α decreased significantly in UC mice followed by BBR treatment. Meanwhile, the expression of IFN-γ and its initiated targets, including IRF8, Ifit1, Ifit3, IRF1, were suppressed significantly by BBR treatment in vivo. The blocking of IFN-γ in vitro led to the silence of IFN-γ signaling pathway after exposure to BBR. Furthermore, the blocking of IFN-γ in vitro led to the silence of IFN-γ signaling pathway after exposure to BBR.ConclusionBBR holds anti-inflammatory activity and can treat UC effectively. The anti-inflammatory property of BBR is tightly related to the suppression of IFN-γ signaling pathway, which is crucial in immune-inflammatory responses of the colon mucosa.     

Surgical management strategy for leiomyosarcoma of Zone I-II inferior vena cava: A case series

Objectives:Leiomyosarcoma of inferior vena cava (IVC) is a rare clinical entity with severe vascular involvement. Surgical management of leiomyosarcoma is still challenging.Methods:This a retrospective study of consecutive patients referred to our hospital from January 2017 to June 2019. Depending on the anatomical site of affected IVC, leiomyosarcomas were categorized into zone I-II. The clinical data including baseline information, surgical parameters, peri-operative management, short- and mid-term outcomes were observed.Results:Four patients with leiomyosarcoma of zone I-III underwent radical resection without intraoperative mortality. Prosthetic grafts were interpositioned in all patients to instruct vena cava. Renal vein reconstruction was perfumed in two patients due to involvement to renal veins. Median blood loss was 450 mL (200–600 mL), median operative time was 215 minutes (150–240 minutes). No Clavien-Dindo IIIa or higher complication was observed. No organ dysfunction and recurrence were observed with median follow-up of 25.5 months.Conclusions:Curative resection of zone I-II leiomyosarcoma is associated with longer survival in selected cases, en-bloc resection with complex vascular reconstruction could be considered.     

IL-1 receptor-associated kinase 1 participates in the modulation of the NLRP3 inflammasome by tumor-associated macrophages in hepatocellular carcinoma

BackgroundHepatocellular carcinomas (HCCs) occur frequently in the digestive system and are associated with high mortality. This current study examined the regulatory relationship between interleukin (IL)-1 receptor-associated kinase 1 (IRAK1), NLR family pyrin domain-containing 3 (NLRP3) inflammasomes, and tumor-associated macrophages (TAMs) in the growth and metastasis of HCC.MethodsThe expression of IRAK1 and NLRP3 was assessed in tissues and cells via quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis. Immunohistology was performed to detect the macrophage markers CD68, CD163, and CD168 in tumor tissues. Small interfering (si)RNA targeting IRAK1 (si-IRAK1) was designed to silence IRAK1 expression. Following si-IRAK1 transfection and/or co-culture with TAMs, HCC cell viability, proliferation, migration, and invasion, as well as the expression of NLRP3 and pro-inflammatory cytokines IL-1 β, IL-18, and monocyte chemotactic protein 1 (MCP-1) were assessed.ResultsHCC tissues showed elevated expression of IRAK1 and NLRP3, as well as increased expression of the macrophage markers CD68, CD163, and CD168, compared to adjacent healthy tissues. Silencing of IRAK1 expression in HepG2 and Huh7 cells resulted in suppression of cell proliferation, migration, and invasion, and also reduced expression of NLRP3 and the pro-inflammatory cytokines IL-1β, IL-18, and MCP-1. Moreover, TAMs promoted HepG2 and Huh7 cell proliferation, migration, and invasion, and elevated the expression of NLRP3, IL-1β, IL-18, and MCP-1. Furthermore, IRAK1 silencing reversed the effects of TAMs on HepG2 and Huh7 cells.ConclusionsThe expression of IRAK1 was associated with HCC growth and metastasis, as well as NLRP3 inflammasome activation. The ability of TAMs to promote HCC growth and metastasis may be activated by NLRP3 inflammasomes and regulated by IRAK1.     

急性缺氧条件下氰化钠中毒对大鼠脑组织能量代谢的影响

目的探讨急性高原缺氧条件下氰化钠中毒对大鼠脑组织能量代谢的影响。方法雄性sD大鼠,分为平原组和高原组。平原组动物在本地常规实验室内处理。高原组动物放置于模拟4000m海拔高度的低压舱内3d后开始实验。为大鼠腹腔注射氰化钠（NaCN）3．6mg／kg染毒,于0、0．5、1、2、4、6h6个时相点麻醉后断头取脑。以干湿质量法测定脑组织含水量,伊文思蓝法检测脑组织血管通透性,高效液相色谱（high performance liquid chromatography,HPLC）法测定大鼠脑纹状体和海马组织腺苷三磷酸（adenosine triphosphate,ATP）、腺苷二磷酸（adenosine diphosphate,ADP）和腺苷-磷酸（adenosine monophosphate,AMP）含量。结果与平原组比较,高原缺氧环境氰化钠中毒大鼠脑组织含水量增加,纹状体和海马组织ATP和ADP含量减少,AMP含量增加。结论高原缺氧可导致大鼠脑组织腺苷酸能量代谢障碍,缺氧条件下氰化钠中毒可进一步加重脑组织能量代谢障碍,同时脑水肿也进一步加重。     

特发性室性心动过速的导管射频消融治疗效果

目的 评价导管射频消融(radiofrequency catheter ablation,RFCA)对特发性室速(idiopathic ventricular tachy-cardia,IVT)的治疗效果以及心电图对消融靶点的定位价值.方法 对126例特发性室速患者的电生理资料及RFCA治疗效果进行回顾性分析.多数患者采用激动顺序标测,射频能量采用温控法(60～65℃).结果 126例患者中右室流出道(right ventricular outflow tract,RVOT)IVT 62例、左后间隔IVT 43例,其他部位IVT 21例.本组RFCA的总成功率为87.3%,RVOT-IVT和左后间隔IVT的成功率显著高于其他部位IVT(96.8%和90.7% vs 52.4%,P<0.05).本组8例患者存在发作性晕厥(发作的R-R间期230～260 ms),其中4例合并房室结双径路、2例合并隐匿性房室旁道、2例合并多形性室速.随访6个月至10年,复发9例(复发率为8.2%),均再次RFCA成功.合并心动过速性心肌病者6例,术后3个月心脏大小与心功能均恢复正常.结论 采用激动顺序标测法RFCA治疗IVT成功率高;室速发作时体表心电图对绝大多数室速起源具有定位价值;部分室速可能合并房室旁道或房室结双径路.     

儿童重症监护室真菌肺炎11例临床分析

目的:探讨儿童真菌肺炎的临床易感因素及预防、治疗措施.方法:回顾性分析重庆医科大学附属儿童医院ICU 2007年6月～2008年4月11例确诊为真菌肺炎儿童患者的临床表现、影像学表现、实验室检查、治疗及转归.结果:真菌肺炎好发于年龄小的婴幼儿,病原菌以白色念珠菌多见.9例(占81.8%)合并有先天性心脏病,11例确诊前均有长时间静脉使用广谱抗生素及气管插管机械通气史.所有病例都有咳嗽、咯痰,其中10例有不同程度发热.该组患儿均使用两性霉素B治疗.11例患儿中死亡2例(18.2%),放弃1例(9.1%),治愈8例(72.7%).结论:念珠菌是儿童深部真菌感染的常见病原菌,其发病率和预后与宿主因素、抗生素的使用和抗真菌治疗密切相关.     

MRI基本征象结合DWI参数鉴别非典型脑膜瘤和间变型脑膜瘤

目的 通过MRI基本征象结合扩散加权成像(diffusion-weighted imaging,DWI)参数鉴别非典型脑膜瘤(atypical meningioma,AM)和间变型脑膜瘤(anaplastic meningioma,AAM),提高术前诊断准确度.材料与方法 回顾性分析经病理证实的44例AM患者和16例A...