阳中隐阴法用于萎缩性胃炎治疗的临床研究

目的 观察针灸治疗萎缩性胃炎的临床疗效。方法 取中脘、足三里穴，用了蝇隐阴法治疗38例萎缩性胃炎患者，评定疗效，并与药物组进行疗效比较。结果 针灸组与药物组临床综合疗效比较，有效率分别为86.84%和84.21%，而胃镜及病理活检综合疗效比较，有效率分别为81.58%和84.21%，两者统计学处理P＞0.05，临床无显著性差异。结论 表明针灸治疗萎缩性胃炎具有与药物相同的治疗效果。     

蓝桉果实化学成分的研究

目的 :研究蓝桉Eucalyptus globulus果实的化学成分。 方法 :应用硅胶柱层析、SephadexLH-20凝胶柱层析等方法进行分离纯化 ,根据理化性质和光谱数据等进行结构鉴定。结果 :从蓝桉果实中分离得到 12个化合物 ,鉴定了其中 5个化合物 :桦木酮酸Ⅰ ,白桦脂酸Ⅱ ,熊果酸Ⅲ ,2α ,3β-二羟基乌苏酸Ⅳ。 结论 :化合物I ,Ⅱ ,Ⅲ ,Ⅳ均为首次从该植物中分离得到。     

生脉饮口服液制备工艺改进

通过制备工艺改进,解决了生脉饮口了液灭菌放后产生沉淀的问题,经稳定性考察,ＴＬＣ和含量测定分析,改进工艺与药典工艺制备的生脉饮口服液成分基本相同。     

人参总皂甙增加白血病细胞对化疗药物的敏感性

目的：探讨人参总皂甙（ＴＳＰＧ）对急性髓细胞白血病（ＡＭＬ）化疗药物敏感性的作用。方法：采用白血病祖细胞集落形成（ＣＦＵ－ＡＭＬ）药敏试验法。选用４种化疗药物：高三尖杉酯碱（ＨＨｒ）、阿糖胞苷（Ａｒａ）、阿霉素（Ａｄｒ）和足叶乙甙（Ｖｐ－１６）。结果：ＴＳＰＧ刺激ＣＦＵ－ＡＭＬ在体外增殖，集落数提高３７．９８％，使化疗药物对ＣＦＵ－ＡＭＬ的抑制率从原先的３０．４％￣４７．４％分别提高到５１．２％￣     

全子宫切除术中腰麻联合硬膜外的比较研究

目的：比较腰麻醉联合硬膜外麻醉与连续硬膜外麻醉在全子宫切除手术中的麻醉效果及其对血流动力学的方法：选择期行全子宫切除手术患者１５８例,随机分为两组,Ａ组７８例,行腰麻联合硬膜外麻醉：Ｂ组８０例,行单纯连续硬膜外麻醉,结果：腰麻联合硬膜外麻醉较单纯连续起效时间快,阻滞范围广,肌肉松驰完善,局麻药用量小,呈显著差异;二者在初次用药后１ｈ内的低血压发生率、血压波动以及麻黄碱用量等无明显差异,但血压下降最     

Targeted Disruption of NF1 in Osteocytes Increases FGF23 and Osteoid With Osteomalacia‐like Bone Phenotype

Neurofibromatosis type 1 (NF1, OMIM 162200), caused by NF1 gene mutations, exhibits multi‐system abnormalities, including skeletal deformities in humans. Osteocytes play critical roles in controlling bone modeling and remodeling. However, the role of neurofibromin, the protein product of the NF1 gene, in osteocytes is largely unknown. This study investigated the role of neurofibromin in osteocytes by disrupting Nf1 under the Dmp1‐promoter. The conditional knockout (Nf1 cKO) mice displayed serum profile of a metabolic bone disorder with an osteomalacia‐like bone phenotype. Serum FGF23 levels were 4 times increased in cKO mice compared with age‐matched controls. In addition, calcium‐phosphorus metabolism was significantly altered (calcium reduced; phosphorus reduced; parathyroid hormone [PTH] increased; 1,25(OH)₂D decreased). Bone histomorphometry showed dramatically increased osteoid parameters, including osteoid volume, surface, and thickness. Dynamic bone histomorphometry revealed reduced bone formation rate and mineral apposition rate in the cKO mice. TRAP staining showed a reduced osteoclast number. Micro‐CT demonstrated thinner and porous cortical bones in the cKO mice, in which osteocyte dendrites were disorganized as assessed by electron microscopy. Interestingly, the cKO mice exhibited spontaneous fractures in long bones, as found in NF1 patients. Mechanical testing of femora revealed significantly reduced maximum force and stiffness. Immunohistochemistry showed significantly increased FGF23 protein in the cKO bones. Moreover, primary osteocytes from cKO femora showed about eightfold increase in FGF23 mRNA levels compared with control cells. The upregulation of FGF23 was specifically and significantly inhibited by PI3K inhibitor Ly294002, indicating upregulation of FGF23 through PI3K in Nf1‐deficient osteocytes. Taken together, these results indicate that Nf1 deficiency in osteocytes dramatically increases FGF23 production and causes a mineralization defect (ie, hyperosteoidosis) via the alteration of calcium‐phosphorus metabolism. This study demonstrates critical roles of neurofibromin in osteocytes for osteoid mineralization. © 2017 American Society for Bone and Mineral Research.     

Enhanced wound‐healing performance of a phyto‐polysaccharide‐enriched dressing – a preclinical small and large animal study

Alginate is a natural rich anionic polysaccharide (APS), commonly available as calcium alginate (CAPS). It can maintain a physiologically moist microenvironment, which minimises bacterial infection and facilitates wound healing at a wound site. Patients with burn injuries suffer from pain and an inflammatory response. In this study, we evaluated the CAPS dressing and traditional dressing containing carboxymethyl cellulose (CMC) for wound healing and scar tissue formation in a burn model of rat and swine. In our pilot study of a burn rat model to evaluate inflammatory response and wound healing, we found that the monocyte chemoattractant protein (MCP)‐1 and transforming growth factor (TGF)‐β were up‐regulated in the CAPS treatment group. Next, the burn swine models tested positive for MCP‐1 in a Gram‐positive bacterial infection, and there was overproduction of TGF‐β during the burn wound healing process. Rats were monitored daily for 1 week for cytokine assay and sacrificed on day 28 post‐burn injury. The swine were monitored over 6 weeks. We further examined the pain and related factors and inflammatory cytokine expression in a rodent burns model monitored everyday for 7 days post‐burn. Our results revealed that the efficacy of the dressing containing CAPS for wound repair post‐burn was better than the CMC dressing with respect to natural wound healing and scar formation. The polysaccharide‐enriched dressing exerted an antimicrobial effect on burn wounds, regulated the inflammatory response and stimulated anti‐inflammatory cytokine release. However, one pain assessment method showed no significant difference in the reduction in levels of adenosine triphosphate in serum of rats after wound dressing in either the CAPS or CMC group. In conclusion, a polysaccharide‐enriched dressing outperformed a traditional dressing in reducing wound size, minimising hypertrophic scar formation, regulating cytokines and maximising antimicrobial effects.     

Adjuvant gemcitabine monotherapy for resectable perihilar cholangiocarcinoma with lymph node involvement: a propensity score matching analysis

Purpose

The aim of this study was to evaluate the efficacy of adjuvant gemcitabine monotherapy following resection for perihilar cholangiocarcinoma with lymph node involvement.

Methods

We performed a retrospective analysis of 180 patients undergoing resection for perihilar cholangiocarcinoma with lymph node involvement between 2001 and 2012. The patients were divided into two groups according to the presence (n = 67) or absence (n = 113) of adjuvant gemcitabine monotherapy. Univariate and multivariate analyses were performed followed by a propensity score matching analysis to adjust for the differences in the baseline characteristics of the groups.

Results

The overall survival rates after surgery and the median survival times in patients who were treated with adjuvant chemotherapy were significantly longer than those who were treated without adjuvant chemotherapy (32.9 vs. 15.0 % at 5 years, 37 vs. 20 months, P = 0.001). A multivariate analysis indicated that adjuvant chemotherapy, a residual microscopic tumor, and pathological T stage were independent prognostic factors for survival. After two new cohorts of 32 patients were generated following 1:1 propensity score matching, the overall survival rate in the adjuvant chemotherapy group was found to be significantly longer than that in the surgery alone group (43.2 vs. 15.6 % at 5 years, P = 0.001).

Conclusion

Adjuvant gemcitabine monotherapy may improve survival in node-positive perihilar cholangiocarcinoma patients.

     

浦东地区老年护理病区护工现状调查和对策建议

目的:了解和分析浦东地区各级医疗机构老年护理病区护工管理现状和存在问题,为建立规范的护工管理模式提出建议.方法:采用自行设计的问卷调查表和护工访谈提纲,对35家医疗机构老年护理病区的护工负责人和护工进行调查和访谈.结果:护工中小学及以下学历占62.6％;50岁及以上占55.3％;外省市户籍占73.7％;对自身工作满意度低,表示满意的仅有28.3％;仅有14.3％的护工由护理部负责专业知识的培训.护工的管理制度及相关专业化知识培训也较为匮乏.结论:应完善护工管理体制,建立合理监督机构,加强监督和护工培训体系的建设,规范职业道德教育和专业知识培训.     

Docosahexaenoic Acid Attenuated Experimental Chronic Colitis in Interleukin 10–Deficient Mice by Enhancing Autophagy Through Inhibition of the mTOR Pathway

Background: In the battle against Crohn's disease, autophagy stimulation is a promising therapeutic option—one both new and newly rediscovered. In experimental models, docosahexaenoic acid (DHA)—a long‐chain polyunsaturated fatty acid—has been demonstrated to be useful in the treatment of inflammatory bowel disease through inhibition of the nuclear factor‐κB pathway. However, the impact of DHA on autophagy in the colon remains unclear. Methods: Mice were divided into 3 groups: wild type (placebo), the interleukin 10 knockout group (IL‐10^?/?, placebo), and the DHA group (IL‐10^?/?, DHA). DHA was administered to IL‐10^?/? mice by gavage at a dosage of 35.5 mg/kg/d for 2 weeks. The severity of colitis, expression of proinflammatory cytokines, expression/distribution of LC3B, and mTOR signaling pathway were evaluated in the proximal colon tissues collected from all mice at the end of the experiment. Results: DHA administration ameliorated experimental colitis in the IL‐10^?/? mice, as demonstrated by decreased proinflammatory cytokines (TNF‐α and IFN‐γ), reduced infiltration of inflammatory cells, and lowered histologic scores of the proximal colon mucosa. Moreover, in the DHA‐treated mice, enhanced autophagy was observed to be associated with (1) increased expression and restoration of the distribution integrity of LC3B in the colon and (2) inhibition of the mTOR signaling pathway. Conclusion: This study showed that DHA therapy could attenuate experimental chronic colitis in IL‐10^?/? mice by triggering autophagy via inhibition of the mTOR pathway.