黄蜀葵总黄酮抗脑卒中后抑郁作用的研究

目的研究黄蜀葵总黄酮(TFA)抗脑卒中后抑郁(PSD)的作用。方法采用线栓法制备局灶性脑缺血大鼠模型,在此基础上综合孤养、应激处理复制PSD大鼠模型。观察TFA对PSD大鼠开野行为、血液流变学以及脑组织脂质过氧化的影响。结果TFA可增加PSD大鼠的水平与垂直运动得分;抑制PSD大鼠各切变率下全血黏度、血浆黏度的升高,提高红细胞的变形性;提高脑组织中超氧化物岐化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)的活性,降低丙二醛(MDA)含量。结论TFA具有抗PSD作用,其机制可能与改善血液流变学、抗脂质过氧化作用有关。     

不同检测系统间误差的分析评价

目的评价我室2台IMMAGE全自动免疫分析仪之间的差异,确保使用2台仪器进行特种蛋白测定时结果解释的一致性。方法参照美国临床实验室标准化委员会(NCCLS)文件EP9-A2进行整个比对过程,比对项目为我室常规开展的9种特种蛋白。结果2台仪器9个项目的测定结果相关系数(r)均>0.975,在医学决定水平处(XC)的真实偏差即系统误差(Bc)均<允许误差(Ea)。结论2台仪器间差异在临床可接受范围内,可向临床提供准确一致的报告。     

Decitabine improves patient outcomes in myelodysplastic syndromes: results of a phase III randomized study

BACKGROUND: Aberrant DNA methylation, which results in leukemogenesis, is frequent in patients with myelodysplastic syndromes (MDS) and is a potential target for pharmacologic therapy. Decitabine indirectly depletes methylcytosine and causes hypomethylation of target gene promoters. METHODS: A total of 170 patients with MDS were randomized to receive either decitabine at a dose of 15 mg/m2 given intravenously over 3 hours every 8 hours for 3 days (at a dose of 135 mg/m2 per course) and repeated every 6 weeks, or best supportive care. Response was assessed using the International Working Group criteria and required that response criteria be met for at least 8 weeks. RESULTS: Patients who were treated with decitabine achieved a significantly higher overall response rate (17%), including 9% complete responses, compared with supportive care (0%) (P < .001). An additional 12 patients who were treated with decitabine (13%) achieved hematologic improvement. Responses were durable (median, 10.3 mos) and were associated with transfusion independence. Patients treated with decitabine had a trend toward a longer median time to acute myelogenous leukemia (AML) progression or death compared with patients who received supportive care alone (all patients, 12.1 mos vs. 7.8 mos [P = 0.16]; those with International Prognostic Scoring System intermediate-2/high-risk disease, 12.0 mos vs. 6.8 mos [P = 0.03]; those with de novo disease, 12.6 mos vs. 9.4 mos [P = 0.04]; and treatment-naive patients, 12.3 mos vs. 7.3 mos [P = 0.08]). CONCLUSIONS: Decitabine was found to be clinically effective in the treatment of patients with MDS, provided durable responses, and improved time to AML transformation or death. The duration of decitabine therapy may improve these results further.     

小儿消化性溃疡特点及早期诊断(附47例分析)

报告小儿消化性溃疡47例。该病近年有逐渐增多的趋势。早期症状模糊,仅20％有典型的饥饿疼或夜间疼,部分为脐周的疼痛;有的仅表现为贫血。并发症发生率高达87.2％,主要为消化道出血。症状不典型,儿童对病情叙说不清,医生对该病的认识模糊是早期误诊率高的原因。对早期诊断提出了建议,讨论了有关问题。     

脑外伤患者恢复期的注意障碍

目的探索脑外伤恢复期患者注意的改变及其特征.方法对42例大型医院神经外科住院治疗的脑外伤恢复期患者和42名正常人进行"2,7"划消测验和Strop测验.结果脑外伤患者在标准情况、不相关分心情况和相关分心情况下的划消速度明显低于正常对照组,而精确率无明显差异.进一步比较相关分心情况下划消速度的下降率显示脑外伤患者显著大于正常对照组.Stroop测验显示脑外伤患者读单色字时间、读色块时间和读彩色字颜色时间较正常对照组显著延长,但两组之间错误数无显著性差异.比较两组读彩色字颜色时间的延长率和读彩色字文字时间的延长率,脑外伤患者均显著大于对照组.结论脑外伤后患者的注意力下降.注意的分配受损,抗干扰能力下降,而选择注意相对完整.     

Topological disruption of high-order functional networks in cognitively preserved Parkinson's disease

Aims

This study aimed to characterize the topological alterations and classification performance of high-order functional connectivity (HOFC) networks in cognitively preserved patients with Parkinson's disease (PD), relative to low-order FC (LOFC) networks.

Methods

The topological metrics of the constructed networks (LOFC and HOFC) obtained from fifty-one cognitively normal patients with PD and 60 matched healthy control subjects were analyzed. The discriminative abilities were evaluated using machine learning approach.

Results

The HOFC networks in the PD group showed decreased segregation and integration. The normalized clustering coefficient and small-worldness in the HOFC networks were correlated to motor performance. The altered nodal centralities (distributed in the precuneus, putamen, lingual gyrus, supramarginal gyrus, motor area, postcentral gyrus and inferior occipital gyrus) and intermodular FC (frontoparietal and visual networks, sensorimotor and subcortical networks) were specific to HOFC networks. Several highly connected nodes (thalamus, paracentral lobule, calcarine fissure and precuneus) and improved classification performance were found based on HOFC profiles.

Conclusion

This study identified disrupted topology of functional interactions at a high level with extensive alterations in topological properties and improved differentiation ability in patients with PD prior to clinical symptoms of cognitive impairment, providing complementary insights into complex neurodegeneration in PD.     

稳定型心绞痛的中医证候分布及用药规律研究

目的：通过数据挖掘总结稳定型心绞痛的证候分布特点及组方用药规律。方法：搜索国家知识基础设施数据库（CNKI）、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、PubMed、Web of Science数据库从建库至2022年2月收录的有关中医药治疗稳定型心绞痛的相关文献,建立方药数据库,并对高频药物进行关联规则及系统聚类分析。结果：共纳入文献105篇,处方111首,涉及患者9 786例,涵盖中医证型21种,频次最高证型为气虚血瘀,共提取出7个病性证素和2个病位证素。涉及中药123味,共计使用频次1 162次,使用频次前5位的中药分别是丹参70次、川芎69次、甘草54次、黄芪53次、当归50次。前30味高频药物关联规则分析显示,支持度最高的前3位药对为川芎-当归、川芎-赤芍、川芎-红花,聚类分析得到4个药物核心组合。结论：稳定型心绞痛常见气虚血瘀、痰瘀互结、气滞血瘀证;病性证素以实性居多,常见血瘀、痰浊,虚性证素主要为气虚;用药主要以活血化瘀、理气通滞、化痰降浊、益气通脉为法,是现代中医治疗稳定型心绞痛的主导思想。     

皮肤T细胞淋巴瘤继发噬血细胞性淋巴组织细胞增多症7例临床分析

目的探讨皮肤T细胞淋巴瘤(CTCL)合并继发性噬血细胞性淋巴组织细胞增多症(sHLH)的临床及实验室特征。方法回顾性分析2016年6月至2021年10月武汉市第一医院血液内科收治的CTCL并拟诊sHLH患者, 按照HLH-2004标准和HScore评分对患者进行评估。结果 7例CTCL患者确诊合并sHLH, 分别为2例原发性皮肤γδT细胞淋巴瘤(PC-GDTCL), 3例皮肤结外NK/T细胞淋巴瘤(C-ENKTCL), 2例原发皮肤间变大细胞淋巴瘤(PC-ALCL)。7例患者均接受化疗, 6例死亡, 确诊CTCL合并sHLH后生存期14 ～ 60 d (中位生存期26.5 d)。2例检出HLH相关基因突变(PRF1、LYST突变), 2例PC-GDTCL患者分别检出淋巴瘤相关基因突变(KRAS、KMT2D和JAK3 、SAMHD1突变)。结论 CTCL合并sHLH临床进展迅速, 需早期诊断及干预, 初诊及病情进展时行骨穿检查及淋巴瘤、HLH相关基因突变检测有助于早期诊断。