沙棘酚类特征成分含量测定及其特征图谱质量表征关联分析研究

目的建立沙棘酚类特征成分含量测定及其酚类特征图谱质量表征关联分析方法,应用关联分析评价模式,以有效、精准地评价沙棘药材质量。方法采用二极管阵列检测器液相色谱法(HPLC-PDA)对11批沙棘药材中的酚类特征成分(原儿茶酸、鞣花酸、水仙苷、槲皮素、异鼠李素)进行含量测定,建立沙棘酚类特征图谱,基于特征图谱中特征峰的梳理及所属化学类型对11批沙棘药材进行质的表征,基于特征图谱中特征成分原儿茶酸、鞣花酸、水仙苷、槲皮素、异鼠李素及酚酸类(以原儿茶酸表征)、黄酮类(以水仙苷表征)的含量和峰面积分别对11批沙棘药材进行量的表征,并基于基准药材对11批沙棘药材质与量的表征结果进行关联性分析。结果原儿茶酸、鞣花酸、水仙苷、槲皮素、异鼠李素等特征成分均具有良好的线性关系,方法学考察符合定量要求。以批号7为基准药材,在沙棘酚类特征图谱中共含有18个特征峰,其中酚酸类成分特征峰3个,黄酮类成分特征峰15个,11批药材色谱图中均含有此18个特征峰。采用质量表征关联分析与评价模式,得出批号8、7、10、4、5、11、1特征成分含量总体较高,批号6、2、3、1、11与基准药材关联性最高,综合评价得出批号1、11、8、6、7优良度居前。结论建立的沙棘酚类特征成分含量测定方法简便、准确,构建的沙棘酚类特征图谱质量表征关联分析模式用于分析沙棘药材质量与应用有效性,可有效精准地评价沙棘质量。     

三维超声对宫腔粘连的诊断价值及基于冠状面成像评分系统的初探

目的 评价三维超声对宫腔粘连诊断的准确性,初步建立三维超声对宫腔粘连严重程度的评分系统。方法 收集2019年9月至2020年1月因“月经量减少或闭经”就诊的患者的病例资料,包括经阴道三维超声(three-dimensional transvaginal ultrasound,TVS-3D)及宫腔镜检查,符合纳入和排除标准,共计纳入112例,以宫腔镜检查为金标准,通过灵敏度、特异度,分析判断TVS-3D对宫腔粘连的诊断价值;通过计算Kappa值评价三维超声与宫腔镜检查判断粘连部位的一致性;以宫腔镜下欧洲妇科内镜协会(European Society of Gynecological Endoscopy, ESGE)评级标准判断宫腔粘连严重程度,通过计算受试者工作特征(receiver operating characteristic,ROC)曲线下面积,得出TVS-3D对宫腔粘连严重程度评分的最佳界值。结果 TVS-3D诊断宫腔粘连的灵敏度、特异度分别为82.6%、65.0%,Kappa=0.405,表明TVS-3D具有一定诊断宫腔粘连的效能,但效果一般。TVS-3D对两侧壁及宫腔中央部判断的一致性良好,Kappa值分别为0.771～0.894与0.500～0.610。对重度粘连诊断的最佳界值为9.5分,诊断的灵敏度为81.1%,特异度为94.9%,表明三维超声诊断重度宫腔粘连具有较高的真实性。结论 TVS-3D对宫腔粘连具有一定诊断作用,尤其对两侧壁及宫腔中央部粘连的诊断结果与宫腔镜检查结果具有高度一致性。基于三维超声宫腔冠状面成像的评分系统判断宫腔重度粘连的真实性较高,具有临床应用价值。     

历版《针灸学》针刺行针手法的对比研究

[目的] 对比我国历版《针灸学》中的针刺行针手法,研究分析其演变的原因、对临床的影响及发展趋势。 [方法] 通过查阅历版《针灸学》教材及针刺行针手法相关的文献,对比研究针刺行针手法的定义、种类等学术理论和临床实践应用的发展和变化。 [结果] 针刺行针手法的定义、种类变化与针刺行针手法的实际内涵未具体明确有关,在《针灸学》教材编著过程中,针灸专业领域的学术理论和临床实践的应用在不断地发展和变化,与编写者的学术思想以及教材内容设置的需要等也是密切相关的。[结论] 针刺行针手法的演变过程反映了不同时期对针刺行针手法的内涵理解和操作要求在不断变化,越来越强调针刺行针手法的可量化评价,以更贴近临床实际。针刺行针手法操作的规范化,也有利于针灸理论教学与临床实践相统一。     

Effect of RAGE and its ligands on CD4+ T cells北大核心CSCD

RAGE (receptor for advanced glycation end products) is a multiligand receptor on the cell surface. Ligand-RAGE interactions activate several signal transduction pathways that propagate cellular oxidative stress and inflammatory response. RAGE expressed on the CD4+ T cells has been identified as a central transduction receptor which affects the activation, proliferation, migration and differentiation of the cells. In addition, blockade of RAGE suppressed the development of multiple immune-related disorders mediated by CD4+ T cells. These studies highlight the importance of RAGE and its ligands for CD4+ T cells. This article briefly reviews the role of RAGE and its ligands on the proliferation, migration and differentiation of CD4+ T cells and summarizes the related research progress.     

Venous thromboembolism in non-COVID-19 population during the pandemic: a nationwide multicenter retrospective survey

Journal of Thrombosis and Thrombolysis - Although mechanical thrombectomy is a powerful predictor of stroke outcome, it induces vessel wall injury in the acute phase. This study aimed to analyze...     

Skeletal class II malocclusion caused by mouth breathing in a pediatric patient undergoing treatment by interceptive guidance of occlusion

A 7-year 10-month-old boy was evaluated for mouth breathing and snoring habits. Examination revealed soft convex tissues, maxillary protrusion, mandibular retrusion, and a class II sagittal osteofascial pattern. The patient failed a water holding test. He was clinically diagnosed with skeletal class II malocclusion caused by mouth breathing. Under interceptive guidance of occlusion (iGo), the malocclusion improved with fixed maxillary expansion using functional appliances and interventional treatment of mouth breathing by lip closure exercises. These treatments enabled the patient to gradually return to nasal breathing and guided him to develop physiological occlusion for a coordinated jaw-to-jaw relation. At the 5-year 2-month post-correction follow-up visit (at the age of 13 years), the patient had stable occlusion, a coordinated osteofascial pattern, and normal dentition, periodontium, and temporomandibular joints.     

Differentiation between Clear Cell Sarcoma of the Kidney and Wilms' Tumor with CT

ObjectiveClear cell sarcoma of the kidney (CCSK) is the second-most common but extremely rare primary renal malignancy in children after Wilms'' tumor. The aims of this study were to evaluate the imaging features that could distinguish between CCSK and Wilms'' tumor and to assess the features with diagnostic value for identifying CCSK.Materials and MethodsWe reviewed the initial contrast-enhanced abdominal-pelvic CT scans of children with CCSK and Wilms'' tumor between 2010 to 2019. Fifty-eight children (32 males and 26 females; age, 0.3–10 years), 7 with CCSK, and 51 with Wilms'' tumor, were included. The maximum tumor diameter, presence of engorged perinephric vessels, maximum density of the tumor (Tmax) of the enhancing solid portion, paraspinal muscle, contralateral renal vein density, and density ratios (Tmax/muscle and Tmax/vein) were analyzed on the renal parenchymal phase of contrast-enhanced CT. Fisher''s exact tests and Mann-Whitney U tests were conducted to analyze the categorical and continuous variables, respectively. Logistic regression and receiver operating characteristic curve analyses were also performed.ResultsThe age, sex, and tumor diameter did not differ between the two groups. Engorged perinephric vessels were more common in patients in the CCSK group (71% [5/7] vs. 16% [8/51], p = 0.005). Tmax (median, 148.0 vs. 111.0 Hounsfield unit, p = 0.004), Tmax/muscle (median, 2.64 vs. 1.67, p = 0.002), and Tmax/vein (median, 0.94 vs. 0.59, p = 0.002) were higher in the CCSK compared to the Wilms'' group. Multiple logistic regression revealed that engorged vessels (odds ratio 13.615; 95% confidence interval [CI], 1.770–104.730) and Tmax/muscle (odds ratio 5.881; 95% CI, 1.337–25.871) were significant predictors of CCSK. The cutoff values of Tmax/muscle (86% sensitivity, 77% specificity) and Tmax/vein (71% sensitivity, 86% specificity) for the diagnosis of CCSK were 1.97 and 0.76, respectively.ConclusionPerinephric vessel engorgement and greater tumor enhancement (Tmax/muscle > 1.97 or Tmax/vein > 0.76) are helpful for differentiating between CCSK and Wilms'' tumor in children aged below 10 years.