老年性上消化道疾病的临床及x线特点

本文报告144例老年性上消化道疾病,并与112例青年病人进行比较。初步探讨老年人上消化道疾病在临床及 x 线上有以下特点:1.病史长,平均12.3年;2.一般性消化道症状多,典型症状少,并且消化道肿瘤、胃下垂,憩室明显增多;3.并发症多,为36.3%;4.x 线表现功能性改变、粘膜破坏、胃壁僵硬多见而明显。     

α7⁃nAChR通过抑制软骨细胞凋亡延缓小鼠膝骨关节炎关节软骨退变

目的：探讨激活α7烟碱型乙酰胆碱受体（α7 nicotinic acetylcholine receptor,α7?nAChR）对小鼠骨关节炎（osteoarthritis,OA）软骨细胞凋亡的作用及机制。方法：通过关节腔内注射碘乙酸钠（monosodium iodoacetate,MIA）建立小鼠OA模型。模型小鼠随机分成MIA单独给药组、0.5 mg/kg烟碱（nicotine,Nic）治疗组、1 mg/kg Nic治疗组和Nic +α7?nAChR特异性拮抗剂甲基牛扁碱（methyllycaconitine,MLA）治疗组,对照组小鼠则注射等体积的生理盐水。模型制备后7、14、21 d应用Von Frey纤维丝评价小鼠疼痛行为指标机械缩足反射潜伏期;第21天时处死小鼠,取膝关节标本进行甲苯胺蓝和番红固绿染色,评估膝关节软骨破坏情况并进行关节软骨退变评分;应用原位末端转移酶标技术（terminal deoxynucleotidyl transferase dUTP Nick end labelling,TUNEL）分析关节软骨细胞的凋亡水平;应用免疫印迹法检测凋亡相关蛋白Bcl?2、Bax、cleaved caspase?9和caspase?9的表达。结果：模型制备后21 d,MIA组小鼠机械缩足反射潜伏期阈值显著下降至（0.28 ± 0.02）g,关节软骨退变评分和蛋白聚糖损失评分分别升高至（5.33 ± 1.19）分和（2.33 ± 0.27）分,关节软骨细胞凋亡率升高至（31.83 ± 3.89）%。而1 mg/kg Nic能显著减轻MIA引起的小鼠膝关节疼痛行为（P < 0.05）,降低MIA诱导的软骨退变（P < 0.05）和关节软骨细胞凋亡坏死（P < 0.05）。进一步机制研究发现,MIA可明显降低Bcl?2的表达,增加Bax和cleaved caspase?9的表达,而Nic治疗组能逆转MIA诱导的软骨细胞凋亡相关蛋白表达的影响,显著升高Bcl?2的表达,降低Bax的表达和cleaved caspase?9/caspase?9的比率（P < 0.05）,上述这些Nic的作用均能被MLA消除。结论：激活α7?nAChR能抑制关节软骨细胞的凋亡,对OA模型小鼠的软骨损伤具有保护作用,其抗凋亡机制可能与线粒体凋亡途径有关。     

Role of arachidonoylethanolamine in blood pressure regulation in volume-resistant patients on peritoneal dialysis

In this study we explored the possible role of arachidonoylethanolamine (AEA) in regulating blood pressure in patients on continuous ambulatory peritoneal dialysis (CAPD). One hundred and five patients on CAPD were enrolled. Volume status was evaluated by the overhydration (OH) value obtained by bioimpedance analysis. OH?<?2.0?kg was defined as normal volume (NV) and OH????2.0?kg as high volume (HV). Home mean systolic blood pressure <130?mmHg was defined as controlled hypertension (CHT) and ??130?mmHg as uncontrolled hypertension (UHT). The patients were divided into four subgroups: (1) controlled hypertension with normal volume (CHT-NV), (2) controlled hypertension with high volume (CHT-HV), (3) uncontrolled hypertension with normal volume (UHT-NV), and (4) uncontrolled hypertension with high volume (UHT-HV). AEA was measured by ultra performance liquid chromatography-tandem mass spectrometry. AEA was significantly higher in the HV group as compared with the NV group (P?<?0.05). In addition, AEA was also significantly higher in the CHT-HV group as compared with the UHT-NV group (P?<?0.05). These results may suggest a compensatory function of AEA and TRPV1 pathway to lower blood pressure during volume expansion in CAPD patients.     

华南地区某眼科医院的感染性角膜炎病原菌谱特征

目的 探讨华南地区某眼科医院感染性角膜炎的病原菌谱及其特点。方法 回顾性系列病例研究。选择2013年7月1日至2017年12月31日在中山大学中山眼科中心进行角膜取材和微生物检测的角膜感染患者3 914例。表面麻醉后刮取病灶边缘的病灶组织,进行细菌、真菌培养及鉴定。培养结果阳性的细菌采用生化比色或质谱进行种属鉴定;真菌依据形态学进行种属鉴定。各季节菌谱阳性率差异比较采用卡方检验。结果 感染性角膜炎患者中,男2 468例（63.1%）,女1 446例（36.9%）,年龄（49.5±16.8）岁。病原菌培养阳性的患者共1 673例（42.7%）,其中单纯细菌749例（44.8%）,单纯真菌849例（50.7%）,混合感染75例（4.5%）。最常见的细菌是葡萄球菌属（20.1%）,其次是假单胞菌属（7.5%）;最常见的真菌是镰刀菌属（25.5%）,其次是曲霉菌属（10.3%）。细菌的阳性率在5-8月明显高于1-2月和9-12月（P<0.05）,真菌的阳性率在5-6月明显低于1-2月和9-12月（P<0.05）。结论 在华南地区一所三甲眼科医院的感染性角膜炎中,真菌感染略高于细菌感染,且细菌和真菌感染存在季节性差异。     

Membrane technology for optimizing process optimization of small bioactive compounds in Mailuoning Injection factory effluene北大核心CSCD

Objective: To enrich small bioactive compounds from Mailuoning Injection factory effluene by polyether sulfoxide hollow fiber membrane. Methods: The retention rate of the common polymer (protein, tannin, starch, and pectin) and the permeability of the small molecule pharmacodynamic substance chlorogenic acid were the indicators, and the stop time and membrane type in ultrafiltration process were optimized. The temperature, pressure, and feed rate were investigated to determine the influence degree of each factor on the permeability and retention rate, and then the optimum process parameters of the ultrafiltration membrane process were optimized by using Box-Behnken design-response surface method. Results: The sequence of common polymer retention rate from high to low is: the influencing factor A (temperature), B (pressure), C (feed rate), and there was a negative correlation with the temperature. For the chlorogenic acid transmission rate, the influencing factor A (temperature) was larger than B (pressure), and C (feed rate) was lowest. There was a “∩” relationship between chlorogenic acid permeability and pressure at a certain temperature and rate. The results of optimized process were as follows: liquid temperature was 35 ℃, feed rate was 262 mL/min, and membrane pressure was 15.0 psi (1 psi = 6.895 kPa). The chlorogenic acid transmission rate was (91.470 ± 0.988)%, and polymer retention rate was (80.080 ± 2.296)%. The comprehensive score was (85.780 ± 1.641)% and RSD was 0.46%. There was a small difference between the two processes. Conclusion: Hollow fiber membrane, which is a sustainable and green resource utilization, has a good permeability for small bioactive compounds in wastewater, and has excellent retaining effect on common macromolecules. © 2019, Editorial Office of Chinese Traditional and Herbal Drugs. All right reserved.     

BCL-2抑制剂联合低剂量阿糖胞苷治疗异基因造血干细胞移植后复发老年急性髓系白血病一例报告并文献复习

老年急性髓系白血病(AML)患者治疗困难,长期生存率低,预后差。文献报道,老年AML患者积极进行异基因造血干细胞移植(allo-HSCT)有助于改善远期生存[1]。但是,移植后复发患者通常难以耐受强化疗,很难再次获得完全缓解(CR)。近期我们采用BCL-2抑制剂联合小剂量阿糖胞苷成功治疗1例allo-HSCT后复发的老年AML患者。     

饥不欲食证治探析

饥不欲食以胃为主,与心、肝胆、肾有关,病机关键可分为虚实两端.实为胃失和降,胃气上逆;虚为胃阳不足,气不消谷.证治分类为阳明热郁证,厥阴肝热证,湿阻中焦证(痰湿中阻证、湿热中阻证),肝胃不和证,胃阳虚证,胆火犯胃证,心肾不交证;分别选用栀子豉汤,白虎加人参汤,麻子仁丸,乌梅丸,瓜蒂散,陈平汤,外台茯苓饮,四逆散和温胆汤等方药加减及针灸治疗.     

早期乳腺癌的钼靶X线表现及误诊分析

目的探讨早期乳腺癌的钼靶X线表现,进一步提高该病的影像诊断水平,减少误诊。方法回顾性分析68例经手术或穿刺活检病理证实的早期乳腺癌的钼靶X线片。结果 68例早期乳腺癌发生于致密腺体型14例,多量腺体型21例,少量腺体型23例,脂肪型10例。X线表现为微小钙化25例(36.76%),肿块影23例(33.82%),结构紊乱9例(13.23%),局部密度增高影5例(7.35%),乳管造影异常3例(4.41%),血管增粗3例(4.41%)。其中有15例发生误诊(22.06%)。结论早期乳腺癌的钼靶X线征象不典型,诊断易受腺体类型的影响,影像与临床紧密结合可有效减少误诊。     

超声心动图诊断胎儿肺动脉狭窄的产前及产后对照分析

目的 探讨胎儿肺动脉狭窄产前及产后超声心动图的变化规律.方法 选择2014年6月至2016年6月我院经超声诊断或怀疑肺动脉狭窄的胎儿16例,出生后进行随访.对照分析胎儿产前及产后肺动脉狭窄超声心动图的声像图特征,探讨胎儿肺动脉狭窄产前及产后血流动力学变化规律,对漏诊和误诊病例进行分析.结果 16例胎儿出生后1个月内进行随访,超声心动图证实13例新生儿存在不同程度的肺动脉狭窄,其中10例为单纯性肺动脉瓣狭窄:重度狭窄者具有典型的声像图特征,均伴有三尖瓣重度反流、右房大、右室小、动脉导管血流反向,预后较差;轻度和中度狭窄者产前超声图像特征不明显而容易漏诊,产后随访其狭窄程度可逐渐减轻,2例进行性加重.3例为肺动脉主干狭窄且伴有心内畸形,产前及产后超声表现一致,预后较差.另有3例产前诊断为肺动脉主干轻度狭窄,出生后超声心动图显示肺动脉正常.结论 胎儿肺动脉狭窄产前和产后血流动力学具有特征性改变,需要对胎儿肺动脉狭窄进行产前及产后超声心动图动态随访,评估其狭窄程度和预后.