Hyodeoxycholic acid protects the neurovascular unit against oxygen-glucose deprivation and reoxygenation-induced injury in vitro

Calculus bovis is commonly used for the treatment of stroke in traditional Chinese medicine. Hyodeoxycholic acid(HDCA) is a bioactive compound extracted from calculus bovis. When combined with cholic acid, baicalin and jas-minoidin, HDCA prevents hypoxia-reoxygenation-induced brain injury by suppressing endoplasmic reticulum stress-mediated apoptotic signaling. However, the effects of HDCA in ischemic stroke injury have not yet been studied. Neurovascular unit(NVU) dysfunction occurs in ischemic stroke. Therefore, in this study, we investigated the effects of HDCA on the NVU under ischemic conditions in vitro. We co-cultured primary brain microvascular endothelial cells, neurons and astrocytes using a transwell chamber co-culture system. The NVU was pre-treated with 10.16 or 2.54 μg/mL HDCA for 24 hours before exposure to oxygen-glucose deprivation for 1 hour. The cell counting kit-8 assay was used to detect cell activity. Flow cytometry and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling were used to assess apoptosis. Enzyme-linked immunosorbent assay was used to measure the expression levels of inflammatory cytokines, including interleukin-1β, interleukin-6 and tumor necrosis factor-α, and neurotrophic factors, including brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor. Oxidative stress-related factors, such as superoxide dismutase, nitric oxide, malondialdehyde and γ-glutamyltransferase, were measured using kits. Pretreatment with HDCA significantly decreased blood-brain barrier permeability and neuronal apoptosis, significantly increased transendothelial electrical resistance and γ-glutamyltransferase activity, attenuated oxidative stress damage and the release of inflammatory cytokines, and increased brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor expression. Our findings suggest that HDCA maintains NVU morphological integrity and function by modulating inflammation, oxidation stress, apoptosis, and the expression of neurotrophic factors. Therefore, HDCA may have therapeutic potential in the clinical management of ischemic stroke. This study was approved by the Ethics Committee of Experimental Animals of Beijing University of Chinese Medicine(approval No. BUCM-3-2016040201-2003) in April 2016.     

浙江省2007－2017年罕见病住院病例特征分析

目的 分析2007-2017年浙江省24 388例罕见病住院病例特征，为制定罕见病防控策略提供依据。方法 收集2007-2017年浙江省10家三级甲等（三甲）医院罕见病住院病例资料和各年度住院数，进行描述性统计分析。结果 罕见病病例共24 388例，占住院总例数的2.69‰（24 388/9 054 201），病例数居前3位的疾病类型依次为"血液和造血器官疾病以及某些涉及免疫机能的异常"（占32.81%，8 001/24 388）、"先天性畸形、变形和染色体异常"（占24.87%，6 065/24 388）和"神经系统疾病"（占19.01%，4 635/24 388）；2007-2017年罕见病病例数呈逐年增长趋势，年均增幅19.69%，而罕见病例数占同期住院总例数比例仅在2016-2017年明显上升，各类型罕见病时间分布呈不同特征；罕见病的病例数男女性别比为1.35：1（13 990/10 398），男女性别比最高的3类疾病依次为"消化系统疾病"（4.45：1，1 180/265）、"损伤、中毒和外因的某些其他后果"（3.51：1，281/80）和"神经系统疾病"（2.26：1，3 213/1 422）；各年龄段罕见病类型、各类型罕见病年龄分布均呈不同特征；病例数居前10位的疾病占全部罕见病例数的53.55%（13 060/24 388），其中前3位疾病分别为成人粒细胞缺乏症（14.41%，3 515/24 388）、皮质基底核退化症（7.60%，1 854/24 388）和亨诺克-舍恩莱因紫癜（6.01%，1 466/24 388）。结论 本研究分析的浙江省2007-2017年24 388例罕见病住院病例的特征资料，是推动我国罕见病的研究、监测或登记数据库构建、制定防控策略的参考依据。     

医疗器械口咽通气道产品注册的常见问题及改进建议

近年来,医疗器械口咽通气道产品的注册数量日益增加,针对该产品的相关咨询也逐渐增多。但该产品暂无相关的注册技术审查指导原则,以致该产品的注册申报资料经常出现一些共性问题。现根据医疗器械口咽通气道产品相关法规和标准,对日常工作中遇到的常见问题进行归纳,分析该产品注册申报中的技术审评要求及共性问题,并给出对策或建议。     

多媒体触控一体机在人体解剖学实验教学中的应用

<正>随着多媒体应用的普及,解剖学实验教学中也已把多媒体教学作为重要的教学手段。然而,以电脑加投影仪为代表的传统多媒体设备,由于其自身的缺陷,难以完全取代黑板教学,所以多媒体和黑板在教学中最好结合使用以取长补短~([1])。尽管如此,在两者的结合教学中还是存在一些问题。比如,要使投影仪显示效果清晰,需要教室光线黑暗一些,而黑板教学又要求教室光线比较明亮;电子教鞭一晃而过的指示方法让学生感觉不够     

One Week of Hospitalization Following Elective Hip Surgery Induces Substantial Muscle Atrophy in Older Patients

Objectives

Short successive periods of skeletal muscle disuse have been suggested to substantially contribute to the observed loss of skeletal muscle mass over the life span. Hospitalization of older individuals due to acute illness, injury, or major surgery generally results in a mean hospital stay of 5 to 7 days, during which the level of physical activity is strongly reduced. We hypothesized that hospitalization following elective total hip arthroplasty is accompanied by substantial leg muscle atrophy in older men and women.

沙利度胺联合TACE治疗原发性肝癌疗效与安全性的系统评价

目的:系统评价沙利度胺(thalidomide,TLD)联合肝动脉化疗栓塞术(transcatheter arterial chemoembolization,TACE)治疗原发性肝癌(primary hepatic carcinomas,PHC)的疗效和安全性.方法:计算机检索Cochrane Library(2014年第3期)、Web of Science(1986/2014-03)、Pub Med(1966/2014-03)、CNKI(1917/2014-03)、维普(1989/2014-03)、万方数据库(1998/2014-03),收集所有TLD联合TACE治疗PHC的随机对照试验.由两名评价员严格按照纳入标准选择文献,提取资料,并参照Cochrane系统评价的要求,对选择纳入的随机对照试验进行方法学质量评估后,采用Cochrane协作网提供的Rev Man 5.2软件对总有效率、疾病控制率、生活质量KPS评分、不同年限生存率、甲胎蛋白的变化、血管内皮生长因子(vascular endothelial growth factor,VEGF)的变化及不良反应发生率进行Meta分析.结果:最终纳入22项随机对照试验,包括1590例PHC患者,Meta分析结果显示,TLD联合TA C E组治疗P H C的总有效率(R R合并=1.29,95%C I:1.15-1.44)、疾病控制率(R R合并=1.27,95%CI:1.16-1.39)、生活质量KPS评分(MD合并=9.23,95%CI:6.90-11.55)、半年生存率(RR合并=1.10,95%C I:1.01-1.20)、1年生存率(RR合并=1.25,95%C I:1.13-1.39)、2年生存率(RR合并=1.45,95%CI:1.18-1.78)、3年生存率(R R合并=1.7 0,9 5%C I:1.1 6-2.5 0)、V E G F水平的变化(M D合并=-123.64,95%C I:-143.72--103.55)优于单纯TACE组,差异有统计学意义(均P0.05);不良反应发生率:在药物性皮疹发生率方面,TLD联合TACE组明显高于单纯TACE组,差异有统计学意义(RR=4.50,95%CI:2.34-8.64,P0.00001);在减少消化系应发生率(RR=1.08,95%CI:0.93-1.25)、降低骨髓抑制发生率(RR=1.12,95%CI:0.82-1.52)、降低肝功能异常发生率方面(R R=1.00,95%C I:0.72-1.39),T L D联合TA C E组与单纯TA C E组相近似,差异无统计学意义(均P0.05).结论:目前研究显示,与单纯TACE疗法相比,TLD联合TACE治疗PHC在总有效率、疾病控制率、生活质量KPS评分、半年生存率、1、2、3年生存率、降低V E G F方面具有明显的优势,但在安全性方面,TLD联合TACE组在药物性皮疹发生率方面明显高于单纯TACE组,而在消化系反应、骨髓抑制率、肝功能异常方面与单纯TACE组相似.