实时超声弹性成像在诊断慢性乙肝肝纤维化程度中的应用价值

【摘要】 目的 探讨实时超声弹性成像在诊断慢性乙肝肝纤维化程度中的应用价值。方法 以2016年1月～2019年1月我院收治的慢性乙型肝炎（CHB）患者146例为研究对象。分别行肝脏穿刺检查及实时组织弹性成像（RTE）检查，然后进行病理分期，并记录相应的应变均值（MEAN）、标准偏差（SD）、蓝色区域面积比（%AREA）、复杂度（COMP）、峰度（KURT）、偏度（SKEW）、对比度（CONT）、均等性（ENT）、杂乱度（IDM）、一致性（ASM）、相关性（CORR），并计算得出肝纤维化指数（LFI）值。结果 与S0、S1、S2期比较，S4期MEAN显著降低（P＜0.05）；与S0、S1、S2、S3期比较，S4期%AREA、COMP显著升高（P＜0.05）；与S0、S1、S2期比较，S4期SKEW、LFI显著升高（P＜0.05）；与S0期比较，S3期LFI显著升高（P＜0.05）。Spearman相关分析结果示，MEAN、ENT与肝纤维化分期呈负相关（P＜0.05）。SD、%AREA、COMP、SKEW、IDM、ASM、LFI与肝纤维化分期呈正相关（P＜0.05）。RTE参数MEAN、%AREA、COMP、SKEW、IDM、LFI诊断肝纤维化程度的ROC曲线下面积均在0.7~0.9。当MEAN、%AREA、COMP、SKEW、IDM、LFI 6个参数的截断值分别取10029、3014、2752、042、012、281时，诊断肝纤维化程度的准确性和特异性均在70%以上。〖HT5"H〗结论〖HTK〗〓实时组织弹性成像与慢性乙型肝炎肝纤维化分期具有较高的相关性，其中与肝纤维化指数的相关系数最大，其在慢性乙型肝炎肝纤维化的诊断和评估中具有重要应用价值。     

郭蓉娟教授治疗情志病合并失眠症临床经验总结

为更好地总结和传承郭蓉娟教授治疗情志病合并失眠症的临床经验及用药特色,结合中医传统经典理论,参考相关流派及各医家的不同观点,总结门诊跟师期间的典型病例和师承学习体悟,凝练其授课资料、会议演讲内容、科研课题研究内容和公开发表的论文和论著,检索其学生发表的对导师临证经验和学术思想总结的论文,较为系统地梳理了郭蓉娟教授对情志病合并失眠症的认识。郭教授提出“睡眠-情绪系统”三阶段病机演变规律,在诊疗过程中从失眠入手,可以减少情志病的漏诊率,获取较为真实可靠的信息,并着重阐述昼夜的临床用药特色,调理阴阳,标本同治,并整理归纳其遣方用药规律,其夜间经验方宁心安神方重用酸枣仁、刺五加,取得了良好的临床疗效。郭蓉娟教授治疗情志病合并失眠症临床经验丰富,其遣方用药的科学内涵值得进一步挖掘。     

一种新型PI3K抑制剂JN-65的抗肿瘤活性及其分子模拟机制研究

在恶性血液肿瘤中,PI3K信号通路往往呈现过度表达的紊乱状态,开发PI3K抑制剂治疗恶性血液肿瘤具有广阔的应用前景。本研究通过恶性血液肿瘤的特异性筛选,得到了一个PI3K靶向抑制剂JN-65。MTT检测发现JN-65可以有效抑制血液肿瘤的增殖,其中对白血病细胞特异性较强。体外酶活性检测发现JN-65对PI3K具有一定的抑制活性且对PI3Kγ表现出较强的选择性抑制作用,Western blot实验表明,JN-65能有效抑制PI3K/Akt信号通路,细胞流式实验证明,JN-65通过抑制PI3K信号通路有效地诱导肿瘤细胞的凋亡。本研究采用分子对接模拟方法研究JN-65与PI3K相互作用关系,在分子水平对PI3K的抑制机制进行了研究。JN-65有望成为一个潜在的PI3K抑制剂,能特异性地抑制恶性血液肿瘤。     

水蛭素对单侧输尿管梗阻大鼠肾间质损伤及MCP-1、ICAM-1的干预效应研究

[目的]观察水蛭素对单侧输尿管梗阻（UUO）大鼠肾间质纤维化的干预作用,并探索其作用机制。[方法]健康雄性SD大鼠120只,随机分为假手术组24只和造模组96只。造模组再分为模型组24只、水蛭素高剂量组24只、水蛭素低剂量组24只、贝那普利组24只。各组于术后第3、7、14天分批随机处死。取梗阻侧肾组织行逆转录-聚合酶链反应（RT-PCR）、蛋白免疫印迹（Western Blot）分子技术,检测梗阻侧肾组织单核细胞趋化蛋白-1（MCP-1）、细胞间黏附分子-1（ICAM-1）的分子表达变化。[结果]苏木精-伊红（HE）染色显示,与模型组相比：各用药组肾间质损伤及纤维化程度均有不同程度改善。RT-PCR显示,与模型组相比：水蛭素高剂量组各时间点及水蛭素低剂量组第7、14天ICAM-1相对表达量均明显降低（P<0.05）;水蛭素高剂量组第7、14天MCP-1表达显著降低（P<0.01）;水蛭素高剂量组第3天及水蛭素低剂量组各时间点MCP-1表达量明显降低（P<0.05）。Western Blot显示,与模型组相比：水蛭素高剂量组第7天ICAM-1蛋白表达量显著减少（P<0.01）;水蛭素高剂量组第3、14天及水蛭素低剂量组第14天各时间点ICAM-1蛋白表达均明显降低（P<0.05）;水蛭素高剂量组第14天MCP-1蛋白表达显著降低（P<0.01）;水蛭素高剂量组第3、7天MCP-1蛋白表达明显降低（P<0.05）。[结论]水蛭素能不同程度地改善UUO大鼠肾间质损伤程度,延缓间质纤维化进展,其机制可能与水蛭素干预了UUO大鼠肾间质MCP-1、ICAM-1 mRNA及蛋白质的表达有关。     

Relation of Blood Arsenic Concentration with Effect and Safety of Arsenic-Containing Qinghuang Powder (青黄散) in Patients with Myelodysplastic Syndrome

Objective: To investigate the relation of blood arsenic concentration(BAC) with clinical effect and safety of arsenic-containing Qinghuang Powder(青黄散, QHP) in patients with myelodysplastic syndrome(MDS). Methods: Totally 163 patients with MDS were orally treated with QHP for 2 courses of treatment, 3 months as 1 course. The BACs of patients were detected by atomic fluorescence spectrophotometry at 1, 3, and 6 months during the treatment, and the effective rate, hematological improvement and safety in patients after treatment with QHP were analyzed. Results: After 2 courses of treatment, the total effective rate was 89.6%(146/163), with 31.3%(51/163) of hematological improvement and 58.3%(95/163) of stable disease. The hemoglobin increased from 73.48±19.30 g/L to 80.39±26.56 g/L(P0.05), the absolute neutrophil count increased from 0.81±0.48×10~9/L to 1.08±0.62×10~9/L(P0.05), and no significant changes were observed in platelet counts(P0.05). Among 46 patients previously depended on blood transfusion, 28.3%(13/46) completely got rid of blood transfusion and 21.7%(10/46) reduced the volume of blood transfusion by more than 50% after treatment. The BACs were significantly increased in patients treated for 1 month with 32.17±18.04 μg/L(P0.05), 3 months with 33.56±15.28 μg/L(P0.05), and 6 months with 36.78±11.92 μg/L(P0.05), respectively, as compared with those before treatment(4.08±2.11 μg/L). There were no significant differences of BACs among the patients treated for 1, 3 and 6 months(P0.05). The adverse reactions of digestive tract during the treatment were mild abdominal pain and diarrhea in 14 cases(8.6%), and no patients discontinued the treatment. The BACs of patients with gastrointestinal adverse reactions were significantly lower than those without gastrointestinal adverse reactions(22.39±10.38 vs. 37.89±11.84, μg/L, P0.05). The BACs of patients with clinical effect were significantly higher than those failed to treatment(40.41±11.69 vs. 23.84±12.03, μg/L, P0.05). Conclusion: QHP was effective and safe in the treatment of patients with MDS and the effect was associated with BACs of patients.     

中医外治法治疗癌性疼痛的研究进展

癌性疼痛是晚期肿瘤患者最常见的、最痛苦的症状之一,约有60%~80%的进展期肿瘤患者会出现癌性疼痛,严重影响患者的生活质量。目前,国际上采用世界卫生组织（WHO）三阶梯止痛治疗来控制癌性疼痛,但因其毒副作用较大,导致许多患者不能耐受,迫使治疗终止。中医外治法可有效降低镇痛治疗所导致的毒副作用,并具有较好的止痛效果,因此在临床中应用广泛。现就近年来中医外治法治疗癌性疼痛的研究进展综述如下。     

Effect of Quyu Chencuo Formula(去菀陈莝方)on Renal Fibrosis in Obstructive Nephropathy Rats

Objective: To observe the effect of Quyu Chencuo Formula(去菀陈莝方, QCF) on renal fibrosis in rats with obstructive nephropathy. Methods: Twenty-four rats were randomly divided into three groups, 4 for sham operation as the control group, 10 for unilateral ureteral obstruction(UUO) model group, and the rest 10 for QCF treating UUO model group. All rats were sacrificed under 3% pentobarbital(50 mg/kg) anesthesia on the 14 th day after surgery, then the right kidney samples of rats were harvested for hematoxylin eosin(HE) staining and Masson staining to observe the renal pathological changes. Immunohistochemistry and Western blotting were used to examine the expression of transforming growth factor β1(TGF-β1), and real-time polymerase chain reaction(RT-PCR) was employed to examine the expressions of TGF-β1, α-smooth muscle actin(α-SMA) and E-cadherin mRNA. Results: HE and Masson staining showed that the renal interstitial of the rats in the control group had no significant fibrotic lesion; in the model group, there were obvious interstitial fibrosis; for the QCF group, there were epithelial cell necrosis, infiltration of lymphocytes and mononuclear cells, aggravated interstitial fibrosis in varied degrees, but the pathological changes were less in the QCF group than in the model group. The immunohistochemistry and Western blotting results showed that the TGF-β1 expression was increased significantly in the model group, while decreased significantly in the QCF group(P0.05); RT-PCR showed that the mRNA expression of α-SMA and TGF-β1 increased significantly in the model group, while both were significantly decreased in the QCF group compared with the model group(P0.05). The mRNA expression of E-cadherin was decreased significantly in the model group, and it was significantly increased in the QCF group as compared with the model group(P0.05). Conclusion: QCF may improve renal fibrosis by regulating the expressions of TGF-β1, α-SMA and E-cadherin, and prevent the progress of kidney fibrosis.     

一种核酸适配体高敏检测方法的建立及应用评价

本文建立一种基于免疫印迹的核酸适配体高敏定量分析的检测方法,并探讨其在适配体药物靶向性研究中的应用价值。首先用聚丙烯酰胺凝胶电泳进行核酸适配体的分离,然后利用电转的方法将凝胶上的核酸适配体转移至PVDF膜上,先后孵育Rabbit Anti-Biotin和HRP-Streptavidin抗体,最后利用化学发光仪进行成像。结果显示核酸适配体可以通过该方法进行定量检测分析,且该方法检测灵敏度高,能够识别荧光染料法检测不到的浓度范围。此外,该方法只识别被生物素修饰的核酸适配体,特异性强。结果提示,核酸免疫印记法可以作为核酸适配体药物靶向性研究的一个定量检测手段。     

南充市社区中老年人群血脂血糖现状水平分析

【摘要】 目的 了解社区中老年人群的血脂、血糖现状水平,探讨其与性别和年龄的关系,为本地区心脑血管疾病、糖尿病等疾病的防治提供诊疗依据。方法 对我市38078名社区居民采集清晨空腹血清标本,检测血糖（GLU）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL C）和低密度脂蛋白胆固醇（LDL C）的结果,并对其进行年龄、性别分组统计分析。结果 不同性别和年龄组间的血脂、血糖水平差异有统计学意义（P＜005）,74~89岁年龄组血脂、血糖总体水平高于其他各年龄组（P＜005）;女性血脂水平普遍高于男性（P＜005）。结论 中老年人群血脂、血糖异常率高,应定期对中老年人进行血脂、血糖监测,开展宣传教育活动,提高自我保健意识,预防高血脂、高血糖的发生和发展。     

The Effect of Silica Dust Exposure on the Serum Clara Cell Protein 16 Levels in Chinese Workers

<正>Pneumoconiosis is a systemic occupational disease that commonly manifests as diffuse fibrosis of the lungs caused by long-term inhalation of silica dust in the production process. The development of pneumoconiosis is a chronic and progressive process; once it occurs, it is irreversible, and gradually develops into lung injury and respiratory failure, and can cause death regardless of exposure to dust. The