荔枝核皂苷对小鼠学习记忆障碍的改善

目的:探讨荔枝核皂苷对D-半乳糖诱致小鼠学习记忆障碍的改善作用。方法:50只昆明种小鼠完全随机分为正常对照组、模型对照组、石杉碱甲组(0.4 mg/kg·d)、荔枝核皂苷低(15 g/kg·d)和高(60 g/kg·d)剂量组。上述动物除空白对照组外,均皮下(sc)注射D-半乳糖(500 mg/kg·d)8周,并于第5周起分别灌胃相应药物。采用水迷宫和自主活动仪测试小鼠学习和记忆能力,测定血清糖基化;醛糖还原酶活性;采用高效液相库仑阵列电化学检测系统检测人神经氨酸酶(NA)、多巴胺(DA)、5-羟色胺(5-HT)、5-羟吲哚乙酸(5-HIAA)二羟苯乙酸(DOPAC)的含量变化。结果:荔枝核皂苷明显改善模型小鼠学习和记忆能力,各给药组与模型对照组相比单胺类递质含量差异无统计学意义(P>0.05)。结论:荔枝核皂苷具有改善D-半乳糖诱致小鼠学习记忆障碍的作用;其作用可能与其减少抑制对脑神经细胞的损伤作用有关。     

基于R语言平台的糖尿病证候分布演化规律研究

糖尿病证候分布演变规律的研究对中医治疗糖尿病的临床决策具有重要的意义。本文提出基于R语言平台,以大量临床证候数据作为研究对象,采用聚类分析数据挖掘算法,构建糖尿病证候分布模型;以年龄作为时间变量,构建糖尿病时间序列证候分布演化模型;采用时间序列相似性分析方法,将数据可视化展示,结合中医临床知识分析数据挖掘结果。本研究为糖尿病证候分布演变研究提供一种新的思路与方法,对探究糖尿病证候分布演变的本质产生积极作用,并指导临床实践。     

进行性核上性麻痹的个案分析

通过对一例进行性核上性麻痹患者的临床表现及影像学检查结果进行分析,了解进行性核上性麻痹的临床特征,探讨进行性核上性麻痹的临床表现、诊断及治疗方法.对进行性核上性麻痹容易误诊,目前缺乏特异性治疗方法,应该引起临床工作者的重视.     

丙戊酸钠与经典抗心律失常药作用的比较

在不同实验动物模型上,丙戊酸钠抗氯化钡性大鼠心律失常作用明显强于奎尼丁和利多卡因等,与心得安相当;抗肾上腺素性豚鼠心律失常作用,与异搏定相当,提高家兔电室颤阈值的作用大于心得安,但比利多卡因弱;对大鼠坐骨神经的局部麻醉作用弱于奎尼丁。本品的抗心律失常作用与自主神经活动无关;对心率影响小;对乙酰胆碱性狗心房颤动无效,     

江苏两市MSM抗病毒治疗效果及其影响因素的研究

目的:分析江苏男男性行为(men who have sex with men,MSM)人群的艾滋病抗病毒治疗效果及其影响因素,首次建立江苏省MSM抗病毒治疗评价方法?方法:通过整群抽样的方式选取江苏两市接受免费高效抗逆转病毒治疗(highly active antiretroviral therapy,HAART)的MSM作为研究对象,进行生活史和用药情况的问卷调查;从江苏省艾滋病治疗信息库中获知其CD4值,采用Epidata 3.0和SAS 9.0分别进行资料录入与统计分析?结果:157例MSM总体CD4值提高,服药依从性低?经单因素及多因素分析,确诊后安全套使用水平低?吸烟量大?确诊至治疗时间间隔长是影响治疗效果的危险因素;首次CD4值较高及服药天数较长是保护因素?结论:江苏目前男男性行为人群抗病毒治疗效果显著,建议对符合治疗条件的MSM进行早期治疗,并提高患者服药依从性?     

睡眠剥夺对个体情绪的影响及其机制

睡眠对维持良好的情绪非常重要,睡眠剥夺会导致个体负性情绪的增加、正性情绪的减少.本文回顾了近年有关睡眠剥夺对个体情绪影响的文献,尝试从睡眠对大脑情绪回路、快速眼动睡眠、情绪信息加工以及能量供给和情绪背景的影响这几个方面归纳总结,力图深入理解睡眠剥夺对个体情绪影响的机制.     

原发性肝癌B细胞异位基因2的表达及临床意义

目的 探讨B细胞异位基因2 (B cell translocation gene 2,BTG2)在原发性肝细胞癌中的表达及与术后生存期之间的关系.方法 共纳入125例可手术切除的原发性肝细胞癌患者,其中有完整随访记录101例;用免疫组化方法检测患者肿瘤组织中BTG2蛋白的表达,并分为3组:BTG2高表达组,BTG2蛋白中表达(++)或强表达(+++);BTG2低表达组,BTG2蛋白低表达(+);BTG2阴性组,BTG2蛋白无表达(-).分析BTG2表达水平与临床病理因素和术后总生存期的相关性.选取12对癌与癌旁配对组织,用RT-PCR检测其BTG2表达水平.结果 125例癌组织中,BTG2阴性组、低表达组和高表达组分别为106、13、6例;癌旁组织中,BTG2阴性组、低表达组和高表达组分别为41、14、22例,癌与癌旁组织BTG2表达差异有统计学意义(x2=28.102,P＜0.001).RT-PCR检测结果显示12对癌与癌旁配对组织中,癌组织BTG2表达水平低于癌旁的有8例.癌栓发生与BTG2表达有明显相关性(x2=8.305,P=0.013),其中低表达组癌栓发生率最高.BTG2低表达组中位总生存期为36个月(95％ CI:8.437 ～ 63.564),而高表达和阴性表达组未达到中位总生存期(Log-Rank x2=4.512,P=0.105).亚组分析表明,BTG2高表达组患者总生存期显著长于低表达组(x2=4.266,P=0.039),而高表达与阴性组(x2=2.729,P=0.099)以及低表达与阴性组(x2=1.400,P=0.237)之间差异没有统计学意义.逐步Cox回归分析结果显示,分化程度、肝硬化、癌栓和转移情况是总生存期的独立预后因素.结论 BTG2蛋白在原发性肝细胞癌中的表达呈低表达,并且BTG2蛋白的高表达提示肝癌患者预后较好,可作为肝细胞癌的潜在预后指标.     

Invasive IPMN and MCN: Same Organ, Sifferent Outcomes?

Background

The efficacy of surgery for invasive mucinous neoplasms is unclear. We examined the natural history of invasive mucinous cystic neoplasms (MCN) and invasive intraductal papillary mucinous neoplasms (IPMN) in patients who underwent pancreatic resection.

Methods

The Surveillance, Epidemiology, and End Results (SEER) database (1996–2006) was queried for cases of resected invasive MCN and IPMN. Demographics, tumor characteristics, and overall survival were examined using log-rank analysis and multivariate Cox regression model.

Results

Of 185 MCN cases and 641 IPMN cases, 73% and 48%, respectively, were women (P < 0.0001). Most (73%) IPMN were in the head of the pancreas; most (64%) MCN were in the tail/body (P < 0.0001). Lymph node metastasis was more common for IPMN than MCN (46% vs. 24%, P < 0.0001). Overall survival after resection was better for patients with stage I MCN vs. stage I IPMN (P = 0.0005), and it was better for patients with node-negative MCN vs. node-negative IPMN (P = 0.0061). There was no significant difference in survival of patients with stage IIA MCN vs. stage IIA IPMN (P = 0.5964), stage IIB MCN vs. stage IIB IPMN (P = 0.2262), or node-positive MCN vs. node-positive IPMN (P = 0.2263). Age older than 65 years (hazards ratio (HR) 1.71, P = 0.0046), high tumor grade (HR 2.68, P < 0.0001), higher T stage (HR 2.11, P < 0.0001), and IPMN histology (HR 1.90, P = 0.0040) predicted worse outcome in node-negative patients.

Conclusions

Our findings suggest that survival is better after resection of invasive MCN versus invasive IPMN when disease is localized within the pancreas, but this difference disappears in the presence of nodal metastasis or extrapancreatic extension.     

Laparoscopic extended (subtotal) distal pancreatectomy with resection of both splenic artery and vein

Background

Spleen-preserving distal pancreatectomy can be performed safely and effectively by resecting both splenic vessels (Warshaw procedure) [1–4]. This simplified spleen-preserving technique might also be applied to minimally invasive distal pancreatectomy of benign and borderline malignant tumor [5, 6].

Methods

Although the conservation of both splenic vessels is paramount to preserving the spleen during laparoscopic distal pancreatectomy, preservation of the splenic vessels is not always possible, especially under the following conditions: (1) relatively large tumor, (2) associated with chronic pancreatitis, (3) tumor abutting splenic vascular structures, and (4) bleeding during the splenic vessel conserving procedure, which are potential indications of laparoscopic extended Warshaw procedure. Patient preparation and position was the same as that described in our previous study [7].

Results

During the study’s time period, 38 consecutive patients underwent laparoscopic spleen-preserving distal pancreatectomy. Of those, five patients underwent a laparoscopic extended Warshaw procedure, which all included among 16 patients of extended distal pancreatectomy by dividing the pancreas at the pancreatic neck. All patients were women with a median age of 55 (range, 38–75) years. Median total operation time and blood loss were 215 (range, 200–386) minutes and 100 (range, 0–300) ml, respectively. The median length of hospital stay was 8 (range, 5–15) days. All of postoperative complications (two grade A and two grade B postoperative pancreatic fistula; one grade A bleeding) were able to be treated conservatively. During the median follow-up period of 11 (range, 7–42) months, one focal splenic infarction and one gastric varix were noted; however, no clinically significant complications were reported.

Conclusions

Laparoscopic spleen-preserving extended distal pancreatectomy with resection of both the splenic vessels is feasible and safe [8]. This surgical technique is thought to increase the chance of preservation of the spleen with minimally invasive distal pancreatectomy in well-selected benign or borderline malignant tumor of the distal pancreas.     

狼疮性肾炎环磷酰胺冲击治疗的间期与剂量研究

探讨不同活动程度的狼疮性肾炎(LN)使用环磷酰胺冲击治疗的最佳间期与合理剂量。方法 将96例重症LN患者随机分成三组。A组:环磷酰胺冲击治疗(Ⅳ-CTX),每2周1次,每次8～12mg/kg,连用2天。B组:Ⅳ-CTX每月1次,每次0.5～1.0/m~2。C组:Ⅳ-CTX每三个月1次,每次0.5～1.0/m~2。三组均同时口服强的松。结果 A组起效时间显著比B组与C组快;病情缓解率A组也显著高于B组及C组(P<0.01);病情活动性积分下降至50％时,三组CTX累积量无显著性差异(P>0.05)。B、C两组共15例(23.8％)治疗过程中因病情加重,改为2周1次后得到控制,而A组则有3例(9％)因白细胞下降需将冲击间期延后1周。三组副反应及其发生率无显著统计学差异(P>0.05)。结论 Ⅳ-CTX应根据狼疮活动程度进行选择。在急、重症LN治疗的初期,Ⅳ-CTX以每2周1次,每次8～12mg/kg,连用2天,有利于及时缓解病情,提高疗效;治疗后病情减轻时改为每月1次,每次0.51.0/m~2,狼疮活动基本控制后应以每三个月1次,每次0.5～1.0/m~2,以巩固疗效。