加味骨结核散治疗骨及关节骨结核3例临床报告

临床资料病 例1，薛某某，女，67岁，农民，吉林柳河县人。1999年12月18日，其儿带x线、CT、MRI来我所就诊。其儿述：患者现已截瘫，双下肢无知觉，不能亲自就诊。少食少饮，体质消瘦明显，二便不通，痛苦面容。经省级医院确诊脊髓瘤转移，放弃治疗，出院回家。X线、CT、MRI片显示：T7、8椎体骨质破坏明显，椎间隙消失，椎管内可见骨碎片，椎体周围冷脓肿形成。电话问诊：患者神清言明，高烧，乏力，盗汗，食欲减退，大小便不能自行排出，偶尔胸闷，咽干口渴，身热，背部疼痛较重。     

同期同胞HLA全相合与亲缘间单倍体相合异基因造血干细胞移植治疗恶性血液病对比观察

目的 比较同胞HLA全相合与亲缘间单倍体相合异基因造血干细胞移植(allo-HSCT)在恶性血液病治疗中的造血重建情况、移植相关并发症及临床疗效.方法 18例恶性血液病患者中,HLA同胞全相合9例、亲缘间单倍体相合9例,回顾性分析两组造血重建情况、移植相关并发症及临床疗效情况.结果 两组在造血重建、预处理相关毒性、急慢性移植物抗宿主病(GVHD)及临床疗效经改良预处理方案后无明显差异,但在移植过程中及术后、血制品的输注量、CMV感染率及真菌感染率发生方面,单倍体相合移植组明显高于同胞全相合组.结论 经改良预处理方案后同胞HLA全相合与亲缘间单倍体相合allo-HSCT在恶性血液病治疗方而临床疗效相近,亲缘间单倍体相合移植为恶性血液病治疗开辟了又一新途径,从根本上解决了供者来源问题.     

轻身减肥片质量标准的研究

目的:建立轻身减肥片(黄芪、大黄、菌陈、丹参、山楂等)的质量标准.方法:对黄芪、大黄、菌陈、丹参、山楂等组分进行薄层色谱鉴别.采用高效液相色谱法对方中君药大黄中大黄素和大黄酚进行含量测定;结果:薄层图谱斑点清晰,阴性对照无干扰.大黄素、大黄酚平均加样回收率分别为100.3%、100.5%,RSD分别为1.5%、1.6%.结论:方法准确,方法重复性好,可作为该制剂的质量控制指标.     

固相萃取结合高效液相色谱法测定人血浆中多索茶碱浓度

目的:建立固相萃取结合高效液相色谱法测定人血浆中的多索茶碱浓度,为多索茶碱的体内血药浓度监测和人体药物动力学研究提供测定方法.方法:血样经固相萃取法处理,276 nm紫外检测法测定,内标法定量.结果:平均回收率为82.5%,回归方程为Y=7.68×103X-2.00×103,r=0.999 3.日内与日间RSD均低于10%.结论:该法重复性好、干扰小,是一种较为理想的测量方法.     

乙酰丙酮钒在大鼠胃肠道吸收的初步研究

目的:研究乙酰丙酮钒在大鼠胃、小肠和大肠的吸收特性.方法:采用大鼠在体灌流实验,用石墨炉原子吸收法测定大鼠血浆中钒(V)浓度.结果:乙酰丙酮钒在10mg·kg-1剂量下在胃和大肠的吸收速率常数分别为2.853h-1和0.587h-1,AUC分别为158.6ng·mL-1·h和642.7ng·mL-1·h;在不同给药剂量(以钒计)10,25和50mg·kg-1时小肠的吸收速率常数分别为1.414,1.664和17.118h-1,AUC分别为1 714.0,4 641.2和5 554.7 ng·mL-1·h.结论:大鼠胃和大肠是乙酰丙酮钒的不良吸收部位,而小肠有较好吸收,吸收方式可能是被动扩散.     

中国健康人群和甲亢患者细胞色素氧化酶CYP2C19遗传多态性的比较

目的:考察中国健康人群和甲亢患者细胞色素氧化酶CYP2C19遗传多态性的相关性.方法:应用限制性片段长度多态性分析法(PCR-RFLP)对66例甲亢患者和74例健康志愿者进行了基因多态性分析.结果:甲亢患者和健康志愿者中基因型为野生型纯合子wt/wt的分别为34.85%(23/66)和41.89(31/74);基因型为杂合子wt/m1和wt/m2的分别为50.0%(33/66)和45.94%(34/74);基因型为突变型纯合子ml/ml和ml/m2的为15.15%(10/66)和12.16%(9/74).在本实验中未发现m2/m2基因型.甲亢患者和健康志愿受试者的wt/wt和ml/m1的频率没有显著差别.结论:中国甲亢患者和健康人群细胞色素氧化酶CYP2C19遗传多态性在统计学上没有差别.     

基于影像组学分类器术前预测直肠非黏液性腺癌淋巴结转移

目的：探讨影像组学方法在术前预测直肠非黏液性腺癌淋巴结转移中的价值。方法：回顾性分析91例手术病理切片证实为直肠非黏液性腺癌患者的影像学资料,其中61例为训练样本,30例为验证样本。基于全瘤体积,从每个原发病灶术前高分辨T2加权成像(T2-weighted imaging,T2WI)图像中提取影像组学特征1 301个。基于训练样本,利用最小绝对收缩和选择算子(the least absolute shrinkage and selection operator,LASSO)逻辑回归方法筛选关键特征并构建影像组学分类器。采用受试者工作特征(receiver operating characteristic,ROC)曲线评价影像组学分类器的辨别效能,并将其与形态学标准进行比较。在验证样本中验证影像组学分类器的价值。结果：由5个影像组学特征构建的分类器与淋巴结转移状态有关(P<0.001)。在训练样本和验证样本中,影像组学分类器诊断淋巴结转移的曲线下面积分别为0.874(95% CI：0.787~0.960)和0.878(95% CI：0.727~1.000),形态学标准诊断淋巴结转移的曲线下面积分别为0.619(95% CI：0.487~0.752)和0.556(95% CI：0.355~0.756)。无论是训练样本还是验证样本,影像组学分类器的诊断效能均高于形态学标准(均P<0.05)。结论：影像组学分类器可术前个体化预测直肠非黏液性腺癌淋巴结转移,而且其诊断效能高于形态学标准。     

Effect and Mechanism of Ganoderma lucidum Polysaccharides on Human Fibroblasts and Skin Wound Healing in Mice

Objective: To investigate the effects of Ganoderma lucidum polysaccharides(GL-PS) on human fibroblasts and skin wound healing in Kunming male mice and to explore the putative molecular mechanism. Methods: Primary human skin fibroblasts were cultured. The viability of fibroblasts treated with 0, 10, 20, 40, 80, and 160 μg/mL of GL-PS, respectively were detected by 3-4,5-dimethyl-2-thiazolyl-2,5-diphenyl-2-Htetrazolium bromide(MTT). The migration ability of fibroblasts treated with 0, 10, 20, and 40 μg/mL of GL-PS were measured by transwell assay. The secretion of the C-terminal peptide of procollagen type Ⅰ(CICP) and transforming growth factor-β1(TGF-β1) in the cell supernatant was tested by enzyme-linked immunosorbent assay. The expression of β-catenin was detected by Western blot. Furthermore, the Kunming mouse model with full-layer skin resection trauma was established, and was treated with 10, 20, and 40 mg/mL of GL-PS, respectively as external use. The size of the wound was measured daily, complete healing time in each group was recorded and the percentage of wound contraction was calculated. Results: Compared with the control group, 10, 20, and 40 μg/mL of GL-PS significantly increased the viability of fibroblasts, promoted the migration ability of fibroblasts, and up-regulated the expressions of CICP and TGF-β1 in fibroblasts(P0.05 or P0.01). The expression of β-catenin in fibroblasts treated with 20 and 40 μg/mL of GL-PS was significantly higher than that of the control group(P0.01). Furthermore, after external use of 10, 20, and 40 mg/mL of GL-PS, the rates of wound healing in mice were significantly higher and the wound healing time was significantly less than the control group(P0.05 or P0.01). Conclusion: A certain concentration of GL-PS may promote wound healing via activation of the Wnt/β-catenin signaling pathway and up-regulation of TGF-β1, which might serve as a promising source of skin wound healing.     

NLRP3/IL-1β通路在增殖性糖尿病视网膜病变中的作用机制

目的：探究核苷酸结合寡聚化结构域样受体3(NLRP3)/白介素-1β(IL-1β)通路在增殖性糖尿病视网膜病变中的作用机制。

方法：收集2015-09/2018-03我院眼科收治的增殖性糖尿病视网膜病变患者49例49眼(研究组)和特发性黄斑裂孔患者41例41眼(对照组)。检测研究组患者视网膜增殖前膜与对照组患者黄斑前膜中NLRP3蛋白表达情况、活性氧簇(ROS)、丙二醛(MDA)水平与超氧化物歧化酶(SOD)活性,测定两组患者玻璃体中IL-1β与IL-18浓度。

结果：研究组患者视网膜增殖前膜中NLRP3蛋白阳性表达率明显高于对照组患者黄斑前膜(90% vs 5%,P<0.05),且研究组患者视网膜增殖前膜中ROS与MDA水平明显升高,而SOD活性明显降低。研究组患者玻璃体中IL-1β、IL-18浓度(30.84±7.15、97.61±15.73pg/mL)均明显高于对照组(4.63±0.92、52.07±11.38pg/mL)。

结论：NLRP3与IL-1β在增殖性糖尿病视网膜病变组织中呈高表达,NLRP3/IL-1β通路可上调炎性因子与氧化因子表达水平,促进疾病发展。     

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??Objective??To analyze the clinical and gene mutation characteristics of Duchenne progressive muscular dystrophy ??DMD????summarize the gene mutation hotspots in 97 cases and to explore the correlation between clinical manifestations and genotype. Methods??Totally 97 patients with DMD diagnosed by genetic examination from January 2014 to 2018 were collected and analyzed. The clinical manifestations??serum analyses and gene mutation results were analyzed. Results??The main clinical manifestations of 97 patients??96 boys?? were feeding difficulties?? increased muscle enzyme and limb weakness. Creatine kinase??CK???? lactate dehydrogenase??LDH?? and aspartate aminotransferase??AST?? muscle enzymes were significantly increased. By combining deep-sequencing technologies??the large deletions of DMD gene mutation was in 62 cases??63.92%????there were 11 cases??11.34%?? of large duplication mutation??and 24 cases??24.74%?? of point mutation. All of the mutations could occur in any position in the DMD gene??but there were two hot spots??45 cases were located in the central region gene exon 45??55??72.58% ????12 cases of deletion mutation were located in 5’exon end exon 2??19 area??19.35%??. Conclusion??The main clinical manifestations of the DMD children are feeding difficulty??increased muscle enzyme and limb weakness. The patients with significantly increased muscle enzyme should receive a timely defection of DMD gene.