肝内及肝外胆管癌表达下调microRNAs表达谱的鉴定

目的筛选并鉴定肝内及肝外胆管癌组织表达下调的miRNAs,进行初步的功能研究。方法利用miRNA-基因芯片方法筛选肝内、肝外胆管癌组织特异表达下调或共同表达下调的miRNAs,选择real-time PCR方法进行验证;根据肝内及肝外胆管癌不同的下调miRNAs表达谱,选择差异明显且具有代表性的miRNAs,利用miRNA特异模拟物转染胆管癌细胞系QBC939,利用MTT试剂盒分析细胞增殖变化,研究表达下调miRNAs与胆管癌细胞增殖的关系。结果表达分析显示,肝外胆管癌组织特异表达下调的miRNAs共25个,肝内胆管癌组织特异表达下调的miRNAs共15个,在肝内及肝外胆管癌组织均表达下调的miRNAs共6个。在胆管癌细胞系QBC939中分别过表达miR-181a、miR-596、miR-492以及miR-602可以明显抑制细胞增殖。结论肝内及肝外胆管癌具有不同的miRNAs表达谱,表达下调的miRNAs可以明显抑制胆管癌细胞增殖。     

高脂膳食和跑台运动构建模型大鼠腓肠肌葡萄糖转运体4和cAMP反应元件结合蛋白的变化

BACKGROUND: Some studies indicate that PI3K/Akt signaling pathway is associated with the expression of glucose transporter 4 (GLUT4) and the function of cAMP response element binding protein (CREB) in skeletal muscle. However, it is still unclear whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in skeletal muscle of the rats with high-fat diet and treadmill exercise. OBJECTIVE: To investigate whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in gastrocnemius muscle of the rats with high-fat diet and treadmill exercise.  METHODS: A total of 70 rats were fed with normal diet for 2 weeks, and randomly divided into common feed group (n=20) and high-fat feed group (n=50). Rats in both groups were respectively fed with common feed and high-fat feed for 8 weeks. The rats in the common feed group were equally assigned to common feed quiet group and common feed exercise group. 20 rats from the high-fat feed group whose body weight was 1.4 times of common rats were randomly and equally assigned to obese quiet group and obese exercise group. Rats in the quiet groups did not do exercises. Rats in the exercise groups received adaptive sports for 1 week and medium-intensity treadmill exercise for 8 weeks.  RESULTS AND CONCLUSION: (1) Impairments of PI3K/Akt signaling pathway appeared in obese rats, however, the quantity of GLUT4 expression did not change obviously in gastrocnemius muscles of obese rats. The reasons for the decrease of the nuclear protein CREB level of gastrocnemius muscles of obese rats might be related to the decrease of pAkt-Ser473 level. (2) The increase of the quantity of GLUT4 expression was accompanied by significantly up-regulated pAkt-Ser473 level by exercise intervention in gastrocnemius muscles of obese rats. Exercise intervention significantly increased the expression of nuclear protein CREB in gastrocnemius muscles of chow-fed rats and obese rats, which was consistent with the changes of pAkt-Ser473. These findings suggest that pAkt-Ser473 can play an important role in the effects of high-fat diet and exercise intervention on GLUT4 and CREB protein expression in gastrocnemius muscles of obese rats.       

广州市绝经后妇女心血管病危险因素与骨质疏松的关系

目的 评估心血管病危险因素与骨质疏松的关系.方法 2008年7月至2010年1月对2202名年龄50～73岁广州市社区妇女进行问卷调查,测量血压、血脂、血糖和血尿酸,检测体脂成分、颈动脉内膜中层厚度(IMT)等心血管病危险因素,并测量桡骨和胫骨超声骨密度.采用因子分析法对危险因素提取公因子,并进行四等分位转化.结果 共提取8个公因子,分别反映肥胖程度、瘦体成分、甘油三酯/尿酸、胆固醇、年龄、血压、IMT和体力活动.多因素logistic分析显示:年龄和IMT因子得分越高,瘦体成分因子得分越低,桡骨和胫骨骨质疏松的风险均越高(趋势检验:P<0 01).与最低四分位组相比,各因子得分最高组的OR值(95%C1),瘦体成分为0 62(0.44～0.88)和0.62(0.48～0.80)、年龄为4.02(2.72～5.94)和3.68(2.81～4.82)、IMT为1.41(1.00～2.00)和1.54(1.19～2.00).血压是桡骨骨质疏松的重要危险因素,肥胖是胫骨骨质疏松的独立危险因素.结论 IMT增厚、瘦体成分减少、肥胖、血压高等心血管病危险因素可显著增加骨质疏松风险,改善这些危险因素有助于预防骨质疏松.

Abstract：

Objective To assess the relationship between cardiovascular risk factors and osteoporosis. Methods 2202 women aged 50-73 years were included in this cross-sectional study from the communities in Guangzhou, from July 2008 to January 2010. Cardiovascular risk factors including age, years since menopause, physical activity, anthropometrics, body composition, blood pressure, fasting serum lipids, glucose and uric acid, intima-media thickness(IMT) of carotid artery were assessed. Ultrasonic bone density (speed of sound) at the radius and tibia were determined. Osteoporosis was defined as T-score≤-2.5. Common factors for the cardiovascular risk factors were extracted using the factor analysis method. Results Eight common factors representing obesity, lean mass, blood triglycerides and uric acid, cholesterol, age, blood pressure, IMT and physical activity were extracted. Data from the Multivariate logistic regression showed a dose-dependent association of greater scores of age and IMT factors and lower score of lean mass factor with the increased risk of osteoporosis at the radius and tibia. As compared with the bottom quartile, the OR (95%CI) of radius and tibia osteoporosis were 0.62 (0.44-0.88) and 0.62 (0.48-0.80) for lean mass factor, 4.02 (2.72-5.94) and 3.68(2.81-4.82) for age factor, 1.41 (1.00-2.00) and 1.54 (1.19-2.00) for IMT factors, respectively. Moreover, greater blood pressure score was associated with higher risk of radius osteoporosis while the higher obese score, was correlated with the increased risk of tibia osteoporosis. Conclusion The cardiovascular-related risk factors of greater IMT, obesity, blood pressure and lower lean mass scores were associated with increased osteoporosis risks while called for more concern among the Chinese women.     

全冠修复与嵌体治疗早期牙隐裂的效果比较

目的 比较全冠修复与嵌体治疗早期牙隐裂的效果.方法 选取郑州大学第一附属医院2015年2月至2020年1月收治的早期牙隐裂患者96例,并将患者按照随机数字表法分为全冠组和嵌体组,每组48例.全冠组采用全冠修复治疗,嵌体组采用嵌体治疗,比较两组牙体修复效果、治疗前后疼痛程度(VAS评分)、咀嚼功能及修复满意度.结果 嵌体...     

益气通脉汤对冠心病心力衰竭患者心功能和炎性反应的影响

目的 分析益气通脉汤治疗冠心病心力衰竭(HF)患者心功能和炎性反应的影响.方法 选取冠心病HF患者186例,按随机数字表法分为中医组(n=93)与西医组(n=93),西医组予以常规西医治疗,在西医组用药基础上中医组予以益气通脉汤,对比两组疗效和治疗前后心功能[左心室射血分数(LVEF)、舒张末期左心室内径(LVEDD)...     

“培土生金”法治疗慢性阻塞性肺疾病的现代医学研究

[目的]探讨“培土生金”法治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的现代医学研究。[方法]以中医学理论为指导,以五行学说及脏腑学说为出发点,选取“培土生金”为     

赤芝不同部位油脂组成分析

收集不同产地、品种、采收部位和潮次的赤芝孢子粉和子实体,对其含油率、脂肪酸组成进行测定分析,结果表明:全国不同产地的破壁孢子粉含油率为23.61%~34.17%;浙江主栽赤芝品种子实体含油率为0.81%~1.87%,未破壁孢子粉为0.07%~0.24%,破壁孢子粉为27.54%~34.17%,赤芝孢子粉含油率远远大于子实体,破壁加工可提高孢子粉中油脂提取率150~340倍。赤芝孢子油主要由不饱和脂肪酸组成,其中油酸和亚油酸质量分数分别为53.26%~58.16%,10.69%~16.87%;偏最小二乘法判别分析显示,孢子粉和子实体的脂肪酸组成存在明显差异,通过测定脂肪酸组成,尤其是油酸、硬脂酸、棕榈酸的含量,可以鉴别赤芝类产品来源的组织类型。研究还发现同一品种赤芝1潮孢子粉和子实体中含油率和脂肪酸含量均高于2潮。     

化瘀通痹汤辅助电针治疗下肢动脉硬化闭塞症的应用研究

目的 观察化瘀通痹汤辅助电针治疗下肢动脉硬化闭塞症（ASO）的临床效果。方法 将商丘市第一人民医院2022年1月至2023年9月收治的100例ASO患者作为研究对象开展前瞻性研究,随机分为电针组和联合组各50例。电针组采用电针夹脊穴治疗,联合组采用化瘀通痹汤联合电针夹脊穴治疗,比较两组血糖水平、炎症介质、血管内皮功能及下肢血液循环情况。结果 联合组空腹血糖（FBG）、餐后2 h血糖（2 h PG）、糖化血红蛋白（HbA1c）均低于电针组（P＜0.05）;联合组治疗后C反应蛋白（CRP）、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）均低于电针组（P＜0.05）;联合组治疗后内皮素-1（ET-1）、单核细胞趋化蛋白-1（MCP-1）、血管性假血友病因子（vWF）均低于电针组（P＜0.05）;联合组治疗后胫后动脉与足背动脉的血流峰值、血管内径均高于电针组（P＜0.05）。结论 化瘀通痹汤辅助电针治疗能降低下肢动脉硬化闭塞症患者血糖水平,改善血管内皮功能,减轻炎症反应,改善下肢血液循环。     

应用蒙特卡罗模拟优化肾功能亢进患者万古霉素给药方案的研究

目的根据万古霉素在肾功能亢进(ARC)和肾功能正常患者中的药物代谢动力学/药物效应动力学(PK/PD)原理,应用蒙特卡罗模拟优化ARC和肾功能正常患者万古霉素对常用革兰阳性菌的初始给药方案。方法使用文献公开发表的ARC及肾功能正常患者中的群体PK模型,收集2017至2019年南京医科大学附属苏州医院甲氧西林耐药金黄色葡萄球菌(MRSA)、甲氧西林耐药表皮葡萄球菌(MRSE)、粪肠球菌、屎肠球菌的最小抑菌浓度(MIC)分布。采用蒙特卡罗模拟计算不同万古霉素日剂量的目标获得概率(PTA)和累积反应分数(CFR),以预测达到与PK/PD参数指标AUC0~24 h/MIC的万古霉素给药剂量,推荐最佳给药方案。结果蒙特卡罗模拟结果显示,MIC=0.5时ARC患者对革兰阳性菌万古霉素日剂量2.0 g/d的PTA为97.30%,而肾功能正常患者只需要1.5 g/d,PTA即可达99.16%。MIC=1时,肾功能正常患者需要万古霉素2.5 g/d,PTA可达92.91%,而ARC患者需要万古霉素3.5 g/d,PTA才可达88.71%。当MIC≥2时,万古霉素常规推荐的给药剂量(2.0~4.0 g/d)很难达到理想的PTA值。对于常见革兰阳性菌,肾功能正常患者需要万古霉素3.0 g/d,CFR可达91.36%,而ARC患者需要万古霉素4.5 g/d,CFR可达90.60%。MRSA和屎肠球菌的MIC≤1的占比分别为97.25%和94.50%。肾功能正常患者MRSA感染给予万古霉素2.5 g/d,CFR可达93.95%,屎肠球菌给予万古霉素3.0 g/d,CFR可达94.46%;而ARC患者MRSA感染给予万古霉素3.5 g/d,CFR可达91.42%,屎肠球菌给予4.0 g/d,CFR可达93.07%。MRSE的MIC=1和2占比分别为64.64%和27.44%,粪肠球菌为77.09%和20.13%。肾功能正常患者粪肠球菌感染给予万古霉素4.0 g/d,CFR可达92.55%,MRSE需要万古霉素4.5 g/d,CFR可达92.79%,而ARC患者MRSE和粪肠球菌需要万古霉素6.0 g/d,CFR才可达88.35%和92.03%。当革兰阳性菌MIC≤0.5时ARC患者给予万古霉素2.0 g/d和肾功能正常者予1.5 g/d,PTA均可≥90%。MIC=1时肾功能正常患者推荐万古霉素3.0 g/d,ARC患者推荐万古霉素4.5 g/d,PTA和CFR可达90%以上。MIC≥2的革兰阳性菌万古霉素常规给药日剂量(2.0~4.0 g/d)对于ARC和肾功能正常患者均很难达到目标的PTA及CFR。结论与肾功能正常患者相比,ARC患者万古霉素需要更大的日剂量才可达目标PTA和CFR。MIC≥2的革兰阳性菌感染,建议改用其他敏感性更好的抗革兰阳性菌药物治疗。