T细胞死亡相关基因8的研究进展

背景 T细胞死亡相关基因8(T cell death associated gene 8,TDAG8)受体是一种质子敏感的G蛋白耦联受体(G protein coupled receptor,GPCR),在机体内广泛表达,但其生物学功能和临床相关性仍不十分清楚.随着对TDAG8的研究不断深入,尤其是TDAG8变构激动剂和变构拮抗剂的发现,为揭示TDAG8的生理功能和作用提供了重要的研究工具.目的 通过论述TDAG8可能介导的作用及其机制,为进一步研究阐述TDAG8的生物学功能及其临床相关性提供重要的理论依据.内容 系统性地综述TDAG8的生理功能及其作用机制.趋向 TDAG8可能是炎症反应的重要调节器.     

精神病患者机械通气治疗左心衰竭时丙泊酚的疗效观察

目的:探讨丙泊酚对精神病患者机械通气治疗急性左心功能衰竭时治疗效果.方法:将精神病合并急性左心衰行机械通气的38例随机分成两组:丙泊酚组(n=18):持续静滴丙泊酚0.5～1.0 mg/(kg·h):对照组(n=20):间断用度冷丁50～100 mg静脉注射;观察镇静效果达Ramsay分级Ⅲ～Ⅳ级时间、动态监测给药前、后的生命体征、循环参数的变化.结果:丙泊酚的镇静效果优于对照组,治疗后1 h,两组血流动力学指标均较治疗前有显著改善.与对照组比较,丙泊酚组心脏指数显著升高,肺动脉压、肺毛细血管楔压轻度下降、外周血管阻力有所下降,有统计学差异(P<0.05);丙泊酚组平均动脉压较对照组有所下降,但无统计学意义,P>0.05.结论:精神病患者机械通气治疗急性左心衰时使用丙泊酚镇静效果好,并对血流动力学影响有益.     

Relative roles of inhibin B and sex steroids in the negative feedback regulation of follicle-stimulating hormone in men across the full spectrum of seminiferous epithelium function

CONTEXT AND OBJECTIVE: Our aim was to explore the relative roles of gonadal sex steroids and inhibin B in the regulation of FSH across a spectrum of seminiferous epithelium function. SUBJECTS: The study included three groups: group I, healthy men (n = 31); group II, men with idiopathic hypogonadotropic hypogonadism receiving pulsatile GnRH (n = 12) selected to represent a spectrum of seminiferous tubular development, testicular size, and baseline inhibin B levels; and group III, men with functional anorchia (n = 3) receiving testosterone replacement. DESIGN: Subjects were studied before and after 3 d of acute sex steroid withdrawal. SETTING: The study was conducted at the Mallinckrodt General Clinical Research Center of Massachusetts General Hospital. INTERVENTIONS: Acute biochemical castration was achieved using high-dose ketoconazole (groups I and II) or withdrawal of androgen therapy (group III). MAIN OUTCOME MEASURES: The relationship between FSH and inhibin B in both normal and castrate sex steroid milieu was measured. RESULTS: In both normal and castrate sex steroid milieus, there was a negative relationship between inhibin B and FSH, best described by a logarithmic model. Acute biochemical castration resulted in the most dramatic increases in FSH in men with the lowest baseline inhibin B levels. CONCLUSIONS: We came to the following conclusions: 1) in the human male, inhibin B is the principal gonadal feedback regulator of FSH secretion unless seminiferous tubular function is severely compromised, and a logarithmic model best describes this relationship; and 2) sex steroid inhibition of FSH secretion is most apparent when serum inhibin B levels fall well below the normal range.     

超声造影在睾丸扭转中的诊断价值

目的通过与彩色多普勒超声对比,探讨超声造影在睾丸扭转诊断中的临床应用价值。方法回顾性分析43例经手术或临床随访证实的睾丸扭转患者的超声造影表现,并与彩色多普勒超声的诊断性能进行比较。结果超声造影时,7例完全扭转型患侧睾丸内未见造影剂填充,睾丸周围组织环状增强,呈"晕圈征"。36例不完全扭转型患侧睾丸内部均有造影剂填充,但可见局部造影剂缺损区,与健侧睾丸比较,增强开始时间和达峰时间均明显延长,达峰强度低于正常睾丸组织,呈低增强。超声造影和彩色多普勒超声诊断完全扭转型睾丸扭转的准确率均为100%,两种方法比较差异无统计学意义(χ2=0.000,P=1.000),超声造影诊断不完全扭转型睾丸扭转的准确率为100%,彩色多普勒超声诊断不完全扭转型睾丸扭转的准确率为83.3%,两种方法统计学比较差异有统计学意义(χ2=4.2,P<0.05)。结论超声造影和彩色多普勒超声在诊断完全扭转型时有很好的一致性,超声造影诊断不完全扭转型的准确率优于彩色多普勒超声。超声造影可准确判定睾丸缺血受损的范围及程度,可作为睾丸扭转诊断评估的重要影像学方式。     

归芍地黄丸中山茱萸的定性定量方法研究

摘 要 目的： 建立归芍地黄丸中山茱萸的定性和定量测定方法。方法: 采用TLC对归芍地黄丸中山茱萸进行定性鉴别,并采用HPLC测定山茱萸中莫诺苷、 马钱苷的含量。结果: TLC色谱斑点清晰,分离度好,专属性强;莫诺苷对照品在0.010～2.620 μg范围内线性关系良好（r=0.999 9）,平均回收率为102.75％,RSD为1.40％（n=6）。马钱苷对照品在0.009～2.170 μg范围内线性关系良好（r=0.999 9）,平均回收率为103.59%,RSD为1.10%（n=6）。结论:本方法准确、简单、可行,重复性好,可有效控制该制剂中山茱萸的质量。     

The meta-analysis of the effect of 68Ga-PSMA-PET/CT diagnosis of prostatic cancer compared with bone scan

Background:⁶⁸Ga-PSMA-PET/CT (positron emission tomography/computed tomography) is a promising method for prostate cancer (PC) detection. However, the ability of ⁶⁸Ga-PSMA-PET/CT to detect malignant bone lesions, and whether this method is superior to the existing bone imaging methods are still lack of systematic analysis.Purpose:To evaluate the value of ⁶⁸Ga-PSMA-PET/CT and bone scan in clinical diagnosis of prostatic cancer from the perspective of evidence-based medicine.Methods:PubMed, The Cochrane Library, EMBASE, Springer Link, Sinomed, CNKI, Wanfang database, and CQVIP database were searched to find the satisfactory studies that needed systematic review of trials and compared the value of 68Ga-PSMA-PET/CT and bone scan. All studies published from inception to March 31, 2020. According to the inclusion and exclusion criteria, 2 reviewers independently evaluated and extracted the literature. Review Manager 5.3 was applied to evaluate the included literature quality. The heterogeneity of the included literature was tested by Meta Disc 1.4, and the effect model was selected according to the heterogeneity test results, and the sensitivity (SEN), specificity (SPE), PLR, NLR and diagnostic odds ratio (DOR) were analyzed. After testing the heterogeneity results of literature by using the 95% confidence interval and the forest map.Results:A total of 4 studies were eligible for inclusion in the meta-analysis, which included 318 patients, 120 cases with bone metastasis and 198 cases without bone metastasis. The results of summary evaluation for ⁶⁸Ga-PSMA-PET/CT and bone scan in diagnosis of prostatic cancer as follow respectively: The SEN were 0.97 and 0.86; the SPE were 1.00 and 0.87; the DOR were 1468.33 and 36.23; PLR were 88.45 and 6.67; NLR were 0.05 and 0.19; and the area under curve (AUC) and 95% CI were 0.9973 (1.0000–0.9927) and 0.8838 (0.9584–0.8092).Conclusion:By comparing the diagnostic results of ⁶⁸Ga-PSMA-PET/CT and bone scan imaging diagnosis methods, the ⁶⁸Ga-PSMA-PET/CT has a higher SEN and SPE than bone scan, and it has a higher diagnostic efficiency for prostate cancer bone metastasis, which is worthy of clinical application.     

Clinical joints manifestations in patients with psoriatic arthritis on musculoskeletal ultrasound

Clinical Rheumatology - To investigate the clinical joints manifestations under musculoskeletal ultrasound (MSUS) and hematological findings in patients with psoriatic arthritis (PsA), which may...     

麻醉前应用新型抗胆碱药物对失血大鼠肠系膜微循环改变的影响

目的:探讨麻醉前应用新型抗胆碱药物长托宁(盐酸戊乙奎醚)对失血大鼠肠系膜微循环改变的影响。方法:4月龄SD大鼠14只,随机分为长托宁组和对照组(n均=7),分别于5%水合氯醛麻醉前腹腔注射长托宁和生理盐水(0.17ml/100g),麻醉30min后行颈总动脉插管及腹腔侧切口暴露肠系膜,放血前和放血至动脉压恒定于60mmHg时观测两组大鼠肠系膜微血管口径及血液流速,统计学分析比较组间微血管收缩率和微血流速度。结果:失血可致肠系膜微血管显著收缩,血流速度明显减慢,长托宁组大鼠微血管收缩率及血液流速减缓率均明显低于对照组(P0.05)。结论:麻醉前长托宁干预能有效改善大鼠失血性肠系膜微循环障碍。     

温哥华量表在90Sr治疗瘢痕疙瘩中的应用

目的 在瘢痕疙瘩患者进行90Sr同位素敷贴治疗前,按照温哥华瘢痕量表进行评分,推断治疗效果,合理选择适应症.方法 选取2008年1月至2013年1月在本院皮肤科及外科门诊确诊的瘢痕疙瘩患者105例,按照温哥华瘢痕量表根据色泽、厚度、血管分布、柔软度进行评分,分为两组(A组0～8分,B组9～15分),采用90Sr同位素敷贴治疗,治疗后随访6 ～12个月,进行疗效评价.结果 在131例瘢痕疙瘩患者中,痊愈率48.09％;好转率51.91％;总有效率100％.其中A组剂量30.12±3.15Gy,痊愈率62.69％,不良反应发生率16.42％.B组剂量44.16±5.56Gy,痊愈率32.81％,不良反应发生率48.48％.经spssl6.0统计学软件处理,差异有统计学意义.结论 在瘢痕疙瘩患者进行90Sr同位素敷贴治疗前,按照温哥华瘢痕量表进行评分,根据量表评分来选择合适患者治疗,是一种简单、有效且较为准确的方法.