米非司酮-Ⅱ在预防卵巢过度刺激综合征中的作用

目的观察米非司酮-Ⅱ在预防卵巢过度刺激综合征(OHSS)中的效果。方法选取实施体外受精-胚胎移植(IVF)长方案控制性促排卵过程中出现OHSS早期征象并行全胚冷冻的166例患者分为2组,观察组84例,对照组82例。观察组患者于取卵后即给予米非司酮-Ⅱ25 mg口服,每日1次,连续5 d;对照组则给予安慰剂。对比患者取卵后5、8 d激素水平、卵巢体积及黄体期变化,观察治疗效果。结果 2组患者基础促卵泡成熟激素(FSH)水平、窦卵泡数、促性腺激素使用量、注射绒毛膜促性腺激素(HCG)日雌二醇(E2)水平、获卵数、可利用胚胎数、取卵前卵巢体积、取卵后5、8 d FSH、黄体生成素、黄体酮及注射HCG日E2水平比较差异均无统计学意义(P>0.05);对照组患者早期中重度OHSS发生率高于观察组(P<0.05);观察组患者取卵后8 d卵巢体积及黄体期均小于对照组(P<0.05)。结论米非司酮-Ⅱ可以缓解OHSS患者症状,降低中重度OHSS发生率,对预防早发型OHSS有一定效果。     

针刺足三里的静息态脑功能局部一致性研究简

目的观察针刺足三里的静息态脑区功能局部一致性（Reho）,探讨针刺穴位的作用机制。方法选择10例健康志愿者,其中男性4例,女性6例;年龄20～34岁,中位年龄23岁。利用GESigna HDxt3.0T磁共振成像系统对针刺前（对照组）、针刺足三里后分别进行静息态扫描,运用统计参数图（SPM8）软件,采用Reho的数据后处理方法,分析2组被试不同脑区Reho值的差异.并运用错误发现校正（FDR-corrected）,得到有统计学差异的脑区。结果针刺足三里组与针刺前相比,Reho值增高的脑区有右侧前扣带回（8.17）、左侧额中回（4.84）;Reho值减低的脑区有左侧小脑半球（-7.75）、右侧后扣带回（-6.66）、左侧豆状核（-6.87）、右侧岛叶皮层（-7.57）、左侧胼胝体（-5.71）、左侧楔前叶（-4.68）、右侧额叶内侧回（-8.59）。结论针刺足三里后造成局部脑组织血氧水平信号同步性改变,提示针刺足三里不仅有特异的脑功能激活区.而且引起的脑功能活动存在Reho差异。     

β型甲状腺激素抵抗综合征患者临床特点分析

背景　β型甲状腺激素抵抗综合征（RTHβ）属于罕见内分泌疾病,临床极易误诊、误治。目的　总结RTHβ患者的临床特点,为临床医师了解本病提供帮助。方法　选取2013-2016年于中国医科大学附属第一医院内分泌与代谢病科诊断为RTHβ的患者6例。回顾性分析6例RTHβ患者的临床资料,包括性别、诊断年龄、发病年龄、家族史、主诉、心电图检查结果、甲状腺触诊结果、甲状腺超声检查结果、甲状腺核素静态显像结果、甲状腺功能指标〔游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）〕、促甲状腺素受体抗体（TRAb）、性激素结合蛋白（SHBG）、血清铁蛋白、脂代谢指标、骨代谢指标、骨密度、基因测序情况等。结果　6例RTHβ患者的诊断年龄均高于发病年龄,患者在确诊RTHβ之前均被误诊为甲状腺功能亢进症,长期服用抗甲状腺药物治疗。患者主诉均存在心悸、多汗,3例伴心房颤动。6例患者甲状腺核素静态显像均显示甲状腺双叶摄取率增高。5例RTHβ患者甲状腺超声显示有甲状腺肿大,4例显示多发结节。6例RTHβ患者血清FT3、FT4水平升高,TSH水平在参考范围,且TRAb均为阴性;血清SHBG和血清铁蛋白均在参考范围;甲状腺激素受体（TR）β基因测序均存在点突变。结论　RTHβ的临床表现存在高度异质性,临床诊断时需注意与甲状腺功能亢进症和甲状腺功能减退症区分,同时注意并非所有的RTHβ患者能检测出TRβ基因突变。对于高度怀疑为RTHβ的患者,可以采用促甲状腺素释放激素（TRH）兴奋试验、左旋-三碘甲腺原氨酸（L-T3）抑制试验或TRH兴奋试验联合L-T3抑制试验进行临床诊断。     

Effects of Hirudin on High Glucose-Induced Oxidative Stress and Inflammatory Pathway in Rat Dorsal Root Ganglion Neurons

Objective: To investigate protective effects of hirudin on oxidative stress and apoptosis of spinal dorsal root ganglion cells in high-glucose rats at the cellular and molecular level. Methods: Dorsal root ganglion neurons(DRGn) were harvested from embryonic day in 15 SD rats, purified and identificated after primary culture. They were divided into the normal control group, high-glucose(HG) group, positive control(alpha-lipoic acid, ALA) group, low-dose hirudin group(H1), medium-dose hirudin group(H2) and high-dose hirudin group(H3). The control group was cultured by neuron specific culture medium, while the HG group was cultured by neuron specific culture medium and 20 mmol/L glucose(HG medium). The hirudin groups were cultured by HG medium+0.25 IU/mL hirudin(H1), HG medium+0.5 IU/mL hirudin(H2) and HG medium+1 IU/mL hirudin(H3). The ALA group was cultured by HG medium+100 μmol/L ALA. 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenylt etrazolium bromide(MTT) assay was used to explore the optimum concentration and intervention time. Flow cytometry assay was used to detect the level of reactive oxygen series(ROS). Western blot and quantificational realtime polymerase chain reaction(qRT-PCR) were used to detect the expression of protein and mRNA of nuclear factor erythroid 2-related factor 2(Nrf-2), hemeoxygence-1(HO-1), nuclear factor-κB(NF-κB) and Caspase-3. TUNEL assay was used to test the apoptosis rate of different groups. Results: After 24 h of culture, the cell activity of hirudin and ALA groups were higher than that of HG group, and there was a statistical difference between the H1 group and HG group(P0.05). In hirudin groups, the apoptosis rate of cells, the expression of activated Caspase-3 protein and Caspase-3 mRNA were lower than those of HG group(P0.01), higher than those of ALA group(P0.01 or P0.05). The ROS level of hirudin groups was higher than that of ALA group(P0.01), lower than that of HG group(P0.01 or P0.05). The expression of NF-κB(P65) protein in H3 group were lower than those of HG group(P0.05). The expression of Nrf-2 protein in hirudin groups was higher than that of HG group(P0.01), lower than that of ALA group(P0.01 or P0.05). The expression of HO-1 protein in hirudin groups was lower than that of ALA group(P0.01 or P0.05), higher than that of HG group(P0.01 or P0.05). Conclusions: The activity of DRGn cells can be promoted by hirudin under HG conditions. The effects of hirudin on the inhibition of HG on DRGn cells damage mainly include scavenging ROS, up-regulating Nrf-2/HO-1 pathway, inhibiting activation of NF-κB pathway, down-regulating the expression of and Caspase-3 and reducing DRGn cell apoptosis.     

Effect and Safety of CX-DZ-Ⅱ Intelligent Electroacupuncture Therapeutic Instrument for Neck Pain Caused by Cervical Spondylos: Study Protocol for A Randomized Controlled Trial

Background: Neck pain caused by cervical spondylosis(CS) is a chronic pain condition, with an increasingly high incidence in the general population. Electroacupuncture is a common analgesic modality that has been widely applied in neck pain treatment. However, current electroacupuncture instruments used in the clinic have low intelligence levels and obscure parameter standards. We here designed this study for assessing the effect and safety of a new, intelligent electroacupuncture instrument, the CX-DZ-Ⅱ, in treating neck pain. Methods: The present study is a prospective, two-center, randomized, controlled, open-label, non-inferiority trial for CX-DZ-Ⅱ on treating neck pain caused by CS. Totally 160 eligible patients will be included in this trial and randomly assigned to an experimental group and a control group in a 1:1 ratio. A semi-standard acupoint selection strategy will be employed. In the experimental group, selected acupoints will be stimulated by CX-DZ-Ⅱ. Electroacupuncture treatment will be accomplished by a pre-existing electroacupuncture instrument in the control group. The duration of treatment will be 2 weeks. The primary outcome is the change of Visual Analog Scale(VAS) score after one course of treatment. The secondary outcomes include the VAS scores after each treatment, the responder rate, drug-usage rate of non-steroidal antipyretic analgesics, the rate of adverse events occurrence, and the performance of instrument. Discussion: This study will evaluate the effect and safety of the CX-DZ-Ⅱ intelligent electroacupuncture therapeutic instrument in comparison with a pre-existing non-intelligent instrument in the treatment of neck pain caused by CS. The results will hopefully demonstrate a more optimal electroacupuncture instrument for the treatment of neck pain.(Trial registration No. gov NCT03005301).     

两种局灶性脑缺血大鼠模型的影像及超微结构比较

目的比较大鼠大脑中动脉闭塞（MCAO）模型和光化学诱导局灶性脑缺血模型的磁共振影像及超微结构的差异。方法分别建立大鼠MCAO和光化学诱导局灶性脑缺血模型,利用小动物磁共振成像系统观察脑缺血区域及周边血管分布,结合透射电镜技术比较两种模型缺血区超微结构的变化。结果MCAO模型缺血区范围较大且不稳定,细胞结构破坏严重,血管变形显著,新生血管较少。光化学诱导模型缺血区范围较小且稳定,细胞结构损伤区域较小,新生血管较多。结论两种模型方法各有优缺点,均为脑缺血后血管损伤保护及溶栓治疗的研究提供实用性工具,可根据科研需求选取适合的造模方法     

茜草炮制前后红外图谱分析

[目的]分析茜草及茜草炭的红外原谱及二阶导数谱,提取红外谱图特征。[方法]利用现代红外光谱技术,对茜草及茜草炭进行分析。[结果]茜草炒炭前后红外原谱、二阶导数谱有明显的变化,表明红外技术用于中药材及其炮制品的鉴别是可行的。[结论]红外光谱法样品的制备较简单,仪器设备普及性较强,在中药材饮片的快速鉴别中占据一定的优势。