温阳通便推拿法治疗老年功能性便秘合并失眠临床研究

目的：观察温阳通便推拿法治疗老年功能性便秘合并失眠的临床疗效。方法：选取100 例老年功能性便秘合并失眠患者为研究对象,随机分为观察组和对照组各50 例。对照组给予枸橼酸莫沙必利胶囊和艾司唑仑片口服,观察组在对照组基础上采用温阳通便推拿法治疗,2 组均治疗4 周。对比2 组治疗前后便秘症状评分、匹兹堡睡眠质量指数（PSQI） 评分,以及便秘和失眠治疗总有效率,记录2 组不良反应发生情况。结果：治疗后,2 组各项便秘症状评分及便秘症状总分均较治疗前降低,观察组排便困难、排便时间、排便频度及便秘症状总分均低于对照组,差异均有统计学意义（P＜0.05）。治疗后,2 组PSQI 评分均较治疗前降低（P＜0.05）,观察组PSQI 评分低于对照组（P＜0.05）。观察组便秘及失眠治疗总有效率分别为92.00%、94.00%,对照组分别为76.00%、80.00%,观察组便秘及失眠治疗总有效率均高于对照组（P＜0.05）。治疗期间,观察组有3 例患者因推拿手法不当导致腰背部疼痛,调整手法力度后未再出现该情况,对照组有2 例患者出现腹泻,减少用药剂量后不良反应消失。结论：温阳通便推拿法可改善老年功能性便秘合并失眠患者的便秘和失眠症状。     

脑电图在偏头痛患者中的诊断价值

目的:探讨脑电图在偏头痛患者中的诊断价值.方法:连续收集武汉大学人民医院和武汉大学中南医院2015年6月至2016年6月确诊的偏头痛患者80例(实验组),总结其脑电图特点,同时按照1∶2配对设计的原则,选取同期成人体检者160例作为对照组.结果:实验组中脑电图异常38例,对照组40例,均为轻度及以下异常.实验组中脑电图特点总结:38例异常脑电图中有21例为轻度异常脑电图,表现具有相对特异性,主要为局灶性尖波,即局部导联的散发性低波幅尖波、小尖波,未见明显的尖慢波、棘波、棘慢复合波,以临床上疼痛的部位相对多见(13/21,61.9％).结论:偏头痛患者脑电图改变具有相对特异性,其对偏头痛患者的诊断具有较好的参考价值.     

DXA、力学测试和矿盐含量评估大鼠股骨性能的精确性比较

目的 为深入了解DXA、力学测试和矿盐含量在航天骨丢失研究的应用,本文比较了这三种方法评估大鼠股骨性能的精确性,并比较了大鼠股骨在活体、离体和冷冻三种情况下的DXA测量差别.方法 选择3只雄性SD大鼠,首先对其两侧股骨进行DXA测量,得到活体、离体和冷冻三种情况的骨矿密度(BMD),然后进行力学测试和矿盐含量测试.结果 DXA、力学测试和矿盐含量的变异系数(CV)分别为7.5%～8.5%,10.1%～17.1%和0.8%.对于DXA测量,活体股骨BMD值与离体和冷冻股骨BMD值都有极其显著差别(P＜0.001),而离体与冷冻股骨BMD值无显著性差别.结论 矿盐含量精确性好于DXA和力学测试.DXA测量活体与离体骨骼差别很大,冷冻不会影响DXA测量.     

The Lupus-derived Anti-double-stranded DNA IgG Contributes to Myofibroblast-like Phenotype in Mesangial Cells

Anti–double-stranded DNA (dsDNA) antibodies have been indicated to play a major role in the pathogenesis of lupus nephritis (LN), which is characterized by mesangial alterations, including phenotypic changes. To explore the effects of anti-dsDNA antibodies on the phenotype of mesangial cells (MCs), the anti-dsDNA IgG in sera and histological features of glomeruli were analyzed in the mice models of immune-complex glomerulonephritis. The MCs were cultured in vitro with the addition of anti-dsDNA or non-anti-dsDNA IgG. Compared to the anti-dsDNA-negative controls, the serum positive mice had increased extracellular matrix accumulation and higher alpha-smooth muscle actin expression in the mesangial region. The anti-dsDNA IgG enhanced the synthesis of transforming growth factor beta, alpha-smooth muscle actin, and fibronectin, and even induced the myofibroblast-like morphological features in cultured MCs. Our results indicated that anti-dsDNA antibodies contribute to the phenotypic changes in MCs, which suggests another mechanism of renal injuries in LN induced by anti-dsDNA antibodies.     

Astragaloside IV protects against ischemic brain injury in a murine model of transient focal ischemia

Astragalus membranaceus is a herbal medicine that has been used clinically in stroke patients in China for decades, but its potential neuroprotective effect against ischemic brain injury has not been experimentally tested. In this study, we investigated the effect of Astragaloside IV, a purified extract from Astragalus membranaceus, in a murine model of focal cerebral ischemia/reperfusion produced by transient (1.5 h) middle cerebral artery occlusion. As determined at 72 h after ischemia, post-ischemic treatment of Astragaloside IV (20 or 40 mg/kg) markedly and significantly (P < 0.03 vs. vehicle-treated animals) reduced infarct volume. Astragaloside IV treatment also decreased the levels of malondialdehyde, an indicator of lipid peroxidation, and increased the levels of the antioxidant enzymes glutathione peroxidase and superoxide dismutase in ischemic tissues. The results presented here provide the first evidence of a neuroprotective effect of Astragaloside IV in the model of ischemic brain injury. We suggest that the anti-infarction effect by Astragaloside IV may be derived at least in part from its antioxidant properties.     

慢性肾炎患者网织红细胞参数动态变化及意义

目的探讨网织红细胞(网红)参数在慢性肾炎患者中变化及临床意义。方法用COULTER-GENS.SYSTEM2五分类血细胞仪对50例慢性肾炎治疗前后及200例健康体检者的网红及红系参数进行测定,并将两者结果作比较并分析。结果慢性肾炎患者红细胞计数(RBC)和血红蛋白(Hb)治疗前比正常对照组极显著性下降(P<0.01),未成熟网织红细胞比例(IRF)和平均网织红细胞体积(MRV)有明显增高(P<0.05);治疗后IRF比对照组及治疗前极显著性升高(P<0.01),RET%、MRV、RBC、Hb比治疗前均有较明显的增加(P<0.05);将慢性肾炎治疗前后各组共100例标本的IRF与Hb、RBC进行相关分析,结果IRF与Hb、RBC均存有一定的正相关性(分别为r=0.536和r=0.231,P<0.01)。结论网红参数为反映慢性肾炎骨髓造血功能较好的指标;其中IRF为更灵敏指标,与红系参数变化具有较好相关性;网红参数测定对于慢性肾炎指导临床药物使用及预防感染、贫血、出血等具有重要意义。     

点式引流手术在下肢慢性静脉功能不全伴脂质硬皮症中的疗效

目的:探讨点式引流手术在下肢慢性静脉功能不全(chronic venous insufficiency,CVI)伴脂质硬皮症(lipodermatosclerosis,LDS)患者中的疗效和可行性。方法:将60例CVI伴LDS患者随机分为试验组和对照组,各30例。试验组行下肢浅静脉高位结扎剥脱术、浅静脉抽剥术和交通静脉结扎术联合LDS病灶点式引流手术治疗;对照组仅行下肢浅静脉高位结扎术、浅静脉抽剥术和交通静脉结扎术。比较2组患者术后皮下硬结厚度、临床严重程度评分(venous clinical severity score,VCSS)、生活质量调查量表(chronic venous insufficiency questionnaire,CIVIQ)评分及术后下肢静脉血中转化生长因子β1(transforming growth factor-β1,TGF-β1)浓度的差异。结果:术后随访6~12个月,平均8.6个月,随访率100%。试验组患者术后LDS临床表现先于对照组缓解消退。术后3、6个月时试验组仅分别有7、2例仍有皮下硬结,而对照组仍有22、15例,P0.01。术后1、3、6个月时,试验组VCSS评分低于对照组、CIVIQ评分优于对照组(P0.01)。术后1个月时试验组TGF-β1明显低于对照组(P0.05)。结论:下肢浅静脉高位结扎术、浅静脉抽剥术和交通静脉结扎术联合LDS病灶点式引流手术,对CVI伴LDS患者有较好的疗效。     

银杏叶提取物后处理对大鼠局灶性脑缺血再灌注损伤保护作用的研究

目的 探讨银杏叶提取物EGb761对大鼠局灶性脑缺血再灌注损伤的保护作用及其机制.方法 制作大鼠右侧大脑中动脉闭塞再灌注模型.将30只清洁级雄性SD大鼠随机分为3组,即假手术组（n-10）：给予5 ml生理盐水腹腔注射;对照组（n-10）：缺血90 min,再灌注24 h,5 ml生理盐水腹腔注射;实验组（n-10）：缺血90 min,再灌注24 h,在再灌注即刻20 mg/kg银杏叶提取物生理盐水稀释成5 ml腹腔注射.再灌注24 h后采用四分法测定大鼠的神经功能障碍评分（NDS）;实验结束后断头取脑采用TTC染色法测定脑梗死面积（以其同侧大脑半球体积的百分比表示）;采用western blot测定脑组织微管相关蛋白2（MAP2）的表达水平.结果 与假手术组比较,对照组、实验组小鼠NDS评分均显著升高,分别为（2.49±0.85）分和（1.58±0.62）分,3组间比较差异均明显（P＜0.05）;对照组、实验组脑梗死面积均显著增大（P＜0.05）,实验组脑梗死面积较对照组显著减小（P＜0.05）;与假手术组比较,与假手术组比较,对照组、实验组缺血侧MAP2蛋白的表达水平均显著降低（P＜0.05）,实验组缺血侧MAP2蛋白的表达水平较对照组显著升高（P＜0.05）.结论 银杏提取物EGb761对大鼠局灶性脑缺血再灌注损伤具有显著的保护效应,其效应与MAP2蛋白表达水平升高有关.     

医疗机构放射工作人员血清中胰岛素样生长因子结合蛋白3水平的影响因素分析

目的 探究低剂量电离辐射对医疗机构放射工作人员外周静脉血清中胰岛素样生长因子结合蛋白3（IGFBP-3）表达水平的影响。方法 采用单纯随机抽样法选取183名放射工作人员纳入此次研究,按放射工种分组,其中介入放射学组37例、核医学组43例、放射治疗组48例和诊断放射学组55例。血清IGFBP-3浓度测定采用酶联免疫吸附试验。结果 4个不同工种组间放射工作人员血清IGFBP-3浓度的差异具有统计学意义（F＝6.056,P<0.05）,其中介入放射学组血清IGFBP-3浓度最高（t＝2.815、3.611、3.936,P<0.05）;不同年有效剂量组间放射工作人员血清中IGFBP-3的浓度差异具有统计学意义（F＝8.380,P<0.05）。随着放射工龄和年有效剂量的增加,放射工作人员血清IGFBP-3浓度呈现上升趋势（r_s=0.202、0.151,P<0.05）。结论 血清IGFBP-3表达水平有作为反映长期慢性低剂量电离辐射累积暴露的生物标志物的潜力。     

Evaluation of protective effects of Chi-Zhi-Huang decoction on Phase I drug metabolism of liver injured rats by cocktail probe drugs

AIM OF THE STUDY: Chi-Zhi-Huang decoction (PGR) is one of the traditional Chinese medicine (TCM) preparations with unique effect on withdrawing jaundice and has been used to treat icteric patients in China for many years. In this research, we aim at to evaluate the potential activity of PGR in restoring hepatic drug metabolism in a damaged liver. MATERIALS AND METHODS: A cocktail approach with caffeine (10mg/kg), dapsone (10mg/kg) and chlorzoxazone (20mg/kg) respectively as probe drug of cytochrome P450 (CYP) isoform of CYP 1A2, 3A4 and 2E1 was used to evaluate its possible effects on Phase I oxidative metabolism. Pretreated with three dosages of PGR water extract (0.75, 1.5 and 3g/kg, po) for 5 days, male Wistar rats (220-240 g) were intoxicated by phenylisothiocyanate (PITC, 100mg/kg, po) 24h before probes intravenous injection. The pharmacokinetics of the probes in the blood was determined simultaneously by HPLC, and their non-compartmental parameters were used to evaluate the metabolic difference among the groups. Moreover, the levels of liver enzymes (ALT, AST, ALP) and bilirubins were also measured for insight of liver function. RESULTS: The findings in this study suggest that PGR induces CYP 3A4, does not have much effect on CYP 2E1, and inhibits CYP 1A2 at high dosage. CONCLUSION: The current pharmacokinetic approach allowed the protective effects of PGR on oxidative drug metabolism in damaged liver to be systemically examined and will certainly help in the explanation of synergistic effect of the composites formula.