硫酸镁对普鲁帕酮致心律失常的干预作用

目的探讨静脉滴注硫酸镁对普鲁帕酮致心律失常作用的干预效果。方法将92例心律失常患者随机分为对照组和干预组,每组46例。两组均口服普鲁帕酮,干预组同时静脉滴注硫酸镁,于治疗1周后常规心电图观察心律失常变化及致心律失常作用。结果心律失常消失率对照组为43.4%(20/46)、干预组为82.6%(39/46),致心律失常率对照组为19.6%、干预组为4.4%,两组比较有统计学意义(P<0.01)。结论普鲁帕酮抗心律失常同时有致心律失常作用,使用硫酸镁干预可降低致心律失常发生率。     

阴式子宫瘢痕妊娠病灶清除术的临床疗效评价

目的 观察阴式子宫瘢痕妊娠病灶清除术治疗剖宫产术后瘢痕妊娠的意义.方法 选取我院2018年10月—2019年10月收治的64例剖宫产术后瘢痕妊娠患者的临床资料,根据手术方案的不同,将实施阴式子宫瘢痕妊娠病灶清除术的病例作为观察组(n=33),将选择腹腔镜子宫瘢痕妊娠病灶消除术的病例作为对照组(n=31).比较两组手术疗...     

中国女性与日本女性股骨颈几何参数的比较

目的：股骨颈脆性骨折是后果最严重、医疗花费最高和病死率最高的骨质疏松性骨折类型。股骨颈几何参数(femoral neck geometric parameters,FNGPs)是反映股骨颈几何学特征的重要参数,与股骨颈强度和脆性骨折风险密切相关。股骨颈脆性骨折的发病率存在明显的种族差异,但FNGPs是否有种族差异尚未明确。本研究旨在比较中国女性与日本女性FNGPs的差异。方法：本研究为横断面研究,从湖南省长沙市及周边地区招募女性健康志愿者3 859名,年龄为10.0～86.0(45.7±17.1)岁。测量并记录研究对象的体重、身高,并计算其体重指数(body mass index,BMI),采用双能X线骨密度测量仪测量研究对象的股骨颈投射骨面积(bone area, BA)和股骨颈骨密度(bone mineral density,BMD)。采用BA和/或BMD计算各种FNGPs,包括股骨颈轴长中点的外周直径(outer diameter,OD)、横截面积(cross-sectional area,CSA)、平均皮质厚度(cortical thickness,CT)、内皮质直径(endo...     

解郁透达化气法治疗肝郁血结型失眠症105例临床分析

目的探讨解郁透达化气法治疗肝郁血结所致失眠的临床疗效。方法对105例患者采用解郁透达化气法辨证论治,经2至4周治疗后观察临床疗效。结果105例患者中治愈11例,好转84例,未愈7例,总有效率达90.48%。结论解郁透达化气法治疗肝郁血结的失眠疗效良好。     

基于技术接受模型的新建医院信息系统护士使用满意度影响因素研究

介绍技术接受模型特点及应用情况,基于技术接受模型并应用问卷调查方法,分析新建医院护士使用医院信息系统满意度现状及影响因素,提出护理管理者应根据护士不同特征,采取针对性措施提高护士使用医院信息系统满意度。     

近五年针刺治疗慢性疼痛机制研究进展

针刺镇痛在临床上被广泛应用。针刺的神经传导通路与机体痛觉传导通路基本相似,对周围神经和中枢神经均有一定的影响,因此推断这可能是针刺缓解疼痛的一种调节机制。本文总结了近五年针刺治疗各种疼痛疾病的机制研究,从传导通路上分析得知针刺能激发神经元活性,改善周围神经的病理变化,增加神经元之间突触传递,修复受损的周围神经以缓解疼痛。此外,应用针刺或加用电针治疗痛症,能改善大脑内与疼痛相关各功能区之间的联系,对镇痛起到一定的中枢调控作用。在研究中还发现针刺能减少病变区炎性反应和细胞凋亡,增加细胞自噬和血管调节因子的表达。这些反应之间常存在一定的相互作用,共同缓解机体疼痛症状。然而,临床中针刺手法及辅助方法众多,治疗选取的相关穴位各异,根据疾病定位定性后选择最优组合方式是今后总结经验的重要目标。     

Isoproterenol disperses distribution of NADPH oxidase,MMP-9, and pPKCε in the heart,which are mitigated by endothelin receptor antagonist CPU0213

Aim： Spatial dispersion of bioactive substances in the myocardium could serve as pathological basis for arrhythmogenesis and cardiac impairment by β-adrenoceptor stimulation. We hypothesized that dispersed NADPH oxidase, protein kinase Cε （PKCε）, early response gene （ERG）, and matrix metalloproteinase 9 （MMP-9） across the heart by isoproterenol （ISO） medication might be mediated by the endothelin （ET） - ROS pathway. We aimed to verify if ISO induced spatially heterogeneous distribution of pPKCε, NAPDH oxidase, MMP-9 and ERG could be mitigated by either an ET receptor antagonist CPU0213 or iNOS inhibitor aminoguanidine. Methods：Rats were treated with ISO （1 mg/kg sc） for 10 days, and drug interventions （mg/kg） either CPU0213 （30 sc） or aminoguanidine （100 ip） were administered on days 8-10. Expression of NADPH oxidase, MMP-9, ERG, and PKCε in the left and right ventricle （LV, RV） and septum （S） were measured separately. Results： Ventricular hypertrophy was found in the LV, S, and RV, in association with dispersed QTc and oxidative stress in ISO-treated rats. mRNA and protein expression of MMP-9, PKCε, NADPH oxidase and ERG in the LV, S, and RV were obviously dispersed, with augmented expression mainly in the LV and S. Dispersed parameters were re-harmonized by either CPU0213, or aminoguanidine. Conclusion： We found at the first time that ISO-induced dispersed distribution of pPKCε, NADPH oxidase, MMP-9, and ERG in the LV, S, and RV of the heart, which were suppressed by either CPU0213 or aminoguanidine. It indicates that the ET-ROS pathway plays a role in the dispersed distribution of bioactive substances following sustained β-receptor stimulation.     

Paeonol protects rat vascular endothelial cells from ox-LDL-induced injury in vitro via downregulating microRNA-21 expression and TNF-α release

Aim： Paeonol （2＇-hydroxy-4＇-methoxyacetophenone） from Cortex moutan root is a potential therapeutic agent for atherosclerosis. This study sought to investigate the mechanisms underlying anti-inflammatory effects of paeonol in rat vascular endothelial cells （VECs） in vitro.
Methods： VECs were isolated from rat thoracic aortas. The cells were pretreated with paeonol for 24 h, and then stimulated with ox-LDL for another 24 h. The expression of microRNA-21 （miR-21） and PTEN in VECs was analyzed using qRT-PCR. The expression of PTEN protein was detected by Western blotting. TNF-α release by VECs was measured by ELISA.

Results： Ox-LDL treatment inhibited VEC growth in dose- and time-dependent manners （the value of IC50 was about 20 mg/L at 24 h）. Furthermore, ox-LDL （20 mg/L） significantly increased miR-21 expression and inhibited the expression of PTEN, one of downstream target genes of miR-21 in VECs. In addition, ox-LDL （20 mg/L） significantly increased the release of TNF-α from VECs. Pretreatment with paeonol increased the survival rate of ox-LDL-treated VECs in dose- and time-dependent manners. Moreover, paeonol （120 μmol/L） prevented ox-LDL-induced increases in miR-21 expression and TNF-α release, and ox-LDL-induced inhibition in PTEN expression. A dual-luciferase reporter assay showed that miR-21 bound directly to PTEN＇s 3＇-UTR, thus inhibiting PTEN expression. In ox-LDL treated VECs, transfection with a miR-21 mimic significantly increased miR-21 expression and inhibited PTEN expression, and attenuated the protective effects of paeonol pretreatment, whereas transfection with an miR-21 inhibitor significantly decreased miR-21 expression and increased PTEN expression, thus enhanced the protective effects of paeonol pretreatment.

Conclusion： miR-21 is an important target of paeonol for its protective effects against ox-LDL-induced VEC injury, which may play critical roles in development of atherosclerosis.     

PCR-GeneScan法检测遗传性聋相关基因GJB2 235 delC和mtDNA A1555G突变

目的:检测GJB2 235delC杂合突变和mtDNA A1555G突变。方法:对120例样本进行诊断试验,其中测序GJB2 235delC杂合突变样本16例,mtDNA A1555G突变17例。用PCR方法对目标片段进行扩增,PCR产物在3100DNA sequencer(ABI)上聚丙烯酰胺胶毛细管电泳,GeneScan、GeneMarker软件数据分析。结果:120例样本均得到检测结果,检出GJB2 235delC杂合突变样本17例,mtDNA A1555G突变17例,1例正常样本误诊为235delC杂合突变而出现假阳性。结论:PCR-GeneScan技术可以同时检测2种不同基因的突变,单管多重PCR和GeneScan荧光标记法结合是同时检测多种突变一种新的思路,而且可能是一种有效的方法。     

替吉奥单药治疗老年晚期乳腺癌的临床疗效与安全性

目的 观察替吉奥单药治疗老年晚期乳腺癌的疗效与安全性。方法 回顾性分析老年晚期乳腺癌患者65例,研究组32例(S组)：替吉奥 40～60 mg(＜1.25 m²,40 mg; 1.25～1．5 m²,50 mg;＞1.5 m²,60 mg),于早、晚饭后口服,连服14天,21天重复。对照组33例（X组）：卡培他滨每日2000 mg/m²,分2次,连服14天,21天重复,至少2周期后评价疗效。结果 65例患者均可评价疗效, S组、X组有效率（RR）分别为31.3％(10/32)、27.3％(9/33),疾病控制率（DCR）分别为78.1％（25/32）、69.7％(23/33）,中位疾病进展时间（TTP）分别为7.5、7.0月,中位总生存时间（OS）分别为17.3、15.2月,两组比较差异无统计学意义（P＞0.05）。研究组与对照组常见的不良反应为骨髓抑制、胃肠道反应、口角炎、乏力,多见Ⅰ～Ⅱ度,可耐受,两组差异无统计学意义;对照组手足综合征明显高于研究组,差异有统计学意义（P=0.000）。 结论 替吉奥单药治疗老年乳腺癌疗效肯定,耐受性好于卡培他滨,值得临床进一步研究、推广。