川芎嗪对犬CABG后LAD平滑肌细胞表达Ⅷ胶原和p53的影响

目的:探讨川芎嗪(LG)对冠状动脉旁路移植术(CABG)后冠脉左前降支(LAD)血管平滑肌细胞表达VIII型胶原和p53反应性改变的影响. 方法:45只健康杂交犬体质量(17.9±2.2) kg,结扎LAD近段制作局部冠状动脉狭窄模型后,将存活的28只犬分为LG组(n=10),维拉帕米(VR)组(n=10)和生理盐水(CN)对照组(n=8),三组均行CABG,手术前后对各组犬施加不同的药物干预. 经犬右心耳抽血检测不同时段血浆NO含量变化;术后2 wk切取局部LAD, 用Western Blot法检测LAD组织匀浆VIII型胶原和p53蛋白表达,并用免疫组化方法观察两种分子在局部的原位表达情况. 结果:吻合血管后血浆NO含量60 min时,LG组下降至(77.7±2.4) μmol/L,VR组为(69.3±1.5) μmol/L,CN对照组为(62.4±2.1) μmol/L,LG组与其他两组相比较差异具有统计学意义(P<0.05);三组正常LAD的组织匀浆表达VIII 型胶原和p53水平低,VR组和CN对照组的血管吻合处远段LAD表达VIII 型胶原增加比川芎嗪组明显,而LG组p53表达增加比其他两组明显. 免疫组化方法检测表明:三组的吻合处远段血管片段局部VIII 型胶原表达明显增加,LG组明显弱于其他两组,LG组可以检测到p53表达,而其他两组吻合后损伤血管的p53无明显表达. 结论:LG可抑制CABG后血管内皮损伤及LAD平滑肌细胞表达VIII胶原反应性的上调和促进p53表达,表明其可能具有防治CABG术后再狭窄的作用.     

4-氨甲酰基-4′-叠氮-1,2,3-三氮唑核苷的合成研究

目的 合成4-氨甲酰基-4′-叠氮-1,2,3-三氮唑核苷,以期发现具有高抗病毒活性的核苷类药物。方法 以商业易得的二丙酮叉-D-葡萄糖为起始原料,经9步反应得到重要糖基叠氮化合物,再与炔丙酸甲酯进行[3+2]偶极环加成反应以构建三氮唑环以及自由基脱羧叠氮化反应和脱保护得到4-氨甲酰基-4′-叠氮-1,2,3-三氮唑核苷。结果　以最长线性步骤5步反应,30%的总收率合成了4-氨甲酰基-4′-叠氮-1,2,3-三氮唑,这为后期的抗病毒活性测试奠定了基础。     

Theoretical and Experimental Models to Evaluate the Possibility of Corrosion Resistant Concrete for Coastal Offshore Structures

This study built theoretical and practical models to evaluate the corrosion resistance of concrete for coastal offshore structures in Vietnam. A mathematical model was developed in the form of a system of nonlinear partial differential equations characterizing the diffusion “free calcium hydroxide” in a solid of a concrete structure. The model describes the process of non-stationary mass conductivity observed in the “concrete structure—marine environment” system under non-uniform arbitrary initial conditions, as well as combined boundary conditions of the second and third kind, taking into account the nonlinear nature of the coefficients of mass conductivity k and mass transfer β. It was shown that the solution of the boundary value problem of non-stationary mass conductivity allows us to conclude about the duration of the service life of a concrete structure, which will be determined by the processes occurring at the interface: in concrete—mass conductivity, depending on the structural and mechanical characteristics of hydraulic structures, and in the liquid phase—mass transfer, determined by the conditions of interaction at the interface of the indicated phases.     

血流重建术对成人烟雾病患者抑郁焦虑状态的影响

目的 探讨血流重建术对成人烟雾病患者抑郁、焦虑状态和脑灌注的影响,并分析抑郁、焦虑状态改变与脑灌注变化的相关性.方法 连续纳入2015年1月至2016年6月我院收治的成人烟雾病患者64例,其中手术治疗42例(联合血流重建组16例、间接血流重建组26例),保守治疗22例(保守治疗组).在入院时、治疗6个月(±1个月)和治...     

P2Y12 inhibitor pretreatment in patients with nonST-segment elevation acute coronary syndrome: A meta-analysis

Background:The 2020 European Society of Cardiology guidelines do not recommend pretreatment for nonST-segment elevation myocardial infarction (NSTEMI) patients with unclear coronary anatomy, which is inconsistent with our routine preoperative approach to loading P2Y12 receptor inhibitors (e.g., preoperative loading of 300 mg of clopidogrel).Objectives:The purpose of our study was to compare the safety and effectiveness of P2Y12 inhibitors administered before coronary angiography or at least before percutaneous coronary intervention (PCI) with during or after PCI.Methods:Cochrane, PubMed, and Embase databases were searched. The primary effect endpoint and safety endpoint were any-cause death and major bleeding, respectively. Major adverse cardiovascular events, myocardial infarction and revascularization were also analyzed.Results:Our search identified 9 trials. P2Y12 inhibitor pretreatment was associated with lower death from any cause (OR 0.62, 95% CI 0.53–0.72, P < 0.00001) without increasing the risk of bleeding (OR 1.02, 95% CI 0.80–1.30, P = 0.89). However, prasugrel or ticagrelor pretreatment was not associated with a lower risk of mortality (OR 0.70, 95% CI 0.31–1.59, P = 0.40) and increased the risk of bleeding (OR 1.67, 95% CI 1.10–2.54, P = 0.02).Conclusions:In summary, clopidogrel pretreatment was associated with significantly lower mortality, major adverse cardiovascular events, myocardial infarction and revascularization with no increase in major bleeding. However, these advantages were not observed with prasugrel or ticagrelor pretreatment.     

铜绿假单胞菌氨基糖苷类药物修饰酶基因研究

目的 调查铜绿假单胞菌对常用抗生素的耐药特性及氨基糖苷类药物修饰酶基因表达。方法 用Phoenix^TM-100系统鉴定细菌和药敏试验。用琼脂扩散法检测20株多重耐药铜绿假单胞菌对阿米卡星、庆大霉素、妥布霉素和奈替米星4种药物的敏感性。采用聚合酶链反应（PCR）扩增4种氨基糖苷类药物修饰酶基因,并使用DNA测序加以证实。结果 190株铜绿假单胞菌对氯霉素、四环素、复方磺胺耐药率最高,均为98．9％;对亚胺培南、美洛培南的耐药率分别为15．3％和6．8％。从20株菌中检出aac（6′）-Ⅰ、aac（6′）-Ⅱ和ant（2″）-Ⅰ3种修饰酶基因,阳性率分别为10％、60％和65％,未发现ant（3″）-Ⅰ基因。20株菌对阿米卡星、庆大霉素、妥布霉素和奈替米星的耐药率分别为35．0％、90．0％、70．0％、60．0％。结论 本地区铜绿假单胞菌对氨基糖苷类药物的耐药与修饰酶基因的传播表达有关。     

PI3K-Akt/mTOR/AMPK通路基因突变与鼻咽癌疗效及预后的关系

目的：基因突变是导致肿瘤发生、发展的重要原因之一。本研究探讨磷脂酰肌醇3激酶-蛋白激酶B(phosphatidylinositol 3 kinase-protein kinase B,PI3K-Akt)、雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)、AMP依赖的蛋白激酶[adenosine 5’-monophosphate (AMP)-activated protein kinase,AMPK]信号通路与鼻咽癌患者疗效及预后的关系。方法：选取中南大学湘雅医学院附属肿瘤医院/湖南省肿瘤医院头颈放疗二科31例初治中晚期鼻咽癌患者,采用基因测序平台Illumina NextSeq CN500检测治疗前鼻咽部活检组织中288个基因的全部外显子、38个基因的内含子、启动子或融合断点区域,对728个基因的编码区域进行目标区域捕获的高深度测序,并检测肿瘤基因4种变异类型,包括点突变、小片段的插入缺失、拷贝数变异和目前已知的融合基因。31例患者均接受以铂类为基础的诱导化学治疗联合同步放化疗,并对患者进行长期随访。结果：PI3K-Akt通路突变患者的3年区域无失...     

温和灸对大鼠颈椎间盘退变组织Ⅰ型、Ⅱ型胶原表达的影响

目的:观察温和灸对大鼠颈椎间盘退变组织Ⅰ型胶原、Ⅱ型胶原表达的影响。方法:采用动静力失衡性颈椎间盘退变模型,运用原位杂交技术观察温和灸天柱穴、大杼穴对大鼠颈椎间盘组织Ⅰ型胶原、Ⅱ型胶原表达的影响,并设假手术组、芬必得组、模型对照组。结果:对大鼠颈椎间盘组织内的Ⅰ型胶原蛋白表达,假手术组与其他各组之间比较有非常显著性差异(P<0.01);温和灸组、假手术组与模型组之间比较无显著性差异(P>0.05)。而对Ⅱ型胶原蛋白的表达,假手术组与其他各组之间比较有非常显著性差异(P<0.01);温和灸组与芬必得组、模型组之间比较有非常显著性差异(P<0.01,P<0.05)。结论:温和灸可以促进Ⅱ型胶原的合成,降低Ⅰ型/Ⅱ型胶原比值,从而增加颈椎间盘的抗牵拉能力,维持椎间盘正常的力学特性。     

脐尿管癌的超声诊断

目的分析探讨脐尿管癌的超声表现。方法对本组5例经手术、病理证实的脐尿管癌患者,进行分析总结。结果5例病灶均位于膀胱顶部或前壁,均累及膀胱壁全层,其中有2例浸润至侧壁,有3例侵犯膀胱周围组织。病理诊断均为腺癌。超声图像表现以低回声为主,回声不均质,肿块形态不规则。结论脐尿管癌是一种少见的恶性肿瘤,肿瘤的部位对于诊断较有帮助,超声检查可了解肿瘤的部位、大小及其侵犯程度,具有一定的临床应用价值。     

针刺结合龙氏手法对神经根型颈椎病的镇痛作用研究

目的比较针刺结合龙氏手法与单纯针刺治疗神经根型颈椎病的镇痛作用。方法按随机对照方法,治疗组采用龙氏手法结合针刺,对照组采用单纯针刺方法。通过观察简化McGill疼痛问卷及疗效标准以评定疗效。结果治疗组总有效率为97.23%,对照组为90.91%,疗效比较差异无统计学意义(P>0.05);但在VAS、PPI、PRI上,治疗组均优于对照组。结论龙氏手法结合针刺更有利于神经根型颈椎病的止痛。