反义寡核苷酸对脑胶质瘤细胞生长抑制作用的动态研究

目的　探讨原癌基因 c- m yb反义寡核苷酸 (AON)对 C6脑胶质瘤细胞的体内生长抑制作用。方法　将 C6脑胶质瘤细胞接种于裸鼠皮下 ,当肿瘤长至 10 mm左右时随机分成 3组 (每组 12只 ) ,分别用 c- mybAON、正义寡核苷酸 (SON)和生理盐水瘤区原位注射 ,注药后 4、8、12和 16日各组处死动物 3只 ,动态观察肿瘤的体积、重量及病理学改变 ;用流式细胞仪检测肿瘤细胞的凋亡 ;以免疫组化方法分析各组的 c- m yb、bcl- 2蛋白阳性表达率。结果　 c- myb AON组的肿瘤体积抑制率分别为第 4天 6 6 .7% ,第 8天 71.4% ,第 12天 72 % ,第 16天73% ,与对照组相比 ,其生长抑制作用具有显著性 (P<0 .0 5 ) ;AON组凋亡细胞百分率为第 4天 3.4% ,第 8天 2 7.1% ,第 12天 46 .1% ,第 16天 48.4% ,是 SON组和对照组相应时段凋亡细胞的 3.5倍以上 (P<0 .0 5 ) ;AON组 c-myb和 bcl- 2蛋白阳性表达率较对照组有显著降低 (P<0 .0 5 ) ;且 AON治疗后的脑胶质瘤中见较多炎性细胞浸润和钙化灶。结论　 c- myb癌基因有可能成为反义基因治疗恶性脑胶质瘤的优选靶点之一     

福建省城乡人群恒牙龋病流行病学抽样调查报告

目的：了解福建省居民口腔健康状况及流行趋势,为今后进行口腔健康教育、开展口腔保健项目提供依据。方法：采用多阶段、分层、整群随机抽样的方法对福州市、泉州市、南平市的5,12,15,18,35－44及65－74岁年龄组的城乡人群12792人（男女各半）进行口腔检查。结果：随着年龄的增大,龋均、患龋率、充填率呈上升趋势（P＜0．01）。35－44岁、65－74岁年龄组龋均、患龋率城市高于农村（P＜0．01）,其他年龄组城乡之间差别无显著性（P＞0．05）。各年龄组充填率城市均高于农村（P＜0．01）。福建省城乡居民的恒牙患龋率、龋均高于全国平均水平。结论：应从小进行口腔健康教育,增强口腔健康意识,加大实施口腔预防保健措施的力度。     

术中应用丝裂霉素C预防翼状胬肉术后复发的疗效观察

目的 :探讨丝裂霉素 (mitomycinC ,MMC)在翼状胬肉转移术中的应用及与MMC接触的眼表组织超微结构改变。方法 :将 5 7例 (6 2只眼 )原发性进行期翼状胬肉随机分为对照组和MMC组 ,对照组 2 8例 (30只眼 ) ,MMC组2 9例 (32只眼 )。对照组行单纯翼状胬肉转移术 ,MMC组术中局部放置饱含 0 4mg·ml-1MMC的棉片 1min。比较两组复发率及术后并发症。电镜观察并比较接触及未与MMC接触的眼表组织的超微结构。术后随访 (7 6± 3 4)月 (1～13个月 )。结果 :MMC组 2只眼 (6 3% )复发 ,对照组 11只眼 (36 7% )复发 (P <0 0 0 5 ) ,随访期间未见严重并发症。电镜观察到与MMC接触的眼表组织显示大多数纤维母细胞 (fibroblast,FB)的粗面内质网 (roughendoplasmicreticulum ,RER)扩张 ,其他细胞无明显改变 ,对照组无此改变。结论 :原发性翼状胬肉转移术中局部应用 0 4mg·ml-1MMC 1min ,是一种防止术后复发的安全、有效而又简单的方法。眼表组织接触 0 4mg·ml-1MMC 1min后 ,FB显示RER扩张。     

Application of network pharmacology and molecular docking to elucidate the potential mechanism of Astragalus–Scorpion against prostate cancer

The present study aimed to investigate the molecular mechanism of the Astragalus–Scorpion drug pair in the treatment of prostate cancer (PCa). We employed network pharmacology and molecular docking technology to retrieving the active ingredients and corresponding targets of Astragalus–Scorpion by using TCMSP, BATMAN-TCM, TCMID and Swiss Target Prediction Databases. The targets related to PCa were retrieved through GeneCards. Cytoscape software was used to construct the ‘active ingredient–target disease’ network, and GO and KEGG enrichment analyses were performed on the common targets. Autodock software was used for molecular docking verification. In total, 26 active ingredients, 340 potential targets related to active ingredients and 122 common targets were screened from Astragalus–Scorpion drug pair. The core targets of the protein–protein interaction (PPI) network were JUN, AKT1, IL6, MAPK1 and RELA, whereas the core active ingredients were quercetin, kaempferol, formononetin, 7-o-methylisomucronulatol and calycosin. Nearly 762 GO entries and 154 pathways were obtained by using the pathway enrichment analysis. Molecular docking results revealed that quercetin and kaempferol bind to AKT1 and formononetin binds to RELA, all of which were found to be stable bounds.     

Pulmonary contusions in patients with rib fractures: The need to better classify a common injury

BackgroundPulmonary contusions are common injuries. Computed tomography reveals vast contused lung volume spectrum, yet pulmonary contusions are defined dichotomously (unilateral vs bilateral). We assessed whether there is stepwise increased risk of pulmonary complications among patients without, with unilateral, and with bilateral pulmonary contusion.MethodsWe identified adults admitted with rib fractures using the largest US inpatient database. After propensity-score-matching patients without vs with unilateral vs bilateral pulmonary contusions and adjusting for residual confounders, we compared risk for pneumonia, ventilator-associated pneumonia (VAP), respiratory failure, intubation, and mortality.ResultsAmong 148,140 encounters of adults with multiple rib fractures, 19% had concomitant pulmonary contusions. Matched patients with pulmonary contusions had increased risk of pneumonia 19% [95%CI:16–33%], respiratory failure 40% [95%CI: 31–50%], and intubation 46% [95%CI: 33–61%]. Delineation showed bilateral contusions, not unilateral contusions, attributed to increased risk of complications.ConclusionsThere is likely a correlation between contused lung volume and risk of pulmonary complications; dichotomously classifying pulmonary contusions is insufficient. Better understanding this correlation requires establishing the clinically significant contusion volume and a correspondingly refined classification system.     

Box-Behnken设计-响应面法优化经典名方四妙勇安汤煎煮工艺研究

目的 遵循中医药传承创新发展的基本准则——“遵古原则”,考察经典名方四妙勇安汤（Simiao Yong’an Decoction,SYD）的煎煮工艺,确保原汤剂原汁原味的传统功效,并进行质量综合评价,为经典名方SYD进一步制剂开发提供参考。方法 采用Box-Behnken设计-响应面法对加水量、浸泡时间、煎煮时间进行考察,通过指纹图谱结合多元统计分析进行定性半定量评价,通过含量测定分析和干膏率进行定量评价,综合以上评价方法优选煎煮工艺并验证。结果 通过Box-Behnken设计-响应面法制备17批煎煮样品,建立了17批样品HPLC指纹图谱,标定了14个共有峰,利用多元统计分析对指纹图谱共有峰数据进行主成分分析（principal component analysis,PCA）与正交偏最小二乘法-判别分析（orthogonal partial least squares-discriminant analysis,OPLS-DA）并计算得分,结果显示9号工艺为最佳煎煮工艺,即煎煮2次,第1次加16倍量水,浸泡30 min,煎煮30 min;第2次加16倍量水,煎煮30 min。同时采用H...     

Differential contribution of the factors determining long-term renal function after partial nephrectomy over time

PurposeTo define how much of renal function was determined by the preserved renal parenchymal volume and the ischemic insult during partial nephrectomy (PN) long after surgery.MethodsWe analyzed the data of 530 consecutive patients who had undergone PN. For all patients, renal function was measured preoperatively and again at 3 postoperative months, then annually using ^99mTc-diethylenetriaminepentaacetic acid renal scan. Perioperative variables potentially affecting the long-term ipsilateral glomerular filtration rate (GFR) and their time-varying contribution were assessed using a linear mixed model.ResultsThe mean preoperative ipsilateral GFR was 42.9 ml/min, which decreased by 27.3% at 3 months but began to recover thereafter continuing until 4 years (Δ% GFR at 1, 2, 3, 4, and 5 years: 22.3%, 18.5%, 14.7%, 10.0%, and 9.6%, respectively). Parenchymal volume reduction and ischemic time were significantly associated with postoperative ipsilateral GFR throughout observation period unvarying with time. Diabetes and proteinuria were not significant determinants of ipsilateral function at 3 months but became significant at 5 years. In multivariate analysis regarding recovery slope, volume reduction (β = ?0.026, SE 0.006, P < 0.0001), preoperative ipsilateral GFR (β = ?0.021, SE 0.007, P = 0.0012), proteinuria (β = ?0.942, SE 0.372, P = 0.0116), and diabetes (β = ?0.396, SE 0.197, P = 0.0447) were independently significant.ConclusionIpsilateral renal function continued to improve until 5 years after PN. Parenchymal volume loss was the major determinant and its impact on long-term ipsilateral renal function remained constant while ischemic time affected early GFR reduction with its impact diminishing over time. Patient-related factors including diabetes and proteinuria gained significance over time and became independent determinants of recovery slope.     

Tezacaftor/ivacaftor in people with cystic fibrosis who stopped lumacaftor/ivacaftor due to respiratory adverse events

BackgroundIncreased rates of respiratory adverse events have been observed in people ≥12 years of age with cystic fibrosis homozygous for the Phe508del-CFTR mutation treated with lumacaftor/ivacaftor, particularly in those with percent predicted forced expiratory volume in 1 s (ppFEV₁) of <40%. We evaluated the safety, tolerability, and efficacy of tezacaftor/ivacaftor in people with cystic fibrosis homozygous for Phe508del-CFTR who discontinued lumacaftor/ivacaftor due to treatment-related respiratory signs or symptoms.MethodsParticipants ≥12 years of age with cystic fibrosis homozygous for Phe508del-CFTR with ppFEV₁ of ≥25% and ≤90% were randomized 1:1 and treated with tezacaftor/ivacaftor or placebo for 56 days.ResultsOf 97 participants, 94 (96.9%) completed the study. The primary endpoint was incidence of predefined respiratory adverse events of special interest (chest discomfort, dyspnea, respiration abnormal, asthma, bronchial hyperreactivity, bronchospasm, and wheezing): tezacaftor/ivacaftor, 14.0%; placebo, 21.3%. The adverse events were mild or moderate in severity. None were serious or led to treatment interruption or discontinuation. Overall, the discontinuation rate was similar between groups. The mean (SD) ppFEV₁ at baseline was 44.6% (16.1%) with tezacaftor/ivacaftor and 48.0% (18.1%) with placebo. The posterior mean difference in absolute change in ppFEV₁ from baseline to the average value of days 28 and 56 was 2.7 percentage points with tezacaftor/ivacaftor vs placebo.ConclusionsTezacaftor/ivacaftor was generally safe, well tolerated, and efficacious in people ≥12 years of age with cystic fibrosis homozygous for Phe508del-CFTR with ppFEV₁ of ≥25% and ≤90% who previously discontinued lumacaftor/ivacaftor due to treatment-related respiratory signs or symptoms.     

Efficacy and safety of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia: A meta-analysis with trial sequential analysis of 23 randomised controlled trials

To further identify the real efficacy and safety of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia, we conducted this meta-analysis. The systematic search strategy was performed using PubMed, Embase, Cochrane Library, and Chinese databases. As a result, a total of 23 RCTs (1445 patients) were included. Patients receiving dexmedetomidine combined with local anaesthetics had a lower rescue analgesia rate [risk ratio (RR): 0.48; 95% confidence interval (CI): 0.36-0.65] and lower rescue analgesic consumption [weighted mean difference (WMD): −10.80 mg; 95%CI: −13.28 to −8.31 mg] than patients receiving local anaesthetics alone. The dexmedetomidine-related adverse reactions included bradycardia (RR: 1.33; 95%CI: 0.32-5.56) and hypotension (RR: 3.00; 95%CI: 0.49-18.42). In addition, the time to first analgesic request (WMD: 296.16 minutes; 95%CI: 165.69 minutes ~ 426.63 minutes), incidence of postoperative nausea and vomiting (PONV) and pain scores at 4 hours postoperatively were also significantly lower in patients receiving dexmedetomidine combined with local anaesthetics. This meta-analysis demonstrated that the use of dexmedetomidine as an adjuvant to wound infiltration is effective for reducing the rescue analgesia rate, rescue analgesic consumption and PONV. In addition, limited evidence shows that dexmedetomidine can prolong postoperative analgesia for approximately 5 hours. Further investigations on dexmedetomidine-related adverse reactions and the dose–response effect of dexmedetomidine in wound infiltration are warranted.