大黄素对肠缺血再灌注损伤小鼠TREM-1受体及炎症介质表达的实验研究

目的观察大黄素干预下肠缺血再灌注损伤(IIR)小鼠外周血s TREM-1及下游炎症介质NF-κB和TNF-α的表达和小肠组织病理学变化,探讨大黄素对肠缺血再灌注损伤的作用机制。方法将雄性健康清洁级昆明小鼠随机分为假手术(S)组,模型(I/R)组,模型+大黄素(C)组,每组9只。肠缺血再灌注模型的制备采用夹闭肠系膜上动脉法,其中S组仅行开腹术不夹闭肠系膜上动脉,C组于再灌注前5 min将大黄素注入小鼠腹腔(2.5mg/kg),S组和I/R组分别注入等量生理盐水,24 h后处死小鼠留取标本,分别比较3组小鼠血清中sTREM-1和TNF-α的浓度、肠黏膜损伤程度和肝脏细胞NF-κB表达情况。结果 3组小鼠血清s TREM-1浓度、血清TNF-α浓度、肝脏细胞NF-κB染色积分比较,S组比I/R组明显降低、C组比I/R组明显降低,但C组比S组增高,差异均具有统计学意义(P<0.05);光镜下观察S组小肠黏膜结构基本正常,I/R组小肠绒毛结构破坏较重,C组小肠黏膜损伤较轻,经非参数秩和检验,S组与I/R组和C组与I/R比较差异有统计学意义,S组与C组比较差异无统计学意义。结论大黄素干预下外周血s TREM-1和TNF-α及肝细胞NF-κB表达显著下降且肠道及全身炎症症状减轻,提示大黄素可阻断肠缺血再灌注损伤的发生发展过程。     

乳酸左氧氟沙星氯化钠注射液不良反应12例报告分析及安全性评价

目的：对乳酸左氧氟沙星氯化钠注射液不良反应进行分析研究,做出安全性风险评价。方法对我市2014年收集的12例乳酸左氧氟沙星氯化钠注射液不良反应报告采用回顾性研究方式,用Excel电子表筛选方法,进行统计、分析。结果本资料12例报告中,50岁以上人群所占比例最大,有6例（占50％）;男性患者发生药品不良反应的几率明显高于女性;药品不良反应临床表现为全身性损害、皮肤及其附件损害、胃肠道损害（各占33．3％,41．7％,25％）;新的严重的药品不良反应2例（占16．7％）;好转5例,痊愈7例,无死亡病例。结论乳酸左氧氟沙星氯化钠注射液使用风险在临床中可表现为各种不良反应,不当给药方法和联合用药对该药不良反应的发生可能具有相当大的影响。应严格掌握适应症,加强不良反应监测才能确保乳酸左氧氟沙星氯化钠注射液使用的安全性和有效性。     

Low PRRX1 expression and high ZEB1 expression are significantly correlated with epithelial-mesenchymal transition and tumor angiogenesis in non-small cell lung cancer

Background:Paired related homeobox 1 (PRRX1) and zinc finger E-box binding homeobox 1 (ZEB1) have been observed to play a vital role in the epithelial-mesenchymal transition (EMT) process in different types of cancer. The microvessel density (MVD) is the most common indicator used to quantify angiogenesis. This study aimed to investigate expression of PRRX1 and ZEB1 in non-small cell lung cancer (NSCLC) and to explore associations between these factors and tumor prognosis, EMT markers and angiogenesis.Methods:Data for a total of 111 surgically resected NSCLC cases from January 2013 to December 2014 were collected. We used an immunohistochemical method to detect expression levels of PRRX1, ZEB1, and E-cadherin, and to assess MVD (marked by CD34 staining). SPSS 26.0 was employed to evaluate the connection between these factors and clinical and histopathological features, overall survival (OS) and tumor angiogenesis.Results:PRRX1 expression was obviously lower in tumor samples than in control samples. Low expression of PRRX1, which was more common in the high-MVD group than in the low-MVD group (P = .009), correlated positively with E-cadherin expression (P < .001). Additionally, we showed that ZEB1 was expressed at higher levels in tumor samples than in normal samples. High expression of ZEB1 was associated negatively with E-cadherin expression (P < .001) and positively associated with high MVD (P = .001). Based on Kaplan-Meier and multivariate survival analyses, we found that PRRX1, ZEB1, E-cadherin and the MVD had predictive value for OS in NSCLC patients.Conclusions:These findings suggest that PRRX1 and ZEB1 may serve as novel prognostic biomarkers and potential therapeutic targets.     

Regular arrangement of collecting venules under endoscopy for predicting a Helicobacter pylori-negative stomach: A systematic review and meta-analysis

Background and aimsThe regular arrangement of collecting venules (RAC) refers to the appearance of multiple regular tiny veins in the body of the stomach and is considered to be very effective for identifying gastric mucosa with non-Helicobacter pylori infection. This meta-analysis was conducted to systematically evaluate the value of the sign in predicting a Helicobacter pylori-negative stomach and the relevant factors that may affect the performance of this prediction.MethodsTwo biomedical databases (PubMed and EMBASE) were systematically searched through April 20, 2020. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the SROC curve (AUC) were calculated.ResultsFourteen articles with 4070 patients were included. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for the RAC in predicting non-Hp infection were 0.80 (0.67–0.89), 0.97 (0.93–0.98), 24.8 (12.2–50.8), 0.21 (0.12–0.36), 120 (47–301) and 0.97 (0.19–1.00), respectively.ConclusionsThe RAC is a valuable endoscopic feature for the prediction of patients without Hp infection.     

结核分枝杆菌耐热抗原激活的人γδT细胞Th2极性分化特征以及T-bet/GATA-3对分化的调控作用

目的研究结核杆菌耐热抗原(MTB-HAg)激活的人外周血γδT细胞Th2极性分化特点和表达于T细胞中的T盒(T-bet)和GATA结合蛋白3(GATA-3)转录因子的调控作用。方法用MTB-HAg刺激人外周血单个核细胞(PBMC)获得MTB-HAg激活的T细胞(MTBAT),分别在中性条件和Th2极化条件培养后,再经10 ng/m L佛波醇酯(PMA)、500 ng/m L离子霉素(ionomycin)和2.5μmol/L莫能菌素(monensin)刺激6 h,四色荧光抗体染色流式细胞术检测γδT细胞和αβT细胞内细胞因子γ干扰素(IFN-γ)和白细胞介素4(IL-4)的表达。流式细胞术分选28 d MTBAT中的γδT细胞和CD4+T细胞,反转录PCR(RT-PCR)检测T-bet和GATA-3 mRNA的表达。结果在中性条件和Th2极化条件下培养的MTBAT中,γδT细胞一直优势表达IFN-γ,而Th2极化条件下,随培养时间增加IFN-γ+αβT细胞百分率显著下降。与中性条件培养比较,Th2极化条件下MTBAT培养28 d,Th0型(IFN-γ+IL-4+)γδT细胞显著增加;而Th2型(IFN-γ-IL-4+)αβT细胞显著增加。RT-PCR结果显示,Th2极化的γδT细胞仍高表达T-bet mRNA,而在CD4+T细胞T-bet mRNA表达被显著下调;同时,GATA-3 mRNA在γδT细胞和CD4+T细胞的表达均显著上调。结论 Th2极化条件下,大部分γδT细胞仍为Th1型,仅部分极性分化为Th0型细胞;Th2极性分化的γδT细胞转录因子T-bet和GATA-3未表现出交互调节功能。     

医学院校信息管理与信息系统专业毕业论文撰写的教学模式

介绍了现阶段卫生信息化建设的人才需求、医学院校信息管理与信息系统专业毕业的就业形势和毕业论文撰写教学的重要性,重点分析了毕业论文撰写教学存在的问题,并以蚌埠医学院为例,有针对性地提出了具体改进措施,构建了基于成长性评价思想的新型毕业论文撰写教学模式。     

Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre,randomised, double-blinded trial

Purpose

Recent clinical data suggest that terlipressin, a vasopressin analogue, may be more beneficial in septic shock patients than catecholamines. However, terlipressin’s effect on mortality is unknown. We set out to ascertain the efficacy and safety of continuous terlipressin infusion compared with norepinephrine (NE) in patients with septic shock.

Methods

In this multicentre, randomised, double-blinded trial, patients with septic shock recruited from 21 intensive care units in 11 provinces of China were randomised (1:1) to receive either terlipressin (20–160 µg/h with maximum infusion rate of 4 mg/day) or NE (4–30 µg/min) before open-label vasopressors. The primary endpoint was mortality 28 days after the start of infusion. Primary efficacy endpoint analysis and safety analysis were performed on the data from a modified intention-to-treat population.

Results

Between 1 January 2013 and 28 February 2016, 617 patients were randomised (312 to the terlipressin group, 305 to the NE group). The modified intention-to-treat population comprised 526 (85.3%) patients (260 in the terlipressin group and 266 in the NE group). There was no significant difference in 28-day mortality rate between the terlipressin group (40%) and the NE group (38%) (odds ratio 0.93 [95% CI 0.55–1.56]; p?=?0.80). Change in SOFA score on day 7 was similar between the two groups: ??7 (IQR ??11 to 3) in the terlipressin group and ??6 (IQR ??10 to 5) in the NE group. There was no difference between the groups in the number of days alive and free of vasopressors. Overall, serious adverse events were more common in the terlipressin group than in the NE group (30% vs 12%; p?<?0.001).

Conclusions

In this multicentre, randomised, double-blinded trial, we observed no difference in mortality between terlipressin and NE infusion in patients with septic shock. Patients in the terlipressin group had a higher number of serious adverse events.

Trial registration

This trial is registered at ClinicalTrials.gov: ID NCT01697410.

     

A new dimeric neolignan from Magnolia grandiflora L. seeds

Archives of Pharmacal Research - Bioassay-guided fractionation of the MeOH extract of Magnolia grandiflora seeds resulted in the isolation of a new dimeric neolignan, named bishonokiol A (1), as...     

酮康唑相关杂质国家标准物质的研制

目的:研制酮康唑相关杂质标准物质,提升国内酮康唑品种的质控标准。方法:对酮康唑杂质B、C、D、E进行合成与结构确证,并采用中国药典2010年版二部酮康唑有关物质检查方法测定各杂质的纯度,再根据各杂质的水分和炽灼残渣结果用质量平衡法确定首批各杂质国家标准物质的含量。最后采用标准曲线法测定了酮康唑诸杂质对酮康唑在220 nm检测波长下的相对校正因子。结果:研制的酮康唑杂质B、C、D、E标准物质与欧洲药典(EP 8.0版)中规定的结构一致。中国药典2010年版二部中酮康唑有关物质检查项下规定的色谱系统对酮康唑及其各杂质均能有效分离。以质量平衡法表示,本研究标定的酮康唑各杂质B、C、D、E的含量分别为95.2%、97.9%、98.5%和99.4%。各杂质对酮康唑的相对校正因子分别为1.13、1.08、0.94、1.01。结论:建立了首批酮康唑杂质B、C、D、E国家标准物质。