89例老年急性胆囊炎的临床治疗体会

目的探讨老年急性胆囊炎的临床治疗方法。方法选取牡丹江某医院2009年2月-2010年9月收治的89例老年急性胆囊炎患者,将其分为对照组（46例）与研究组（43例）。对照组患者采取保守治疗,研究组患者采取手术治疗,通过对比2组患者的治愈情况及平均住院时间,评价不同治疗方法的效果。结果研究组治愈率97.67%,对照组治愈率95.65%,差异无统计学意义;研究组患者平均住院时间明显比对照组短,差异有统计学意义（P〈0.05）。结论针对老年急性胆囊炎患者,应根据实际病情采取适宜的方式进行治疗。     

冠状动脉支架术治疗48例冠心病临床疗效分析

目的探讨冠状动脉支架术治疗冠心病的临床效果。方法对48例冠心病患者行冠状动脉支架术,并进行2年随访,了解治疗效果。结果 48例接受冠状动脉支架手术治疗的患者中46例患者心绞痛症状得到有效缓解,复发时间延长,治疗有效,有效率95.83%。2例患者治疗无效。结论冠状动脉支架术对于冠心病患者的心绞痛症状有很好的缓解作用,且手术的安全性较高。     

山茱萸多糖对衰老大鼠晶状体中Sirt1基因表达的影响

目的：初步探讨山茱萸多糖治疗年龄相关性白内障的可能机制，为其预防和治疗寻找新的药物和靶点。方法：选用60只昆明大鼠，按体质量随机分为3组，每组20只，分别为对照组（C组）、衰老模型组（A组）和山茱萸多糖给药组（D组）。在相同环境下，C组正常饮食，每日颈背部皮下注射0．9％氯化钠注射液，剂量计算参照其他给药组D-半乳糖给药量；A和D组正常饮食，每日颈背部皮下注射D-半乳糖100mg／（kg·d）；连续皮下注射45d后，C和A组每日按照等剂量灌药量灌服温开水；D组按照多糖0．4g／蛞灌服山莱萸多糖，连续灌服30d。试验终期颈椎离断术处死大鼠，4℃迅速取眼分离晶状体置于液氮备用。免疫组化方法检测各组间总超氧化物歧化酶（T-SOD）和总抗氧化能力（T-AOC）的变化，RT—PCR（逆转录cDNA的聚合酶链式扩增反应）检测各组Sirt1、p53和FOXO1 mRNA的表达变化。结果：A组和D组大鼠晶状体中Sirt1 mRNA的表达较C组均显著上升（P〈0．05、P〈0．01），且D组较A组显著上升（P〈0．01）；A组和D组大鼠晶状体中p53 mRNA的表达较C组显著上升（P均〈0．01），而D组较A组显著下降（P〈0．05）；A组和D组大鼠晶状体中FOXO1 mRNA的表达较C组显著上升（P〈0．05、P〈0．01），且D组较A组显著上升（P〈0．01）。另外A组和D组大鼠晶状体中T—SOD的活性较C组显著上升（P均〈0．01），且D组较A组显著上升（P〈0．01）；A纽和D组大晶状体中鼠T-AOC的活性较C组显著上升（P均〈0．01），且D较A组显著上升（P〈0．01）。结论：山茱萸多糖可能通过调节Sirt1的表达，从而调节下游基因p53和FOXO1的表达，最终抑制或延缓晶状体上皮细胞的凋亡，减缓年龄相关性白内障的进展。     

A bridge to transplantation: The life experiences of patients with a left ventricular assist device

BackgroundThe Left Ventricular Assist Device (LVAD) is a rapidly spreading treatment given to patients with advanced heart failure due to organ donor shortage. Thus, there is a need to study the life experience of patients who underwent LVAD implantation as a bridge to transplantation.ObjectiveTo examine the life experiences of patients who underwent LVAD implantation as a bridge to transplantation.MethodsThis qualitative, phenomenological research was carried out with 13 patients who underwent LVAD implantation as a bridge to transplantation. Data were collected through semi-structured in-depth interviews. Interviews were recorded through an audio recorder, transcribed verbatim, and evaluated using the inductive content analysis method.ResultsTwo main themes (fear and coping), each with four sub-themes, were obtained after data were analyzed. Participants’ fears and coping strategies for these were identified.ConclusionIn this study, fears and coping strategies came to the forefront in the life experiences of patients who underwent LVAD implantation as a bridge to transplantation.     

Statins can induce myasthenia gravis

The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, are commonly prescribed for prevention of cardiovascular morbidity. A rare side effect of statin medication is the induction of autoimmune illnesses, including myasthenia gravis (myasthenia). Here we present two patients with seropositive myasthenia that developed 4 weeks after initiation of atorvastatin, increasing the total reported patients to seven. Reviewing recent literature we highlight the connections between statins, auto-immunity and myasthenia. Statins may favour T-cell phenotypes that reduce cell-mediated immunity but could increase antibody-mediated humoral immunity.     

探究关节镜手术治疗踝关节骨折后创伤性关节炎

目的总结关节镜手术治疗踝关节骨折后创伤性关节炎主要方案。方法选取我院2013年1月~2014年6月收治的踝关节骨折后创伤性关节炎患者78例,随机分成对照组和实验组各39例,对照组接受常规手术治疗方案,实验组接受关节镜手术治疗。结果实验组患者治疗效果明显优于对照组(P0.05)。结论临床上关节镜手术治疗踝关节骨折后创伤性关节炎患者有助于提升患者整体治疗效率。     

Effects of genistein and equol on human and rat testicular 3β-hydroxysteroid dehydrogenase and 17β-hydroxysteroid dehydrogenase 3 activities

The objective of the present study was to investigate the effects of genistein and equol on 3β-hydroxysteroid de- hydrogenase （3β-HSD） and 17β-hydroxysteroid dehydrogenase 3 （17β-HSD3） in human and rat testis microsomes. These enzymes （3β-HSD and 17β-HSD3）, along with two others （cytochrome P450 side-chain cleavage enzyme and cytochrome P450 17α-hydroxylase/17-20 lyase）, catalyze the reactions that convert the steroid cholesterol into the sex hormone testosterone. Genistein inhibited 3β-HSD activity （0.2 μmol L^-1 pregnenolone） with half-maximal inhibition or a half-maximal inhibitory concentration （IC50） of 87 ± 15 （human） and 636 ± 155 nmol L^-1 （rat）. Genistein＇s mode of action on 3β-HSD activity was competitive for the substrate pregnenolonrge and noncompetitive for the cofactor NAD＋. There was no difference in genistein＇s potency of 3β-HSD inhibition between intact rat Leydig cells and testis microsomes. In contrast to its potent inhibition of 3β-HSD, genistein had lesser effects on human and rat 17β-HSD3 （0.1 μmol L^-1 androstenedione）, with an IC50 〉 100μmol L^-1. On the other hand, equol only inhibited human 3β-HSD by 42%, and had no effect on 3β-HSD and 17β-HSD3 in rat tissues. These observations imply that the ability of soy isoflavones to regulate androgen biosynthesis in Leydig cells is due in part to action on Leydig cell 3β- HSD activity. Given the increasing intake of soy-based food products and their potential effect on blood androgen levels, these findings are greatly relevant to public health.