健脾化瘀解毒中药复方对溃疡性结肠炎患者血清细胞因子EGF、TGF-β1及TNF-α的影响

[目的]通过观察健脾化瘀解毒复方治疗溃疡性结肠炎(UC)的临床疗效,进一步探讨其分子生物学作用机制。[方法]采用随机、阳性药平行对照方法,将60例轻中度溃疡性结肠炎患者分为观察组30例和对照组30例,观察组给予健脾化瘀解毒复方中药,对照组给予美沙拉嗪4 g/d,疗程为3个月,观察治疗前后高敏C反应蛋白(CRP)、血小板(PLT)、Mayo评分的变化,并检测血清中表皮生长因子(EGF)、转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)的表达水平。[结果]血清CRP值、PLT、Mayo评分、EGF、TGF-β1及TNF-α表达治疗前观察组和对照组无统计学差异(P0.05),与治疗前相比,健脾化瘀解毒复方组和观察组治疗后CRP值、PLT、Mayo评分降低、EGF升高、TGF-β1及TNF-α表达降低,均具有统计学差异(P0.01);与对照组相比,健脾化瘀解毒复方组PLT、Mayo评分、TNF-α均具有统计学差异(P0.05);且观察组治疗有效率为93.1%优于对照组的76.7%。[结论]健脾化瘀解毒复方具有良好的抗溃疡性结肠炎的作用,其机制可能与调节血清EGF、TGF-β1、TNF-α的表达有关,其抗炎效果优于美沙拉嗪组。     

邵荣世治疗复发性口腔溃疡经验

总结邵荣世治疗复发性口腔溃疡的经验,认为复发性口腔溃疡的发生与心、脾(胃)关系密切,病因除了实热、虚寒、阴火外,湿热也是重要因素之一,根据病机将本病分为实热火盛、湿热内阻、阴虚火旺、脾虚夹湿四型。临证应从心脾(胃)论治,清热泻火方选导赤散合清胃散加减;清利湿热方选藿朴夏苓汤加减;养阴清热方选玉女煎加减;健脾温化方选香砂六君子汤加减论治,疗效卓著。     

影响脑梗死功能结局的危险因素

目的 探索影响脑梗死功能结局的危险因素。 方法 回顾性分析594例脑梗死患者的临床资料,并与年龄、性别相匹配的351例健康者相对照。比较两组人口统计学、既往史和临床实验室指标,并采用非条件 logistic 回归进行多因素分析,了解影响脑梗死功能结局的危险因素。 结果 同型半胱氨酸、脂蛋白a、空腹血糖、入院时的收缩压和高血压史是影响脑梗死功能结局的独立危险因素。 结论 临床应及早控制引起脑梗死预后不良的危险因素,以减轻、防止不良的功能结局和预防脑梗死的再发。     

Optimizing arthroscopic knots using braided or monofilament suture

Surgeons need to know how the material properties of a suture affect the security of a surgical knot. The purpose of this study was to compare the security of some clinically important arthroscopic knots when tied using a braided multifilament suture and to draw comparisons with results of similar knots tied with monofilament suture. Permanent braided polyester suture was used to test 10 knot configurations. Eight of the knots included (1) two types of initial cinching knots followed by (2) one of four combinations of half-hitches. We also tested the taut-line hitch locked with half-hitches and the original Revo knot. Each knot was subjected to cyclic loading followed by an ultimate load to failure. Clinical failure was defined as the maximum force that resulted in 3 mm of loop displacement. Force versus displacement data were obtained, and the maximal loop holding capacities were compared statistically. The Duncan loop with switched-post half-hitches and the Revo knot (Linvatec, Largo, FL) showed the highest knot-holding capacities (mean, 87N and 92N, respectively) when compared with all other configurations (P < .0001) for braided suture. A similar knot- holding capacity was described for monofilament suture using the Duncan loop locked with switched-post, reversed-direction half-hitches (mean, 81 N). All knots without post switching slipped completely at significantly lower loads than knots with post switching (monofilament, P < .001; braided, P < .0001). When compared with results of knots tied with monofilament suture, the braided switched-post configurations had smaller cyclic displacements (braided, 0.7 mm; monofilament, 1.7 mm). Although the Revo knot showed good strength for braided suture, it was significantly weaker than other configurations when tied with monofilament suture. Therefore, it is important to test the knot strength for a given suture material before applying it clinically.Arthroscopy 1998 Jan-Feb;14(1):57-65     

Genistein alleviates H2O2-induced senescence of human umbilical vein endothelial cells via regulating the TXNIP/NLRP3 axis

ContextGenistein (Gen) has shown protective effects against ageing process.ObjectiveTo explore the role of Gen on the senescence of H₂O₂-induced human umbilical vein endothelial cells (HUVECs) and investigate the possible mechanism.Materials and methodsHUVECs were treated with different concentrations of H₂O₂ (50, 100, 200 and 400 μmol/L) for 1 h or Gen administration (20, 40, 80 and 160 μg/mL) for 24 h. Functional experiments (cell counting kit-8, β-galactosidase staining and flow cytometry) were used to detect the effect of Gen on H₂O₂-induced HUVECs. After HUVECs were transfected with TXNIP overexpression plasmids, the expression of p16, p21, thioredoxin-interacting protein (TXNIP), nucleotide-binding and oligomerization domain-like receptor 3 (NLRP3), cleaved caspase-3 and cleaved caspase-1 in HUVECs were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot.ResultsH₂O₂ (200 and 400 μmol/L) inhibited the proliferation of HUVECs. At concentrations of >50 μmol/L, H₂O₂ induced the cell cycle progression arrests in G1 phase and promoted cell senescence of HUVECs. Gen had no obvious cytotoxicity to HUVECs below 160 µg/mL. H₂O₂-induced HUVEC senescence and the expression of TXNIP and NLRP3 in HUVECs were down-regulated by Gen (40 and 80 µg/mL). Expressions of TXNIP and NLRP3 in HUVECs were up-regulated by H₂O₂ but down-regulated by Gen. Overexpressed TXNIP partially reversed the suppressive effect of Gen on H₂O₂-induced senescence and apoptosis of HUVECs. Expressions of p16, p21, TXNIP, NLRP3, cleaved caspase-3 and cleaved caspase-1 in H₂O₂-treated HUVECs were inhibited by Gen, while the inhibition as such was partially reversed by overexpressed TXNIP.Discussion and conclusionsH₂O₂-induced HUVEC senescence was alleviated by Gen via suppressing the TXNIP/NLRP3 axis, which may offer a potential therapeutic approach for improving HUVEC senescence and provide a new direction for the treatment of cardiovascular disease.     

Application of a six sigma model to evaluate the analytical performance of urinary biochemical analytes and design a risk‐based statistical quality control strategy for these assays: A multicenter study

BackgroundThe six sigma model has been widely used in clinical laboratory quality management. In this study, we first applied the six sigma model to (a) evaluate the analytical performance of urinary biochemical analytes across five laboratories, (b) design risk‐based statistical quality control (SQC) strategies, and (c) formulate improvement measures for each of the analytes when needed.MethodsInternal quality control (IQC) and external quality assessment (EQA) data for urinary biochemical analytes were collected from five laboratories, and the sigma value of each analyte was calculated based on coefficients of variation, bias, and total allowable error (TEa). Normalized sigma method decision charts for these urinary biochemical analytes were then generated. Risk‐based SQC strategies and improvement measures were formulated for each laboratory according to the flowchart of Westgard sigma rules, including run sizes and the quality goal index (QGI).ResultsSigma values of urinary biochemical analytes were significantly different at different quality control levels. Although identical detection platforms with matching reagents were used, differences in these analytes were also observed between laboratories. Risk‐based SQC strategies for urinary biochemical analytes were formulated based on the flowchart of Westgard sigma rules, including run size and analytical performance. Appropriate improvement measures were implemented for urinary biochemical analytes with analytical performance lower than six sigma according to the QGI calculation.ConclusionsIn multilocation laboratory systems, a six sigma model is an excellent quality management tool and can quantitatively evaluate analytical performance and guide risk‐based SQC strategy development and improvement measure implementation.     

乳腺癌患者血清miR-765,miR-200b水平检测及与临床病理学相关研究

目的 探讨乳腺癌患者血清miR-765与miR-200b的表达及其临床应用价值。方法 选取乳腺癌患者58例,乳腺良性疾病患者28例及体检健康者30例,应用实时荧光定量PCR技术检测血清miR-765和miR-200b的表达水平,评价指标的诊断价值,并分析与乳腺癌临床病理特征的相关性。结果 乳腺癌患者血清miR-765和miR-200b相对表达量均显著性低于乳腺良性疾病患者(t=3.955,2.657,P<0.05)和健康对照者(t=4.465,3.518,P<0.05)。ROC曲线分析结果显示,miR-765在乳腺癌诊断中的AUC为0.843(95%CI:0.767～0.919),miR-200b在乳腺癌诊断中的AUC为0.897(95%CI:0837～0.957)。miR-765联合miR-200b在乳腺癌诊断中的AUC为0.952(95%CI:0.941～0.990),两者联合优于单一检测miR-765或miR-200b。在乳腺癌患者中血清miR-765相对表达量与临床分期相关(t=3.222,P<0.05); miR-200b相对表达量与临床分期、淋巴结转移相关(t=1.855,3.987,P均<0.05)。结论 乳腺癌患者血清miR-765与miR-200b表达水平显著降低,并与乳腺癌临床病理特征明显相关,血清miR-765与miR-200b联合检测具有较高的临床应用价值。     

Outcomes of long-term iron supplementation in pediatric restless legs syndrome/periodic limb movement disorder (RLS/PLMD)

ObjectivesRestless legs syndrome (RLS) and periodic limb movement disorder (PLMD) are thought to center around a genetically mediated sensitivity to iron insufficiency. Previous studies have shown the effectiveness of short-term iron therapy in children with low iron storage. Little is known, however, about long-term iron treatment in children with RLS and PLMD. Therefore, we performed this study to assess the long-term effect of iron therapy in children with RLS and PLMD.MethodsA retrospective chart review was performed for children who met the following criteria: A) diagnosed as having either RLS or PLMD, B) started on iron supplementation, C) followed up for >2 years in a sleep clinic. Baseline values for iron, ferritin, and periodic limb movement of sleep index (PLMS index) were defined in the three months leading up to the initiation of iron therapy. Values were also computed for follow-up periods of 3–6 months, 1–2 years, and >2 years. Serum iron and ferritin levels and PLMS index were compared between baseline and all subsequent follow-ups.ResultsIn total, 105 patients met inclusion criteria, of whom 64 were diagnosed with PLMD alone, seven with RLS alone, and 35 with both RLS and PLMD. The average age was 10.2 ± 5.3 years. Compared to the baseline (27.4 ± 12.1 ng/ml), the average ferritin values at 3–6 months (45.62 ± 21.2 ng/ml, p < 0.001, n = 34), 1–2 years (52.0 ± 48.3 ng/ml, p <0.001, n = 63), and >2 years (54.7 ± 40.5 ng/ml, p <0.001, n = 67) were all significantly increased. Inversely, compared to baseline (21 ± 27.0/h, n = 66), PLMS index values at 3–6 months (7.5 ± 9.5/h p < 0.05, n = 11), 1–2 years (6.9 ± 8.9/h, p <0.001, n = 29), and >2 years (10 ± 14.5/h, p <0.001, n = 31) were all significantly decreased. No significant change in serum iron levels was noted at any time point.ConclusionWhile retrospective in nature, this study demonstrates a sustained improvement in PLMS index and maintenance of adequate ferritin levels >2 years after iron therapy initiation in our RLS/PLMD cohort with a long-term follow-up. Iron therapy appears to lead to long-lasting improvements in children with RLS/PLMD.     

多层螺旋CT平扫结合重组技术诊断输尿管结石75例

目的:探讨多层螺旋CT结合重组技术对输尿管结石诊断的临床价值。方法:回顾性分析75例确诊的输尿管结石患者64层螺旋CT平扫资料,在工作站进行输尿管多平面及曲面重建。结果:75例共发现结石87个,肾盂输尿管移行处22个,输尿管中段35个,下段包括输尿管膀胱壁内段30个;52例见软组织边缘征,膀胱壁内段结石3例见并发膀胱充盈缺损。与横断位图像测量相比,重组图像测量结石大小,14个结石提高了分级级别。结论:多层螺旋CT平扫结合重建可获得良好的输尿管成像,重组图像可校正结石大小的临床分级,为临床提供更多精准有效的信息。     

补肝荣筋汤治疗绝经后膝关节骨性关节炎的临床观察

目的 观察补肝荣筋汤治疗绝经后女性膝关节骨性关节炎的临床疗效及安全性.方法 将符合纳入标准的96例单侧绝经后膝关节骨性关节炎患者采用随机数表法分为对照组和治疗组各48例,对照组给予口服硫酸氨基葡萄糖钾胶囊,0.5g/次,3次/日;治疗组在此基础上给予内服补肝荣筋汤,200 mL/次,2次/日.2组疗程均为1月,并随访1...