三色膏联合微波治疗急性踝关节扭伤临床观察

目的:观察三色膏联合微波治疗急性踝关节扭伤的临床疗效,并进行对比研究。方法:将60例急性踝关节扭伤患者随机分为2组:治疗组30例,予三色膏联合微波治疗;对照组30例,予单纯微波治疗。治疗2周后观察两组临床疗效,治疗前后主要症状、体征的变化情况。结果:经治疗后,两组患者疗效比较,总有效率治疗组优于对照组(P<0.05)。两组治疗后主要症状、体征积分与本组治疗前比较,差异有统计学意义(P<0.01)。治疗组治疗后主要症状、体征积分与对照组比较,差异有统计学意义(P<0.05,P<0.01),提示治疗组在改善患者关节症状、体征方面优于对照组。结论:三色膏联合微波治疗急性踝关节扭伤可有效缓解关节疼痛、减轻关节肿胀、改善踝关节活动功能。     

Smoking quantity determines disease activity and function in Chinese patients with ankylosing spondylitis

The objective of this study was to systemically and comprehensively evaluate the associations between smoking and disease outcomes in patients with ankylosing spondylitis (AS). Information on smoking, clinical features, and sociodemographic characteristics was collected by a questionnaire administered directly to the patient. Group differences were analyzed by t test or chi-square test. Logistic regression analysis was conducted with the Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), C-reactive protein, and erythrocyte sedimentation rate as the dependent variables and different stratification of smoking duration, smoking intensity, and cumulative smoking as independent variables. In order to compare our results with previous studies, meta-analysis was performed to calculate standardized mean difference (SMD) for relationship between outcomes and smoking status. A total of 1178 AS patients were analyzed. Compared with non-smokers, the risk of having active disease (BASDAI ≥?4) was higher in patients who smoked at least 15 years, or 15 cigarettes per day, or 15 pack-years (OR?=?1.70 [1.06, 2.73], 1.75 [1.08, 2.82], and 1.97 [1.06, 3.67], respectively); and smokers had increasing risk of BASDAI ≥?4 with increasing years of smoking, or cigarettes per day, or pack-years (p_-trend?=?0.010, 0.008 and 0.006, respectively). The risk of having active disease was higher in patients who smoked at least 15 cigarettes per day or 15 pack-years (OR?=?1.74 [1.06, 2.84] and 2.89 [1.56, 5.35], respectively), with increasing number of cigarettes per day and pack-years. Smokers had an increased risk of BASFI ≥?4 (p_-trend?=?0.040 and 0.007, respectively). By meta-analysis, current, former and ever smokers had significantly higher BASDAI (SMD?=?0.34 [0.18, 0.48], 0.10 [0.01, 0.19], and 0.27 [0.20, 0.34], respectively) and BASFI (SMD?=?0.35 [0.16, 0.55], 0.30 [0.22, 0.39], and 0.35 [0.21, 0.50], respectively) compared to non-smokers. Smoking is a risk factor for greater disease activity and worse functioning in AS patients.     

Interpretation of illness in patients with chronic diseases from Shanghai and their associations with life satisfaction,escape from illness,and ability to reflect the implications of illness

The aim of this study is to analyze how patients with chronic diseases from Shanghai interpret their disease, and how these interpretations influence patients＇ life satisfaction, intention to escape from their illness and their ability to reflect on the implications of their illness. METHODS： A cross-sectional study enrolling 142 patients （mean age （50 ±16） years; 63% men, 37% women） with chronic diseases （60% cancer） was recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China and surveyed using standardized questionnaires. RESULTS： Patients with chronic diseases from Shanghai interpreted their illness mostly as an Adverse Interruption of Life （55%）, as a Threat/Enemy （50%）, but also as a Challenge （49%）, and only rarely as a Call for Help （18%） or as a Punishment （13%）. Particularly fatalistic negative （i.e., Threat/Enemy, Adverse Interruption of Life） and strategy-associated disease interpretations （i.e., Relieving Break, Call for Help） were moderately associated with patients＇ intention to escape from illness. In contrast, positive interpretations （i.e., something of Value, Challenge） and also the guilt-associated negative interpretation Failure were moderately related with patients＇ ability to reflect on their illness. However, life satisfaction was weakly associated only with the view that illness might be a Challenge. Interestingly, 58% of those who would see their illness as an Adverse Interruption （AI＋） could see it also as a Challenge （Ch＋）. Detailed analyses showed that AI＋Ch＋ patients differ from their AI＋Chcounterparts significantly with respect to their ability to reflect life and implications of illness （F=9.1 ; P=-0.004）.     

Bivariate genome-wide association study suggests fatty acid desaturase genes and cadherin DCHS2 for variation of both compressive strength index and appendicular lean mass in males

Compressive strength index (CSI) is a newly established index for predicting hip fracture, the most serious consequence of osteoporosis. Appendicular lean mass (ALM), which influences skeletal strength of the lower limbs, is another trait associated with the risk of hip fracture. In this study, we performed a bivariate genome-wide association study (GWAS) to identify new candidate genes responsible for both CSI and ALM. In our discovery sample of 1627 unrelated Chinese subjects (802 males and 825 females), we scanned 909,509 SNPs using the Affymetrix Human Genome SNP 6.0 genotyping array. We successfully replicated our results in a sample of 2286 Caucasian subjects (558 males and 1728 females). The results indicated that five SNPs (rs174583, rs174577, rs174549, rs174548, rs7672337) in the FADS1, FADS2, and DCHS2 genes had significant bivariate associations with CSI and ALM in male subjects for both the GWAS discovery (with P < 8.42 × 10^? 6) and the Caucasian sample (with P < 0.07). We performed further replication analysis in a 2nd Caucasian sample with 501 Caucasian male subjects, using Affymetrix 500 k arrays, and found that two of the above SNPs (rs174548 and rs174549, P = 0.07) had bivariate associations with both CSI and ALM in males; the other 3 SNPs were not typed with the 500 k array. The above findings suggest that the 3 genes, FADS1, FADS2, and DCHS2, containing these SNPs might play dual roles influencing both CSI and ALM in males. Our findings provide new insights into our understanding of the genetic basis of bone metabolism and the pathogenesis of osteoporosis.     

microRNAs调控消化系肿瘤多药耐药的研究进展

肿瘤多药耐药(multidrug resistance,MDR)是影响化疗效果的最大障碍,尤其是消化系肿瘤发生耐药的现象最为突出.因此,如何逆转MDR已经成为抗肿瘤研究的热点问题.近年来,有关研究发现微小RNA(microRNAs)与多种肿瘤耐药的发生密切相关.microRNAs是一类内源性非编码RNA分子,通过降解mRNA或抑制mRNA翻译的方式调控着众多基因的表达.本综述重点阐述了microRNAs的生物学特性,与胃癌、肠癌、肝癌、胆管癌及胰腺癌等消化系肿瘤MDR的关系及其潜在的信号调控通路,以期为消化系肿瘤耐药的预防和靶向治疗提供新的思路和手段.     

Down-regulation of GFRalpha-1 expression by antisense oligodeoxynucleotide aggravates thermal hyperalgesia in a rat model of neuropathic pain

Glial cell line-derived neurotrophic factor (GDNF) has been hypothesized to play an important role in the modulation of nociceptive signals especially during neuropathic pain. The present study examined the expression of GDNF and GFRalpha-1 (the high-affinity receptor of GDNF) in dorsal root ganglions (DRG) in a rat model of neuropathic pain induced by chronic constriction injury (CCI) to the sciatic nerve. In order to address the role of GDNF and GFRalpha-1 in neuropathic pain, antisense oligodeoxynucleotide (ODN) specifically against GFRalpha-1 was intrathecally administered to result in down-regulation of GFRalpha-1 expression. The results showed that both the protein and mRNA levels of GDNF and GFRalpha-1 were significantly increased after CCI, while the thermal hyperalgesia of neuropathic pain rats could be significantly aggravated by antisense ODN treatment, but not by normal saline (NS) or mismatch ODN treatment. The present study demonstrated that endogenous GDNF and GFRalpha-1 might play an anti-hyperalgesic role in neuropathic pain of rats. In addition, we found a down-regulation of somatostatin (SOM) in DRG and spinal dorsal horn after expression of GFRalpha-1 was knocked down, which suggested the possible relationship between the anti-hyperalgesic effect of GDNF and GFRalpha-1 on neuropathic pain and endogenous SOM.     

Sucrose preference is restored by electro-acupuncture combined with chlorimipramine in the depression-model rats

The present study was to investigate the effect of electroacupuncture (EA) combined with chlorimipramine on the sucrose preference of depressive rats induced by chronic mild stress (CMS). Rats were exposed chronically (1st - 4th week) to a variety of mild unpredictable stresses. The tricyclic antidepressant chlorimipramine and EA were administrated on these depressive rats for 6 weeks (5th - 11th week). EA was applied at points of "Bai-Hui" (Du 20) and "An-Mian" (EX 17) (right side), by EA apparatus (Model 6805-2, Shanghai). Dense (60Hz/5sec)-sparse (4Hz/2.5sec) frequency of the wave was selected and the current intensity (< or = 1mA) was adjusted to provoke slight twitches of the rat's ear. The preference for 1% sucrose solution and the immobility time in the forced swimming test were measured as the symptoms of anhedonia and depressed mood, which were central features of major depression. The preference for 1% sucrose solution was reduced by CMS, but could be restored to normal level after 6 weeks treatment with chlorimipramine at 5mg/kg or EA combined with chlorimipramine at 2.5mg/kg. In the forced swimming test, the immobility time of depressive rats was decreased in both groups. However, the preference for sucrose and the immobility time in the depressive rats were not significantly changed by the treatment with only EA or chlorimipramine at 2.5 mg/kg. The results suggested that EA could potentiate the antidepressant effect of chlorimipramine in low dose, and EA combined with antidepressant might be a better method in treating depression.