医患冲突引起群体性事件演变机理研究

通过背景、内部动力、外部引爆、关系结构和功能5个方面来分析、研究医患冲突引起群体性事件的演变机理,以期减少及防止医患冲突引起群体性事件的发生,同时对处置此类群体性事件也有着重要的借鉴意义.     

奇异变形杆菌耐药性研究进展

奇异变形杆菌是临床重要的条件致病菌,可以引起消化道、泌尿道等各种类型的感染。其导致的感染尤其是尿路感染病情严重、持久难治。近年来,有关奇异变形杆菌的耐药报道日益增多,其耐药性呈上升趋势。本研究主要从奇异变形杆菌对-内酰胺类、喹诺酮类等常见抗菌药物的耐药性着手,通过描述其生物学特征、耐药机制、主要耐药基因类型及流行情况、临床感染及治疗情况、未来发展趋势5个方面来介绍奇异变形杆菌耐药性的研究进展。     

基于NF-κB/NLRP3/Caspase-1通路介导的巨噬细胞焦亡探究葛根芩连汤对动脉粥样硬化易损斑块的干预机制

目的 探究葛根芩连汤（GQL）通过调控核转录因子（NF）-κB/NOD样受体蛋白3（NLRP3）/胱天蛋白酶（Caspase）-1通路介导的巨噬细胞焦亡对动脉粥样硬化（AS）易损斑块的作用。方法 12只正常C57BL/6CNC小鼠作为空白组，60只同品系的载脂蛋白E基因敲除（ApoE^-/-）小鼠随机分为5组，即模型组、葛根芩连汤低、中、高剂量组（GQL-D、Z、G组）、立普妥组，以高脂饲料喂养造模。空白组、模型组予等体积无菌蒸馏水灌胃；GQL-D、Z、G、立普妥组分别予对应浓度的药物灌胃8周。苏木素-伊红（HE）染色观测主动脉区域斑块情况，酶联免疫吸附测定法（ELISA）检测血清白细胞介素-1β（IL-1β）、白细胞介素-18（IL-18）水平，ELISA检测巨噬细胞甘露糖受体（MMR/CD206）/凋亡相关斑点样蛋白（ASC）、CD206/NLRP3蛋白表达水平，蛋白免疫印迹法（Western blot）检测各组小鼠gasdermin D蛋白C端（C-terminal GSDMD）、gasdermin D蛋白N端（N-terminal GSDMD）、NLRP3、含胱天蛋白酶-1前体（pro-Caspase-1）和NF-κB p65蛋白表达水平。结果 与空白组比较，模型小鼠AS病变程度严重，血清IL-1β、IL-18、组织ASC、NLRP3、C-terminal GSDMD、N-terminal GSDMD、pro-Caspase-1和NF-κB p65表达水平明显升高（P<0.05），CD206水平明显下降（P<0.05）；与模型组比较，给药各组小鼠主动脉壁AS病变程度有所减轻，血清IL-1β、IL-18、组织ASC、NLRP3、C-terminal GSDMD、N-terminal GSDMD、pro-Caspase-1和NF-κB p65表达水平有不同程度下降，CD206水平不同程度上升，部分组结果差异有统计学意义（P<0.05）。结论 GQL对AS易损斑块的干预作用可能是通过调控NF-κB/NLRP3/Caspase-1通路，减轻其介导的巨噬细胞焦亡来实现的。     

Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden

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Verletzungsprävention innerhalb eines internationalen Sportverbandes – Eine Prozessbeschreibung am Beispiel des alpinen Skirennsports

Since 2006 structured and evidence based research on injury prevention is conducted under the guidance and support of the International Ski Federation (FIS) within the Injury Surveillance System (ISS). The outcome of this work is used directly by the FIS for the implementation of concrete injury prevention measures through regimentation modification on the one hand. On the other hand the outcome of the FIS ISS Network is a series of journal publications for the scientific community. The current paper describes the scientific process within the FIS ISS Network on the basis of the work which has already been published and explains recently implemented prevention measures in the area of equipment.     

Reward bias and lateralization in gambling behavior: behavioral activation system and alpha band analysis

The present research explored the main factors that can influence subjects’ choices in the case of decisions. In order to elucidate the individual differences that influence the decisional processes, making their strategies more or less advantageous, we tested the effect of a reward sensitivity in the behavioral activation system (BAS-Reward) constructed on the ability to distinguish between high- and low-risk decisions. Secondly, the lateralization effect, related to increased activation of the left (BAS-related) hemisphere, was explored. Thirty-one subjects were tested using the Iowa Gambling Task, and the BAS-Reward measure was applied to distinguish between high-BAS and low-BAS groups. Behavioral responses (gain/loss options) and alpha-band modulation were considered. It was found that high-BAS group increased their tendency to opt in favor of the immediate reward (loss strategy) rather than the long-term option (win strategy). Secondly, high-BAS subjects showed an increased left-hemisphere activation in response to losing (with immediate reward) choices in comparison with low-BAS subjects. A “reward bias” effect was supposed to explain both the bad strategy and the unbalanced hemispheric activation for high-BAS and more risk-taking subjects.     

A case control study of sexual dysfunction in asian and non-asian couples 1981–1985

Thirty-one Asian clients referred to a well-established sexual dysfunction clinic between 1981 and 1985 were matched for age and sex with 31 non-Asian clients referred in the same period. These two groups were compared on a number of characteristics including type of presenting problem, marital status, referral source and therapy outcome. The findings are discussed in the light of differing sexual mores between the two cultures.     

自噬在肾间质纤维化中的作用及中药干预研究进展

肾间质纤维化（RIF）是慢性肾脏疾病进展至肾功能衰竭的共同通路，其发病机制主要与肾脏炎症损伤、氧化应激、细胞凋亡、细胞外基质（ECM）的过度沉积等相关，转化生长因子-β₁（TGF-β₁）信号通路、哺乳动物雷帕霉素靶蛋白（mTOR）信号通路等多种信号通路介导了RIF的发生发展。因其发生机制复杂，临床上尚无特异性防治措施。自噬是真核细胞产生的非损伤性应答，通过降解和重吸收作用，参与维持组织内稳态的平衡。目前，中医药在治疗慢性肾脏疾病延缓RIF的进程中以其多成分、多效应、多靶点的的独特优势取得了较好的临床疗效。学者研究发现自噬与中医阴阳学说、癥瘕积聚理论等在一定程度上相符合，并且自噬参与了RIF的诸多环节，RIF病程进展与自噬关系密切，通过干预自噬靶向治疗RIF已成为研究的前沿方向。然而，有关自噬在RIF中的作用及中医药调控自噬治疗RIF的研究相对比较少，因此，有必要进一步阐述自噬与RIF的关系，以明确自噬在RIF中发挥的作用机制及中医药调控自噬靶向治疗RIF的机制，该文就中医理论与自噬和RIF的相关性，结合自噬在RIF中炎症损伤、氧化应激、细胞凋亡、ECM过度沉积等的作用，自噬与TGF-β₁信号通路、mTOR信号通路在RIF的调控机制，对自噬在RIF中的作用及中药干预的研究进行疏理和总结，以期为RIF的治疗及新药研发提供参考依据。     

散偏汤加减治疗偏头痛研究进展

偏头痛是一种常见的神经血管功能紊乱性疾病，多表现为反复发作的单侧或两侧剧烈头痛，偶伴恶心、呕吐、畏光、畏声等症状，具有反复发作、家族遗传的特点。中医认为偏头痛属于“头风”范畴，其发病多由外风引动导致，且与肝风内动有关。散偏汤出自清代医家陈士铎所创《辨证录·头痛门》，由川芎、白芷、郁李仁、香附、柴胡、白芥子、甘草组成，具有行气止痛，活血化瘀的作用，临床上常用于治疗偏头痛。目前应用散偏汤治疗偏头痛的临床研究多使用原方加减用药，或单独应用，或与西药/针刺联合应用。临床试验结果显示可以明显降低偏头痛积分、疼痛视觉模拟评分及内皮素水平等，减少止痛药使用频率，改善偏头痛症状显著且不良反应少。动物实验多从偏头痛发病不同解剖水平上探究散偏汤加减的起效机制，主要有降低一氧化氮（NO）、一氧化氮合酶（NOS）水平，减少神经递质的释放如5-羟色胺（5-HT）、神经肽（NPY），抑制神经元兴奋，阻断伤害性感受传导通路的传递，进而促进脑血液循环，调节神经递质而达到防治偏头痛的作用。该文结合偏头痛的发病机制，对散偏汤加减的临床应用、实验研究等方面的最新进展进行了系统综述，总结其防治偏头痛的作用机制，为临床治疗偏头痛提供新的思路。