围手术期炎症标志物与术后认知功能障碍相关性的Meta分析

目的 应用询证医学方法系统评价围手术期炎症标志物水平与术后认知功能障碍（postoperative cognitive dysfunction, POCD）之间的相关性,为临床预测POCD的发生提供依据。 方法 检索PubMed、The Cochrane Library、EMBASE、ISI Web of Knowledge、Google Scholar、百度学术、CNKI数据库、维普数据库和万方医学网。文献检索时间从建库至2015年11月,查找对POCD及非POCD患者血清炎症标志物指标进行检测的相关病例对照研究,采用Review Manager 5.1、STATA12.0软件进行分析。采用随机效应模型,计算每项指标的标准化均数差（standardized mean difference, SMD）及95%CI。并对研究结果分别进行回归分析、发表偏倚检验、异质性检验。 结果 共有15项符合条件的研究被纳入。在POCD及非POCD患者术后血清炎症标志物浓度的比较中,POCD组患者血清有着更高浓度的S-100β蛋白［SMD（95%CI）：1.82（0.90~2.74）,P〈0.001,N（POCD/非POCD）=195/431,8篇研究］和IL-6［SMD（95%CI）：1.35（0.67~2.02）,P〈0.001,N（POCD/非POCD）=128/162,6篇研究］,但两组患者的神经元特异性烯醇化酶（neuron-specific enolase, NSE）、IL-1β、TNF-α浓度无显著增高（P〉0.05）。线性回归分析发现POCD患者和非POCD患者术后IL-6以及S-100β蛋白的SMD和POCD患者术前IL-6以及S-100β蛋白外周血浓度无显著正相关性。 结论 POCD的发生与术后外周血炎症标记物浓度有关,尤其与IL-6和S-100β密切相关;但是IL-6和S-100β蛋白的术前血清浓度不能作为术后是否发生POCD的预测指标。     

A pH-triggered delayed-release chronotherapeutic drug delivery system of aceclofenac for effective management of early morning symptoms of rheumatoid arthritis

Abstract

Context: Rheumatoid arthritis (RA) is differentiated as an early morning exacerbation of the core arthritis condition associated with increase in pain and stiffness in joints and necessitate for medication. Objective: The aim of the present work was to develop and optimise a pH-triggered delayed-release colon-specific aceclofenac microspheres and to accomplish chronotherapy of RA. Methods: A 3-factor, 3-level Box–Behnken design (BBD) was used to optimise selected variables. Developed formulation was evaluated for in vivo delayed response and anti-arthritis activity in rats. Results: The particle size and encapsulation efficacy of these microspheres were 117.36?±?10.54?µm and 85.06?±?5.85%, respectively. Optimised formulation was analysed by SEM, DSC, X-RPD and FTIR. The in vivo evaluation reveled delayed anti-inflammatory activity in carrageenan-induced rats and anti-arthritic activity in freund’s adjuvant-induced arthritis rats. Conclusion: The optimised aceclofenac microspheres formulation is potential for the chronotherapy of early morning symptoms of RA.     

Dipeptidyl peptidase‐4 inhibitor‐associated bullous pemphigoid in a patient with acquired reactive perforating collagenosis

Bullous pemphigoid (BP) is a common autoimmune blistering disorder with unknown etiology. Recently, increasing numbers of BP cases which developed under the medication with dipeptidyl peptidase‐4 inhibitors (DPP4i), widely used antihyperglycemic drugs, have been reported in published works. Here, we report a case of DPP4i (teneligliptin)‐associated BP that developed in a 70‐year‐old Japanese man. Interestingly, the patient had acquired reactive perforating collagenosis (ARPC), which is also known to be associated with the onset of BP. In the present case, clinical, histopathological and immunological findings suggested that DPP4i rather than ARPC was associated with the onset of BP.     

S-100B与脑出血性疾病的关系

脑出血性疾病是神经内科的危重急症,早期、及时、准确、无创性的诊断对疾病预后有着非常重要的意义。S-100B是存在于神经系统的特有的标记性蛋白,具有广泛的生物学活性和重要的生理功能。近年来研究发现脑出血性疾病早期检测S-100B能反映脑损伤程度和判断预后。S-100B有望成为神经系统新的诊断手段。     

灵芪胶囊抑制鼠S180生长的形态学观察

目的:观察灵芪胶囊对小鼠体内肉瘤S180生长的影响及荷瘤鼠肉瘤组织学变化,分析其抗肿瘤的作用机理,进一步完善其抗肿瘤作用机制.方法:设立正常对照组,肿瘤模型组,灵芪胶囊组和阳性对照组.用小鼠肉瘤S180细胞株建立动物肿瘤模型,灌胃给予S180小鼠灵芪胶囊后,光镜观察肉瘤组织的形态学变化.结果:小鼠肉瘤组织中肉瘤细胞发生不同程度的变性和坏死以及中性粒细胞,淋巴细胞为主的炎细胞浸润变性和坏死.灵芪胶囊可促进肿瘤细胞的凋亡及坏死.并引发相应的炎细胞反应.结论:灵芪胶囊有抑制S180细胞体内生长的作用.     

双基因（VP3、IL-18）联合致小鼠骨肉瘤S-180细胞凋亡的效应

目的探讨VP3、IL-18双基因抑制骨肉瘤S-180的联合抑瘤作用。方法将VP3、IL-18基因插入pVAX1表达载体的pCMV启动子之下的EcoRI位点，构建成pVVP3及pVVp3-IL18。将该重组质粒与单独表达凋亡素基因的重组质粒分别注射荷S-180肿瘤细胞的BALB／C小鼠，比较抑瘤趋势和抑瘤率。结果联合应用VP3基因和IL-18基因的重组病毒治疗组的抑瘤率（46．16％）高于单独应用VP3基因组的抑瘤率（19．56％），两组比较有统计学差异（P〈0．05）。结论凋亡素基因具有凋亡诱导效应及体内的抑瘤效应。凋亡素基因VP3与IL-18基因有协同抑瘤效应，联合基因治疗骨肉瘤可提高抑瘤效果。     

紫雪花水提液抗肿瘤的初步研究

目的观察紫雪花水提液对小鼠移殖性肿瘤S180的抑瘤作用,及其对免疫器官的影响。方法采用昆明种小鼠,随机分组进行实验,观察不同剂量紫雪花水提液(6.8,13.5,27 g/kg)3种剂量、紫雪花水提液与氟脲嘧啶(5-FU)合用以及单用氟脲嘧啶对小鼠移殖性肿瘤S180的抑瘤率的差别以及对胸腺、脾脏、肝脏的影响。结果紫雪花水提液3种剂量和紫雪花水提液与氟脲嘧啶合用及氟脲嘧啶单用对小鼠S180均有不同程度的抑制肿瘤生长的作用,抑瘤率分别为22.35%(P>0.05),40.01%(P<0.05),26.45%(P>0.05),50.5%(P<0.01),56%(P<0.01)。紫雪花水提液在发挥抑瘤作用的同时,可降低肝脏和脾脏的重量,但对胸腺有明显的保护作用。与5-Fu(0.025 g/kg)合用有抑瘤作用,并可明显的对抗5-Fu抑制胸腺的作用。结论3种剂量紫雪花水提液均有抑制小鼠移殖性肿瘤S180的生长作用。紫雪花水提液与5-Fu合用对小鼠移殖性肿瘤S180有抑瘤作用,同时,具有明显的对抗5-Fu抑制胸腺的作用。     

参虫颗粒体内抗肿瘤实验研究

目的了解参虫颗粒的体内抑瘤作用和对比化疗药物的影响。方法体内抑瘤率和生命延长率观察分别用S180、人肝癌H22荷瘤小鼠进行;增效减毒实验采用S180小鼠,环磷酰胺作为化疗药物毒性模型。结果2,4,8 g/kg的参虫颗粒对小鼠S180实体瘤的平均抑瘤率为18.05%,21.24%和27.28%;对H22实体瘤的平均抑瘤率分别为17.35%,20.34%和27.26%;S180和H22具有一定的抗肿瘤作用,对化疗药物环磷酰胺有明显的减毒增效作用。结论参虫颗粒对移植性小鼠S180和H22具有一定的抗肿瘤作用,对化疗药物环磷酰胺有明显的减毒增效作用。     

Inflammation-like glial response in lead-exposed immature rat brain.

Numerous studies on lead (Pb) neurotoxicity have indicated this metal to be a dangerous toxin, particularly during developmental stages of higher organisms. Astrocytes are responsible for sequestration of this metal in brain tissue. Activation of astroglia may often lead to loss of the buffering function and contribute to pathological processes. This phenomenon is accompanied by death of neuronal cells and may be connected with inflammatory events arising from the production of a wide range of cytokines and chemokines. The effects of prolonged exposure to Pb upon glial activation are examined in immature rats to investigate this potential proinflammatory effect. When analyzed at the protein level, glial activation is observed after Pb exposure, as reflected by the increased level of glial fibrillary acidic protein and S-100beta proteins in all parts of the brain examined. These changes are associated with elevation of proinflammatory cytokines. Production of interleukin (IL)-1beta and tumor necrosis factor-alpha is observed in hippocampus, and production of IL-6 is seen in forebrain. The expression of fractalkine is observed in both hippocampus and forebrain but inconsiderably in the cerebellum. In parallel with cytokine expression, signs of synaptic damage in hippocampus are seen after Pb exposure, as indicated by decreased levels of the axonal markers synapsin I and synaptophysin. Obtained results indicate chronic glial activation with coexisting inflammatory and neurodegenerative features as a new mechanism of Pb neurotoxicity in immature rat brain.     

S-100b蛋白检测对小儿化脓性脑膜炎与病毒性脑炎的鉴别诊断价值

目的通过对脑脊液(cerebrospinal-fluid,CSF)和血清中S-100b蛋白含量检测,早期诊断、鉴别诊断小儿化脓性脑膜炎(化脑)与病毒性脑炎(病脑)。方法采用ELISA法检测14例化脓性脑膜炎患儿及18例病毒性脑炎患儿急性期、恢复期CSF和血清中S-100b蛋白水平,并与正常对照组比较。结果①急性期病脑组CSF和血清中S-100b蛋白明显高于化脑组和对照组,化脑组高于对照组(P均<0.01)。②恢复期化脑组、病脑组CSF和血清中S-100b蛋白水平明显低于急性期(P均<0.01);病脑组仍明显高于化脑组和对照组(P均<0.01),而化脑组与对照组比较无差异(P均>0.05)。③化脑组、病脑组CSF中S-100b蛋白含量分别与其各自的血清含量呈正相关(P均<0.01)。结论CSF和血清中S-100b蛋白的检测,对小儿化脑与病脑具有早期诊断和鉴别诊断价值,从而为临床尽早用药提供实验室依据。