踝肱指数和肱踝动脉脉搏波速度与血管舒张功能联合载脂蛋白B与载脂蛋白A-1比值对中青年冠心病血瘀证的预测价值研究

背景 冠心病属中医“胸痹心痛”范畴,其证候分布以血瘀证最为多见,与老年人相比,中青年血瘀证的发生率更高。本研究在团队前期研究基础上进行拓展,首次运用动脉弹性和血管内皮功能检测联合载脂蛋白比值诊断中青年冠心病血瘀证,旨在为早期发现中青年冠心病血瘀证提供新思路,也可为优化补充冠心病血瘀证的诊断标准提供参考。目的 探讨踝肱指数(ABI)、肱踝动脉脉搏波速度(baPWV)、血管舒张功能(FMD)联合载脂蛋白B与载脂蛋白A-1比值(apoB/apoA-1)与中青年冠心病血瘀证的关系及其预测价值。方法 选取2016年12月至2021年12月于中日友好医院中西医结合心脏内科住院治疗的中青年(<50岁)冠心病患者,并根据《冠心病血瘀证诊断标准》分为血瘀证组和非血瘀证组。收集患者首次冠状动脉造影前的ABI、baPWV、FMD和apoB/apoA-1等临床资料。采用多因素Logistic回归分析构建中青年冠心病患者血瘀证的预测模型,并采用受试者工作特征(ROC)曲线进行预测价值评价。结果 本研究共纳入中青年冠心病患者206例,其中血瘀证组127例,非血瘀证组79例。多因素Logistic回归分析结果...     

转录因子Ascl2调控Acss1/3的表达影响结直肠癌患者预后

转录因子Ascl2作为WNT信号靶基因,可影响结直肠癌（CRC）前体细胞干性特征,探讨其能否调控短链脂肪酸β-氧化而影响CRC患者的预后。方法 下载稳定干扰Ascl2表达的CRC LS174T细胞（sh-Ascl2/LS174T）的mRNA及miRNA差异表达数据（GSE69036和GSE34926）分析其靶基因;应用RT-PCR方法和Western 印迹定量检测sh-Ascl2/LS174T及对照细胞中的Ascl2、Acss1和Acss3的mRNA表达水平,以及Ascl2和Acss1蛋白表达水平,从GSE44076表达数据和UALCAN数据比较在正常结直肠粘膜、CRC组织和不同临床病理分期的肿瘤组织的表达水平差异;TCGA数据库下载548例CRC患者基因 mRNA表达量及相关临床信息,用Spearman等级相关分析表达相关性,Kaplan-Meier法进行生存分析,Cox回归分析评估危险因素。结果 sh-Ascl2/LS174T细胞中Acss1的mRNA较对照细胞下调2.08倍,miR-4282表达水平下调2.069倍。RT-PCR定量检测sh-Ascl2/LS174T细胞中Acss1的mRNA和miR-4282水平明显下降(P＜0.01), Acss3的mRNA水平明显升高(P＜0.05);Acss1和Ascl2蛋白水平较对照细胞均明显下降。CRC组织Ascl2和Acss1的mRNA水平明显高于癌旁结直肠粘膜组织(P＜0.001),而Acss3明显低于癌旁结直肠粘膜组织 (P＜0.001);CRC组织中Ascl2与Acss1的mRNA表达水平呈正相关,与Acss3的表达水平呈负相关(均P＜0.001)。Ascl2和Acss3表达水平与疾病特异性生存期（DSS）、总体生存期（OS）、无进展生存期（PFS）无关,Acss1高表达组比低表达组的DSS (P=0.0389)和OS (P=0.04)明显降低。Ascl2与Acss1基因异常表达、Ascl2、Acss1和Acss3基因异常联合表达与CRC患者的DSS存在显著的联系(P=0.0377和P=0.0161),Ascl2、Acss1和Acss3三个基因的联合异常表达是影响CRC患者DSS的危险因素之一(P=0.043)。结论Ascl2对CRC细胞中的Acss1/3的表达可能具有调控作用而导致其短链脂肪酸β-氧化的重编程,它们的联合异常表达可以一定程度预测CRC患者的预后     

右美托咪定调控Nrf2/HO-1通路对H2O2诱导心肌细胞氧化应激损伤的作用研究

目的 探讨右美托咪定调控核因子E2相关因子2(Nrf2)/血红素加氧酶1(HO-1)通路对过氧化氢(H₂O₂)诱导心肌细胞氧化应激损伤的作用。方法 体外培养大鼠H9C2心肌细胞,设置对照组、H₂O₂组、1μmol右美托咪定+H₂O₂组、5μmol右美托咪定+H₂O₂组、10μmol右美托咪定+H₂O₂组。CCK-8法检测各组H9C2细胞增殖情况;酶联免疫吸附试验(ELISA)检测各组H9C2细胞丙二醛(MDA)、超氧化物歧化酶(SOD)水平;实时荧光定量聚合酶链反应(q RT-PCR)检测各组H9C2细胞Nrf2、HO-1 mRNA相对表达量;Western blotting检测各组H9C2细胞Nrf2、HO-1蛋白相对表达量。结果 与对照组比较,H₂O₂组H9C2细胞存活率、SOD水平、Nrf2、HO-1 mRNA及蛋白相对...     

格隆溴铵对高氧诱导幼鼠急性肺损伤的影响及其机制研究

目的 探究格隆溴铵对高氧诱导幼鼠急性肺损伤（ALI）的影响及作用机制。方法 从30只SD幼鼠中随机选取10只为对照组,其余幼鼠成功复制高氧诱导的ALI模型,随机分为ALI组、格隆溴铵组,每组10只。格隆溴铵组雾化吸入0.8 mg/（kg·d）格隆溴铵,ALI组、对照组吸入等体积生理盐水,连续给药7 d后,测量幼鼠肺组织湿/干重比值（W/D）、肺指数,检测白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）及肿瘤坏死因子-α（TNF-α）水平及血清活性氧基团（ROS）、超氧化物歧化酶（SOD）水平,比较肺组织病理学变化及Toll样受体4/髓分化因子88（TLR4/MyD88）通路蛋白的表达。结果 与对照组比较,ALI组W/D及肺指数升高（P <0.05）,血清IL-1β、IL-6、TNF-α、SOD水平升高（P <0.05）,ROS水平降低（P <0.05）,TLR4、MyD88蛋白相对表达量上调（P <0.05）;与ALI组比较,格隆溴铵组W/D及肺指数降低（P <0.05）,血清IL-1β、IL-6、TNF-α、SOD水平降低（P <0.05）,ROS水平升高（P <0.05）,TLR4、MyD88蛋白相对表达量下调（P <0.05）。结论 格隆溴铵能改善血清炎症指标及氧化应激指标,降低高氧诱导的ALI,其作用机制可能与TLR4/MyD88通路有关。     

EB病毒在结外NK/T细胞淋巴瘤中的预后价值：一项淮海淋巴瘤协作组的多中心回顾性研究

目的 基于倾向性评分逆处理概率加权(IPTW)法评估EB病毒(EBV)在结外NK/T细胞淋巴瘤患者中的预后价值。方法 收集2012年10月—2021年4月淮海淋巴瘤协作组中8家医疗机构初诊为结外NK/T细胞淋巴瘤且具有全血EBV-DNA数据的468例患者的临床资料。采用IPTW法分析EBV载量对结外NK/T细胞淋巴瘤患者生存期的影响;采用Cox比例风险模型进行多因素分析;绘制Kaplan-Meier曲线,组间比较采用Log rank χ²检验。结果 468例结外NK/T细胞淋巴瘤患者中,EBV-DNA阳性266例,EBV-DNA阴性202例。EBV-DNA阳性组和阴性组患者的5年OS分别为62.5%和89.2%,两组比较,经Log rank χ²检验,差异有统计学意义(χ²=42.900,P=0.000)。IPTW前,两组的美国东部肿瘤协作组(ECOG)活动状态(PS)评分(ECOG PS评分)、原发部位、CA分期、Ann Arbor分期、白蛋白、乳酸脱氢酶、治疗方案比较,差异均有统计学意义(P<0.05)。IPT...     

急性脑梗死患者血清CTRP-3、D-二聚体、sTREM2水平及相关临床特征与溶栓后出血性转化的关系

目的 探讨急性脑梗死患者血清补体C1q/肿瘤坏死因子相关蛋白3（CTRP-3）、D-二聚体、可溶性髓样细胞触发受体2（sTREM2）水平及相关临床特征与溶栓后出血性转化（HT）的关系。方法 回顾性分析2018年9月—2022年9月在青海省人民医院接受溶栓治疗的120例急性脑梗死患者的临床资料,根据患者溶栓后是否发生HT分为HT组（30例）、非HT组（90例）。比较两组患者的临床资料及血清CTRP-3、D-二聚体、sTREM2水平。采用多因素逐步Logistic回归分析急性脑梗死患者溶栓后发生HT的危险因素;绘制受试者工作特征（ROC）曲线,分析急性脑梗死患者溶栓后HT预测模型预测HT发生的价值。结果 HT组心房颤动（以下简称房颤）、大面积脑梗死、入院NIHSS评分≥ 15分占比高于非HT组（P <0.05）,血清CTRP-3水平低于非HT组（P <0.05）,D-二聚体、sTREM2水平高于非HT组（P <0.05）。血清CTRP-3、D-二聚体、sTREM2水平预测急性脑梗死患者溶栓后发生HT的敏感性分别为66.7%（95% CI：0.598,0.756）、70.0%（95% CI：0.607,0.812）、80.0%（95% CI：0.714,0.889）,特异性分别为73.3%（95% CI：0.636,0.821）、86.7%（95% CI：0.778,0.923）、86.7%（95% CI：0.747,0.942）。多因素Logistic逐步回归分析结果显示,房颤［O^R=1.237（95% CI：1.103,1.387）］、大面积脑梗死［O^R=2.338（95% CI：1.292,4.231）］、入院NIHSS评分≥ 15分［O^R=2.087（95% CI：1.231,3.538）］、CTRP-3 ≤ 269.265 μg/L ［O^R=3.006（95% CI：1.508,5.992）］、D-二聚体≥ 2.625 mg/L ［O^R=2.649（95% CI：1.374,5.107）］、sTREM2 ≥ 314.675 ng/L ［O^R=2.328（95% CI：1.411,3.841）］是急性脑梗死患者溶栓后发生HT的危险因素（P <0.05）。根据多因素Logistic逐步回归分析结果建立急性脑梗死患者溶栓后HT预测模型,Logit（P） = -33.887 + 0.213×房颤+ 0.849×大面积脑梗死+0.736×入院NIHSS评分+ 1.101×CTRP-3 + 0.974×D-二聚体+ 0.845×sTREM2;ROC曲线分析结果表明,预测模型预测HT发生的敏感性为93.3%（95% CI：0.841,0.991）,特异性为87.8%（95% CI：0.808,0.976）。结论 血清CTRP-3、D-二聚体、sTREM2水平与急性脑梗死患者溶栓后HT有关,预测价值较高,且急性脑梗死患者溶栓后HT预测模型预测HT优于各项指标单独预测。     

Adult adjustment of persons with severe/profound mental disabilities: A longitudinal study

The parents of 14 individuals with severe/profound mental disabilities were interviewed one and three years after their children graduated or aged out of high school. Two categories of information were sought concerning the adult adjustment of these individuals. General status variables included marital status, place of residence, agencies contacted concerning employment opportunities, financial resources, leisure activities, means of transportation, sources of help in resolving problems, and amount of postsecondary training. Employment variables included location of employment, wages, number of hours worked per week, and job benefits received. Results indicated that three years after exiting high school, all participants were very dependent upon others for housing, transportation, and financial assistance. Ten of the 14 individuals were employed 3 years after exiting high school, all in sheltered workshops.     

Changes in ultrastructure of hepatocytes and liver test results before,during, and after treatment with interferon-β in patients with HBeAg-positive chronic active hepatitis

We studied the histological and ultrastructural changes in the liver and alterations in the liver test results before, during, and after treatment with human interferon- from five patients with hepatitis B e antigen-positive chronic active hepatitis. A daily dose of 3×10⁶ to 6×10⁶ units of interferon- was given intravenously for four weeks. The total index of periportal and portal inflammation, intralobular degeneration, and focal necrosis before treatment was decreased significantly six months after treatment (P<0.05). Ultrastructurally, the structure of endoplasmic reticulum was irregularly shaped or fragmentally decreased during treatment, but these disappeared six or 12 months after treatment. Glycogen particles diminished greatly during treatment. The alanine aminotransferase concentrations in these patients increased during treatment. Serum albumin and cholinesterase levels decreased significantly at the fourth week of treatment (P<0.01) and at the third day (P<0.01) to the second week (P<0.05) of treatment, respectively. These results suggest that interferon- injures endoplasmic reticulum and glycogen areas and damages the cholinesterase activity in the early stage of treatment and protein synthesis in patients with hepatitis B e antigen-positive chronic active hepatitis.     

Histochemical study of pituitary adenomas with Ki-67 and anti-DNA polymerase α monoclonal antibodies,bromodeoxyuridine labeling,and nucleolar organizer region counts

Summary The growth potential of 65 pituitary adenomas was determined by histochemical analysis with Ki-67 and anti-DNA polymerase monoclonal antibodies, bromodeoxyuridine (BrdUdR) labeling, and counts of argyrophilic nucleolar organizer regions (Ag-NORs). The mean proliferating cell indices (PCIs) determined by Ki-67 and anti-DNA polymerase and the BrdUdR labeling index (LI) were generally very low [1.0±0.2%, 1.1±0.2%, and 0.5±0.1% (±SE), respectively]. Apart from adrenocorticotropic hormone-positive adenomas, which had significantly higher indices, there were no statistically significant differences in the indices among the other subtypes of pituitary adenomas. Recurrent tumors had higher Ki-67 and DNA polymerase PCIs and BrdUdR LIs (3.6%, 4.2%, 1.4%) than primary tumors (0.8%, 0.8%, 0.3%; P<0.005). The number of Ag-NORs did not correlated significantly with any of the three indices. The mean number of Ag-NORs was higher in nonfunctioning adenomas than in functioning adenomas (2.04 vs 1.66, P<0.005); among prolactin-positive adenomas, those treated preoperatively with bromocriptine had more Ag-NORs than untreated tumors (1.75 vs 1.57, P<0.005). These results suggest that the Ki-67 and DNA polymerase PCIs and the BrdUdR LI predict the growth potential of individual pituitary adenomas, whereas the number of Ag-NORs appears to correlate with hormone production rather than with the proliferative potential.Supported by grants CA-13525 and CA-50210 from the National Cancer Institute, by a grant from the Phi Beta Psi Sorority, and by Grant-in-Aid A 63771083 from the Ministry of Education, Science, and Culture of Japan