清炎颗粒治疗小鼠肾盂肾炎的实验研究

目的:探讨清炎颗粒治疗肾盂肾炎的作用机制。方法:采用孙建实方法改进造模,除空白组正常喂养外,治疗组给予清炎颗粒,模型组给予生理盐水,对照组给予至灵胶囊灌胃,分别喂养至3,7,15,30,60 d处死。取胸腺称重,计算胸腺指数,并取肾做病理分析。结果:清炎颗粒能提高不同时段小鼠的胸腺指数,并减轻相应时段的病理改变。结论:清炎颗粒通过提高小鼠的免疫功能来达到治疗肾盂肾炎的目的。     

Population interconnectivity over the past 120,000 years explains distribution and diversity of Central African hunter-gatherers

The evolutionary history of African hunter-gatherers holds key insights into modern human diversity. Here, we combine ethnographic and genetic data on Central African hunter-gatherers (CAHG) to show that their current distribution and density are explained by ecology rather than by a displacement to marginal habitats due to recent farming expansions, as commonly assumed. We also estimate the range of hunter-gatherer presence across Central Africa over the past 120,000 years using paleoclimatic reconstructions, which were statistically validated by our newly compiled dataset of dated archaeological sites. Finally, we show that genomic estimates of divergence times between CAHG groups match our ecological estimates of periods favoring population splits, and that recoveries of connectivity would have facilitated subsequent gene flow. Our results reveal that CAHG stem from a deep history of partially connected populations. This form of sociality allowed the coexistence of relatively large effective population sizes and local differentiation, with important implications for the evolution of genetic and cultural diversity in Homo sapiens.

The evolutionary history of African hunter-gatherers may hold key insights into patterns and processes behind the evolution of modern human diversity. Recent genomic studies have revealed that these populations represent the oldest and most diverse human genetic lineages and have been genetically differentiated from one another since the origin of humans (1–3) (SI Appendix, Table S1). Therefore, a first question is whether their current ecological niches were also characteristic of early Homo sapiens populations. However, genetic data alone can neither determine the geographic distribution of hunter-gatherers in the past nor demonstrate a deep history of adaptation of hunter-gatherers to their current environments. In fact, various studies have proposed that farming expansions within the past 5,000 years (in particular by the ancestors of Bantu speakers) would have only recently displaced hunter-gatherers to marginalized regions less favorable to agriculture (such as rainforests and deserts) (4–7).For example, the central part of Africa, between latitudes 5°N and 5°S currently is inhabited by ∼20 scattered hunter-gatherer ethnic groups (8). These Central African hunter-gatherers (CAHG) form a genetic clade thought to have diverged from other African populations as far back as 120,000 to 200,000 years ago (2, 9). The lack of any major linguistic specificity between them is often implied to reflect extensive contacts with surrounding farmer populations (8, 10), and seen as evidence of recent displacement into marginal forest environments by expanding farming populations. However, anthropologists have remarked on the huge variability in lifestyle, habitat, techniques, and tools between CAHG (11), suggestive of long-term cultural diversification and adaptation to forest environments. Research on the drivers of demography and adaptation of CAHG populations remains extremely limited, which can be partially attributed to the lack of archaeological and osteological data resulting from a rapid disintegration of fossil remains in the rainforest’s acidic soils, in addition to social instability in the region (12). Therefore, we are still left with crucial questions regarding the time depth of occupation of Central Africa by hunter-gatherers, the breadth of the niche exploited by earlier populations in the region, and variations in levels of interconnectivity at different points in time.To address those questions, we first compiled ethnographic data on the distribution of 749 camps from 11 hunter-gatherer groups extending from West to East Central Africa. We used them as inputs for environmental niche models (ENMs) to determine the relative influence of several bioclimatic and ecological factors, as well as the presence of farming populations, on the distribution and abundance of CAHG (13, 14). Then, we used high-resolution paleoclimatic reconstructions and topographic maps to make continuous predictions about where CAHG could have lived over the past 120,000 years and the potential extension of their interaction networks. Next, we compiled all reliably dated archaeological assemblages ascribed to hunter-gatherer groups in the Congo Basin (n = 168) and confirmed the model’s ability to predict the location and date of the sites. We further contextualized genomic estimates of population divergences with changes in population densities and interpopulation connectivity predicted by our model. Last, we complemented these analyses with a detailed assessment of present and historical gene flow between nine CAHG populations (n = 265 individuals), which we used to assess recent interactions between previously diverged CAHG populations, after farming expansions. Our study therefore provides a causal link between past environmental changes and human population dynamics over evolutionary time, by predicting where and when populations across Central Africa could have exchanged genetic and/or cultural information throughout their evolutionary history.     

Impact of pathological response after preoperative transcatheter arterial chemoembolization (TACE) on incidences of microvascular invasion and early tumor recurrence in hepatocellular carcinoma: a multicenter propensity score matching analysis

BackgroundTo study the influence of pathological responses (PR) after transcatheter arterial chemoembolization (TACE) on incidences of microvascular invasion (MVI) and early recurrence in hepatocellular carcinoma (HCC) patients.MethodsBetween 2013 to 2015, consecutive HCC patients who underwent liver resection with “curative” intent at three hospitals were enrolled in this study. Patients with different areas of PR after preoperative TACE were compared with those without preoperative TACE on the incidences of MVI, early recurrence rates and patterns of recurrence before and after propensity score matching (PSM).ResultsOf 1,970 patients, 737 patients who received preoperative TACE were divided into three groups according to the areas of PR: ≥90% (n=226), 60–90% (n=447), and <60% (n=64). PR ≥90% was an independent protective factor of incidences of MVI [odds ratio (OR), 0.144; 95% confidence interval (CI), 0.082–0.245, P<0.001) and early recurrence (HR, 0.742; 95% CI, 0.561–0.963, P=0.032); while PR<60% was an independent risk factor of incidences of MVI (OR, 6.076; 95% CI, 3.004–11.728, P<0.001) and early recurrence (HR, 1.428; 95% CI, 1.095–1.929; P=0.009). Furthermore, patients with PR <60% were significantly more likely to develop multiple intrahepatic recurrences involving multiple hepatic segments when compared with patients without preoperative TACE.ConclusionsThis study indicated the area of PR after TACE was closely associated with the incidences of MVI and early tumor recurrence. Patients with PR <60% were at significantly higher risks of having more MVI, early and multiple tumor recurrences     

低密度脂蛋白对体外培养的肾小球系膜细胞表型转化的影响

目的通过低密度脂蛋白(LDL)的刺激,观察LDL对体外培养的大鼠肾小球系膜细胞表型转化的诱导作用。方法采用不同浓度的LDL(0,25,50,100,150μg/ml)刺激体外培养的大鼠肾小球系膜细胞的水平,以台盼蓝染色检测LDL对系膜细胞的毒性作用,MTT比色法检测细胞增殖,透射电镜观察系膜细胞的形态学变化,免疫细胞化学染色及Western blot检测α-SMA、CTGF、Ⅳ型胶原及FN的表达。结果在LDL作用下,倒置显微镜下细胞变为长梭形,透射电镜下细胞表面微绒毛减少。免疫细胞化学染色及Western blot显示α-SMA、CTGF、Ⅳ型胶原及FN表达增强。结论在LDL刺激下,系膜细胞可以发生表型转化。     

静脉注射三乙醇胺对SD大鼠的病理性损伤作用

目的 观察静脉注射三乙醇胺后SD大鼠的组织病理学改变及其可逆性。方法 60只SD大鼠,随机分为对照组和300 mg/kg剂量组,连续30 d给药和恢复4周,分别进行大体解剖和组织病理学检查。结果 连续给药30 d,SD大鼠肝细胞嗜酸性变,肾髓质肾小管上皮细胞变性,脾小体生发中心增大,白髓边缘带增宽,淋巴结内淋巴滤泡数量增多,生发中心增大;恢复4周,肝脏、脾脏和淋巴结病变恢复不明显。结论 静脉注射一定剂量的三乙醇胺,对SD大鼠肝脏、肾脏、脾脏和淋巴结有一定的损伤作用,其中,肾脏的损伤可逆,脾脏、淋巴结和肝脏的损伤有一定程度的恢复。     

留置导尿集尿袋更换时间与尿路感染的相关性研究

目的：探讨留置导尿患者集尿袋更换时间与尿路感染的相关性及护理预防对策；方法：选择我院内科病区脑血管意外留置导尿患者61例，分实验组与对照组在不同间隔时间内予以更换集尿袋，追踪监测尿培养，对出现尿培养阳性结果进行统计学分析。结论：在严格按照护理质控与院内感染要求下，临床上集尿袋更换间隔时间以一周一次较为科学有效。     

红斑狼疮并肺、胸膜改变27例临床分析

我科从１９９３年１月～１９９５年１０月收治系统性红斑狼疮患者４６例。发现肺部有不同程度改变２１例（４５．６％），胸膜腔渗出６例（１３．０％）。２７例肺、胸膜改变中Ｘ线胸部正位片提示：双肺纹理增多模糊８例（２９．６％），双肺斑片影７例（２５．９％），双侧性胸膜腔渗出液４例（４．８％），单侧性胸膜腔渗出液２例（７．４％），反复咳嗽无痰２例（７．４％）。持续性胸痛２例（７．４％）。肺部可闻湿性罗音２例（７．４％）。Ｂｃｒｎａｒｄｏ等尸检发现［１］，红斑狼疮合并肺脏病变的原因为免疫组织学检查可见肺泡膜呈颗粒状沉着，免疫组织病理学证实狼疮性肺炎系ＤＮＡ、抗ＤＮＡ抗体的免疫复合物沉积作用，导致肺实质纤维化和肺间质小血管非特异性炎症等病理改变。     

髂筋膜间隙阻滞对股骨粗隆间骨折患者体位改变的镇痛效应

目的 探讨术前髂筋膜间隙阻滞对股骨粗隆间骨折手术患者体位改变的镇痛效应.方法 选择80例股骨粗隆间骨折行择期手术治疗的患者,美国麻醉医师协会麻醉风险评分(ASA)Ⅰ～Ⅱ级,随机分为髂筋膜间隙阻滞组(F组)和静脉注射地佐辛组(D组),每组40例.于入室前60 min,F组以0.4％罗哌卡因30 ml行髂筋膜间隙阻滞,D组以地佐辛注射液5 mg静脉注射.记录第1次过床(T1)、第2次过床(T2)、麻醉体位摆放(T3)时间点被动活动的视觉模拟评分(VAS)和局麻药毒性反应情况.结果 F组T1、T2、T3的VAS评分分别为(4.5±1.4)分、(3.8±1.2)分、(3.9±0.7)分,明显低于D组各时间点VAS评分[(7.9±1.2)分、(7.5±0.8)分、(7.0±1.1)分,P均＜0.05].F组无局麻药中毒发生;D组在静脉注射地佐辛60 min内,恶心3例(7.5％),头晕2例(5.0％).结论 髂筋膜间隙阻滞可以安全有效地用于股骨粗隆间骨折手术患者的转运及椎管内麻醉前体位的摆放.     

水通道蛋白-9在肝脏的表达及其意义

水通道蛋白-9(aquaporin-9,AQP9)是一种在肝组织中表达的跨膜转运蛋白。肝组织细胞内AQP9定位于细 胞质膜。AQP9除可通透水,还可以通透甘油、尿素等其他多种小分子。大量研究证明AQP9参与肝组织多种生理和 病理过程。AQP9在肝脏上的表达对肝脏生理和病理过程有多种影响,肝脏AQP9的研究可为肝脏疾病的诊断和治疗 提供新的靶点。     

Evidence-Based Nutrition Interventions Improved Adolescents’ Knowledge and Behaviors in Indonesia

Adolescence is a nutritionally vulnerable and critical life stage. However, few programs and policies focus on improving adolescent nutrition in Indonesia. To address this gap, we implemented a gender-responsive package of interventions: (1) breakfast and weekly iron-folic acid supplementation (WIFS), (2) a school-based nutrition education program, and (3) a social behavior change communication strategy. We surveyed 514 adolescents at baseline (2019) and endline (2020) in Klaten and Lombok Barat districts in Indonesia. The survey included a knowledge assessment on nutrition, as well as indicators of attitudes and behaviors on diet, physical activity, and WIFS. We employed multivariable linear and logistic regression to test for pre–post intervention differences. Overall knowledge was significantly higher post-intervention (β: 3.3; 95% confidence interval [CI]: 2.6, 3.9). Diet diversity was high at both timepoints, however, at post-intervention there was significantly higher odds of consuming vitamin A-rich fruits and vegetables (Odds Ratio [OR]: 1.5; 95% CI: 1.1, 2.0) and lower odds of consuming sugar-sweetened beverages (OR: 0.4; 95% CI: 0.3, 0.5). Post-intervention, there was higher odds of reporting 60 min of daily physical activity (OR: 2.3; 95% CI: 1.7, 3.2) and WIFS among girls (OR: 6.7; 95% CI: 1.5, 30.9). The package of interventions may be a promising first step to improving adolescent nutrition in Indonesia.