急性脑梗死患者颈动脉硬化与C反应蛋白及纤维蛋白原的相关性

目的探讨急性脑梗死患者高敏C反应蛋白和纤维蛋白原的变化与颈动脉粥样硬化超声指标之间的关系。方法应用高频多普勒超声检测颈动脉内膜—中膜厚度、斑块总计分和血流速度;同时检测其血C反应蛋白和纤维蛋白原浓度;连续观察103例,其中急性脑梗死组33例,慢性脑梗死组34例,年龄相匹配的正常对照组36例。各项数据用SPSS10软件统计分析。结果颈动脉内膜—中膜厚度和斑块发生率急性组和慢性组较对照组增加(P均<0.01),而急性组和慢性组间差异无显著性(P>0.05);慢性组颈动脉斑块积分较急性组显著增加(P>0.05);C反应蛋白浓度急性组(19.54±37.96mg/L)较慢性组(4.01±7.22mg/L)和对照组(1.66±1.17mg/L)增高(P均<0.01);慢性组较对照组增高但差异无显著性(P>0.05)。急性组、慢性组和对照组间C反应蛋白浓度95%的可信范围分别为1.24～2.08mg/L、4.52～34.56mg/L和1.42～6.62mg/L。急性组血浆纤维蛋白原浓度依次大于慢性组和对照组,但差异无显著性(P>0.05)。多元逐步回归分析表明:血C反应蛋白浓度与纤维蛋白原和斑块总计分呈正相关,与血流阻力指数呈负相关。血纤维蛋白原浓度与高密度脂蛋白胆固醇浓度呈负相关。结论脑梗死患者急性期纤维蛋白原血浓度变化不敏感;C反应蛋白血浓度升高与颈动脉内膜—中膜厚度无关,与纤维蛋白原血浓度和斑块总计分关系密切。     

复方硝酸益康唑乳膏治疗足癣和体股癣随机双盲对照临床试验

目的:评价复方硝酸益康唑乳膏治疗足癣和体股癣的疗效及安全性, 并与1%硝酸益康唑霜对比.方法:每天外用2次,疗程体股癣2周, 足癣 4周,随访2周.足癣可疗效评价病例,试验组38例,对照组33例.体股癣试验组33例,对照组35例.结果:试验组对足癣,在第4周时脱屑症状的改善和临床的综合改善明显优于对照组(P<0.01); 在停药后2周, 角化、浸渍和瘙痒症状的改善和临床的综合改善优于对照组(P<0.05).试验组对体股癣,在第1周时瘙痒症状的改善和临床的综合改善优于对照组(P<0.05); 在停药后2周, 丘疹症状的改善优于对照组(P<0.05).试验组对足癣,在第2周时临床有效率57.89%(对照组51.52%),真菌学清除率71.05%(对照组72.73%);在第4周分别为94.74%(对照组81.82%)和94.74%(对照组100%);在停药后2周分别为100%(对照组81.82%,P<0.05)和100%(对照组93.94%).试验组对体股癣, 在第1周的临床有效率87.88%(对照组60.00%,P<0.01),真菌学清除率90.91%(对照组88.57%);在第2周分别为96.97%(对照组91.43%)和100%(对照组97.14%);在停药后2周分别为100%(对照组100%)和100%(对照组100%).试验组不良反应发生率2.74%(对照组2.86%),表现为局部轻度刺激.结论:复方硝酸益康唑乳膏治疗足癣和体股癣,可在短时间内抑制皮肤炎症反应,缩短了疗程,提高了疗效,且与单纯的硝酸益康唑霜有同样强的抗真菌作用.     

脑脊液乳胶凝集试验在儿童新型隐球菌性脑膜炎诊断和治疗中的应用

目的：探讨脑脊液乳胶凝集试验在隐球菌性脑膜炎诊断和治疗中的应用价值。方法：回顾性分析10例新型隐球菌性脑膜炎患儿的临床资料。通过临床表现,结合脑脊液墨汁染色、乳胶凝集试验与真菌培养,确诊新型隐球菌脑膜炎。随访2~4年抗真菌治疗的效果和乳胶凝集试验滴度变化。结果：10例患儿中,首次脑脊液检查乳胶凝聚试验和/或墨汁染色阳性者8例（乳胶凝集试验滴度1∶64~1∶1024）;另2例中1例在第4次检查时始出现乳胶凝集试验阳性（滴度1∶256）,1例在第11次检查时墨汁染色阳性而确诊。经正规抗真菌治疗后,6例痊愈,2例死亡,2例失访。治疗后6个月、1年、2年和4年脑脊液乳胶凝集试验仍阳性（滴度1∶2~1∶16）者分别有6例、3例、2例和1例。结论：脑脊液乳胶凝集试验对于新型隐球菌性脑膜炎的快速诊断具有重要价值,但不宜作为停止抗真菌治疗的依据。     

烟酰胺磷酸核糖转移酶的调控因素及药物作用

烟酰胺磷酸核糖转移酶（Nampt）是生命过程中不可或缺的蛋白,具有多种生理功能,对许多疾病如心脑血管疾病、糖尿病、癌症、自身免疫性疾病等有潜在的作用。阐明各种生理、病理状态以及化合物对Nampt表达水平的改变,可为Nampt的基础性和应用性研究起到推动作用。本文就各种因素对Nampt转录、表达调控的研究进展进行了较为系统的综述。     

How the EQ-5D utilities are derived matters in Chinese diabetes patients: a comparison based on different EQ-5D scoring functions for China

Quality of Life Research - In China, multiple approaches to calculating EQ-5D utilities are available, including the two EQ-5D-3L (3L2014 and 3L2018) scoring functions, the EQ-5D-5L (5L) scoring...     

两种不同剂量辛伐他汀对冠心病患者血脂异常的疗效与安全性评价

探讨两种剂量辛伐他汀治疗冠心病血脂异常患者的疗效与安全性。采用自身对照的方法,选取总胆固醇≥4.68 mmol/L和/或低密度脂蛋白胆固醇≥26mmol/L的冠心病患者,按随机原则分别入选辛伐他汀10mg剂量组与20 m剂量组,10mg组52例,其中男性34例,女18例,平均年龄67.9岁;20 mg组50例,男31例,女19例,平均年龄67.2岁。于服药后90 d和180 d后复查血脂、肝肾功能和肌酸激酶,并记录随访期间不良反应。结果发现,辛伐他汀10mg组与20mg组分别在90和180 d后总胆固醇和低密度脂蛋白胆固醇水平较治疗前均显著降低(p<0.05)。20 mg组在90和180 d后总胆固醇和低密度脂蛋白胆固醇降低的幅度较10 mg组均有显著性增高(p<0.05)。10 mg和20 mg组在治疗180 d后降低总胆固醇的达标率分别为23%和34%;降低低密度脂蛋白胆固醇的达标率分别为25%和44%,组间有显著性差异(p<0.05)。在随访期间高密度脂蛋白胆固醇有逐渐升高;甘油三酯呈逐渐降低的趋势,但无统计学上的显著性意义。治疗期间有少数患者肝酶和肌酸激酶轻度升高,无严重不良反应。此结果提示,辛伐他汀每日10mg或20mg均能有效降低冠心病血脂异常患者总胆固醇及低密度脂蛋白胆固醇水平而且安全,20 mg剂量组的效果优于10 mg组。     

Inhibitory effect of human telomerase antisense oligodeoxyribonucleotides on the growth of gastric cancer cell lines in variant tumor pathological subtype

AIM: To investigate the inhibitory effect of specialized human telomerase antisense oligodeoxyribonucleotides on the growth of well (MKN-28), moderately (SGC-7901) and poorly (MKN-45) differentiated gastric cancer cell lines under specific conditions and its inhibition mechanism, and to observe the correlation between the growth inhibition ratio and the tumor pathologic subtype of gastric cancer cells. METHODS: Telomerase activity in three gastric cancer cell lines of variant tumor pathologic subtype was determined by modified TRAP assay before and after the specialized human telomerase antisense oligodeoxyribonucleotides were dealt with under specific conditions. Effect of antisense oligomer under specific conditions of the growth and viability of gastric cancer cell lines was explored by using trypan blue dye exclusion assay, and cell apoptosis was detected by cell morphology observation, flow cytometry and TUNEL assay. RESULTS: Telomerase activity was detected in well, moderately and poorly differentiated gastric cancer cell lines (the quantification expression of telomerase activity was 43.7TPG, 56.5TPG, 76.7TPG, respectively). Telomerase activity was controlled to 30.2TPG, 36.3TPG and 35.2TPG for MKN-28, SGC-7901 and MKN-45 cell lines respectively after treatment with human telomerase antisense oligomers at the concentration of 5 μmol/L, and was entirely inhibited at 10 μmol/L, against the template region of telomerase RNA component, whereas no inhibition effect was detected in missense oligomers (P<0.05). After treatment with antisense oligomers at different concentrations under specific conditions for 96 h, significant growth inhibition effects were found in MKN-45 and SGC-7901 gastric cancer cell lines (the inhibition ratio was 40.89% and 71.28%), but not in MKN-28 cell lines (15.86%). The ratio of inactive SGC-7901 cells increased according to the prolongation of treatment from 48 to 96 h. Missense oligomers could not lead to the same effect (P<0.05). Apoptosis of SGC-7901 and MKN-45 cells was detected not only by morphology and TUNEL assay but also by flow cytometry. The apoptotic rate reached 33.56% for SGC-7901 cells and 44.75% for MKN-45 cells. CONCLUSION: The viability and proliferation of gastric cancer cells can be inhibited by antisense telomerase oligomers. The growth inhibition of gastric cancer cells is correlated with concentration, time and sequence specialty of antisense oligomers. The inhibition mechanism of antisense human telomerase oligomers depends not only on the sequence specialty but also on the biological characteristics of gastric cancer cell lines.     

Circulating and local visfatin/Nampt/PBEF levels in spontaneously hypertensive rats,stroke-prone spontaneously hypertensive rats and Wistar-Kyoto rats

Visfatin (also known as nicotinamide phosphoribosyltransferase and pre-B cell colony-enhancing factor) is a multifunctional protein. Visfatin has been reported to be involved in several biological processes in the cardiovascular system, . However, the role of visfatin in hypertension is still unclear. In this study, we examined the circulating and local adipose visfatin levels in spontaneously hypertensive rats (SHR), stroke-prone spontaneously hypertensive rats (SHR-SP), and in their normotensive control Wistar-Kyoto (WKY). SHR and SHR-SP rats exhibited lower body weight, lower fat tissue and hypolipidemia. No differences of serum visfatin levels were observed in SHR/SHR-SP and WKY. Serum visfatin levels did not correlate to serum glucose, lipids, insulin, and fat pad weights, but significantly correlated to weights of skeletal muscle. Visfatin expression in visceral fat tissue was slightly lower in SHR-SP compared with that in WKY. Moreover, there were no significant differences of visfatin expression in skeletal muscles among WKY, SHR and SHR-SP. Finally, visfatin protein was detected in L6 rat skeletal muscle cell culture medium, indicating that visfatin was secreted from skeletal muscle cells. Thus, our results may provide useful information for understanding the characteristic of visfatin in hypertensive models, and support the view that visfatin may be a myokine.     

Endoscopic mucosal resection with double band ligation versus endoscopic submucosal dissection for small rectal neuroendocrine tumors

BACKGROUND Endoscopic resection remains an effective method for the treatment of small rectal neuroendocrine tumors(NETs)(≤ 10 mm). Moreover, endoscopic mucosal resection(EMR) with double band ligation(EMR-dB), a simplified modification of EMR with band ligation, is an alternative strategy to remove small rectal NETs.AIM To evaluate the feasibility and safety of EMR-dB for the treatment of small rectal NETs(≤ 10 mm).METHODS A total of 50 patients with small rectal NETs, without regional lymph no...