2型糖尿病中医辨证分型与红细胞CR1分子基因型及数量表达的相关性研究

目的:探讨2型糖尿病中医辨证分型与红细胞CR1分子基因型及数量表达的关系.方法:检测58例2型糖尿病患者和27名健康人的红细胞CR1分子基因型及数量表达.结果:健康对照组及2型糖尿病燥热伤肺型、胃燥津伤型、肾阴亏虚型的红细胞CR1分子基因型高表达呈依次下降,而中、低表达呈逐渐上升趋势(P＜0.025);CR1分子数量表达亦呈依次下降,肾阴亏虚型与健康对照组、燥热伤肺型、胃燥津伤型比较,胃燥津伤型与健康对照组比较有显著差异(P＜0.001;P＜0.05).结论:红细胞CR1分子基因型及数量表达与2型糖尿病中医辨证分型,特别是肾阴亏虚型密切相关.     

系统性红斑狼疮患者CpG基序甲基化状态与淋巴细胞功能相关抗原-1表达的研究

目的 研究系统性红斑狼疮患者(SLE)CpG基序甲基化状态和淋巴细胞功能相关抗原-1(LFA-1)mRNA的表达水平,并探讨两者的关系.方法 提取26例SLE患者与17名健康人外周血淋巴细胞,分别用5-甲基胞嘧啶抗体与流式细胞仪检测CpG基序甲基化状态和反转录-聚合酶链反应(RT-PCR)分析LFA-1 mRNA表达水平.结果 SLE患者的CpG基序甲基化水平(10.0±1.2)低于健康对照组(11.9±1.0,P<0.05),并与SLE疾病活动指数(SLEDAI)旱负相关(r=-0.62,P<0.05);SLE患者IJFA-1 mRNA表达(0.55±0.11)明显高于健康对照组(0.25±0.08,P<0.05),并与SLEDAI呈正相关(r=0.54,P<0.05);SLE患者CpG基序甲基化水平与LFA-1 mRNA表达呈负相关(r=-0.57,P<0.05).结论 SLE患者存在CpG基序低甲基化状态,并与LFA-1高表达相关联,表观遗传学在SLE发病机制中具有重要作用.     

美沙酮维持治疗患者脱失的影响因素研究

目的 了解美沙酮维持治疗(MMT)门诊患者脱失的影响因素. 方法 将在天心区和衡阳市MMT门诊参治的353名患者,按维持时间长短分为脱失组和对照组,分析两组患者人口学、治疗前吸毒情况、治疗中情况、心理状况、接受家庭帮教情况之间的差别,分析影响患者脱失的因素. 结果 影响MMT门诊患者脱失的主要人口学因素有患者婚姻状况及家庭关系;影响MMT门诊患者脱失的吸毒行为因素有同居者吸毒状况;影响MMT门诊患者脱失的社会学因素有参加MMT后与吸毒朋友交往情况及是否实施社会帮教;影响MMT门诊患者脱失的心理学因素主要是焦虑状况和患者自尊状况. 结论 门诊对影响患者脱失的因素提前进行干预,能有效减少患者脱失,提高门诊治疗效果.     

系统性红斑狼疮患者CpG基序甲基化状态与淋巴细胞功能相关抗原-1表达的研究

目的 研究系统性红斑狼疮患者(SLE)CpG基序甲基化状态和淋巴细胞功能相关抗原-1(LFA-1)mRNA的表达水平,并探讨两者的关系.方法 提取26例SLE患者与17名健康人外周血淋巴细胞,分别用5-甲基胞嘧啶抗体与流式细胞仪检测CpG基序甲基化状态和反转录-聚合酶链反应(RT-PCR)分析LFA-1 mRNA表达水平.结果 SLE患者的CpG基序甲基化水平(10.0±1.2)低于健康对照组(11.9±1.0,P<0.05),并与SLE疾病活动指数(SLEDAI)旱负相关(r=-0.62,P<0.05);SLE患者IJFA-1 mRNA表达(0.55±0.11)明显高于健康对照组(0.25±0.08,P<0.05),并与SLEDAI呈正相关(r=0.54,P<0.05);SLE患者CpG基序甲基化水平与LFA-1 mRNA表达呈负相关(r=-0.57,P<0.05).结论 SLE患者存在CpG基序低甲基化状态,并与LFA-1高表达相关联,表观遗传学在SLE发病机制中具有重要作用.     

2021-09期目录

Objective To investigate the predictive effect of thyroglobulin antibody (TgAb) level after operation and the trend of TgAb change after 131I treatment on the curative effect of 131I treatment in patients with differentiated thyroid carcinoma (DTC). Methods A total of 95 patients with DTC who were positive for TgAb and who underwent total thyroidectomy and 131I treatment in the Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from December 2016 to May 2018 were retrospectively analyzed. The patients included 16 males and 79 females, aged 11?63 (37.74±11.27) years old. 131I treatment was administered 2–6 months after surgery. Based on the response to therapy assessment system of DTC in the American Thyroid Association Management Guidelines and according to the images, the curative effect was divided into three groups, namely, structural excellent response group (A group, 54 cases), structural incomplete response group (B group, 19 cases), and structural indeterminate response group (C group, 22 cases). The following parameters were observed among the three groups: TgAb level before 131I treatment; percentage change at 1.5 months, 3–6 months, and 6–12 months; and rate of change of TgAb. The factors that might affect the curative effect were analyzed. Receiver operating characteristic (ROC) curves were drawn with the following: the TgAb level before 131I treatment; percentage change of TgAb at 1.5 months after treatment; and percentage change of TgAb at 3–6 months after treatment. The best critical value for predicting therapeutic effect was determined, and the diagnostic efficiency was calculated. The measurement data were compared through variance analysis or Kruskal-Wallis rank sum test. Chi-square test or Fisher's exact text were used to compare the count data among the groups. The multivariate Logistic regression analysis was used to analyze the factors that may affect the curative effect. Results The univariate regression analysis results showed that the mean age (F=3.48, P=0.03), lymph node metastasis rate (χ2=10.28, P<0.01), TgAb level before 131I treatment (χ2=16.03, P<0.01), 131I dose (Fisher's exact text, P=0.002), percentage changeand and rate of change of TgAb (except percentage change at 6?12 months) at 1.5 months, 3?6 months, and 6?12 months were significantly different among the three groups (χ2=8.55–22.79, all P<0.05). The multivariate Logistic regression analysis result showed that TgAb levels before 131I treatment were significantly different among the three groups (β=?0.006, OR=0.994; P<0.01), percentage change of TgAb at 1.5 months (β=0.327, OR=1.387; P=0.046), and percentage change of TgAb at 3?6 months (β=2.521, OR=12.439; P=0.041) had statistical significance. The optimal cut-off value of TgAb level on ROC curve was 201.4 U/mL with a sensitivity of 74.1% and specificity of 68.3%. The area under ROC curve (AUC) was 0.740. The optimal cut-off values of the percentage change of TgAb in 1.5 months and for 3–6 months after treatment were 9.7% and 19.2%; the sensitivities were 72.2% and 61.0%; the specificities were 87.0% and 58.5%; and the AUCs were 0.660 and 0.752, respectively. Conclusions Postoperative TgAb level enabled the prediction of the therapeutic effect of 131I. Patients with lower TgAb level showed better therapeutic effect. The decrease of TgAb after treatment was more significant than before treatment, suggesting that the 131I therapeutic effect was satisfactory.     

鸦胆子油乳联合索拉非尼+TACE治疗中晚期原发性肝癌的效果及对血清VEGF、bFGF与生存预后的影响

目的：探讨鸦胆子油乳联合索拉非尼+经导管动脉化疗栓塞术（TACE）治疗中晚期原发性肝癌的效果及对患者血清血管内皮生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）与生存预后的影响。方法：回顾性分析2018年1月-2019年12月江西省人民医院收治的88例中晚期原发性肝癌患者的临床资料,根据治疗方法不同对患者进行分组,将TACE联合口服索拉非尼治疗的42例患者纳入常规组,将在常规组基础上加用鸦胆子油乳治疗的46例患者纳入研究组。两组均持续治疗12周,治疗后均随访6～24个月。比较治疗后两组疾病控制率（DCR）、客观有效率（ORR）;比较两组治疗前后血清VEGF、bFGF水平、生活质量[肝癌患者生活质量测定量表（QOL-LC）]评分;比较两组治疗期间中重度不良反应发生率;比较两组随访期间无进展生存期（PFS）与总生存期。结果：治疗后研究组DCR、ORR均高于常规组,差异均有统计学意义（P<0.05）。治疗后,两组血清VEGF、bFGF水平均较治疗前降低,且研究组均低于常规组,差异均有统计学意义（P<0.05）。治疗后,两组各维度QOL-LC评分较治疗前均上升,且研究组均高...     

信号肽序列修饰的单纯疱疹病毒-2多表位复合DNA疫苗构建

目的:构建经糖蛋白gD信号肽修饰的单纯疱疹病毒2型(HSV-2)糖蛋白gD、gB、gC和早期表达蛋白ICP 27的多表位复合DNA疫苗.方法:国内HSV-2野生株经测序与PCR鉴定后利用PCR技术从其基因组中扩增出HSV-2 ICP27 377-459、gD146-179、gD223-306、gB529-606、gC247-282、gD1-77 6个基因片段,PCR鉴定后按先后顺序,采用多基因片段一步酶切连接法获得HV融合基因片段,经pGEMT载体克隆后定向插入真核表达质粒pcDNA3.1载体中,构建出重组真核表达质粒HV-pcDNA3.1,并对其进行酶切分析及测序鉴定.PCR扩增gD146-179信号肽片段,进一步酶切连接构建重组质粒gDs-HV-his-pcDNA3.1,并对其进行测序鉴定.结果:酶切重组质粒HV-pcDNA3.1,电泳可见两条带,分别为融合基因HV(1.3 kb)和线性质粒pcDNA3.1(5.4 kb).测序结果表明,克隆基因插入方向正确,重组质粒gDs-HV-his-pcDNA3.1与GenBank HSV-2中相关序列同源性达99.9%.结论:成功构建了经糖蛋白gD信号肽修饰的HSV-2多表位复合DNA疫苗.     

SCORTEN评分系统评估重症大疱性药疹的可行性分析

重症大疱性药疹(SBDE)包括重症多形红斑即Stevens-Johnson综合征(SJS)和中毒性表皮松解症(TEN,国内称大疱性表皮坏死松解症),为一组累及皮肤及黏膜的严重疾病谱,主要根据Bastuji-Garin等1993年提出的根据单个皮损特征及表皮剥脱占体表面积(TBSA)比例进行分类.近来认为重症多形红斑是不同于SJS和TEN的疾病而被剔除[2-3].     

ADAM33在IL-4刺激的人气道平滑肌细胞中对NF-κB和TGF-β1表达的影响

目的 探讨解整合素-基质金属蛋白酶33(ADAM33)在白介素-4(IL-4)刺激的人气道平滑肌细胞(HASMCs)中对NF-κB和TGF-β1表达的影响,为进一步完善哮喘的发病机制提供理论基础.方法 以50μg/L的IL-4刺激HASMCs,以未刺激细胞组为对照,24h后实时荧光定量PCR法和Western blot法检测ADAM33的表达;设计并合成ADAM33-siRNA,IL-4刺激24h后瞬时转染ADAM33-siRNA,实时荧光定量PCR法和Western blot法检测抑制率;并且检测TGF-β1、NF-κB mRNA和蛋白的表达情况.结果 50 μg/L的IL-4较对照组明显促进了HASMCs中ADAM33的表达(P＜0.05),在mRNA水平表达量增加约4.36倍,蛋白水平增加约3.3倍;ADAM33-siRNA-575明显抑制了ADAM33在HASMCs中的表达;干扰组、阴性对照组和空白对照组TGF-β1 mRNA的相对表达量分别为0.602±0.024、1.01±0.176和1.239 ±0.171,NF-κB mRNA的表达量分别为0.54±0.08、1.014±0.21和1.049±0.378;TGF-β1蛋白的表达量分别为0.227±0.016、0.7 ±0.048和0.715±0.025,NF-κB蛋白的表达量分别为0.335±0.048、0.922±0.04和0.943±0.046.干扰组TGF-β1、NF-κB不论是在mRNA水平,还是在蛋白水平,均明显低于阴性对照组和空白对照组(P＜0.05).结论 ADAM33可能是IL-4调节人气道平滑肌细胞NF-κB/TGF-β1信号通路中的一个关键信号分子,有望成为防治哮喘的重要靶点.