Journal of Hainan Medical University(中文版)
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    2023(20):1521-1525, DOI: 10.13210/j.cnki.jhmu.20220914.002
    摘要:
    鸡矢藤是我国传统药用植物,主要分布在我国南方地区,属于南药范畴,具有分布广、资源丰富的特点。传统上应用上,鸡矢藤具有止痛、解毒、消炎和抗惊厥等作用。现代研究表明,鸡矢藤主要含有环烯醚萜类和挥发油类成分,这些成分多具有止痛、抗炎、保肝、保肾及抗菌等药理活性。本文通过对近年来国内外有关鸡矢藤的化学成分和药理活性进行综述,为进一步研究开发其药用价值提供参考。
    2023(20):1526-1530, DOI: 10.13210/j.cnki.jhmu.20230825.004
    摘要:
    目的:研究岩藻多糖对高脂饮食诱导的非酒精性脂肪性肝病的预防作用。 方法:将实验小鼠随机分为3组:对照组、高脂饮食组和岩藻多糖干预组。对照组喂食标准饲料,其余两组喂食高脂饲料。对照组和高脂饮食组每天给予生理盐水灌胃,岩藻多糖干预组给予岩藻多糖溶液灌胃,剂量为100 mg∙kg⁃1∙d⁃1,每天灌胃一次,持续干预12周。最后一次灌胃12 h后,测量各组小鼠的体重和肝脏重量,并计算肝指数。使用生化试剂盒检测各组小鼠肝脏组织中谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TC)和甘油三酯(TG)的含量变化。利用苏木精⁃伊红染色比较各组小鼠肝组织的病理形态变化。测定各组小鼠肝组织中炎症因子白细胞介素⁃6、肿瘤坏死因子和氧化应激指标丙二醛的含量,以及谷胱甘肽过氧化物酶和超氧化物歧化酶的活性变化。 结果:与对照组相比,接受高脂饲料的小鼠体重和肝指数明显增加(P<0.01)。此外,高脂饮食组小鼠肝脏组织中的TG、TC、AST和ALT含量均较对照组显著增加(P<0.01)。高脂饮食组小鼠的肝脏组织也出现了明显的病理性变化,并伴随着炎症因子表达的增加和氧化应激反应的显著增加。与高脂饮食组小鼠相比,接受岩藻多糖干预的小鼠的肝组织中上述指标均得到显著改善(P<0.01)。 结论:岩藻多糖可以抑制高脂饮食引起的肝脏脂质沉积以及肝脏炎症和氧化应激反应。
    2023(20):1531-1538, DOI: 10.13210/j.cnki.jhmu.20230829.001
    摘要:
    目的:观察芪参汤对TGR5介导的NLRP3炎症小体的影响,从而明确其抑制巨噬细胞M1型极化改善非酒精性脂肪性肝炎的分子机制。 方法:小鼠巨噬细胞RAW264.7随机分为空白组、模型组、芪参汤组、TGR5激动剂组和芪参汤+TGR5激动剂组。除空白组外,余下各组通过棕榈酸诱导构建巨噬细胞NLRP3活化模型,并给予相应的药物进行干预。分别采用酶联免疫吸附试验检测巨噬细胞上清中TNF⁃α、IL⁃6、IL⁃1β和CXCL2的含量,流式细胞术检测巨噬细胞极化标记分子CD86和iNOS的表达水平,Western blot检测TGR5/STAT1/STAT6信号通路和NLRP3炎症小体蛋白的表达丰度。 结果:与空白组相比,模型组巨噬细胞TNF⁃α、IL⁃6、IL⁃1β、CXCL2的含量和CD86、iNOS阳性表达的巨噬细胞比例均显著增加,差异均具有统计学意义(P<0.01)。与模型组比较,芪参汤组TNF⁃α、IL⁃6、IL⁃1β、CXCL2的含量和CD86、iNOS阳性表达的巨噬细胞比例均显著降低,差异均具有统计学意义(P<0.01)。此外,与空白组相比,模型组巨噬细胞裂解液中NLRP3、Pro⁃IL⁃1β蛋白的表达和细胞上清液中Caspase⁃1 p10、p20及IL⁃1β p17蛋白的表达均显著增加,差异均具有统计学意义(P<0.01)。与模型组比较,芪参汤组巨噬细胞裂解液中NLRP3、Pro⁃IL⁃1β蛋白的表达和细胞上清液中Caspase⁃1 p10、p20及IL⁃1β p17蛋白的表达均显著降低,差异均具有统计学意义(P<0.01)。 结论:参汤能够通过抑制TGR5/STAT1/STAT6信号通路抑制巨噬细胞NLRP3炎症小体的活化,从而抑制巨噬细胞M1型极化,改善炎症反应。
    2023(20):1539-1545, DOI: 10.13210/j.cnki.jhmu.20230901.003
    摘要:
    目的:采用无创诊断方法及其联合模型,对慢性乙型病毒性肝炎(CHB)合并非酒精性脂肪性肝病(NAFLD)显著肝纤维化(≥S2)患者的诊断效能进行评估,并探讨其临床特征。 方法:回顾性收集2018年1月~2023年1月就诊于新疆医科大学附属中医医院且诊断为CHB且合并NAFLD(肝穿病理提示存在肝脏脂肪变性)的住院患者104名。所有患者均进行肝穿刺活检,整理收集患者的一般资料、实验室检查结果、肝脏硬度(LSM)、FIB⁃4、APRI、GGT/PLT、AST/PLT等结果,以不同纤维化分期(S)进行分组,探讨结果:104例患者中S1期患者55例,S2期患者32例,S3期患者11例,S4期患者6例。P<0.05)。无创诊断方法LSM、FIB⁃4、APRI、GGT/PLT、AST/PLT受试者工作特征曲线下面积分别为0.716、0.623、0.669、0.644、0.669(P<0.05);联合模型LSM联合FIB⁃4、LSM联合APRI、LSM联合GGT/PLT、LSM联合AST/PLT受试者工作特征曲线下面积分别为0.712、0.719、0.715、0.719(P<0.05)。 结论:目前临床常用的无创肝纤维化评估方法虽对CHB合并NAFLD显著肝纤维化具有一定的诊断效能,但无法替代肝活检,可作为肝活检的辅助方法在临床中用于定期评估。
    2023(20):1546-1554, DOI: 10.13210/j.cnki.jhmu.20230825.002
    摘要:
    目的:探讨体检人群中代谢综合征(metabolic syndrome,MS)及其不同组分高尿酸血症(hyperuricemia, HUA)流行特征。 方法:纳入2021年6月~2023年3月在某医院健康管理中心的体检者作为研究对象。分析MS及其不同组分的HUA患病率,进一步将研究对象按性别分层,评估不同MS组分数量人群的血清尿酸水平(serum uric acid, SUA)和HUA患病率及两性中具有最高HUA患病率的MS组分组合方式;logistic回归分析不同MS组分数量人群HUA的患病风险。 结果:共有66 520人纳入本次研究,MS组SUA水平(t=-82.947,P<0.001)和HUA患病率(χ2=3 421.632,P<0.001)显著高于非MS组。腹型肥胖、高血压、高密度脂蛋白胆固醇(HDL‑C)降低和甘油三酯(TG)增高者的SUA水平和HUA患病率显著高于正常者(P<0.001),而糖尿病患者SUA水平和HUA患病率存在性别差异,男性糖尿病患者SUA水平和HUA患病率显著低于血糖正常者,女性中这一结果相反。随MS组分数量增加,女性SUA水平和HUA患病率逐渐上升,而男性中,仅在MS1~MS4中观察到这样的趋势。男性HUA患病率最高的MS组分组合为腹型肥胖+高血压+HDL‑C降低+TG增高(54.35%),女性为腹型肥胖+高血压+糖尿病+HDL‑C降低+TG增高(41.46%)。Logistic回归分析显示:校正性别、年龄和民族后,女性HUA的患病风险随着MS组分数量的增加而增加,而在男性中,MS1~MS4的HUA患病风险不断上升。进一步校正体重指数、总胆固醇增高、低密度脂蛋白增高、冠心病后,结果仍然一致。 结论:体检人群中MS及其各组分是HUA的危险因素,MS组分的不同组合与HUA的相关性不同,HUA的患病风险与MS异常组分数量具有相关性。
    2023(20):1555-1562, DOI: 10.13210/j.cnki.jhmu.20230726.002
    摘要:
    目的:利用网络药理学、生物信息学分析糖尿病肾病(DN)患者造成肾损伤的关键基因以及探讨关键基因的表达变化对DN的影响。 方法:从GEO数据库中检索并获取了2型糖尿病患者肾小球转录组样本与健康人肾小球转录组的基因芯片数据集GSE96804。通过R语言对标准化基因进行差异分析获得差异表达基因,同时通过基于本体论(GO)富集和KEGG通路富集分析、GSEA分析注释和获得与2型糖尿病肾病患者肾小球炎症相关的关键基因和通路,同时通过蛋白⁃蛋白相互作用网络(PPI)分析通路之间的串扰。使用人源转录本GSE30122进行验证,同时对交叉的差异基因利用Cytoscape排序,获取排名前十的关键基因作为Hub基因,用Nephroseq数据库探讨其对患者的影响。 结果:通过基于R语言的limma包分析得1 235个DGEs,GSEA⁃KEGG通路富集发现2型糖尿病肾病患者肾小球炎症主要影响包括外源性刺激,脂质水平的变化,免疫系统调节能力的激活,细胞趋化和分化以及肾脏的发育在内的多种生物过程,DGEs在转录因子通路、Toll样受体通路、脂肪细胞因子信号通路、细胞黏附通路、细胞趋化因子通路等富集,判断其与糖尿病肾病炎症有重要联系。通过与Neqhroseq比对,获取在肾小球具有表达差异的5个关键基因。 结论:转录因子通路、Toll样受体通路、趋化因子信号传导、细胞黏附通路、脂肪细胞因子通路是2型糖尿病患者诱发肾病炎症的关键通路,同时CD8A、PTPRC、TCR2、CCL5、ITGAM可能为DN诊断的潜在生物标志物。
    2023(20):1563-1573, DOI: 10.13210/j.cnki.jhmu.20230905.001
    摘要:
    目的:探究E2F3基因在黑色素瘤中的变异、表达及临床意义。 方法:首先,采用cBioportal数据库、Oncomine数据库、GEO数据库分析E2F3基因在黑色素瘤中的变异情况和表达水平,OSskcm数据库和TISIDB数据库分析E2F3与黑色素瘤的预后和肿瘤免疫浸润细胞的关系。接着,采用LinkedOmics 数据库鉴定黑色素瘤中与E2F3表达相关的差异基因并进行生物学功能分析,利用Cytoscpae筛选Hub基因。最后,通过CMap数据库筛选治疗黑色素瘤的小分子化合物。 结果E2F3基因在黑色素瘤中的变异率为约4%,突变位点有21个。与正常皮肤组织相比,E2F3基因在黑色素瘤中的表达明显升高(P<0.01)。E2F3基因的变异和表达水平升高与黑色素瘤患者的总生存期(OS)缩短有关(P<0.05)。E2F3的CNA水平与pDC、Neutrophil、Act DC、Th17等淋巴细胞的表达水平呈负相关,与CXCL5、CCL13、CCR1等趋化因子的表达水平呈负相关。E2F3的甲基化水平与Th1、Neutrophil、Act DC等淋巴细胞的表达水平呈正相关,与CXCL16、CXCL12、CCR1等趋化因子的表达水平呈正相关。E2F3的表达水平与Th17、Tcm CD4、Th1等淋巴细胞的表达水平呈负相关,与CXCL 16、CCL 22、CCL 2等趋化因子的表达水平呈负相关。黑色素瘤中UHRF1BP1等96个基因的表达与E2F3的表达呈显著相关(|cor|≥0.5,P<0.05),以上基因主要与RNA转运、真核生物的核糖体生物生成、细胞周期等通路有关;其中,WDR12、WDR43、RBM28、UTP18、DKC1、PAK1IP1、DDX31、TEX10、TRUB1、TRMT61B是前10位hub基因。YC⁃1、辛伐他汀、细胞松弛素⁃d、Deforolimus和细胞松弛素⁃b可能是治疗黑色素瘤的5种潜在小分子化合物。 结论E2F3基因突变和表达水平升高与黑色素瘤的不良预后有关,可通过影响不同肿瘤免疫浸润细胞亚型的表达参与黑色素瘤的发生和发展,其可能是黑色素瘤的潜在诊断标志物和治疗靶点。
    2023(20):1574-1577, DOI: 10.13210/j.cnki.jhmu.20230804.004
    摘要:
    目的:探讨总胆汁酸/血小板对乙型肝炎病毒(HBV)相关肝纤维化的诊断价值。 方法:选择海南医学院第一附属医院2021年2月~2022年12月感染科收治160例慢性HBV感染患者,根据其肝活检的肝纤维化程度分为两组:显著性肝纤维化组、非显著性肝纤维化组,对比观察两组总胆汁酸/血小板情况及其与肝纤维化的相关性,并以及其他无创性肝纤维化诊断模型给予效能评价。 结果:(1)与非显著性肝纤维化组比较,显著性肝纤维化组总胆汁酸水平升高,血小板水平下降,总胆汁酸/血小板的水平明显升高,差异都具有统计学意义(P<0.05)。(2)血小板随着肝纤维化程度的增加而降低,总胆汁酸随着肝纤维化程度的增加而增加,总胆汁酸 /血小板随着肝纤维化程度的增加而增加。(3)总胆汁酸/血小板、APRI、FIB⁃4、弹性成像在诊断肝纤维化程度的曲线下面积分别为0.69、0.57、0.56、0.68。 结论:总胆汁酸/血小板对HBV相关肝纤维化的诊断效能不亚于其他肝纤维化诊断方法,且无创、简单、便捷,值得临床进一步推广验证。
    2023(20):1578-1588, DOI: 10.13210/j.cnki.jhmu.20230426.002
    摘要:
    目的:运用Meta分析和数据挖掘方法评价益肾活血法治疗非增殖期糖尿病视网膜病变(NPDR)的有效性和安全性并总结其用药规律。 方法:检索CNKI、VIP、WF、PubMed、the Cochrane Library、SinoMed、Embase中英文医学数据库中收录的有关中医药治疗NPDR的文献。参照Cochrane系统评价员手册对纳入的文献进行质量评价,应用RevMan 5.4.1软件进行统计分析。对中药名称进行规范化处理后,使用SPSS Modeler 18进行关联规则分析,然后使用Cytoscape制作复杂网络图。 结果:共纳入20项RCT,Meta分析结果显示,益肾活血法单用或联合西药治疗在提高NPDR患者的临床总有效率[RR=1.21,95% CI(1.16,1.27),P<0.000 01]、中医症候疗效[RR=1.28,95% CI(1.18,1.39),P<0.000 01]、视力[MD=0.11,95% CI(0.05,0.17),P=0.000 1]、HDL⁃C[MD=0.14,95% CI(0.03,0.25),P=0.02];减少眼底血管瘤个数[MD=-3.51,95% CI(-5.73,-1.28),P=0.002]、出血斑面积[MD=-0.70,95% CI(-0.95,-0.46),P<0.000 01];降低CMT[MD=-35.31,95% CI(-55.47,-15.14),P=0.000 6]、FBG[MD=-0.39,95% CI(-0.72,-0.05),P=0.02 ]、LDL⁃C[MD=-0.36,95% CI(-0.64,-0.08),P=0.01 ]、全血高切黏度[MD=-0.43,95% CI(-0.75,-0.12),P=0.006]、血浆黏度[MD=-0.36,95% CI(-0.67,-0.06),P=0.02]和纤维蛋白原[MD=-0.50,95% CI(-0.81,-0.19),P=0.002]等方面均优于单纯西药治疗,差异有统计学意义。所录入的20首方剂共涉及中药70味。枸杞子、三七、丹参、黄芪、生地黄为高频和核心药物,关联规则分析总结常用的药对包括生地黄⁃三七、生地黄⁃枸杞子等。 结论:益肾活血法单用或联合西药可以更有效提高NPDR的临床疗效,但仍需更高质量的临床研究加以验证。
    2023(20):1589-1593, DOI: 10.13210/j.cnki.jhmu.20220803.003
    摘要:
    膀胱癌是泌尿生殖系统第二常见的恶性肿瘤,仅次于前列腺癌,具有高度异质性,其发生、发展机制涉及多个基因组结构和功能的异常改变。利用分子生物学技术研究膀胱癌的分子分型对明确疾病发病机制、选择治疗方案具有重要意义。现对膀胱癌分子分型的研究进展作一综述。
    2023(20):1594-1600, DOI: 10.13210/j.cnki.jhmu.20220808.001
    摘要:
    幽门螺杆菌(Helicobacter pyloriH. pylori)是一种革兰阴性菌,主要定植于胃和十二指肠,它可以引起胃部炎症、消化性溃疡和胃癌等消化道疾病,根除H. pylori可以有效阻止消化道疾病的发生和发展。抗生素是治疗H. pylori的主要药物之一,由于抗生素的长期应用,H. pylori对抗生素的耐药率逐年上升,降低了H. pylori的根除率,增加了再次治疗的难度及患者的经济负担。本文将从H. pylori耐药现状、耐药机制和治疗三个方面进行综述,为应对严峻的耐药形势提供参考。
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    2022,28(16):1-5, DOI: 10.13210/j.cnki.jhmu.20220729.001
    摘要:
    新型冠状病毒(SARS‑CoV‑2)感染可导致一系列胃肠道损害。相关研究报道了SARS‑CoV‑2感染可导致溃疡性结肠炎的发生和进展,可能与SARS‑CoV‑2感染引发的细胞因子风暴有关。近日,我们还关注了感染SARS‑CoV‑2是否会加重接受生物免疫治疗UC患者的病情以及接种SARS‑CoV‑2疫苗对这些患者是否安全有效等问题。目前,有关SARS‑CoV‑2、SARS‑CoV‑2疫苗和溃疡性结肠炎之间的相互作用机制尚不完全清楚,需要更多的研究进一步明确其中的关系。
    2022,28(16):6-12, DOI: 10.13210/j.cnki.jhmu.20220525.002
    [摘要] (265) [HTML] (0) [PDF 2.54 M] (793)
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    目的:探索海南番木瓜提取物对D‑半乳糖所致小鼠衰老模型的改善学习记忆障碍和抗衰老的作用。方法:将水迷宫实验筛选认知能力正常的4月龄昆明种小鼠共72只,根据随机平均原则,分为阴性对照组、模型组、吡拉西坦组以及海南番木瓜提取物高、中、低剂量组(400、200、100 mg/kg),共6组,每组12只,海南番木瓜提取物与吡拉西坦组每天以灌胃给药途径给予以上药物,阴性对照与模型两个组以同样的给药途径给予等量0.9% NaCl溶液。各组小鼠每周称重1次;给药的同时,每天用2% D‑半乳糖对除阴性对照组小鼠外各组小鼠进行腹腔注射,阴性对照组小鼠注射0.9% NaCl溶液,共7周。49 d后,通过Morris水迷宫观察小鼠的空间学习记忆能力;后取各组小鼠脑组织分别检测其超氧化物歧化酶(Superoxide Dismutase,SOD)、丙二醛(malondialdehyde,MDA)、过氧化氢酶(catalase,CAT)、一氧化氮合酶(Nitric oxide synthase,NOS)的含量;以HE染色法观察海马组织病理学的改变,Western blot测定脑组织核因子‑E2‑相关因子(Nrf2)蛋白表达水平。结果:海南番木瓜提取物干预衰老模型小鼠后,其高、中、低剂量组可不同程度地缩短小鼠的游泳时间和游泳距离,同时能升高小鼠脑组织SOD、CAT、NOS活力和降低MDA含量;且高剂量组表现最佳,优于吡拉西坦组(P<0.01);同时能通过减少神经元细胞核固缩来改善小鼠海马组织中神经元组织病理学改变,并能呈剂量依赖性提高小鼠脑组织中Nrf2蛋白的表达。结论:海南番木瓜一定程度上有延缓D‑半乳糖所致亚急性衰老小鼠的各项体征,具有一定的抗衰老的作用,其作用可能与Nrf2信号通路有一定的联系。
    2019,25(5):6-9, DOI:
    摘要:
    Objective: To study the effect of Baihe Dihuang Decoction in improving anxiety and its mechanism of action. Methods: Male mice were randomly divided into 5 groups: blank control group, Baihe Dihuang Decoction high, medium, low-dose group and diazepam group. After continuous intragastric administration for 14 d, the behavioral test of the mouse elevated plus maze experiment and opening test was performed. The brain tissue GABA and Glu content was measured by immunosorbent assay (ELISA). Results: Compared with the blank control group, the middle and high doses of Baihe Dihuang Decoction could increase the time and frequency of movement of the mice in the open cross labyrinth in the open arm and increase the number of times that the mouse entered the central area in the opening test. The anti-anxiety effect also showed an increase in the brain tissue GABA content in mice, ignificantly decreased Glu contents in mice. Conclusion: Baihe Dihuang Decoction has some anxiolytic effect, and antianxiety effect may be related to increasing brain tissue GABA content, decreased Glu contents in mice.
    2019,25(5):1-5, DOI:
    摘要:
    Objective: The current study aims to identify the effects of exogenous application of pulsed electromagnetic fields on skin wound healing in diabetic rats, and thus provides experimental evidence for its more scientific clinical application in the future. Methods: The diabetic animal models were established via intraperitoneal injection of streptozotocin in 4-monthold male rats. Fourth eight rats were randomly assigned into the diabetes group (DM) and diabetes coupled with pulsed electromagnetic fields (DM+PEMF) group. Another 24 normal rats were used as the blank control group (Control). Then, all the rats in the three groups were subjected to dorsal surgery for the establishment of soft tissue wound model (circular wound with the diameter of 2 cm). Then, the rats in the DM+PEMF group were subjected to pulsed electromagnetic fields stimulation. Then, 6 rats in each group were sacrificed at Day 5, 12 and 19 post surgery. The glucose levels, wound closure, wound healing time and tissue tensile strength were examined and analyzed. Results: Pulsed electromagnetic fields significantly increased the wound closure rate in diabetic rats at Day 5, 12 and 19 post surgery, decreased overall wound healing period in diabetic rats, and also enhanced tissue tensile strength in diabetic rats at Day 5, 12 and 19 post surgery. Conclusion: Low-intensity pulsed electromagnetic fields can significantly accelerate diabetic wound healing process, and also improve diabetic tissue repair capacity. This study may be helpful for providing more scientific and reasonable experimental evidence for the treatment of pulsed electromagnetic fields on diabetic wound healing in clinics.
    2022,28(7):544-549, DOI: 10.13210/j.cnki.jhmu.20210303.002
    摘要:
    目的:基于中医传承计算平台探索分析中医药治疗化疗性腹泻用药思路、配伍规律。方法:以“中医”、“中药”、“化疗”、“腹泻”为主题词,检索中国知网(CNKI)、万方数据库(WanFang)、维普数据库中(VIP),检索时间为自建库以来至2020年11月,筛选下载中医药治疗化疗性腹泻的临床研究文献,运用中医传承计算平台对中药的频数进行统计,并总结出核心处方及挖掘新处方。结果:共检索出相关文献145篇,筛选出目标文献57篇、包括相关处方57个;高频药物依次为白术、茯苓、党参、黄连、炙甘草等;设定置信度为0.7、支持度为10,得到12组核心配伍,聚类分析6类。结论:化疗性腹泻的中医药用药以补虚益气、利水渗湿为主,配以清热、收涩药。基于中医传承计算平台数据挖掘分析出来的方药组合及新方组合可供临床医生参考以及在基层医院推行应用。
    2018,13(24):2121-2124, DOI: 10.13210/j.cnki.jhmu.20181115.009
    [摘要] (170) [HTML] (0) [PDF 2.17 M] (331)
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    目的:探讨百令胶囊联合依达拉奉对慢性阻塞性肺病患者免疫功能、抗氧化功能及相关因子水平的影响。方法:收集2016年3月~2018年3月于我院呼吸内科接受治疗的慢性阻塞性肺病患者160例,随机分为对照组与观察组,每组各80例。对照组患者接受依达拉奉治疗;观察组患者接受百令胶囊联合依达拉奉治疗。分别于治疗前后,检测并比较两组患者T淋巴细胞、超氧化物岐化酶(SOD)、血清丙二醛(MDA)、一氧化氮(NO)、血清转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)及基质金属蛋白酶-9(MMP-9)水平。结果:治疗后,对照组及观察组患者CD3+、CD4+及CD4+/CD8+、SOD及NO水平均显著升高,CD8+、MDA水平显著降低;且治疗后观察组患者T淋巴细胞及抗氧化酶水平变化趋势较对照组患者明显(P<0.05)。治疗后,对照组及观察组患者血清中TGF-β1、MMP-9及TNF-α水平均明显降低,且观察组上述指标变化趋势较对照组明显(P<0.05)。结论:百令胶囊联合依达拉奉治疗慢性阻塞性肺病,可显著增强患者免疫功能及抗氧化功能,缓解机体炎症反应,具有较好的临床疗效。
    2018,13(24):2158-2161, DOI: 10.13210/j.cnki.jhmu.20181114.002
    [摘要] (186) [HTML] (0) [PDF 2.09 M] (326)
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    目的:探究EASI导联与血清心型脂肪酸结合蛋白(H-FABP)、缺血修饰清蛋白(IMA)联合检测在冠心病心肌缺血病人诊断中的意义。方法:将2016年3月~2018年6月来我院治疗的106例冠心病心肌缺血患者作为观察组,将同期于我院体检的106例健康成年人定义为对照组。比较两组心电图异常率、血清H-FABP、IMA,单项及联合检测诊断冠心病心肌缺血的诊断效能﹑不同联合检测的ROC曲线下面积。 结果: 观察组心电图异常率及血清H-FABP﹑IMA水平高于对照组(χ2=59.483,P=0.000;t=36.306,P=0.000;t=42.837,P=0.000);单独EASI导联﹑血清H-FABP﹑IMA诊断冠心病心肌缺血特异度有统计学差异(χ2=6.134,P=0.047), H-FABP的诊断特异度高于EASI导联、血清IMA(χ2=4.151,P=0.042;χ2=5.403,P=0.020);不同平行联合检测诊断冠心病心肌缺血敏感度﹑阴性预测值有统计学差异(χ2=43.318,P=0.000;χ2=23.424,P=0.000),不同系列联合检测诊断冠心病心肌缺血特异度有统计学差异(χ2=9.969,P=0.007);平行联合检测时EASI导联+H-FABP、H-FABP+IMA、EASI导联+H-FABP+IMA的ROC曲线下面积分别为0.713、0.782和0.914,系列联合检测ROC曲线下面积分别为0.709、0.724和0.883,EASI导联+H-FABP+IMA的ROC曲线下面积高于EASI导联+H-FABP、H-FABP+IMA(P<0.05)。结论: EASI导联与血清H-FABP﹑IMA联合对于诊断冠心病心肌缺血具有重要意义,可以考虑在临床工作中联合应用。
    2018,13(24):2117-2120, 2124, DOI: 10.13210/j.cnki.jhmu.20181119.001
    [摘要] (318) [HTML] (0) [PDF 2.80 M] (321)
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    目的:探讨溃疡性结肠炎组织中cingulin、claudin-2表达量与菌群紊乱、氧化应激及炎症的相关性。方法:选取在本院确诊并作为UC组的UC患者70例,同期至本院进行肠镜体检的结肠息肉患者90例作为结肠息肉组。对比两者肠道病变组织中cingulin、claudin-2蛋白表达量以及粪便标本中菌群分布、血清中氧化应激及炎症相关指标的差异。结果:UC组结肠病灶中cingulin、claudin-2蛋白表达量高于结肠息肉组;肠道内大肠杆菌的计数高于结肠息肉组,双歧杆菌、乳酸杆菌的计数值低于结肠息肉组;血清中氧化应激指标GSH-Px、T-AOC的含量低于结肠息肉组,ROS、LHP的含量高于结肠息肉组;血清中炎症因子IL-4、IL-6、IL-17、IL-23、TGF-β的含量均高于结肠息肉组。相关性分析显示:UC病灶组织中cingulin、claudin-2蛋白表达量与菌群紊乱、氧化应激及炎症反应指标均直接相关。结论:UC病灶中存在cingulin、claudin-2异常高表达,可推进机体肠道菌群紊乱及全身炎症应激反应。
    2018,13(24):2103-2106, 2111, DOI: 10.13210/j.cnki.jhmu.20181119.002
    摘要:
    目的:研究骨肉瘤组织中miR-494、miR-130b的表达量并探究下游靶基因。方法:收集在延安大学附属医院手术切除的骨肉瘤组织,另取同期关节置换术后的正常骨组织作为对照;抽提miRNA后测定miR-494、miR-130b的表达量,抽提RNA后测定增殖基因、侵袭基因的mRNA表达量,抽提蛋白后测定血管新生分子的蛋白含量。结果:骨肉瘤组织中miR-494、Runx3、ELL2、p16、RECK、TIMP1的表达量以及TSSC3的蛋白含量显著低于正常骨组织,miR-130b、β-catenin、CyclinD1、Sox9、ADAMTS18、CatD、STMN1的表达量以及CEACAM6、VEGF、Ang-2的蛋白含量显著高于正常骨组织;骨肉瘤组织中miR-494与Runx3、ELL2、p16、RECK、TIMP1、TSSC3呈正相关,与β-catenin、CyclinD1、Sox9、ADAMTS18、CatD、STMN1、CEACAM6、VEGF、Ang-2呈负相关,miR-130b与Runx3、ELL2、p16、RECK、TIMP1、TSSC3呈负相关,与β-catenin、CyclinD1、Sox9、ADAMTS18、CatD、STMN1、CEACAM6、VEGF、Ang-2呈正相关。结论:骨肉瘤组织中miR-494的低表达以及miR-130b的高表达能够调控增殖、侵袭基因的表达及血管新生分子的生成。
    2019,25(5):69-72, DOI:
    摘要:
    Gastric cancer is one of common malignant tumors in clinic. It has high incidence, high mortality and poor prognosis. Generally, gastric cancer is divided into early gastric cancer (EGC) and advanced gastric cancer. The 5-year survival rate of EGC is higher than that of advanced gastric cancer. In recent years, with the continuous development of science and technology, a variety of medical instruments and technologies have been updated, greatly promoting the detection rate of EGC, reducing the rate of EGC missed diagnosis. This article reviews the progress of EGC endoscopic diagnosis.
    2019,25(5):61-64, DOI:
    摘要:
    Objective: To investigate the effects of routine rehabilitation therapy combined with low frequency head stimulation on monoamine neurotransmitters, neuron-specific enolase (NSE), endothelin-1 (ET-1) and cerebral hemodynamics in children with cerebral palsy. Methods: From January 2017 to June 2018, 110 children with cerebral palsy were randomly divided into observation group (55 cases) and control group (55 cases). The control group received routine rehabilitation treatment, while the observation group received low-frequency head stimulation on the basis of routine rehabilitation treatment. The changes of dopamine (DA), norepinephrine (NE), serotonin (5-HT), NSE, ET-1 levels and mean blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) were compared in two groups. Results: Before treatment, there was no significant difference in DA, NE and 5-HT levels in two groups. After treatment, DA, NE and 5-HT levels in the observation group were (192.23±22.71) ng/mL, (98.02±11.71) ng/L, (210.07±25.03) ng/L, and in the control group. the DA, NE, 5-HT levels were (147.06±17.02) ng/mL, (83.07±11.15) ng/L, and (171.88±20.45) ng/L, respectively. The DA, NE and 5-HT levels in two groups were higher than those before treatment, and DA, NE and 5-HT levels in the observation group were higher than those in the control group. Before treatment, there was no significant difference in NSE and ET-1 levels between the two groups. After treatment, the NSE and ET-1 levels in the observation group were (7.97±2.07) μg/L and (41.01±10.07) pg/ mL, and the NSE and ET-1 levels in the control group were (10.38±3.02) μg/L, (58.46±15.02) pg/ mL, respectively. the NSE and ET-1 in two groups were lower than those before treatment, and the NSE and ET-1 of the observation group were lower than the control group. Before treatment, there was no significant difference in mean blood flow velocity between ACA, MCA and PCA. After treatment, the mean blood flow velocities of ACA, MCA, and PCA in the observation group were (46.88±7.72) cm/s, (59.85±10.18) cm/s, and (49.15±7.02) cm/s, respectively, which was significantly higher than before treatment and higher than that of the control group in the same period. Conclusion: Conventional rehabilitation combined with low-frequency electrical stimulation of the head can effectively increase the content of monoamine neurotransmitters in children with cerebral palsy, enhance cerebral blood circulation, and reduce brain damage
    2019,25(5):65-68, DOI:
    摘要:
    Objective: To study the refractory factors associated with schizophrenia. Methods: 200 patients with refractory schizophrenia and 200 patients with non-refractory schizophrenia were selected. The CYP series of genes CYP1A2, CYP3A4 and CYP2D6 were detected by drug gene, and the rapid metabolic probabilities of the three genes were compared and analyzed. 200 patients with refractory schizophrenia were randomly divided into two groups: the combined drug treatment group and the single drug treatment group. The results were compared between the treatment of 0W and 4W for drug gene detection, 3 genes fast metabolizing type and BPRS scale. analysis. Results: The rapid metabolizing probability and non-refractory difference of CYP1A2, CYP3A4 and CYP2D6 genes in patients with refractory schizophrenia were significant. The comparison of fast metabotropic probabilities of CYP1A2, CYP3A4 and CYP2D6 genes in patients treated with 4W after treatment There was no significant difference in the single drug treatment group. The BPRS scale score was significantly higher in the drug-treated group than in the single-drug group. After logistic regression analysis, the refractory characteristics of schizophrenia and The CYP series of genes CYP1A2, CYP3A4, and CYP2D6 are rapidly metabolized. Conclusion: CYP series of genes CYP1A2, CYP3A4, CYP2D6 fast metabolites are related factors of refractory schizophrenia, antipsychotic drugs combined with CYP enzyme inhibitor treatment can improve the efficacy.
    2019,25(5):73-76, DOI:
    摘要:
    Cervical laminoplasty surgery is an alternative to laminectomy. It can increase the space of the spinal cord available by raising the lamina, and achieve the indirect decompression effect to treat cervical spondylosis. Various techniques of laminoplasty have since been developed after two prototype techniques: Hirabayashi’s open-door laminoplasty and Kurokawa’s double-door laminoplasty. Several studies report superior biomechanical stability of the cervical spine after laminoplasty compared with laminectomy. Recent development in laminoplasty is preservation of muscle attachment, which enabled dynamic and static stabilization of the cervical spine by neck extensor muscles. After treatment with new laminoplasty techniques with active postoperative neck muscle exercises, postoperative instability, kyphosis, axial neck pain, and loss of ROM become minimal. The development,complications and future trends of cervical laminoplasty are summarized below.
    2019(1):69-72, DOI: 10.13210/j.cnki.jhmu.20181211.002
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    目的:探讨3.0 T磁共振头颅磁敏感加权成像(SWI)和波谱成像(MRS)影像分度在新生儿缺氧缺血性脑病(HIE)脑损伤程度评估中的应用价值及HIE早期诊断相关预测因素。方法:选取我院在新生儿科诊断为HIE的患儿60例。比较头颅SWI 与MRS序列检查对颅内出血灶的检出率、损伤脑叶数、临床分度和SWI分度、MRS分度之间相关以及HIE早期诊断相关预测因素。结果:60例HIE患儿的影像检查结果中,SWI的检出率为91.4%,MRS的检出率为100%,不同病情程度的HIE患儿的一般资料比较,差异具有统计学意义(P<0.05);临床分度和SWI分度、MRS分度之间显著相关(P<0.05),但两种影像学方法对于检测临床分度无差异(P>0.05);对于损伤脑叶数的检测,临床分度为轻度时,SWI优于MRS(P<0.05);多因素Logistic回归分析表明羊水粪染、脐带绕颈、Apgar值为HIE独立预测因素(P<0.05)。结论:3.0 T磁共振SWI及MRS作为近年来磁共振新开发的成像技术,对新生儿颅内出血具有高度敏感性。3.0 T磁共振SWI及MRS可无创分析脑内具体生物化学成分水平的变化,从统计学的定量角度反映出更多的生化指标,从而判断出新生儿脑损伤的严重程度。
    [摘要] (246) [HTML] (0) [PDF 2.34 M] (270)
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    目的:分析中西医结合疗法治疗非特异性溃疡性结肠炎(ulcerative colitis,UC)的疗效及对凝血功能、炎性因子水平的影响。方法:先抽取220名实验对象,要求其是UC活动期患者,并将实验对象随机平均分成对照组和实验组两组。对照组采用单纯西药治疗,实验组在对照组疗法基础上加用中药灌肠治疗。对两组临床疗效进行评价和比较。比较两组在治疗前及治疗后凝血酶原时间(PT)、凝血活酶时间(APTT)、D-二聚体(D-D)、血浆纤维蛋白原(Fib)等凝血指标;比较两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)等血清炎性因子含量。结果:试验组和对照组在临床期间达到预想效果的概率分别达到了97%和75%,可以看出实验组的效果是比对照组要好的试验组的临床有效率和疗效均优于对照组,两组之间存在着不同,有统计学意义(P<0.05)。两组治疗后的血浆Fib水平和血浆D-D水平均较治疗前显著降低,差异有统计学意义(P<0.05),而且观察组治疗后的血浆Fib水平和血浆D-D水平均低于对照组,差异有统计学意义(P<0.05)。两组治疗后的各项血清炎性因子水平均较治疗前降低,差异有统计学意义(P<0.05),而且观察组治疗后的各项血清炎性因子水平均低于对照组,差异有统计学意义(P<0.05)。结论:中西医结合治疗UC患者疗效显著,解决凝血纤溶功能的失衡,有效降低炎症反应程及并发症发生率,促进患者康复。
    2019(1):77-80, DOI: 10.13210/j.cnki.jhmu.20181115.008
    [摘要] (162) [HTML] (0) [PDF 2.36 M] (265)
    摘要:
    随着生产生活方式的改变、饮食结构的变化以及人口老龄化的加剧,糖尿病的发生率和致残率及致死率有逐年升高的趋势。糖尿病的发病原因有多种,可能与遗传因素、环境因素、饮食习惯等多种因素密切相关。危及糖尿病患者生活质量和生存状态的多为其并发症,其中涉及各种大血管并发症和微血管并发症,如糖尿病心肌病、糖尿病肾病、糖尿病脑病及糖尿病足等。本文对糖尿病肾病、糖尿病视网膜病变和糖尿病足的发病的相关分子机制进行论述,为新药研发和临床治疗提供借鉴。
    2020,26(09):686-693, DOI: 10.13210/j.cnki.jhmu.20200218.001
    摘要:
    目的:估计近十年中国大学生抑郁症患病率,旨在揭示我国大学生抑郁症患病的流行趋势,为日后制定大学生抑郁症的防控策略提供参考依据。方法:计算机检索PubMed、荷兰医学文献数据库(Ebase)、Cochrane图书馆(Cochrane Library)、中国期刊全文数据库(CNKI)、万方数据库(Wangfang)、维普期刊数据库(VIP)中公开发表的关于中国大学生抑郁症患病率的横断面研究,提取相关数据后运用R3.6.1软件进行Meta分析。结果:共纳入相关文献37篇,样本量总计52 622人,近十年中国大学生抑郁症患病率的研究结果分布在8.00%~74.00%,采用随机效应模型计算的总体患病率为31.38%,95% CI为(26.31%,36.44%)。亚组分析结果表明,性别、地区、年级、生源地、文献质量会对研究结果产生一定影响。结论:近十年来中国大学生抑郁症的患病率存在着升高的趋势,高校需要加强对大学生心理健康问题的关注。
    2019(1):29-32, DOI: 10.13210/j.cnki.jhmu.20181115.002
    [摘要] (161) [HTML] (0) [PDF 2.34 M] (241)
    摘要:
    目的:研究胰岛素降解酶(IDE)基因rs11187007位点多态性与妊娠期糖尿病(GDM)患者胰岛素抵抗、全身炎症反应的相关性。方法:选择我院确诊的GDM孕妇作为GDM组、同期产检并分娩的健康孕妇作为对照组。采集外周血并测定IDE基因rs11187007位点的基因型及细胞因子IL-6、IL-10、TNF-α、Chemerin、Omentin-1的含量,采集胎盘并测定IRS-1、IRS-2、GLUT3、GLUT4的表达量。结果:GDM组孕妇外周血中IDE基因rs11187007位点AA基因型的构成比、IL-10及Omentin-1的含量以及胎盘中IRS-1、IRS-2、GLUT3、GLUT4的mRNA表达量均低于对照组,外周血中IDE基因rs11187007位点AG基因型、GG基因型的构成比以及IL-6、TNF-α、Chemerin的含量高于对照组;AG基因型、GG基因型的GDM胎盘中IRS-1、IRS-2、GLUT3、GLUT4的mRNA表达量以及外周血中IL-10、Omentin-1的含量低于AA基因型的GDM胎盘,外周血中IL-6、TNF-α、Chemerin的含量高于AA基因型的GDM孕妇。结论:GDM患者体内IDE基因rs11187007位点等位基因A向G的突变能够加重胰岛素抵抗及全身炎症反应。
    2019,25(5):41-44, DOI:
    摘要:
    Objective: To investigate the effects of gastrodin on neurotransmitter effect, stress response, blood vessel and nerve function in migraine patients. Methods: A total of 90 patients with migraine admitted to our hospital from September 2016 to December 2017 were randomly divided into observation group and control group with 45 cases in each group. The control group was treated with flunarizine hydrochloride, while the observation group was treated with gastrodin based on the control group. The levels of neurotransmitter effect[including 5-serotonin (5-HT) and tumor necrosis factor alpha (TNF-alpha)], stress response[oxidized low density lipoprotein (ox-LDL) and paraoxonase-1 (PON-1)], vascular function[including nitric oxide (NO), endothelin-1 (ET-1)] and neurological function[including high brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP)] related indexes were observed and compared between the two groups. Results: The two groups showed significant changes in transmitter effect, stress response, blood vessel and nerve function. Before treatment, there was no significant difference in the levels between the two groups. After treatment, the levels of TNF-a, ox-LDL, NO, ET-1, BDNF and CGRP in the two groups were significantly lower than those before treatment, while the levels of 5-HT and PON-1 were significantly higher than those before treatment. And after treatment, the levels of TNF-a, ox- LDL, NO, ET-1, BDNF and CGRP in the observation group were significantly lower than those in the control group, while the levels of 5-HT and PON-1 were significantly higher than those in the control group. Conclusions: Gastrodin treatment can regulate oxidative stress level and improve vascular and neurological function in migraine patients.
    2019,25(5):49-52, DOI:
    摘要:
    Objective: To observe the effect of Hegu neediling method combined with tendon-stretching and plucking massage on trigger point in the treatment of acute thoracodorsal myofascitis. Methods: A total of 84 patients with acute thoracodorsal myofascitis who met the diagnostic and inclusion criteria were assigned into the treatment group and the control group randomly, the treatment group was treated with Hegu neediling method combined with tendonstretching and plucking massage, while the control group was treated with conventional electroacupuncture. Two groups of patients were treated for two weeks. VAS score and ODI were compared before treatment, after the first treatment and after the treatment course, and the clinical efficacy was evaluated after treatment. Results: The total effective rates of the treatment group and the control group were 97.62% and 80.95%, respectively. The treatment group was significantly better than the control group. The VAS and ODI scores of the treatment group decreased after the first treatment and the end of the treatment, and the treatment group was significantly better than the control group. Conclusion: Hegu neediling method combined with tendon-stretching and plucking massage can relieve pain and improve limb dysfunction in patients with acute thoracodorsal myofascitis.

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