Journal of Hainan Medical University(中文版)
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    2022,28(16):1201-1206, 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):1207-1213, DOI: 10.13210/j.cnki.jhmu.20220525.002
    摘要:
    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。
    2022,28(16):1214-1221, DOI: 10.13210/j.cnki.jhmu.20220609.001
    摘要:
    目的:探讨海桐皮汤提取膏经皮给药后对小鼠镇痛、抗炎作用的影响及其机制。方法:应用热板法、醋酸扭体实验以验证海桐皮汤提取膏对疼痛模型小鼠的镇痛作用;采用二甲苯致耳廓肿胀模型、角叉菜胶致右足肿胀模型,结合ELISA法测定小鼠血清中肿瘤坏死因子(tumor necrosis factor⁃α, TNF⁃α)、白介素1β(interleukin⁃1β, IL⁃1β)、白介素6 (interleukin⁃6, IL⁃6)的水平,观察海桐皮汤提取膏对炎症模型小鼠的抗炎作用。结果:在镇痛方面,与模型组比较,工艺1组、工艺2组均可明显延长小鼠的热板痛阈值及扭体反应潜伏期(P<0.05),显著减少小鼠扭体的次数(P<0.001),且工艺1组的效果更明显(P<0.05);在抗炎方面,与空白组比较,模型组小鼠右后足肿胀度及肿胀率均明显增高(P<0.01),表明小鼠急性炎症造模成功。与模型组比较,工艺1组、工艺2组均能明显降低小鼠的足肿胀度和肿胀率(P<0.05),并降低小鼠的耳廓肿胀度,提升其肿胀抑制率(P<0.05),且工艺1组有效作用更显著(P<0.05)。与模型组相比,工艺1组可明显降低TNF⁃α、IL⁃1β的含量(P<0.01),与工艺2组相比,工艺1组可明显降低IL⁃1β含量(P<0.05)。结论:两种不同工艺制备的海桐皮汤提取膏经皮给药后对小鼠具有较好镇痛、抗炎作用,其作用机制可能与减少体内TNF⁃α、IL⁃1β、IL⁃6等促炎性细胞因子表达有关,且工艺1组抗炎镇痛效果优于工艺2组,可能与中药挥发油的单独提取、储存保证了挥发油较长时效的药理活性有关。
    2022,28(16):1222-1227, DOI: 10.13210/j.cnki.jhmu.20220530.002
    摘要:
    目的:探究佐剂性关节炎大鼠 miR145‑5p/Smads通路变化与巨噬细胞极化之间的联系。方法:12只大鼠使用随机数字表法分成正常组和注射弗氏完全佐剂(0.1 mL/只)致炎的模型组,6只/组。大鼠关节炎形成后第12天,酶联免疫吸附试验检测滑膜组织中巨噬细胞极化标志物IL‑8、CD206表达。免疫蛋白印记法检测滑膜组织中TGF‑β1/Smads通路因子表达。RT‑qPCR法检测滑膜组织中miR145‑5p、Smads3、Smads7的表达。结果:与正常组相比,模型组大鼠IL‑8、TGF‑β1、Smad3的表达水平明显升高(P<0.05);CD206、Smad7、miR145‑5p的表达水平显著降低(P<0.01)。相关性结果显示,IL‑8与Smad3呈正相关(P<0.01),Smad7呈负相关(P<0.05);CD206与Smad3呈负相关(P<0.01),与Smad7呈正相关(P<0.05);miR145‑5p与Smad3呈负相关(P<0.01),与Smad7呈正相关(P<0.01)。结论:miR145‑5p可能通过抑制Smad3表达,进而抑制TGF‑β1/Smads通路过激活,调节巨噬细胞极化,抑制佐剂性关节炎的发展。
    2022,28(16):1228-1231, DOI: 10.13210/j.cnki.jhmu.20220622.001
    摘要:
    目的:研究和评估血浆置换对慢加急肝衰竭辅助治疗的临床效果。方法:选择慢加急性肝衰竭患者60例进行分组,予以综合治疗者为对照组,加用血浆置换者为血浆置换组,分别检测两组治疗后总胆红素(TBil)、PT百分活动度(PTA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、白蛋白(ALB)、白介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)指标的变化,评估临床症状缓解程度。结果:两组TBil、ALB、ALT、AST、IL-6、PCT、CRP均较治疗前下降,PTA均上升,但血浆置换组疗效优于对照组,差异有统计学意义(P<0.05),血浆置换组总有效率80.0%,高于治疗组46.6%,差异有统计学意义(P<0.05)。结论:血浆置换可辅助改善慢加急性肝衰竭患者的肝功能、清除大量炎症因子,促进肝功能的恢复,改善预后。
    2022,28(16):1232-1241, DOI: 10.13210/j.cnki.jhmu.20210917.001
    摘要:
    目的:系统评价寒喘祖帕颗粒治疗支气管哮喘的临床疗效及安全性。方法:计算机检索Cochrane Library、PubMed、EMBASE、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM),维普中文科技期刊数据库(VIP)和万方数字资源库(Wangfang),检索时间限定为建库至2021年6月,检索所有寒喘祖帕颗粒治疗支气管哮喘的随机对照试验(randomized control trials, RCTs),并追踪纳入研究的参考文献。由两位评价者独立对纳入的研究进行资料提取,并使用Cochrane偏倚风险评估工具评估文献的方法学质量,利用RevMan5.3软件进行meta分析。结果:检索相关文献97篇,最终纳入13项研究,涉及1 189例患者。Meta分析结果显示,在临床总有效率方面,试验组临床疗效优于对照组[相对危险度(RR)=1.18,95% CI(1.13,1.24),P<0.000 01];在改善肺功能方面,试验组改善FEV1(L)[加权均数差(WMD)=0.48,95% CI (0.22,0.74),P =0.000 3]、FVC(L) [WMD=1.23,95% CI (0.5,1.96),P=0.001]、FEV1/FVC(%) [WMD=7.37,95% CI (5.91,8.84),P<0.000 01]和PEF[标准化均数差(SMD)=1.19,95% CI (0.82,1.56),P<0.000 01]优于对照组;在炎性因子指标改善方面,试验组改善IL-4 [WMD=-12.13,95%CI (-16.36,-7.90),P<0.000 01]、IL-6 [WMD=-29.55,95% CI (-40.71,-18.39),P<0.000 01]、TNF-α [SMD=-2.73,95%CI (-3.57,-1.88),P<0.000 01]优于对照组;在改善动脉血气分析指标方面,试验组改善PaO2WMD=8.97,95% CI (6.09,11.85),P<0.000 01]优于对照组;在不良事件发生率方面,对试验组、对照组不良事件发生频率进行分析,发现两组不良事件发生风险[RR=0.68, 95%CI (0.39,1.18),P=0.17]差异无统计学意义。结论:寒喘祖帕颗粒治疗支气管哮喘具有较好的临床疗效,且不会增加不良事件发生率。
    2022,28(16):1252-1260, DOI: 10.13210/j.cnki.jhmu.20210511.002
    摘要:
    目的:基于网络药理学分析减味膈下逐瘀汤治疗非酒精性脂肪肝(non‑alcoholic fatty liver disease,NAFLD)的关键化合物及其作用靶点和通路,以探索其治疗作用的分子机制。方法:利用GEO‑Datasets搜集、筛选患病与正常情况下的差异基因,并绘制热图和火山图,通过TCMSP平台和Drugbank数据库检索减味膈下逐瘀汤中诸药的活性化合物,设定OB≥30%和DL≥0.18为阈值,筛选潜在的活性化合物及作用靶点。构建减味膈下逐瘀汤和NAFLD差异基因分子靶点图,利用STRING数据库获取PPI网络和网络拓扑参数,导入Cytoscape对其进行可视化分析,筛选核心调控基因,同时使用SwissDock平台将筛选得到的主要活性成分与靶点进行分子对接。通过DAVID进行GO生物功能富集分析和KEGG代谢通道富集分析,确定主要通路。结果:通过筛选后得到差异基因377个(127个上调基因及250个下调基因),减味膈下逐瘀汤活性化合物225个,308个对应靶点;筛选得到关键靶标14个,对应化合物168个,关键靶点涉及MYC、FOSL2、FOS等。GO功能富集分析结果显示减味膈下逐瘀汤主要对DNA结合转录激活因子活性表达和RNA聚合酶Ⅱ特异性转录起调节作用;分子对接结果显示主要活性成分槲皮素、黄芩素与VCAM1、HSPB1、MYC、JUN等具有较好的结合活性;KEGG富集分析结果显示,主要涉及IL‑17信号通路、Wnt受体信号通路、NF‑κB信号通路、TNF信号通路及糖尿病并发症中的AGE‑RAGE信号通路等。结论:减味膈下逐瘀汤通过多成分/多靶点的相互作用,实现了从多种途径整体治疗NAFLD的目标。应用网络药理学的方法,为进一步深入研究减味膈下逐瘀汤治疗NAFLD作用机制提供了新的研究途径和科学依据。
    2022,28(16):1261-1267, DOI: 10.13210/j.cnki.jhmu.20210506.001
    摘要:
    目的:运用“中医传承辅助平台(V2.5)”软件分析中医药治疗心脏神经官能症的组方及用药规律。方法:检索中国期刊全文数据库、万方数据库、维普中文期刊服务平台及中国生物医学文献数据库,依据纳入及排除标准筛选出运用中药方剂治疗心脏神经官能症的文献,利用中医传承辅助平台进行数据挖掘,统计用药频次及常用剂量、中药四气五味及归经频次。运用关联规则、复杂系统熵聚类分析法,提取核心药物组合,并采用无监督的熵层次聚类预测潜在新处方。结果:通过文献检索及筛选,最终录入210首方剂,通过“频次统计”共提取出181味中药,累计使用频次2 410次。其中,使用频次≥15次的中药共46味,根据功效主治,可大致包括理气药、安神药、补气药、清热药及补血药等。分析中药的四气五味及归经规律可知,温性、甘味药物最为常用,多归于心经,肝经和脾经次之。基于关联规则的组方规律发现,在药物组合中,白芍-柴胡应用最多;枳壳和柴胡的关联度最强,高达90%;网络图则提示,柴胡、当归、白芍、茯苓等药物为关联网络的核心。基于复杂系统熵聚类组合,可得到24个药物核心组合。运用无监督的熵层次聚类算法,提取出核心药物组合12种,进一步聚类得到6种潜在新方。结论:中医治疗心脏神经官能症以“气血同调”、“标本兼顾”、“补泻兼施”为原则,重视气郁的始动病机,主要从心肝脾入手,以疏肝理气、清热化痰、镇静安神、活血利水等为具体治法。
    2022,28(16):1268-1274, DOI: 10.13210/j.cnki.jhmu.20210507.002
    摘要:
    心肌缺血再灌注(ischemia/reperfusion,I/R)损伤是在冠心病、中风、心脏骤停和复苏、器官移植、休克等事件后缺血或闭塞的冠状动脉恢复供血时发生的病理改变。心肌I/R损伤常伴有心血管不良事件,严重影响心肌缺血的预后。心肌I/R损伤的潜在机制复杂,涉及氧自由基损伤、钙超载、炎症反应、细胞凋亡、补体激活、免疫失衡、内质网应激、细胞自噬、心肌能量代谢紊乱、心肌微血管内皮细胞损伤等多种病理过程。为减轻I/R损伤,缺血预处理是一种有效的防治措施。目前相关发病机制与防治措施实验性研究较多,但临床应用仍然有限,因此I/R损伤的防治仍然是一大挑战。心肌I/R损伤的发病机制不完全明确,治疗方法和药物有限,故本文对其损伤涉及的分子机制和相关信号通路以及新兴靶向治疗的研究做一总结,为心肌I/R损伤的临床防治提供治疗策略和理论依据。
    2022,28(16):1275-1280, DOI: 10.13210/j.cnki.jhmu.20210419.004
    摘要:
    能量代谢紊乱是心力衰竭进展中的一大病理改变,该过程导致心肌产能不足,进一步加重心功能障碍,而以葡萄糖和脂肪酸为主的代谢底物利用紊乱在这过程中起重要作用。近些年来的研究表明以益气温阳为主要作用的一些中药或复方在调节能量代谢紊乱方面有很好的效果,发现中药中的一些有效成分能够调节心肌细胞代谢底物的摄取和利用,使心肌细胞的代谢在缺氧条件下朝有利于机体的方向调整,增加心肌总体能量供给,改善心功能。本文就中药干预心衰心肌细胞糖脂代谢研究进行综述,初步总结中药干预心衰心肌葡萄糖和脂肪酸代谢的规律和机制,以期从中医药角度为能量代谢疗法的研究提供线索。
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    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.
    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.
    2019,25(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.
    2019,25(5):26-30, DOI:
    摘要:
    Objective: To investigate the correlation between the change in expression of the tumor associated macrophage (TAM) markers CD68 and CD206 and the clinicopathological parameters. Methods: We retrospectively analyzed 28 PGI-DLBCL patients by immunohistochemical stainning. The surface expression of biomarkers CD68 and CD206 on TAMs in samples obtained at diagnosis was compared with that in specimens obtained at first relapse. Based on the change in expression levels of CD68 and CD206 from diagnosis to relapse, patients were categorized into three groups: “increased”, “stable” and “decreased”. Results: A significant difference was observed between the three groups with respect to CD68 and CD206 expressions (P=0.012) and there existed a consistency between the two (P=0.008). The three groups showed a negative correlation with age, sex, stage, B symptoms, diagnosis, ECOG performance status, and IPI scores, while a positive correlation was observed with the site of lesion of CD206 expression (P=0.032). The time to relapse (TTR) in the three groups of CD68 and CD206 was not significantly different (P=0.23, P=0.818). Conclusion: Our study suggests that increase in CD206 and decrease in CD68 expression at relapse indicates M1-TAM polarization into M2-TAM, which plays an important role in PGI-DLBCL relapse. Furthermore, M2-TAM polarization may be associated with the site of Primary gastric diffuse large B lymphoma.
    2019(11):805-809, DOI: 10.13210/j.cnki.jhmu.20190404.002
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    目的:探讨鹰嘴豆芽素A对宫颈癌细胞增殖及迁移能力的调控作用及其可能的分子机制。方法:体外培养Hela细胞,以不同质量浓度的鹰嘴豆芽素A处理宫颈癌Hela细胞,CCK-8法检测鹰嘴豆芽素A对宫颈癌细胞的增殖影响;划痕实验检测对细胞迁移的影响;RT-PCR法检测鹰嘴豆芽素A对Bcl-2 /Bax mRNA水平表达的变化。结果:鹰嘴豆芽素A能够抑制Hela细胞的增殖和迁移,呈现剂量和时间依赖性(P<0.05);质量浓度为10、20、40、80、160 μmol/L鹰嘴豆芽素A处理Hela细胞24 h、48 h后,抑制Hela细胞增殖和迁移速率明显上升,并且高于对照组(P<0.05);促凋亡蛋白Bax表达水平升高,抗凋亡蛋白Bcl-2表达水平降低,呈剂量依赖性。结论:鹰嘴豆芽素A能够抑制宫颈癌Hela细胞的增殖和迁移,其作用机制可能与下调Bcl-2,上调Bax有关。
    2019,25(5):45-48, DOI:
    摘要:
    Objective: To explore the effect of selenium supplementation on thyroid function, immune response and oxidative stress in HT patients with normal thyroid function. Methods: A total of 120 Hashimoto's thyroiditis patients with normal thyroid function admitted to our hospital from June 2016 to March 2018 were randomly divided into treatment group and control group with 60 cases in each group. The control group was given oral placebo, while the treatment group was given selenium yeast. The expression levels of thyroid function [including thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4)], immune response [including thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TGAb), interferon-γ (IFN-γ), interleukin-4 (IL-4)] and oxidative stress [including malondialdehyde (MDA), glutathione peroxidase (GPx) and superoxide dismutase (SOD)] were observed and compared between the two groups. Results: The two groups showed significant changes in auxiliary diagnosis, immune response and oxidative stress. Before treatment, there was no significant difference in the levels between the two groups. After treatment, there was no significant difference in the above indexes between the control group and that before treatment. There was no significant difference in thyroid function related indexes between the treatment group and the control group. The levels of TPOAb, TGAb, IFN-γ and MDA in the treatment group were significantly lower than those before treatment and in the control group, while the levels of IL-4, GPx and SOD were significantly higher than those before treatment and in the control group. Conclusions: Selenium supplementation can stabilize thyroid function, reduce the level of thyroid antibody production, and improve immune response and oxidative stress response in HT patients.
    2019,25(5):37-40, DOI:
    摘要:
    Objective: To study the effect of shexiangbaoxin pill combined with tirofiban hydrochloride on related factors in elderly patients with acute coronary symdrome. Methods: A total of 96 elderly patients with acute coronary symdrome in our hospital from January 2015 to May 2018 were enrolled in this study. The subjects were divided into the control group (n=48) and the treatment group (n=48) randomly. The control group were treated with tirofiban hydrochloride, the treatment group were treated with shexiangbaoxin pill combined with tirofiban hydrochloride, and both the two groups were treated for 2 weeks. The PT, TT, APTT and serum FIB, CK-MB, cTnT, vWF, ET-1, NO, sICAM-1, MMP-9, hs-CRP of the two groups before and after treatment were compared. Results: There were no significantly differences of the PT, TT, APTT and serum FIB, CK-MB, cTnT, vWF, ET-1, NO, sICAM-1, MMP-9, hs-CRP of the two groups before treatment. The PT, TT, APTT and serum NO of the two groups after treatment were significantly higher than before treatment, the serum FIB, vWF, ET, sICAM-1, MMP-9, hs-CRP of the two groups after treatment were significantly lower than before treatment, and that of the treatment group after treatment were significantly better than the control group. The serum CK-MB, cTnT of the two groups after treatment were significantly higher than before treatment, but that of the treatment group after treatment were significantly lower than the control group. Conclusion: Shexiangbaoxin pill combined with tirofiban hydrochloride can significantly improve the blood coagulation function and reduce the Myocardial injury, vascular endothelial damage, inflammation of the elderly patients with acute coronary symdrome, and it was worthy clinical application.
    2019,25(5):31-36, DOI:
    摘要:
    Objective: To systematically evaluate the effects of sleep status on renal function in patients with chronic kidney disease (CKD). Methods: To search the relevant literature related to the effects of sleep status on renal function of CKD patients on PubMed database, EMBase database, the Cochrane Library database, CNKI database, Chinese Biomedical Literature Database, VIP and Wanfang database from the initial to June 2018, all literature that met the criteria were included. According to the type of studies, the quality of the literature was evaluated by NOS scale in the cohort study and AHRQ scale in the cross-sectional study, and systematically evaluated the outcome indicators, the main outcome indicators were estimated glomerular filtration rate (eGFR) and endogenous creatinine clearance rate (Ccr), while the secondary indicators were Pittsburgh Sleep Quality Index (PSQI), Sleep Quality (SQ), Serum Creatinine (Scr), Hemoglobin (Hb), Albumin (ALB) and Urine Protein/Creatinine Ratio (UPCR). Results: Four literature and one meeting abstract were included in this study, of which four were cohort studies, three of them the NOS quality evaluations were high, one of them was medium, the remaining one was cross-sectional study, and the AHRQ quality evaluation was medium. This study shows that sleep status has a certain correlation with renal function. Shorter sleep time or poor sleep quality can lead to deterioration of renal function. Among them, the research data of Sabbatinit research team in Italy showed that Ccr gradually decreased with the increased of the PSQI; studies of Cohen research team and the Ricardo research team in the United States showed that eGFR decreased with the increased of the PSQI; the study of Kumar research team in the United States showed that the lower SQ , the worse renal function; the study of Knutson’ research team in British showed that the shorter sleep time, the lower eGFR. In addition, studies showed that sleep index also has influence on Hb, ALB, Scr, UPCR and other indicators. Conclusion: Sleep status can affect the renal function of CKD patients in different degrees. Shorter sleep time and poor sleep quality will damage renal function and accelerate the progress of CKD.
    2019(11):815-817, 825, DOI: 10.13210/j.cnki.jhmu.20190409.003
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    目的:观察注意缺陷多动障碍(ADHD)模型动物自发性高血压大鼠(SHR)血清皮质酮(CORT)、促肾上腺皮质激素(ACTH)、促肾上腺皮质激素释放激素(CRH)水平及下丘脑糖皮质激素受体(GR)、糖皮质激素受体(MR)、CRH及海马GR、MR mRNA的表达情况,探讨SHR大鼠下丘脑-垂体-肾上腺轴(HPA)功能及相关影响因素。方法:以幼年SHR大鼠为ADHD模型组、Wistar京都大鼠(WKY)为对照组,采用ELISA法检测血清CORT、ACTH、CRH水平,RT-PCR法检测大鼠下丘脑GR、MR、CRH及海马GR、MR mRNA的表达水平。结果:SHR大鼠血清CORT、ACTH水平明显低于WKY大鼠(P<0.01),血清CRH水平明显高于WKY大鼠(P<0.01),下丘脑及海马GR、MR mRNA的表达水平明显高于WKY大鼠(P<0.01),而下丘脑CRH mRNA表达则低于WKY大鼠(P<0.01)。结论:SHR大鼠HPA轴呈低反应性,可能与CRH启动障碍及下丘脑和海马GR、MR mRNA 高表达相关。
    2019(11):810-814, DOI: 10.13210/j.cnki.jhmu.20190404.003
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    目的:探讨伊伐布雷定(IVA)对心肌梗死大鼠心肌细胞Notch和 NF-κB信号通路的影响。方法:采用结扎冠状动脉左前降支建立心肌梗死模型,将存活大鼠随机分为模型组(MI组,n=8)和治疗组(IVA组,n=8)。以相同部位穿线但不结扎冠状动脉左前降支的大鼠作为对照组(CON组,n=8)。 IVA给药28 d。检测所有大鼠血流动力学和心功能指标:心率(HR)、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、左室收缩压(LVSP)、左室舒张末压(LVEDP)和左室内压最大上升和下降速率(±dp/dt);左室重量指数、左室截面直径和心肌梗死面积;RT-PCR检测大鼠心肌细胞Notch信号通路成分mRNA的表达水平(Notch-1、Dll-4、Hes-1);Western-blot检测DICD-1蛋白和P65蛋白表达水平。组间比较采用单因素方差分析,两两比较采用 SNK法。结果:MI组SBP、 DBP、MAP、LASP、LVEDP和±dp/dt均低于对照组(P<0.05);而IVA上述指标均高于MI组(P<0.05)。MI组左室重量指数和左室截面直径明显大于对照组(P<0.05),但小于IVA组(P<0.05)。MI组Notch-1 mRNA表达水平明显高于对照组(P<0.05),但低于IVA组(P<0.05)。3组Dll-4和Hes-1 mRNA表达水平的比较差异无统计学意义(P>0.05)。MI组心肌细胞NICD-1蛋白和P65蛋白表达水平明显高于CON组(P<0.05),但是低于IVA组(P<0.05)。结论:IVA可能通过Notch和 NF-κB信号通路发挥改善心肌梗死大鼠心功能和抑制心室重构的作用。
    2019(11):829-833, DOI: 10.13210/j.cnki.jhmu.20190426.003
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    目的:探究脑内多巴胺神经递质表达对神经内科住院患者睡眠障碍的影响。 方法:选取我院神经内科收治的34例睡眠障碍患者和同期30例志愿者作为研究对象,分别为观察组和对照组,64例入选人员均于2周前停止服用咖啡、酒等刺激性饮料,采用匹兹堡睡眠质量指数量表(PSQI)、汉密顿抑郁量表(HAMD)检测睡眠质量和抑郁程度,同时进行脑部MRI检查,2 d后进行PET/CT扫描11C-雷氯必利标记的脑内多巴胺神经递质与受体结合情况。采用SPSS分析多巴胺神经递质与睡眠障碍相关指标的相关性。 结果:观察组HAMD、PSQI评分均显著高于对照组,差异具有统计学意义(P<0.05)。PET/CT扫描11C-雷氯必利多分布于伏隔核、尾状核、壳核。观察组伏隔核、尾状核、壳核多巴胺结合力均显著低于对照组,差异具有统计学意义(P<0.05)。采用pearson相关性分析,观察组病程与伏隔核、尾状核、壳核呈负相关(r=-0.754、-0.717、-0.728,P<0.05),而HAMD、PSQI评分与伏隔核、尾状核、壳核无相关性(P>0.05)。 结论:睡眠障碍患者多巴胺受体结合降低,同时与睡眠障碍的病程相关,提示多巴胺表达水平降低和睡眠障碍具有临床意义。
    2019,25(5):10-13, DOI:
    摘要:
    Objective: To investigate the effect of dexmedetomidine against liver ischemia-reperfusion injury in rats by reducing endoplasmic reticulum stress. Methods: A total of 24 adult male Sprague-Dawley rats were randomly divided into sham operation group (6 rats, Sham group), liver ischemia-reperfusion injury group (6 rats, I/R group), and liver ischemia-reperfusion injury +dexmedetomidine pretreatment group (6 rats, I/R +Dex pretreatment group) (25 μg/kg intraperitoneally 30 min before ischemia), and liver ischemia-reperfusion injury +dexmedetomidine post-treatment group (6 rats, I/R +Dex post-treatment group) (25 μg/kg intraperitoneally 30 min after reperfusion). Hepatic ischemia-reperfusion injury model was performed by after clamping the hepatic hilum for 30 min and reperfusion for 6 h. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured by automatic biochemical analyzer. Malondialdehyde (MDA) and superoxide dismutase (SOD) activity were detected by enzyme-linked immunosorbent assay (ELISA). The pathological changes of each group were observed by HE staining. The expression of endoplasmic reticulum stress (P-PERK, P-IRE1α, CHOP) were detected by Western blot. Results: Compared with the Sham group, the serum levels of ALT and AST were significantly higher in the I/R group, compared with the I/R group, the serum ALT and AST in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were significantly reduced; Compared with the Sham group, MDA activity in the liver tissue of the I/R group was significantly increased, while the SOD activity was significantly decreased, and the pathological score of the liver tissue was significantly increased; Compared with the I/R group, MDA activity and liver histopathology scores in I/R+Dex pretreatment group and the I/R+Dex post-treatment group were decreased, while SOD activity increased; The expression of P-PERK, P-IRE1α, CHOP in the I/R group were significantly higher than that in the Sham group, while the expression of the above indicators were reduced in I/R+Dex pretreatment group and the I/R+Dex post-treatment group. Conclusion: Dexmedetomidine can significantly attenuated liver ischemia-reperfusion injury in rats, which may be related to the reduction of endoplasmic reticulum stress.
    2019,25(5):22-25, DOI:
    摘要:
    Objective: To explore the best time for progesterone supplementation in AID ovulation induction cycles by Letrozole. Methods: The data analysed in this study were collected from 509 patients who were performed AID (Artificial Insemination by Donor) administrated letrozole (LE) between 2014.8-2015.7. All patients were randomly divided into 4 groups by the time of progesterone administrated, including experimental group and the control group. The experimental group was divided into group 1-72 h after ovulation, group 2-48 h after ovulation, group 3-24 h after ovulation and control group—without administrated LE. The gestation and live birth rate were evaluated by monitoring vaginal ultrasound and HCG blood value 14 d after AID. Results: The pregnancy rate with administrated progesterone added 72 h after ovulation was 31.9%, which was significantly higher than those of other groups, the same situation as groups added progesterone was significantly higher than the control group. However, there was no significant difference in the numbers of abortions among the four groups. The LBR of group 4 was significantly lower than that of group 1. Conclutions: Progesterone administrated 72 h after ovulation can promoted the gestation rate, but did not affect the rate of miscarrage .
    2019,25(5):18-21, DOI:
    摘要:
    Objective: To study the expression and significance of KAI1/CD82, p27 proteins in gastric carcinoma. Methods: The expressions of KAI1/CD82, p27 proteins were detected by immunohistchemistry S-P method in 58 cases of gastric carcinoma tissues and 23 normal gastric tissues. Results: The positive rates of KAI1/CD82 and p27 proteins in gastric carcinoma tissues were 29.3% and 34.4%, but 90% and 85% respectively in normal gastric tissue. And there is a significant difference between the two groups. The expression level of KAI1/CD82 and p27 proteins was significantly related to tumor invasive depth, grade of tumor differentiation, the clinical stage and lymph node metastasis, And has nothing to do with age or gender. There was a positive correlation between the expression of KAI1/CD82 and P27 in gastric cancer tissues. Conclusion: The expression of KAI1/CD82 and p27 protein may be involved in the initiation and development in gastric carcinoma, and the combined detection of KAI1/CD82 and p27 proteins may be significant in predicting the invision and metastasis of gastric carcinoma.
    2019(11):801-804, 809, DOI: 10.13210/j.cnki.jhmu.20190416.002
    [摘要] (638) [HTML] (0) [PDF 3.79 M] (202)
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    目的:利用壮药南酸枣树皮水煎剂干预慢性难愈合创面模型大鼠,探究其疗效机制。方法:采用全层皮肤缺损法改进慢性难愈合创面大鼠模型,将40只大鼠随机分为空白对照组、模型组、湿润烧伤膏组、南酸枣树皮组,空白对照组和模型组外敷生理盐水,湿润烧伤膏组采用皮肤再生医疗技术,南酸枣树皮组外敷南酸枣树皮水煎剂。12 d后取全层皮肤组织进行超微病理检测,利用RT-PCR技术观察PTEN、VEGF mRNA的变化情况。结果:经12 d药物干预后,湿润烧伤膏组、南酸枣树皮组皮肤细胞器的形态结构基本恢复。第12天湿润烧伤膏组、南酸枣树皮组分别与第1天相比,均出现PTEN mRNA水平降低、VEGF mRNA水平增高,差异具有统计学意义(P<0.05);第12天湿润烧伤膏组、南酸枣树皮组分别与模型组相比,均出现PTEN mRNA水平降低、VEGF mRNA水平增高,差异具有统计学意义(P<0.05);而湿润烧伤膏组与南酸枣树皮组相比差异无统计学意义 (P>0.05)。结论:壮药南酸枣树皮能显著改善慢性难愈合创面导致的细胞结构异常,调控PTEN介导的信号通路传导效应,改善损伤病灶,促进创面组织修复。

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