Journal of Hainan Medical University(中文版)
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    2023(03):161-167, DOI: 10.13210/j.cnki.jhmu.20221219.002
    摘要:
    目的:分析海南省三亚市某酒店方舱医院的新型冠状病毒肺炎感染者(奥密克戎变异株BA5.1.3感染)的流行病学特征,为优化疫情防控策略提供依据。方法:收集2022年8月10日~8月30日三亚市某酒店方舱医院收治的新型冠状病毒感染者的流行病学资料,进行描述性流行病学分析。结果:截至2022年8月30日,该酒店方舱医院共收治新型冠状病毒肺炎感染者703例,其流行病学特征分析结果显示:男性328例,占46.7%,女性375例,占53.3%,男女比例0.87∶1,年龄跨度为8个月~85岁,M(P25,P75)为37(20,49)岁,以31~59岁人群为主,占51.4%;无症状感染者占39.8%,轻型感染者占60.2%,主要临床症状为咳嗽24.8%(105/423)、发热18.7%(79/423);8.8%的感染者有慢性基础疾病史,高血压和糖尿病最常见;累计出院416例感染者,总体住院时间的M(P25,P75)为14(10,15)d;未接种COVID‑19疫苗者占10.1%,完成1次疫苗接种者占5.0%,完成2次疫苗接种者占36.3%,完成3次疫苗接种者占48.6%,≥60岁感染者中完成2次和3次疫苗接种的仅占10.1%和8.8%。结论:此次毒株为新型冠状病毒奥密克戎变异株BA5.1.3,国内首次报道,传染性和隐匿性更强,各年龄段人群普遍易感。因此需要加强个人防控,做好外防输入和内防扩散;加强核酸检测,做到及时发现和早期处理;加强COVID‑19疫苗接种工作,提高疫苗接种率,减少感染率。
    2023(03):168-174, DOI: 10.13210/j.cnki.jhmu.20221205.001
    摘要:
    目的:研究茯苓皮提取物对高尿酸血症(HUA)小鼠的降尿酸和肾脏保护作用。方法:用醇和水溶剂提取茯苓皮活性成分,用次黄嘌呤和氧嗪酸钾建立高尿酸血症模型,70只雄性昆明小鼠随机分为空白组、模型组(500 mg/kg次黄嘌呤 + 250 mg/kg氧嗪酸钾)、茯苓皮醇提物(PCE)高(388 mg/kg)、低(97 mg/kg)剂量组、茯苓皮水提物(PCW)高(96 mg/kg)、低(24 mg/kg)剂量组、 苯溴马隆(BEN)组(7.5 mg/kg),分别给药治疗16 d。末次给药后,收集24 h尿量(UV),测定尿液中尿酸(UUA)、肌酐(UCr);收集左右肾,观察左肾的形态及右肾的病理变化;测定血清中尿酸(SUA)、肌酐(SCr)、尿素氮(BUN);计算尿酸排泄分数(FEUA)和尿酸清除率(CUr);酶联免疫吸附测定法(ELISA)检测肾脏中阴离子转运蛋白1(OAT1)、尿酸转运体1(URAT1)、葡萄糖转运蛋白 9(GLUT9)、肿瘤坏死因子α(TNF⁃α)和白介素6(IL⁃6)含量。结果:与模型组比较,PCE和PCW能增加HUA小鼠的UUA、UCr、FEUA、CUr、OAT1(P<0.05,P<0.01)、降低HUA小鼠的SUA、SCr、BUN、URAT1、GLUT9、TNF⁃α、IL⁃6(P<0.05, P<0.01);改善HUA小鼠的肾脏形态及病理变化,且优于阳性药BEN。结论:茯苓皮提取物对HUA小鼠具有降尿酸和肾脏保护作用,其作用可能与促进尿酸排泄,调节尿酸转运蛋白,降低炎症因子水平有关。
    2023(03):175-182, DOI: 10.13210/j.cnki.jhmu.20221129.001
    摘要:
    目的:明确耐力训练对小鼠力竭运动后心肌组织中circRNA‑lncRNA‑miRNA‑mRNA表达谱的影响。方法:45只雄性C57BL/6小鼠随机分为对照(C)、低强度耐力训练(LSET)与高强度耐力训练(HSET)组(n=15)。对照组小鼠不进行跑台训练,LSET与HSET组小鼠分别以30%与60%力竭运动量进行跑台训练,每天一次,每周5天,训练5周后行力竭运动。取心肌组织提取总RNA,利用Illimina转录组测序分析心肌组织中circRNA‑lncRNA‑miRNA‑mRNA表达谱。结果:LSET与HSET组小鼠力竭运动时间与路程较C组延长,且HSET组小鼠力竭运动时间与路程长于LSET组(P<0.05)。转录组测序共筛选出54个差异表达的circRNA(28个下调和26个上调),7个差异表达的lncRNA(均下调),3个差异表达的miRNA(1个下调和2个上调),99个差异表达的mRNA(81个下调和18个上调)(P<0.05)。相互作用网络分析发现ENSMUSG00000113041、MSTRG.79740、mmu‑miR‑374c‑5p、18个下调的mRNA与3个表达上调的mRNA构成调控网络。GO功能分析发现差异表达的mRNA主要富集在初级代谢过程与大分子合成与代谢过程。KEGG通路分析发现差异表达的mRNA主要富集于补体和凝血级联反应途径、雌激素信号通路及胰高血糖素信号通路。结论:耐力训练可以改变小鼠力竭运动后心肌组织中circRNA‑lncRNA‑miRNA‑mRNA表达谱,这些差异表达的RNA构成调控网络影响心肌细胞的合成与代谢进而参与对心肌损伤的调节。
    2023(03):183-189, DOI: 10.13210/j.cnki.jhmu.20221201.002
    摘要:
    目的:探讨丹皮酚对LPS诱导的巨噬细胞RAW264.7细胞炎症损伤的保护作用及其机制研究。方法:培养巨噬细胞RAW264.7,并分成空白组、LPS(1 μg/mL)组、丹皮酚(240 μmol/mL)组和TAK242(10 μmol/mL)组。采用CCK8法检测细胞活性,倒置显微镜观察细胞形态,比色法测定细胞培养液中GSH、MDA含量,JC‑1法检测线粒体膜电位,免疫荧光法检测F4/80及p‑NF‑κB蛋白表达分布,Western blotting检测细胞中TLR4/MAPK/NF‑κB相关通路蛋白表达。结果:与空白组比较,1 μg/mL LPS诱导的细胞活力为0.4972±0.061(P<0.01),接近半数抑制率。与LPS组比较,240 μmol/mL 丹皮酚预处理的细胞组下调p‑NF‑κB蛋白表达最显著(P<0.01),10 μmol/mL TAK242预处理细胞组抑制TLR4蛋白表达最显著(P<0.01)。与LPS组比较,丹皮酚组细胞形态有所恢复;降低细胞培养液中MDA含量、增高GSH含量(P<0.01);线粒体膜电位结果中,丹皮酚组红光显著增强,绿光显著减弱(P<0.001);丹皮酚组F4/80及p‑NF‑κB蛋白表达分布显著降低(P<0.01),并下调了TLR4、p‑IκB、p‑p38、p‑JNK、p‑NF‑κB蛋白表达(P<0.05)。结论:丹皮酚可改善LPS诱导的RAW264.7细胞炎症损伤,其机制可能与TLR4/MAPK/NF‑κB通路相关。
    2023(03):190-197, DOI: 10.13210/j.cnki.jhmu.20221219.001
    摘要:
    目的:探究圣草次苷(Eriocitrin)对肺腺癌(Lung adenocarcinoma, LUAD)细胞系A549 和 H1299 增殖和迁移能力的影响,以及对上皮间充质转化(Epithelial‑Mesenchymal Transition ,EMT)的作用机制。方法:采用 CCK8 方法检测不同浓度圣草次苷对LUAD细胞系A549和H1299增殖能力的影响;采用划痕实验评价A549和H1299细胞的迁移能力;用Western Blot法和qRT‑PCR法分别检测EMT相关上皮钙黏蛋白(E‑cadherin和N‑cadherin)、波形蛋白(Vimentin)、铁死亡相关蛋白SLC7A11、GPX4、FTH和EMT标志分子E‑cadherin、N‑cadherin、Snail的mRNA水平,及细胞活性氧(reactive oxygen species,ROS)的水平,观察圣草次苷对LUAD细胞系铁死亡的影响。结果:圣草次苷可以明显抑制LUAD细胞系A549和H1299的增殖能力,并呈现出一定的剂量和时间依赖性。与对照组相比,不同浓度的圣草次苷作用24和48 h后均明显降低划痕愈合率,差异具有统计学意义(P<0.01)。与对照组相比,圣草次苷增加了LUAD细胞系A549和H1299的ROS的表达水平,增加了EMT相关蛋白E‑cadherin的蛋白表达水平,降低了N‑cadherin和Vimentin蛋白表达水平。此外,qRT‑PCR结果也显示:圣草次苷上调了E‑cadherin mRNA的表达,下调了N‑cadherin、Snail mRNA表达,铁死亡相关基因SLC7A11、GPX4、FTH蛋白水平均下调,差异具有统计学意义(P<0.05)。结论:圣草次苷通过EMT途径抑制LUAD细胞的增殖和迁移,并促进铁死亡过程的发生,在LUAD预防和辅助化疗中具有一定的应用潜力。
    2023(03):198-202, DOI: 10.13210/j.cnki.jhmu.20221128.001
    摘要:
    目的:探究糖尿病视网膜病变患者病情发展与OCTA血流密度等指标之间的联系。方法:选取2020年9月~2021年7月就诊于中国中医科学院眼科医院的63例(100眼)诊断为2型糖尿病的患者,其中糖尿病视网膜病变患者44例(72眼),有2型糖尿病而无视网膜病变(NDR)19例(28眼)。所有患者均进行OCTA检查,统计FAZ、PERIM、AI、FD、SVD、DVD等指标。结果:(1)SVD、旁中心凹SVD,DVD、旁中心凹DVD随DR病程的进展逐渐降低,差异均有统计学意义(P=0.000)SVD中心凹、DVD中心凹差异无统计学意义(P>0.05);(2)SVD、旁中心SVD、DVD、旁中心DVD与DR进程相关系数分别为:-0.525,-0.586,-0.323,-0.424(P<0.05),均呈中等负相关;(3)AI、FD随DR病程进展逐渐降低,差异具有统计学意义(P=0.011,P=0.000),FAZ与PERIM随DR病程变化差异无统计学意义(P>0.05);(4)FAZ、PERIM与DR进程相关系数分别为:-0.031,0.084(P>0.05),无相关性,AI、FD与DR进程相关系数分别为0.307,-0.459(P<0.05),分别呈中等正、负相关;(5)FAZ、PERIM、AI、FD与年龄相关系数分别为:-0.124,-0.052,0.113,-0.170(P>0.05),无相关性。结论:DR病情的进展与OCTA浅层血流密度、深层血流密度有呈中等相关性;与AI、FD呈中等相关性。OCTA可以辅助评估DR疾病进展。
    2023(03):203-209, DOI: 10.13210/j.cnki.jhmu.20221201.001
    摘要:
    目的:探究寻常型银屑病患者焦虑状况,分析银屑病患者焦虑与病情、氧化应激及炎症因子的相关性。方法:招募2021年8月~2022年2月东直门中医院皮肤科的84例银屑病患者,采集汉密尔顿焦虑量表评分(HAMA)、银屑病皮损面积和严重程度指数评分(PASI)、VAS瘙痒评分(VAS),检测血清丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH‑px)、白介素‑6(IL‑6)、白介素‑17A(IL‑17A)、肿瘤坏死因子‑α(TNF‑α)。基于HAMA评分进行分组对照研究及相关性分析,此外采集84例健康人的HAMA评分进行对照研究。结果:寻常型银屑病患者HAMA评分高于健康人(Z=-7.730,P<0.05);寻常型银屑病伴焦虑患者在PASI、VAS评分,MDA、SOD、GSH‑px、IL‑6、IL‑17A分泌水平均与寻常型银屑病无焦虑患者存在差异;寻常型银屑病患者HAMA评分与PASI、VAS评分呈显著正相关(r=0.564,0.513,P<0.05);与血清中MDA、IL‑6、IL‑17A呈正相关性(r=0.390,0.355,0.248,P<0.05);与SOD、GSH‑px呈负相关(r=-0.313,-0.502,P<0.05);未发现与TNF‑α的相关性。结论:银屑病患者焦虑风险高于健康人群;焦虑与银屑病关系密切,并体现在银屑病患者的皮损、瘙痒、氧化应激及炎症因子水平等方面;焦虑与银屑病共病机制可能与氧化应激亢进、炎症因子水平上调相关。
    2023(03):210-215, DOI: 10.13210/j.cnki.jhmu.20220906.001
    摘要:
    目的:探讨18F⁃FDG PET/CT影像组学特征预测晚期非小细胞肺癌(non⁃small cell lung cancer, NSCLC)化疗预后的价值。方法:本项目回顾性研究了146例治疗前行18F⁃FDG PET/CT检查的Ⅲ期、Ⅳ期NSCLC病例,全部病例在PET/CT检查后都进行了规范化化疗,按8∶2比率将病例随机分为训练组和测试组,并提取影像组学特征。在训练组中应用最小绝对收缩和选择算子(LASSO)算法和Cox风险比例回归模型分别筛选预测无进展生存(Progression⁃free survival,PFS)的影像组学特征和临床特征,分别建立影像组学模型、临床模型及二者结合的复合模型,计算影像组学评分(Rad⁃score)、临床评分及复合评分,并在测试组中进行检验。结果:LASSO算法最终筛选出4个影像组学特征,ROC结果表明:影像组学模型在训练组中预测PFS的AUC为0.746,测试组AUC为0.622。COX多因素分析共纳入了3种与PFS相关的临床特征,分别是病理类型、临床分期及MTV30。临床模型、影像组学模型及复合模型预测NSCLC患者化疗后PFS的ROC曲线下面积分别为0.746、0.753、0.716,以影像组学模型诊断效能最高,其灵敏度及特异度分别为0.663及0.833。Delong检验验证影像组学模型与复合模型(Z=1.777,P=0.076)及临床模型(Z=0.323,P=0.747)间的预测效能无统计学差异。结论:PET/CT影像组学模型对晚期NSCLC的化疗预后具有较好的预测价值。
    2023(03):216-221, DOI: 10.13210/j.cnki.jhmu.20221213.001
    摘要:
    目的:探讨加速康复外科(ERAS)理念指导下12 h出入院日间腹腔镜胆囊切除术的安全及有效性。方法:以180例ERAS指导下的12 h出入院日间胆囊切除术患者为研究对象,按照加速康复外科理念进行指导评估,以同期常规日间胆囊切除术患者180例为对照组。对围手术期与快速康复治疗理念的相关指标进行量化分析,评估临床安全、有效性。结果:两组在平均年龄、性别分布、胆囊相关病程时常与临床症状的分布中比较,差异均无统计学意义(P>0.05)。两组在术前吸烟史、高血压病史、心脑血管病史及腹部手术史、疾病构成比方面比较,差异均无统计学意义(P>0.05)。所有患者均无中转开腹,与常规手术组相比,ERAS日间手术患者术中平均出血量、手术时间、再次返回病房前肌力等方面比较,差异均无统计学意义(P>0.05)。ERAS日间手术组患者下地时两组的肌力与常规手术组患者相比,无明显统计学差异(t=1.64,P=0.082)。与常规手术组患者相比,ERAS日间手术组患者术后6 h外周血白细胞的水平无明显升高;肝功能相关指标,转氨酶、总胆红素、间接胆红素均无明显异常(P>0.05)。结论:ERAS理念指导的12 h日间腹腔镜胆囊切除,能改善胆囊患者的临床疗效,安全、可行。
    2023(03):222-228, DOI: 10.13210/j.cnki.jhmu.20210817.001
    摘要:
    目的:系统评价他汀联合曲美他嗪对冠状动脉粥样硬化性心脏病基于inflammasomes/免疫损伤应答学说的炎性因子水平调控及心室重构的改善。方法:计算机检索EMbase、The Cochrane Library、Web of Science、Medline、Pubmed、万方数据(WanFang Data)、中国知网(CNKI)、中国生物医学文献服务系统(CBM)、维普数据库(VIP)共9个数据库,检索时限均为建库至2021年6月7日。人工检索所有纳入研究的参考文献,根据Cochrane 系统评价方法,筛选关于阿托伐他汀联合曲美他嗪及常规治疗(抗血小板、控制血压、利尿、扩张冠脉等)对比应用曲美他嗪或他汀类药物联合常规治疗冠状动脉粥样硬化性心脏病患者的中、英文随机对照试验(RCT),并进行纳入文献资料的提取和质量评价,运用RevMan5.4软件进行Meta分析。结局指标包括炎性因子指标:CRP(C反应蛋白)、IL‑6(白介素6)、肿瘤坏死因子α(TNF-α),以及心室重构相关结局指标:左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)。结果:最终纳入随机对照试验12项,共计1 120例冠心病患者。Meta分析结果:(1)炎性因子方面:他汀联合曲美他嗪组较对照组(单纯应用他汀类药物或曲美他嗪)可显著降低冠心病患者血液CRP[n=770,SMD=-2.70,95%CI(-2.55,-‑1.40),P<-0.000 01]、TNF-α[n=678,SMD=-2.25,95%CI(-3.39,-1.12),P<-0.0001]、IL‑6[n=770,SMD=-2.10,95%CI(-3.10,-1.10),P<0.000 01]三种炎性因子的表达程度。(2)心室重构方面:他汀联合曲美他嗪组和对照组(单纯应用他汀类药物或曲美他嗪)相比,更能明显降低治疗前冠心病患者的左室收缩末期内径[n=626, SMD=‑1.55,95%CI(-2.10,-0.99),P<-0.000 01]及左室舒张末期内径[n=626, SMD=-1.18,95%CI[-1.56,-0.80),P<-0.000 01]。结论:他汀联合曲美他嗪和对照组相比更能明显降低炎性因子水平,并改善冠心病患者的心室重构。
    2023(03):229-234, DOI: 10.13210/j.cnki.jhmu.20220922.002
    摘要:
    因冠状动脉斑块细小且随心脏不停跳动,MRI对冠状动脉粥样硬化斑块性质的评估一直是研究的难点之一。最新研究表明,冠周脂肪环境的变化与冠状动脉粥样硬化斑块性质密切相关。目前新的多模态磁共振成像技术能定量评估冠周脂肪环境变化,有望能有效评估冠状动脉斑块性质,因此研究冠周脂肪具有重要的临床意义。现从冠周脂肪的生物学意义、冠周脂肪评估的比较影像学及其影像学的临床应用等方面进展进行综述。
    2023(03):235-240, DOI: 10.13210/j.cnki.jhmu.20210609.002
    摘要:
    代谢性疾病的患病率逐年升高,严重影响着人们的身体健康与生命安全,及早发现并干预是面对它们的共同策略。红外热成像作为一种特殊的医学影像技术,可以尽早发现机体代谢功能的改变,是适应代谢性疾病防治策略的影像技术手段。本文综述了红外热成像在单一代谢异常如肥胖、高血糖、血压异常,多组分代谢异常以及代谢性疾病最终阶段等情况下的应用情况,分析代谢性疾病在红外热成像下的特征表达及疾病发展过程中热图变化的规律,讨论当前研究存在的不足。为今后红外热成像在代谢性疾病的临床应用探索提供参考。
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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.
    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] (162) [HTML] (0) [PDF 2.54 M] (333)
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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):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
    [摘要] (533) [HTML] (0) [PDF 2.81 M] (205)
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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
    [摘要] (348) [HTML] (0) [PDF 3.07 M] (205)
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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 .

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