简介:Objective: Toexploretheregulationofearlybraintissuemetabolicchangingafterbraininjuriesandtheclinicalsignificance. Methods: Therewere17patientswithbraininjuries.EarlydirectmonitoringofPtiO2,PtiCO2,pHandbraintemperature,dynamicobservationoftherelationbetweenvariousparametersandclinicsafterbraininjurieswereperformed. Results: EarlychangesofPtiO2,PtiCO2andpHwerecloselycorrelatedwithoutcome.ThedeathrateobviouslyincreasedwhenPtiO2wascontinuouslylowerthan9mm?Hgwithin24hoursafterinjuries.Secondarybraininjuryprolongedandaggravatedbraintissuemetabolicdisturbance.Whenintracerebralpressurewasover30mm?HgPtiO2begantodecrease.Thebraintemperatureinbraindeathpatientswasevidentlylowerthanaxillarytemperature. Conclusions: ThedirectmonitoringofPtiO2,PtiCO2,pHandbraintemperatureissafeandaccurateandcanfindearlyanoxiadamagetobraintissueandprovidereliablebasisforclinicaltherapy.Ithasaninstructivesignificanceinselectingandstudyinganewtreatmentmethodinbraininjuries.Anditcanbetakenasacriterioninclinicaljudgingbraindeaths.
简介:目的:研究胃癌组织中TROP2和HER2蛋白表达,探讨TROP2和HER2蛋白在胃癌中的临床病理学意义以及二者的相关性。方法:应用免疫组织化学方法SP法检测56例胃癌组织中TROP2和HER2蛋白表达。结果:胃癌组织中TROP2和HER2蛋白阳性表达率分别为69.6%和32.1%。胃癌组织中TROP2蛋白表达与与淋巴结转移、淋巴血管侵犯、浸润深度及临床分期有关(P﹤0.05),而与患者性别、年龄、肿瘤部位、Lauren分型等无关(P﹥0.05)。HER2蛋白在胃癌中的表达与与Lauren分型、淋巴结转移和临床分期有关(P﹤0.05),而与患者性别、年龄、肿瘤部位、浸润深度、淋巴血管侵犯等无关(P﹥0.05)。胃癌中TROP2与HER2蛋白表达无相关性(P﹥0.05)。结论:TROP2高表达与胃癌的侵袭转移有关,提示检测TROP2可预测胃癌的临床生物学行为,可作为未来靶向治疗的一个靶点。
简介:摘要目的临床上脑卒中人群常可并发肺炎,肺炎严重影响人们生活甚至可致死亡.A2DS2评分可用于预测脑卒中人群是否会并发肺炎,对其预测效果进行临床分析.方法2014年9月我院根据相关临床经验和地区人群特点制定了特色型“A2DS2评分系统”,准备投入到临床应用中.现选取在我院就诊并诊断为脑卒中接受治疗的患者80例和相关负责医生20名,对80例脑卒中患者进行为期一年的随访.患者随访结果为“参照标准”,10名医生采用临床上常用预测方法对80例脑卒中患者预测的结果称为对照组.结果80例脑卒中患者调查结果显示,缺血性卒中最常见.观察组预测结果和“参考标准”相符程度(95.71%)与对照组相符程度(70.00%)相比明显较高;观察组医生满意度(90.00%)高于对照组满意度(60.00%),结果具有统计学意义(P<0.05).结论通过临床常用预测方法预测卒中后肺炎有一定的难度,新制定的A2DS2系统对于预测卒中后肺炎有重要作用,可以有效地提高预测的准确率,深受医生和患者好评,医生可以对患者临床预防进行专业指导,避免出现时治疗无效引起严重后果.关键词A2DS2评分;脑卒中;肺炎;预测价值ExploringtheforecastvalueofA2DS2scoreonconcurrencypneumoniaofpatientswithstrokeAbstractObjectiveStrokepatientsoftenaccompanypneumonia,pneumoniainfluencespeople’slifestrictlyandmayleadtodeath.A2DS2scorecanpredictifstrokepatientsoccurpneumonia,analyzeditsclinicaleffect.MethodWemade‘A2DS2ScoreSystem’accordingtoourhospital’srelatedclinicalexperienceanddistrict’sfeatures,itwasusedinclinical.Selected80patientswhowerediagnosedstrokeand20doctors,followed80patientsforoneyear.TheresultswasregarGdedas‘referencestandard’,80patientswhoacceptedroutineforecastmethodby10doctorswereselectedascontrolgroup;ResultThesurveyof80strokepaGtientsshowedthatischemicstrokewasthemostcommon.Thecorrespondbetweenforecastresultandtheresultof‘referencestandard’inobservationgroup(95.71%)washigherthan(70.00%)ofcontrolgroup;Thesatisfactiontodoctorsinobservation(90.00%)washigherthan(60.00%)ofcontrolgroup,theresultshadstatisticalsignificance(P<0.05).ConclusionClinicalroutineforecastmethodisdifficulttoforecastpneumonia,new-madeA2DS2systemhasimportanteffectonforecastingpneumonia,itcanincreasetheaccuracyeffectivelyandwelcomedbydoctorsandpatients,doctorscanprovideprofessionalguidanceforpatientstoavoidseriousKeryeswuolrtdbecauseofinvalidtreatment.A2DS2score;stroke;pneumonia;forecastvalue中图分类号R18文献标识码B文章编号1008-6315(2015)12-0256-01
简介:目的:探讨人表皮生长因子受体2(humanepidermalgrowthfactorreceptor2,HER2)和环氧化酶2(cyclooxygenase-2,COX-2)在非小细胞肺癌(non-smallcelllungcancer,NSCLC)中的表达,其各自与临床特征之间的关系及二者在NSCLC中表达的相互关系。方法采用免疫组化链霉菌抗生物素蛋白-过氧化物酶(streptavidin-peroxidase,SP)法检测72例NSCLC中HER2、COX-2的表达情况。结果①72例NSCLC中,HER2、COX-2的阳性表达率分别为55.6%、65.3%;②HER2在NSCLC中的阳性表达与组织学类型、分化程度、肿块大小、淋巴结转移及临床分期相关(P<0.05),而与性别、年龄、吸烟、病变部位无关(P>0.05);③COX-2的阳性表达与年龄、组织学类型、肿块大小、淋巴结转移及临床分期相关(P<0.05),而与性别、吸烟、病变部位及分化程度无关(P>0.05);④HER2、COX-2在NSCLC中的阳性表达呈正相关关系。结论HER2、COX-2可以作为判断NSCLC恶性程度的生物学指标。
简介:摘要目的观察蓝萼甲素预处理对H2O2诱导H9c2心肌细胞损伤模型的保护作用,并采用网络药理学方法预测蓝萼甲素抗H9c2心肌细胞凋亡的作用机制。方法将H9c2心肌细胞按随机数字表法分为空白对照组、模型组及蓝萼甲素低、中、高剂量组。空白对照组使用无血清培养液处理。模型组采用无血清培养4 h后,加入250 μmol/L H2O2干预6 h。蓝萼甲素低、中、高剂量组分别给予蓝萼甲素0.125、0.250、0.500 μg/ml预处理4 h后,加入浓度为250 μmol/L H2O2干预6 h。采用MTT法检测心肌细胞活力,观察细胞形态,采用Annexin Ⅴ-FITC/PI荧光双染及Hoechst 33258荧光染色检测细胞凋亡情况。通过Pubchem数据库获得蓝萼甲素的化学结构式,使用Swiss Target Prediction和Pharmmapper平台预测蓝萼甲素潜在靶点,利用GeneCards数据库筛选蓝萼甲素抗H9c2心肌细胞凋亡的作用靶点。采用Cytoscape软件构建蓝萼甲素作用的靶点网络,通过String数据库和Cytoscape软件绘制蛋白相互作用网络,并用Metascape数据库对靶点进行GO及KEGG通路富集分析。结果与模型组比较,蓝萼甲素低、中、高剂量组H9c2心肌细胞活力[(66.56±6.51)%、(79.21±6.89)%、(94.06±5.19)%比(51.75±4.14)%]升高(P<0.01),细胞凋亡率[(24.12±4.71)%、(17.42±4.39)%、(7.65±1.56)%比(36.73±5.65)%]降低(P<0.01)。网络药理学分析结果提示,蓝萼甲素有22个与抗H9c2心肌细胞凋亡相关的靶点,主要调节氧化应激、细胞迁移、激酶结合活性等,可调节MAPK1、VEGFA、MMP9、NOS3、MMP2、MAPK14等靶点通路,发挥抗H9c2心肌细胞凋亡作用。结论蓝萼甲素预处理对H2O2诱导H9c2心肌细胞损伤有保护作用,其机制可能通过多靶点-多途径发挥抗氧化应激和减少细胞凋亡的作用。
简介:摘要目的探讨2型糖尿病(T2DM)患者SLC2A2 rs5393、rs5400位点基因多态性与二甲双胍疗效的相关性。方法选取2016年1月至2019年4月期间在山西医科大学第一医院就诊的T2DM患者90例(T2DM组)及90例体检健康者(对照组)作为研究对象,通过PCR-限制性片段长度多态性(PCR-RELP)法检测SLC2A2 rs5393、rs5400位点基因多态性分布频率。对T2DM患者进行二甲双胍治疗,随访90 d,分析二甲双胍疗效与各基因型的关系。结果对照组与T2DM组SLC2A2 rs5393、rs5400各基因型符合Hardy-Weinberg平衡定律。与对照组相比,T2DM组rs5393位点AC型、CC型比例显著升高(P<0.05),rs5400位点CT、TT型频率显著升高(P<0.05)。rs5393位点中,治疗前AA型、AC型、CC型空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c)水平差异无统计学意义(P>0.05);二甲双胍治疗后AC型、CC型患者FPG、2 h PBG、HbA1c降低幅度低于AA型(P<0.05),CC型FPG、HbA1c降低幅度低于AC型(P<0.05)。rs5400位点中,治疗前CC型、CT型、TT型FPG、2 h PBG、HbA1c水平差异无统计学意义(P>0.05);二甲双胍治疗后CT型、TT型患者FPG、2 h PBG、HbA1c降低幅度低于CC型(P<0.05),TT型FPG、HbA1c降低幅度低于CT型(P<0.05)。结论SLC2A2基因多态性位点rs5393 AA型患者、rs5400 CC型T2DM患者对二甲双胍敏感,降糖疗效较好。
简介:AbstractIntroduction:Darier’s disease is a rare autosomal dominant skin disorder caused by mutations in ATP2A2. Recently, the high prevalence of neuropsychiatric symptoms is frequently reported in Darier’s disease patients.We present a case of patient with concurrence of Darier’s disease and depression and detected the mutations in ATP2A2.Case presentation:A 29-year-old man presented with a 15-year history of brown, harsh keratotic papules on his scalp, face, neck, trunk, axilla, ingunia and upper limbs. Meanwhile, he had persistent depression. He was diagnosed as Darier’s disease according to clinical manifestations and result of histological examination. We sequenced all coding regions of ATP2A2. The mutation c.2993_2994del (p. Val998Alafs*33) in exon 20 of ATP2A2 was detected.Discussion:Darier’s disease has been associated with several extracutaneous manifestations, in particular neuropsychiatric morbidity. Likely gene disrupting mutations in ATP2A2 was reported to have a close relationship to Darier’s disease cases with reported co-occurring neuropsychiatric features. Consistent with the previous reports, an likely gene disrupting mutations was detected in our patient with concurrence of DD and depression.Conclusion:The psychiatric disorders in patients with Darier’s disease should be well appreciated .The underlying mechanism in correlation between the mutation in ATP2A2 and neuropsychiatric phenotypes in Darier’s disease remain unclarified and warrants further investigation.
简介:AbstractBackground:The complete mesogastrium excision (CME) based on D2 radical gastrectomy is believed to significantly reduce the local-regional recurrence compared with D2 radical gastrectomy in advanced gastric cancer, and it is widely used in China. This study aimed to explore whether D2 + CME is superior to D2 on surgical outcomes during gastrectomy from Chinese data.Methods:Feasible studies comparing the D2 + CME (D2 + CME group) and D2 (D2 group) published up to March 2020 are searched from electronic databases. The data showing surgical and complication outcomes are extracted to be pooled and analyzed.Results:Fourteen records including 1352 patients were included. The D2 + CME group had a shorter mean operative time (weighted mean difference [WMD] = -16.72 min, 95% confidence interval [CI]: -26.56 to - 6.87 min, P < 0.001), lower mean blood loss (WMD = -39.08 mL, 95% CI: -49.94 to -28.21 mL, P < 0.001), higher mean number of retrieved lymph nodes (WMD = 2.13, 95% CI: 0.58-3.67, P = 0.007), shorter time to first flatus (WMD =-0.31 d, 95% CI: -0.53 to - 0.10 d, P = 0.005), and postoperative hospital days (WMD =-1.09, 95% CI: -1.92 to -0.25, P = 0.010) than the D2 group. Subgroup analysis suggested that the advantages from the D2 + CME group were obvious in traditional open radical gastrectomy, proximal gastrectomy, and distal gastrectomy compared with D2 group. The evaluations of post-operative complications showed that the patients who underwent D2 + CME had a lower incidence of post-operative complications than the patients who underwent D2 surgery alone (relative risk [RR] = 0.65, 95% CI: 0.45-0.87, P = 0.003). The D2 radical gastrectomy plus CME improved 3-year overall survival (OS) (RR = 1.16, 95% CI: 1.02-1.32, P = 0.020) and lowered the local recurrence rate (RR = 0.51, 95% CI: 0.28-0.94, P = 0.030). The patients undergoing laparoscopic surgery or total gastrectomy had more significant advantages compared between D2 + CME and D2 groups in 3-year OS.Conclusion:The data from China show that D2 radical gastrectomy plus CME are reliable procedures and safety compared to D2 radical gastrectomy with faster recovery, lower risk, and better prognosis.
简介:摘要2例散发性偏瘫性偏头痛患儿,例1,男,5岁10月龄,因“反复惊厥发作5年余,行为异常20 d”入院。例2,男,4岁6月龄,因“反复惊厥发作3年余,发热伴右侧肢体活动受限1 d”入院。2例患儿均无相关家族史,早期表现为热性惊厥,随年龄增长,在发热等诱因下出现先兆头痛伴急性脑病发作。基因检测均为ATP1A2基因错义变异,分别为c.2143G>A(p.Gly715Arg)、c.2563G>A(p.Gly855Arg)。
简介:摘要分析2019年3月遵义医科大学附属医院收治的Cornelia de Lange综合征(CdLs)患儿2例的临床资料及基因变异结果。2例均在婴儿期起病,表现为难治性癫痫,均伴发育落后及特殊外貌,基因检测显示X染色体上SMC1A基因突变,例1为c.2561dupA(p.K854fs)移码突变;例2为c.3441+1G>A(exon24)剪接突变,均为新生杂合突变,位点未见文献报道。2例患儿为SMC1A基因突变所致CdLs,进一步扩大了CdLs的基因型。提示对于早期癫痫起病伴特殊外貌及发育落后的患儿需考虑CdLs的可能,必要时需行基因检测。
简介:摘要辅助性T细胞17(Th17)是近年发现的新CD4+T细胞亚群,主要通过分泌细胞因子白细胞介素17趋化中性粒细胞在气道募集而促进非Th2优势型哮喘的发生。甲基化-CpG结合域蛋白在DNA甲基化中具有调控作用,且能通过调控Th17分化而影响哮喘的进展。文中主要综述了近年甲基化-CpG结合域蛋白2调控Th17优势分化进而介导非Th2优势型哮喘的研究进展。
简介:摘要多发性内分泌腺瘤2型是国内的一种内分泌系统疾病,在国内报道尚少,发病率低,但是一旦发生往往恶性程度较高。国外相关研究较多,国内医师对于此种疾病的鉴别及相关治疗认识尚未完全清晰,本文根据相关研究进展对多发性内分泌腺瘤进行了综述,对疾病相关的诊断、治疗等进行了阐述,提高临床工作者对于其认识。
简介:摘要目的检测子宫内膜息肉组织中HER-2及COX-2表达,探讨子宫内膜息肉的发病机制。方法采用免疫组化法检测50例子宫内膜息肉和同时行诊刮术获取正常子宫内膜中HER-2及COX-2的表达。结果子宫内膜息肉组织中,HER-2及COX-2表达均高于正常子宫内膜组织,差异有统计学意义(P<0.05)。HER-2及COX-2在子宫内膜息肉表达呈正相关(r=0.38,P<0.05)。结论HER-2及COX-2可能存在协同作用,并可能与子宫内膜息肉的发生有关。
简介:目的用Nrf2/ARE通路激活剂上调Ⅱ相解毒酶和抗氧化酶在胰岛B细胞中的表达,观察其对T2DM大鼠胰岛B细胞形态结构的影响。方法建立T2DM大鼠模型,分为糖尿病模型组(DM组)、tBHQ干预组(tBHQ组),同时设正常对照组(NC组)。连续干预8周后处死各组大鼠,检测空腹血糖(FBG)和空腹胰岛素(FINS)水平,观察胰岛细胞形态结构及凋亡,ELISA检测血清及胰腺组织中丙二醛(MDA)、肿瘤坏死因子-α(TNF-α)和总超氧化物歧化酶(T-SOD)水平,Westernblot检测胰腺总Nrf2、核Nrf2蛋白表达。结果DM组FBG和FINS水平分别较NC组明显增高和降低(均P=0.000),tBHQ组FBG和FINS水平分别较DM组明显降低和增高(均P=0.000)。与NC组比较,DM组胰岛细胞数目明显减少,出现肿胀、坏死,凋亡增加,tBHQ组胰岛细胞较DM组明显改善。与NC组比较,DM组血清及胰腺组织中MDA、TNF-α水平显著升高,T.SOD水平显著降低(均P=0.000);tBHQ组血清及胰腺组织中MDA、TNF-α水平较DM组明显降低,T-SOD水平明显升高(均P=0.000)。DM组总Nrf2、核Nrf2蛋白的表达均较NC组显著降低(P总Nerf2=0.000,P核Nerf2=0.006),与DM组比较,tBHQ组总Nrf2、核Nrf2蛋白的表达均明显增加(均P=0.000)。结论激活Nrf2/ARE通路可通过上调Ⅱ相解毒酶和抗氧化酶在胰岛B细胞中的表达来减轻氧化应激和慢性炎症反应对胰岛B细胞的进一步损伤。