应用韦氏活骨Ⅰ号胶囊治疗早中期股骨头缺血性坏死的疗效评价

目的评价韦氏活骨Ⅰ号在早中期股骨头缺血性坏死（ ONFH）治疗中的作用及疗效。方法选取早中期ONFH患者203例（256髋），分为2组，疗程6个月，都予以患肢皮牵引。对照组联合应用止疼药物、活血药物及促进骨质生成药物；实验组在对照组用药基础上加用韦氏活骨Ⅰ号胶囊治疗。治疗后3、6、12个月复查，以后每年复诊1次，比较两组治疗前后血清碱性磷酸酶、血液流变指标、影像学检查及Harris评分的变化情况，进行临床疗效评价。结果应用韦氏活骨Ⅰ号胶囊后，患者血清碱性磷酸酶及Harris评分均较治疗前有统计学差异（P＜0.01），血液流变指标有统计学差异（ P＜0.01），X线显示股骨头骨质破坏区边缘由模糊逐渐变得清晰、硬化，骨密度逐渐趋于均匀，患者疼痛症状明显减轻甚至消失，关节活动度得到显著改善，治愈率也比对照组更高。结论韦氏活骨Ⅰ号胶囊作为纯中药制剂治疗ONFH效果明显，具有改善血液循环和加速骨生成的作用，临床疗效与传统保守疗法比较具有统计学差异。     

三七活血片治疗急性软组织损伤的机制探讨

摘 要 目的： 研究三七活血片对急性软组织损伤的治疗作用及其机制。方法: 140只大鼠分为空白组,模型组,阳性药对照组,三七活血片低、中、高剂量组(0.5,1.0,2.0 g·kg^-1),建立大鼠急性软组织损伤模型,于给药d3和d5,取大鼠损伤组织测定前列腺素（PGE2）、白细胞介素-6(IL-6)、一氧化氮(NO)及超氧化物歧化酶(SOD)含量;给药d5,观察三七活血片对大鼠全血黏度、血浆黏度的影响。结果: 与模型组比较,三七活血片可明显降低大鼠受伤组织中NO、PGE₂与IL-6水平;升高组织中SOD水平;可明显降低血液黏度和血浆黏度(P<0.01或P<0.05)。结论:三七活血片对大鼠急性软组织损伤有较好的治疗和修复作用,其治疗机制可能与抑制受伤局部组织细胞释放的自由基、PGE₂、IL-6的含量,提高局部血液流变有关。     

Pharmacokinetics of tralokinumab in adolescents with asthma: implications for future dosing

AimsTralokinumab, an investigational human immunoglobulin G4 monoclonal antibody, potently and specifically neutralizes interleukin‐13, a central mediator of asthma. Tralokinumab has shown improvements in clinical endpoints in adults with uncontrolled asthma. The present study explored the pharmacokinetics (PK) and safety of a single tralokinumab dose, and utilized a population PK modelling and simulation approach to evaluate the optimal dosing strategy for adolescents.MethodsAdolescent subjects with asthma, using daily controller medication, received a single subcutaneous dose of tralokinumab 300 mg. Safety, immunogenicity and PK data were collected during a 57‐day follow‐up. A population PK model was developed using data from the present study and prior studies in adults. Simulations were performed to evaluate dose adjustment requirements for adolescents.ResultsTwenty adolescents (12–17 years) were enrolled; all completed the study. No clinically relevant safety findings or antidrug antibodies were detected. PK parameters were similar to those observed in adults. PK modelling showed that body weight was a minor predictor of tralokinumab PK; after incorporating body weight into the PK model, a 15% (nonparametric 95% confidence interval 5%, 26%) lower clearance was found in adolescents compared with adults [173 (151, 209) vs. 204 (191, 229) ml day^–1]. Simulations showed no therapeutically relevant differences in exposures between adolescent and adult populations, and similar PK profiles for weight‐based (4 mg kg^–1) and fixed (300 mg) fortnightly subcutaneous doses of tralokinumab.ConclusionSingle‐dose administration of tralokinumab 300 mg in adolescents was well tolerated, with a PK profile similar to that in adults. Exposure predictions suggest that dose adjustment is not required for adolescents.     

Regression analysis and variable selection for two-stage multiple-infection group testing data

Group testing, as a cost-effective strategy, has been widely used to perform large-scale screening for rare infections. Recently, the use of multiplex assays has transformed the goal of group testing from detecting a single disease to diagnosing multiple infections simultaneously. Existing research on multiple-infection group testing data either exclude individual covariate information or ignore possible retests on suspicious individuals. To incorporate both, we propose a new regression model. This new model allows us to perform a regression analysis for each infection using multiple-infection group testing data. Furthermore, we introduce an efficient variable selection method to reveal truly relevant risk factors for each disease. Our methodology also allows for the estimation of the assay sensitivity and specificity when they are unknown. We examine the finite sample performance of our method through extensive simulation studies and apply it to a chlamydia and gonorrhea screening data set to illustrate its practical usefulness.     

Comparison of the neuroprotective effects and recovery profiles of isoflurane,sevoflurane and desflurane as neurosurgical pre-conditioning on ischemia/reperfusion cerebral injury

Background: There are a few reports regarding the comparison of these anesthetic agents, but previous studies mainly focus on the veterinary anesthesiology. Less attention has been focused comparing the effectiveness of these inhalational anesthetic agents in neurosurgery. This lack of interest is regretful particularly considering the fact that anesthetics during neurosurgery are an issue of extreme sensitivity and subtlety, where the cerebral oxygenation process plays a significant role in the neuroprotective mechanisms. Objective: The purpose of this retrospective study is to contribute to the existing knowledge of the comparative studies of the volatile anesthetic agents such as isoflurane, sevoflurane and desflurane by evaluating the maintenance and emergence characteristics after volatile anesthetics-induced preconditioning with isoflurane, sevoflurane or desflurane for inpatient ischemia/reperfusion cerebral injury during cerebral or neural surgeries. Methods: The aim was to investigate their neuroprotective mechanisms and effects by analyzing and comparing the superiority of each agent in a Chinese patient population, in terms of faster emergence, and early and intermediate recovery. The intraoperative haemodynamic profiles and postoperative adverse effects of these three agents were also systematically analyzed. Results: We found that sevoflurane, when compared with isoflurane and desflurane, provided anesthesia with similar hemodynamic stability but allowed for a smoother, more rapid emergence and better quality of induction and recovery to surgical patients under clinical conditions, particularly to those who were experiencing substantial cerebral vasodilation. Conclusion: Sevoflurane offers several advantages, including a relative lack of airway irritation, a more rapid onset and recovery, and greater hemodynamic stability than other potent inhaled agents. These properties would appear to afford sevoflurane significant clinical potential.     

冰冻人血浆醛固酮标准物质的研制

目的 研制冰冻人血浆醛固酮国家二级标准物质,用于血浆醛固酮的量值溯源、室内质量控制、实验室能力验证、相关试剂和方法的评估及验证等,促进血浆醛固酮检测标准化进程,实现结果互认.方法 收集无肉眼可见溶血、乳糜和黄疸的混合血浆材料,经过浓度配比、过滤、分装后,-70℃保存.参照JJG 1006-1994和JJF 1343-2...     

RhoE/Rnd3及CyclinB1蛋白在人乳腺癌中的表达及相关性

目的：探讨RhoE/Rnd3及CyclinB1蛋白在乳腺癌中的表达情况及其相关性。方法：采用免疫组化方法检测60例乳腺浸润性导管癌、30例正常乳腺组织中RhoE/Rnd3及CyclinB1蛋白的表达情况。结果：RhoE/Rnd3及Cyclin B1蛋白在正常乳腺中的表达率分别为73.3%和43.3%,二者的表达差异具有显著性意义（P〈0.05）;在乳腺癌中的表达率分别为40.0%和70.0%,二者的表达差异具有显著性意义（P〈0.05）。RhoE/Rnd3及CyclinB1蛋白表达呈负相关（P〈0.05）。RhoE/Rnd3的表达与患者年龄和淋巴结转移呈负相关,与生育史呈正相关;CyclinB1表达与患者年龄和ER状态呈正相关。结论：RhoE/Rnd3在乳腺癌的发生中呈负调控作用,CyclinB1在乳腺癌发生中呈正调控作用,RhoE/Rnd3可能通过抑制CyclinB1来抑制乳腺癌的发生;RhoE/Rnd3过表达与乳腺癌预后较好有关,CyclinB1过表达与乳腺癌预后不良有关。     

麦门冬汤对放射性肺损伤大鼠肺组织TGF-β、TNF-α表达的影响

目的探讨麦门冬汤对放射性肺损伤大鼠肺组织TGF-β、TNF-α表达的影响。方法将72只健康成年清洁级雌性Wistar大鼠随机分为空白对照组（A组）24只,单纯照射组（B组）24只,照射加中药组（C组）24只,A、B两组以蒸馏水2ml／200g体重灌胃一周后,C组以每日2ml／200g体重（1．6g／200g体重）灌胃服用中药一周,开始照射,照射期间,每周测体重一次,依照上述剂量,A、B组以蒸馏水、C组以中药继续灌胃至照射结束。分别在完成10次照射后（第5周）,以及在照射开始后的第12、26周,检测各组大鼠肺组织TGF-β、TNF-α表达。结果①TGF-β蛋白表达：B组大鼠TGF-β于照射第5周时出现表达达到高峰;在各时间点,A、C组大鼠TGF-β表达均低于B组（P〈0．01）;（2）TNF．Ⅱ表达：B组大鼠肺组织TNF-α的表达在第5周时达到高峰,C组在第5周时明显抑制了TNF-α表达,在第5周、12周、26周,C组大鼠TNF-α表达均明显低于B组（P〈0．01）。结论中药麦门冬汤具有较好的预防放射性肺损伤功效,其作用机制与阻抑肺组织TGF-β、TNF-α表达有关。     

人脐血源性MSCs成骨诱导分化后的免疫调节作用

目的:探讨脐血源性间充质干细胞(mesenchymal stem cells,MSCs)经成骨诱导分化后,其对淋巴细胞的免疫调节作用。方法:从人脐血中分离、培养及扩增MSCs,流式细胞仪测定细胞表型;将获得的MSCs在成骨诱导体系中诱导分化并鉴定,将诱导后的成骨细胞分别以不同剂量加入到外周血混合淋巴细胞培养体系和植物血凝素(PHA)刺激的外周血淋巴细胞转化体系中,用3H-TdR标记β液体闪烁计数仪检测细胞增殖,观察对混合淋巴细胞反应和淋巴细胞转化的影响。结果:从人脐血中分离获得的MSCs,呈成纤维样的细胞形态,CD29和CD105表达阳性,CD34和CD45表达阴性;在成骨诱导剂诱导下,具有成骨细胞样表型,可表达碱性磷酸酶,并形成矿化结节;人脐血源性MSCs经成骨诱导分化后在体外对混合淋巴细胞反应和PHA诱导的淋巴细胞转化均具有明显的抑制作用,抑制作用与细胞数量呈正相关。结论:脐血源性MSCs诱导为成骨细胞后对同种异体淋巴细胞具有免疫调节作用,为其作为骨组织工程异基因种子细胞来源打下基础。     

超声心动图检测室壁运动评价冠脉搭桥手术效果及影响因素

目的：应用超声心动图彩色室壁运动技术（ＣＫ）检测室壁运动，以评价冠脉搭桥术效果。方法：对２０例患者（男１８例，女２例，年龄４６￣７３岁）分别于术前、术后测量心内膜位移幅度（ＳＥＭ）及心内膜位移速度（Ｖｓｅｍ）。结果：冠脉拾桥术可使室壁运动功能得到改善，但心肌梗塞的节段室壁运动术后恢复较差，高血压、高指血症及高粘血症对术后室壁运动的早期恢复无影响。结论：ＣＫ技术对评价冠脉搭桥术疗效以及预测再狭窄具有