治疗性浅低温对脑心脏及其他器官的保护作用及机制

心脏骤停患者被实施心肺脑复苏时会产生不可避免的再灌注损伤，治疗性浅低温（ MTH）被证实可以对再灌注后的颅脑产生保护作用，治疗性浅低温同样被证实在心肌缺血或是急性心肌梗死（ AMI）中有保护作用，但在其他器官中是否有保护作用还有待进一步研究。治疗性浅低温其保护性作用机制及相应的并发症也有待进一步了解与完善。本文就治疗性浅低温对脑、心脏及其他器官的保护作用及其机制做一简要综述。     

部分补益类中药多糖成分在胃癌中的研究进展＊

中药多糖成分是一类天然高分子多聚物，是由醛糖/酮糖通过糖苷键连接而成，是中药成分中发挥作用的主要的活性生物大分子。近年来国内外的相关研究指出中药中的多糖成分具有显著的抗肿瘤功效，而补益类中药具有“扶正”和“祛邪”双重功效，既可以扶正固本，提高机体免疫力，又可以发挥抗炎、抗肿瘤、抗病毒等功效，更加符合中医治疗胃癌的研究方向和治疗原则。本文通过PubMed、Medline、Cochrane、CNKI、SinoMed、万方、维普等国内外医学类数据库查阅了近20年的相关文献，对国内外文献中已报道的具有补益功效的中药多糖成分在胃癌的作用进行总结，旨在为胃癌的中医药治疗提供临床指导，同时为后续中药多糖的药理活性的研究及健康产品开发利用提供参考依据。     

牛磺酸通过调控miR-126对高糖诱导的大鼠内皮细胞凋亡的影响及其作用机制＊

目的 探讨牛磺酸通过调控miR-126对高糖诱导的大鼠内皮细胞凋亡的影响及其作用机制。方法 体外培养的大鼠胸主动脉内皮细胞，分为NC组（葡萄糖浓度5.5 mmol·L^-1）、HG组（葡萄糖浓度为30.0 mmol·L^-1）、HG+低浓度牛磺酸组（葡萄糖浓度为30.0 mmol·L^-1，牛磺酸浓度为5.0 μmol·L^-1）、HG+中浓度牛磺酸组（葡萄糖浓度为30.0 mmol·L^-1，牛磺酸浓度为10.0 μmol·L^-1）和HG+高浓度牛磺酸组（葡萄糖浓度为30.0 mmol·L^-1，牛磺酸浓度为20.0 μmol·L^-1）。将模拟物（miR-126 mimics）及其阴性对照（miR-NC）、miR-126抑制物（anti- miR-126）及其阴性对照（anti-miR-NC）分别转染至大鼠胸主动脉内皮细胞。细胞计数试剂盒（CCK-8）检测细胞活力；流式细胞术检测细胞凋亡。实时荧光定量PCR（RT-qPCR）检测miR-126表达水平。蛋白质印迹（Western blot）检测细胞裂解的半胱氨酸天冬氨酸蛋白酶3（Cleaved-caspase3）、半胱氨酸天冬氨酸蛋白酶3前体（Pro-caspase3）蛋白表达。结果 与NC组比较，HG组大鼠胸主动脉内皮细胞活性显著降低（P<0.05）；与HG组比较，HG+低浓度牛磺酸组、HG+中浓度牛磺酸组、HG+高浓度牛磺酸组大鼠胸主动脉内皮细胞活性显著升高（P<0.05）。与NC组比较，HG组大鼠胸主动脉内皮细胞凋亡率、Cleaved-caspase3蛋白表达显著上升，Pro-caspase3蛋白表达显著降低（P<0.05）；与HG组比较，HG+低浓度牛磺酸组、HG+中浓度牛磺酸组、HG+高浓度牛磺酸组大鼠胸主动脉内皮细胞凋亡率、Cleaved-caspase3蛋白表达显著降低，Pro-caspase3蛋白表达显著升高（P<0.05）。与NC组比较，HG组大鼠胸主动脉内皮细胞中miR-126表达显著降低（P<0.05）；与HG组比较，HG+低浓度牛磺酸组、HG+中浓度牛磺酸组、HG+高浓度牛磺酸组大鼠胸主动脉内皮细胞中miR-126表达显著升高（P<0.05）。与HG+miR-NC组比较，HG+miR-126组大鼠胸主动脉内皮细胞中miR-126表达显著升高，细胞活性、Pro-caspase3蛋白表达显著升高（P<0.05）；凋亡率、Cleaved-caspase3蛋白表达显著降低（P<0.05）。与HG+牛磺酸组和HG+牛磺酸+anti-miR-NC组比较，HG+牛磺酸+anti-miR-126组大鼠胸主动脉内皮细胞中miR-126表达显著降低，细胞活性、Pro-caspase3蛋白表达显著降低，凋亡率、Cleaved-caspase3蛋白表达显著升高（P<0.05）。结论 牛磺酸通过上调miR-126促进高糖诱导的大鼠内皮细胞凋亡，为治疗糖尿病提供了理论依据。     

音乐电针治疗抑郁症机制的实验研究进展＊

音乐电针疗法将音乐声波转化为脉冲电流，作用于人体的感官和经穴，是音乐疗法与针刺疗法的有形结合，多项临床研究表明对抑郁症治疗效果良好，但目前作用机制尚未明晰。根据抑郁症发病的“单胺类神经递质假说”“兴奋性氨基酸假说”“细胞因子假说”“脑源性神经营养因子假说”“神经内分泌假说”“神经肽Y假说”，众多学者分别从上调海马区5-羟色胺（5-hydroxy tryptamine，5-HT）、去甲肾上腺素（Norepinephrine，NE）、多巴胺（Dopamine，DA）；脑源性神经营养因子（Brain-derived neurotrophic factor，BDNF）；下丘脑促甲状腺激素释放激素（Thyrotropin-releasing hormone，TRH）；额叶、海马、下丘脑神经肽Y（Neuropeptide Y，NPY）表达水平；下调海马区白细胞介素-1β（Interleukin-1β，IL-1β）及白细胞介素-6（Interleukin-6，IL-6）；兴奋性氨基酸谷氨酸（Glutamic acid，Glu）水平等角度揭示音乐电针治疗抑郁症的作用机制。现将音乐电针治疗抑郁症机制的实验研究进展及存在问题进行梳理归纳，以期为未来音乐电针治疗抑郁症的实验研究及临床研究提供一定的启示和思路。     

基于网络药理学及实验验证初步探讨麦门冬汤治疗肺纤维化的作用机制＊

目的 运用网络药理学的方法来研讨麦门冬汤治疗肺纤维化（Pulmonary fibrosis，PF）的作用机制。方法 利用数据库分别筛选麦门冬汤各药材的活性成分及对应的靶点，并获得肺纤维化相关的治疗靶点，提取成分与疾病的交集靶点；构建“成分-靶点-通路”网络，对靶点进行KEGG（Kyoto Encyclopedia of Genes and Genomes）通路富集和GO（Gene Ontology）生物功能分析，进一步对度值评分较高的分子及靶点进行分子对接分析，评估成分与靶点的结合活性。结果 筛选得到麦门冬汤有145个活性成分，疾病与活性成分共有靶点704个，网络分析结果显示麦门冬汤活性成分涉及血管内皮生长因子、信号转导与转录激活因子3、半胱氨酸蛋白酶3、酪氨酸受体激酶SRC等相关的50个蛋白靶点，药物可通过影响多种细胞分化及生物酶活性来调节AGE-RAGE信号通路、癌症信号通路及人类巨细胞病毒感染等信号通路从而发挥治疗肺纤维化的作用，分子对接结果显示β-谷甾醇、豆甾醇、山奈酚、原阿片碱、白桦脂酸、槲皮素化合物与靶点AKT1、GAPDH、STAT3、MAPK3有较低的结合能，表明以上小分子具有潜在的抑制肺纤维化活性；体外实验表明麦门冬汤可促进MRC-5人胚肺成纤维细胞中AKT1、p-AKT蛋白表达，下调VEGF蛋白。结论 麦门冬汤治疗肺纤维化的作用具有多成分-多靶点-多途径的特点，该研究可为麦门冬汤的现代化研究提供新的研究思路和方向。     

基于患者满意度最大化的医院投诉处理机制研究

新时期市场经济机制下医院面向患者的服务导向面临着新的转变,这就要求在患者投诉处理机制上进行新的变革和探索以患者满意度最大化均衡为目标来进行相关流程的调整优化和重新定义。本文分析了目前医院基于患者满意度最大化目标的投诉处理机制中存在的问题,并结合了相关理论、笔者从业经验以及研究成果提出了旨在提升患者满意度的医院投诉处理机制的建议和对策。     

Nitric Oxide Mechanism of Protection in Ischemia and Reperfusion Injury

In 1992 nitric oxide (NO) was declared molecule of the year by Science magazine, and ever since research on this molecule continues to increase. Following this award, NO was shown to be a mediator/protector of ischemia and reperfusion injury in many organs, such as the heart, liver, lungs, and kidneys. Controversy has existed concerning the actual protective effects of NO. However, literature from the past 15 years seems to reinforce the consensus that NO is indeed protective. Some of the protective actions of NO in ischemia and reperfusion are due to its potential as an antioxidant and anti-inflammatory agent, along with its beneficial effects on cell signaling and inhibition of nuclear proteins, such as NF-κ B and AP-1. New therapeutic potentials for this drug are also continuously emerging. Exogenous NO and endogenous NO may both play protective roles during ischemia and reperfusion injury. Sodium nitroprusside and nitroglycerin have been used clinically with much success; though only recently have they been tested and proven effective in attenuating some of the injuries associated with ischemia and reperfusion. NO inhalation has, in the past, mostly been used for its pulmonary effects, but has also recently been shown to be protective in other organs. The potential of NO in the treatment of ischemic disease is only just being realized. Elucidation of the mechanism by which NO exerts its protective effects needs further investigation. Therefore, this paper will focus on the mechanistic actions of NO in ischemia and reperfusion injury, along with the compound's potential therapeutic benefits.     

Radiation burn—From mechanism to management

Radiation burn can occur with diagnostic or therapeutic use of ionizing radiation. A nonintentional radiation burn is relatively uncommon. Skin has a specific tolerance to radiation, above which different grades of radiation burn can occur. Being a rare and less studied problem, no precise guideline is present for its management. Because of few unresolved issues in the pathophysiology of deep radiation burn, its management is difficult. To date no specific guidelines are present for the treatment of radiation burn.     

Myeloperoxidase Release After Allergen‐Specific Conjunctival Challenge

Background: Allergen‐specific conjunctival challenge is a fruitful and complete tool in evaluating pathophysiological phenomena of allergic inflammation. After challenge, a significant neutrophil infiltrate occurred in allergic subjects. The primary (azurophilic) granules of neutrophils contain a variety of enzymes that might potentiate inflammation, such as myeloperoxidase (MPO). It is not known whether allergen‐specific conjunctival challenge (ASCC) is able to elicit MPO release. We also investigated the possible role of immunotherapy (IT) in the release of MPO. Method: The groups studied included Dactylis glomerata‐sensitive adult atopic patients suffering from seasonal allergic rhinoconjunctivitis, and healthy adult nonatopic volunteer controls. One group of allergic patients received no specific hyposensitization (not‐IT allergic group). A second group of allergic patients had been immunotherapy‐treated with Dactylis glomerata extract for the preceding three years and continued to receive a maintenance dose within the highest potency of the extract (IT‐allergic group). ASCC with Dactylis glomerata was performed outside the pollen season in all subjects. Myeloperoxidase was assayed by MPO‐enzyme immunoassay method. Results: Thirty minutes after challenge, myeloperoxidase levels in the non‐immunotherapy allergic patients were significantly higher compared than in the healthy group (p < 0.001). The levels of myeloperoxidase released in the immunotherapy allergic group were significantly lower than those in the nonimmunotherapy allergic group (p < 0.001) and higher than those in non‐allergic subjects (p < 0.001). Conclusion: These results indicate that after ASCC there is a release of MPO. Our study suggests that immunotherapy actively modifies the release of MPO after ASCC.     

幽门螺杆菌与胃癌发生发展机制的研究

大量研究表明，幽门螺杆菌（HP）感染与胃癌有一定的相关性，是胃癌发生、发展的重要影响因素，近年来随着学者们的深入研究，发现HP对胃癌的作用途径复杂多样，文章主要综述HP对胃癌的作用机制、相关因子及途径等。