冠心病进展相关基因筛选及冠心Ⅱ号方干预靶点的预测

目的:探索冠心病疾病进展相关基因,并预测冠心Ⅱ号方防治冠心病的作用靶点。方法:从基因表达综合数据库(GEO)下载急性心肌梗死(AMI)与稳定型冠心病(SCAD)病人转录组表达谱,通过差异表达分析和加权基因共表达网络分析(WGCNA),筛选冠心病疾病进展相关基因,并针对冠心病进展相关基因进行基因本体(GO)功能分析与京都基因与基因组百科全书(KEGG)通路富集分析。从中药系统药理学数据库与分析平台(TCMSP)数据库下载冠心Ⅱ号方的有效成分及药效靶点,与冠心病疾病进展相关基因进行交集分析,获得冠心Ⅱ号方防治冠心病的潜在靶点。结果:通过差异表达分析比较AMI和SCAD转录组表达谱,共获得166个差异表达基因(DEGs)。通过WGCNA获得与AMI相关的基因模块Black。取DEGs与Black模块的交集,获得64个冠心病疾病进展相关基因。从TCMSP数据库共获得224个冠心Ⅱ号方的药效靶点,将药效靶点与冠心病疾病进展相关基因取交集,得到冠心Ⅱ号方防治冠心病的潜在作用靶点,即过氧化物酶体增殖物激活受体(PPARG)、单核细胞分化抗原CD14(CD14)和细胞色素P4501b1(CYP1B1)...     

基于网络药理学及分子对接探讨润肝养心方治疗心脏神经症的分子机制

目的:基于网络药理学和分子对接方法探讨润肝养心方治疗心脏神经症(CN)的物质基础和作用机制。方法:通过中药系统药理学数据库与分析平台(TCMSP)、有机小分子生物活性数据库(PubChem)、Swiss Target Prediction数据库检索并筛选出润肝养心方(麦冬、酸枣仁、柏子仁、炒白芍、当归、五味子、茯苓、炙甘草)的药物活性成分及作用靶点,利用基因名片数据库(GeneCard)、在线人类孟德尔遗传数据库(OMIM)、DisGeNET数据库筛选CN疾病靶点,将药物和疾病靶点两者取交集后获得的共有靶点导入STRING数据库获得蛋白互作关系,应用Cytoscape 3.8.2软件构建蛋白质相互作用(PPI)网络;采用R语言ClusterProfiler程序包(3.18.0)对关键靶点进行基因本体(GO)和京都基因和基因组百科全书(KEGG)富集分析,并利用Cytoscape 3.8.2构建关键靶点-功能-通路图及关键靶点中药药理调控网络;采用AutoDock Tools 1.5.6进行分子对接研究。结果:润肝养心方筛选得到活性成分146个、作用靶点245个、CN及润肝养心方共有靶点...     

抗血小板活化的文献计量学及可视化分析＊

目的 通过对研究抗血小板活化的相关文献进行计量学及可视化分析，探索中西医抗血小板活化研究的发展状况。方法 全面系统地检索2010年至2021年中国知网（CNKI）和Web of Science 2个数据平台关于抗血小板活化研究的文献，应用文献计量学的研究方法和CiteSpace 5.7.R2软件对国家、机构、作者、关键词等进行分析和可视化展示。结果 共纳入1236篇中文和3914篇英文文献。美国是抗血小板活化相关文献的主要贡献者，其近10年在该领域的发文量高达1500篇，占总文献量的38.32%。Harvard Univ是该研究领域的核心机构，其发文量及中介中心性均居于世界第一。在作者方面，发表英文文章最多的是JOENRONG SHEU，为46篇；发表中文文章最多的是陈章强，为13篇。中英文文献中高频关键词分别有血小板活化、血小板活化因子、冠心病、CD62P、氯吡格雷、platelet、activation、expression、aggregation、mechanism等。通过关键词的共现、聚类、时间线及突现分析发现，近10年该领域的研究热点集中在血小板活化机制、血小板活化指标、抗血小板活化的治疗等方面。结论 本研究借助可视化研究工具，揭示了抗血小板活化研究领域的热点、前沿及发展趋势，以期为临床抗血小板活化药物的研发等相关工作的开展提供预判与参考。     

放射性131Ⅰ治疗分化型甲状腺癌肺转移的疗效及其主要预后因素的系统评价

Objective To assess the effect of radioiodine-131 (131Ⅰ) on treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors. Methods Five databases were retrieved and all published studies which analyzed the effect of 131Ⅰ on pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors were systematically reviewed. The data about the impact of 131Ⅰ treatment and the main prognostic factors on the 5-yr and 10-yr survival rates of the patients were abstracted. RevMan 4.2 software was used to statistically analyze. Results Eleven retrospective cohort studies were included. The pooled results suggested that the 5-yr survival rates of the patients who received 131Ⅰ therapy and who did not received 131Ⅰl therapy were 74.9% and 27.1% , respectively ;The lO-yr survival rates(P<0.01)of the two groups were 60.8% % 12.2% , respectively;The difference between them had statistical significance (P<0.01). The 5-yr and 10-yr survival rates of the patients only with pulmonary metastases were higher than those of the patients with multiple metastases (P<0.01). The 5-yr (P = 0.01) and 10-yr (P = 0. 002)surviv10al rates of the patients only with papillary thyroid carcinoma were higher than those of the patients with follicular thyroid carcinoma. The 5-yr and 10-yr survival rates of male and female patients were similar(P>0.05). Conclusions 131Ⅰ treatment increases the 5-yr and 10-yr survival rates of patients with pulmonary metastases from differentiated thyroid carcinoma. The extent of metastases and the histologie type of differentiated thyroid carcinoma are two main predicting factors of prognosis. The 5-yr and 10-yr survival rates of patients are not influenced by gender.     

放射性131Ⅰ治疗分化型甲状腺癌肺转移的疗效及其主要预后因素的系统评价

Objective To assess the effect of radioiodine-131 (131Ⅰ) on treatment of pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors. Methods Five databases were retrieved and all published studies which analyzed the effect of 131Ⅰ on pulmonary metastases from differentiated thyroid carcinoma and the main prognostic factors were systematically reviewed. The data about the impact of 131Ⅰ treatment and the main prognostic factors on the 5-yr and 10-yr survival rates of the patients were abstracted. RevMan 4.2 software was used to statistically analyze. Results Eleven retrospective cohort studies were included. The pooled results suggested that the 5-yr survival rates of the patients who received 131Ⅰ therapy and who did not received 131Ⅰl therapy were 74.9% and 27.1% , respectively ;The lO-yr survival rates(P<0.01)of the two groups were 60.8% % 12.2% , respectively;The difference between them had statistical significance (P<0.01). The 5-yr and 10-yr survival rates of the patients only with pulmonary metastases were higher than those of the patients with multiple metastases (P<0.01). The 5-yr (P = 0.01) and 10-yr (P = 0. 002)surviv10al rates of the patients only with papillary thyroid carcinoma were higher than those of the patients with follicular thyroid carcinoma. The 5-yr and 10-yr survival rates of male and female patients were similar(P>0.05). Conclusions 131Ⅰ treatment increases the 5-yr and 10-yr survival rates of patients with pulmonary metastases from differentiated thyroid carcinoma. The extent of metastases and the histologie type of differentiated thyroid carcinoma are two main predicting factors of prognosis. The 5-yr and 10-yr survival rates of patients are not influenced by gender.     

军队干休所家庭病房护理模式的建立与体会

目的探索干休所家庭病房护理工作经验,使患者在满足治疗的同时,又能享受家庭的天伦之乐,更好地为全所离休干部健康服务。方法通过具体工作实践,采取边工作、边积累、边总结的方法,最后进行综合整理分析。结果通过实践总结出建立家庭病房护理模式的几点体会:(1)家庭病房为老干部带来方便,是满足老干部治疗需求和保持高质量生活的有效方法,更具人性化;(2)家庭病房的护理模式要求护理操作技术规范化、提高自我保护意识,增强法律观念;(3)重视宣教和加强护理员的培训工作;(4)家庭病房的护理模式有助于提高干休所护理人员的医疗水平,且为干休所的保健工作带来方便。结论家庭病房护理模式的实施,在治病和促进康复的同时,保持了高质量的生活;同时,提高了干休所护理人员的医疗水平。     

胶囊内镜诊断回肠DieuIafoy病1例

病例：患者男,70岁,退休工人,因“1 d内解暗红色血便4次,量约600 g”于2013-11-12急诊入院。入院前1 d无明显诱因解暗红色血便3次,总量约500 g,自服“云南白药”后又解暗红色血便1次,量约100 g,拟“中消化道出血”收治。1个月前曾有类似出血史,急诊入院后胃镜、结肠镜检查均未见出血病灶,予禁食、补液、止血以及口服云南白药治疗,3 d后粪便转黄,离院。既往有高血压、2型糖尿病史20年余,慢性阻塞性肺病史10余年,平时血压、血糖控制不理想。     

氧化低密度脂蛋白损伤血管内皮细胞的机制及雌激素保护作用

<正>血管内皮细胞是血管壁的主要屏障,其功能失调和损伤是动脉粥样硬化的始动环节。氧化低密度脂蛋白(oxidized-low density lipoprotein,ox-LDL)对内皮细胞的损伤是动脉粥样硬化发生和发展的重要因素[1]。内皮细胞作为雌激素的靶点,大量动物和体外实验证明,雌激素对内皮细胞起保护作用[2]。然而,心脏与雌孕激素替代研究和妇女健康行动研究2个多中心临床试验的数据显示,雌孕激素替代治疗增加绝经后妇女冠心病、静脉血栓栓塞及乳腺癌的发生[3]。鉴于雌激素对心血管系统作用的复杂性,人们一方面     

冠心病患者白细胞介素8与白细胞血小板间黏附的相关性研究

目的通过分析冠心病患者血清白细胞介素8(interleukin-8,IL-8)表达量与血小板糖膜蛋白(GP)Ⅱb/Ⅲa活性、白细胞血小板聚集率之间的关系,探讨趋化因子IL-8参与冠心病发病的作用机制。方法选择冠心病患者102例(冠心病组),健康体检者45例(对照组),冠心病组于冠状动脉造影前,空腹抽取静脉血6ml,对照组于清晨空腹抽取静脉血6ml,采用流式细胞术检测白细胞血小板聚集率及GPⅡb/Ⅲa表达水平,应用酶联免疫吸附法检测血清IL-8水平。结果冠心病组IL-8[(65.98±26.44)ng/L vs(41.91±19.67)ng/L]、GPⅡb/Ⅲa[(15.06±7.89)%vs(8.06±2.34)%]、血小板中性粒细胞聚集率和血小板单核细胞聚集率较对照组明显升高,差异有统计学意义(P<0.01)。相关性分析显示,IL-8与血小板中性粒细胞聚集率、血小板单核细胞聚集率和GPⅡb/Ⅲa呈正相关(P<0.05,P<0.01)。结论冠心病患者血清IL-8表达水平与GPⅡb/Ⅲa活性、白细胞血小板聚集率显著相关,可作为潜在的检验指标和治疗靶点进行临床应用推广。