橡皮圈腔内牵拉法在内镜黏膜下剥离术中辅助价值研究

目的　评价橡皮圈腔内牵拉法用于内镜黏膜下剥离术（endoscopic submucosal dissection,ESD） 中的有效性及安全性。方法　纳入2016年1月—2019年12月因直肠内分泌瘤就诊于首都医科大学附属北京友谊医院的49例患者,其中2016年1月—2018年5月行常规ESD的患者32例（非牵拉组）,2018年6月—2019年12月行橡皮圈腔内牵拉ESD的患者17例（牵拉组）,比较2组患者基本信息、ESD手术时间、并发症等指标。结果　牵拉组和非牵拉组在年龄、性别及病变大小方面差异均无统计学意义（P均>0.05）。牵拉组ESD操作时间为（13.76±5.71） min,非牵拉组ESD操作时间为（22.99±10.32） min,两者差异有统计学意义（t=-3.408,P=0.001）。牵拉组未发生术后并发症,非牵拉组有3例出现穿孔,但穿孔发生率差异无统计学意义（P=0.542）。结论　橡皮圈腔内牵拉法辅助ESD,可以安全完成ESD操作并有效提高剥离效率。     

Peripheral axonal injury results in reduced mu opioid receptor pre- and post-synaptic action in the spinal cord

In both the spared nerve injury (SNI) and spinal nerve ligation (SNL) rat peripheral neuropathic pain models the presynaptic inhibitory effect of the mu opioid receptor (MOR) agonist (DAMGO) on primary afferent-evoked excitatory postsynaptic currents (EPSCs) and miniature EPSCs in superficial dorsal horn neurons is substantially reduced, but only in those spinal cord segments innervated by injured primary afferents. The two nerve injury models also reduce the postsynaptic potassium channel opening action of DAMGO on lamina II spinal cord neurons, but again only in segments receiving injured afferent input. The inhibitory action of DAMGO on ERK (extracellular signal-regulated kinase) activation in dorsal horn neurons is also reduced in affected segments following nerve injury. MOR expression decreases substantially in injured dorsal root ganglion neurons (DRG), while intact neighboring DRGs are unaffected. Decreased activation of MOR on injured primary afferent central terminals and the second order neurons they innervate may minimize any reduction by opioids of the spontaneous pain mediated by ectopic input from axotomized small diameter afferents. Retention of MOR expression and activity in nearby non-injured afferents will enable, however, an opioid-mediated reduction of stimulus-evoked and spontaneous pain carried by intact nociceptor afferents and we find that intrathecal DAMGO (1000 ng) reduces mechanical hypersensitivity in rats with SNL. Axotomy-induced changes in MOR may contribute to opioid- insensitive components of neuropathic pain while the absence of these changes in intact afferents may contribute to the opioid sensitive components.     

主动脉内气囊反搏对冠心病泵衰竭的治疗作用

为评价主动脉内气囊反搏（IABP）对冠心病泵衰竭的治疗作用，本文回顾性分析了7例因急性心梗心原性休克及冠心病心脏直视手术低心输出量而应用IABP的病例。结果表明行IABP后30分钟反搏压达65～130mmHg，心脏指数由1．60±0.20L／min／m2上升到2．27±0．20L／min／m2（P＜0．001），平均动脉压由47.0±16.0mmHg上升到85.3±25.4mmHg（P＜0.001），并有相应的临床改善，未见并发症。因此，IABP是治疗冠心病泵衰竭的有效手段。     

INAUGURAL ARTICLE by a Recently Elected Academy Member:Characterization of a 34-kDa soybean binding protein for the syringolide elicitors

Syringolides are water-soluble, low-molecular-weight elicitors that trigger defense responses in soybean cultivars carrying the Rpg4 disease-resistance gene but not in rpg4 cultivars. ¹²⁵I-syringolide 1 previously was shown to bind to a soluble protein(s) in extracts from soybean leaves. A 34-kDa protein that accounted for ¹²⁵I-syringolide 1 binding activity was isolated with a syringolide affinity-gel column. Partial sequences of internal peptides of the 34-kDa protein were identical to P34, a previously described soybean seed allergen. In soybean seeds, P34 is processed from a 46-kDa precursor protein and was shown to have homology with thiol proteases. P34 is a moderately abundant protein in soybean seeds and cotyledons but its level in leaves is low. cDNAs encoding 46-, 34-, and 32-kDa forms of the soybean protein were cloned into the baculovirus vector, pVL1392, and expressed in insect cells. The resulting 32- and 34-kDa proteins, but not the 46-kDa protein, exhibited ligand-specific ¹²⁵I-syringolide binding activity. These results suggest that P34 may be the receptor that mediates syringolide signaling.     

血小板计数与脾面积比值和血小板计数与脾长径比值诊断乙肝肝硬化患者食管静脉曲张的对比研究

目的 比较血小板计数与脾面积比值(PC/SA)和血小板计数与脾长径比值(PC/SD)诊断乙肝肝硬化患者食管静脉曲张(EV)的价值.方法 选取在我院就诊的172例乙肝肝硬化患者,根据胃镜检查结果分为EV组121例和无EV组51例,均行胃镜、血常规及腹部超声检查,采集血小板计数(PC)、脾长径、脾厚径,计算PC/SA和PC...     

艾司西酞普兰治疗首发重症抑郁伴失眠患者的临床试验研究

目的观察艾司西酞普兰对首发重症抑郁伴失眠患者睡眠因子的影响。方法中国地区4家中心开放研究,对伴失眠的首发重症抑郁患者进行询问病史、体格检查、实验室检查、匹兹堡睡眠质量指数量表(PSQI)和汉密尔顿抑郁量表(HAMD)等,符合入选标准并且没有排除因素者进入试验。受试者在开始治疗前1天进行失眠严重指数量表(ISI)、蒙哥马利抑郁量表(MADRS)、广泛性焦虑量表(GAD-7)和临床疗效总评量表(CGI)的评分,并开始记录睡眠日记。同时给予艾司西酞普兰早餐后口服治疗,初始剂量为5~10 mg/d。每天清晨与晚上记录睡眠日记,在下一次访视时返还给研究者。分别在开始治疗第7天、第14天和第30天进行随访,再次完成PSQI、ISI、MADRS、GAD-7和CGI的评分。同时包括不良事件的记录。每次随访后根据患者的疗效调整艾司西酞普兰的剂量,最高剂量为20 mg/d。对人口统计学特征、生命体征以及评分量表等应用SSPS 10.0软件进行ANOVA分析。结果入组患者160例,男性67例,平均年龄(42±12)岁;女性93例,平均年龄(41±12)岁。在4个访视点中体重、血压、心率每两个访视点之间均无统计学差异。在4个访视点中PSQI、ISI、MADRS、GAD-7和CGI的评分逐渐减少,并且每2个访视点之间均有统计学差异。开始药物治疗第7天即有明显的疗效,这种疗效从开始药物治疗的第30天仍然继续强化。艾司西酞普兰的剂量由初始剂量(9.7±1.5)mg,逐渐增加到(14.8±4.0)mg,在(14.8±4.0)mg水平发挥了比较理想的疗效。只有2例患者出现轻微头晕、心慌等不适。结论失眠是抑郁症患者最常见的症状,艾司西酞普兰在治疗伴失眠首发的重症抑郁症状的同时可以很好地改善患者的失眠,效果明显。本研究提示艾司西酞普兰治疗伴失眠首发的重症抑郁症患者的最佳有效剂量为15 mg/d。     

Inhibition of STAT3 signaling and induction of SHP1 mediate antiangiogenic and antitumor activities of ergosterol peroxide in U266 multiple myeloma cells

Background  

Ergosterol peroxide (EP) derived from edible mushroom has been shown to exert anti-tumor activity in several cancer cells. In the present study, anti-angiogenic activity of EP was investigated with the underlying molecular mechanisms in human multiple myeloma U266 cells.     

Yoga Training Improves Metabolic Parameters in Obese Boys

Yoga has been known to have stimulatory or inhibitory effects on the metabolic parameters and to be uncomplicated therapy for obesity. The purpose of the present study was to test the effect of an 8-week of yoga-asana training on body composition, lipid profile, and insulin resistance (IR) in obese adolescent boys. Twenty volunteers with body mass index (BMI) greater than the 95th percentile were randomly assigned to yoga (age 14.7±0.5 years, n=10) and control groups (age 14.6±1.0 years, n=10). The yoga group performed exercises three times per week at 40~60% of heart-rate reserve (HRR) for 8 weeks. IR was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). After yoga training, body weight, BMI, fat mass (FM), and body fat % (BF %) were significantly decreased, and fat-free mass and basal metabolic rate were significantly increased than baseline values. FM and BF % were significantly improved in the yoga group compared with the control group (p<0.05). Total cholesterol (TC) was significantly decreased in the yoga group (p<0.01). HDL-cholesterol was decreased in both groups (p<0.05). No significant changes were observed between or within groups for triglycerides, LDL-cholesterol, glucose, insulin, and HOMA-IR. Our findings show that an 8-week of yoga training improves body composition and TC levels in obese adolescent boys, suggesting that yoga training may be effective in controlling some metabolic syndrome factors in obese adolescent boys.