目的 探讨急性心肌梗死患者入院首次中心粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与院内主要不良心血管事件(MACE)发生的相关性。方法 回顾分析2016年1月—2016年12月入住我院的急性心肌梗死患者179例,分为发生院内不良事件组(n=46)和未发生组(n=133)。采用单因素及多因素Logistics回归分析评估NLR与MACE风险的相关性。结果 179例患者中,46例患者发生院内MACE。发生院内MACE组患者的淋巴细胞计数低于未发生组(P<0.05),NLR高于未发生组(P<0.05),发生院内MACE组患者入院时的心、肾功能较未发生组差(P<0.05)。单因素回归分析显示,NLR水平与院内MACE发病率相关(OR=1.079,95%CI:1.014～1.147, P＜0.05)。多因素logistic回归分析校正性别、年龄、高血压病史、糖尿病史、Killip II级以上、收缩压、入院首次白细胞、eGFR、超敏C反应蛋白、左室射血分数及多支病变后显示,NLR是院内MACE的独立危险因素(OR=1.182,95%CI:1.034～1.352,P＜0.05);此外,超敏C反应蛋白及LVEF<50也是院内MACE的独立危险因素(P＜0.05)。结论 入院首次高NLR与急性心肌梗死患者发生院内MACE相关,是患者发生院内MACE的独立危险因素。

Objective To explore the correlation between first neutrophil/lymphocyte ratio(NLR) and in-hospital major adverse cardiac events (MACE) in patients with in patients with acute myocardial infarction. Methods Total of 179 patients with acute myocardial infarction in Guangzhou First People's Hospital from Jan 2016 to Dec 2016 were enrolled. MACE was defined as malignant arrhythmia, recurrence of myocardial infarction, target vascular reconstruction, acute left heart failure, stroke, cardiac shock and death.Baseline data and in-hospital clinical adverse events were compared among two groups. All patients were divided into two groups:MACE(+) group and MACE(-) group. Univariate and multivariate logistic regression was used to assess the correlation between NLR and in-hospital MACE. Results In-hospital MACE occurred in 46(25.7%)patients. Univariate logistic analysis showed that NLR was strongly related with MACE incidence(OR=1.079,95%CI:1.014～1.147, P＜0.05). Multivariate logistic regression analysis found that after adjusting other traditional risk factors including female gender, age, hypertension,diabetes, overKillip II grade, systolic blood pressure,first white blood cells after admitted,basic renal dysfunction,Hs-CRP,LVEF and multivessel lesions. NLR was still a significant independent predictor of in-hospital MACE in patients with acute myocardial infarction. Additionally, hs-CRP and LVEF<50% were also associated with in-hospital MACE(P＜0.05). Conclusion NLR is the independent risk factor for in-hospital MACE occurrence in acute myocardial infarction at the early admission.

目的 探索蟾毒灵对舌鳞状细胞癌Tca8113细胞增殖、凋亡的影响及可能作用机制。方法 以人舌鳞癌Tca8113细胞为研究对象,MTT法检测10、20、40、80、160 nmol/L浓度蟾毒灵体外抑制Tca8113细胞增殖的活性;检测蟾毒灵干预下肿瘤细胞Na⁺-K⁺-ATP酶活性的变化;Western blot发检测Bcl-2、Bax、caspase-3蛋白表达。结果 蟾毒灵有抑制Tca8113细胞的活性,且呈剂量-时间依赖性;在蟾毒灵干预下Tca8113细胞Na⁺-K⁺-ATP酶收到抑制;Western blot结果显示凋亡相关Bax、caspase-3蛋白表达上调,Bcl-2蛋白表达下调。结论 蟾毒灵通过抑制细胞膜Na⁺-K⁺-ATP酶活性,通过调节Bcl-2凋亡通路的相关蛋白,最终激活caspase-3,诱导人舌鳞癌Tca8113细胞凋亡。

Objective To explore the effects of bufalin on proliferation and apoptosis of tongue squamous cell carcinoma Tca8113 cells and its possible mechanism. Methods Tca8113 cells were treated with 10, 20, 40, 80 and 160 nmol/L Tca8113 cells in vitro. MTT assay was used to detect the inhibitory effect of bufalin on the proliferation of Tca8113 cells; And the activity of Na⁺-K⁺-ATPase in tumor cells was detected by the interference of bufalin; The expression of Bcl-2, Bax and caspase-3 protein was detected by Western blot. Results Bufalin inhibited the activity of Tca8113 cells in a dose-and time-dependent manner; Na⁺-K⁺-ATPase in Tca8113 cells was inhibited by bufalin; The results of Western blot showed that the expression of Bax and caspase-3 protein was up-regulated and the expression of Bcl-2 protein was down-regulated. Conclusion Bufalin induced the apoptosis of human tongue squamous cell carcinoma Tca8113 cells by inhibiting the activity of Na⁺-K⁺-ATPase and regulating the related proteins of Bcl-2 apoptosis pathway, finally activating caspase-3.

目的 研究孟鲁斯特治疗哮喘的临床疗效及其对患者Th1/Th2细胞免疫平衡和相关炎症因子水平的影响。方法 选取哮喘患者68例随机分为对照组31例及观察组37例,对照组予以常规糖皮质激素吸入治疗,观察组在此基础上加服孟鲁斯特。用药3个月后流式细胞仪检测两组患者外周血Th1、Th2数量变化,ELISA定量外周血IL-4及IFN-γ含量变化并作临床效果评定。结果 两组患者经治疗后,外周血Th1/Th2比例均升高,IL-4/IFN-γ细胞因子水平下降,但观察组较对照组变化更为明显,差异有统计学意义(P＜0.01)。疗效方面,观察组总有效率94.59%,高于对照组的74.19%,差异具有统计学意义(P＜0.01),同时两组均未见明显不良反应。结论 哮喘患者加用孟鲁斯特具有明显免疫调节功能,使Th1/Th2水平趋于平衡,作为哮喘辅助治疗药物疗效确切。

目的 构建吉西他滨耐药乳腺癌细胞4T1耐药株并建立裸鼠乳腺癌肝转移模型。方法 采用低浓度加量持续诱导法,诱导吉西他滨耐药乳腺癌细胞4T1耐药株,命名为4T1/Gem;CCK-8法测定4T1与4T1/Gem细胞的增殖抑制率,计算耐药指数; Western blot法检测细胞P-gp蛋白表达;B超引导下注射4T1/Gem细胞悬液诱导裸鼠肝脏成瘤;HE染色观察肿瘤组织病理情况,免疫组化法检测瘤组织ER、PR、HER2、Ki-67和P-gp蛋白的表达。结果 经过14个月的诱导成功建立4T1/Gem细胞株,可在含40 μg/mL的Gem培养液中稳定生长。4T1/Gem细胞耐药指数为4T1细胞的788.547倍。与亲代相比,4T1/Gem处于G1期和G2期的细胞增加,S期细胞减少;上调P-gp蛋白的表达。4T1/Gem细胞成功建立裸鼠乳腺癌肝转移模型,瘤组织中ER、PR、HER2蛋白阴性表达,Ki-67阳性10％和P-gp蛋白阳性表达。结论 成功构建吉西他滨耐药乳腺癌细胞4T1耐药株并建立裸鼠乳腺癌肝转移模型,为开发治疗乳腺癌肝转移化疗耐药的药物提供实验基础。

Objective To construct a gemcitabine-resistant variant of the breast cancer cell line (4T1/Gem) and establish a nude mouse model of breast cancer with hepatic metastatic. Methods A gemcitabine-resistant variant of the breast cancer 4T1 cell line was induced by gradually increasing the concentration of gemcitabine; this variant is referred to in this study as 4T1/Gem. The proliferation suppression rates of 4T1 and 4T1/Gem cells were determined by using the CCK-8 essay to evaluate the drug resistance indices of the cell lines. Western blot analysis was used to detect P-gp protein expression. Under ultrasonography, a 4T1/Gem cell suspension was injected into nude mice to induce liver tumors. H&E staining was used to observe tumor pathology, and immunohistochemistry was used to detect the expression of ER, PR, HER-2, Ki-67, and P-gp. Results After 14 months of induction, a 4T1/Gem cell line is established successfully. The cell line can grow stably in culture liquid containing 40 μg/ml gemcitabine. The drug resistance index of 4T1/Gem is 788.547. Compared with the 4T1 cell line, the 4T1/Gem cell line can upregulate P-gp protein expression and successfully establish a nude mouse model of breast cancer with hepatic metastatic. ER, PR, and HER-2 proteins exhibit negative expression in the tumor tissue. The positive expression of P-gp and 10% of Ki-67 proteins is also observed. Conclusion This study successfully constructs a gemcitabine-resistant variant of the breast cancer cell line (4T1/Gem)and establishes a nude mouse model of breast cancer with hepatic metastatic, thereby providing an experimental basis for developing and treating a drug-resistant variant of breast cancer.

目的 评估SCORTEN评分与我国SJS/TEN患者疾病严重程度的一致性,比较单用糖皮质激素(TCS)和糖皮质激素—丙种球蛋白冲击(TCS-IVIG)联合治疗SJS/TEN的临床效果。方法 收集我院2005年6月—2015年5月住院的SJS/TEN患者,计算每例患者的SCORTEN评分,采用Hosmer-Lemeshow检验评估SCORTEN模型的预期死亡率和实际死亡率的拟合度;比较单用TCS和TCS-IVIG联合治疗的患者在疾病严重程度、住院天数、疾病控制时间和死亡率方面的差异。结果 SCORTEN模型的预期死亡率和实际死亡率之间的拟合度良好(各组P值均大于0.5);二组患者在住院天数、疾病控制时间和死亡率方面的差异没有统计学意义(P分别为0.105,0.910,0.701),但TCS-IVIG组患者的疾病严重程度显著高于TCS组(P=0.017)。结论 SCORTEN评分可以用于评估国内SJS/TEN患者的病情严重程度,并预测患者预后;与单用TCS相比,联合IVIG有助于提高重症SJS/TEN患者的救治效果。

Objectivs To evaluate the performance of SCORTEN in severity of SJS/TEN in China, and to compare the efficacy of corticosteroid therapy (TCS) and intravenous immunoglobulin combined therapy (TCS-IVIG). Methods Collected retrospectively the data of the SJS/TEN patients from June 2005 to May 2015 in our hospital. Hosmer-Lemeshow statistic were used to assess SCORTEN model calibration. And the differences between TCS group and TCS-IVIG group were compared in severity-of-illness, length of hospitalization, disease control time and mortality. Results A good calibration were found in all groups (all P＞0.5). Although the severity-of-illness in the TCS-IVIG group was significantly higher than that in the TCS group (P=0.017), there was no statistical significance between the two groups in length of hospitalization, disease control time and mortality (P=0.105, 0.910, 0.701, respectively). Conclusion SCORTEN can be used to assess the severity-of-illness in Chinese patients with SJS/TEN and to predict the prognosis. Compared with single TCS, It could improve the clinical outcomes of patients with severe SJS/TEN combined with IVIG.

目的 观察养血祛瘀方联合血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)类药物对糖尿病肾病不同分期的疗效。方法 134例糖尿病肾病患者采用随机区组设计方案,以初诊时间(月份)作为配伍因素,随机分为治疗组67例和对照组67例,两组均采用常规西医综合基础治疗,对照组给予ACEI或ARB类药物治疗,治疗组在对照组治疗的基础上联用养血祛瘀方治疗,观察60 d,分析两组治疗前后24h尿微量白蛋白、24 h尿蛋白定量、血清C反应蛋白(hs-CRP)的变化。结果 对于糖尿病肾病Ⅲ期患者,治疗组较对照组尿蛋白减少,但差异无统计学意义(P＞0.05),治疗组较对照组hs-CRP水平明显下降(P＜0.05);对于糖尿病肾病Ⅳ期患者,治疗组较对照组尿蛋白减少(P＜0.05),治疗组较对照组hs-CRP水平下降(P＜0.05)。结论 养血祛瘀方联合ACEI或ARB类药物可有效减少糖尿病肾病Ⅳ期患者蛋白尿,降低糖尿病肾病患者hs-CRP水平。

Objective To investigate the efficacy of Yang Xue Qu Yu Fang combined with ARB/ACEI on different stages of diabetic nephropathy. Mehtods 134 patients who suffered from diabetic nephropathy were randomly divided into observation group and control group, each of them had 67 cases. The experiment use randomized block design and choose the time (months) of initial diagnosis as the compatibility factors. Both groups were treated by conventional therapy. The control group was given medicine of ARB/ACEI while the observation group was added Yang Xue Qu Yu Fang on the basis of control group. We observed all the patients for 60 days, to compare the microalbuminuria in urine of 24h, the urinary protein of 24h and the serum high sensitive C-reaction protein (Hs-CRP) between two groups before and after treatment. Results For patients of the 3rd stage of diabetic nephropathy, the albuminuria in observation group decreased obviously, but there was no significant difference between two groups (P>0.05), the serum Hs-CRP in observation group decreased obviously (P<0.05). For patients of the 4rd stage of diabetic nephropathy, the albuminuria in observation group decreased obviously (P<0.05), the serum Hs-CRP in observation group decreased obviously (P<0.05). Conclusion The Yang Xue Qu Yu Fang combined with ARB/ACEI can effectively reduce the albuminuria and can obviously lower the Hs-CRP level in the patients of the 4rd stage of diabetic nephropathy.

目的 体外构建胶原—壳聚糖复合支架材料,分析其物理化学性质及生物相容性,探讨其应用于组织工程支架材料的可行性。方法 利用冷冻干燥的方法构建三维多孔的胶原支架材料,通过甲醛交联以及添加壳聚糖的方法改善其物理化学性能。通过体外降解实验以及电镜扫描的方法检测材料的各项物理化学指标;通过细胞接种的方法研究材料的生物相容性。结果 胶原—壳聚糖复合材料通过冷冻干燥的方法,能够获得稳定的三维多孔结构,电镜显示孔隙贯通,体外降解速度降低,并且能够支持细胞生长。理化性质分析显示该结构适合细胞生长,具有良好的生物相容性。结论 本课题体外构建胶原—壳聚糖复合支架材料,满足组织工程生物材料的理化以及生物相容性要求,为其应用于组织工程支架材料提供重要的依据。

Objective We build up the Collagen-Chitosan compound scaffold in vitro,and study the physical,chemical and biological properties,to analyze the feasibility in tissue engineering. Methods The three-dimensional porous scaffold was obtained by freezing-drying method,and optimized by using formaldehyde and Chitosan.We used hydrolysis in vitro and SEM scanning to investigate its physical and chemical properties.The biocompatibility of scaffold was analyzed in MEF cells. Results Collagen-Chitosan compound scaffold we obtained by freezing-drying method was a kind of stable 3D vesicular structure.The scaffold degenerated in decreased velocity in vitro.The physical and chemical properties showed that it was suitable for the cells grow in it,which suggested that it has a good biocompatibility. Conclusion This kind of Collagen-Chitosan compound scaffold is constructed.It's qualified by the physical and chemical properties,and biocompatibility which the biomaterials require.The evidence are important for its application in tissue engineering.

目的 观察葛根素对新西兰白兔视网膜缺血/再灌注损伤组织中细胞凋亡的保护作用。方法 新西兰白兔30只随机分为缺血再灌注对照组和葛根素治疗实验组,各组右眼应用前房灌注加压法建立视网膜缺血再灌注模型,分别于再灌注后第12、24、72 h处死动物,摘除眼球,制作石蜡切片,用TUNEL法检测细胞凋亡,计算凋亡指数。结果 对照组缺血再灌注12 h在神经节细胞层和内核层可见凋亡细胞;24 h神经节细胞层细胞数有所减少,视网膜神经节细胞层、内核层及外核层均见凋亡细胞明显增多;72 h神经节细胞层细胞数明显减少,神经节细胞层、内核层及外核层仍见凋亡细胞,但较24 h有所减少。葛根素治疗视网膜的凋亡细胞在各个时间段的表达规律与对照组相似,但凋亡细胞计数在12 h,24 h,72 h均较对照组明显减少,两组间差异有统计学意义。结论 葛根素能减轻缺血-再灌注损伤的视网膜细胞凋亡,对视网膜有保护作用。

Objective To observe the protective effects of Puerarin on apoptosis of ischemic injury in rabbit retina. Methods Retinal ischemia was induced in rabbits by increasing intraocular pressure to 120 mmHg for 60 minutes. TdT-mediated biotin-dUTP nick end labelling(TUNEL) staining technique was used to examine the apoptosis of retinal ganglion cells in the control group and the puerarin treatment group. Results The number of apoptotic cells in 12, 24 and 72h after reperfusion in the puerarin treatment group was obvious lower than that in the control group(P<0.05). Conclusion Puerarin has protective effects in protecting against apoptosis in ischemia reperfusion injury of rabbit retina.

目的 探讨心肌细胞RyR2和L型钙通道的基因变异与室性心律失常和心源性猝死的相关性。方法 回顾分析2010年1月—2012年12月在我院就诊的慢性心力衰竭患者622例的临床资料,并选取同一时期体检中心体检的健康人群516例作为对照组,门诊或者电话随访记录慢性心力衰竭患者的死亡为终点,通过候选基因分析可能具有相关功能的4个基因变异,rs41315858(G1885E)、rs3766871(G1886S)、rs790896(G>A)和rs723672(T>C),采用Logestic、Cox回归分析对4个候选基因变异进行相关性研究。结果 入选622例慢性心力衰竭患者和516例对照组,基因分析结果显示RyR2上的基因变异rs376687lA等位基因携带可以增加慢性心力衰竭患者发生室性心律失常的风险性;校正可能与该疾病相关的危险因素后,rs376687lA等位基因携带会增加心源性死亡和心源性猝死的风险,RyR2上的基因变异rs790896A等位基因携带可以降低心源性猝死风险。结论 RyR2上的基因变异rs376687lA是室性心律失常和心源性猝死的遗传学预测因子,而rs790896A等位基因是慢性心力衰竭患者的保护因子,可降低室性心律失常和心源性猝死的风险。

Objective To investigate the myocardial cells RyR2 and L-type calcium channel gene variants with ventricular arrhythmias and sudden cardiac death correlation. Methods Retrospective analysis of patients with chronic heart failure from January 2010 to December 2012 in our hospital including 622 cases of clinical data, and to select 516 cases of healthy people in medical examination center during the same period as a control group.Clinic or telephone follow-up recorded chronic patients with heart failure and sudden death acting as end. We analyzed possible candidate genes, according to four gene variants related functions, rs41315858 (G1885E), rs3766871 (G1886S), rs790896 (G> A) and rs723672 (T> C), by using Logestic, Cox regression analysis of four candidate gene variants for related research. Results 622 cases of chronic heart failure patients were enrolled and 516 patients in the control group. Genetic analysis showed that the gene variant alleles carried rs376687lA RyR2 may increase in patients with chronic heart failure ventricular arrhythmia risk; correction may be associated with the disease after risk factors, rs376687lA allele carries an increased risk of cardiogenic death and sudden cardiac death, and gene mutation alleles carried on rs790896A RyR2 can reduce the risk of sudden cardiac death. Conclusion Gene mutation rs376687lA RyR2 on genetics is predictor of ventricular arrhythmias and sudden cardiac death, and rs790896A allele is protective factor in patients with chronic heart failure which can be reduced ventricular arrhythmias and sudden cardiac death in risk.

目的 探讨黄芪枳术汤结合肠内营养的对颅脑术后患者ALB/PA/TP的影响。方法 将60例颅脑术后患者随机分为观察组(n=30)和对照组(n=30)。观察组给予中药黄芪枳术汤和整蛋白肠内营养液,对照组仅给予整蛋白肠内营养液。通过观察两组病人营养支持前后各项营养指标的变化和胃肠道的并发症,对两种治疗方式的疗效进行比较。结果 观察组病人营养支持后第7,14 天各项营养指标总蛋白(TP),白蛋白(ALB),前白蛋白(PA),血红蛋白(HGb)水平均高于对照组,差异有意义(P均＜0.05),观察组的胃肠道症状的发生率较对照组少。结论 黄芪枳术汤能加强肠内营养疗效,促进胃肠功能恢复及减少术后并发症,黄芪枳术汤结合肠内营养能增加颅脑术后患者的摄入量,提高血清蛋白水平,改善机体的营养状况,促进患者的早日康复。