目的 探讨Reversine对人肝星状细胞系LX-2凋亡的影响。方法 设对照组和Reversine干预组,其中Reversine干预组分为7个浓度,分别为1,5,10,20,40,80,120 μg/mL,CCK-8法检测Reversine对LX-2增殖的影响,选取最佳浓度。将细胞重悬在加入5 μL FITC-Annexin V和5 μL PI,用流式细胞仪进行了凋亡率分析,免疫荧光检测凋亡蛋白bcl-2及caspase 3。结果 Reversine可促进LX-2细胞凋亡,随着Reversine浓度增加,LX-2的凋亡可呈剂量依赖关系,其中10 μg/mL为最佳浓度,LX-2细胞的bcl-2蛋白的表达显著下降而cleaved-caspase 3的表达显著上升。结论 Reversine可通过促进caspase-3蛋白活化、抑制bcl-2蛋白表达的方式诱导LX-2凋亡。

目的 评价鞘内注射雷帕霉素对CCI神经病理性痛大鼠的痛阈及脊髓背角胶质细胞表达的影响。方法 健康雄性SD大鼠30只随机分为6组:①CCI组:CCI术后14天处死;②正常对照组:不做任何处理; ③前对照剂组:鞘内置管3天后行CCI术,术后4小时后鞘内给同体积生理盐水,连给3天; ④前给药组:鞘内置管3天后行CCI术,术后4小时鞘内给雷帕霉素溶液,连给3天; ⑤后对照剂组:鞘内置管3天后行CCI术,术后7天鞘内给同体积生理盐水,连给3天;⑥后给药组:鞘内置管3天后行CCI术,术后7天鞘内给雷帕霉素溶液,连给3天。各组于CCI术前1天和术后第2、4、6、8、10、12、14天测机械痛阈和热痛阈。术后14天测痛后用多聚甲醛灌注大鼠,取L4~5脊髓,免疫组化染色,星形胶质细胞标记蛋白(GFAP)检测星形胶质细胞表达变化,并定量分析。结果 与对照组相比,CCI手术组热痛阈和机械痛阈从CCI手术后第4天开始下降(P<0.05);前后给药对照剂组与CCI组相比,差别无统计学意义(P>0.05)。前给药组痛阈从CCI手术后第4天开始上升并持续至手术后第14天,与CCI组相比,差别有统计学意义 (P<0.05)。与CCI组相比,后给药组痛阈从CCI第8天开始上升并持续至手术后第14天,差别有统计学意义(P<0.05)。 与正常对照组比较,CCI组、前、后对照剂组手术侧脊髓背角GFAP染色阳性区平均光密度与阳性面积均有增加,差别有统计学意义(P<0.05)。前、后给药组手术侧GFAP染色阳性区平均光密度与阳性面积与CCI组比较,均有明显降低,差别有统计学意义(P<0.05)。结论 鞘内注射雷帕霉素可缓解大鼠神经病理性痛,并抑制脊髓背角胶质细胞的激活。

Objective To evaluate the effects of intrathecal injection of rapamycin on pain threshold and spinal cord gliacyte activation in rats of neuropathic pain. Methods Healthy 30 male SD rats were randomly divided into 6 groups(n=5 in each group): ① control group without operation or intrathecal injection. ②CCI group without intrathecal injection. ③ intrathecal injection of rapamycin 10 μg(10 μL) 4 hours after CCI operation and the next 2 days once a day. ④ intrathecal injection of NS10 μL 4 hours after CCI operation and the next 2 days once a day. ⑤ intrathecal injection of rapamycin 10 μg(10 μL) 7 days after CCI operation and the next 2 days once a day.⑥ intrathecal injection of NS10 μL 7 days after CCI operation and the next 2 days once a day. Mechanical and thermal threshold were tested 1 day before the CCI operation and 2^th、4^th、6^th、8^th、10^th、12^th、14^th days after the CCI operation for all the rats. Lumbar segment of spinal cords was removed for determination of glial fibrillary acidic protein(GEAP) in spinal cord by immuohistochemistry dyeing and assay in the 14th day after CCI operation for all the rats. Results Mechanical and thermal hyperalgesia emerged on 4th day and maintained till 14th day after CCI operation(P<0.05). After intrathecal injection of rapamycin 4 hours or 7days after CCI, mechanical and thermal threshold significantly increased compared to intrathecal injection of NS(P<0.05). And the sum area of GFAP positive and the mean density of GFAP positive area in the dorsal horn of operation side greatly increased in rapamycin treated groups compared NS treated groups(P<0.05). Conclusion Intrathecal injection of rapamycin may attenuate CCI induced hyperalgesia and inhibit the activation of astrocyte.

目的 观察不同剂量卡介苗核酸(Bacille Calmette-guerin DNA , BCG-DNA)在不同干预时间对哮喘小鼠气道高反应性及气道炎症的干预作用。方法 1.将Balb/c雌鼠随机分为哮喘模型组、NS对照组、BCG- DNA干预组。干预组根据干预的时间和干预制剂剂量的不同分为-7DNA1 μg、-7DNA10 μg、-7DNA100 μg、10DNA1 μg、10DNA10 μg、10DNA100 μg、17DNA1 μg、17DNA10 μg、17DNA100 μg组。2.在末次激发48小时后,测定各浓度级乙酰甲胆碱激发下的增强的呼气间歇 (Enhanced Pause, Penh)值,将其与小鼠激发前吸入NS后的Penh的百分比(Penh%NS),作为其气道反应性评价指标;其次对肺泡灌洗液进行细胞学分析。结果 1.气道反应性:①-7DNA1 μg组从Mch为3.12～50 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);②-7DNA10 μg组和-7DNA 100 μg组从Mch为6.25～25 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);③10DNA10 μg组从Mch为12.5～25 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);④10DNA100 μg组从Mch为3.12、12.5～50 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05);⑤17DNA1 μg组在Mch为3.12、12.5 mg/mL的Penh%NS显著低于哮喘组(P<0.05);⑥17DNA10 μg组在Mch为12.5 mg/mL之间的Penh%NS显著低于哮喘组(P<0.05) 2.气道炎症:10DNA1 μg、-7DNA10 μg、10DNA10 μg和17DNA10 μg组的BALF细胞分类Eos%分别为:35.34±3.81、27.30±6.91、38.20±6.56、42.17±5.17;显著低于哮喘组的Eos%(48.8±6.12)(P<0.05);10DNA1 μg组的Eos%显著低于-7DNA1 μg组的Eos%(P<0.05);-7DNA10 μg组的Eos%显著低于10DNA10 μg、17DNA10 μg、-7DNA1 μg和-7DNA100 μg组的Eos%(P<0.05)。结论 BCG-DNA能降低哮喘小鼠的气道高反应性,减轻哮喘小鼠的气道炎症,早期(－7 d)中小剂量的干预效果较佳。

Objective To investigate the effect of Bacille Calmette-Guerin BCG-DNA on airway hyperresponsiveness and airway inflammation in asthmatic mouse model. Methods 1.According to different intervention, mouse were divided into asthma groups, NS control group, BCG-DNA group. According to different time and dosage intervened with asthma model, the BCG-DNA group were subdivided into -7DNA1 μg、-7DNA10 μg、-7DNA100 μg、10DNA1 μg、10DNA10 μg、10DNA100 μg、17DNA1 μg、17DNA10 μg and 17DNA100 μg group. 2.48 hours after the final incitation, the mice were stimulated with increasing concentrations of methacholine, and the airway resistance was measured. Enhance pause (Penh) was taken for each group. Bronchoalveolar lavage cytology was performed to evaluate the airway inflammation. Results 1.Airway hyperresponsiveness: ① Penh%NS of-7DNA1 μg group was significantly lower than the asthma group when Mch was 3.12~50 mg/mL (P<0.05); ② Penh%NS of -7DNA10 μg group and -7DNA100 μg group were significantly lower than the asthma group when Mch was 6.25~50 mg/mL (P<0.05);③ Penh%NS of 10DNA10 μg group was significantly lower than the asthma group when Mch was 12.5~25 mg/mL (P<0.05); ④ Penh%NS of 10DNA100 μg group was significantly lower than the asthma group when Mch was 3.12,12.5~50 mg/mL (P<0.05); ⑤ Penh%NS of 17DNA1 μg group was significantly lower than the asthma group when Mch was 3.12 or 12.5 mg/mL (P<0.05);⑥Penh%NS of 17DNA10 μg group was significantly lower than the asthma group when Mch was 12.5 mg/mL(P<0.05). 2.Airway inflammation: The Eos% of 10DNA1 μg, -7DNA10 μg,10DNA10 μg and 17DNA10 μg group (35.34±3.81、27.30±6.91、38.20±6.56、42.17±5.17) were lower than the asthma group (P<0.05); The Eos% of 10DNA1 μg group was lower than the -7DNA1 μg group (P<0.05); The Eos% of -7DNA10 μg group was lower than the 10DNA10μg, 17DNA10 μg,-7DNA1 μg and -7DNA100 μg group (P<0.05). Conclusion BCG-DNA can inhibit the airway inflammation and hyperresponsiveness in asthmatic mouse model. Early interventions with middle dose bring better results.

目的 分析于剖宫产产妇围手术期实施针对性护理对其切口感染率及不良情绪的影响。方法 选取2015年6月—2016年4月于我院择期行剖宫产术的102例产妇,通过随机数表法分为观察组与对照组,各51例。给予对照组常规护理,在此基础上观察组给予针对性护理干预。对比两组术后恢复情况、护理前后疼痛评分(VAS)、抑郁评分(SDS)及焦虑评分(SAS)变化情况,并统计两组并发症发生率、护理满意度。结果 观察组肛门排气时间、切口愈合时间、24 h睡眠时间、住院时间、下床活动时间均少于对照组,差异有统计学意义(P＜0.05);护理前两组SAS评分、SDS评分、VAS评分间无明显差异(P＞0.05),经护理干预,观察组SAS评分、SDS评分、VAS评分低于对照组,差异有统计学意义(P＜0.05);两组切口感染率、并发症发生率(1.96%、7.84%)低于对照组(15.69%、31.37%),差异有统计学意义(P＜0.05);两组护理满意度对比,观察组(98.04%)高于对照组(82.35%),差异有统计学意义(P＜0.05)。结论 给予剖宫产围术期产妇针对性护理疗效确切,可缓解不良情绪,减轻疼痛感,促使机体功能及早康复,减少切口感染与并发症发生。

目的 探讨吸烟对稳定期COPD患者炎症反应和肺功能的影响。方法 选取2013年8月—2016年9月我院门诊收治的稳定期COPD患者70例为研究对象,其中吸烟35例(X1组)、不吸烟35例(X2组),另选取同期入院的不吸烟健康志愿者35例纳入健康组,采用酶联免疫吸附试验(ELISA)测定血清白介素-6(IL-6)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平,以肺功能检测仪测定三组一秒用力呼气容积(FEV1)、一秒用力呼气容积/用力肺活量比值(FEV1/FVC)、FEV1占预计值百分比(FEV1％),并采用自拟症状评分表及简明健康调查简表(SF-36)评价呼吸困难程度及生活质量。结果 X1组IL-6、IL-8及TNF-α依次为(135.27±1.24)pg/mL、(189.45±1.14)pg/mL、(39.39±1.14)pg/mL,明显高于X2组、健康组(P均<0.05);X1组FEV1(0.75±0.14)L、FEV1/FVC(3.65±1.87)％、FEV1％(3.45±0.12)％低于X2组、健康组(P均<0.05);X1组症状积分(10.17±1.02)分较X2组、健康对照组高(P<0.05),而其SF-36评分(54.27±1.46)分明显低于X2及健康组(P<0.05);X2组上述指标与健康组比较亦有统计学意义(P均<0.05)。结论 吸烟可明显增加稳定期COPD患者IL-6、IL-8、TNF-α等炎症因子水平,同时降低肺功能,临床应采取措施进行有效干预,防止患者病情恶化。

目的 探究曲美他嗪对慢性心力衰竭患者血清炎症因子水平及心功能的影响。方法 选择2015年4月—2016年3月我院收治的慢性心力衰竭患者94例,根据随机数表法分为两组,每组47例。对照组实施阿托伐他汀治疗,观察组在此基础上予以曲美他嗪治疗。比较两组患者治疗6个月后血清炎症因子和脑利钠肽(BNP)、心功能以及临床疗效。结果 观察组血清C-反应蛋白(CRP)、BNP、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P＜0.05);观察组左收缩末期内径(LVESD)、左室舒张末期内径(LVEDd)水平较对照组明显降低,而左室射血分数(LVEF)高于对照组,差异有统计学意义(P＜0.05);观察组患者治疗有效率与对照组相比明显提高,差异有统计学意义(P＜0.05)。结论 对慢性心力衰竭患者实施曲美他嗪治疗,能有效提高患者临床疗效,降低患者血清炎症因子,改善心功能,值得临床推广与应用。

Objective To investigate the effect of Trimetazidine on serum inflammatory factors levels and cardiac function in patients with chronic heart failure (CHF). Methods 94 CHF patients admitted into our hospital from April 2015 to March 2016 were divided into two groups randomly, 47 cases in each. Control group took Atorvastatin, and on this basis observation group was given Trimetazidine. The serum inflammatory factors levels, brain natriuretic peptide (BNP), cardiac function and clinical efficacy of two groups after treatment for 6 months were compared. Results The serum C-reactive protein (CRP), BNP, Tumor necrosis factor-α (TNF-α) levels of observation group were lower than control group (P<0.05); The left ventricular end-systolic diameter (LVESD), Left ventricular end-diastolic diameter (LVEDd) levels of observation group significantly decreased compared with control group, but left ventricular ejection fraction (LVEF) was higher than control group (P<0.05); The curative effective rate of observation group significantly increased compared with control group (P<0.05). Conclusion Trimetazidine for treating CHF patients may effectively increase clinical efficacy, decrease serum inflammatory factors and improve cardiac function, which is worthy of clinical promotion and application.

目的 观察轻性精神疾病患者对不同躯体疾病患者病情的影响,为临床轻性精神疾病合并躯体疾病患者的诊治提供参考。方法 选择我院门诊于2015年3月—2016年3月期间诊治的124例轻性精神疾病合并躯体疾病患者作为研究对象,设为观察组。选择同期诊治的124例不伴有精神疾病的躯体疾病患者设为对照组。两组患者分别根据患者实际情况采用精神疾病和合并躯体疾病临床诊疗指南进行治疗,并按照孙传兴编著的临床疾病诊断依据治愈好转标准(第二版)判断治疗预后。比较两组患者中不同躯体疾病患者的治愈率、好转率、复发率。结果 对照组和观察组患者的年龄、性别、文化背景、躯体疾病类型比较差异无统计学意义(P>0.05)。两组患者经过临床规范治疗后,观察组患者不同躯体疾病治愈率和好转率与对照组相同躯体疾病患者比较,差异无统计学意义(P>0.05),但观察组患者所有类型躯体疾病患者的复发率均明显高于对照组同类躯体疾病患者,组间比较差异有统计学意义(P<0.05)。治疗结束后至随访期间,观察组患者完全遵医率明显低于对照组,组间比较差异有统计学意义(P＜0.05)。结论 轻性精神疾病患者的躯体疾病病情进展和单纯躯体疾病患者之间存在差异,临床医护人员在诊治轻性精神疾病合并躯体疾病患者时,应重视精神疾病对躯体疾病的影响,酌情调整治疗方案,确保患者预后良好。

Objective To observe the effect of mild mental illness on the condition of patients with physical diseases, to provide reference for clinical diagnosis and treatment. Methods We selected 124 cases of patients with mild mental illness combined with physical diseases in our hospital from March 2015 to March 2016 as the research objects, and set up as the observation group. 124 patients with physical diseases but without mental illness were selected as the control group. Based on the actual situation of patients in the two groups, clinical guidelines of mental disorders and physical diseases were adopted to the treatment, and according to the clinical disease diagnosis based on cure and improvement standard edited by Sun Chuanxing (Second Edition), we judged the prognosis conditions. And then the cure rate, improvement rate and recurrence rate were compared between the two groups of patients with physical diseases. Results There were no significant differences in age, sex, culture background, and physical disease types in the control group and the observation group (P>0.05). After the clinical standard treatment, compared with patients with the same physical diseases in the control groups, it had no statistically differences in cure rate and improvement rate of the patients with different physical diseases (P>0.05), but all types of physical disease recurrence rate of patients in the observation group was significantly higher than that of the control group, there was statistically difference between the two groups(P<0.05). After the end of treatment to the follow-up period, the rate of patients' completely following the medical treatment in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P< 0.05). Conclusion There is progressive difference between patients with mild mental illness combined with physical diseases and patients with only physical diseases. When the clinical medical personnel are faced with the diagnosis and treatment of patients with mild mental illness combined with physical diseases, they should pay attention to the impact of mental illness on the physical diseases, and adjust the treatment plan appropriately in order to ensure a good prognosis of patients.

目的 观察分析急性左心衰竭患者应用不同剂量硝酸甘油对血浆中氨基末端B型脑钠肽(NT-proBNP)的影响。方法 选取我院120例急性左心衰竭患者作为研究对象,采用随机数字表法进行分组,其中对照组给予小剂量硝酸甘油,观察组患者采取大剂量硝酸甘油,观察并比较两组患者用药后NT-proBNP的变化情况及临床疗效。结果 经不同剂量药物治疗后,观察组总有效率(96.67%)明显高于对照组(68.33%),差异有统计学意义( χ²=16.681,P＜0.05);用药前,两组患者NT-proBNP水平相近,差异无统计学意义(t=0.384,P＞0.05);用药后6 h、12 h及24 h,观察组患者NT-proBNP指标水平有明显降低,较对照组改善明显,差异有统计学意义(t=17.470、13.988、13.900,P＜0.05)。结论 在常规治疗基础上,应用硝酸甘油微泵注入,采用大剂量硝酸甘油给药治疗急性左心衰竭,可在短时间内降低患者NT-proBNP指标水平,缓解患者症状,临床效果显著。

Objective To observe and analyze the influence and significance of different doses of nitroglycerin on plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute left ventricular failure. Methods One hundred and twenty patients with acute left heart failure were randomly assigned into control group and observation group. Patients in the control group were treated with low dose of nitroglycerin, while patients in the observation group were given high dose of nitroglycerin. NT-proBNP and clinical efficacy in the two groups were observed and compared after treatment. Results After different doses of drug treatment, the overall response rate in the observation group (96.67%) was significantly higher than that in the control group (68.33%), with statistically significant difference (χ²=16.68, P<0.05). Before treatment, NT-proBNP levels were similar, without statistically significant difference (t=0.384, P>0.05). At 6, 12 and 24 hours after treatment, NT-proBNP level was obviously decreased, which was improved than the control group, there were statistically significant differences (t=17.470, 13.988, 13.900, P<0.05). Conclusion Conventional treatment combined high-dose nitroglycerin micro-injection may reduce NT-proBNP indicator levels, relieve symptoms, and have significant clinical effect in patients with acute left heart failure.

目的 运用Sirius系统对准分子术前患者的前房参数以及角膜中央厚度进行检测,探讨上述因素之间的相关性、规律性,以及性别、年龄对其的影响。方法 分组:对210例近视眼患者(420只眼)根据屈光度分为低度近视组,中度近视组、高度近视组。采用Sirius系统对三组检测眼进行角膜中央厚度、中央前房深度、前房容积、颞侧及鼻侧房角宽度进行测量,并采用相关性分析,单因素方差分析对检测数据进行统计学分析。结果 屈光度数绝对值与颞侧房角呈正相关,中央前房深度与前房容积呈正相关、与颞侧及鼻侧房角宽度均呈正相关。颞侧与鼻侧房角宽度亦呈正相关。年龄与中央前房深度呈负相关。不同屈光度度数组别之间颞侧房角宽度存在统计学差异性。男性中央前房深度及颞侧房角宽度明显大于女性。结论 Sirius系统可以作为一种便捷、准确且无创的角膜厚度及前房参数的测量工具。近视眼患者的前房参数与屈光度数、中央角膜厚度、年龄、性别存在一定的相关性性、规律性。

Objective To analyze the correlation and principle of anterior chamber parameter and central cornea thickness, the influence by the sexual and age in the pre-operative patients with excimer laser by using Sirius system. Methods 210 patients (410 eyes)were divided into 3 groups based on refractive status:low myopia,moderate myopia and high myopia.Central cornea thickness(CCT),anterior chamber depth(ACD),anterior chamber volume(ACV),temporal(T) and nasal anterior chamber width(N) were measured by Sirius system. The results are analyzed by correlation and one-way anova of statistics. Results A positive correlation was found in the absolute value of diopter and temporal anterior chamber width, the anterior chamber depth(ACD) and anterior chamber volume(ACV), temporal(T) and nasal anterior chamber width(N), and also in the temporal and nasal anterior chamber width. There was a negative correlation between age and temporal and nasal anterior chamber width. There were significantly statistics differences in the temporal anterior chamber width between different diopter groups. The anterior chamber depth(ACD) and temporal anterior chamber width of males were obvious deeper than females. Conclusion The Sirius system may be used as a convenient, precise and noninvasive technique in cornea thickness and anterior chamber parameter measurement. There is a definite correlation and principle in the anterior chamber parameter and diopter, central cornea thickness, age and sexual.

目的 了解非结核分枝杆菌(nontuberculous mycobacteria,NTM)肺病患者免疫功能低下发生率,以及免疫支持的应用状况、探讨免疫支持治疗对患者2月末痰菌阴转及病变吸收的影响,为临床实施免疫干预提供参考依据。方法 分析广州市胸科医院2014年1月—2015年12月确诊的资料完整的381例NTM肺病患者免疫功能情况以及免疫支持的应用状况,观察组(加用免疫调节剂母牛分枝杆菌菌苗)228例与同期对照组(未使用免疫调节剂)153例进行2月末痰菌阴转及病变吸收情况比较。结果 381例患者中,免疫功能低下的发生率为45.67% (174／381);免疫支持率为59.84% (228／381)。细菌学改变:治疗前所有患者痰抗酸杆菌涂片和培养均为阳性。治疗2个月后两组的阴转率分别为67／228(29.38%)、17／153(11.11%),χ²=17.79,P<0.05。 影像学改变:两组的病变吸收有效率分别为62／228(27.19%)、16／153(10.45%),χ²=15.75,P<0.05;空洞吸收有效率分别为61／228(26.75%)、15／153(9.80%),χ² =20.42,P<0.05。结论 非结核分枝杆菌肺病患者存在较高比例的免疫功能低下风险,观察组的痰茵阴转、病灶吸收和空洞闭合的疗效高于对照组。

Objective To explore the immune status of patients with nontuberculous mycobacterial(NTM) pulmonary disease, and the application of immunotherapy. to evaluate the influence of immunotherapy on sputum negative conversion and lesion absorption at the end of two months. provide reference data for immunotherapy. Methods The immune function and immunotherapy of 381 patients diagnosed as NTM pulmonary disease were retrospectively analyzed from January 2014 to December 2015 in Guangzhou Chest Hospital. Curative group (treated with antitubercular agents and immunomodulator mycobacterium vaccae) were compared with control group(treated with antitubercular agents alone) in sputum negative conversion and lesion absorption at the end of two month treatment. Results Of the 381 cases,45.67%(174／381)of the patients were immunocompromised, 59.84% (228／381)received immunotherapy. Bacteriologic changes: Both sputum smear and sputum culture were positive in all patents before treatment. after two months treatment, negative conversion in two groups were 67／228(29.38%),17／153(11.11%),χ²=17.79,P<0.05. 3. Radiological change: The rate of lesion absorption in curative group and control group were respectively 62／228(27.19%),16／153(10.45%),χ²=15.75,P<0.05;The rate of promoting cavity closure were respectively 61／228(26.75%),15／153(9.80%),χ²=20.42,P<0.05. Conclusion The immune function of NTM pulmonary disease had high ratio of being compromised. Curative group showed a significant effect of sputum negative conversion, lesion absorption and promoting cavity closure compared to the control group. Added to chemotherapy, M. vaccae is helpful in the treatment of nevertreated TB patients in terms of improving both Immunotherapy with M. vaccae had a beneficial influence on sputum negative conversion and X-ray appearances.