论著

12例原发性肺淋巴上皮瘤样癌的临床病理分析

Clinicopathologic analysis of 12 cases with primary lymphoepithelioma-like carcinoma of the lung

:9-10
 
目的 分析总结12例原发性肺淋巴上皮瘤样癌(LELC)的临床病理特点。方法 回顾性分析12例肺LELC患者的临床病理资料。结果 12例肺LELC患者的组织学标本中,肿瘤细胞均明显表达HCK,原位杂交EBER阳性率为91.7%。全组中位生存期61.3个月,2年和5年生存率分别为84.6%和57.7%。结论 原发性肺LELC临床罕见,发病可能与EB病毒感染有关,经及时治疗有较好的预后。
Objective To investigate the pathological and clinical significance of 12 cases with primary Lymphoepithelioma-like carcinoma of the lung (LELC). Methods Retrospectively detectded and analyzed the clincalpathological feature of 12 cases of LELC of the lung. Results Histological study showed that tumor cells were significantly expressed HCK by immunohistochemistry staining and showed out 91.7% positive rate of EBER by situ hybridization. In this series, the median survival time was 61.3 months. The overall 2 and 5 year survival rates of the 12 cases were 84.6% and 57.7%. Conclusion Pulmonary LELC is very rare. It may be associated with Epstein-Barr virus infection, and has a batter prognosis after therapy.
临床诊疗

DPP-4抑制剂联合二甲双胍治疗2型糖尿病的临床疗效观察

Clinical Observation of DPP-4 Inhibitor Combined Melbine in Treatment of Type 2 Diabetic

:65-66
 
目的 探讨DPP-4抑制剂联合二甲双胍治疗2型糖尿病的临床疗效及安全性。方法 选取医院近3年收治的糖尿病病人70例,随机分为对照组(35例)和治疗组(35例),对照组给予二甲双胍治疗,治疗组给予二甲双胍联合DPP-4抑制剂控制血糖,经3个月治疗,比较治疗后血糖指标、胰岛功能指标及低血糖、不良反应情况。结果 对照组和治疗组治疗后FPG、2hPG、HbA1c水平均有降低,治疗组治疗后血糖检测指标优于对照组(P>0.05)。胰岛功能监测显示治疗组治疗后空腹胰岛素、服糖后2小时胰岛素浓度升高优于对照组,胰高血糖素水平降低幅度大于对照组,治疗前后胰岛素及胰高血糖素均有变化,组间比较P>0.05,有临床意义。治疗期间两组患者均未发生低血糖、药物不良反应。结论 DPP-4抑制剂联合二甲双胍可显著提高降糖效果,改善胰岛功能,并且无低血糖、药物不良反应发生。
论著

CO2激光在宫颈上皮内瘤变Ⅱ级中的疗效

Efficacy of CO2 laser in the treatment of cervical intraepithelial lesions

:1288-1295
 
目的 评估CO2激光治疗宫颈上皮内瘤变Ⅱ级(CIN2)病例的疗效。方法 收集2021年11月至2023年10月在本院行CO2激光治疗的92例CIN2患者的临床资料, 采用液基细胞学检查(LCT)和人乳头状瘤病毒(HPV)联合筛查随访,随访6~12个月, 任一结果异常者转诊阴道镜检查, 必要时行病理活组织检查(活检)观察鳞状上皮内病变情况。结果 92例CIN2患者中, 年龄25~45岁、有人工流产史、性伴侣人数3个及以上、因发现宫颈病变就诊者占比较多,患者均未生育。所有患者就诊时均发现HPV阳性, 20.65%患者报告HPV16阳性, HPV18阳性者占比1.09%, HPV其他12种阳性占60.87%, HPV16阳性伴其他12种阳性占17.39%。79例患者随访6个月后总HPV+LCT均阴率为74.68%(59/79),LCT和HPV阴转率分别为92.41%(73/79)和74.68%(59/79)。所有患者术后12个月LCT均转阴。29例患者在术后12个月均无病变持续或病变发展。25岁以下患者术后6个月及12个月HPV持续率最低, 45~55岁患者术后HPV持续率最高,且多发生HPV16阳性及合并其他HPV亚型阳性的情况。结论 CO2激光治疗可提高患者术后HPV与LCT阴转率, 所有患者术后6个月及12个月随访均无病变加重,且可明显改善年轻患者HPV感染情况。对于有生育要求且具备适应证的CIN2患者, 应积极采取CO2激光治疗以获得更高健康收益。
Objective To evaluate the therapeutic efficacy of CO2 laser treatment in cervical intraepithelial neoplasia grade 2(CIN2)patients. Methods We retrospectively analyzed data from 92 CIN2 patients who underwent CO2 laser therapy at the institution from November 2021 to October 2023. Postoperative followed-up for 6-12 months, screening with liquid-based cytopathology test(LCT)and high-risk human papilloma virus(HPV)testing. Patients with abnormal results in either test were referred for colposcopy, with biopsy performed to evaluate residual or recurrent squamous intraepithelial lesions. Results Among total of 92 patients, most patients aged 25-45 years old, with a history of induced abortion, had three or more sexual partners, and visited hospital due to cervical lesions, and none of the patients gave birth. All patients were found to be HPV positive at hospital visits, with 20. 65% of HPV16 positive, 1. 09% of HPV18 positive, 60. 87% of other 12 kinds HPV positive, while HPV16 positive with other 12 kinds accounted for 17. 39%. Among the 79 patients after 6-month follow-up, the dual-negative conversion rate(HPV+LCT)was 74. 68%(59/79), with LCT and HPV negative rates reaching 92. 41%(73/79)and 74. 68%(59/79), respectively. After 12-month follow-up, all patients achieved LCT negativity, 29 patients with no documented lesion persistence or disease progression. Notably, patients aged <25 years exhibited the lowest postoperative HPV persistence rates between 6- to 12-month follow-up, whereas those aged 45-55 years demonstrated the highest persistence rates, frequently associated with HPV16 positivity or co-infection with other HPV subtypes. Conclusions CO2 laser therapy significantly increases postoperative negative conversion rates for HPV and LCT. No lesion progression was observed in patients between 6- to 12-month follow-ups. The therapy also notably improves HPV clearance in younger patients. For patients with CIN2 who have fertility requirements and meet the indications, CO2 laser therapy should be actively adopted to achieve greater health benefits.
论著

抗增殖蛋白2对脓毒症心肌损伤线粒体功能稳态的作用机制研究

Research on the mechanism of prohibitin 2 on mitochondrial functional homeostasis in sepsis-induced myocardial injury

:1201-1207
 
目的 探讨抗增殖蛋白2(PHB2)脓毒症心肌损伤线粒体功能的调控机制。方法 体外培养大鼠心肌细胞株(H9C2),分为对照组、脂多糖(LPS)组、LPS+PHB2 siRNA(si-PHB2)组。检测氧化应激指标细胞内丙二醛(MDA)水平、荧光探针检测细胞内活性氧(ROS)水平;线粒体指标:三磷酸腺苷(ATP)水平、线粒体膜电位、线粒体电镜、线粒体半定量评分;免疫印迹法检测PHB2、PTEN诱导激酶1(PTNKI)、帕金蛋白(Parkin)、线粒体转录因子(TFAM)的表达。结果 LPS刺激后MDA水平和ROS水平升高、ATP水平低,LPS+si-PHB2组MDA(6.21±0.39 vs 3.59±0.33, P<0.05)、细胞内的ROS(15 131.37±88.72 vs 8 628.67±71.95, P<0.05)的水平较LPS组升高,ATP(3.46±0.34 vs 4.52±0.25, P<0.05)和线粒体膜电位水平(0.33±0.04 vs 0.55±0.09, P<0.05)进一步降低;电镜观察显示与正常组相比,LPS组、LPS+si-PHB2组出现不同程度线粒体损伤,线粒体损伤半定量评分显示LPS+si-PHB2组的损伤较LPS组更为明显(1.42±0.10 vs 0.81±0.04, P<0.05); 免疫印迹法结果显示LPS处理后PHB2、PINK1、Parkin 表达上调,TFAM表达下调,LPS+si-PHB2组的线粒体自噬相关蛋白PINK1(1.33±0.06 vs 1.79±0.21, P<0.05)、Parkin(1.43±0.08 vs 1.86±0.09, P<0.05)和线粒体生物发生关键蛋白TFAM(0.29±0.01 vs 0.74±0.06, P<0.05)表达均较LPS组降低。结论 LPS可促进大鼠心肌细胞PHB2表达,si-PHB2干扰后线粒体自噬蛋白和生物发生蛋白表达抑制,心肌细胞氧化应激损害和线粒体功能障碍加重,提示PHB2表达上调可能恢复线粒体稳态改善脓毒症心肌损伤的线粒体功能。
Objective To explore the regulatory mechanism of septic myocardial injury by prohibitin 2(PHB2). Methods Rat myocardial cell lines(H9C2)were cultured in vitro and divided into control group,LPS group,LPS + PHB2 siRNA(si-PHB2) group. The indicators for detecting oxidative stress include the levels of intracellular malondialdehyde(MDA)and reactive oxygen species(ROS). The indicators for mitochondrial detection include adenosine triphosphate(ATP)levels,mitochondrial membrane potential,mitochondrial electron microscopy,and semi-quantitative mitochondrial scoring. Western blotting was used to detect the expression of PHB2,PTEN induced putative kinase(PINK1),Parkin,mitochondrial transcription factor A(TFAM). Results After LPS stimulation,MDA level and intracellular ROS level increased,ATP level decreased. Compared with LPS group,MDA(6. 21±0. 39 vs 3. 59±0. 33, P<0. 05)level and intracellular ROS level(15 131. 37±88. 72 vs 8 628. 67±71. 95, P<0. 05)in LPS + si-PHB2 group increased significantly,while ATP(3. 46±0. 34 vs 4. 52±0. 25, P<0. 05)and MMP(0. 33±0. 04 vs 0. 55±0. 09, P<0. 05)level further decreased. Compared with the normal group,the structure of mitochondria in LPS group and LPS + si-PHB2 group was damaged in different degree. The semi-quantitative score of mitochondrial damage showed that the damage in LPS + si-PHB2 group was more obvious than that in LPS group(1. 42±0. 10 vs 0. 81±0. 04, P<0. 05). Western blotting showed that the expression of PHB2,PINK1 and Parkin were up-regulated and the expression of TFAM was down-regulated after LPS treatment,mitohagy-related proteins PINK1(1. 33±0. 06 vs 1. 79±0. 21, P<0. 05),Parkin(1. 43±0. 08 vs 1. 86±0. 09, P<0. 05)and mitochondrial biogenetic protein TFAM(0. 29±0. 01 vs 0. 74±0. 06, P<0. 05)in LPS+si-PHB2 group were lower than those in LPS group. Conclusions LPS can promote the expression of PHB2 in rat cardiomyocytes. After interfering with PHB2 expression,we found that mitochondrial autophagy and biogenesis are inhibited,and mitochondrial dysfunction,oxidative stress exacerbated,suggesting that the up-regulation of PHB2 expression may restore mitochondrial homeostasis and improve mitochondrial function in septic myocardial injury.
论著

长病程 2 型糖尿病患者胰岛 β 细胞功能与 BMI 的相关性研究

Correlation between islet β cell function and BMI in patients with long course type 2 diabetes

:1094-1102
 
       目的   探讨长病程2型糖尿病(T2DM)患者体质指数(BMI)与胰岛β细胞功能间的相关关系。法    选取2023年12月—2024年3月于承德市中心医院内分泌风湿免疫科住院的260例长病程(病程≥10年)T2DM患者作为研究对象,依据BMI将其分成正常组、超重组和肥胖组,比较三组间一般资料、检验学指标及检查的差异,分析胰岛β细胞功能与各指标间的相关性。结果   三组研究对象在空腹静脉血糖(FPG)、空腹C肽(FCP)、胰岛素抵抗指数(HOMA-IR)、尿酸(UA)、甘油三酯(TG)等上差异有统计学意义(P<0.05),在胰岛β细胞功能指数(HOMA-β)比较差异无统计学意义(P>0.05);肥胖组的FPG、FCP、HOMA-IR、UA、TG均高于正常组(P<0.05),超重组的UA、TG均高于正常组(P<0.05),肥胖组的FPG、HOMA-IR、UA高于超重组(P<0.05),Spearman相关分析结果显示HOMA-β与体质量指数(BMI)无相关性(r=0.046,P=0.461),HOMA-β与UA(r=0.226,P<0.001)、TG(r=0.148,P=0.017)呈正相关,HOMA-IR与BMI(r=0.279,P<0.001)与、UA相关(r=0.284,P<0.001)及TG(r=0.349,P<0.001)呈正相关,多元线性回归分析显示UA是HOMA-β的影响因素(P<0.05),BMI、UA、TG是HOMA-IR的影响因素(P<0.05)。论    长病程的T2DM患者,其胰岛素抵抗水平随着BMI的增加逐渐升高,而胰岛β细胞功能指数与BMI的相关性不显著。同时,UA和TG也是长病程T2DM患者胰岛β细胞功能的影响因素。
       Objective  To explore the correlation between body mass index(BMI)and islet β cell function in patients with long course type 2 diabetes mellitus(T2DM).Methods  A total of 260 patients with T2DM with a long course of disease(course≥10 years)admitted to the Department of Endocrinology and Rheumatology of Chengde Central Hospital from December 2023 to March 2024 were selected as the study objects,and were divided into normal group,overweight group and obese group according to BMI.Comparison among the three groups in general data,inspection index and and the difference of the islet β cell function were performed,and the correlation among the indexes was analyzed.Results  There were statistically significant differences in fasting plasma glucose(FPG),fasting C peptide(FCP),homeostasis model assessment-insulin resistance(HOMA-IR),uric acid(UA)and triglycerides(TG)among the three groups(P<0.05),but no statistically significant differences in homeostatic model assessment of β-cell function(HOMA-β)(P>0.05).The levels of FPG,FCP,HOMA-IR,UA and TG in the obese group were higher than those in the normal group(P<0.05);the levels of UA and TG in the overweight group were higher than those inthe normal group(P<0.05);the levels of FPG,HOMA-IR and UA in the obese group were higher than those in the overweight groupP<0.05).Spearman correlation analysis showed that HOMA-β was not correlated with BMI(r=0.046,P=0.461),but was positively correlated with UA and TG(r=0.226,P<0.001;r=0.148,P=0.017),HOMA-IR was positively correlated with BMI,UA and TG(r=0.279,P<0.001;r=0.284,P<0.001;r=0.349,P<0.001).Multiple linear regression analysis showed that UA was the influencing factor of HOMA-β(P<0.05),BMI,UA and TG were the influencing factors of HOMA-IR(P<0.05).Conclusions  In T2DM patients with long disease course,the level of insulin  resistance increased gradually with the increase of BMI,but the correlation between β-cell function index and BMI was not significant.At the same time,UA and TG are also factors affecting the function of islet β cells in patients with long-course T2DM.
论著

2005—2024 年中医药治疗小儿腺样体肥大的可视化分析

Visual analysis of traditional Chinese medicine treatment for pediatric adenoid hypertrophy from 2005 to 2024

:1045-1054
 
       目的   探讨中医药治疗小儿腺样体肥大(AH)的研究现状、研究热点及趋势,为本领域研究者提供借鉴。方法   检索中国知网(CNKI)数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量,运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果   共纳入文献395篇,年发文量整体呈现波动上升的趋势;发文量最多的作者为姜之炎;发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队;研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论  AH领域研究内容主要以内治法、外治法、作用机制为主;研究热点逐渐从临床研究转向作用机制等实验研究;应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。
       Objective  To explore the research status,research hotspots,and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children,to provide a reference for researchers in this field.Methods  The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1,2005,to January 31,2024.Excel 2019 was applied to analyze the number of published papers,and CiteSpace 6.2.R6 software was applied to analyze its authors,institutions,and keywords.Results  A total of 395 papers were included,and the annual number of papers showed a fluctuating upward trend.The author with the largest number of papers was JIANG Zhiyan.Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers.The core  research teams including JIANG Zhiyan,YU Jingmao,and YAN Zhaojun were initially formed.The  research institutions were mainly Chinese medicine colleges and their affiliated hospitals.High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods,clinical efficacy.Conclusions  The research content in this field is mainly based on internal treatment,external treatment,and mechanism.The focus has gradually shifted from clinical research to experimental research such as mechanism.The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend.
论著

虾青素通过 Nrf2/NLRX1 通路激活线粒体自噬缓解阿尔茨海默病

Astaxanthin alleviates Alzheimer’s disease by activating mitophagy via Nrf2/NLRX1 pathway

:975-981
 
       目的   探讨谷氨酸对HT22细胞线粒体自噬和细胞凋亡的影响,并评估虾青素预处理的保护作用及其分子机制。方法   用谷氨酸及虾青素处理HT22细胞,通过蛋白印迹及聚合酶联反应等评估其对线粒体自噬的影响。结果   谷氨酸处理显著抑制线粒体初级自噬(PINK1、Parkin、pULK1ser555和LC3Ⅱ)和次级自噬(LAMP1和Rab7),上调cleaved Caspase-3的表达(P<0.05)。虾青素预处理减少细胞凋亡,恢复了线粒体自噬,PINK1、Parkin、pULK1ser555和LC3Ⅱ的表达水平上升(分别为2.3倍、2.6倍、83.3%及81.1%)(P<0.05),该作用被自噬抑制剂BafA1阻断。此外,谷氨酸抑制Nrf2核内转移和NLRX1表达,而预处理显著促进Nrf2的核内转移并上调NLRX1,分别上调25.8%、33.2%。生物信息学分析显示NLRX1启动子区域含有3个Nrf2结合位点,提示Nrf2通过调控NLRX1转录活性发挥作用。结论   文章揭示虾青素通过Nrf2/NLRX1通路激活线粒体自噬,展现神经保护作用。
       Objective  To explore the effects of glutamate on mitophagy and apoptosis in HT22 cells and evaluate the protective effects and molecular mechanisms of astaxanthin pretreatment.Methods  HT22 cells were treated with glutamate and astaxanthin.The effects on mitophagy were assessed using Western Blot and PCR.Results  Glutamate treatment  significantly inhibited primary mitophagy(PINK1,Parkin,pULK1ser555 and LC3II)and secondary mitophagy(LAMP1 and Rab7)while upregulating cleaved Caspase-3 expression.Astaxanthin pretreatment notably reduced apoptosis and restored mitophagy,the expression levels of PINK1,Parkin,pULK1ser555 and LC3II were significantly upregulated(by 2.3-fold,2.6-fold,83.3% and 81.1% respectively,P<0.05),but this effect was blocked by the autophagy inhibitor BafA1.Additionally,glutamate suppressed Nrf2 nuclear translocation and NLRX1 expression,whereas astaxanthin promoted Nrf2 nuclear translocation and increased NLRX1 expression by 25.8% and 33.2%,respectively.Bioinformatics analysis  revealed three Nrf2 binding sites in the NLRX1 promoter region,suggesting that Nrf2 may regulate NLRX1 transcriptional activity.Conclusions  The study demonstrates that astaxanthin exhibited potential neuroprotective effect by activating mitophagy through the Nrf2/NLRX1 pathway.
论著

2022—2024 年南宁市食源性疾病流行病学分析及卫生管理建议

Epidemiological analysis of foodborne diseases in Nanning City from 2022 to 2024

:935-944
 
       目的   调查南宁市2022—2024年食源性疾病的发生情况,并分析该地食源性疾病的流行病学特征,为防控食源性疾病提供依据。方法   在2022年1月—2024年12月统计南宁市多中心上报的食源性疾病发生情况,并分析食源性疾病的分布特征。结果  2022年1月—2024年12月在南宁市共计调查21 712例食源性疾病患者,其中男性占49.25%,女性占50.75%;食源性疾病以18~59岁、4~17岁年龄段占比相对较高,在季节方面2022年以秋季占比较高,2023—2024年以夏季占比较高;散居儿童、学生和农民是食源性疾病的主要人群,混合食品、水果及其制品、粮食类及其制品、肉类及其制品为前四位暴露食品;包装方面以散装占比最高、进食场所则以家庭占比最高;食源性疾病患者3年间不同性别、年龄段、发病季节、人群类型、暴露食品、包装形式及进食场所比较差异均有统计学意义(P<0.05)。症状主要以消化道症状、其他/全身症状为主。结论   南宁市2022—2024年食源性疾病发生例数有所增长,多发于夏秋季节,散居儿童、学生、农民是食源性疾病的高风险群体,同时针对散装食品,尤其混合食品、水果及其制品、粮食类及其制品、肉类及其制品等主要暴露食品应做好重点防控监测,可根据本地食源性疾病发生的流行病学特征进行对应的宣传教育,以确保食品安全。
       Objective  To explore the occurrence of foodborne diseases in Nanning City from 2022 to 2024,and analyze the epidemiological characteristics of foodborne diseases in the area,providing a basis for the prevention and control of foodborne diseasesMethods  From January 2022 to December 2024,the incidence of foodborne diseases reported by multiple centers in Nanning City was statistically analyzed,and the distribution characteristics of foodborne diseases were analyzed.Results  From January 2022 to December 2024,a total of 21 712 foodborne disease patients were analyzed in Nanning City,among them,males account for 49.25% and females account for 50.75%.Foodborne diseases had a relatively high proportion in the age groups of 18-59 and 4-17 years old.In terms of seasons,the proportion was higher in autumn 2022 and in summer 2023-2024.Scattered children,students,and farmers were the main populations of foodborne diseases,with mixed foods,fruits and their products,grains and their products,and meat and its products being the top four exposed foods.In terms of packaging,bulk packaging had the highest proportion,while in terms of eating places,household packaging has the highest proportion.There were statistically significant differences in the gender,age group,onset season,population type,exposed food,packaging form,and eating location of foodborne disease patients over a three-year period.Conclusions  The number of foodborne diseases in Nanning City has increased from 2022 to 2024,mostly occurring in summer and autumn seasons.Scattered children,students,and farmers are high-risk groups for foodborne diseases.At the same time,key prevention and control monitoring should be carried out for bulk foods,especially mixed foods,fruits and their products,grains and their products,meat and their products,and corresponding publicity and education can be carried out according to the epidemiological characteristics of local foodborne diseases to ensure food safety.
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