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《广州医药》编辑部
目的 分析舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁患者的效果。方法 选择2023年1月—2025年1月平顶山市第一人民医院收治的86例冠心病介入术后患者,随机分为对照组(43例)、舒肝解郁胶囊组(43例),均进行常规治疗及体外反搏治疗,舒肝解郁胶囊组加用舒肝解郁胶囊,测量并比较两组患者治疗前后心肺功能,评估患者焦虑和抑郁情绪、临床疗效及生活质量。结果 治疗后舒肝解郁胶囊组左心室射血分数(LVEF)和最大摄氧量(VO2max)均显著高于对照组(P<0.05);治疗后舒肝解郁胶囊组汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分均低于对照组(P<0.05);舒肝解郁胶囊组总有效率高于对照组(P<0.05);治疗后舒肝解郁胶囊组生活质量综合评定问卷(GQOLI-74)各维度评分均显著高于对照组(P<0.05)。结论 舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁效果显著,可减轻患者负面情绪,改善其心肺功能及生活质量。
Objective To analyze the effect of Shugan Jieyu Capsule combined with external counterpulsation in the treatment of anxiety and depression in patients with coronary artery disease after percutaneous coronary intervention(PCI).Methods From January 2023 to January 2025,86 patients with coronary heart disease who had undergone PCI in our hospital were enrolled and randomly divided into a control group(43 cases) and a Shugan Jieyu Capsule group(43 cases).All patients received conventional treatment and external counterpulsation.The Shugan Jieyu Capsule group was given Shugan Jieyu Capsule in addition.Cardiopulmonary function was measured and compared before and after treatment between the two groups,and anxiety and depression,clinical efficacy,and quality of life were evaluated.Results After treatment,the left ventricular ejection fraction(LVEF) and maximum oxygen uptake(VO2max) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).The Hamilton Anxiety Rating Scale(HAMA) and Hamilton Depression Rating Scale(HAMD) scores in the Shugan Jieyu Capsule group were significantly lower than those in the control group(P<0.05).The total effective rate in the Shugan Jieyu Capsule group was significantly higher than that in the control group(P<0.05).After treatment,the scores on all dimensions of the General Quality of Life Assessment Questionnaire-74(GQOLI-74) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).Conclusions Shugan Jieyu Capsule combined with external counterpulsation is effective in treating anxiety and depression after PCI,alleviating negative emotions and improving cardiopulmonary function and quality of life.
泛血管疾病(PVD)是一类以动脉粥样硬化为共同病理基础、累及心、脑、肾及外周血管系统的临床综合征, 具有多血管床共病特征, 发病率高、致残致死率大。非编码RNA(ncRNA)作为基因表达的重要调控因子, 在PVD的发生发展中发挥关键作用。微小RNA(miRNA)、长链非编码RNA(lncRNA)、环状RNA(circRNA)等ncRNA通过调节炎症反应、内皮功能、血管重塑、代谢稳态等多路径参与PVD的病理过程, 并展现出时空特异性和双向调控特征。最新研究揭示ncRNA在临床中的诊断预测及靶向干预潜力, 包括外泌体载体及circRNA递送系统等新策略。此外, 中医药通过调控ncRNA网络, 干预血瘀、痰浊等证型相关通路, 体现中西医结合治疗的系统优势。本文系统综述了ncRNA在PVD中的作用机制与研究进展, 强调其在精准诊疗与转化研究中的应用前景, 并指出未来需加强基础与临床协同、推进个体化干预策略的落地实施。
Panvascular diseases(PVD)are a group of clinical syndromes characterized by atherosclerosis as a common pathological foundation, involving heart,brain,kidneys,and peripheral vascular systems.These diseases often exhibit multi-vascular bed comorbidities and are associated with high incidence,disability, and mortality rates.Non-coding RNAs(ncRNAs), as key regulators of gene expression, play a crucial role in the onset and progression of PVD.Various types of ncRNAs—including microRNAs(miRNAs), long non-coding RNAs(lncRNAs), and circular RNAs(circRNAs)—are involved in the pathological processes of PVD through multiple pathways, such as modulation of inflammatory responses, endothelial function, vascular remodeling, and metabolic homeostasis, exhibiting spatiotemporal specificity and bidirectional regulatory effects.Recent studies have highlighted the potential of ncRNAs in clinical diagnosis, prognosis, and targeted therapy,with novel strategies including exosome-based delivery and circRNA-targeting systems.In addition, traditional Chinese medicine(TCM)exerts regulatory effects on ncRNA networks to intervene in syndrome-specific pathways, such as those related to blood stasis and phlegm-dampness, reflecting the systemic advantages of integrating TCM with Western medicine.This review systematically summarizes the regulatory mechanisms and research progress of ncRNAs in PVD,emphasizes their potential in precision medicine and translational research, and proposes the need to strengthen collaboration between basic and clinical studies to facilitate the implementation of personalized therapeutic strategies.
更好地保障医务人员的职业安全与健康是备受关注的议题。文章介绍了华南理工大学附属第二医院(广州市第一人民医院)基于国际医院评审认证标准促进医院职业安全与健康管理体系建设完善的经验做法, 为国内三甲医院的职业安全与健康管理体系建设提供参考。
How to better protect the occupational safety and health of medical personnel is a topic of great concern.This article introduces the empirical approach of Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology to establish and improve hospital occupational safety and health management system based on international hospital accreditation standard.It provides a reference for the construction of occupational safety and health management system in domestic 3A-grade hospital.
目的 探讨非编码长链 RNA ANRIL(lncRNA-ANRIL)通过调控miR‐181b 介导磷酸酶及张力蛋白同源物基因(PTEN)对冠状动脉粥样硬化性心脏病(冠心病)心肌损伤影响的机制。方法 纳入2023年10月—2024年6月广州市第一人民医院30例确诊为冠心病的患者为观察组, 另选择同期本院体检中心30名健康者为对照组,检测两组研究者血压指标、血脂指标以及血清 lncRNA-ANRIL、miR-181b、PTEN水平, 并比较检测结果。结果 两组的性别、年龄、BMI、吸烟、高血压一般资料对比差异无统计学意义(P>0.05); 观察组收缩压、舒张压水平以及总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均高于对照组,而高密度脂蛋白胆固醇则低于对照组(P<0.05); 观察组血清 lncRNA ANRIL Exon 1-2、lncRNA ANRIL Exon 17-18相对表达水平以及PTEN水平低于对照组(t=12.623、7.741、8.231, P=0.001), 而miR-181b水平则高于对照组(t=37.250, P=0.001)。结论 相较于正常人群, 冠心病患者血清lncRNA-ANRIL和PTEN水平明显降低,而miR-181b水平升高,提示lncRNA-ANRIL可通过调控miR-181b来调节PTEN的表达, 从而影响冠心病心肌损伤的过程。
Objective To explore the mechanism of competitive binding of non coding long stranded RNA ANRIL(lncRNA-ANRIL)to miR-181b to mediate phosphatase and tensin homolog gene(PTEN)on myocardial injury in coronary heart disease.Methods Thirty patients diagnosed with coronary heart disease in our hospital from October 2023 to June 2024 were included as the observation group,and another 30 individuals from physical examination center during the same period were selected as the control group.Blood pressure indicators,blood lipid indicators, and serum levels of lncRNA-ANRIL, miR-181b, and PTEN were measured in the two groups of patients, and the test results were compared.Results There was no significant difference between the two groups in terms of gender, age, BMI, smoking and hypertension(P>0.05).The levels of systolic blood pressure(SBP), diastolic blood pressure(DBP), total cholesterol(TC), triglycerides(TG), and low-density lipoprotein cholesterol(LDL-C) in the observation group were higher than those in the control group,while high-density lipoprotein cholesterol(HDL-C) was lower than that in the control group(P<0.05).The relative expression levels of lncRNA-ANRIL Exon 1-2, Exon 17-18, and PTEN levels in the observation group were lower than those in the control group(t=12.623, 7.741, 8.231, P=0.001), while the level of miR-181b was higher than that in the control group(t=37.250, P=0.001).Conclusions Compared with healthy individuals, serum levels of lncRNA-ANRIL and PTEN are significantly reduced in patients with coronary heart disease, while miR-181b levels are elevated, indicating that lncRNA ANRIL can regulate PTEN expression by miR-181b, thereby affecting the process of myocardial injury in coronary heart disease.
目的 通过对原位换管与首次置管比较,验证采用原位换管方式的可行性。方法 选取儿童肾内科先后采用了首次置管与原位换管的病例20例。将原位换管作为原位换管组,首次置管作为首次置管组,比较两组操作成功有效率、导管留置天数、最大血流速/体质量[mL/(min·kg)]、操作并发症的差异。结果 两组均一次性穿刺成功,两组在管道留置天数和血流速/体质量[mL/(min·kg)]及并发症比较差异均无统计学意义(P>0.05)。结论 原位换管与首次置管的效果相同,原位换管操作简单、对患者的损伤更小。
腺苷至肌苷RNA编辑(AIRE)是指转录前体RNA在腺苷酸脱氨酶的作用下,某些位点的腺苷发生脱氨反应转变成肌苷的过程,在碱基配对时,肌苷被识别作鸟苷,导致转录组重编写。随着高通量测序技术的不断进步,大量异常的AIRE被发现可导致氨基酸编码改变、RNA剪切异常以及microRNA-mRNA重定向等过程,从而参与肿瘤的发生发展。绝大部分的AIRE位点均位于基因非编码区,解析它们的生物学功能仍存在一定的挑战。本综述旨在描述AIRE的生物学机制和AIRE位点在不同肿瘤发生发展作用的进展,为AIRE与肿瘤的研究提供思路。
Adenosine-to-inosine RNA editing(AIRE)is catalysed by adenosine deaminases acting on RNA(ADARs),which converts adenosine to inosine in nascent RNA.Since inosine is recognized as guanosine in post-transcriptional process,AIRE is functionally approximate to an A-to-G mutation and results in transcriptome recoding.With the continuous advancement of high-throughput sequencing technology,a large number of abnormal AIRE events have been found to exert different biological mechanisms such as amino acid changes,RNA splicing abnormalities and microRNA-mRNA redirection,which plays an important role in the development of human tumorigenesis.Most of AIRE sites are located in non-coding region,which brings challenges in analyzing their biological functions.This review aims to describe the biological mechanisms of AIRE and the relationship between AIRE sites and the development of different tumor types,providing ideas for the study of AIRE and tumors.
目的 探讨子宫内膜异位症(EMT)患者卵泡液来源的外泌体差异微小RNA(miRNA)对卵母细胞质量的影响。方法 收集2021年12月—2022年3月在广州市第一人民医院生殖医学中心进行体外受精-胚胎移植/卵细胞浆内单精子注射助孕的20例不孕症患者的卵泡液,分为EMT组(EMT不孕症患者10例)和对照组(单纯男性因素不孕症患者10例)。采用高通量测序对卵泡液外泌体微小RNA(miRNA)谱进行分析,选出具有组间差异的miRNAs。结果 与单纯男性因素不孕患者相比,EMT组有18个外泌体miRNAs差异有统计学意义,其中上调9个、下调9个。靶基因预测并采用GO和KEGG富集分析发现,这些靶基因主要参与磷脂酰肌醇-3-激酶/蛋白激酶B( PI3K-Akt)、核苷酸结合寡聚结构域NOD样受体、Ras等信号通路。结论 EMT患者卵泡液来源的外泌体miRNA存在差异,差异的外泌体miRNAs可能通过多个信号通路影响EMT患者卵母细胞质量。
Objective To investigate the effect of differential microRNA(miRNA)derived from follicular fluid exosomes on oocyte quality in patients with endometriosis(EMT). Methods Follicular fluid was collected from 20 infertile patients undergoing IVF-ET / ICSI in the Reproductive Medicine Center of Guangzhou First People's Hospital from December 2021 to March 2022,including EMT group(10 patients with EMT infertility)and control group(10 patients with simple male factor infertility).The miRNA spectrum in follicular fluid exosomes was analyzed by high-throughput sequencing and miRNAs with differences between groups were selected. Results Compared with patients with infertility due to simple male factors,there were significant differences in 18 exosomal miRNAs in the EMT group,of which 9 were up-regulated and 9 were down-regulated.GO and KEGG enrichment analysis showed that these target genes were mainly involved in phosphatidylinositol-3-kinase / protein kinase B,Nucleotide binding oligomerization domain-like receptor and other signaling pathways. Conclusions There are differences in follicular fluid-derived exosomal miRNAs in EMT patients.Differential exosomal miRNAs may affect oocyte quality in EMT patients through multiple signaling pathways.
目的 探讨影响颈内动脉闭塞(ICAO)患者预后的相关因素,为临床改善ICAO患者预后提供理论依据。方法 回顾性分析2017—2022年广西医科大学附属武鸣医院因ICAO入住神经内科的131例患者,根据ICAO发病时间分为急性颈内动脉闭塞(AICAO)和慢性颈内动脉闭塞(CICAO),根据预后的不同,分为预后良好和预后不良组,比较两组的基本信息(性别、年龄等)、既往病史(包括高血压、糖尿病、冠心病等)、发病时神经功能损害程度(美国国立卫生研究院卒中神经功能缺损评分NIHSS评分)、侧支循环代偿评分、介入手术开通治疗、出血转化之间的差异,分析影响患者预后的相关因素。结果 CICAO患者总体预后良好,AICAO预后良好组患者发病时NIHSS评分<6分、侧支循环代偿良好比例高于预后不良组,而出血转化率低于预后不良组,组间比较差异均有统计学意义(P<0.05)。二分类Logistic回归分析显示,发病时NIHSS评分、侧支循环代偿评分、介入手术开通治疗、出血转化、次全闭塞对AICAO预后影响有统计学意义(P<0.05)。两组间的基本信息、既往病史、介入手术开通治疗等比较差异无统计学意义(P>0.05)。结论 CIACO较AICAO总体预后良好,发病时NIHSS评分<6分、侧支循环代偿良好、无出血转化是IACO预后良好的相关因素。发病时NIHSS评分高、侧支循环代偿不良、出血转化是ACAO预后不良的危险因素
Objective To evaluate the prognostic significance of a group of clinical indices in the patients with internal carotid artery occlusion(ICAO). Methods From 2017 to 2022,a total of 131 patients with ICAO were enrolled.All eligible patients were divided into acute ICAO(AICAO)and chronic ICAO groups(CICAO),which were subdivided into good and poor prognosis groups.A respective analysis was performed to identify a practical profile for the outcome prediction of the patients with ICAO. Results The overall prognosis of CIACO was good.The proportion of NIHSS score < 6 in AICAO group with good prognosis and good collateral circulation compensation was significantly higher than that in poor prognosis group,while bleeding conversion was lower than that in poor prognosis group,with statistical significance(P<0.05).Dichotomous logistic regression analysis showed that the prognostic effects of NIHSS score,collateral circulatory compensation score,interventional initiation,hemorrhagic transformation,and subtotal occlusion on the prognosis of AICAO were statistically significant.There were no significant differences in basic information,past medical history,interventional operation between the two groups(P>0.05). Conclusions The patients with CICAO have a better prognosis than those with AICAO.NIHSS score < 6,good collateral circulation and no-hemorrhagic transformation may have strong prognostic relevance to ICAO.High NIHSS score,poor collateral circulation and hemorrhagic transformation at the time of onset are risk factors for poor prognosis of ACAO .
目的 探讨微RNA-29b(miR-29b)对子宫内膜癌细胞增殖、迁移和侵袭的影响。方法 子宫内膜癌HEC-1-B细胞分为miR-29b模拟物组(MM组)、miR-29b阻遏物组(MR组)和阴性对照物组(MNC组),分别转染miR-29b拟似物、miR-29b阻遏物和miR-29b阴性对照物,每组设置6个复孔。以实时定量逆转录PCR检测miR-29b表达,以水溶性四氮唑(WST-1)检测miR-29b对HEC-1-B子宫内膜癌细胞增殖的影响,以Transwell小室检测HEC-1-B子宫内膜癌细胞迁移和侵袭的影响,以Western blot法检测磷酸酶张力蛋白同源物(PTEN)-蛋白激酶 B(AKT)通路蛋白表达水平。结果 MNC组、MM组、MR组miR-29b相对表达量分别为(2 032.1±873.4)、(19 272.8±2 087.9)、(472.7±105.6),组间比较差异有统计学意义(P<0.05)。MM组0、3、5、7 d时OD值分别为(0.32±0.06)、(0.53±0.08)、(1.13±0.12)和(1.92±0.14),MNC组0、3、5、7 d时OD值分别为(0.34±0.09)、(0.71±0.08)、(1.67±0.21)和(3.49±0.24),MR组0、3、5、7 d时OD值分别为(0.38±0.09)、(0.84±0.18)、(2.43±0.24)和(5.67±0.15),3组0 d时OD值比较差异无统计学意义(P=0.216),三组3 d、5 d、7 d时OD值比较差异存在统计学意义(P<0.001)。MNC组、MM组和MR组迁移细胞数分别为(403.9±23.8)(102.6±15.7)和(685.7±46.8)个,上述3组侵袭细胞数分别为(82.1±12.7)(38.2±10.6)和(124.6±21.6)个,MM组和MNC组上述指标比较差异均有统计学意义(P<0.05),MR组和MM组上述指标比较差异均有统计学意义(P<0.05)。MNC组、MM组、MR组PTEN蛋白相对表达量分别为(0.25±0.08)、(0.69±0.11)、(0.11±0.05),上述3组p-AKT蛋白相对表达量分别为(0.58±0.10)、(0.13±0.06)和(0.79±0.08),上述3组AKT蛋白相对表达量分别为(0.38±0.09)、(0.37±0.11)和(0.37±0.08),MM组与MNC组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05);MR组与MNC组、MM组PTEN、p-AKT水平比较差异有统计学意义(P<0.05),AKT水平比较差异无统计学意义(P>0.05)。结论 过表达miR-29b对子宫内膜癌细胞增殖、迁移和侵袭具有抑制作用,靶向PTEN-AKT可能是其重要作用途径。
Objective To investigate the effects of microRNA-29b on proliferation,migration and invasion of endometrial cancer cells.Methods The endometrial cancer HEC-1-B cells were divided into micro29b mimetic group(MM group),micro29b repressor group(MR group)and negative control group(MNC group),and the micro29b mimetic,micro29b repressor and micro29b negative control were transfected into each group,six compound holes with each group.The real-time quantitative reverse transcription polymerase chain reaction(RT-PCR)was used to detect the expression of mi29b,WST-1 was used to detect the effect of mi29b on the proliferation of HEC-1-B endometrial cancer cells,Transwell chamber was used to detect the migration and invasion of HEC-1-B endometrial cancer cells,and Western blot was used to detect the expression level of PTEN-AKT pathway protein.Results The relative expression levels of microRNA-29b in MNC group,MM group and MR group were(2 032.1±873.4),(19 272.8±2 087.9)and(472.7±105.6),respectively,and there were significant differences between groups(P<0.05).OD values of MM group at 0 d,3 d,5 d and 7 d were(0.32±0.06),(0.53±0.08),(1.13±0.12)and(1.92±0.14)respectively.The OD values of MNC group at 0,3,5 and 7 days were(0.34±0.09),(0.71±0.08),(1.67±0.21)and(3.49±0.24)respectively.The OD values of MR group at 0 d,3 d,5 d and 7 d were(0.38±0.09),(0.84±0.18),(2.43±0.24)and(5.67±0.15)respectively.There was no significant difference in OD value between the three groups on day 0 (P=0.216).There were significant differences in OD value between the three groups on day 3,day 5 and day 7(P<0.001).The number of migrating cells in MNC group,MM group and MR group were(403.9±23.8)cells,(102.6±15.7)cells and(685.7±46.8)cells,respectively.The number of invasive cells in the above three groups were(82.1±12.7)cells,(38.2±10.6)cells and(124.6±21.6)cells.There were significant differences in the above indexes between MM group and MNC group(P<0.05),also between MR group and MM group(P<0.05).The relative expression levels of PTEN protein in MNC group,MM group and MR group were(0.25±0.08),(0.69±0.11)and(0.11±0.05).The relative expression levels of p-AKT protein in the above three groups were(0.58±0.10),(0.13±0.06)and(0.79±0.08).The relative expression levels of AKT protein in the above three groups were(0.38±0.09),(0.37±0.11)and(0.37±0.08),respectively.Compared with MNC group,the levels of PTEN and p-AKT in MM group had statistical significance(P<0.05),but there was no statistical difference in AKT level(P>0.05).Compared with MNC group and MM group,the levels of PTEN and p-AKT in MR group had statistical significance(P<0.05),and there was no statistical difference in AKT level(P>0.05).Conclusions Overexpression of microRNA-29b can inhibit the proliferation,migration and invasion of endometrial cancer cells,and targeting PTEN-AKT may be an important pathway.
在过去的几十年中,随着RNA生物学的深入研究,越来越多的证据表明,非编码RNA(ncRNA)对包括癌症在内的多种疾病进展起着关键作用,同时在作为生物标志物和治疗靶点方面表现出了巨大的潜力。在全球范围内,消化道(GI)肿瘤是肿瘤相关死亡的主要原因,目前消化道肿瘤晚期患者的生存率依然很低。既往大量研究报道了ncRNA中,特别是长链非编码RNA(lncRNA)在消化道肿瘤发生发展中发挥重要作用。本文将着重阐述lncRNA在消化道肿瘤分子生物学中的作用,旨在为深入理解lncRNA在消化道肿瘤发生发展机制以及临床转化应用提供新的思路和线索。
In recent decades,an increasing body of evidence has pointed to the pivotal roles of non-coding RNAs(ncRNAs),particularly long non-coding RNAs(lncRNAs),in the development of various diseases,including cancer.Meanwhile,ncRNAs have been shown great potential as biomarker and therapeutic target.Gastrointestinal(GI)cancers are a leading cause of cancer-related mortality globally and the survival rate of advanced GI cancer patients is still very low.Extensive research has underscored the significant involvement of lncRNAs in the initiation and progression of GI cancers.This review aims to offer a comprehensive overview of lncRNAs,shedding light on their roles in the molecular biology of GI cancers.By synthesizing previous studies,this review seeks to provide new insights into the mechanisms underlying lncRNAs' contribution to GI cancer development and their potential clinical applications.