简介：Objective:Toobservetheeffectofelectroacupuncture(EA)onMeniere'sdisease.Methods:Atotalof114cases(38malesand76females)ofMeniere'sdiseaseweretreatedwithEAofErmen(耳门TE21),Tinggong(听宫SI19),Tinghui(听会GB2),Yifeng(NFDB1风TE17),Fengchi(风池GB20)andBaihui(百会GV20).Thetreatmentwasgiven3timesaweek,9timesaltogether.Follow-upwasmadeattheendofthe3rd,6thand12thmonthsaftertreatment.Results:Follow-upin114patientsshowedthatafterEAtreatment,63cases(55.26%)werecured,30(26.31%)hadremarkableimprovementintheirsymptoms,10(8.77%)respondedwithimprovementand11(9.65%)failedinthetreatment,withatotaleffectiverateof90.35%.Conclusion:EAtreatmentwaseffectiveincontrollingMeniere'sdiseasepatients'symptomsandreducingattack.

简介：AbstractThroughout the past 2020, the pandemic COVID-19 has caused a big global shock, meanwhile it brought a great impact on the public health network. Trauma emergency system faced a giant challenge and how to manage trauma under the pandemic of COVID-19 was widely discussed. However, the trauma treatment of special population (geriatric patients and patients taking anticoagulant drugs) has received inadequate attention. Due to the high mortality following severe traumatic hemorrhage, hemostasis and trauma-induced coagulopathy are the important concerns in trauma treatment. Sepsis is another topic should not be ignored when we talking about trauma. COVID-19 itself is a special kind of sepsis, and it may even be called as serious systemic infection syndrome. Sepsis has been become a serious problem waiting to be solved urgently no matter in the fields of trauma, or in intensive care and infection, etc. This article reviewed the research progress in areas including trauma emergency care, trauma bleeding and coagulation, geriatric trauma and basic research of trauma within 2020.

简介：Therearemanycausesofpain.Generallyspeaking,inflammationisthemostcommoncause,followedbyinjury,ulceration,spur,chemicalstimulation,etc..Acupuncturehasitsuniqueeffectivenessoninflammationthatischaracterizedasredness,swelling,warmthandpain,includingneuritisandarthritis.

简介：Aim:Tostudypercutaneousabsorptionandmetabolismofketoprofenisopropylester(KPE)viaexcisednudemouse'sandmonkey'sskin.Methods:Excisedskinwaspreparedbysurgicalexcisionandenzymedigestion.Sideby-sidediffusioncellswereusedforinvitropermeationstudies.TheconcentrationsofKPEanditsmetaboliteinsampleswereassayedbyHPLC.Results:AllKPEpenetrationthroughwholethicknessskinandstrippedskinwasmetabolizedtoketoprofen(KP).theconcentrationofwhichinthereciiversolutionincreasedlinearlywithtime.Astothenudemouseskin.thesteady-statefluxofKPthroughwholethicknessskinwas2.5timesthatofKPEthroughthewhloethicknessskin,buttheKPandKPEremaininginthewholethicknessskinafterthefinishingofKPEpenetrationwas22.2timesincomperedwiththeKPremaininginthewholethicknessskinafterthefinshingofKPpenetration.TherateofformationofthesteadystateKPfromKPEthroughtdermiswassignificantlylowerthanthatofKPEthroughthewholethicknessskin.Inhemonkeyskin,therateofformationofthesteady-stateKPfromKPEthroughthewholethicknessskinwas0.7timesthatfromKPEthroughstrippedskin.TheKPandKPEremaininginthewholethicknessskinafterthefinishingofKPEpenetrationwas2.0timethatinthestrippedskinafterthefinishingofKPEpenetration.Therateoffornationofthesteady-stateKPfromKPEthroughdermiswaslowerthanthatfromKPEthroughthewholethicknessskinandthestrippedskin.theKPremainingindermisafterthefinsihingofKPEpenetrationwasalsosignificantlylowerthantheKPremaininginthewholethicknessskinandthestrippedskinafterthefinishingofKPEpenetration.Conclusion:KPestersareofbenefittoimporovethelocalactionofKP.andskinesterasemetabolismmainlydevelopsintheepidermis.

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简介：目的　研究严重烧伤后大鼠心肌细胞中c-fos、c-mycmRNA和蛋白的动态表达及意义。　方法　复制Wistar大鼠30%体表面积Ⅲ度烧伤模型，设烧伤组、补液组、维拉帕米治疗组和对照组，烧伤后在不同时相点处死动物取材。免疫组化方法检测c-fos、c-myc蛋白的表达，原位杂交法检测c-fos、c-mycmRNA的表达。　结果　各实验组c-fos、c-myc蛋白及mRNA表达随伤后时间推移逐渐增强达到峰值后下降。组间比较，烧伤组、补液组、维拉帕米组c-fos、c-myc表达呈依次降低，差异有显著性意义。　结论　严重烧伤可诱导心肌内早期反应基因c-fos、c-myc的表达。不论是烧伤组、补液组还是维拉帕米组，c-fos、c-mycmRNA水平及蛋白水平都有不同程度的表达。其表达不同于心肌梗死和压力超负荷病理状态下基因表达特点，提示三者间可能有着不同的信号转导机制和调节机制。

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简介：摘要目的C型凝集素结构域家族7成员A(CLEC7A)在脑胶质瘤中的表达及临床意义。方法利用基因表达谱数据交互分析(GEPIA)及GlioVis数据库分析CLEC7A在胶质瘤组织中表达水平。通过癌症基因组图谱(TCGA)及中国脑胶质瘤基因图谱计划(CGGA)数据库共收集1 095例胶质瘤样本，用于分析CLEC7A表达与胶质瘤临床病理特征及预后相关性。使用富集分析明确CLEC7A参与的生物学过程。利用单细胞转录组测序数据分析及Spearman相关检验分析CLEC7A表达与胶质瘤免疫浸润的相关性。结果与非肿瘤脑组织相比(Gravendeel：4.247±0.121；Rembrant：5.972±0.400)，CLEC7A在胶质瘤组织中显著上调(Gravendeel：5.134±0.577；Rembrant：6.399±0.676)，差异有统计学意义(Gravendeel：t＝－4.333，P<0.01；Rembrant：t＝－3.292，P<0.01)。多因素Cox回归分析显示CLEC7A表达水平是胶质瘤患者预后的独立影响因素[TCGA：风险比(HR)：1.637；CGGA：HR：1.678，均P<0.05]。GeneMANIA数据库分析显示CLEC7A与半乳糖凝集素-3(LGALS3)具有强相关性。利用单细胞转录组测序数据(GSE117891)及肿瘤免疫单细胞中心(TISCH)网站分析显示CLEC7A在胶质瘤免疫微环境中胶质瘤相关性小胶质细胞/巨噬细胞(GAMMs)中特异性高表达，并且利用Spearman检验基于TIMER数据进行验证(低级别胶质瘤：R＝0.749；高级别胶质瘤：R＝0.205，均P<0.01)。结论CLEC7A可能是胶质瘤预后评估及精准治疗的新型标志物。

简介：摘要目的探讨肾小球补体C1q及C3c沉积与糖尿病肾病进展的相关性。方法纳入2011年1月至2019年7月在南京医科大学第一附属医院确诊的2型糖尿病肾病患者112例，其中男性83例（74.1%），年龄（51.22±11.12）岁，随访时间19.0（8.5，31.3）个月。根据肾小球C1q和C3c是否沉积分为四组：C1q无沉积C3c无沉积组（n=38）、C1q无沉积C3c沉积组（n=24）、C1q沉积C3c无沉积组（n=14）和C1q沉积C3c沉积组（n=36），检测24 h尿蛋白等临床指标并收集病理资料。采用Cox回归及Kaplan-Meier生存曲线评估肾C1q和C3c沉积对肾脏预后的影响。结果四组间24 h尿蛋白差异有统计学意义［分别为1.84（0.92，3.89），4.19（2.09，6.50）3.30（1.84，6.70），3.64（2.49，7.22）g/24 h，P<0.01］，C1q沉积C3c沉积组24 h尿蛋白定量显著高于C1q无沉积C3c无沉积组（P<0.01）。Kaplan-Meier生存曲线结果提示，四组累积生存率差异有统计学意义（Log-rank χ²=8.785，P<0.05），C1q沉积C3c无沉积组累计生存率最低，预后最差。调整后的多因素Cox分析显示，肾小球C1q和C3c共沉积［风险比（HR）2.260，95%可信区间1.329~3.845，P<0.01］、肾小球C1q+C3c+IgM均沉积（HR=4.142，95%可信区间 1.071~16.021，P<0.05）是肾脏预后的独立危险因素。结论肾小球C1q及C3c沉积与糖尿病肾病患者蛋白尿、较差的肾功能和预后不良相关，且肾小球C1q和C3c共沉积是糖尿病肾病进展的独立危险因素。

简介：摘要目的探讨高密度脂蛋白胆固醇（HDL-C）与低密度脂蛋白胆固醇（LDL-C）与脑梗死的临床意义。方法将我院于2016年1月～2017年10月收治的70例脑梗死患者作为观察组，同期的健康体检者70例为对照组，测定并比较两组的LDL-C、HDL-C的含量，对结果进行比较分析。结果试验组的HDL-C的含量显著低于对照组，LDL-C的含量显著高于对照组，差异有统计学意义（P<0.05）。结论脑梗死的发生与LDL-C、HDL-C具有重要的相关性，其可以作为一项生化指标对脑梗死的发生进行预测判断，具有较高的临床价值。

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简介：目的了解福建汉族人群D2S44、D10S28、D4S163VNTR多态性，为亲权关系概率计算提供基因频率。方法采用美国Lifecodes公司提供的VNTR检测试剂盒，应用RFLP技术首次对福建省9个地市103名汉族无关个体进行D2S44、D10S28、D4S163VNTR多态性研究，并将所得基因频率与中国台湾、香港、新加坡等地区进行比较。结果福建汉族人群三位点VNTR呈高度多态性，其杂合率分别为88．6％、86．3％、90．6％，呈孟德尔经典遗传，分布符合Hardy-Weinberg平衡定律。结论福建、台湾、香港、新加坡华人互为比较，D2S44、D10S28位点基因频率没有显著性差别(P>0．500)。

简介：摘要目的鉴定1例人类白细胞抗原(human leukocyte antigen，HLA)罕见等位基因C*08：84，并调查该基因的家系遗传情况，预测分析其氨基酸残基改变在编码蛋白分子三维空间结构影响。方法应用单核苷酸序列分析、序列特异性寡核苷酸探针聚合酶链反应及单等位基因组特异性测序确定HLA-C分型并对该基因的先证者进行家系调查。应用Swiss-Model服务器，Phyre2和FATCAT在线软件对其三级结构进行模拟分析，对差异氨基酸结构和所处位置及可能的影响进行推测。结果家系分析表明HLA-C*08：84来自先证者母亲，与同源性最高的HLA-C*08：01相比较存在g.512G>C(p.Trp147Ser)变异。其编码三级结构模拟分析表明氨基酸变异位置为α2链，该位置参与构成抗原多肽结合凹槽F。C*08：84与C*08：01、C*08：02、C*08：03、C*08：22肽结合区182个氨基酸主链分子间抗原结合槽均方根偏差(RMSD)分别为1.70 nm、1.79 nm、0.71 nm、1.70 nm。结论确认并分析了罕见等位基因C*08：84，对其临床意义进行初步探讨和分析。

简介：目的：观察肾衰方对慢性肾脏病（chronickidneydisease,CKD）患者超敏C反应蛋白（hypersensitiveC-reactiveprotein,hs-CRP）水平及左心功能和结构的影响。方法：选取我院门诊或住院60例慢性肾脏病患者,随机分为治疗组和对照组各30例。治疗组在一般治疗的基础上予肾衰方治疗,对照组在一般治疗的基础上予尿毒清颗粒治疗,两组均以4周为1疗程,治疗2个疗程。观察两组患者治疗前后hs-CRP、肾功能及心脏彩超相关指标的变化。结果：总有效率治疗组83.33%、对照组66.67%,两组比较差异有统计学意义（P〈0.05）。治疗后中医证候积分、Scr、hs-CRP治疗组较对照组明显降低（P〈0.05）,Ccr治疗组较对照组明显升高（P〈0.05）。hs-CRP与Scr水平呈明显正相关（r=＋0.632,P〈0.01）,与Ccr呈明显负相关（r=-0.525,P〈0.01）,与LVEF水平呈明显负相关（r=-0.701,P〈0.05）。但两组患者LVDs、LVDd、IVST、LVPWT、LVMI治疗前后无明显改变,差异无统计学意义（P〉0.5）。结论：肾衰方治疗CKD患者临床疗效优于尿毒清,它可有效降低CKD患者hs-CRP水平,保护肾功能,改善左心室的收缩及舒张功能,减轻或延缓CVD的发生与发展,提高CKD患者的生存质量和生存率。

简介：Objective:Thereisnosaferwaytotransportachildthanaschoolbus.FatalcrashesinvolvingoccupantsareextremelyrareeventsintheUS.Inrecentyears,schoolbustransportationbegantodevelopinChina.WewanttobringadvancedexperienceonschoolbussafetyinWesterncountriessuchastheUStodevelopingcountries.Methods:WesearchedthepapersrelatedtoschoolbussafetyfromMedline,ChineseScientificJournalsDatabaseandtheWeboftheNationalHighwayTrafficSafetyAdministration(NHTSA).Results:Therewereonly9papersrelatedtoschoolbussafety,whichshowedthathigherlevelsofsafetystandardsonschoolbuses,schoolbus-relatedtransportationandenvironmentallawsandinjurypreventionweretheprimaryreasonsforthedesiredoutcome.Fewschoolbusisrelatedtodeathsandinjuriesinthedevelopedcountries.Conclusions:Thedevelopingcountriesshouldmakestrictenvironmentallawsandstandardsonschoolbussafetytopreventchildren'sinjuryanddeath.

简介：Symptomatichepato-diaphragmaticinterpositionofabowellooporChilaiditi'ssyndromeisapeculiaranatomicalconditionmostoftenfoundbychance.Itsdescribedsymptomsrangefromintermittent,mildabdominalpainanddyspepsiatoacuteintestinalobstruction.Wereportacaseofhepato-diaphragmaticmigrationofthehepaticflexureofthecolonassociatedtoanunusual,heretoforeunreported,angina-likepainexclusivelyevokedbytheleftlateraldecubitus.Tomaximizethechanceofobservinganatomicalchangesindifferentpostures,computedtomographyofthechestandabdomenwasperformedafterairinsufflationintothecolon.Whilefrankherniationintothechestwasexcluded,thescanshowedthatthehepaticflexure-withtheinterpositionofthediaphragm-cameincontactwiththerightsideoftheheartintheleftlateral,butnotinthesupine,decubitus.Thisfindingwasreproducedbyechocardiographywhichalsoshowedvirtuallyunalteredhemodynamicsafterthechangeofposture.ECG,leftandrightventricularglobalandregionalfunctionaswellascardiacinjurymarkersalsoremainedunchangedduringthemaneuver,indicatingthatthepainevokedbythelatterwasunlikelyduetomyocardialischemia.ThiscasesuggeststhatChilaiditi'ssyndromeshouldbeincludedamongthepossible,althoughrare,causesofunexplainedangina-likesymptoms.

简介：Parkinsonsdisease(PD)isacommon,progressiveneurodegenerativediseasecharacterisedbydegenerationofnigrostriataldopaminergicneurons,aggregationofα-synucleinandmotorsymptoms.Currentdopamine-replacementstrategiesprovidesymptomaticrelief,howevertheireffectivenesswearoffovertimeandtheirprolongeduseleadstodisablingside-effectsinPDpatients.ThereisthereforeacriticalneedtodevelopnewdrugsanddrugtargetstoprotectdopaminergicneuronsandtheiraxonsfromdegenerationinPD.Overrecentyears,therehasbeenrobustevidencegeneratedshowingthatepigeneticdysregulationoccursinPDpatients,andthatepigeneticmodulationisapromisingtherapeuticapproachforPD.Thisarticlefirstdiscussesthepresentevidenceimplicatingglobal,anddopaminergicneuron-specific,alterationsinthemethylomeinPD,andthetherapeuticpotentialofpharmacologicallytargetingthemethylome.Itthenfocusesonanothermechanismofepigeneticregulation,histoneacetylation,anddescribeshowthehistoneacetyltransferase(HAT)andhistonedeacetylase(HDAC)enzymesthatmediatethisprocessareattractivetherapeutictargetsforPD.Itdiscussestheuseofactivatorsand/orinhibitorsofHDACsandHATsinmodelsofPD,andhowtheseapproachesfortheselectivemodulationofhistoneacetylationelicitneuroprotectiveeffects.Finally,itoutlinesthepotentialofemployingsmallmoleculeepigeneticmodulatorsasneuroprotectivetherapiesforPD,andthefutureresearchthatwillberequiredtodetermineandrealisethistherapeuticpotential.

简介：煽动性的肠疾病(IBD)经常与象眼的神经炎那样的extraintestinal表明(EIM)被联系(在上)尽管这到目前为止在仅仅一些成年病人被描述了，所有谁与Crohns疾病(CD)被影响。而且，在上并且demyelinating疾病比的被表明了在IBD病人更经常在控制人口。在我们的当前的案例报告，我们与活跃CD描述一个孩子开发了突然的盲目由于在那上双边不与任何已知的原因有关，并且那即时对类固醇的高剂量作出回应。调查和临床的后续到目前为止在这个病人排除了demyelinating疾病的发展。到我们的知识，这是第一份报告在上在有CD的一个小儿科的病人。对这个案例的可能的解释包括活跃的肠疾病的阵发性的EIM，联系自体免疫的混乱例如一周期性孤立在上，多重硬化的第一表明，或能出现在以后的后续的另一demyelinating疾病。

简介：In2001and2002,publicationoftheresultsofthreelargerandomizedcontrolledtriais(RCTs)changedourunderstandingoftherisksandbenefitsofhormonereplacementtherapy(HRT),leadingtonewguidancefromnationaladvisorybodiesonitsuse.Manyclinicaliyrelevantquestionsremainunanswered,butparadoxicallythereultsofrecenttrialsmayhavemadeitmoredifficulttodesignthestudiesnecessarytoanswerthesequestions.TheUKWISDOMtrial(oestrogen-progestogenvsplaceboinhealthywomen),forexample,hasbeendiscontinued.