Effect of thyroidectomy and adrenalectomy on changes in liver glutathione and malonaldehyde levels after acute ethanol injection

At low concentrations ethanol is metabolized largely by alcohol dehydrogenase to acetaldehyde, while at higher concentrations a microsomal ethanol oxidising system (MEOS) is involved, namely cytochrome P450 IIE1, which also probably generates free radical species. In hyperthyroidism hepatic glutathione stores are depleted and net superoxide anion production occurs. In contrast, in hypothyroidism hepatic glutathione may be increased and thus renders the liver less sensitive to alcohol generated free radical production. Steroid hormones inhibit lipid peroxidation. Sixty male Wistar rats either underwent thyroidectomy, adrenalectomy, or sham procedures. Twenty control animals were pair fed with thyroidectomized animals, whilst another twenty fed ad libitum. An intraperitoneal injection of alcohol (75 mmol/kg) was given 2.5 h prior to sacrifice to half the animals in each group, the remainder receiving saline. The total hepatic glutathione contents of the pair fed and the ad libitum groups were not different, but were significantly increased by thyroidectomy (p = <0.001). This effect was significantly reduced by alcohol (p < 0.01). The sham procedures and dietary restrictions had no effect. The ethanol alone reduced total hepatic glutathione, but this only reached statistical significance in the thyroidectomized and sham-adrenalectomized groups. Hepatic malonaldehyde (MDA) levels were significantly reduced in the thyroidectomy group but alcohol had no effect on them. We conclude that hypothyroidism increased hepatic glutathione status, presumably by reducing radical production by enzyme systems, which would otherwise consume this important scavenger. Long term exposure to ethanol with induction of MEOS is probably required for it to generate toxic levels of free radical species.     

长非编码RNA SNAI3-AS1调控人软骨细胞C28/I2增殖能力及退变的机制研究

摘要 目的：为了探究长非编码RNA SNAI3-AS1（LncRNA SNAI3-AS1,即SNAI3-AS1）在骨性关节炎（osteoarthritis,OA）进展中的作用与机制。方法：通过全转录组测序筛选出在OA中差异表达的lncRNA SNAI3-AS1,并通过实时荧光定量PCR（qRT-PCR）检测SNAI3-AS1在软骨细胞退变模型中的表达情况。在软骨细胞C28/I2中分别转染SNAI3-AS1特异性siRNA或真核过表达质粒,分别敲低或过表达SNAI3-AS1,通过MTT、平板克隆形成和EdU掺入实验检测细胞增殖活力,Western Blot检测炎症和细胞外基质蛋白的表达情况。通过生物信息学网站预测SNAI3-AS1相互作用的miRNA和下游靶基因,并通过双荧光素酶报告基因和RIP实验进行验证。结果：相较于正常软骨细胞, SNAI3-AS1的表达水平在OA中显著下调。敲低正常软骨细胞中SNAI3-AS1的表达后,软骨细胞的增殖能力减弱并促进了软骨细胞的退变,而在OA模型的软骨细胞中过表达SNAI3-AS1后,软骨细胞的增殖活力加强并抑制了软骨细胞的退变。在机制上,SNAI3-AS1可充当竞争性内源性RNA（ceRNA）,经海绵吸附miR-2278间接上调PRELP,发挥促进软骨细胞增殖和抑制其退变的作用。结论：LncRNA SNAI3-AS1通过LncRNA SNAI3-AS1/ miR-2278/PRELP轴参与骨性关节炎的发生发展过程。     

传染性单核细胞增多症患儿NLR、CD4+/CD8+比值、ADA与EBV-DNA载量的相关性分析及对肝损害的影响

摘要 目的：探讨传染性单核细胞增多症（IM）患儿外周血中性粒细胞/淋巴细胞比值（NLR）、CD4⁺/CD8⁺比值、腺苷脱氨酶（ADA）与EB病毒（EBV）-脱氧核糖核酸（DNA）载量的相关性,分析其对IM患儿肝损害的影响。方法：选择2019年1月至2022年4月我院儿科收治的102例IM患儿（IM组）,另选择同期我科收治的95例EB病毒检测阴性的发热患儿（非IM组）和体检健康的73例健康儿童（对照组）。根据是否发生肝损害将IM患儿分为肝损害组（61例）和非肝损害组（41例）。比较外周血NLR、CD4⁺/CD8⁺比值、ADA与EBV-DNA载量,Pearson法分析NLR、CD4⁺/CD8⁺比值、ADA与EBV-DNA载量的相关性。多因素Logistic回归分析IM患儿发生肝损害的影响因素。结果：IM组ADA高于非IM组和对照组（P＜0.05）,且非IM组高于对照组（P＜0.05）,NLR、CD4⁺/CD8⁺比值低于非IM组和对照组（P＜0.05）,且非IM组低于对照组（P＜0.05）,IM组EBV-DNA载量高于非IM组（P＜0.05）。IM患儿ADA与EBV-DNA载量呈正相关（r=0.493,P＜0.05）,NLR、CD4⁺/CD8⁺比值与EBV-DNA载量呈负相关（r=-0.419、-472,P＜0.05）。肝损害组ADA、EBV-DNA载量高于非肝损害组（P＜0.05）,NLR、CD4⁺/CD8+⁺比值低于非肝损害组（P＜0.05）。肝脏肿大、高EBV-DNA载量、高ADA是IM患儿肝损害的危险因素（P＜0.05）,高NLR、高CD4⁺/ CD8⁺比值是保护因素（P＜0.05）。结论：IM患儿ADA增高,NLR、CD4⁺/CD8⁺比值降低,与EBV-DNA载量增加以及肝损害有关。     

铜蓝蛋白、鳞状细胞癌相关抗原与慢性肾功能衰竭的关系及对病情进展的预测价值研究

摘要 目的：分析铜蓝蛋白（CER）、鳞状细胞癌相关抗原（SCCA）与慢性肾功能衰竭的关系及对病情进展的预测价值。方法：选择我院自2019年4月至2021年4月接诊的169例慢性肾功能衰竭患者作为研究对象,根据24 h尿白蛋白定量分为微量白蛋白尿组（＜200 mg/24 h,102例）和大量白蛋白尿组（＞200 mg/24 h,67例）。比较两组各项实验室指标及血清CER、SCCA水平,分析CER、SCCA与慢性肾功能衰竭患者肾功能指标的关系。随访12个月,观察病情进展,使用受试者工作特征曲线（ROC）评价血清CER联合SCCA对病情进展的预测效能。结果：大量白蛋白尿组血清肌酐（Scr）、血尿素氮（BUN）水平均明显高于微量白蛋白尿组,肾小球滤过率（GFR）低于微量白蛋白尿组（P＜0.05）;大量白蛋白尿组血清CER、SCCA水平均高于微量白蛋白尿组（P＜0.05）;经Pearson相关性分析,慢性肾功能衰竭患者血清CER、SCCA水平均与Scr、BUN呈正相关,与GFR呈负相关（P＜0.05）;经多因素Logistic回归分析,GFR、CER、SCCA均是慢性肾功能衰竭患者病情进展的独立预测因素（P＜0.05）;经ROC曲线分析,血清CER联合SCCA预测慢性肾功能衰竭患者病情进展的AUC为0.925,明显大于GFR的0.620（P＜0.05）。结论：血清CER、SCCA水平与慢性肾功能衰竭患者肾功能呈负相关,联合预测病情进展效能较好,值得临床予以重视应用。     

探究壮方柔肝化纤颗粒对肝纤维化大鼠肝组织病理影响机制

摘要 目的：探究壮方柔肝化纤颗粒对肝纤维化大鼠肝组织病理影响机制。方法：选取80只雄性Wistar大鼠随机将其平均分成正常对照组、病理模型组、柔肝化纤颗粒低、中、高剂量组,每组各16只。四氯化碳复合因素造模,观察记录大鼠肝脏形态,采用HE染色、Masson染色观察大鼠肝组织和胶原纤维变化,检测血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）指标数值,分析大鼠肝组织中谷胱甘肽过氧化物酶（GSH-Px）、羟脯氨酸（HYP）、超氧化物歧化酶（SOD）与丙二醛（MDA）的含量。结果：柔肝化纤颗粒低、中、高剂量组大鼠肝细胞变性、坏死及纤维化组织增生程度均较病理模型组明显减轻。柔肝化纤颗粒低、中、高剂量组血清ALT、AST指标数值与肝组织中HYP、MDA指标水平较病理模型组呈现剂量依赖性降低（P＜0.001）,而柔肝化纤颗粒高剂量组GSH-Px、SOD的指标含量显著高于病理模型组,差异均有统计学意义（P＜0.001）。结论：柔肝化纤颗粒可有效改善肝纤维化大鼠的肝细胞损害情况,减轻其肝组织炎症程度,对肝纤维化大鼠有一定的保肝护肝与抗肝纤维化作用,其机制可能与提高GSH-Px与SOD的水平、降低HYP与MDA的含量、降低氧化应激水平、调节脂质代谢、减少机体胶原蛋白合成等相关。     

Treatment-resistant depression: definition,prevalence, detection,management, and investigational interventions

Treatment-resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition hampers precise estimates of the prevalence of TRD, and also belies efforts to identify risk factors, prevention opportunities, and effective interventions. In addition, it results in heterogeneity in clinical practice decision-making, adversely affecting quality of care. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have adopted the most used definition of TRD (i.e., inadequate response to a minimum of two antidepressants despite adequacy of the treatment trial and adherence to treatment). It is currently estimated that at least 30% of persons with depression meet this definition. A significant percentage of persons with TRD are actually pseudo-resistant (e.g., due to inadequacy of treatment trials or non-adherence to treatment). Although multiple sociodemographic, clinical, treatment and contextual factors are known to negatively moderate response in persons with depression, very few factors are regarded as predictive of non-response across multiple modalities of treatment. Intravenous ketamine and intranasal esketamine (co-administered with an antidepressant) are established as efficacious in the management of TRD. Some second-generation antipsychotics (e.g., aripiprazole, brexpiprazole, cariprazine, quetiapine XR) are proven effective as adjunctive treatments to antidepressants in partial responders, but only the olanzapine-fluoxetine combination has been studied in FDA-defined TRD. Repetitive transcranial magnetic stimulation (TMS) is established as effective and FDA-approved for individuals with TRD, with accelerated theta-burst TMS also recently showing efficacy. Electroconvulsive therapy is regarded as an effective acute and maintenance intervention in TRD, with preliminary evidence suggesting non-inferiority to acute intravenous ketamine. Evidence for extending antidepressant trial, medication switching and combining antidepressants is mixed. Manual-based psychotherapies are not established as efficacious on their own in TRD, but offer significant symptomatic relief when added to conventional antidepressants. Digital therapeutics are under study and represent a potential future clinical vista in this population.     

抑郁症患者的脑CT灌注成像特征与认知功能的相关性

摘要 目的：探讨抑郁症患者的脑CT灌注成像特征与认知功能的相关性。方法：选取我院2020年1月到2023年1月收治的90例抑郁症患者作为研究对象,将其分为观察组,另选取同期来我院体检的90名健康志愿者作为对照组。收集所有受检者脑CT灌注成像检查数据,分析抑郁症患者的脑CT灌注成像特征,并建立受试者工作特征（ROC）曲线分析脑CT灌注成像对抑郁症的诊断效能。随后对观察组和对照组受检者均进行认知功能评估,其中包括连线检测（TMT）、视觉再生测验（VRT）、言语流畅性测验（VF）、数字广度测验（DST）以及数字符号测验（SDMT）,并分析脑CT灌注成像与抑郁症认知功能的相关性。结果：观察组与对照组受检者rCBV、rCBF、MTT、TIP、右枕叶、左枕叶、右颞叶、左颞叶、右顶叶、左顶叶CT值对比无明显差异（P＞0.05）,观察组与对照组受检者右额叶、左额叶CT值对比差异显著,观察组明显低于对照组（P＜0.05）;90例抑郁症患者经过汉密尔顿抑郁量表（HAMD）评估后分数均＞20分,确定存在抑郁症状,脑CT灌注成像与HAMD评分诊断抑郁症的准确性、灵敏度、特异性、阳性预测值和阴性预测值对比无明显差异（P＞0.05）,脑CT灌注成像的曲线下面积为83.89,最佳诊断着色界限值为82.53%,HAMD评分的曲线下面积为84.26,最佳诊断着色界限值为87.57%;观察组与对照组受检者连线提笔数、连线错误数、视觉再生检测结果对比无明显差异（P＞0.05）,观察组与对照组受检者连线、言语流畅性、数字广度、数字符号检测结果对比差异显著（P＜0.05）;Spearman相关分析结果表明：连线提笔数、连线错误数、视觉再生与脑CT灌注参数均无明显相关性（P＞0.05）,连线、言语流畅性、数字广度、数字符号与rCBV、rCBF、MTT、TIP、右枕叶、左枕叶、右颞叶、左颞叶、右顶叶、左顶叶CT值无明显相关性（P＞0.05）,连线与右额叶、左额叶CT值呈负相关（P＜0.05）,言语流畅性、数字广度、数字符号与右额叶、左额叶CT值呈正相关（P＜0.05）。结论：抑郁症患者的脑CT灌注成像与健康群体呈现差异,其中右额叶、左额叶差异情况最为显著,提示抑郁症患者可能存在大脑额叶功能改变,另外,抑郁症患者的大脑额叶功能与认知功能变化具有明显相关性。     

亚硒酸钠对四氯化碳损伤草鱼肝原代细胞与肝组织的保护作用

不同浓度四氯化碳（ＣＣｌ４）对草鱼肝原代细胞的损伤实验中,ＣＣｌ４浓度为１０μｌ／ｍｌ可引起细胞血清中丙氨酸氨基转移酶（ＡＬＴ）、天门冬氨酸氨基转移酶（ＡＳＴ）、乳酸脱氢酶（ＬＤＨ）逸出量与细胞破损率显著增高,培养液中添加亚硒酸钠（Ｎａ２ＳｅＯ３）０．２μｇ／ｍｌ,则可降低ＡＬＴ、ＡＳＴ、ＬＤＨ的逸出量,减轻细胞破损程度。Ｎａ２ＳｅＯ３保护实验中,Ｎａ２ＳｅＯ２＋ＣＣｌ４组预先腹腔注射（ｉｐ）０．１ｍｇ／ｋｇ．ｂｗ连续三日,末次ｉｐＣＣｌ４混合液１ｍｌ／ｋｇ．ｂｗ,２４ｈ内肝组织超氧物歧化酶（ＳＯＤ）相对活性比ＣＣｌ４组提高达９１．５％,第七日仍提高达５４．５％,与对照组的水平基本接近;血清中丙氨酸氨基转氨酶（ＡＬＴ）水平逐渐降低。本实验还观察到Ｎａ２ＳｅＯ３可引起肝脂质过氧化物显著降低,肝微粒体蛋白含量与细胞色素Ｐ—４５０活性升高;组织切片观察显示肝组织损伤程度减轻,７２ｈ后细胞核增多。表明Ｎａ２ＳｅＯ３可提高草鱼肝清除自由基能力,增强肝脏解毒功能。     

原位缺口平移标记断裂DNA技术及其在检测流行性出血热尸检和实验动物组织中细胞凋亡和早期死亡的应用

原位缺口平移技术（ＩＳＮＴ）已被用于检测细胞核中ＤＮＡ断裂鉴别尸检组织中细胞的凋亡和坏死断裂、流行性出血热（ＥＨＦ）组织中存在散在单个细胞变性死亡和灶性梗死样坏死,前者带有细胞凋亡的特征。本文以ＥＨＦ肝脏和实验性病毒感染鼠脑组织为例,应用缺口平移法,在ＤＮＡ聚合酶或Ｋｌｅｎｏｗ酶的作用下,将地高辛标记的ｄＵＴＰ掺入合成到ＤＮＡ的断裂部位,通过碱性磷酸酶标抗地高辛抗体免疫组化法显示细胞ＤＮＡ的断裂,检测和鉴别细胞的凋亡和坏死。为分析死后解剖时间间隔及组织固定时间对该方法的影响,本文选用死后２～１４０ｈ尸检、经常规固定石蜡包埋后存放１０～３５年的标本和在１０％福尔马林固定了１０～３５年之后再进行常规处理的标本。实验时用蛋白酶Ｋ（ＰＫ）消化前后对比并分别在标记反应液中略去ＤＮＡ聚合酶作为阴性对照,用ＤＮＡ酶消化组织人为制造ＤＮＡ缺日作为阳性对照。结果发现,未经ＰＫ消化的组织,仅灶性肝细胞核ＩＳＮＴ标记阳性,经ＰＫ消化后,散在的带有凋亡特征的肝细胞胞核也出现阳性,灶性肝细胞胞核标记染色增强,但无论是蛋白酶消化与否,明确梗死样坏死的肝细胞均不被标记。结果还发现,死后２～２４ｈ内尸检组织和长时间（１０～３４年）存放的石     

肝炎平对D－氨基半乳精所致肝损害保护作用的酶组织化学研究

本实验采用Ｄ－氨基半乳糖（Ｄ－ＧａｌＮ）诱导的大鼠急性肝损伤模型,观察大鼠肝脏组织化学的变化,探讨肝炎平对急性肝损伤的保护作用。实验分为四组,即正常对照组、模型组、肝炎平及肝得健保护组。结果表明：肝炎平对肝细胞膜系统有一定的保护作用。肝炎平组和肝得健组ＳＤＨ、ＣＣＯ及ＣｈＥ活性明显高于模型组,且与正常对照组相近。本实验模型组ＡＣＰ的活性明显高于正常组,而肝炎平组ＡＣＰ的活性明显低于模型组,与正常对照组无显著性差异。提示：肝炎平可显著改善因Ｄ－氨基半乳糖所致肝损害的作用。且其对肝细胞的保护作用与肝得健一致。