帕瑞昔布联合股神经阻滞用于膝关节置换术后镇痛的效果评价及其对患者免疫功能的影响

目的:探讨帕瑞昔布联合股神经阻滞用于膝关节置换术后镇痛的效果及对患者免疫功能的影响。方法:选择2016年10月-2017年10月我院骨科住院部收治并行单侧膝关节置换的患者108例,按镇痛方式分为对照组和观察组各54例。对照组患者采用单纯股神经阻滞,观察组采用股神经阻滞联合帕瑞昔布。比较两组静息及活动状态下术后VAS评分、术后膝关节HSS评分、不良反应的发生情况及免疫指标的变化情况。结果:静息及活动状态下,观察组术后VAS评分均明显低于对照组(P均0.05),膝关节HSS评分显著高于对照组(P0.05)。两组术后不良反应的发生情况比较差异无统计学意义(P0.05)。手术结束时,两组CD4~+较麻醉前均显著下降(P均0.05);术后72 h,两组CD4~+、CD8~+及CD4~+/CD8~+较麻醉前均无显著差异(P均0.05)。观察组术后72 h CD4~+比对照组高(P0.05),而CD4~+/CD8~+显著低于对照组(P0.05)。结论:帕瑞昔布联合股神经阻滞对膝关节置换术后镇痛临床效果好,利于保护和改善患者免疫功能,促进膝关节功能的康复。     

PFNA内固定在老年人股骨转子间骨折的手术效果及对髋关节功能改善效果

目的:研究股骨近端螺旋刀片抗旋髓内钉(PFNA)内固定治疗老年股骨转子间骨折的效果及对髋关节功能影响。方法:研究对象选取我院2012年8月到2015年5月间收治的老年股骨转子间骨折患者86例,采用随机数字法将其分为对照组(43例)和观察组(43例)。对照组患者接受动力髋螺钉(DHS)内固定治疗,观察组患者接受PFNA内固定治疗。比较两组患者的手术效果和并发症发生率,同时术后随访,比较两组患者的髋关节功能评分和炎症因子表达水平。结果:在手术时间、术中出血量、卧床时间及骨折愈合时间方面,观察组均明显低于对照组(P0.01);观察组的总并发症发生率(4.66%)明显低于对照组(20.94%)(x~2=5.11,P=0.02);术后随访6个月,两组的Harris髋关节功能评分优良率比较无明显差异(P0.05);手术后,血清IL-6、IL-10、TNF-α表达水平,观察组均明显低于对照组(P0.01)。结论:PFNA治疗老年股骨转子间骨折的效果显著,手术创伤较小,术中出血量低,且并发症较低,且术后髋关节功能恢复效果较好,值得在临床推广。     

复方丹参滴丸联合阿司匹林对冠心病患者血小板聚集功能及血脂水平的影响

目的:探讨复方丹参滴丸联合阿司匹林对冠心病(CHD)患者血小板聚集功能及血脂水平的影响。方法:选取2011年10月到2016年12月在我院接受治疗的CHD患者320例作为本次研究对象,采用乱数表法将所有患者分为对照组和观察组各160例,两组患者均采用扩冠、抗凝和降压药物等常规内科治疗,在此基础上对照组给予阿司匹林治疗,观察组给予复方丹参滴丸联合阿司匹林治疗,两组均治疗6个月。对比两组临床疗效、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)及高密度脂蛋白(HDL)、血栓素B2(TXB2)水平,记录血小板最大聚集率(PAGM)及不良事件发生率。结果:治疗后观察组的总有效率为93.13%,显著高于对照组的68.75%(P0.05)。治疗6个月后观察组HDL水平高于治疗前和对照组,LDL、TC、TG水平低于治疗前和对照组(P0.05)。治疗6个月后两组患者PAGM、TXB2水平均有明显下降,且观察组PAGM、TXB2水平低于对照组(P0.05)。观察组不良事件发生率为2.50%,显著低于对照组的18.13%(P0.05)。结论:复方丹参滴丸与阿司匹林联合治疗CHD临床疗效较好,可以有效抑制血小板凝聚,调节血脂,降低不良事件发生率,值得在临床上推广。     

张家口市大气颗粒物PM2.5、PM10浓度与慢性阻塞性肺疾病住院人次的关系研究

目的:研究张家口市大气颗粒物对慢性阻塞性肺疾病(COPD)的影响,并分析大气颗粒物对不同特征人群的影响。方法:从张家口市医保办公室获取张家口市2013年1月1日-2015年12月31日两家三甲医院COPD患者的住院病历资料,从中国环境监测总站网站获取大气污染物的监测数据,从张家口市气象局获取气象资料。建立广义相加模型(GAM),在控制长期趋势、星期几效应和温湿度影响后,应用条件Logitic回归方法评估PM_(2.5)、PM_(10)对COPD住院人次的影响。根据患者不同特征(性别、年龄、季节)进行分层分析,评估颗粒物污染的高危人群。结果:研究纳入两家三甲医院,共1984例住院COPD患者,其中男性患者1258例(63.4%)、女性患者726例(36.6%),≥75岁患者678例(34.2%),60~75岁患者936例(47.2%)、芨60岁患者370例(18.6%)。2013-2015年PM_(2.5)、PM_(10)年均浓度分别为[(36.54±20.34)μg/m~3、(84.37±52.54)μg/m~3],[(34.50±27.08)μg/m~3、(78.43±69.78)μg/m~3],[(32.04±21.35)μg/m~3、(75.46±50.02)μg/m~3],两者在移动平均滞后3d时,对COPD的影响最大,即PM_(2.5)每增加10μg/m~3,COPD住院人次增加1.90%(95%CI:1.002-1.033,P0.05),PM_(10)每增加10μg/m~3,COPD住院人次增加2.10%(95%CI:1.005-1.045,P0.05)。分层分析结果显示:PM_(2.5)、PM_(10)每升高10μg/m~3,女性COPD患者住院人次增加1.09%、1.14%,差异具有统计学意义(P0.05);≥75岁患者,COPD住院人次增加1.03%、0.99%,差异具有统计学意义(P0.05);而年龄芨60岁、60~75岁、男性以及季节分层分析中,PM_(2.5)、PM_(10)浓度与COPD住院人次无统计学意义(P0.05)。结论:颗粒物污染会增加COPD住院率,≥75岁的老年患者及女性患者更敏感。     

四磨汤对宫颈癌化疗患者胃肠功能的保护作用及对血清IL-8、CEA、CA125水平的影响

目的:研究四磨汤对恩度联合力朴素治疗的宫颈癌患者胃肠功能的保护作用及对其血清白细胞介素8(IL-8)、癌胚抗原(CEA)、糖类抗原125(CA125)的影响。方法:选取2015年9月至2016年8月我院收治的88例宫颈癌患者,根据患者入院顺序分为观察组和对照组,每组44例。对照组在放疗基础上加以恩度联合力朴素完成化疗,观察组在对照组治疗基础上加以四磨汤。比较两组患者治疗前后血清IL-8、CEA、CA125水平及外周血CD3~+、CD4~+、CD8~+细胞比例的变化和胃肠道毒副反应、胃肠道放射性损伤的发生情况。结果:治疗后,两组患者血清IL-8、CEA、CA125水平均较治疗前显著降低(P0.05),且观察组的血清IL-8、CEA、CA125水平较对照组明显降低(P0.05);两组患者CD3~+、CD4~+细胞比例较治疗前显著降低(P0.05),CD8~+细胞比例较治疗前显著升高(P0.05),但观察组的CD3~+、CD4~+、CD8~+细胞比例细胞比例显著高于对照组(P0.05)。观察组不良反应发生率、早期胃肠道放射性损伤发生率、Ⅱ、Ⅲ级胃肠道放射性损伤率均显著低于对照组(P0.05)。结论:四磨汤用于恩度联合力朴素治疗的宫颈癌患者能有效保护患者胃肠功能,降低患者血清IL-8、CEA、CA125水平,增强患者免疫力。     

Wild‐type p53 enhances endothelial barrier function by mediating RAC1 signalling and RhoA inhibition

Inflammation is the major cause of endothelial barrier hyper‐permeability, associated with acute lung injury and acute respiratory distress syndrome. This study reports that p53 “orchestrates” the defence of vascular endothelium against LPS, by mediating the opposing actions of Rac1 and RhoA in pulmonary tissues. Human lung microvascular endothelial cells treated with HSP90 inhibitors activated both Rac1‐ and P21‐activated kinase, which is an essential element of vascular barrier function. 17AAG increased the phosphorylation of both LIMK and cofilin, in contrast to LPS which counteracted those effects. Mouse lung microvascular endothelial cells exposed to LPS exhibited decreased expression of phospho‐cofilin. 17AAG treatment resulted in reduced levels of active cofilin. Silencing of cofilin pyridoxal phosphate phosphatase (PDXP) blocked the LPS‐induced hyper‐permeability, and P53 inhibition reversed the 17AAG‐induced PDXP down‐regulation. P190RHOGAP suppression enhanced the LPS‐triggered barrier dysfunction in endothelial monolayers. 17AAG treatment resulted in P190RHOGAP induction and blocked the LPS‐induced pMLC2 up‐regulation in wild‐type mice. Pulmonary endothelial cells from “super p53” mice, which carry additional p53‐tg alleles, exhibited a lower response to LPS than the controls. Collectively, our findings help elucidate the mechanisms by which p53 operates to enhance barrier function.     

A machine‐learning approach for extending classical wildlife resource selection analyses

Resource selection functions (RSFs) are tremendously valuable for ecologists and resource managers because they quantify spatial patterns in resource utilization by wildlife, thereby facilitating identification of critical habitat areas and characterizing specific habitat features that are selected or avoided. RSFs discriminate between known‐use resource units (e.g., telemetry locations) and available (or randomly selected) resource units based on an array of environmental features, and in their standard form are performed using logistic regression. As generalized linear models, standard RSFs have some notable limitations, such as difficulties in accommodating nonlinear (e.g., humped or threshold) relationships and complex interactions. Increasingly, ecologists are using flexible machine‐learning methods (e.g., random forests, neural networks) to overcome these limitations. Herein, we investigate the seasonal resource selection patterns of mule deer (Odocoileus hemionus) by comparing a logistic regression framework with random forest (RF), a popular machine‐learning algorithm. Random forest (RF) models detected nonlinear relationships (e.g., optimal ranges for slope and elevation) and complex interactions which would have been very challenging to discover and characterize using standard model‐based approaches. Compared with standard RSF models, RF models exhibited improved predictive skill, provided novel insights about resource selection patterns of mule deer, and, when projected across a relevant geographic space, manifested notable differences in predicted habitat suitability. We recommend that wildlife researchers harness the strengths of machine‐learning tools like RF in addition to “classical” tools (e.g., mixed‐effects logistic regression) for evaluating resource selection, especially in cases where extensive telemetry data sets are available.     

Gentiopicroside ameliorates bleomycin-induced pulmonary fibrosis in mice via inhibiting inflammatory and fibrotic process

Pulmonary fibrosis (PF) is a chronic and ultimately fatal interstitial lung disease of various causes. The advent of nintedanib and pirfenidone provides treatment options for PF patients for the first time. However, the adverse effects of the two drugs such as gastrointestinal disorders and hepatic dysfunction often lead to treatment discontinuation. Gentiopicroside (GPS) is a natural secoiridoid glycoside from gentian species of medicinal plants, and has a variety of pharmacological activities, including hepatoprotective and cholagogic, anti-inflammatory, antinociceptive, and smooth muscle relaxing activities. The present study aimed to investigate the therapeutical effects of GPS on bleomycin (BLM)-induced PF in mice. Severe lung inflammation and fibrosis were observed in BLM-treated mice. GPS significantly ameliorated inflammatory and fibrotic responses in lungs of PF mice which were confirmed by histopathological examinations including light microscopy and transmission electron microscopy. Additionally, GPS significantly decreased the levels of inflammatory cytokines including TNF-α and IL-1β in bronchoalveolar lavage fluid and reduced the content of hydroxyproline in lungs of PF mice. Furthermore, GPS significantly downregulated the expression of TGF-β1 and CTGF in lungs of PF mice. In vitro, GPS inhibited epithelial-mesenchymal transition of A549?cells stimulated by TGF-β1, in a dose-dependent manner. Our findings suggest that GPS has the potential as an ideal drug candidate for PF, as it has both anti-inflammatory and anti-fibrotic effects. Alveolar epithelial cells and TGF-β1 may be the main target cells and molecule of GPS on BLM-induced PF, respectively.     

Habitat attribute similarities reduce impacts of land‐use conversion on seed removal

Changes in land use strongly influence habitat attributes (e.g., herbaceous ground cover and tree richness) and can consequently affect ecological functions. Most studies have focused on the response of these ecological functions to land‐use changes within only a single vegetation type. These studies have often focused solely on agricultural conversion of forests, making it nearly impossible to draw general conclusions across other vegetation types or with other land‐use changes (e.g., afforestation). We examined the consequences of agricultural conversion for seed removal by ants in native grassland, savanna, and savanna‐forest habitats that had been transformed to planted pastures (Brachiaria decumbens) and tree plantations (Eucalyptus spp.) and explored if changes in seed removal were correlated with differences in habitat attributes between habitat types. We found that land‐use changes affected seed removal across the tree cover gradient and that the magnitude of impact was influenced by similarity in habitat attributes between native and converted habitats, being greater where there was afforestation (Eucalyptus spp in grassland and savanna). Herbaceous ground cover, soil hardness, and tree richness were the most important habitat attributes that correlated with differences in seed removal. Our results reveal that the magnitude of impact of land‐use changes on seed removal varies depending on native vegetation type and is associated with the type of habitat attribute change. Our findings have implications for biodiversity in tropical grassy systems: afforestation can have a greater detrimental impact on ecological function than tree loss.     

Chemical Crosslinking Mass Spectrometry Reveals the Conformational Landscape of the Activation Helix of PPARγ; a Model for Ligand-Dependent Antagonism

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