右美托咪定联合帕瑞昔布钠对老年腹腔镜胃癌手术患者应激反应、细胞免疫功能和认知功能的影响

摘要 目的：探讨帕瑞昔布钠和右美托咪定联合麻醉对老年腹腔镜胃癌手术患者细胞免疫功能、应激反应和认知功能的影响。方法：纳入2019年8月~2022年7月期间西安交通大学第二附属医院收治的150例老年腹腔镜胃癌手术患者。按照随机数字表法将患者分为帕瑞昔布钠组（n=50,帕瑞昔布钠）、右美托咪定组（n=50,右美托咪定）和联合组（n=50,右美托咪定联合帕瑞昔布钠）。对比三组临床指标、视觉模拟评分法（VAS）、简易精神状态检查表（MMSE）评分、术后认知功能障碍（POCD）发生率、应激反应指标[皮质醇（Cor）、肾上腺素（E）、促肾上腺皮质激素（ACTH）]、细胞免疫功能变化情况。结果：联合组的术后住院天数、肛门排气时间短于右美托咪定组、帕瑞昔布钠组（P<0.05）。联合组术后12 h、术后24 h、术后48 h VAS评分低于右美托咪定组、帕瑞昔布钠组（P<0.05）。联合组术后24 h、术后72 h MMSE评分高于右美托咪定组、帕瑞昔布钠组（P<0.05）。联合组的POCD发生率低于右美托咪定组、帕瑞昔布钠组（P<0.05）。三组术后1 d Cor、E、ACTH升高,但联合组低于帕瑞昔布钠组、右美托咪定组同期（P<0.05）。三组术后1 d CD8⁺升高,但联合组低于帕瑞昔布钠组、右美托咪定组同期;CD3⁺、CD4⁺、CD4⁺CD8⁺下降,但联合组高于帕瑞昔布钠组、右美托咪定组同期（P<0.05）。结论：右美托咪定联合帕瑞昔布钠应用于老年腹腔镜胃癌手术患者,镇痛效果显著,可减轻机体的应激反应、免疫抑制及对认知功能的损害。     

miR-455-5p靶向SOCS3抑制RSV感染致气道上皮炎症反应的机制研究

摘要 目的：揭示miR-455-5p对呼吸道合胞病毒（RSV）感染致气道上皮细胞炎症反应的作用机制。方法：qRT-PCR检测30例健康体检儿童（健康组）、RSV感染轻症组（n=41）和重症组（n=31）患儿血清miR-455-5p水平。将16HBE细胞分为Control组、NC-agomir组、miR-455-5p-agomir组、NC-antagomir组、miR-455-5p-antagomir组。使用Lipofectamine 3000转染16HBE细胞后培养48 h后,分为Blank组、NC组（转染了NC-agomir的细胞）、RSV+NC-agomir组、RSV+miR-455-5p-agomir组,用RSV病毒液感染RSV+NC-agomir组和RSV+miR-455-5p-agomir组16HBE细胞,Blank组和NC组16HBE细胞正常培养。用CCK-8法和EdU法检测细胞增殖、TUNEL法检测细胞凋亡、ELISA法检测上清液中TNF-α、IL-6、IL-8水平,qRT-PCR检测miR-455-5p和SOCS3的mRNA水平,Western blot检测SOCS3、IFN-α、STAT1、STAT2、p-STAT1和p-STAT2的蛋白水平。结果：与健康组相比,轻症组和重症组患儿的血清miR-455-5p水平降低（P<0.05）。与轻症组相比,重症组的血清miR-455-5p水平降低（P<0.05）。与Control组和NC-agomir组相比,miR-455-5p-agomir组16HBE细胞的miR-455-5p水平、相对细胞活力和EdU阳性率升高（P<0.05）,TUNEL阳性率降低（P<0.05）,上清液中的TNF-α、IL-6和IL-8水平降低（P<0.05）,SOCS3 mRNA和蛋白水平降低（P<0.05）,IFN-α蛋白、STAT1和STAT2磷酸化水平升高（P<0.05）。与Control组和NC-antagomir组相比,miR-455-5p-antagomir组16HBE细胞的miR-455-5p水平、相对细胞活力和EdU阳性率降低（P<0.05）,TUNEL阳性率升高（P<0.05）,上清液中的TNF-α、IL-6和IL-8水平升高（P<0.05）,SOCS3 mRNA和蛋白水平升高（P<0.05）,IFN-α蛋白、STAT1和STAT2磷酸化水平降低（P<0.05）。与Blank组和NC组相比,RSV+NC-agomir组16HBE细胞的miR-455-5p水平、相对细胞活力和EdU阳性率降低（P<0.05）,TUNEL阳性率升高（P<0.05）,上清液中的TNF-α、IL-6和IL-8水平升高（P<0.05）,SOCS3 mRNA和蛋白水平升高（P<0.05）,IFN-α蛋白、STAT1和STAT2磷酸化水平降低（P<0.05）。与RSV+NC-agomir组相比,RSV+miR-455-5p-agomir组的miR-455-5p水平、相对细胞活力和EdU阳性率升高（P<0.05）,TUNEL阳性率降低（P<0.05）,上清液中的TNF-α、IL-6和IL-8水平降低（P<0.05）,SOCS3 mRNA和蛋白水平降低（P<0.05）,IFN-α蛋白、STAT1和STAT2磷酸化水平升高（P<0.05）。结论：miR-455-5p在RSV感染患儿血清中下调,上调miR-455-5p通过抑制SOCS3的转录和表达从而激活RSV感染的16HBE细胞中IFN-α介导的抗病毒反应。     

瑞芬太尼靶控输注对宫颈癌根治术患者麻醉苏醒质量、应激反应及Th1/Th2免疫平衡的影响

摘要 目的：观察瑞芬太尼靶控输注对宫颈癌根治术患者麻醉苏醒质量、应激反应及辅助T细胞（Th）1/Th2免疫平衡的影响。方法：按照随机数字表法将2023年1月到2023年6月期间我院接受的120例宫颈癌根治术患者分为舒芬太尼组（n=60,舒芬太尼麻醉）和瑞芬太尼组（n=60,瑞芬太尼麻醉）。对比两组的麻醉苏醒质量、应激反应指标[皮质醇（Cor）、去甲肾上腺素（NE）、血管紧张素1（Ang-1）、血管紧张素2（Ang-2）]、Th1/Th2免疫平衡指标[包括Th1、Th2及调节性T细胞（Treg）、Th1/Th2比值],术后记录不良反应发生情况。结果：与舒芬太尼组相比,瑞芬太尼组的应激呼吸恢复时间、睁眼时间、拔管时间更短（P<0.05）。术后1 d,两组Cor、NE、Ang-1、Ang-2升高,但瑞芬太尼组低于舒芬太尼组（P<0.05）。术后1 d,两组Th1、Treg、Th1/Th2升高,但瑞芬太尼组低于舒芬太尼组;Th2下降,但瑞芬太尼组高于舒芬太尼组（P<0.05）。两组不良反应发生率组间对比未见差异（P>0.05）。结论：瑞芬太尼靶控输注用于宫颈癌根治术患者,可改善麻醉苏醒质量,减轻应激反应,调节Th1/Th2免疫平衡,且不增加不良反应的发生率,效果较好。     

下调miR-223表达对脓毒症心肌病小鼠心肌的保护作用及机制研究

摘要 目的：探讨下调miR-223表达对脓毒症心肌病（SCM）小鼠心肌的保护作用及其机制。方法：按随机数字表法将27只8-10 周龄SPF级雄性C57BL/6小鼠分配至SCM模型（0 h,6 h,12 h,18 h,24 h）时相组、Normal组、SCM组、miR-223 antagomir NC组、miR-223 antagomir组,每组3只。腹腔注射脂多糖（lipopolysaccharide, LPS）15 mg/kg构建SCM小鼠模型。miR-223 antagomir NC组与miR-223 antagomir组分别于建模前连续3天鼠尾静脉注射miR-223 antagomir NC、miR-223 antagomir预处理。采用反转录-聚合酶链反应（RT-PCR）研究SCM模型各个时相组小鼠心肌组织miR-223的表达情况。采用苏木素伊红（HE）染色法观察Normal组、SCM组、miR-223 antagomir NC组和miR-223 antagomir组小鼠心肌病理形态变化。采用酶联免疫吸附实验（ELISA）测定Normal组、SCM组、miR-223 antagomir NC组和miR-223 antagomir组小鼠血清cTnI、BNP、CK-MB、IL-6、IL-1β、TNF-α的含量并进行相关性分析。结果：SCM模型时相组小鼠随刺激时间延长,心肌组织miR-223表达水平逐渐升高。与Normal组比较,SCM组、miR-223 antagomir NC组、miR-223 antagomir组小鼠心肌组织出现不同程度损伤;血清心肌损伤标记物cTnI、BNP、CK-MB及炎性因子IL-6、IL-1β、TNF-α的表达水平均上升,差异具有统计学意义（P<0.05）;与SCM组比较,miR-223 antagomir NC组各项指标相差不大,差异均无统计学意义（P>0.05）;miR-223 antagomir组小鼠心肌组织病理损伤程度有所减轻,心肌损伤标记物cTnI、BNP、CK-MB及炎性因子IL-6、IL-1β、TNF-α水平下降,差异具有统计学意义（P<0.05）。相关性分析结果显示小鼠miR-223表达与心肌损伤标记物cTnI、BNP、CK-MB及炎性因子IL-6、IL-1β、TNF-α的表达呈正相关。结论：下调miR-223表达可通过减轻炎症反应对SCM小鼠心肌产生保护作用。     

小剂量糖皮质激素联合持续性血液净化治疗儿童严重脓毒症的效果及安全性研究

摘要 目的：分析小剂量糖皮质激素联合持续性血液净化治疗儿童严重脓毒症的效果及安全性。方法：选择自2021年1月至2023年1月接诊的102例儿童严重脓毒症患儿作为研究对象,随机分为对照组和观察组,各51例;对照组予以经典治疗方案,观察组在对照组的基础上,予以小剂量糖皮质激素联合持续性血液净化治疗;记录两组治疗后各项信息,比较两组治疗前后外周血乳酸、中心静脉血氧饱和度（ScvO₂）、血清炎症指标、PCIS评分、APACHE Ⅱ评分,观察主要并发症发生情况。结果：与对照组相比,观察组机械通气、低血压持续及入住ICU等时间较短,7 d内停升压药率较高（P＜0.05）;两组28 d病死率比较无差异（P＞0.05）;观察组治疗后乳酸、降钙素原（PCT）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）水平均较对照组低,ScvO₂水平较对照组高（P＜0.05）;观察组治疗后PCIS评分较对照组高,APACHE Ⅱ评分较对照组低（P＜0.05）;观察组主要并发症发生率低于对照组（P＜0.05）。结论：小剂量糖皮质激素联合持续性血液净化治疗有利于儿童严重脓毒症患儿病情转归,减少主要并发症发生,可能与阻断炎症反应有关,值得进一步研究应用。     

铅锌矿渣场植被自然演替与基质的交互效应

矿业废弃地生态系统自然恢复的植被演替过程与机理是生态恢复研究的重要内容之一.以空间代替时间的方法,选择立地条件基本一致的4个不同自然恢复年限铅锌矿区为对象,研究黔西北土法炼锌渣场废弃地植被自然演替与矿渣基质理化性质的交互效应.结果表明： 随着堆置时间的增加,矿渣基质的营养条件明显得到改善,全氮、全磷和全钾含量极显著增加, pH上升,电导率下降,容重降低,有效铅和镉显著降低. 同时,随着恢复时间的增长,植物群落的物种丰富度、多样性指数和均匀度也相应提高.植物群落组成以多年生草本植物为主,植物群落演替在前20年较为缓慢,30年后植被群落盖度可达到53%,超过40年盖度可达87%.矿渣理化性质与物种多样性显著相关,典型变量分别是全氮、全磷和全钾;物种多样性指数与有效铅和镉呈显著负相关.土法炼锌渣场废弃地植被自然演替过程在30年后速度加快,植被生长的限制因子是营养供给不足和重金属的有效性高.     

Overcoming resistance to rapalogs in gliomas by combinatory therapies

Glioblastoma is the most common and aggressive brain tumor type, with a mean patient survival of approximately 1 year. Many previous analyses of the glioma kinome have identified key deregulated pathways that converge and activate mammalian target of rapamycin (mTOR). Following the identification and characterization of mTOR-promoting activity in gliomagenesis, data from preclinical studies suggested the targeting of mTOR by rapamycin or its analogs (rapalogs) as a promising therapeutic approach. However, clinical trials with rapalogs have shown very limited efficacy on glioma due to the development of resistance mechanisms. Analysis of rapalog-insensitive glioma cells has revealed increased activity of growth and survival pathways compensating for mTOR inhibition by rapalogs that are suitable for therapeutic intervention. In addition, recently developed mTOR inhibitors show high anti-glioma activity. In this review, we recapitulate the regulation of mTOR signaling and its involvement in gliomagenesis, discuss mechanisms resulting in resistance to rapalogs, and speculate on strategies to overcome resistance. This article is part of a Special Issue entitled: Inhibitors of Protein Kinases (2012).     

Sensory cues for the gradual frequency fall responses of the gymnotiform electric fish, Rhamphichthys rostratus

The sensory cues for a less known form of frequency shifting behavior, gradual frequency falls, of electric organ discharges (EODs) in a pulse-type gymnotiform electric fish, Rhamphichthys rostratus, were identified. We found that the gradual frequency fall occurs independently of more commonly observed momentary phase shifting behavior, and is due to perturbation of sensory feedback of the fish's own EODs by EODs of neighboring fish. The following components were identified as essential features in the signal mixture of the fish's own and the neighbor's EOD pulses: (1) the neighbor's pulses must be placed within a few millisecond of the fish's own pulses, (2) the neighbor's pulses, presented singly at low frequencies (0.2–4 Hz), were sufficient, (3) the frequency of individual pulse presentation must be below 4 Hz, (4) amplitude modulation of the sensory feedback of the fish's own pulses induced by such insertions of the neighbor's pulses must contain a high frequency component: sinusoidal amplitude modulation of the fish's own EOD feedback at these low frequencies does not induce gradual frequency falls. Differential stimulation across body surfaces, which is required for the jamming avoidance response (JAR) of wave-type gymnotiform electric fish, was not necessary for this behavior. We propose a cascade of high-pass and low-pass frequency filters within the amplitude processing pathway in the central nervous system as the mechanism of the gradual frequency fall response.Abbreviations EOD electric organ discharge - f frequency of EOD or pacemaker command signal - JAR jamming avoidance response - S ₁ stimulus mimicking fish's own EOD - f ₁ frequency of S₁ - S ₂ stimulus mimicking neighbor's EOD - f ₂ frequency of S₂     

Specific lysis of GABAergic synaptosomes by an antiserum to glutamate decarboxylase

An antiserum to pure glutamate decarboxylase (GAD) when incubated with rat cortical synaptosomes in the presence of complement caused release of 33-53% of lactate dehydrogenase (LDH) and 22-41% of total GAD. In addition most of the gamma-aminobutyrate (GABA) present was released. Anti-GAD antiserum alone, or complement alone, were without action. The antiserum plus complement had no effect on noradrenaline or choline uptake, and did not release choline acetylase (ChAT). Anti-ChAT serum plus complement released 30-37% of ChAT and 10-13% of LDH. It prevented choline uptake. This serum did not produce GAD release or prevent GABA, choline or noradrenaline uptake. When cortical synaptosomes were exposed to both antisera plus complement, their actions were strictly additive. The data indicate specific lysis of GABAergic and cholinergic synaptosomal sub-populations.