A comparison study on structure-function relationship of polysaccharides obtained from sea buckthorn berries using different methods:antioxidant and bile acid-binding capacity

In this study,the structural characters,antioxidant activities and bile acid-binding ability of sea buckthorn polysaccharides(HRPs)obtained by the commonly used hot water(HRP-W),pressurized hot water(HRP-H),ultrasonic(HRP-U),acid(HRP-C)and alkali(HRP-A)assisted extraction methods were investigated.The results demonstrated that extraction methods had significant effects on extraction yield,monosaccharide composition,molecular weight,particle size,triple-helical structure,and surface morphology of HRPs except for the major linkage bands.Thermogravimetric analysis showed that HRP-U with filamentous reticular microstructure exhibited better thermal stability.The HRP-A with the lowest molecular weight and highest arabinose content possessed the best antioxidant activities.Moreover,the rheological analysis indicated that HRPs with higher galacturonic acid content and molecular weight showed higher viscosity and stronger crosslinking network(HRP-C,HRP-W and HRP-U),which exhibited stronger bile acid binding capacity.The present findings provide scientific evidence in the preparation technology of sea buckthorn polysaccharides with good antioxidant and bile acid binding capacity which are related to the structure affected by the extraction methods.

Lightweight Dual‑Functional Segregated Nanocomposite Foams for Integrated Infrared Stealth and Absorption‑Dominant Electromagnetic Interference Shielding

Lightweight infrared stealth and absorption-dominant electromagnetic interference(EMI)shielding materials are highly desirable in areas of aerospace,weapons,military and wearable electronics.Herein,lightweight and high-efficiency dual-functional segregated nanocomposite foams with microcellular structures are developed for integrated infrared stealth and absorption-dominant EMI shielding via the efficient and scalable supercritical CO_(2)(SC-CO_(2))foaming combined with hydrogen bonding assembly and compression molding strategy.The obtained lightweight segregated nanocomposite foams exhibit superior infrared stealth performances benefitting from the synergistic effect of highly effective thermal insulation and low infrared emissivity,and outstanding absorption-dominant EMI shielding performances attributed to the synchronous construction of microcellular structures and segregated structures.Particularly,the segregated nanocomposite foams present a large radiation temperature reduction of 70.2℃ at the object temperature of 100℃,and a significantly improved EM wave absorptivity/reflectivity(A/R)ratio of 2.15 at an ultralow Ti_(3)C_(2)T_(x) content of 1.7 vol%.Moreover,the segregated nanocomposite foams exhibit outstanding working reliability and stability upon dynamic compression cycles.The results demonstrate that the lightweight and high-efficiency dual-functional segregated nanocomposite foams have excellent potentials for infrared stealth and absorption-dominant EMI shielding applications in aerospace,weapons,military and wearable electronics.

政策工具视角下职业教育创新发展高地建设政策文本分析

研究构建政策工具、省域、政策目标的三维分析框架,对教育部分别与十一省(直辖市)联合发布的职业教育创新发展高地建设政策文本进行编码和量化统计分析。研究发现:政策工具类型配置较为全面,但形式运用存在结构失衡,对于不同政策目标的响应存在力度偏向。此外,各地选择政策工具制定政策的底层逻辑趋同,但省情市情的差异直接影响职业教育创新发展高地建设目标的选择。在宏观层面,各地需顺应职业教育追求高质量发展的趋势,职业教育创新发展高地建设政策需全面关照各方主体利益,符合高质量发展要求,满足省情市情需要;在操作层面,政府职能部门需要重塑角色定位将管理转向统筹,制定政策应科学合理配置政策工具,通过简政放权释放职业教育创新发展高地建设的发展空间。

Seed Priming with Potassium Nitrate Can Enhance Salt Stress Tolerance in Maize

Salinity is a major abiotic stress that hinders plant development and productivity and influences agricultural yield.Seed priming is a technique used to boost germination and seedling growth under abiotic stress.A pot experiment was conducted to evaluate the impact of seed priming with potassium nitrate(KNO_(3))at various levels(0%,0.50%,1.00%and 1.50%)under salt stress(0,75,100 mM NaCl)on two maize verities(MNH360 and 30T60)for the growth,development and metabolic attributes results revealed that in maize variety MNH360,KNO_(3)priming’s significantly enhanced growth parameters than in maize variety 30T60 under control and salt-stressed conditions.Priming with KNO_(3)enhanced carotenoids and total chlorophyll in the 30T60 variety that protected the maize plants from salt stress.Nevertheless,it was shown that priming with 1.00%KNO_(3)acts as safeguarded to protect them from oxidative damage by salt stress minimizing reactive oxygen species(ROS)formation through increased levels of malondialdehyde(MDA),catalase(CAT),peroxidase(POD),ascorbate peroxidase(APX),and total soluble protein.The findings of the present study confirm that the use of the KNO_(3)seed priming technique is a lowcost,environmentally friendly technique for mitigating adverse impacts of salt stress in maize crops by activating the antioxidant defense system and improving chlorophyll and osmolyte contents.

Physics through the microscope

The electron microscope provides numerous insights into physics, from demonstrations of fundamental quantummechanical principles to the physics of imaging and materials. It reveals the atomic and electronic structure of key regionssuch as defects and interfaces. We can learn the underlying physics governing properties, and gain insight into how tosynthesize new materials with improved properties. Some recent advances and possible future directions are discussed.

Protective eff ect and mechanism of nanoantimicrobial peptide ND-C14 against Streptococcus pneumoniae infection

BACKGROUND:Streptococcus pneumoniae(S.pneumoniae)is a common pathogen that causes bacterial pneumonia.However,with increasing bacterial resistance,there is an urgent need to develop new drugs to treat S.pneumoniae infections.Nanodefensin with a 14-carbon saturated fatty acid(ND-C14)is a novel nanoantimicrobial peptide designed by modifying myristic acid at the C-terminus of humanα-defensin 5(HD5)via an amide bond.However,it is unclear whether ND-C14 is effective against lung infections caused by S.pneumoniae.METHODS:In vitro,three groups were established,including the control group,and the HD5 and ND-C14 treatment groups.A virtual colony-count assay was used to evaluate the antibacterial activity of HD5 and ND-C14 against S.pneumoniae.The morphological changes of S.pneumoniae treated with HD5 or ND-C14 were observed by scanning electron microscopy.In vivo,mice were divided into sham,vehicle,and ND-C14 treatment groups.Mice in the sham group were treated with 25μL of phosphate-buffered saline(PBS).Mice in the vehicle and ND-C14 treatment groups were treated with intratracheal instillation of 25μL of bacterial suspension with 2×108 CFU/mL(total bacterial count:5×10^(6) CFU),and then the mice were given 25μL PBS or intratracheally injected with 25μL of ND-C14(including 20μg or 50μg),respectively.Survival rates were evaluated in the vehicle and ND-C14 treatment groups.Bacterial burden in the blood and bronchoalveolar lavage fluid were counted.The lung histology of the mice was assessed.A propidium iodide uptake assay was used to clarify the destructive eff ect of ND-C14 against S.pneumoniae.RESULTS:Compared with HD5,ND-C14 had a better bactericidal eff ect against S.pneumoniae because of its stronger ability to destroy the membrane structure of S.pneumoniae in vitro.In vivo,ND-C14 significantly delayed the death time and improved the survival rate of mice infected with S.pneumoniae.ND-C14 reduced bacterial burden and lung tissue injury.Moreover,ND-C14 had a membrane permeation eff ect on S.pneumoniae,and its destructive ability increased with increasing ND-C14 concentration.CONCLUSION:The ND-C14 may improve bactericidal eff ects on S.pneumoniae both in vitro and in vivo.

Concordance between four PD-L1 immunohistochemical assays and 22C3 pharmDx assay in esophageal squamous cell carcinoma in a multicenter study

Background:The prediction of response to immunotherapy mostly depends on the programmed death-ligand 1(PD-L1)immunohistochemistry(IHC)status,and the 22C3 pharmDx assay has been approved in esophageal squamous cell carcinoma(ESCC).However,the widespread use of the 22C3 pharmDx assay is limited due to its availability.Thus,alternative PD-L1 assays are needed.We aimed to investigate the analytical and clinical diagnostic performances of four PD-L1 assays and to compare their concordances with the 22C3 pharmDx assay.Methods:The PD-L122C3 pharmDx assay was performed on the Dako Autostainer Link 48 platform,three testing assays(PD-L1 E1L3N XP antibody[Ab],PD-L1 BP6099 Ab and PD-L1 CST E1L3N Ab)on the Leica BOND-MAX/III platform,and one testing assay(PD-L1 MXR006 Ab)on the Roche VENTANA Benchmark Ultra platform.A total of 218 ESCC cases from four centers were included in this retrospective study.Professionals from each center stained and read the IHC slides independently and determined the combined positive score(CPS)and the tumor proportion score(TPS).Results:Regarding analytical performance,the four testing assays demonstrated good correlations with the 22C3 pharmDx assay when evaluated by the TPS or CPS(𝜌>0.8 for all four assays).Regarding diagnostic performance(CPS≥10 was used as the cutoff),the four testing assays showed moderate concordances with the 22C3 pharmDx assay(kappa>0.7 for all four assays).The overall percent agreements between each testing assay and the 22C3 pharmDx assay was at least 87.2%.Conclusion:This study provides insight into the potential interchangeability of the four PD-L1 assays with the 22C3 pharmDx assay.

巴曲酶注射液联合依达拉奉对老年脑梗死患者神经功能及血清相关因子的影响

目的探讨巴曲酶注射液联合依达拉奉对老年脑梗死患者神经功能缺损评分及血清同型半胱氨酸(Hcy)、血管内皮细胞生长因子(VEGF)、神经生长因子(NGF)、脑源性神经生长因子(BDNF)水平变化的影响。方法选择2015年10月~2017年10月解放军171医院神经内科住院的初发老年脑梗死患者84例,根据随机数字表法分为对照组42例,依达拉奉组42例。常规治疗基础上对照组给予巴曲酶注射液,依达拉奉组在对照组基础上加用依达拉奉,均治疗14d。比较2组治疗前及疗程结束后日常生活活动能力(ADL)及美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效、血清VEGF、Hcy、BDNF及NGF水平、不良反应。结果依达拉奉组治疗后ADL评分较治疗前明显升高,NIHSS评分较治疗前明显降低(P<0.01)。依达拉奉组治疗后ADL评分明显高于对照组,NIHSS评分明显低于对照组(P<0.01)。依达拉奉组总有效率明显高于对照组(90.5%vs 71.4%,P<0.05)。2组治疗后VEGF、BDNF及NGF水平明显高于治疗前,Hcy水平明显低于治疗前(P<0.01)。依达拉奉组治疗后VEGF、BDNF及NGF水平明显高于对照组,Hcy水平明显低于对照组(P<0.01)。结论巴曲酶注射液联合依达拉奉治疗老年脑梗死,可促使患者神经功能及日常生活能力恢复,提高治疗效果。

四项血清指标联合检测对冠心病危险分层的诊断价值

目的探讨D-二聚体、分泌型卷曲相关蛋白5(SFRP5)、脂联素与内脏脂肪组织源性丝氨酸蛋白酶抑制剂(VASPIN)联合检测在冠心病临床诊断中的应用。方法选择老年冠心病患者240例,其中急性心肌梗死(AMI)组80例、不稳定性心绞痛(UAP)组80例、稳定性心绞痛(SAP)组80例。另选取健康体检者80例为对照组。分析4项指标的差异及其与Gensini积分的相关性。结果 4组D-二聚体、SFRP5、脂联素与VASPIN水平及Gensini积分比较,差异有统计学意义(P<0.01)。与对照组比较,SAP组、UAP组和AMI组D-二聚体及Gensini积分明显升高,SFRP5、脂联素及VASPIN水平明显降低(P<0.05)。SAP组和UAP组D-二聚体及Gensini积分水平显著低于AMI组,SFRP5、脂联素及VASPIN水平明显高于AMI组(P<0.05);SAP组D-二聚体水平及Gensini积分明显低于UAP组,SFRP5、脂联素及VASPIN水平明显高于UAP组(P<0.05)。Spearman相关性分析结果显示,SFRP5、脂联素及VASPIN水平与Gensini积分呈明显的负相关(r=-0.662,r=-0.532,r=-0.848,P<0.01),D-二聚体与Gensini积分呈正相关(r=0.526,P=0.003)。4项指标联合检测敏感性明显高于各项指标单独检测(P<0.05)。结论 4种指标联合检测可为老年冠心病类型鉴别诊断和疾病严重程度评估的重要依据。

Expert consensus on difficulty assessment of endodontic therapy

Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

斜刃月牙剪冲裁分析与研究

利用Ansys ls-dyna软件,建立了某酸洗-连轧机组的斜刃月牙剪冲裁模型;分析了不同剪切工艺参数下的剪切力峰值的分布规律;讨论了上、下剪刃不同磨损、剪刃侧向间隙、带材厚度对剪切力的影响;结合理论公式验证了模型的合理性;拟合得到了冲裁力公式。分析结果表明,剪刃侧向间隙δ取(0.3±0.1)mm或为(1/30~1/15)h(h为带材厚度)时,剪切表面质量较好;在不考虑剪刃磨损下,剪切工艺范围内带材的最大剪切力在35 kN左右。研究结果为优化剪切工艺参数、分析剪刃寿命以及详细结构优化设计和电气调试提供了理论参考。

医疗大数据在心衰中心建设中的作用

慢性心力衰竭(心衰)患者发病率逐年增加,病死率高,建立国内由专业学会组织、以心衰中心为核心的心衰防治体系,需要医疗大数据技术给予强有力的支撑。利用门诊及住院心衰患者的医疗大数据,如电子病历、影像学数据、实验室检查等建立诊疗大数据,研究基于院内诊疗大数据的心衰风险评估;同时利用移动终端、互联网、云平台等技术,以心衰院后管理临床路径为轴心,构建慢性心衰患者院后管理数据平台,进行疾病监测、院后随访管理等,加强对慢性心衰患者的全程精准管理,以降低心衰患者的住院率和死亡率。

在体检人群中应用自测型免疫化学法粪便潜血试验筛查结直肠癌的结果分析

目的分析体检人群结直肠癌筛查结果,探讨自测型免疫化学法粪便潜血试验作为健康体检项目的意义。方法选择2019年4月至2019年12月在中国航天科工集团七三一医院体检中心进行健康体检的无症状人群为筛查对象。对符合纳入与排除标准的研究对象采用自测型免疫化学法粪便潜血试验进行初筛,初筛阳性者进行结肠镜检查。结合结肠镜和病理检查结果分析自测型免疫化学法粪便潜血试验的依从率、结直肠肿瘤检出率及阳性预测值。结果共有3239例体检者纳入本研究,其中1468例完成了自测型免疫化学法粪便潜血试验,总体依从率为45.32%(1468/3239)。男性和女性受检者的粪便潜血检测依从率分别为48.51%(832/1715)和41.73%(636/1524);不同年龄段(40~49岁、50~59岁、60~69岁、70~74岁)受检者的粪便潜血检测依从率分别为61.70%(820/1329)、43.59%(347/796)、31.02%(210/677)、20.82%(91/437)。共有160例潜血检测结果阳性,粪便潜血检测阳性率10.90%(160/1468)。男性受检者自测型免疫化学法粪便潜血试验的依从率显著高于女性受检者(P<0.01)。自测型免疫化学法粪便潜血试验的依从率随年龄增长逐渐下降,<60岁受检者的依从率显著高于≥60岁受检者(P<0.01)。在粪便潜血检测阳性的160例体检者中,92例完成全结肠镜检查,依从率为57.50%(92/160)。共检出结直肠肿瘤40例,包括结直肠癌1例,腺瘤39例。本次筛查结直肠肿瘤检出率为2.72%(40/1468),阳性预测值为43.48%(40/92),均显著高于本课题组前期筛查结果(分别为0.50%、16.92%)(均P<0.01)。结论自测型免疫化学法粪便潜血试验依从性好,结直肠肿瘤检出率和阳性预测值高,可作为体检人群结直肠癌筛查的有效工具。

李长生教授治疗冠心病的临证经验

冠状动脉粥样硬化性心脏病(冠心病)属于中医学中“胸痹”、“胸痹心痛”、“真心痛”等范畴。李长生教授从医近40年,擅长治疗各类心脑血管疾病。李教授认为冠心病的病机以气虚阴虚为本,以痰浊、血瘀为标,应以益气养阴、化痰活血、宣痹通阳、通络止痛为治疗原则。本文对李长生教授治疗冠心病的临证经验进行介绍。

3D腹腔镜单吻合器法经肛门取出标本在超低位直肠癌保肛手术中的运用

目的研究单吻合器法经肛门取出标本在超低位直肠癌保肛手术的临床疗效。方法回顾性分析2016年1月—2018年1月同济大学附属东方医院胃肠肛肠外科行腹腔镜直肠前切除术的112例超低位直肠癌患者临床资料。其中单吻合器法经肛门取标本手术83例,双吻合器法小切口手术29例,对比两组患者在手术时间、出血量、住院时间、初次造口排便时间、淋巴结检出数、下切缘长度、术后吻合口瘘发生率、肛门Wexner失禁评分以及1年无病生存率(disease-free survival, DFS)等方面的差异。结果全部112例手术顺利完成,两组患者在手术时间、出血量、淋巴结检出数、肛门Wexner失禁评分及1年DFS等方面差异无统计学意义( P >0.05);单吻合器组住院天数少于双吻合器组,分别为(7.9±3.5) d和(10.2±2.5) d,差异有统计学意义( P <0.01);两组初次造口排气时间分别为(13.7±6.0) h和(44.6±5.2) h,差异有统计学意义( P <0.01);两组肿瘤下切缘长度分别为(1.8±0.3) cm和(1.6±0.2) cm,差异有统计学意义( P <0.01);吻合口瘘发生率分别为2/83和4/29,差异有统计学意义( P <0.01)。结论与传统双吻合器法相比,单吻合器法经肛门取出标本进行超低位直肠癌保肛安全可行,可缩短住院时间、促进术后恢复。

康莱特注射液辅助治疗非小细胞肺癌的快速卫生技术评估

目的:快速评估康莱特注射液辅助治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)的有效性、安全性和经济性,高效、快捷地为医院新药遴选以及卫生决策提供循证依据。方法:计算机检索PubMed、EMBase、the Cochrane Library、CRD database、中国知网、万方数据库、中国生物医学文献服务系统和维普数据库,收集康莱特注射液辅助治疗NSCLC的卫生技术评估(health technology assessment,HTA)报告、系统评价/文献荟萃分析(Meta分析)和经济学研究,由2名评价者根据纳入与排除标准独立筛选文献、提取资料和评价质量后,定性分析结果,并根据临床研究中报告的等效疗程计算康莱特注射液和与其效果相当的其他中药注射剂的药品费用。结果:共纳入12篇文献,包括8篇系统评价/Meta分析、4篇经济学研究。有效性方面,与单独应用放化疗比较,康莱特注射液联合放化疗可明显提高有效率,改善生活质量,缓解放化疗引起的不良反应,上述差异均有统计学意义(P<0.05);康莱特注射液联合放化疗与其他中药注射剂联合放化疗的有效率、生活质量以及恶心呕吐等不良反应发生率的差异均无统计学差异(P>0.05)。安全性方面,联合应用康莱特注射液可明显增加静脉炎、咳嗽、呼吸困难和胸痛等不良事件的发生概率。经济性方面,根据以效果相当为基础的最小成本分析结果,康莱特注射液的药品费用高于参芪扶正注射液、康艾注射液、复方苦参注射液、艾迪注射液和参附注射液,低于消癌平注射液。结论:康莱特注射液辅助治疗NSCLC可能具有一定的减少放化疗不良反应、提高疗效和改善生活质量的作用,但联合用药也会增加部分不良事件的发生概率,且药品费用与多种效果相当的同类药品相比明显更高,建议临床治疗中综合考虑患者实际情况和经济水平,谨慎使用。

悬雍垂低温等离子去黏膜化并翻转缝合悬吊术在中度OSAHS患者手术中的应用

目的分析悬雍垂低温等离子去黏膜化翻转缝合悬吊术在中度阻塞性睡眠呼吸暂停综合征(OSAHS)患者外科手术中的临床具体应用价值。方法回顾性分析在悬雍垂腭咽成形术(UPPP)基础上对多导睡眠监测(PSG)确诊中度OSAHS患者进行手术方式改良,采取低温等离子去黏膜化并悬雍垂翻转"8"字缝合悬吊固定手术的32例患者临床资料。其中16例患者为对照组(开展常规H-UPPP手术),16例患者为实验组(低温等离子行悬雍垂去黏膜化,悬雍垂翻转"8"字缝合悬吊固定术),所有患者术前行药物诱导睡眠内镜(DISE)检查评估患者上气道阻塞情况,根据ESS评分、鼾声量表评分对所有患者主观症状及术后并发症发生情况进行评估,并采用SPSS软件进行统计学分析。结果所有患者手术前后比较,术后ESS评分、鼾声量表评分明显改善,差异具有统计学意义(P<0.05),两组间手术方式ESS评分、鼾声量表评分比较无统计学意义(P>0.05);两组间手术时间、术中出血量比较差异具有统计学意义(P<0.05);两组间术后疼痛评分比较,实验组明显好于对照组,差异具有统计学意义(P<0.05);实验组术后咽部异物感、咽部干燥、咽部绷紧感与对照组比较,差异均具有统计学意义(P<0.05);无永久性腭咽关闭不全患者;术后两组患者均无围手术期呼吸困难,无围手术期死亡及术后拔管困难。结论结合低温等离子技术的悬雍垂去黏膜化并翻转缝合悬吊术是针对以腭咽平面、口咽侧壁平面为主要责任平面狭窄及左右狭窄为显著特征的中度OSAHS患者治疗有效的改良手术方法,具有术后反应和主观症状较轻、手术并发症发生率较低的特点,短期疗效确切,值得临床推广。

微小核糖核酸在白塞病发病中的作用及其临床应用前景

微小核糖核酸(miRNA)是核糖核酸干扰的内源性介质,通过诱导转录后靶基因表达沉默发挥生物学作用。miRNA对机体免疫细胞具有多种调控功能,参与固有免疫和适应性免疫的调节。异常表达的miRNA通过调节免疫细胞炎性因子参与白塞病(Behcet’s disease,BD)的发病,可能成为BD诊断的标志物和治疗靶点。本文从miRNA调节自身免疫,部分miRNA参与BD发病的机制,miRNA潜在的临床应用价值等进行综述。

对选择和应用抗眩晕药的理性思考

依据前庭性眩晕的不同病因不同病情及不同愈后结果,合理选择和应用不同的抗眩晕药物,对改善眩晕症状和促进平衡功能康复至关重要。根据各种抗眩晕药的不同药理学效应,针对眩晕症状的大部分西药可被分为促进神经代偿的药物或抑制神经代偿的药物两大类,前者属于多巴胺兴奋剂,而后者属于多巴胺抑制剂,两者的药理学机制却恰好相反。在所有引起眩晕的前庭疾病中,占总数近半的案例属于可逆性病变并可自行恢复,但另外近半病例却因发生了不可逆性前庭损害而难以自愈。对于那些可自愈的眩晕病例,应用多巴胺兴奋剂加速平衡功能的代偿是不必要的甚至是有害的;而对于那些不可逆性单侧前庭永久损害的眩晕病例,应用多巴胺兴奋剂却有助于促进平衡功能的代偿并尽早消除眩晕症状,相反,应用多巴胺抑制剂却会延长平衡障碍的过程并阻碍平衡功能的代偿性恢复。因此,在哪种眩晕条件下需要应用促进平衡代偿的药物,而在哪种眩晕条件下需要应用抑制平衡代偿的药物,以及在哪种眩晕的哪个病程阶段应该积极促进平衡代偿而在哪个病程阶段需要抑制平衡代偿,是眩晕临床工作者应该根据药理学原理和患者的病因病情及病变后果来慎重思考的问题。

右美托咪定治疗糖尿病神经病理性疼痛的机制研究近况

糖尿病神经病理性疼痛(Diabetic neuropathic pain,DNP)是糖尿病常见的并发症之一,是一种严重的慢性疾病,严重影响患者生存质量。而糖尿病患者免疫功能异常使其成为新型冠状病毒的更易感人群,2019冠状病毒病(COVID-19)可通过结合ACE2受体攻击胰腺,加速糖尿病的进展。右美托咪定(Dexmedetomidine,Dex)作为一种具有镇静、镇痛以及抗交感活性的新型的高选择性、高特异性α2受体激动剂,具有镇静、镇痛和抗交感等作用,临床应用十分广泛。近年来,右美托咪定逐渐用于治疗糖尿病神经病理性疼痛,其作用机制的研究也逐渐深入,本文就右美托咪定通过NF-κB相关信号通路,细胞凋亡相关信号通路,ATP-P2X4-NLRP3信号通路,JAK-STAT3信号通路,蛋白激酶C相关信号通路,MAPKs信号通路治疗糖尿病神经病理性疼痛的研究予以综述,以期为进一步阐明治疗糖尿病神经病理性疼痛的确切机制和相应靶点提供依据。