Advancements in Functional Magnetic Resonance Imaging for Persistent Postural-Perceptual Dizziness

Persistent postural-perceptual dizziness, defined in 2017, is a chronic functional vestibular disorder. Which is characterized by persistent dizziness, unsteadiness, and/or non-spinning vertigo. However, the exact mechanisms remain unclear. In recent years, FMRI studies have provided key insights into the pathogenesis of PPPD. This review summarized functional imaging studies of persistent postural dizziness and its predecessors in recent years and found changes in the activity and functional connectivity of important areas of visual processing, multisensory vestibular and spatial cognition in patients with PPPD. In addition, factors such as stimulation mode, personality traits, mental comorbidities and external vestibular lesions have important effects on brain functional activities and connectivity patterns, and further stratified studies on these factors are needed in the future to further clarify and draw exact conclusions on the pathological mechanism of PPPD.

Cervical intervertebral disc degeneration and dizziness

Clinical studies have found that patients withcervical degenerative disease are usually accompanied by dizziness.Anterior cervical surgery can eliminate not only chronic neck pain,cervical radiculopathy or myelopathy,but also dizziness.Immunohistochemical studies show that a large number of mechanoreceptors,especially Ruffini corpuscles,are present in degenerated cervical discs.The available evidence suggests a key role of Ruffini corpuscles in the pathogenesis of dizziness caused by cervical degenerative disease(i.e.cervical discogenic dizziness).Disc degeneration is characterized by an elevation of inflammatory cytokines,which stimulates the mechanoreceptors in degenerated discs and results in peripheral sensitization.Abnormal cervical proprioceptive inputs from the mechanoreceptors are transmitted to the central nervous system,resulting in sensory mismatches with vestibular and visual information and leads to dizziness.In addition,neck pain caused by cervical disc degeneration can play a key role in cervical discogenic dizziness by increasing the sensitivity of muscle spindles.Like cervical discogenic pain,the diagnosis of cervical discogenic dizziness can be challenging and can be made only after other potential causes of dizziness have been ruled out.Conservative treatment is effective for the majority of patients.Existing basic and clinical studies have shown that cervical intervertebral disc degeneration can lead to dizziness.

Effects of Kampo medicine hangebyakujutsutemmato on persistent postural-perceptual dizziness:A retrospective pilot study

BACKGROUND Persistent postural-perceptual dizziness(PPPD)is a functional disorder,typically preceded by acute vestibular disorders.It is characterized by a shift in processing spatial orientation information,to favor visual over vestibular and somatosensory inputs,and a failure of higher cortical mechanisms.To date,no therapies for PPPD have been approved.Kampo medicine hangebyakujutsutemmato(HBT)has been reported to alleviate disturbances of equilibrium.We hypothesized that HBT would be a beneficial treatment for PPPD.AIM To examine the efficacy of HBT for the treatment of PPPD.METHODS Patients with PPPD were enrolled and divided into two groups:The HBT group(n=24)and the non-HBT group(n=14).The participants completed questionnaire surveys[Niigata PPPD questionnaire(NPQ),dizziness handicap inventory,hospital anxiety and depression scale(HADS),orthostatic dysregulation questionnaire,pittsburg sleep quality index(PSQI),and motion sickness scores]before and after HBT treatment.Additionally,to identify HBT responders,multivariate regression analysis was performed using the results of the ques-tionnaire surveys and equilibrium tests;including stabilometry,and caloric,vestibular evoked myogenic response,and head-up tilt tests.RESULTS Thirty-eight outpatients were included in this study,of which 14 patients(3 men,11 women;mean age,63.5±15.9 years)received treatment without HBT,and 24(1 man,23 women;mean age,58.2±18.7 years)received combination treatment with HBT.Following HBT treatment,NPQ scores decreased significantly(baseline 40.1±10.0 vs 2 mo 24.6±17.7,P<0.001).No statistically significant changes were observed in the NPQ scores in the non-HBT group(baseline 38.6±12.2 vs 2 mo 39.4±14.4,P=0.92).Multivariable regression analysis revealed that the results of stabilometry(P=0.02)and the caloric(P=0.03),and head-up tilt tests(P<0.001),HADS(P=0.003),and PSQI(P=0.01)were associated with HBT responsiveness in PPPD patients.CONCLUSION HBT may be an effective adjunct therapy for PPPD.Patients with autonomic dysfunction,unstable balance,semicircular canal paresis,anxiety,and poor sleep quality may be high responders to HBT.

Transient ventricular arrhythmia as a rare cause of dizziness during exercise:A case report

BACKGROUND Dizziness is a common symptom in adults and usually due to peripheral causes affecting semicircular canal function or central causes affecting the pons,medulla,or cerebellum.Arrhythmia is a recognized cause of dizziness in people with structural or ischemic heart disease.We report a case of exercise-induced transient ventricular tachycardia and dizziness in a man with no evidence of organic heart disease.CASE SUMMARY A 42-year-old man presented with a 6 mo history of transient exercise-induced dizziness and prodromal palpitations.The patient was otherwise asymptomatic.Physical examination,otoscopy,vestibular tests,cerebellar tests,laboratory investigations,and imaging investigations were all unremarkable.Twenty-four hour Holter monitoring revealed four episodes of transient ventricular tachycardia during exercise.The patient was started on metoprolol and subsequently underwent radiofrequency catheter ablation.The patient reported a full recovery and no dizziness during daily activities.These results were maintained at the 6 mo follow-up.CONCLUSION Ventricular tachycardia is an uncommon but potentially serious cause of dizziness.The outcome of this case illustrates the benefits of careful clinical examination and communication with specialized centers.High clinical suspicion of arrhythmia in a patient with dizziness merits consultation with a cardiologist and referral to a specialized center to ensure timely diagnosis and treatment.

Clinical evaluation of Xiaoyao Jieyu prescription in the treatment of persistent postural-perceptual dizziness

Objective： The objective of this study is to evaluate the clinical efficacy of Xiaoyao Jieyu prescription （XJP） in the treatment of persistent postural-perceptual dizziness （PPPD）. Methods： A total of 33 PPPD patients were randomly divided into test group and control group. Two groups of patients were given psychological treatment. The test group was given XJP and the control group was given escitalopram. The course of treatment was 12 weeks. Before and after 4 weeks and 8 weeks and 12 weeks, the dizziness handicap inventory （DHI）, Hamilton anxiety scale （HAMA） and Hamilton Depression scale （HAMD） were used to evaluate the treatment effect. Results： The total scores of HAMA, HAMD, DHI and the respective factor scores of DHI significantly decreased in both groups after 4 weeks of treatment compared with those before the treatment （P 〈 0.01）. The DHI scores and the score of function, physiology at 8-week, 12-week, as well as the HAMA and HAMD scores at 4-week, 8-week, 12-week in the test group were significantly lower than those in the control group （P 〈 0.05）. The incidence of adverse reactions in the test group was significantly lower than the control group （P 〈 0.05）. Conclusion： XJP can improve the clinical symptoms of patients with PPPD. It can both improve the physical and functional symptoms of PPPD and reduce anxiety and depression. In the course of treatment, the adverse reaction of the prescription is less and mild. It has the advantages of high efficiency, safety, low price and easy access to materials.

Treatment of Dizziness by Massotherapy and Traditional Chinese Drugs——A Report of 110 cases

Note: HLY = hyperactivity of the liver-yang, STPMJ = stagnation of turbid phlegm in middle-Jiao, DQB = deficiency of qi and blood, DKE = deficiency of the kidney-essence, OCBS = obstruction of collaterals by blood

Integrating cupping therapy in the management of tinnitus and dizziness:a pilot study

Background:Cupping therapy is one of integrative medicine modalities which is used by several nations.Its mechanism of action is not well known but there are several theories explained how it can play a rule in the treatment of diseases.In recent years,huge advances have taken place in understanding of inner ear pathophysiology causing sensorineural hearing loss,tinnitus,and vertigo.Research articles providing evidence of acupuncture treating dizziness and vertigo but no studies of cupping therapy.The aim of this pilot study was to evaluate the safety and efficacy of integrating wet cupping therapy in the management of tinnitus and dizziness associated with ear pathologies.Methods:This is a prospective interventional pilot study in which pre and post intervention outcomes(tinnitus handicap inventory and dizziness handicap inventory)were assessed and compared.27 patients diagnosed with Ménière's disease and idiopathic tinnitus or tinnitus secondary to inner ear pathology were included in this study and received usual medical treatment and wet cupping therapy.Results:There was a significant improvement after 6 sessions of cupping in tinnitus handicap inventory and dizziness handicap inventory but not in patient’s hearing.No adverse events were reported in this study.Conclusion:Wet cupping therapy demonstrates a promising effectiveness in reducing discomforts of both dizziness and tinnitus.A large scale randomized controlled trial is recommended.

Systematic Review and Meta-analysis on the Efficacy and Safety of Tianma Gouteng Granules(天麻钩藤颗粒)in Treatment of Dizziness

Objective:The effectiveness and safety of Tianma Gouteng Granules(天麻钩藤颗粒)in the treatment of dizziness were systematically evaluated.Methods:A randomized controlled trial of Tianma Gouteng Granules for dizziness was screened out by searching CNKI,Wanfang Data,VIP,SinoMed,Cochrane Library,PubMed,Embase,Web of Science in a systematic way and was based on Handbook 5.1 evaluation criteria and tools and RevMan 5.3 software for meta-analysis of the final inclusion of the study.Results:A total of 7 studies were included,6 studies were included in meta-anlysis and 1 other study,with a total sample size of 568 cases,including 328 cases in the experiential group and 240 cases in the control group.The systolic pressure of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness is better than conventional treatment alone(MD=-3.38,95%CI[-4.90,-1.86],P<0.00001).The diastolic pressure of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness had no difference compared with conventional treatment alone(MD=-1.35,95%CI[-2.36,-0.34],P=0.72).The TCM syndromes score of Tianma Gouteng Granules alone or combined with conventional treatment in the treatment of dizziness was better than conventional treatment(MD=-5.18,95%CI[-6.89,-5.47],P<0.00001).The marked effective rate of Tianma Gouteng Granules combined with conventional treatment in the treatment of dizziness was better than conventional treatment(RR=2.09,95%CI[1.35,3.24],P=0.001).The marked effective rate of Tianma Gouteng Granules in the treatment of dizziness was better than conventional treatment(RR=1.85,95%CI[1.34,2.54],P=0.0002).Adverse actions included stomach discomfort,dry mouth,headache,dizziness,nausea,insomnia,rash,etc.The number of reported cases in both groups was small.Conclusion:The treatment of systolic pressure,TCM syndrome score and marked effective rate of Tianma Gouteng Granules alone or combined with conventional treatment for dizziness was better than conventional treatment.There was no difference between Tianma Gouteng Granules alone or combined with conventional treatment on diastolic pressure.No serial reverse actions were reported,and all reverse actions were reported after drug withdrawal or dose reduction,and the sample size was small,requiring large samples for further verification.However,the quality of the study is not high,and it is necessary to improve the level of evidence quality by using clinical trial schemes with large samples,rational design and compliance with international standards.

APPLIED STUDY ON BRAIN ATLAS AFTER AND BEFORE TREATMENT BY SIBELIUM IN ISCHEMIC VASCULAR DIZZINESS

目的:探讨西比灵的临床疗效和脑电地形图的应用价值。方法:应用西比灵治疗300例缺血性血管性头晕患者,通过临床症征和脑电地形图观察其疗效。结果:西比灵治疗缺血性血管性头晕有效率为100％,脑电地形图在治疗前后有明显改变。结论:西比灵是治疗缺血性血管性头晕的较理想药物。脑电地形图是观察西比灵疗效和作用机理的有效指标。

低剂量CT结合SHOX2、RASSF1A甲基化在肺癌早期预警中的应用

目的探讨低剂量CT结合Ras相关区域家族蛋白1A(RASSF1A)、矮小同源盒基因2(SHOX2)甲基化在肺癌早期预测中的应用价值。方法选取2021年1月~2023年1月我院90例拟行肺结节手术患者,根据手术病理学分为肺良性结节组和肺癌组。2组均于术前行低剂量CT检查、SHOX2、RASSF1A甲基化检测,采用Kappa指数分析上述检查结果与手术病理学一致性,分析低剂量CT、SHOX2、RASSF1A甲基化与血清肿瘤标志物[癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA21)]对肺癌诊断效能,采用Spearman低剂量CT检查、SHOX2、RASSF1A甲基化与临床病理特征相关性。结果低剂量CT、SHOX2、RASSF1甲基化及三者联合分别确定40例、43例、46例、58例肺癌,三者联合与手术病理学诊断肺癌效能一致性Kappa值为0.951;三者联合诊断肺癌敏感度96.67%、准确度97.78%均高于三者单一诊断效能(P<0.05);肺癌患者血清CEA、SCC、NSE、CYFRA21水平均高于肺良性结节患者(P<0.05);低剂量CT联合SHOX2、RASSF1甲基化诊断肺癌效能的AUC为0.983,近似于四种血清肿瘤标志物诊断肺癌效能的AUC 0.933;不同肿瘤直径、临床分期、组织学分化肺癌患者低剂量CT检出率及SHOX2、RASSF1A甲基化阳性率比较差异有统计学意义(P<0.05);肺癌患者低剂量CT检出率、SHOX2及RASSF1A甲基化阳性率与肿瘤直径、临床分期呈正相关,与组织学分化呈负相关(P<0.05)。结论低剂量CT联合SHOX2及RASSF1A甲基化可用于肺癌早期预警中,临床可通过其进行早期诊断、评估病情进展程度,以针对性展开后续治疗,改善预后。

结直肠癌患者RAS、BRAF基因突变与MSI状态的相关性及其临床病理特征

目的:结直肠癌是人类最常见的恶行肿瘤之一,其发病率和病死率呈逐年上升趋势。本研究旨在分析结直肠癌患者大鼠肉瘤病毒癌基因(rat sarcoma viral oncogene,RAS)、鼠类肉瘤病毒癌基因同源物(V-Raf murine sarcoma viral oncogene homolog B,BRAF)突变与微卫星不稳定(microsatellite instability,MSI)状态相关性及其临床病理特征,为结直肠癌临床治疗及预后评估提供依据。方法:回顾性分析444例结直肠癌患者的临床病理资料,并提取肿瘤组织基因组DNA,采用荧光定量PCR法检测Kirsten大鼠肉瘤病毒癌基因同源物(Kirsten rat sarcoma viral oncogene homolog,KRAS)、Neuroblastoma大鼠肉瘤病毒癌基因同源物(neuroblastoma rat sarcoma viral oncogene homolog,NRAS)第2、3、4外显子及BRAF V600E突变;运用PCR-毛细血管电泳行MSI状态分析。结果:K(N)RAS基因突变184例(41.44%,184/444),其中KRAS突变173例(94.02%,173/184),NRAS突变11例(5.98%,11/184),K(N)RAS共突变3例。BRAF V600E突变21例(4.7%,21/444)。微卫星高度不稳定(microsatellite instability high,MSIH)48例(10.81%,48/444),微卫星低度不稳定(microsatellite instability low,MSI-L)和微卫星稳定(microsatellite stable,MSS)共396例(89.19%,396/444)。K(N)RAS基因突变右半结肠癌多于左半结肠癌,且黏液腺癌突变率高于单纯腺癌(均P<0.05)。K(N)RAS基因突变与患者性别、年龄、肿瘤大小、肉眼分型、组织学分化程度、淋巴结转移、病理分期均无关(均P>0.05)。女性BRAF V600E突变高于男性,低分化高于中分化(均P<0.05),BRAF V600E突变与患者发病年龄、肿瘤位置、大小、肉眼分型、组织学类型、淋巴结转移、病理分期均无关(均P>0.05)。发生MSI-H的患者中,右半结肠癌多于左半结肠癌,肿瘤直径≥4.5 cm病例多于直径更小病例,隆起型多于其他肉眼分型,黏液腺癌多于单纯腺癌,低分化多于高分化(均P<0.05),而与患者性别和年龄均无关(均P>0.05)。K(N)RAS突变与MSI-H发生无关(P>0.05),但RAS基因Gly位点突变与MSI-H发生相关(P<0.05)。携带RAS基因Gly位点突变的MSI-H结直肠癌患者男性多于女性,发病年龄无差异,右半结肠多于左半结肠,肉眼分型多为溃疡型,单纯腺癌比例高于黏液腺癌,多为中低分化,较多处于病理分期I~II期,常不伴淋巴结转移和BRAF V600E突变,Gly突变位点多为Gly12Ser/Asp突变。BRAF V600E突变与MSI-H发生有关(P<0.05)。与K(N)RAS突变型MSI-L/MSS结直肠癌比较,K(N)RAS突变型MSI-H结直肠癌较易发生于右半结肠,肿瘤直径≥4.5 cm的病例较多,组织学类型多为黏液腺癌,较少发生淋巴结转移,多处于病理分期I~II(均P<0.05);K(N)RAS突变型MSI-H结直肠癌与性别、年龄、肿瘤肉眼分型、组织学分化均无相关(均P>0.05)。与RAS野生型-MSI-L/MSS结直肠癌比较,RAS野生型-MSI-H结直肠癌多发生于右半结肠,肿瘤直径≥4.5 cm,多为溃疡型和隆起型,较多为黏液腺癌,且多为中低分化(均P<0.05),而RAS野生型-MSI-H结直肠癌与性别、年龄、淋巴结转移、病理分期均无关(均P>0.05)。结论:结直肠癌KRAS基因Gly位点突变、BRAF V600E突变与MSI-H发生相关;MSI-H-RAS基因Gly点突变结直肠癌患者有其独特的临床病理特征;RAS-MSI基因状态与临床病理特征相关;K(N)RAS、BRAF V600E、MSI检测有利于结直肠癌患者个体化治疗及预后评估。

RAS基因相关性自身免疫淋巴增殖性疾病1例并文献复习

目的探讨RAS基因相关自身免疫淋巴增殖性疾病(Ras-associated autoimmune lymphoproliferative disorders,RALD)的临床特征及诊疗方法。方法分析2019年本院诊治的1例RALD患者的临床资料,以基因NRAS、KRAS或RALD为检索词,检索PubMed、中国知网、万方数据库2000年1月—2023年11月RAS基因变异相关文献并进行复习。结果患者因“发现血小板减少1.5年,反复发热1.5月”收住院。查体:轻度贫血貌,腹部膨隆,肝脏肋下5 cm,质韧,脾脏肋下3 cm。CD4-CD8-细胞的比例占淋巴细胞的2.3%。NK细胞脱颗粒功能下降。基因检测:存在NRAS基因2号外显子c.38G>A、p.G13D体细胞突变。共检索到RALD患者32例,其中NRAS基因体细胞突变致RALD有13例,KRAS基因体细胞突变致RALD有19例。32例RALD患者主要特征包括脾脏肿大,免疫性贫血,血小板减少,高丙种球蛋白血症,单核细胞增多,双阴性T细胞比例正常或轻度升高。结论RALD患者的临床特征为肝脾肿大、存在自身免疫现象等,基因分析有助于该疾病的诊断。

IL-1Ra基因多态性与无症状细菌性阴道病自然转归关系的研究

目的 研究白细胞介素1受体a(IL-1Ra)基因多态性与无症状细菌性阴道病(aBV)患者不同转归的关系,以期对aBV患者进行分组管理。方法 对aBV患者进行自然转归的研究,在入组时,所有患者均留取了一份静脉血标本和阴道灌洗液的标本单独冻存。4个月后,临床研究结束时,根据临床结局,将完成研究的患者分为3组:自愈、进展和无改变。再检测所有患者IL-1Ra基因多态性以及阴道微环境中IL-1β和IL-1Ra浓度,并比对上述指标在3组不同结局的患者间的差别。结果 共有1 014例中国汉族女性患者入组,984例完成临床随访并获得临床结局数据。其中13例患者的冻存标本在检测时无法使用,共有971分标本完成检测。所有患者均检测到IL-1Ra基因,有A_(1)/A_(1)、A_(1)/A_(2)和A_(2)/A_(2) 3种基因型,主流人群的基因型为A_(1)/A_(1),最少见的基因型为A_(2)/A_(2),未发现少见类型的基因型女性。病情进展组的A_(2)等位基因的频率明显高于自愈组(P<0.05)。在所有患者的阴道灌洗液标本中均能检测到IL-1β和IL-1Ra存在。与进展组比较,自愈组的IL-1β水平明显偏低(P<0.05)。当携带A_(2)等位基因时,进展组IL-1β水平相对偏低,而IL-1Ra水平相对升高,无变化组的数值介于进展组和自愈组之间。结论 aBV患者中的IL-1Ra基因多态性特征与阴道分泌物中的IL-1Ra含量有关。携带等位基因A_(2)与IL-1Ra含量升高、IL-1β含量降低有密切相关性。携带等位基因A_(2)可能通过与IL-1Ra和IL-1β有关的机制影响了aBV的临床转归。

类风湿因子亚型、抗CCP和抗RA33联合检测在早期类风湿关节炎诊断中的应用价值

目的探讨血清类风湿因子(RF)亚型(包括IgG-RF、IgA-RF、IgM-RF)、抗CCP、抗RA33联合检测在早期类风湿关节炎(RA)诊断中的意义。方法收集2021年6月至2022年5月医院收治的可疑RA患者作为研究对象,根据临床诊断结果将患者分为RA组(135例)和非RA组(1556例),测定两组血清IgG-RF、IgA-RF、IgM-RF、抗CCP、抗RA33水平,比较各项指标阳性表达情况,分析联合检测的诊断效能。结果RA组IgG-RF、IgA-RF、IgM-RF、抗CCP、抗RA33水平均高于非RA组(P<0.05);单项指标中,灵敏度和正确指数最高的是抗CCP,特异性最高的是IgG-RF;抗RA33灵敏度最低但特异性比较高。联合检测中以只要有阳性为判断标准,灵敏度和正确指数增加,灵敏度最高的是RF亚型/抗CCP/抗RA33(为99.26%),其次是RF亚型/抗CCP(95.56%);正确指数最高的是RF亚型/抗CCP/抗RA33(78.57%),其次是RF亚型/抗CCP(78.52%)。如果以联合检测中所有项目均阳性为判断标准,特异性明显升高,特异性最高的是RF亚型+抗CCP+抗RA33(99.55%),其次是RF亚型+抗RA33(98.78%)。结论RF亚型、抗CCP和抗RA33等指标对RA诊断具有一定价值,这些指标联合检测可以提高诊断灵敏度、特异性,提高早期诊断效能。

Electromagnetic Waves Collected by a Dental Amalgam Filling Induced Balance Dysregulation and Dizziness over a Period Exceeding 10 Years

This case report describes a woman aged approximately 50 years who has suffered from balance dysregulation and dizziness for more than 10 years. Although the subject underwent several examinations to confirm the etiology of her symptoms, the root cause remained unknown. The symptoms were thought to be caused by electromagnetic wave hypersensitivity because the subject experienced uneasiness and dizziness when a cell phone was held close to her body. A cell phone was used to diagnose the collection of harmful electromagnetic waves, and an amalgam filling was determined to be the cause. The amalgam filling was removed under strict protection, and the subject’s symptoms completely disappeared soon after the filling was removed.

基于ENVI+HEC-RAS的苏北运河生态修复方法及改善效果研究

鉴于生态修复对维持河流健康生命十分重要,以提升植被覆盖度与水质为目标,对苏北运河进行生态修复。基于2018年研究区Landsat8遥感影像数据,运用ENVI软件对苏北运河全河段的土地利用情况进行处理分析,并在增加上游生态来水的情况下,使用HEC-RAS软件对泗阳新一水厂断面的COD水质指标浓度进行模拟。结果表明,苏北运河全河段植物覆盖度最大可提升至59.84%,且Kappa系数结果均大于0.6,精度符合要求;COD水质指标浓度在5、10、12月达到Ⅱ类水标准,其余月份较调控前均已达到Ⅲ类水标准,可见在增大生态来水作用下,运河水质得到提升。

Dental Treatment for Dizziness and Joint Mobility Disorder Caused by Harmful Electromagnetic Waves

With the development of an IT (Information Technology) society, the opportunity to use electronic devices, such as cell phones and personal computers, has increased. These electronic devices pro-vide many benefits to society. However, there have been a number of reports of electromagnetic hypersensitivity (EHS) related to the use of electronic devices. The symptoms of EHS may include headaches, fatigue, tinnitus, dizziness, memory loss, irregular heartbeat, and skin trouble. Since the pathogenic mechanism of such conditions is not yet clear, further research is required. This report shows how a subject’s dizziness and joint mobility disorder, caused by electromagnetic waves emitted by electronic devices, were cured by removing an onlay from the patient’s mouth and replacing it with a gold alloy onlay. The result indicates that the subject’s symptoms were caused by EHS. Although the symptoms were improved after the dental treatment, the underlying mechanism of the symptoms and the reason why this treatment is successful remain unclear. Further research is required to clarify these issues.

五苓散调控RAS对阿霉素肾病综合征大鼠肾损伤的保护作用

目的 探讨五苓散及其拆方以及单体桂皮醛对肾病综合征模型大鼠的影响。方法 通过2次尾静脉注射阿霉素(3 mg/kg)构建阿霉素肾病综合征大鼠模型,并分为模型组、五苓散组、五苓散去桂枝组、五苓散去桂枝加桂皮醛组、桂皮醛组、贝那普利组,每组10只,分别灌胃给予相应药物,连续28 d。最后一次灌胃后收集大鼠24 h尿液,检测尿蛋白、肌酐、尿素氮等指标,Western blot法检测血管紧张素转换酶(ACE)、血管紧张素转化酶2(ACE2)、血管紧张素2(Ang-2)蛋白表达。结果 与模型组比较,五苓散去桂枝加桂皮醛组、桂皮醛组大鼠尿蛋白、肌酐、尿素氮水平以及ACE、Ang-2表达降低(P<0.05,P<0.01),ACE2表达升高(P<0.05,P<0.01)。结论 桂皮醛可能是五苓散中发挥抗肾病综合征的主要活性成分,其作用机制可能与RAS信号通路有关。

瑞马唑仑调节EPAC1/RAP1信号通路对急性心肌梗死大鼠心肌损伤的影响

目的探讨瑞马唑仑调节环腺苷酸激活的交换蛋白1(EPAC1)/RAS相关蛋白1(RAP1)信号通路对急性心肌梗死(AMI)大鼠心肌损伤的影响。方法将大鼠按照随机数字表法分为假手术组、模型组、瑞马唑仑组、瑞马唑仑+8-CPT(EPAC1的激动剂)组,每组20只。除假手术组外,其余各组大鼠通过左前降支结扎法构建AMI大鼠模型;小动物超声仪检测心功能指标;HE染色检测心肌组织病理情况;化学比色法检测大鼠心肌组织超氧化物歧化酶(SOD)和丙二醛(MDA)水平;JC-1染色法检测大鼠心肌细胞线粒体膜电位;TUNEL染色检测心肌细胞TUNEL阳性率;Western blot检测心肌组织EPAC1、RAP1、胱天蛋白酶3(Caspase-3)蛋白表达水平。结果与假手术组相比,模型组大鼠心肌组织结构被严重破坏且浸润大量炎性细胞;心功能指标左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD),心肌组织MDA水平,心肌细胞TUNEL阳性率,心肌组织EPAC1、RAP1、Caspase-3蛋白表达水平均明显升高;左心室射血分数(LVEF)、左心室短轴缩短率(LVFS),心肌组织SOD水平,心肌细胞线粒体膜电位明显降低(P<0.05)。与模型组相比,瑞马唑仑组大鼠心肌损伤缓解,炎性细胞浸润减轻,心功能指标LVEDD、LVESD,心肌组织MDA水平,心肌细胞TUNEL阳性率,心肌组织EPAC1、RAP1、Caspase-3蛋白表达水平均明显降低;LVEF、LVFS,心肌组织SOD水平,心肌细胞线粒体膜电位明显升高(P<0.05)。EPAC1的激动剂减弱了瑞马唑仑对AMI大鼠心肌损伤的缓解作用。结论瑞马唑仑可能通过抑制EPAC1/RAP1信号通路抑制心肌细胞凋亡,减轻AMI大鼠心肌损伤。

毛蕊异黄酮通过RAS/RAF/MEK/ERK信号通路抑制肺癌细胞增殖和迁移的作用机制

目的探讨毛蕊异黄酮(Calycosin)通过RAS/RAF/MEK/ERK信号通路抑制肺癌细胞增殖、迁移的作用机制。方法将肺癌A549细胞分为空白对照组和毛蕊异黄酮20、40、80μmol/L 3个浓度组。MTT法检测细胞存活率;Western Blot检测肺癌A549细胞RAS、p-RAF、p-MEK和p-ERK蛋白的表达;细胞集落试验和划痕试验观察肺癌A549细胞的增殖和迁移。结果当毛蕊异黄酮浓度在80μmol/L以下时,毛蕊异黄酮无明显细胞毒性。毛蕊异黄酮可抑制RAS、p-RAF、p-MEK和p-ERK蛋白表达,且抑制效果呈剂量依赖性;毛蕊异黄酮对肺癌A549细胞增殖和迁移的抑制作用呈剂量依赖性。结论毛蕊异黄酮能够通过RAS/RAF/MEK/ERK信号通路抑制肺癌A549细胞增殖和迁移。