行为活化治疗老年糖尿病伴发抑郁及其对行为抑制/激活系统的影响

目的:探讨行为活化对老年糖尿病(DM)共病抑郁的疗效,及治疗过程中行为抑制、激活系统的变化情况。方法:老年DM伴抑郁症患者随机分组后,分别接受行为活化治疗(BA组,n=36)和支持性心理治疗(SP组,n=33),疗程6周;于治疗前后评定Beck抑郁问卷(BDI)、行为抑制/激活系统量表(BIS/BAS)。结果:1治疗6周时,BA组、SP组BDI(t=9.319,7.041;均P=0.000)、BIS(t=3.677,3.075;P=0.001,0.004)评分均较治疗前降低,BAS评分均较治疗前增高(t=4.484,2.308;P=0.000,0.028);2治疗6周时,BA组BDI、BAS评分的变化率显著高于SP组(t=3.189,2.167;P=0.029,0.044),而两组BIS评分变化率无显著差异(t=0.948,P=0.346);3BA组、SP组的BDI评分变化率均与BAS评分的变化率负相关(r=-0.415,-0.353;P=0.011,0.043),而与BIS评分变化率的相关性均不显著(r=0.266,0.213;P=0.104,0.230)。结论:BA可改善老年糖尿病患者伴发的抑郁,并可能与其对行为激活系统有较强的作用有关。

行为活化治疗对军队离退休干部糖尿病患者共病抑郁的干预效果

目的研究行为活化(behavioral activation,BA)治疗干预军队离退休干部糖尿病(diabetes mellitus,DM)患者共病抑郁障碍的效果。方法将男性军队离退休干部DM共病轻中度抑郁障碍患者69例随机分组,分别为接受BA治疗组36例(研究组)或支持性心理治疗组33例,疗程6周,于干预前、干预后分别评定Beck抑郁问卷(BDI),以BDI减分率评定疗效。结果 (1)与干预前相比,研究组、对照组干预后BDI评分显著降低(P<0.001);研究组干预后BDI评分显著低于对照组(P<0.01)、BDI减分率显著高于对照组(P<0.05);(2)研究组干预有效率为55.56%,较对照组的30.30%显著提高(P<0.05)。结论 BA可显著改善DM患者所共病的抑郁障碍,疗效优于支持性心理治疗。

介入治疗对冠心病患者血小板活化指标和抗血小板治疗效果及预后的影响研究

目的:探究介入治疗对冠心病患者血小板活化指标和抗血小板治疗效果及预后的影响。方法:前瞻性选定我院在2016年8月-2018年8月收治的100例冠心病患者作为观察对象,按随机数表法将其分为观察组和对照组,各50例。对照组患者施行单纯药物治疗,观察组在对照组的基础上施行介入治疗。检测并比较两组患者血小板活化指标变化情况,分析两组抗血小板治疗效果以及预后不良心血管事件(MACE)发生率情况。结果:两组血液生化指标GLU、ALT、Cr、CK、CK-MB、TC相比差异无统计学意义(P>0.05);观察组患者hs-CRP、PS以及AP诱导的MPAR均高于对照组,PGF低于对照组,差异具有统计学意义(P<0.05);观察组11-dh-TXB2及APD诱导的MPAR与对照组相比差异无统计学意义(P>0.05)。观察组抗血小板治疗效果与对照组相比具有显著性差异(P<0.05)。两组MACE发生率相比,差异无统计学意义(P<0.05)。结论:采用介入治疗能够促进冠心病患者血小板聚集率,提高血小板活化及炎性反应,且并未增加预后MACE发生率。

活化健肝汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎50例

目的:观察活化健肝汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎的临床疗效。方法:将100例慢性乙型病毒性肝炎患者按就诊先后顺序分为治疗组和对照组各50例。对照组口服恩替卡韦分散片,每次0.5 mg,每日1次;治疗组在对照组治疗基础上加服活化健肝汤(党参、茯苓、黄芪、当归、丹参、赤芍、郁金、水红花子、虎杖、垂盆草、泽兰、鸡内金、茵陈、甘草),每日1剂,水煎服。每服药4周停3 d再继续服用。两组同时可用保肝及对症治疗药物。治疗6个月后判定疗效。结果:治疗组显效27例,有效17例,无效6例,有效率为88.0%;对照组显效20例,有效13例,无效17例,有效率为66.0%。两组对比,差别有统计学意义(P<0.05)。结论:活化健肝汤联合恩替卡韦分散片治疗慢性乙型病毒性肝炎,疗效肯定,无明显副作用。

DC-CIK免疫治疗联合化疗对肺癌患者近远期疗效的影响

目的探讨自体树突状细胞(DC)-细胞因子活化杀伤细胞(CIK)免疫治疗联合化学治疗(简称化疗)对肺癌患者近远期疗效的影响。方法选取医院2018年9月至2020年8月收治的肺癌患者60例,按治疗方式的不同分为对照组和观察组,各30例。两组患者均采取常规化疗方案治疗,观察组患者加用DC-CIK免疫治疗。结果观察组患者的客观缓解率为73.33%,显著高于对照组的46.67%(P<0.05);治疗后,观察组患者的生活质量评分显著更高,临床症状评分显著更低(P<0.05);观察组患者的中位生存期显著长于对照组(P<0.05);观察组患者1年生存率为80.00%,显著高于对照组的50.00(P<0.05)。结论DC-CIK免疫治疗联合化疗可提高肺癌患者的近远期疗效,有助于改善患者的疾病症状和机体免疫功能,提升整体生活质量。

Cytochrome P450 Directed Prodrug Activation Therapy in Research of Cancer Enzymology

Cancer enzymology is a promising filiation of bio-medical sciences. In thepast decades, enzymes, such as GST(glutathione S-transferase) , PKC(protein kinase C) , Topo(DNAtopoisomerases), TK(tyrosine kinase), CD (bacterial cytosine deaminase), CPG2(carboxypeptidase G2) ,and PNP (purine nucleoside phosphorylase), have been known to bear close relations to cancer. Theirspecific expression and influence on the process of tumor initiation, promotion and progressionattract scientists to apply them as a biochemical marker of certain malignant tumor, a predictor ofresponse in cancer chemotherapy; to apply them to drug design, tumor prevention and as adjuvant toradiotherapy or surgery.

让时光放慢脚步

有人说，现在的女人越来越难看出年龄。美容院是怎样把女人越变越年轻，不光是女人．永远年轻是每个人心中的遥远的愿望，但自然规律把每个人的皮肤都刻上了岁月的痕迹。作为美容师，美容院除了帮助客人减压、美白以外一个最重要的作用就是延缓衰老，对抗皱纹，使皮肤变得光滑、白皙。

Overview of immunosuppression in liver transplantation

Continued advances in surgical techniques and immunosuppressive therapy have allowed liver transplantation to become an extremely successful treatment option for patients with end-stage liver disease.Beginning with the revolutionary discovery of cyclosporine in the 1970s,immunosuppressive regimens have evolved greatly and current statistics confirm one-year graft survival rates in excess of 80%. Immunosuppressive regimens include calcineurin inhibitors,anti-metabolites,mTOR inhibitors,steroids and antibody-based therapies.These agents target different sites in the T cell activation cascade,usually by inhibiting T cell activation or via T cell depletion.They are used as induction therapy in the immediate periand post-operative period,as long-term maintenance medications to preserve graft function and as salvage therapy for acute rejection in liver transplant recipients. This review will focus on existing immunosuppressive agents for liver transplantation and consider newer medications on the horizon.

JAK-STAT pathway in carcinogenesis:Is it relevant to cholangiocarcinoma progression?

The features of JAK-STAT signaling in liver cells are discussed in the current review. The role of this signaling cascade in carcinogenesis is accentuated. The possible involvement of this pathway and alteration of its elements are compared for normal cholangiocytes, cholangiocarcinoma predisposition and development. Prolactin and interleukin-6 are described in detail as the best studied examples. In addition, the non-classical nuclear translocation of cytokine receptors is discussed in terms of its possible implication to cholangiocarcinoma development.

Characterization of pancreatic stem cells derived from adult human pancreas ducts by fluorescence activated cell sorting

AIM： To isolate putative pancreatic stem cells （PSCs） from human adult tissues of pancreas duct using serumfree, conditioned medium. The characterization of surface phenotype of these PSCs was analyzed by flow cytometry. The potential for pancreatic lineage and the capability of β-cell differentiation in these PSCs were evaluated as well. METHODS： By using serum-free medium supplemented with essential growth factors, we attempted to isolate the putative PSCs which has been reported to express nestin and pdx-1. The MatrigelTM was employed to evaluate the differential capacity of isolated cells. Dithizone staining, insulin content/secretion measurement, and immunohistochemistry staining were used to monitor the differentiation. Fluorescence activated cell sorting （FACS） was used to detect the phenotypic markers of putative PSCs. RESULTS： A monolayer of spindle-like cells was cultivated. The putative PSCs expressed pdx-1 and nestin. They were also able to differentiate into insulin-, glucagon-, and somatostatin-positive cells. The spectrum of phenotypic markers in PSCs was investigated; a similarity was revealed when using human bone marrow-derived stem cells as the comparative experiment, such as CD29, CD44, CD49, CD50, CD51, CD62E, PDGFR-α, CD73 （SH2）, CD81, CD105（SH3）. CONCLUSION： In this study, we successfully isolated PSCs from adult human pancreatic duct by using serumfree medium. These PSCs not only expressed nestin and pdx-1 but also exhibited markers attributable to mesenchymal stem cells. Although work is needed to elucidate the role of these cells, the application of these PSCs might be therapeutic strategies for diabetes mellitus.

Antioxidant therapy for chronic hepatitis C after failure of interferon:Results of phase Ⅱ randomized,double-blind placebo controlled clinical trial

AIM： TO assess the safety and efficacy of antioxidant therapy for patients with chronic hepatitis C virus （HCV） infection.METHODS： One hundred chronic HCV infection patients failed in interferon treatment were enrolled and randomly assigned to receive combined intravenous and oral antioxidants or placebo, or oral treatment alone, Primary end points were liver enzymes, HCV-RNA levels and histology.RESULTS： Combined oral and intravenous antioxidant therapy was associated with a significant decline in ALT levels in 52% of patients who received antioxidant therapy vs 20% of patients who received placebo （P = 0.05）. Histology activity index （HAI） score at the end of treatment was reduced in 48% of patients who received antioxidant therapy vs 26% of patients who received placebo （P = 0.21）. HCV-RNA levels decreased by l-log or more in 28% of patients who received antioxidant therapy vs 12% who received placebo （P = NS）. In part 11 of the trial, oral administration of antioxidants was not associated with significant alterations in any of the end points.CONCLUSION： Antioxidant therapy has a mild beneficial effect on the inflammatory response of chronic HCV infection patients who are non-responders to interferon. Combined antiviral and antioxidant therapy may be beneficial for these patients.

Intestinal microflora molecular markers of spleen-deficient rats and evaluation of traditional Chinese drugs

AIM:To find a rapid and efficient analysis method of gastrointestinal microflora in Pi-deficient(spleen-deficient) rats and to evaluate traditional Chinese drugs.METHODS:Enterobacterial repetitive intergenic consensus-PCR(ERIC-PCR) based assay was performed to examine changes of intestinal microflora in two Pi-deficienct animal models and to evaluate the efficacy of four traditional Chinese drugs as well as a probiotic recipe and another therapy in Pi-deficient rats.RESULTS:A molecular marker was identified for Pi-deficiency in rats.The pharmacodynamic evaluation system,including identified molecular markers(net integral area and abundance of DNA bands),Shannon's index for diversity of intestinal microflora,and Sorenson's pairwise similarity coefficient,was established.The four major clinical recipes of traditional Chinese drugs for Pi-deficiency in rats,especially at their medium dose(equivalence to the clinical dose),produced more pronounced recovery activities in Pi-deficient rats,while higher doses of these recipes did not show a better therapeutic effect but some toxic effects such as perturbation deterioration of intestinal microflora.CONCLUSION:Both fingerprint analysis and identified marker can show Pi-deficiency in rats and its difference after treatment.The identified molecular marker may be applied in screening for the active compounds both in relative traditional Chinese drugs and in pharmacodynamic study of Pi-deficiency in rats.

Checkmate to liver biopsy in chronic hepatitis C?

Liver biopsy (LB) has traditionally been considered the gold standard for pretreatment evaluation of liver fibrosis in patients with chronic hepatitis C (CHC). However, LB is an invasive procedure with several shortcomings (intra-and interobserver variability of histopathological interpretation, sampling errors, high cost) and the risk of rare but potentially life-threatening complications. In addition, LB is poorly accepted by patients and it is not suitable for repeated evaluation. Further-more, the prevalence of CHC makes LB unrealistic to be performed in all patients with this disease who are candidates for antiviral therapy. The above-mentioned drawbacks of LB have led to the development of non-invasive methods for the assessment of liver fibrosis. Several noninvasive methods, ranging from serum marker assays to advanced imaging techniques, have proved to be excellent tools for the evaluation of liver fibrosis in patients with CHC, whereas the value of LB as a gold standard for staging fibrosis prior to antiviral therapy has become questionable for clinicians. Despite significant resistance from those in favor of LB, noninvasive methods for pretreatment assessment of liver fibrosis in patients with CHC have become part of routine clinical practice. With protease inhibitors-based triple therapy already available and substantial improvement in sustained virological response, the time has come to move forward to noninvasiveness, with no risks for the patient and, thus, no need for LB in the assessment of liver fibrosis in the decision making for antiviral therapy in CHC.

Does antioxidant therapy influence every aspect of quality of life?

To present problems that might severely impact the conclusions drawn by the authors of an article on antioxidant treatment in chronic pancreatitis(World J Gastroenterol 2010;16:4066-4071).We analyzed and discussed this paper by Shah et al,and found that promising as it is,this study has some methodological shortcomings,such as:cross-sectional nature of the study,lack of initial evaluations of quality of life and regular follow-ups to determine the dynamics and real directions of changes in quality of life.We therefore concluded that the results of the study by Shah et al are biased and,although very promising,should not be considered as scientifically relevant.

Impact of adjuvant chemotherapy delay on survival in cancer breast patients

Objective： The proper time to commence adjuvant chemotherapy after primary surgery for breast cancer is unknown. It is usually prescribed within 2-3 months after definitive surgery. The aim of this retrospective study was to assess the impact of adjuvant chemotherapy （CT） delay beyond 3 weeks （ 21 days） in premenopausal patients with ER-absent tumors being treated for early stages breast cancer on overall survival （OS） and disease-free survival （DFS）. Methods： This retrospective study was conducted through revision of medical records of premenopausal patients diagnosed with early stage ｜-｜IIA breast cancer and ER-absent tumors who received adjuvant CT after definitive surgery at the Department of Clinical Oncology, Ain-Shams University Hospitals. Results： Between 2005 and 2008, 105 patients were retrospectively analyzed and included. Patients were divided into 2 groups： Group A including 48 patients who started adjuvant CT 〈 21 days of surgery and group B which included 57 patients who had CT delay 〉 21 days. Both groups were matched demographically. Comparisons of overall survival, and disease-free survival between group A and group B patients all favored group A. At 5-year the OS rates were 87% and 73% for groups A and B respectively （P = 0.001）, while DFS rates were 85% and 64% in groups A and B respectively （P = 0.001）. Analysis of other prognostic factors （age, T, N, grade, HER2 status, surgery type, CT type, local radiotherapy received） were analyzed. Only nodal status predicted for worse DFS （P = 0.05） and OS （P = 0.006）. Conclusion： Delay in initiating adjuvant chemotherapy for early stage breast cancer patients with ER-absent tumors was associated with a decrease in both OS and DFS rates.

Clinical observation of Huatan Huoxue Formula in treating coronary heart disease with hyperlipidemia

OBJECTIVE: To explore the effect of the Huatan Huoxue Formula combined with atorvastatin calcium in the treatment of coronary heart disease with hyperlipidemia. METHODS: 50 patients with coronary heart disease and hyperlipidemia were randomly divided into the experimental group and the control group, with 25 cases in each group, who were treated in the East Hospital of Beijing University of Chinese Medicine. From March 2015 to April 2016. Patients in the experimental group were given the Huatan Huoxue Formula combined with atorvastatin with 8 weeks; while the control group was just treated with atorvastatin. Blood Lipid changes were compared between the two groups. RESULTS: Blood Lipid levels were significantly improved in the two groups after treatment. Compared with the control group, the levels of TG, TC and LDL-C in the experimental group were decreased, while the HDL-C was increased more significantly. The difference was statistically significant(P<0.05).CONCLUSIONS: The effect of the Huatan Huoxue Formula combined with atorvastatin on coronary heart disease and hyperlipidemia patients is more significant.

Investigation of the Effect of Neoadjuvant Chemotherapy on Stage Ⅱ Breast Cancer

OBJECTIVE To investigate the effect of neoadjuvant chemotherapy in treatment of Stage Ⅱ breast cancer. METHODS The data from 113 patients with breast cancer of the same pathologic type in Stage Ⅱ,during the period of 1995 to 2001,were analyzed retrospectively.Among the patients,47 were treated with neoadjuvant chemotherapy,and 66 received no adjuvant therapy before surgery（control group）.After the patients of the neoadjuvant chemotherapy group had received 2 courses of chemotherapy with the CMF regimen,the surgical procedure was conducted. RESULTS Complete remission（CR）was attained in 9 of the 47 cases receiving neoadjuvant chemotherapy and partial remission（PR）was reached for 22 cases.The rate of breast-conserving surgery was enhanced from 22.73%to 46.81%（P〈0.05）in the neoadjuvant treatment group. There was no difference in the 5-year overall survival（OS）and disease-free survival（DFS）rate between the two groups（P〉0.05）,but the 5-year OS and DFS of the cases with clinical tumor remission was higher compared to the control group（P〈0.05）. CONCLUSION Neoadjuvant chemotherapy can enhance the rate of breast conservation for Stage Ⅱ breast cancer and may improve the prognosis of the cases with clinical remission.

Preparation and Evaluation of High Antioxidant Talbina as a Protective and Therapeutic Meal

Functional properties of Talbina were used in ancient Arab for nutritional purpose. It was a meal made from barley flour and milk. The high antioxidant Talbina was formulated from whole flour of harley and oat, milk, date palm syrup （debis） and date palm seeds. The chemical composition, organoleptic properties and antioxidant activity of high antioxidant Talbina were determined. Sensory evaluation of traditional and high antioxidant Talbina showed that the developed product Talbina was considered as good for overall acceptability of all panelists. Also, the formulated Talbina contains high values of antioxidants components and natural nutrients. The antioxidant activity of formulated Talbina containing barley or oat may be due to presence of phenolic compounds and proanthocyanidins in the barley and oat. Increasing the antioxidant activity of high antioxidant Talbina containing barley and oat may be due to the adding of dates palm seeds which contain very high values of phenolic compounds and other antioxidants components. Date palm seeds as well as barley and/or oat give high antioxidants components which protect cells from oxidative stress and help to reduce the risk of cancer and heart disease as well as natural anti-depressant. Moreover, increasing the antioxidant activity in the formulated Talbina may play a role for reducing power, radical scavenging activity and the lipid peroxidation inhibition. In conclusion, supplementation of traditional Talbina containing barley and/or oat with date palm syrup （debis） and date palm seeds can produce simple and healthy meal to provide a good source of daily dietary antioxidants and micronutrients.