Objective:To systematically evaluate the clinical value of monoclonal antibodies for neuromyelitis optica spectrum disorders (NMOSD), a multidimensional assessment of three monoclonal antibody therapies (eculizumab, inebilizumab, and satralizumab) was conducted using the updated drug evaluation framework from the Rapid Guide for Drug Evaluation and Selection in Chinese Medical Institutions (2nd Edition). This study aims to provide evidence-based guidance for optimizing monoclonal antibody selection in clinical practice. Methods:A quantitative scoring system was employed across five distinct domains: pharmacological properties (28 points), efficacy (27 points), safety (25 points), economics (10 points), and other attributes (10 points). Results:The comprehensive evaluation scores, with a maximum of 100 points, were as follows: eculizumab (70.43), satralizumab (69.33), and inebilizumab (68). Conclusion:Eculizumab is strongly endorsed as the first-line therapeutic option due to its optimal benefit-risk profile. Satralizumab and inebilizumab may be considered as conditional alternatives, contingent upon institutional resources and individual patient factors. This tiered recommendation framework facilitates adaptive formulary management that aligns with the evolving therapeutic landscape and socioeconomic conditions, thereby providing a replicable model for healthcare systems worldwide.

Background:Studies have confirmed that optical coherence tomography angiography (OCTA) can detect early retinal microvascular impairment in many diseases. However, as far as we know, only one study has found retinal and optic disc microcirculation changes in Wilson's disease (WD) by OCTA. The purpose of our study was to evaluate the OCTA parameters in WD. Methods:We performed a cross-sectional study at the First Affiliated Hospital of Guangdong Pharmaceutical University between June 2021 and April 2022. A total of 42 WD patients and 40 gender- and age-matched healthy controls (HEC) were recruited in this study. WD patients were divided into neurological form (NWD) and hepatic form (HWD) of the disease. All participants underwent retinal OCTA to assess the superficial vessel density (VD), deep VD, and foveal avascular zone (FAZ) parameters. The FAZ parameters included the area in mm2, perimeter in mm, and VD of the 300 µm-width annulus surrounding FAZ (FD-300). Statistical tests used in this study included Chi-squared test, one-way analysis, correlation analysis, and t-test or Mann-Whitney U test. Results:WD patients comprised 21 females and 21 males, with mean age of 30.54±9.83 years. HEC comprised 16 females and 24 males, with mean age of 30.42±7.37 years. NWD had smaller FD-300 (51.67%±5.29% vs. 55.87%±3.85%, P<0.01) than HEC and smaller FD-300 (51.67%±5.29% vs. 55.42%±4.09%, P<0.05) than HWD. There was no significant difference in OCTA parameters between HWD and HEC. Conclusions:Our study indicated that OCTA may be a useful tool for detecting central nervous system (CNS) injury in WD. We speculate that the decrease of FD-300 may be a sign of CNS injury in WD.

Introduction Wernekinck commissure syndrome (WCS) is an extremely rare midbrain syndrome, which selectively destroys the decussation of the superior cerebellar peduncle and the central tegmental tract, which commonly presents with bilateral cerebellar ataxia, dysarthria, and internuclear ophthalmoplegia. Palatal myoclonus in Wernekinck commissure syndrome is uncommon and often occurs as a late phenomenon due to hypertrophic degeneration of bilateral inferior olivary nuclei. Material and method A patient with WCS, admitted to our hospital from December 2023, was chosen for this study, and the syndrome's clinical manifestations, imaging features, and etiology were retrospectively analyzed based on the literature. A 68-year-old right-handed East Asian man presented with dizziness, slurred speech, difficulty with swallowing and walking, and rhythmic contractions of the soft palate. He had several risk factors for ischemic cerebrovascular diseases (age, sex, dyslipidemia, hypertension and smoking history). Brain magnetic resonance imaging showed hyperintensity of DWI and hypointensity of ADC at the caudal midbrain which was around the paramedian mesencephalic tegmentum anterior to the aqueduct of midbrain. Results He was diagnosed with Wernekinck commissure syndrome (WCS) secondary to caudal paramedian midbrain infarction. He was started on dual antiplatelet therapy (aspirin and clopidogrel) and intensive statin therapy. Blood pressure and glucose were also adjusted. His symptoms improved rapidly, and he walked steadily and speak clearly after 7 days of treatment. Conclusions Palatal myoclonus is known to occur as a late phenomenon due to hypertrophic degeneration of bilateral inferior olivary nuclei. However, Our case suggests that palatal myoclonus can occur in the early stages in WCS.

A retrospective analysis was performed on one case of adult-onset type Ⅱcitrullinemia(CTLN2)caused by homozygous mutations of SLC25A13 genes.The patient,a 28-year-old male,had repeated limb convulsions for more than 4 years and worsened for 2 months.He usually liked to eat peanuts and meat.The brain MRI examination showed no abnormality,and anti-epileptic treatment was not effective.Further examination of blood aminotransferase,blood ammonia and citrulline were elevated,genetic testing showed that the SLC25A13 gene c.851_854del homozygous pathogenic mutation,the diagnosis was CTLN2,and the treatment was treated with a high-protein,high-fat,low-sugar diet and arginine,and there were no seizures followed up for half a year.Patients with recurrent seizures with special dietary preferences should be paid attention to the possibility of CTLN2,and genetic testing plays an important role in the diagnosis of CTLN2 and provides a basis for clinical diagnosis and treatment.

Abstract Background Morphological changes of retina in patients with Wilson's disease (WD) can be found by optical coherence tomography (OCT), and such changes had significant differences between neurological forms (NWD) and hepatic forms (HWD) of WD. The aim of this study was to evaluate the relationship between morphological parameters of retina and brain magnetic resonance imaging (MRI) lesions, course of disease, type of disease, and sexuality in WD. Methods A total of 46 WD patients and 40 health controls (HC) were recruited in this study. A total of 42 WD patients were divided into different groups according to clinical manifestations, course of disease, sexuality, and brain MRI lesions. We employed the Global Assessment Scale to assess neurological severity of WD patients. All WD patients and HC underwent retinal OCT to assess the thickness of inner limiting membrane (ILM) layer to retinal pigment epithelium layer and inner retina layer (ILM to inner plexiform layer, ILM–IPL). Results Compared to HWD, NWD had thinner superior parafovea zone (108.07 ± 6.89 vs. 114.40 ± 5.54 μm, p < .01), temporal parafovea zone (97.17 ± 6.65 vs. 103.60 ± 4.53 μm, p < .01), inferior parafovea zone (108.114 ± 7.65 vs. 114.93 ± 5.84 μm, p < .01), and nasal parafovea zone (105.53 ± 8.01 vs. 112.10 ± 5.44 μm, p < .01) in inner retina layer. Course of disease influenced the retina thickness. Male patients had thinner inner retina layer compared to female patients. Conclusion Our results demonstrated that WD had thinner inner retina layer compared to HC, and NWD had thinner inner retina layer compared to HWD. We speculated the thickness of inner retina layer may be a potential useful biomarker for NWD.

Objective To analyze and explore the risk factors for neurological symptoms in patients with purely hepatic Wilson's disease (WD) at diagnosis. Methods This retrospective study was conducted at the First Affiliated Hospital of the Guangdong Pharmaceutical University on 68 patients with purely hepatic WD aged 20.6 ± 7.2 years. The physical examinations, laboratory tests, color Doppler ultrasound of the liver and spleen, and magnetic resonance imaging (MRI) of the brain were performed. Results The elevated alanine transaminase (ALT) and aspartate transaminase (AST) levels and 24-h urinary copper level were higher in the purely hepatic WD who developed neurological symptoms (NH-WD) group than those in the purely hepatic WD (H-WD) group. Adherence to low-copper diet, and daily oral doses of penicillamine (PCA) and zinc gluconate (ZG) were lower in the NH-WD group than those in the H-WD group. Logistic regression analysis showed that insufficient doses of PCA and ZG were associated with the development of neurological symptoms in patients with purely hepatic WD at diagnosis. Conclusion The development of neurological symptoms in patients with purely hepatic WD was closely associated with insufficient doses of PCA and ZG, and the inferior efficacy of copper-chelating agents. During the course of anti-copper treatment, the patient's medical status and the efficacy of copper excretion should be closely monitored.

目的:研究用高压氧联合驱铜疗法治疗脑型肝豆状核变性(WD)的临床疗效.方法:选择2019年1月至2021年12月在广东药科大学附属第一医院接受诊治的脑型WD病例40例〔平均年龄(27.05±6.79)岁〕,将其随机分为观察组和对照组(20例/组).为观察组患者采用二巯基丙磺钠驱铜联合高压氧疗法进行治疗(二巯基丙磺钠驱铜治疗以8d为1个疗程,共治疗2个疗程;高压氧治疗以6 d为1个疗程,共治疗2个疗程),为对照组患者单用二巯基丙磺钠驱铜疗法进行治疗(方法同上).然后比较两组患者的治疗效果.结果:1)治疗前,两组患者血清SOD、MDA的水平相比,差异无统计学意义(P>0.05).治疗后,观察组患者血清SOD的水平较治疗前显著升高,且高于对照组患者治疗后血清SOD的水平,差异有统计学意义(P<0.05).治疗后,两组患者血清MDA的水平与治疗前相比,差异无统计学意义(P>0.05);两组患者血清MDA的水平相比,差异无统计学意义(P>0.05).2)治疗前,两组患者的BFM-M评分相比,差异无统计学意义(P>0.05).治疗后,观察组患者的BFM-M评分较治疗前显著降低,且低于对照组患者治疗后的BFM-M评分,差异有统计学意义(P<0.05).结论:对脑型WD患者进行高压氧联合驱铜治疗可显著改善其神经症状,保护其神经功能.

Abstract Background: Morphological changes of retina in patients with Wilson’s disease (WD) can be found by optical coherence tomography (OCT), and such changes have significant differences between neurological forms（NWD ) and hepatic forms (HWD) of WD. We aimed to evaluate the relationship between morphological parameters of retina and brain magnetic resonance imaging (MRI) changes, course of disease, type of disease and sexuality in WD. This is a single center, prospective study including forty-six WD patients and forty healthy controls (HC). We employed theGlobal Assessment Scale (GAS) to assess the the neurological sign of WD patients. Results: NWD had thinner superior parafovea zone (108.07±6.89 um vs. 114.40±5.54 um, p<0.01), temporal parafovea zone (97.17±6.65 um vs. 103.60±4.53 um, p<0.01), inferior parafovea zone (108.114±7.65 um vs. 114.93±5.84 um, p<0.01) nasal parafovea zone (105.53±8.01 um vs. 112.10±5.44 um, p<0.01) in inner retina thickness than HWD. The course of disease influenced the retina thickness, male patients had thinner inner retina thickness than female patients. Conclusion: Our results demonstrated that WD had thinner inner retina thickness than HC and NWD had thinner inner retina thickness than HWD. We spectualted the thickness of inner retina layer may a potential useful biomarker for NWD.

To measure the linear structure of the brain in patients with Wilson's disease (WD) and analyze its correlation with neurological symptoms. A total of 174 patients diagnosed with WD were enrolled. According to the type of clinical presentation, the patients with WD were divided into two groups: neurological (NWD) and hepatic (HWD). Sixty healthy volunteers were assigned to a control group. All patients with WD and healthy controls underwent brain magnetic resonance imaging (MRI). The severity of the neurological symptoms was assessed using the Burke Fahn Marsden Movement subscale (BFM-M). Linear brain measurements were performed using T1-weighted MRI scans of all the patients, and the correlation between these linear indices and BFM-M score was investigated. The Huckman index, third ventricle width, and sulcus width of the NWD group were significantly higher than those of the HWD and control groups (P < .05). The frontal horn index, ventricular index, and lateral ventricular body width index of the NWD group were significantly lower than those of the HWD and control groups (P < .05). The Huckman index and third ventricle width of the HWD group were higher than those of the control group (P < .05), whereas the body width index of the lateral ventricle was lower than that of the control group (P < .05). The BFM-M score correlated with the Huckman index (r = 0.29, P < .05), third ventricle width (r = 0.426, P < .001), and lateral ventricular body width index (r = -0.19, P < .05). This study demonstrated significant changes in the linear structure of patients with WD. Linear brain measurement analysis could be used as a potential method to assess the severity of neurological symptoms in WD.

Background:Hepatolenticular degeneration (HLD), also known as Wilson disease (WD), is a rare autosomal-recessive hereditary disease, which is often missed and misdiagnosed because of its various clinical manifestations. And WD is even more rare with giant subarachnoid cysts. In this report, we will provide a case of WD with an intracranial arachnoid cyst (IAC). Case description:A 27-year-old woman was hospitalized in a traditional Chinese medicine hospital in Guangzhou with the first manifestation of a "slight involuntary tremor of her left upper limb". There was no improvement after acupuncture treatment, and then she was transferred to another large general hospital in Guangzhou. MRI examination of the head showed "left frontal, parietal and temporal giant subarachnoid cyst" and the patient underwent "left frontotemporal arachnoid cyst celiac shunt operation." After the operation, the patient's left limb shaking remained unchanged. Subsequently, the patient was referred to another big hospital in Guangzhou, considered "Parkinson's disease," and given "Medopa, Antan" and other treatments. However, the patient's limb shaking continued to increase and gradually developed to the extremities. At last, the patient was referred to our hospital, combined with the medical history, neurological signs, and auxiliary examination results, improve the examination of corneal K-F ring, blood ceruloplasmin, gene screening, and other tests; the diagnosis was confirmed as hepatolenticular degeneration. Conclusion:After expelling copper and symptomatic treatment, the condition is improved.

目的 探讨翻转课堂混合式教学模式在神经内科住院医师规范化培训中的教学效果,为提高住培学生学习效果及兴趣寻求更为优越的教育模式.方法 对12名住培学生按照神经内科住院医师规范化培训要求进行《神经病学》理论授课,绪论至第九章部分采用传统授课方法,第十至第十八章部分以翻转课堂的混合式教学形式进行.比较翻转课堂的混合式教学前后学生评判性思维及自主学习能力改变情况、传统教学与翻转课堂混合式教学两种模式的满意度调查情况.结果 学生在接受翻转课堂的混合式教学后,评判性思维及自主学习能力均得到明显提高;翻转课堂混合式教学模式对提高学习积极性、增强理论知识感性认识、加深对知识的理解和记忆、缩短理论与临床实际的差距、增强分析临床问题的能力、有效利用学校资源、提高自学能力、锻炼归纳总结及表达的能力、培养评判性思维能力等方面均明显优于传统教学模式.结论 翻转课堂混合式教学模式应用于神经内科住院医师规范化培训能增强住培学生评判性思维及自主学习能力,增加教学满意度,提高神经内科住培学生学习效果及学习兴趣.

目的 分析脑型肝豆状核变性病人的临床特点和基因突变的特点.方法 收集2010年1月-2020年3月我院56例脑型肝豆状核变性患者,分析发病年龄、病程、临床表现特点、血象、肝功能、腹部B超、颅脑磁共振、ATB7B基因变异特点.结果 56例脑型肝豆状核变性病人中发病年龄11～20岁34例(60.7％),病程1～3年35例(62.5％);临床表现以震颤起病16例(28.6％),构音障碍起病24例(42.8％),伴有精神、性格障碍者5例(8.9％);56例(100％)24 h尿铜>100μg;45例(80.35％)血清铜蓝蛋白低于0.2 g/L;眼科裂隙灯下可见角膜K-F环阳性56例(100％),血细胞减少5例(8.9％),转氨酶升高12例(21.4％),50例(89.2％)腹部彩超结果 均有异常,41例(73.2％)头颅磁共振有异常;42例(75％)患者检测出致病变异位点,表现为复合杂合突变或纯合突变,14例(25％)患者仅检测到单个突变位点.所有致病变异中,Arg778 Leu在本研究人群中等位频率最高,占25.9％(29/112),其中3例为纯合突变;其次为Ile1148Thr(15/112)、Gly943Asp(6/112)、2304 dupC(5/112)、Pro992Leu(4/112),等位频率分别为13.4％、5.3％、4.5％、3.6％.结论 脑型肝豆状核变性患者临床表现多样,临床上对于类似患者要完善铜蓝蛋白、24 h尿铜、角膜K-F环、腹部彩超、颅脑磁共振等相关检查,基因检测有助于提高早期诊断率.

目的 研究帕金森病(Parkinson disease,PD)患者身体质量指数(body mass index,BMI)变化及其与PD运动症状和非运动症状之间的关系.方法 纳入83例PD患者和同期65名健康体检者作为对照.患者均进行统一的PD评分量表(unified Parkinson disease rating scale,UPDRS)第三部分UPDRS-Ⅲ评定、改良Hoehn-Yahr(H-Y)分级评定,汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)和抑郁量表(Hamilton depression scale,HAMD)、简易智力状态健康量表(mini mental state health scale,MMSE)和蒙特利尔认识评定量表(Montreal cognitive assessment scale,MoCA)及便秘评分系统(constipation scoring system,CCS)评分和卧立位血压测定.根据BMI结果将PD组分为低BMI PD组和不伴低BMI PD组.结果 PD组与对照组比较,PD组BMI[(21.4±2.3)kg/m2 vs.(23.7±1.2)kg/m2]、MMSE(24.7±1.8 vs.25.9±1.7)、MoCA(23.6±2.4 vs.25.9±1.3)评分均更低(P<0.01),收缩压下降[(13.0±3.0)mmHg vs.(8.3±2.3)mmHg]及舒张压下降[(7.1±1.7)mmHg vs.(5.2±1.4)mmHg]更多、CCS评分(15.4±2.8 vs.12.2±2.9)、HAMA(8.3±3.0 vs.6.6±2.0)及HAMD(11.1±4.1 vs.6.9±1.8)评分更高(P<0.01).低BMI组较不伴低BMI组MMSE(22.9±2.1 vs.25.1±1.6)、MoCA(21.2±1.8 vs.24.0±2.0)评分均更低(P<0.01),收缩压下降(16.5±2.0 mmHg vs.12.3±2.7 mmHg)及舒张压下降(8.2±2.0 mmHg vs.6.9±1.6 mmHg)更多,CCS评分(18.3±3.2 vs.14.8±2.4)、HAMD(18.4±2.6 vs.9.8±2.7)及HAMA(13.8±2.2 vs.7.3±1.7)评分更高(P<0.01).结论 PD患者BMI降低,伴低BMI的PD患者运动及非运动症状更严重,临床需要重视对PD患者的BMI动态监测.

目的:探讨肝豆汤加减联合二巯基丙磺酸钠治疗肝豆状核变性患者的安全性及疗效性.方法:选取广东药科大学附属第一医院于2018年1月至2019年12月期间收治的86例肝豆状核变性患者,随机分为对照组与观察组,各43例.其中观察组给予肝豆汤加减联合二巯基丙磺酸钠进行干预治疗,对照组单独给予二巯基丙磺酸钠治疗,对两组的临床疗效及安全性进行比较.结果:治疗前两组患者的Berg平衡量表(BBS)评分与尿酮水平比较,差异无统计学意义(P＞0.05).治疗后观察组患者的BBS评分与尿酮水平改善程度优于对照组,差异具有统计学意义(P＜0.05);观察组患者不良反应共发生6例(13.95％)低于对照组的13例(30.23％),差异具有统计学意义(P＜0.05).结论:肝豆汤加减联合二巯基丙磺酸钠治疗肝豆状核变性具有明显的改善神经功能、改善肝功能、提高驱铜疗效作用,并可有效防止单独西药驱铜治疗引起的白细胞减少.

目的 比较部分脾动脉栓塞术(partial splenic embolization,PSE)与脾切除术治疗肝豆状核变性(hepatolenticular degeneration,HLD)合并脾功能亢进(脾亢)的疗效.方法 收集广东药科大学附属第一医院2006年3月至2016年12月收治的22例HLD合并脾亢行PSE和脾切除术病例,PSE组10例,脾切除术组12例,随访2年,收集患者的一般信息、血常规、肝功能、凝血指标、术后主要并发症和随访情况.结果 PSE与脾切除术均可使白细胞和血小板升高,两组术后白细胞、血小板对比差异有统计学意义(P<0.05).PSE组与脾切除术组术后红细胞和血红蛋白对比,仅术后第7天时差异有统计学意义(P<0.05).PSE组术后1年与术前的丙氨酸氨基转移酶对比下降(P=0.007);两组术后1年的总胆红素与术前对比明显下降(PPSE=0.035,P脾切=0.0001).但白蛋白前后无明显变化(P>0.05).两组术后1年的PT均较术前缩短改善(P<0.05);脾切除术组术后APTT与术前对比均缩短(P<0.05).两组术后主要并发症都是发热和腹胀、腹痛,PSE组并发症较轻.两组术后神经系统症状均未加重.结论 PSE和脾切除术均可有效改善HLD合并脾亢所致的血细胞三系减低、肝功能和凝血指标.虽PSE部分疗效不如脾切除术显著,但PSE具有相对安全、创伤小,术后并发症较轻,手术指征要求低,可重复治疗的优势,值得临床推广应用.

目的 研究淫羊藿苷(ICA)治疗实验性自身免疫性脑脊髓炎(EAE)对环磷腺苷效应元件结合蛋白(CREB)的影响,并探讨ICA治疗的作用机制.方法 复制C57BL/6小鼠EAE模型,并将其分为3组,每组6只.模型对照组:予生理盐水3 ml/d灌胃;ICA组:予以ICA 300 mg/(kg·d)灌胃;ICA+H89组:予以ICA 300 mg/(kg·d)灌胃并予以蛋白激酶A(PKA)特异性阻断剂H895 mg/(kg·d)腹腔注射;另取6只未经模型复制的C57BL/6小鼠同等条件下饲养作为正常对照组,予生理盐水3 ml/d灌胃.EAE小鼠在发病达高峰时开始给药,1次/d,连续给药5 d.每日进行神经损害评分,至给药结束后次日.给药结束后次日进行神经损害评分后处死小鼠,立即采集脊髓颈膨大部分进行Western blotting检测,检测CREB的表达.结果 ICA组小鼠神经损害表现明显改善,与治疗前比较差异有统计学意义(P<0.05),而ICA+H89组小鼠及模型对照组小鼠神经损害评分均无改善,治疗前后比较差异无统计学意义(P>0.05).模型对照组脊髓组织中CREB的表达较正常对照组降低(P<0.05).ICA组治疗后CREB的表达与模型对照组比较,差异有统计学意义(P<0.05),ICA组CREB的表达升高.但同时给予ICA与H89治疗的小鼠并不能提高脊髓组织中CREB的表达,与模型组比较差异无统计学意义(P>0.05).结论 ICA可能是通过PKA途径提高中枢神经系统中CREB的表达,从而发挥对EAE的治疗作用.

The slow onset of traditional antidepressants has become an urgent clinical issue, researchers are constantly exploring new antidepressants with prompt action. Previous studies have found that zinc levels were decreased in serum and brain of depressed patients or animal models. Zinc treatment can improve depressive symptoms and enhance the antidepressant effects of monoamine antidepressants. However, its mechanism of action is still unclear. This present study aims to investigate whether the zinc can enhance the rapid action of traditional antidepressant imipramine and to explore the potential mechanisms of action through the rapid antidepressant targets CREB (cAMP-response element binding protein) and mTOR (mammalian target of the rapamycin). Drug treatment included intraperitoneal injection of imipramine or zinc alone and imipramine plus zinc. Zinc had a rapid enhanced antidepressive effect on the imipramine and achieved a rapid antidepressant effect similar to ketamine. Combination of zinc with imipramine rapidly enhanced the phosphorylation of mTOR Ser2448 and CREB Ser133, and increased the expression of mTOR and CREB, which were dependent on the activation of PKA. In conclusion, combination therapy with zinc and monoamine antidepressants may overcome the problem of slow-onset action of traditional antidepressants in clinical uses.

目的 采用实时荧光定量PCR (qRT-PCR)法探索全反式维甲酸(ATRA)对兔颈动脉粥样硬化斑块组织炎症因子表达的影响.方法 选取24只纯种雄性新西兰白兔随机分为对照组、模型组、ATRA组.对照组给予基础饲料、其余两组给予高脂饲料,共饲养12周.饲养4周后,ATRA组ig 5 mg/kg的ATRA,模型组和对照组ig等量溶剂,每天1次,至12周末处死各组动物.取颈动脉粥样硬化斑块组织,进行HE染色,显微镜下观察管壁结构;提取组织RNA,qRT-PCR法测定组织中转化生长因子-β1(TGF-β1)、白细胞介素-10(IL-10)、基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶-9(MMP-9)mRNA的相对表达量.结果 模型组可见典型的AS斑块,可见薄层的纤维帽及大的脂质核心,以及大量炎症细胞浸润,内弹力纤维膜断裂;ATRA组内皮细胞形态基本完整,可见少量炎性细胞浸润.与对照组比较,模型组中TGF-β1和IL-10 mRNA的相对表达量明显降低(P＜0.05),而MMP-2和MMP-9 mRNA的相对表达量明显升高(P＜0.05);与模型组比较,ATRA组的TGF-β1和IL-10 mRNA的相对表达量明显升高(P＜0.05),MMP-2和MMP-9 mRNA的相对表达量明显降低(P＜0.05).结论 ATRA可通过调节炎症因子的表达抗动脉粥样硬化.