目的 探讨微小RNA(miR)-346与异柠檬酸脱氢酶(IDH)基因野生型胶质瘤中三基序蛋白质38(TRIM38)基因表达水平和患者总体生存期(OS)的关系.方法 利用中国胶质瘤基因组图谱计划(CGGA)数据库的多组学分子数据,比较miR-346在胶质瘤中的表达改变以及与TRIM38基因表达和患者OS的关系;采用细胞转染和双荧光素酶实验检测miR-346与TRIM38基因在胶质瘤细胞中的相互关系.结果 共纳入CGGA中各级别胶质瘤样本198例及对照脑组织样本5例进行比较,发现miR-346表达水平随肿瘤级别的增加而降低(P＜0.05),且IDH基因野生型肿瘤表达水平低于IDH基因突变型肿瘤(P＜0.05).Pearson相关性分析发现IDH基因野生型胶质瘤中,miR-346与TRIM38基因表达之间呈显著负向相关性(P＜0.05).生存分析显示miR-346低表达组患者的OS与miR-346高表达组患者相比显著缩短(P=0.05),其预后指示能力独立于患者年龄及治疗方案等因素(均P＜0.05),但不独立于肿瘤级别(P＞0.05).细胞实验发现转染miR-346类似物可降低U251细胞中TRIM38基因的表达水平(P＜0.05).双荧光素酶实验证实miR-346与TRIM38存在特异性结合.结论 miR346在IDH野生型胶质瘤样本中表达下降,且与患者的不良预后相关,这可能与其靶向调控促癌基因TRIM38表达有关.

Objective:To explore the expression of inward rectifier potassium channel Kir4.1 in malignant gliomas and its correlation and correlation mechanism with epilepsy, edema and other symptoms of gliomas through database and document analysis.Methods:Oncomine database was used to analyze the expression of glioblastoma compared with normal brain tissue in TCGA data set. Specimens and pathological information of patients with different clinical grades of glioma were collected to analyze the expression of Kir4.1 in different grades of glioma. Kir4.1 mutations in gliomas were analyzed by cbioportal database.Results:The results of oncomine database showed great differences due to the differences of sample size. RT-PCR and immunohistochemistry showed that the expression of Kir4.1 in high-grade glioma was less than in low-grade glioma, but the expression of Kir4.1 in low-grade glioma was higher than in normal brain tissues, and the difference was statistically significant (P<0.05). The cbioportal database showed that the mutation probability of Kir4.1 was extremely low in glioblastoma, and the difference between partial genome alteration and the number of mutations was statistically significant (P<0.05). MSH2, ERRFI1, CTNNB1, SEPRINE1, FOXM1, RAD50 and other genes were highly expressed in the altered group, while INPP4B, XBP1, AXL and other genes were highly expressed in the non-altered group.Conclusion:The expression of Kir4.1 is different in different grades of glioma. High grade glioma has lower expression of Kir4.1, and the expression of Kir4.1 may be related to epilepsy, edema and other clinical symptoms in patients with high grade glioma, which provides a new idea for exploring the potential mechanism of Kir4.1 in glioblastoma in the future.

目的 探讨阿德福韦酯联合拉米夫定治疗对活动性代偿期乙型肝炎肝硬化患者肝功能、抗病毒效果及生存率的影响.方法 选取2015年1月—2017年1月本院收治的112例活动性代偿期乙型肝炎肝硬化患者,根据治疗方法不同分为观察组52例和对照组60例,对照组采用拉米夫定片治疗,观察组在对照组基础上联合阿德福韦酯片治疗.比较2组治疗后临床疗效、治疗前后肝功能指标变化和乙型肝炎病毒(HBV)DNA定量及其转阴率,并随访2年,比较2组治疗后6、12、18、24个月的生存率及随访期间肝癌发生率.结果 治疗后,观察组总有效率显著高于对照组(P<0.05).治疗后2组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)、HBV DNA定量明显降低,白蛋白(Alb)水平明显升高,且观察组ALT、AST、TBIL、HBV DNA定量显著低于对照组,Alb水平显著高于对照组,差异均有统计学意义(P<0.05或P<0.01).观察组HBV DNA转阴率显著高于对照组(P<0.05).治疗后18、24个月观察组生存率均高于对照组(P<0.05).2组随访期间肝癌发生率比较差异无统计学意义(P>0.05).结论 活动性代偿期乙型肝炎肝硬化患者采用阿德福韦酯联合拉米夫定治疗可取得较好的临床效果,可明显改善患者肝功能、降低HBV DNA水平、提高HBV DNA转阴率,对延长患者生存期有重要意义.

目的:探究高迁移率族蛋白1(HMGB1)拮抗剂BoxA尾静脉注射对细菌性脑膜炎(BM)大鼠模型的临床体征改善和炎症抑制作用.方法:除外正常对照的雄性Sprague-Dawley(SD)大鼠设为对照组(n=20),另取60只大鼠行脑室立体定向注射20 μL大肠杆菌Escherichia coli (DH5α 1×107 CFU/mL)建立BM模型,之后随机分为两组(各组n=30),一组尾静脉注射HMGB1拮抗剂BoxA,即BoxA组;一组麻醉后进行尾静脉注射无菌磷酸盐(PBS),即Vehicle组.造模3d后,对各组大鼠的临床指标以及病理生理参数(颅内压和脑脊液白细胞(WBC)计数)进行评估,使用酶联免疫吸附实验(ELISA)法检测血清中HMGB1的相对含量,使用伊文思蓝染色观察血脑屏障(BBB)通透性,使用免疫荧光染色检测大脑皮层炎症因子(IL-1β和TNF-α)的表达水平.结果:相比Contro1组,Vehicle组临床指标,颅内压,WBC计数以及血清HMGB1含量明显提升(P＜0.05);而BoxA组相比Vehicle组,以上改变有部分减少(P＜0.05).另外,Vehicle组较Control组EB渗漏增加且炎症因子(IL-1β和TNF-α)表达水平增高(P＜0.05).与Vehicle组相比,BoxA组的这些变化亦被部分调节(P＜0.05).结论:HMGB1抑制剂BoxA尾静脉注射能够下调HMGB1表达水平并同时缓解细菌性脑膜炎大鼠的临床症状和炎症反应.

恩替卡韦是一种强效选择性鸟嘌呤核苷(酸)类似物 ,具有明显的抗 HBV作用[1].马来酸恩替卡韦片是恩替卡韦的马来酸盐化合物 ,成分、药物效力学、药物代谢动力学与恩替卡韦相似[2 ].近年来 ,肝癌患者的抗病毒治疗越来越受到重视,肝动脉化疗栓塞术(transcatheter arterial chemoembolization , TACE)是目前中晚期肝癌的主要手段.本研究回顾性分析西京医院近年来比较马来酸恩替卡韦和恩替卡韦联合T ACE治疗HBV相关的肝癌患者的临床疗效 ,结果如下.

目的：研究在胃腺癌中肝癌衍生生长因子（HDGF）的表达情况和临床意义。方法利用免疫组织化学检测手段观察18例正常胃上皮组织，25例胃高/中分化及21例低／未分化腺癌组织中HDGF的表达。在不同分化级别的胃腺癌标本中应用卡方检验比较HDGF的表达，并分析HDGF表达与临床病理特征的相关性。结果 HDGF表达率在正常胃上皮组织中为17%，而胃腺癌中上调为69%，差异有统计学意义（χ2=14．61，P<0．05）；HDGF表达与胃腺癌组织的分化程度（χ2=4．76，P<0．05）、浸润深度（χ2=5．97，P<0．05）和淋巴结侵袭（χ2=8．81，P<0．05）有关。结论 HDGF相比正常胃组织在胃腺癌中明显上调，并且和其临床病理因素正相关，提示HDGF于发病进程的潜在促进作用。

Objective To investigate the influence of adefovir dipivoxil (ADV) versus telbivudine (LdT) combined with entecavir (ETV) on liver function and serum virology of hepatitis B patients with decompensated liver cirrhosis (DLC). Methods Eighty DLC patients in our hospital from February 2014 to April 2015 were selected and divided into two groups (40 in each group). Observation group was given LdT combined with ETV, control group was given ADV. The liver function and serum virology were observed 12, 24, 48 weeks after treatment in the two groups. Results Before treatment, the expression level and Child-pugh score between observation group [ALT(156.3±50.2)U/L, ALB (30.5±3.8)g/L, TBil (60.4±23.1)µmol/L, PTA (40.3%±7.8%), and Child-pugh score (11.3±1.5) points] and control group [ALT (154.1±51.4)U/L, ALB (31.3±4.2)g/L, TBil (58.9±24.3)µmol/L, PTA (42.1%±8.4%), and the score (11.2±2.0) points] were compared with no statistically significant difference between the two groups (P>0.05); after a period of treatment, ALT, TBil and Child-pugh score decreased gradually, while ALB and PTA increased gradually in the two groups, and the difference was statistically significant compared to the pretreatment (P<0.05). With the passage of time, ALT, TBil and Child-Pugh score were lower, while ALB and PTA higher in the observation group than in control group, and the difference was statistically significant (P<0.05). At the same period after treatment, the negative conversion rates of HBV-DNA and HBeAg were obviously higher in the observation group than in the control group (P<0.05). Conclusion LDT combined with ETV in treating decompensated hepatitic cirrhosis has better effect than ADV does. Liver function recovered quicker, negative conversion ratio is higher, adverse reaction is less and LDT plus ETV is worthy of wide application. DOI: 10.11855/j.issn.0577-7402.2016.12.14

目的:观察唯尔本注射液用于67例老年慢性肺部感染中的临床疗效.方法:在常规治疗的基础上加用唯尔本注射液,疗程3个月,另有32例用常规治疗做对照.结果:治疗组疗效明显优于对照组(P＜0.05),治疗后咳、喘、痰等临床症状及发作次数明显好转和减少,而无毒副作用.结论:在治疗老年慢性肺部感染中有明显疗效.