目的 研究五味子乙素(Sch.B)是否可通过降低活性氧(ROS)的生成保护糖尿病状态下心肌细胞;是否通过抑制细胞凋亡减轻高糖诱导的心肌细胞损伤.方法 链脲佐菌素诱导Wistar大鼠制备1型糖尿病模型.口服药物Sch.B 4周后进行取材和检测.心肌细胞分为低糖组和高糖组,高糖+Sch.B组和高糖+氧自由基清除剂组.DHE染色检测各组细胞ROS的生成,并用Hoechst 33258检测各组细胞凋亡情况.结果 Sch.B组大鼠心肌组织排列相对规整,染色均一.Sch.B组与糖尿病组大鼠相比凋亡相关蛋白半胱天冬酶-3/9和线粒体中细胞色素C表达下降.DHE染色可发现,Sch.B处理后能明显降低高糖诱导心肌细胞的ROS生成.Hoechst 33258染色可发现,Sch.B和氧自由基清除剂处理后可明显降低高糖处理心肌细胞凋亡的比例.结论 Sch.B可抑制糖尿病状态下心肌细胞胞浆和线粒体中ROS的生成,抑制心肌细胞氧化应激反应,降低线粒体途径的细胞凋亡,保护心肌细胞.

冠状动脉粥样硬化斑块破裂或侵蚀引起的血栓形成造成心肌梗死事件的发生.了解斑块是如何从稳定型转变为危及生命的高危易损斑块的过程并寻求有效的早期干预是临床亟需解决的问题.目前,临床中使用的腔内影像学技术可以识别斑块的形态特征,但不能可靠预测哪些稳定型斑块会转变为高危易损斑块发生破裂继发心肌梗死.本文从高危斑块单模态成像进展、血管内分子成像到多模态血管内成像技术的进展作相关整理,并总结近年来多项评估高危易损斑块的研究,对冠脉内高危易损斑块识别的多模态成像在临床转化的可能性和潜力进行综述.

目的 探讨持续气道正压通气(CPAP)对早期阿尔茨海默病(AD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的睡眠障碍及神经心理的影响.方法 纳入2019年5月至2020年12月诊断的早期AD合并OSAHS患者42例,随机分为CPAP联合治疗组(20例)和单纯药物治疗组(22例).采用蒙特利尔认知功能评分量表(MoCA)、简易精神状态量表(MMSE)和霍普金斯词语学习测验(HVLT)评估神经认知功能变化;9条目患者健康问卷(PHQ9)评估抑郁情绪状态;多导睡眠图评价睡眠特征和呼吸参数;Epworth嗜睡量表(ESS)和匹茨堡睡眠质量指数(PSQI)评估患者的主观睡眠状况.分别比较使用CPAP治疗3个月后CPAP联合治疗组自身及其与单纯药物治疗组两组间的睡眠状况、认知功能及情绪的变化情况.结果 治疗3个月后,CPAP联合治疗组的ESS、PSQI和PHQ9评分较治疗前明显降低,MoCA、MMSE、HVLT(总分和延迟回忆)较治疗前明显增高(均P＜0.05),呼吸暂停低通气指数较治疗前明显降低(P＜0.05),最低血氧饱和度明显升高(P＜0.05),治疗前后的睡眠结构参数的差异无统计学意义(P＞0.05).治疗3个月后,CPAP联合治疗组患者的ESS、PSQI和PHQ9评分较单纯药物治疗组明显降低(均P＜0.05),而两组认知评分差异无统计学意义(P＞0.05).结论 CPAP连续治疗3个月可显著缓解早期AD合并OSAHS患者的低通气和缺氧程度,改善日间嗜睡及抑郁状态,认知功能有明显改善,而睡眠结构紊乱无明显变化.

目的:探讨匹多莫德联合脾氨肽对呼吸道合胞病毒(RSV)感染小鼠模型免疫细胞水平及组织病毒载量等有关影响,以通过调节免疫因子的释放实现抗病毒作用.方法:选用75只无特定病原体(SPF)级健康雌性小鼠,将其采用随机数表法分为空白组、模型组、匹多莫德组、脾氨肽组和匹多莫德+脾氨肽联合组(联合组),每组15只.空白组使用0.9％氯化钠(NaCl)溶液50μl滴入小鼠鼻腔,模型组、匹多莫德组、脾氨肽组和联合组小鼠鼻腔滴入50μl的RSV进行感染,持续3 d成功造模后分别给予空白组和模型组0.9％的NaCl溶液、脾氨肽组给予脾氨肽0.35 mg/(kg·d)、匹多莫德组给予匹多莫德150 mg/(kg·d)、联合组每日匹多莫德颗粒150 mg/kg+脾氨肽0.35 mg/kg,各组均连续灌胃7 d,分别在小鼠灌胃后第1 d、3 d和7 d检测小鼠肺组织病毒载量、肺泡灌洗液中γδT、CD4+CD25+Treg、白细胞介素17(IL-17)及IL-10含量,以及第7 d小鼠肺组织HE染色切片的病理状态.结果:匹多莫德组、脾氨肽组和联合组小鼠体征表现、肺组织HE染色切片中的肺泡壁厚度变化、充血水肿和管内炎性细胞浸润均较模型组有显著改善,其中联合组效果更为明显;模型组与3个匹多莫德组、脾氨肽组和联合组病毒载量从灌胃后第1～7 d均持续升高.第1 d、3 d和7 d,匹多莫德组、脾氨肽组和联合组与模型组同时间点比较差异有统计学意义(F=7.496,F=7.832,F=7.784;P<0.01),且以联合组病毒载量最低;模型组肺泡灌洗液中γδT细胞自第1～3 d明显升高,第7 d出现下降,匹多莫德组、脾氨肽组和联合组则自第1～7 d呈不断升高趋势,与模型组相同时间点比较,差异均有统计学意义(t=5.107,t=4.889,t=5.003;P<0.05).模型组与匹多莫德组、脾氨肽组和联合组CD4+CD25+Treg细胞自第1～7 d逐步升高,与模型组相同时间点比较具有显著性统计学意义(t=4.224,t=3.718,t=4.089;P<0.05);模型组肺泡灌洗液中IL-17含量第1～3 d逐渐升高,第7 d略下降,匹多莫德组、脾氨肽组和联合组均为不断升高趋势,与模型组比较差异有统计学意义(F=7.286,P<0.01);而IL-10含量模型组与匹多莫德组、脾氨肽组和联合组均呈逐步降低趋势,其差异有统计学意义(F=7.747,P<0.01).结论:对于RSV感染的呼吸道疾病,临床上联合应用匹多莫德和脾氨肽效果较单独使用更为显著,可明显减少病毒载量,改善机体体征,通过调节免疫因子的释放实现抗病毒作用.

该研究围绕目前我国医学教育现状与俄罗斯等"一带一路"沿线国家医学教育特点,比较分析了中国与"一带一路"沿线国家医学教育的不同及可借鉴的经验,提出:(1)建立并完善中国与"一带一路"沿线国家医学教育交流与合作机制,提高院校医学教育质量;(2)汲取他国的好做法、好经验,完善毕业后医学教育和评估体系;(3)进一步加大医学教育的资源投入,强化医学教育融入人文教育,提高我国整体医学自主创新能力.

目的:探究白藜芦醇通过激活PI3K/Akt通路抑制心肌梗死大鼠细胞线粒体凋亡的作用机制.方法:选择45只成年雄性SD大鼠,将其随机分为对照组、模型组和白藜芦醇组,每组15只.将模型组和白藜芦醇组建立缺血-再灌注(I/R)模型,对白藜芦醇组大鼠舌静脉注射白藜芦醇进行干预,检测和比较大鼠心肌细胞损伤情况和凋亡情况.分别使用蛋白免疫印迹法(Western blot)和实时荧光定量聚合酶链反应(qRT-PCR)法检测磷脂酰肌醇3激酶-蛋白激酶B(PI3K/Akt)通路和线粒体凋亡基因表达水平.结果:模型组大鼠血清肌钙蛋白T(cTnT)和肌酸激酶同工酶(CK-MB)水平显著升高,白藜芦醇组大鼠血清cTnT和CK-MB水平显著低于模型组,其差异有统计学意义(t=27.129,t=14.971;P<0.05).模型组大鼠的心肌细胞凋亡率显著升高,白藜芦醇组大鼠心肌细胞凋亡率显著低于模型组,其差异有统计学意义(t=12.687,P<0.05).建模后心肌细胞中的PI3K/Akt通路被显著抑制,而白藜芦醇可显著促进PI3K/Akt通路活化.建模后大鼠心肌细胞B淋巴细胞瘤-2(Bcl-2)mRNA水平下调而细胞死亡调解子(BIM)、Bcl-2相关蛋白X(BAX)、半胱天冬酶9(Caspase9)、半胱天冬酶3(Caspase3)mRNA水平上调,白藜芦醇可显著抑制BIM、BAX、Caspase9以及Caspase3基因表达并促进Bcl-2基因表达.结论:白藜芦醇通过激活PI3K/Akt通路可抑制心肌梗死大鼠细胞线粒体凋亡,并减少I/R引起的心肌细胞损伤.

我国将大学生创新能力的培养作为教育改革的重要目标,将“高等教育的任务是培养具有创新精神和实践能力的高级专门人才”写入《中华人民共和国高等教育法》.提高大学生创新能力既是法律规定的教育任务,也是适应社会发展的迫切需要.文章从大学生创新能力要素构成的角度,分析大学生创新能力存在的问题,探讨培养大学生创新能力的对策.

Objective To explore the effect of problem oriented nursing program on the patients′ recovery and quality of life after gastric cancer surgery,so as to accumulate evidence for clinical intervention.Methods 80 cases of patients with gastric cancer of gastrointestinal surgery in our hospital from September 2013 to June 2016,all in accordance with the standards of the enrolled subjects were randomly divided into two groups,were divided into study group and control group,40 cases in each group.While the control group to carry out the traditional nursing intervention,while the research group is the implementation of the problem oriented nursing program.Patients in the two groups before and after intervention for seventh days and compiled by Zung SAS,the SDS scale,and the visual analogue pain assessment;quality of life before and after intervention in third months were compared between the two groups.Results There was no significant difference in anxiety and depression scores between the two groups before the intervention(P>0.05).The anxiety and depression scores of the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in pain scores between the two groups before the intervention(P>0.05);the pain degree of the study group was lower than that of the control group,the difference was statistically significant(P<0.05).No significant differences in quality of life scores of each dimension of the two groups of patients before intervention(P>0.05);intervention score in physiological function,physical function,general health,physical function,emotional function,mental health,social function and activities of the study group were higher than those of the control group,the difference was statistically significant(P<0.05).Conclusion For the surgical treatment of gastric cancer patients,nursing intervention program of problem oriented,to improve the recovery of the patients,and can promote the improvement of life quality,achieve satisfactory clinical effect.

中国是礼仪之邦.重视礼仪教育,提高个人素养,成为一名德才兼备的人,更有利于我们行走在社会上.对此,对高校礼仪教育对学生成才的影响做以阐述.

随着社会的发展，人们生活水平的不断提高，极大程度上改善了人们的生活质量，但是对于精神障碍患者而言，由于数量较多，家庭比较贫困，社会保障不完善等因素的影响下，生活质量依然没有得到很好的改善。因此，为了使精神障碍患者的生活质量得到提高，文章就对精神障碍患者社会权利保障缺失的原因及对策进行了研究，为我国的发展提供有力的保障。

结合职业教育改革与发展新形势,对实践教育体系新内涵做出新的诠释,以在校实践模拟保障机制、社会生产实践组织机制、就业实践“滴灌”思想的确立、完善就业实践引导课程等四个方面作为重要突破口,着重提升法学实践教育体系内部保障与服务作用,切实改变高校法学实践教育体系的现状.

法律效力层级能够有效地确定我国法律体系的适用范围，解决在实际司法实践中存在的冲突。而药品关乎社会群众的生命，对于药品的监督管理是保障人民群众生命财产安全的有效途径。文章通过阐述法律效力层级内涵及意义，分析了中国药品法律效力层级，联系实际提出了中国药品法律适用冲突与选择的规则，以健全我国法律体系，保证药品的安全。

近年来，我国不断发生各种药品缺陷损害案件(如万络事件等)，这类案件的发生不仅给人们带来的巨大的经济损失，还威胁到了人们的人身安全。因此，我国应加强对这类案件的惩处力度，从法律上降低发生此类案件的概率。但是，在我国现行的法律中，在用于裁定药品缺陷损害案件时常会出现一些问题。基于此，本文就药品缺陷损害案件的若干法律问题进行探讨，分析出其中的不足之处，并提出有效的解决措施以降低此类案件的发生，给我国人们的人身安全提供良好的保障。

在我国,很多精神障碍患者在就业的过程中都会遭受到不同程度的歧视,一些精神障碍患者自觉无法融入到社会群体当中,不仅会产生自卑心理,也会造成性格的扭曲.本文从精神疾病的释义角度出发,简单的阐述了支持性就业的相关概念.文章中还简单的阐述了就业歧视对于精神障碍患者在社会保障方面的影响,并给出了合适的解决策略,促使政府逐渐建立起完善的社会保障制度,为精神障碍患者提供更好的就业机会.

论文阐述了当前医德医风建设中存在的问题,提出要解决这些问题,需要把好医学院校这一关口,倡导在医学院校中加强医德医风教育,并提出了解决的内容、方法和途径.

Objective Subacute toxicity of abamectin was studied and the oxidative damage was reported. Methods A total of 30 healthy Wistar rats(15 male and 15 female) were randomly divided into 3 groups,such as 5.38 mg/kg(1/4 LD50),2.69 mg/kg (1/8 LD50) and control group (oil). The drug was given for 30 days by gavage. The rats were observed daily and weighted per week. At the end of experiment,the histopathological examinations of selected organs were done and the serum MDA,GSH-Px and SOD activity were measured. Results The treatment of abamectin significantly affected the body weight increment during experimental periods. There were statistical differences in the ratios of organs (brain, liver and kidney) to body weight among three groups of female rats (F=22.34、93.15、60.77,P<0.05),and these ratios were significantly high in the treated female rats with 5.38 mg/kg. There were statistical differences in the serum MDA,GSH-Px and SOD activity among three groups (F = 57.48、120.62、30.45, P < 0.05),and they were significantly decreased in the treated group. The histopathological examination showed that the liver in the treated rats had obvious damages. Conclusion Subacute oral exposure to abamectin at 5.38 mg/kg could cause obvious toxicity,the liver might be sensitive organ and oxidative damage maybe play important role.

Objective To explore the value of quantitative tissue velocity imaging(QTVI)to the assess went of left ventricular systolic and diastolic functions in patients with systemic lupus erythematosus.Methods Forty female patients before menopause with SLE were divided into two groups according to different courses of disease:SLE groupⅠ(5years,n=18)and SLE groupⅡ(≥5years,n=22).And another 20 healthy volunteers were served as control group.After echocardiography,QTVI technique was applied to measure the systolic peak velocity(Vs),early diastolic peak velocity(Ve)and end diastolic peak velocity(Va)at the mitral annular leval of the anteroseptal,posterior,septal,lateral,anterior and inferior walls,and Ve/Va ratio was calculated and compared.The mean value of the velocities represented the mitral annular global movement.Results There were no significant differences in Vs and Va of all walls at the mitral annular level,and their mean values between SLE groupⅠ and control group(P0.05),and Ve,Ve/Va ratio of all walls and the mean value were significantly lower in SLEⅠ group than those in control group(P0.05,P0.01).Vs,Ve,Ve/Va and their mean values of all walls at the mitral annular level,and Va of all walls except lateral wall were lower in SLE group Ⅱ than those in control group(P0.05,P0.01).Vs of lateral wall at the mitral annular level and the Vs mean values of all walls,Vs and Ve/Va and their mean values of all walls,and Va of anterior wall were lower in SLE group Ⅱ than those in SLE group Ⅰ(P0.05,P0.01).Vs,Ve,Va and Ve/Va were negatively correlated with the courses of disease of SLE(r=-0.637,P=0.000;r=-0.700,P=0.000;r=-0.367,P=0.020;r=-0.779,P=0.000).Conclusion QTVI technique can detect abnormal left ventricular function early and sensitively,which helps preventing the cardiac complication in the early stage.

White adipose tissue (WAT) was not simply for energy storage.It is an important endocrine and secretory organ,which releases a series of multiple-function mediators.WAT is involved in a wide spectrum of diseases,including cardiovascular and metabolic complications,inflammation-and immune-related disorders,such as RA.In this review,we summarize the most recent advances in adiponectin research in the context of RA,focusing primarily on its effect on RA-related cells,its regulation on pro-inflammatory cytokines,as well as its validation as a biomarker for RA.

Objective To explore the efficacy of hormone replacement therapy (HRT) for rheumatoid arthritis (RA).Methods The literature about HRT in the treatment of rheumatoid arthritis were searched.Eleven papers were subjected to a Meta-analysis and a heterogeneity test was conducted to evaluate the efficacy of HRT.Results HRT reduced the level of erythrocyte sedimentation rate (ESR) in RA patients (P=0.016),the SMD was-0.22(-0.40,-0.04); improved bone mineral density (BMD) in RA patients (P=0.022),the WMD was 2.83(0.41,5.26); decreased clinical parameters for disease activity evaluations of RA patients (P=0.048),the SMD was-0.19 (-0.38,0.00); decreased the level of C-reactive protein (CRP) in RA patients,the SMD was-0.08 (-0.37,0.21),but the difference was not statistically significant (P=0.591).Conclusion The findings from this Meta-analysis indicate that HRT can reduce the ESR level,improve clinical indexes and improve BMD level of RA patients.HRT may suppress disease activity and osteoporosis of RA patients,so it may be used as an auxiliary therapy in the treatment of RA.