目的 探讨人肾小管上皮细胞(HKC)内核转录因子NF-κB(NF-κB)反馈调控单免疫球蛋白白介素1受体相关蛋白(SIGIRR)表达的分子机制.方法 分子克隆法构建pLNCX2-G418-SIGIRR过表达载体,经PT67细胞包装后感染HKC细胞,构建SIGIRR过表达细胞和对照细胞.使用IL-1β诱导,Western blot验证过表达SIGIRR可抑制NF-κB活化.使用NF-κB阻断剂和干涉NF-κB活性后,免疫荧光法验证活化的NF-κB可调控SIGIRR表达.在线工具预测SI-GIRR启动子区存在NF-κB结合位点.分子克隆法从人基因组DNA内获取含有结合位点的SIGIRR启动子序列,连接至荧光素酶载体pGL3-Luc,构建pGL3-Luc-SIGIRR,并突变结合位点.使用荧光素酶报告基因实验和染色质免疫沉淀技术(ChIP)共同验证活化的NF-κB可结合在SIGIRR启动子区调控SIGIRR基因的表达.结果 构建的pLNCX2-G418-SIGIRR逆转录病毒载体经酶切、测序验证后对比SI-GIRR基因编码序列完全一致,重组体和对照载体经病毒包装后转入HKC细胞后成功构建HKC/SIGIRR实验组和HKC/Co对照组细胞系,在mRNA和蛋白水平的SIGIRR表达差异有统计学意义(P<0.05,P<0.001).过表达SIGIRR细胞组相比对照组细胞可以减少IL-1β诱导的NF-κB的活化(P<0.001),抑制NF-κB活化和干涉NF-κB表达后,SI-GIRR的表达出现下调.提取人基因组DNA后,分子克隆法获得SIGIRR目的启动子序列连接至载体,成功构建pGL3-Luc-SIGIRR荧光素酶载体并定点突变载体,经酶切和测序验证与目的序列完全一致.通过荧光素酶报告基因实验和CHIP实验证实NF-κB可结合SIGIRR启动子区域,调控SI-GIRR表达.结论 HKC细胞中SIGIRR可以影响NF-κB的活化,活化的NF-κB可以结合到SIGIRR的启动子区域,调控SIGIRR的基因表达变化,形成一个反馈体系,控制NF-κB的过度活化.

目的 探讨格雷夫斯病(GD)患者甲状腺细胞子宫球蛋白相关蛋白1(UGRP1)的表达与碘131(131I)治疗后甲状腺功能减退症(甲减)发生风险之间的关系.方法 38例拟行131I治疗的GD患者,通过免疫组化方法检测甲状腺穿刺细胞学所取甲状腺细胞UGRP1的表达,分为UGRP1阳性组(20例)和UGRP1阴性组(18例),131I治疗后12周随访甲状腺功能,分别计算两组的甲减发生率.结果 UGRP1阳性组采用131I治疗,甲减发生率75％;UGRP1阴性组采用131I治疗,甲减发生率33％,两组比较差异有统计学意义(P＜0.01).结论 UGRP1阳性表达组采用131I治疗甲减发生风险较阴性表达组高,提示可以根据UGRP1的表达情况预测GD患者131I治疗发生甲减风险.

1 病例资料 患者,女性,33岁,因"孕期发现血压升高2 个月"于2016年10月25日入院. 患者于孕24周在当地医院产检时发现血压升高,时测血压180/120 mmHg,诊断中孕合并高血压,予硝苯地平片口服,每天2次,每次10 mg,血压控制不理想,波动在200～150/140 ～110 mmHg. 曾于2016 年8 月24 日在本院产科检查,腹部B超提示左侧肾上腺可见42 mm × 49 mm包块(见图1),就诊泌尿外科,建议终止妊娠,患者及家属拒绝. 病程中无面色发白、大汗淋漓、烦躁恐惧等. 偶有阵发性头晕、心前区不适,全身发热. 视力较前明显减弱,近期有视物模糊,近1周有头痛不适,为前额部搏动性疼痛,夜间为主. 既往史:患者既往于2006年在当地行剖宫产手术,否认高血压、心脏病、糖尿病等病史. 月经及婚育史:初潮年龄14岁,经期3 ～5 d,周期28～30 d,末次月经2016年3月7日;足月产一女,健在一女,无流产史. 否认家族性遗传病史. 入院后体格检查:体温36. 5℃,脉搏105 次/分,呼吸 22 次/分,血压 183/124 mmHg,心、肺查体无异常,腹膨隆,下腹部可见一长约10 cm的陈旧性手术瘢痕,双下肢无水肿.

Objective To determine the ankle-brachial indexes(ABI)of those patients with type 2 diabetes mellitus(T2DM),un-complicated or complicated with cerebral infarction(CI),and to investigate the correlation between ABI and T 2DM patients with CI.Methods From Jan 2016 to Jan 2017,358 cases of T2DM inpatients hospitalized in our hospital were collected as the study objectives,and were divid-ed into the T2DM group(n=182)and the T2DM+CI group(n=176)according to their complications with or without CI.Then the ABI scores and other related clinical data in the two groups,such as general conditions,blood glucose levels and biochemical examinations,were detectedand recorded.And the correlation analysis of their clinical characteristics and their ABI and CI were performed by means of Pearson analysis,multivariate linear regression analysis and logistic regression analysis.Results There was significant difference between the T 2DM group and the T2DM+CI group in the ABI grades,and the proportions of grade B and C of the ABI grades in the T 2DM+CI group were sig-nificantly higher than those in the T 2DM group(P<0.05).Pearson correlation analysis showed that ABI was significantly negatively correla -ted with age,duration of diabetes,systolic blood pressure(SBP), fasting blood glucose and HbA1c(rvalues of -0.230, -0.152, -0. 108, -0.120, -0.143, respectively; all P<0.05).Multiple linear regression analysis showed that age, duration of diabetes and SBP were independent risk factorsof ABI.Logistic regression analysis showed that the CI risk was significantly increased in those patients with mild stenosis or moderate to severe stenosis when compared to the patients with normal ABI(OR values of 1.34,2.23, respectively;P<0.05). Conclusion The risk of cerebral infarction in T2DM patients may be closely associated with the reduction of ABI scores.

Objective To investigate the influence and mechanism of IFN-γ on the expression of Fas in Hashimoto thyrioditis.Methods ① The expressions of IFN-γ,Fas in Hashimoto thyrioditis and normal control were investigated by immunohistochemical staining;② The FRTL-5 cells were cultured in vitro,treated with IFN-γ at different concentration in different time.Quantitative RT-PCR and flow cytometry assay were used to examine the expressions of Fas mRNA and protein respectively.Results ① The staining of Fas in thyroid follicles and IFN-γ in lymphocytes in HT samples were strongly observed compared to normal controls.In addition,Fas protein positive thyroid follicular cells were common in lymphocyte infiltration areas;② The expression of Fas mRNA in FRTL-5 cells induced by IFN-γ had time-concentration dependent relation within certain ranges(P<0.05);③ The expression level of Fas on FRTL-5 cells treated with IFN-γ was significantly higher than that of normal control by flow cytometry assay.Conclusion IFN-γ mediated thyroid follicular cells apoptosis by up-regulating the expressions of Fas in HT.

目的：探讨肌电图对诊断腰椎间盘突出症的价值。方法分别对65例健康志愿者和65例临床确诊为腰椎间盘突出症的患者进行肌电图检查，观察腓神经、胫神经、股神经的传导速度和胫前肌、股内侧肌、趾短伸肌的电活动变化。结果65例患者中，肌电图检查异常者为60例，与临床符合率为92．3％；与健康志愿者相比，腓神经、胫神经、股神经的神经传导速度减慢，复合动作电位的潜伏期延长，胫前肌、股内侧肌、趾短伸肌的时限延长，电压增高。结论肌电图是辅助诊断腰椎间盘突出的重要方法。

目的:探讨体感诱发电位(SEP)分级和颈椎磁共振成像(MRI)测量颈脊髓体积及颈椎管容积比值在脊髓型颈椎病(CSM)患者疗效中的早期预测价值.方法:对82例CSM患者进行SEP检测和颈椎MRI测量,在治疗前、治疗第1个月、3个月、6个月时应用日本骨科学会评分系统(JOA评分)对患者颈脊髓功能进行评估.计算第6个月JOA评分的改善率,以对SEP分级及颈椎MRI测量脊髓体积/颈椎管容积早期的预测价值进行评价.结果:SEPI级和Ⅱ级、颈脊髓体积/颈椎管容积低比值组患者JOA评分在治疗前与SEPⅢ级和Ⅳ级、颈脊髓体积/颈椎管容积高比值组患者,差异无显著性意义(P＞0.05),在治疗第1个月、3个月、6个月时JOA评分均明显高于SEPⅢ级和Ⅳ级、颈脊髓体积/颈椎管容积高比值组患者,差异具有显著性意义(P＜0.05).SEP分级、颈椎MRI测量脊髓体积/椎管容积分别与第6个月的JOA改善率的比较,结果均有显著性意义(P＜ 0.01);SEP分级及颈椎MRI测量预测患者非手术治疗预后不良(JOA改善率≤25％)的敏感性分别为74.2％ 、83.9％,特异性分别为86.3％、88.2％,准确性分别为81.7％、86.6％.结论:SEP分级和颈椎MRI测量均能早期对CSM患者疗效进行预测,临床上将两者结合使用,有利于早期选择治疗方案,促进患者康复.

目的:探讨神经传导速度及H反射测定对2型糖尿病周围神经病变的诊断价值。方法:对477例2型糖尿病患者进行神经传导速度及H反射测定,同时与病程进行相关分析。结果:NCV异常率为61.43%,以下肢腓肠神经损害最为常见;H反射异常率为70.23%,高于NCV异常率;NCV异常率、H反射异常率均与病程呈正相关。结论:NCV和H反射对2型糖尿病周围神经病变具有重要的早期诊断价值,两者可互为补充,提高2型糖尿病周围神经病变的诊断率。

<正>脊髓型颈椎病(cervical spondylotic myelopathy,CSM)是中老年人的常见病和多发病,并与多种致病因素有关,近年来该病已有低龄化趋势,且越来越显露出它相关的职业特性。体感诱发电位(somatosensory evoked potential,SEP)作为一种能直接反映脊髓功能状态的检测方法,目前广泛应用于临床检查及脊柱手术的术中监护,对CSM的诊断及预后评估起着重要作用。本文综合分析一组CSM

<正>人脑为一复杂的非线性系统,脑电活动随时间变化而动态变化,且会随时受到诸如警觉水平、环境刺激、内在心理活动及认知活动等因素的影响。脑电活动的这种非线性特征使得传统的线性分析方法具有一定的局限性。近年人们将非线性分析方法引入脑电图的定量分析方面,用来研究脑电活动复杂

Objective To understand whether central obese adolescents had neurochemical abnormalities in frontal lobe and hippocampus,and to analyze the change of attention and working memory load distribution by measuring the event-related potential.Methods A total of 34 participants were recruited in a middle school in Hefei.The anthropometric parameters of height,weight,waist circumference(WC),hip circumference triceps,subscapular and abdominal skinfold thickness(SF)were measured according to standard procedures.The defining of obese was using by body mass index(BMI),and the central obese was defined as waist-hip ratio(WHR)sex-age-specific P90 cut-off point from data of the Anhui physical fitness surveillance of students from urban areas in 2005.Body composition was measured by dual-energy X-ray absorptiometry,and the neurochemical metabolic action in frontal lobe and hippocampus was measured on '1H-MRS,and P300 latent was measured by event-related potential.Results The means of weight,BMI,WC,WHR,SFs,percent body fat and body fat in central obese group were all higher than those in control group.The contents of NAA,NAA/Cr and Cho on '1H-MRS reduced in central obese group.In the analysis of covariance,the correct mean of P300 latent period in central obese group was longer than control group after adjusted body fat.Conclusion Body fat in central distribution may influence the metabolism in brain and it can negative affect attention distribution and working memory load.

目的探讨听觉事件相关电位P300在多发性脑梗塞患者的早期认知损害中的临床应用价值.方法分别对24名无痴呆的多发性脑梗塞患者及年龄匹配的24名正常人进行神经心理学量表(长谷川智力量表,HDS)评分及听觉P300检测.结果两组神经心理学量表(HDS)评分均正常.两组听觉P300比较,无痴呆多发性脑梗塞组P300潜伏期延长,差异有显著性.结论听觉P300测定在评价多发性脑梗塞患者的早期认知损害中具有一定的临床意义,且较HDS敏感.

目的 探讨听觉事件相关电位P3 0 0 在多发性脑梗塞患者的早期认知损害中的临床应用价值。方法 分别对 2 4名无痴呆的多发性脑梗塞患者及年龄匹配的 2 4名正常人进行神经心理学量表 （长谷川智力量表 ,HDS）评分及听觉P3 0 0检测。结果 两组神经心理学量表 （HDS）评分均正常。两组听觉P3 0 0 比较 ,无痴呆多发性脑梗塞组P3 0 0 潜伏期延长 ,差异有显著性。结论 听觉P3 0 0 测定在评价多发性脑梗塞患者的早期认知损害中具有一定的临床意义 ,且较HDS敏感。

目的探讨特异性神经元抗体(尤其是抗-Hu抗体)对国内人群神经系统副肿瘤综合征(paraneoplastic syndromes of nervous system,PNSNS)筛检诊断的特异性和灵敏性.方法采用免疫组织化学ABC法和Western blot对20例PNSNS和120例非PNSNS患者的血清进行检测,并采用流行病学筛检公式计算出特异度和灵敏度.结果 PNSNS组和非PNSNS组ABC法阳性结果差异有统计学意义(X2=33.45,P＜0.01),特异性神经元抗体筛检诊断PNSNS的灵敏度为95%,特异度为72.5%;PNSNS组和非PNSNS组Western blot法阳性率差异有统计学意义(X2=117.12,P＜0.01),抗-Hu抗体筛检诊断的PNSNS的灵敏度为95%,特异度为98.3%.结论血清特异性神经元抗体(尤其是抗-Hu抗体)是国内人群中PNSNS患者较敏感和特异性的血清标志物,在神经元的免疫损伤中具有重要作用.

目的探讨P300对血管性痴呆(VD)的早期诊断及与Alzheimer病(AD)鉴别的价值.方法分别对20名正常人(NC)、20例VD患者、24例无痴呆脑梗死患者(CI)及20例AD患者进行神经心理学量表长谷川智力量表(HDS)评分,并选用听觉oddball序列分别对上述各组进行P300测试.结果 (1)VD组与CI组及NC组比较,N2、P3潜伏期(PL)明显延长(均P<0.05);P3PL与HDS评分呈负相关(r=-0.686,P＜0.01),且较HDS更为敏感;梗死部位与P300变化有一定关系,梗死位于颞叶、额叶的患者与其他梗死部位的患者相比,P3PL异常率明显增高(P＜0.05).(2)AD组与VD组相比,N1 PL更长,差异有显著性(P<0.05).结论 (1)P300对VD的早期诊断具有重要意义.(2)N1PL在VD与AD的鉴别诊断中有一定的意义.

离子通道病学(Channelopathy)是近年来国际学术发展中新兴的一门前沿学科,涉及神经生理学、神经病学、分子遗传学、细胞生物学、分子生物学、分子药理学等多个研究领域,已成为基础医学、临床医学、生命科学工作者研究的热点.随着研究方法和手段的不断进步,对于离子通道病的研究已经可以从早期的宏观整体深入到单个细胞甚至分子的微观世界,向前飞跃了一大步,随之而来的热衷于细胞分子水平的研究而忽视整体研究一度成为一种趋势;然而经过实践的验证发现,单纯局限于细胞分子水平,往往与整体存在较大偏差和距离,在一定程度上甚至阻碍了离子通道病研究的继续发展,因而从分子到细胞再回到整体成为离子通道病研究的又一次飞跃.纵观这一曲折历程,系统科学的方法-整合(Integration)思维不断渗透、贯穿其中,并逐渐发挥指导性的作用.

P300是事件相关电位(event-related potentials,ERPs)内源性成分中潜伏期在300 ms左右的正相诱发电位,与大脑的认知加工过程密切相关.P300电位是多结构起源的神经细胞电活动的综合场电位,其构成主要是神经细胞兴奋性突触后电位(EPSP)、抑制性突触后电位(IPSP)及动作电位.P300电位受多种神经递质系统(如胆碱能、氨基酸类、多巴胺能、5-羟色胺能、去甲肾上腺素能等)的影响.本文就这些神经递质对P300的影响作一综述.

目的探讨听神经瘤患者脑干听觉诱发电位的异常表现及诊断价值 . 方法对确诊的 30例听神经瘤患者作常规脑干听觉诱发电位检查 . 结果正常 1例 , 异常 29例 (96.7% ), 肿瘤侧表现为主波缺失、潜伏期 (PL)及峰间期 (IPL)延长 , 非肿瘤侧以 IPL(Ⅲ～Ⅴ )/(Ⅰ～Ⅲ ) >1为主要表现 . 结论脑干听觉诱发电位对听神经瘤具有高度敏感性 , 对听神经瘤的诊断具有重要意义 .

Objective　To investigate the relationship between P300 of auditory event-related potential (ERP) and age, sex in healthy people. Methods　Auditory P300 was tested in 60 healthy people of different ages and the results were analyzed by t-test and the linear correlation. Results　The peak-latency (PL) and amplitude (Amp) of P300 were significantly different between the less than 59-year-old group and the more than 60-year-old group. For all subjects tested, age had positive linear correlation with PL of P300 and negative linear correlation with Amp of P300. There is no significantly sex difference in healthy people. Conclusion　There is influence of age on auditory P300. The PL is increased and the Amp is decreased with aging.

目的:探讨脑诱发电位(BEP)在诊断急性脊髓炎同多发性硬化关系中的作用.方法:对28例急性脊髓炎患者进行了3种BEP检查,对其结果同正常对照值比较.结果:SEP异常率为90%,VEP异常率为52%,AEP异常率20%.其潜伏期值同正常对照值比较显著延长(P<0.01).结论:对急性脊髓炎患者做BEP检查有助于多发性硬化的早期诊断.