Background Observational studies have demonstrated that there was a significant correlation between systemic lupus erythematosus (SLE) and anxiety disorder, but the causal relationship between them is not so clearly established. This study aims to reveal the potential causal link between SLE and anxiety disorder. Methods Summary statistical data of SLE and anxiety disorder were from two large-scale genome-wide association studies (GWAS) of European ancestry, followed by a bidirectional two-sample Mendelian randomization (MR) analysis. The inverse variance-weighted (IVW) method was used as the main method to evaluate causal effects, while MR-Egger, weighted median, simple mode, and weighted mode were supplementary methods. Outliers were excluded by MR-pleiotropy residual sum and outlier (MR-PRESSO). Cochran's Q test, MR-Egger intercept test, and leave-one-out analysis were used to evaluate the stability of the results. Results According to the results of IVW, we did not observe that there was a statistically significant causal association between genetically predicted SLE and the risk of anxiety disorder (OR = 1.000, 95%CI = 0.992 to 1.008, p =.997). Conversely, there were no causal effects between anxiety disorder and SLE risk (OR = 1.000, 95%CI = 0.992 to 1.008, p = .997). A similar result was obtained by supplementing the MR method. In addition, sensitivity analysis indicated high stability of the result. Conclusion Bidirectional two-sample MR study does not support the causal relationship between SLE and anxiety disorder.

Abstract Background Cerebral infarction (CI) is an unusual complication in patients with bleeding disorders. To our knowledge, this is the first case of postoperative internal border-zone infarction (I-BZI) from Hemophilia A. Case presentation We present a case of Hemophilia A developing I-BZI, after surgical treatment of giant hemophilic pseudotumor. A 36-year-old man was introduced from other hospital by Hemophilia with giant hemophilic pseudotumor in his left thigh. Patient and his relatives did not have a history of thrombophilia. After excluding the relevant surgical contraindications, we performed the operation of pseudotumor resection. Prior to surgery, blood tests revealed hemoglobin of 137 g/L. FVIII activity was 1.5%. Activated partial thromboplastin time (APTT) was 71.50 s and D-dimer was 3.33 mg/L FEU. Immediately before surgery, the patient received an intravenous infusion of FVIII products (Xyntha®) at a dose of 3500 IU for his body weight of 80 kg. Post-operative day two (POD2), patient developed vomiting, decreased response, and dysarthria. Hemoglobin was 54 g/L with blood pressure of 110/70 mmHg. Magnetic resonance imaging of the brain showed there were multiple acute cerebral infarctions in bilateral lateral ventricles (internal border zone) and multiple ischemic foci in the white matter areas and basal ganglia of the bilateral cerebral hemispheres. This case suggested that acute severe anemia can be one of the causes of I-BZI. Conclusions For the treatment of I-BZI caused by acute anemia from Hemophilia A, volume expansion, red blood cell supplement and continuous improvement of coagulation with suitable dose of factor VIII (FVIII) should be considered to improve prognosis.

目的:观察恒古骨伤愈合剂治疗膝骨性关节炎(Knee Osteoarthritis,KOA)的临床疗效及安全性.方法:纳入KOA患者128例,其中气滞血瘀型64例,肝肾亏虚型64例.采用SPSS 25.0统计软件生成随机数序列,分别将两种证型的患者随机分为2组,其中气滞血瘀型对照组和治疗组各32例;肝肾亏虚型对照组和治疗组各32例.对照组口服塞来昔布胶囊200mg/次,1次/d;治疗组给予恒古骨伤愈合剂,25 mL/次,1次/2 d,治疗6周后采用WOMAC评分及疗效评定标准评定患者的临床疗效,并记录治疗过程中不良反应情况.结果:剔除脱落病例后,最后共纳入病例121例,气滞血瘀型62例,其中对照组30例,治疗组32例;肝肾亏虚型59例,其中对照组28例,治疗组31例.对照组和治疗组患者治疗后WOMAC各项评分较治疗前均明显下降,差异有统计学意义(P＜0.05).气滞血瘀型患者中,治疗组的疼痛评分及总评分较对照组下降,差异有统计学意义(P＜0.05);肝肾亏虚型患者中,治疗组的僵硬、功能评分以及总评分较对照组下降,差异有统计学意义(P＜0.05).对照组和治疗组的总有效率相比,差异无统计学意义(P＞0.05);但肝肾亏虚型中治疗组的显效率明显高于对照组,差异有统计学意义(P＜0.05).总体而言,治疗组不良反应发生率较对照组降低,差异有统计学意义(P＜0.05).此外,血常规、肝肾功能及尿常规结果显示两组患者在治疗前至治疗后6周时以上实验室指标均未见明显异常,且较治疗前无明显波动.结论:恒古骨伤愈合剂具有活血益气、补益肝肾的作用,临床上治疗气滞血瘀、肝肾亏虚证型的KOA患者,可以缓解膝关节疼痛、僵硬,改善膝关节功能,其疗效优于口服塞来昔布胶囊,且不良反应相对较少,值得临床推广应用.

膝骨关节炎(knee osteoarthritis,KOA)是骨科临床常见的一种慢性退行性疾病,目前尚无明确能够阻止或逆转KOA进展的治疗方法.富血小板血浆(platelet rich plasma,PRP)是富含血小板的血浆制品,在修复软骨损伤方面具有显著优势.随着对软骨下骨研究的不断深入,许多学者开展了关于PRP软骨下骨注射治疗KOA的研究.本文对软骨下骨和PRP进行了概述,并从作用机制和临床疗效2个方面就PRP软骨下骨注射治疗KOA的研究进展进行了综述.

[目的]探析从"肺主治节"的角度论治不寐的理论依据及临床意义.[方法]围绕"肺者,相傅之官,治节出焉",对"肺主治节"的内涵进行分析,探析"肺主治节"与不寐的相关性.在查阅诸多古籍和现代研究的基础上,探究"肺主治节"在不寐的发生及诊治中的意义,并各附医案以证其效.[结果]从"肺主治节"诊治不寐有较好的理论基础.若肺失治节,将影响呼吸节律、卫气循行、气血循行、水液输布、魄之所处等,从而影响人体寤寐节律,产生不寐.各家分别立足于调节肺的气机、调和营卫、调和气血、养阴润肺、温肺化饮、养气安魄等角度治疗不寐,获得良效.[结论]"肺失治节"能引致呼吸失司、营卫不和、气血失调、津水不布、魄无所归,从而引起不同证型的不寐.不寐调治从肺入手,效如桴鼓.

目的 观察麦冬多糖(OJP)对转化生长因子-β1(TGF-β1)诱导的人胚胎肺成纤维(HEL)细胞表型转化的影响,探讨其分子机制.方法 将经6ng/mL诱导TGF-β1的HEL细胞作为模型组,加入25、50、100μg/mL OJP继续培养的HEL细胞作为OJP干预组.通过电镜观察细胞的超微结构;实时荧光定量RT-PCR检测α-SMA mRNA和COLⅠmRNA表达;Western blot检测α-平滑肌肌动蛋白(α-SMA)、Ⅰ型胶原蛋白(COLⅠ)、Smad2蛋白和p-Smad2蛋白表达.结果 模型组及25、50、100μg/mL OJP干预组细胞的存活率分别为(99.65±1.55)％,(88.39±1.68)％,(82.77±1.96)％和(79.48±1.74)％,OJP干预组存活率低于模型组且随浓度的增加呈剂量依赖趋势,差异有统计学意义(P均<0.05);100μg/mL OJP干预组细胞表面微绒毛减少、微丝变短,胞浆内线粒体数目下降,粗面内质网减少;模型组和100μg/mL OJP干预组α-SMA mRNA表达量为(1.00±0.09)和(0.69±0.05),COLⅠmRNA表达量为(1.02±0.11)和(0.86±0.09),100μg/mL OJP干预组细胞α-SMA和COLⅠmRNA表达较模型组下调(P均<0.05);与模型组比较,100μg/mL OJP干预组α-SMA、COLⅠ、Smad2和p-Smad2蛋白表达明显下降(P均<0.01)[α-SMA蛋白:(0.48±0.03)比(1.56±0.02);COLⅠ蛋白:(0.41±0.02)比(1.66±0.02);Smad2蛋白:(0.71±0.01)比(1.34±0.01);p-Smad2蛋白:(0.69±0.01)比(1.52±0.01),P均<0.05].结论 麦冬多糖可能通过干预TGF-β/Smads信号通路,在一定程度上抑制成纤维细胞向肌成纤维细胞的转化.