目的 探究miR-206-3p在缺氧/复氧(H/R)诱导的大鼠H9c2心肌细胞损伤中的作用及机制.方法 体外培养H9c2细胞,建立H/R损伤心肌细胞模型,将细胞分为对照组(Control),H/R模型组,H/R+miRNA 阴性对照组(H/R+miR-NC),H/R+miR-206-3p模拟物组(H/R+miR-206-3p mimics),H/R+miR-206-3p模拟物组+pcDNA 阴性对照组(H/R+miR-206-3p mimics+pcDNA3.1)和H/R+miR-206-3p模拟物组+PDCD4过表达组(H/R+miR-206-3p mimics+pcDNA3.1-PDCD4),实时荧光定量PCR检测各组细胞中miR-206-3p和PDCD4的相对表达水平,Western blot检测各组细胞中PDCD4蛋白表达,Targetscan和双荧光素酶实验分析PDCD4与miR-206-3p的靶向关系,MTT法检测各组细胞活性,流式细胞术检测各组细胞凋亡.结果 与对照组相比,H/R组miR-206-3p表达降低,PDCD4表达升高(P＜0.05);与miR-NC组相比,miR-206-3p模拟物组中miR-206-3p表达升高,PDCD4表达降低(P＜0.05).Targetscan网站分析及双荧光素酶实验证实PDCD4为miR-206-3p的靶基因.相比miR-NC组,miR-206-3p模拟物组细胞活力升高,凋亡率下降;相比miR-206-3p mimics+pcDNA3.1组,PDCD4过表达组细胞活力下降,凋亡率升高.结论 过表达miR-206-3p可以靶向负调控PDCD4在缺氧复氧诱导的心肌细胞损伤中发挥保护作用.

Objective To explore the protective effect of salidroside on early reperfusion in patients with acute cerebral infarction treated with urokinase intravenous thrombolysis.Methods 98 patients with acute cerebral infarction who were consistent with intravenous thrombolysis after screening were enrolled in the study.They were equally divided into the control group and the treatment group by sealed envelop method in one to one ratio.The control group received urokinase intravenous thrombolytic therapy on the basis of dehydration,anticoagulation,brain rehabilitation,regulating blood pressure,blood glucose and other conventional treatment.Based on the treatment in the control group,the treatment group was treated with Hongjingtian injection for 10 days.The serum malondialdehyde(MDA),superoxide dismutase(SOD),plasma endothelin-1(ET-1) and high sensitive C-reactive protein(hs-CRP),neurological deficit score(NIHSS),Barthel index and clinical effect in the two groups were observed.Results There were no significant differences in levels of MDA,SOD,ET-1,hs-CRP,NIHSS and Barthel index between the two groups before treatment (t=0.30,0.26,0.41,004,0.57,0.33,all P>0.05).After treatment,there were statistically significant differences between the control group and the treatment group in levels of MDA,SOD,ET-1,hs-CRP,NIHSS score and Barthel index[(7.54±1.14)nmol/mL vs.(6.04±1.21)nmol/mL,(92.42±15.28)U/mL vs.(108.54±19.24)U/mL,(64.5±7.4)pg/mL vs.(41.4±8.1)pg/mL,(3.84±1.04)μmol/L vs.(2.54±0.84)μmol/L,(16.5±5.4)points vs.(11.2±3.1)points,(62.1±12.4) vs.(71.4±10.4)](t=6.31,4.59,14.74,6.81,5.96,4.02,all P<0.01).The total effective rate of the treatment group was 91.84%,which of the control group was 63.39%,the difference was statistically significant(χ2=8.83,P<0.05).Conclusion Salidroside can relieve lipid peroxidation in patients with acute cerebral infarction,promote decomposition of oxyradical,reduce inflammatory reactions,improve neurological function and quality of life.The curative effect is significant.It has protective effect on early reperfusion in patients with acute cerebral infarction treated with urokinase intravenous thrombolysis.

Objective It is to study the protection of Silver sulfadiazine combined with Sanhuang-shengfu oil on peripheral circulation disorders and foot ulcer in diabetic rats,and to explore its mechanism. Methods 80 healthy Wistar rats were select-ed to establish diabetic model,and the successful models (n = 70)were randomly divided into peripheral circulatory disorder group and ulcer group,every group included 35 rats. The successful peripheral circulatory disorders models (n = 32)and foot ulcer models (n = 34)were randomly divided into control group and observation group,both groups were given Silver sulfadia-zine on the wound surface,the observation group was added with Sanhuang-shengfu oil on the wound surface. Both groups were treated for 35 days. The plantar temperature,hot pain threshold of rats were detected in the peripheral circulatory disorders group,and the intergrown condition of ulcer,and the level of VEGF in the serum were detected in the ulcer group during treat-ment (1,2,3 weeks). Results In peripheral circulatory disorder group,the plantar temperature was lower at 2 weeks before treatment than that before treatment (P < 0. 05),and the temperature in observation group was higher than that in control group (P < 0. 05);the skin temperature at 3 weeks after treatment was higher than that before treatment and in control group (P < 0. 05),but no significant changes was found in control group (P > 0. 05);pain threshold was decreased gradually with treatment time increased in both groups,and the threshold at every time point in observation group were lower than that in con-trol group (P < 0. 05). In ulcer group,the healing rates at 2 and 3 weeks after therapy in observation group were higher than that in control group (P < 0. 05);the levels of serum VEGF at every time point after treatment were higher than that before treatment,and the increase in observation group was more significant than that in control group. Conclusion Silver sulfadia-zine combined with Sanhuang-shengfu oil can improve the plantar temperature decrease and pain dysesthesia of rats caused by diabetic peripheral circulatory disorders,and can promote wound healing of diabetic foot ulcers in rats by up-regulation of VEGF.

目的:探索米索前列醇应用于产后出血的临床效果。方法:选取我院产妇413例,①随机将140例产妇分为2组。胎儿娩出后,治疗组给予米索前列醇400μg,对照组给予缩宫素20IU。②将273例产妇随机分为3组,I组舌下含服给药,II组直肠给药,III组阴道给药。结果:①治疗组与对照组相比,产程时间缩短,出血量少,p<0.05,差异有统计学意义;两组患者血压变化,p>0.05,差异无统计学意义。②三种给药方法对各观察指标影响无明显差异,p>0.05。结论:米索前列醇可明显减少产妇出血量,价格低廉,操作简单,副作用较小,值得在临床推广使用。

目的:探讨电话随访,对骨科出院患者进行健康教育,解决患者出院后存在的一些康复问题,提高患者的遵医行为,避免由于康复阶段处理不当而影响功能恢复,甚至致残。方法:通过有计划定时的规范护士电话随访,对骨科患者家庭康复有针对性的专科指导,并督促患者按出院医嘱规定的时间及时到医院复查。结果:通过电话随访,骨科患者家庭康复意识、使用支具注意事项、功能锻炼等遵医行为得到提高,避免了不必要的并发症发生。结论:电话随访对骨科家庭健康教育起到督促、咨询、指导作用,同时提高患者的遵医行为,避免了由于康复阶段处理不当而导致的患者功能恢复不理想,并发症发生,消除患者担心出院后肢体功能锻炼不到位的顾虑,提高医院服务质量,减少医疗费用。

抗感染药物是当今医疗必备的一种重要药物,抗感染治疗使临床医师最基本的本领,抗感染药物的应用是双刃剑,应用合理可以治疗病患,应用不合理则会带来严重的后果,本文就抗感染药物中的抗真菌药物的应用进展做一系统介绍.

本文主要对常用的抗生素药物的种类做简单的概述,并对目前发展较为迅速的研究方法做一简要的说明。

近几年来,国内外对急性脑梗死溶栓治疗的适应证、治疗时间窗、药物剂量、疗效判定等被广泛关注[1].2002～2004年,笔者采用东菱克栓酶治疗急性脑梗死69例,取得较好效果.

服药时,人们最关注的往往是服药的时间和剂量,因为这两者直接关系着药物疗效的发挥.此时人们忽略了一个细节,那就是服药期间的饮食,不合理的饮食会降低药效,严重的还可能危及生命.