最新刊期
卷 49 ， 期 11 ， 2024
- “最新《脓毒症性凝血病诊疗中国专家共识(2024版)》发布，涵盖发病机制、分型、实验室评估、诊断和治疗等5个部分，共14条推荐意见，指导临床工作。”
摘要：Sepsis-induced coagulopathy (SIC), a critical and potentially lethal condition arising from sepsis, results in endothelial damage and significant coagulation dysregulation, making it a major factor contributing to mortality among sepsis patients. Early diagnosis and treatment of SIC are expected to improve the prognosis of sepsis patients. In 2019, the International Society on Thrombosis and Hemostasis (ISTH) issued the first guidelines for the diagnosis and treatment of SIC, but there are no corresponding protocols in China. Therefore, Chinese Society of Thrombosis, Hemostasis and Critical Care, Chinese Medicine Education Association, and Chinese People's Liberation Army Professional Committee of Critical Care Medicine jointly formulated the "Chinese Expert Consensus on the Diagnosis and Treatment of Sepsis-induced Coagulopathy (2024 edition)." This consensus includes 5 parts: pathogenesis, classification, laboratory approaches, diagnosis and treatment, with a total of 14 evidence-based recommendations to guide clinical practice.关键词：sepsis;coagulopathy;immunothrombosis;thromboinflammation;phenotypes;anticoagulation- 11
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发布时间：2024-12-05
Guideline and Consensus
- “在垂体神经内分泌肿瘤领域，专家系统论述了难治性催乳素瘤治疗的最新进展，为难治性催乳素瘤诊治提供新思路。”摘要：Refractory prolactinoma is the most common pituitary neuroendocrine tumor. Dopamine receptor agonists (DA) are the primary choice for drug treatment. Most patients with prolactinomas respond well to DA. However, a minority of prolactinomas patients still show resistance to DA. Although drug-resistant and refractory prolactinomas are rare in clinical practice, their treatment is extremely challenging. Even a combination of drug therapy, multiple surgeries, and radiotherapy may not yield satisfactory outcomes. Therefore, standardizing the diagnosis and treatment process and pathway for refractory prolactionmas and exploring more effective multidisciplinary collaborative treatment strategies are urgent problems to be solved. In the clinical management of refractory prolactinomas, it is often necessary to consider the patient's condition comprehensively, replace other types of DA, or consider surgery, radiotherapy, and immunotherapy, which requires multidisciplinary diagnosis and treatment. This review synthesizes the latest literature at home and abroad to systematically discuss the latest advances in drug therapy, surgery, and radiotherapy treatments for refractory prolactionmas, aiming to provide new ideas for basic research, clinical diagnosis and treatment.关键词：refractory prolactinoma;dopamine;clinical treatment
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发布时间：2024-12-05 - “在内分泌疾病领域，库欣病诊断与治疗取得新进展，专家探讨了经典和新兴诊断方法及治疗策略，为临床治疗提供新思路。”摘要：Cushing's disease is a severe endocrine disorder caused by excess secretion of adrenocorticotropic hormone from pituitary. Due to its subtle early clinical manifestations , the diagnosis of Cushing's disease is often delayed, and differentiating it from ectopic adrenocorticotropic hormone syndrome is a challenge. Combined functional tests can improve the diagnostic accuracy of Cushing's disease. The primary treatment for Cushing's disease is surgical removal of pituitary adenoma. However, about 1/3 of patients do not respond or experience recurrence after surgery, necessitating second-line treatments including medication. The development of novel drugs has enhanced the role of pharmacotherapy in the management of Cushing's disease. The review discusses the classic and emerging diagnostic methods and treatment strategies of Cushing's disease to deepen clinicians' understanding of its current treatment status and prospects.关键词：Cushing's disease;ectopic adrenocorticotropic hormone syndrome;adrenocorticotropic hormone;cortisol
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发布时间：2024-12-05 - “据最新研究，垂体TSH腺瘤罕见，需与甲亢等疾病鉴别，手术切除为首选治疗。”
摘要：Pituitary thyroid-stimulating hormone (TSH) adenomas is a rare pituitary disorder, accounting for less than 2% of pituitary adenomas. The clinical manifestations primarily include mild to moderate symptoms of hyperthyroidism, corresponding symptoms caused by other anterior pituitary hormone secretion disorders, and symptoms resulting from the mass effect of pituitary tumors. Pituitary TSH adenomas need to be differentiated from primary hyperthyroidism (Graves' disease) and resistance to thyroid hormone (RTH), as misdiagnosis can lead to tumor growth and aggravation of the condition. Currently, with the help of sensitive laboratory tests, imaging examinations, and targeted functional tests, pituitary TSH adenomas can be diagnosed relatively accurately. The preferred treatment is surgical resection. In cases where surgery is not feasible or unsuccessful, radiotherapy or medical therapy can be considered. Long-acting somatostatin analogs can effectively reduce tumor volume and decrease TSH secretion, thereby normalizing free 3,5,3',5'-tetraiodothyronine (FT4) and free 3,5,3'-triiodothyronine (FT3). Early identification and effective treatment are significant for patients with pituitary TSH adenomas. This review summarizes the epidemiology, pathological characteristics, screening objects, clinical manifestations, auxiliary examinations, diagnosis and treatment, follow-up and evaluation of pituitary TSH adenoma, aiming to provide guidance for the clinical diagnosis and treatment of this condition.关键词：pituitary thyroid-stimulating hormone adenomas;resistance to thyroid hormone;thyrotoxicosis;diagnosis;treatment- 12
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发布时间：2024-12-05 - “无功能垂体腺瘤研究进展，多学科团队合作，全基因组测序技术，为临床管理提供指导。”摘要：Non-functional pituitary adenomas (NFPAs) are relatively common intracranial sellar tumors. The diagnostic rate of NFPAs has significantly increased in recent years due to the widespread application of computed tomography (CT) and magnetic resonance imaging (MRI) in clinical practice. NFPAs do not exhibit increased biochemical hormone secretion, so they may not present with obvious clinical manifestations. However, as the tumor grows, it can cause mass effect symptoms, such as headache, visual impairment, and related pituitary target gland dysfunction, and even life-threatening pituitary stroke. The evaluation of pituitary function in patients with NFPAs and the selection of treatment plans require close collaboration and scientific management by a multidisciplinary team. The genetic and epigenetic mechanisms underlying the occurrence and development of NFPAs have not yet been fully elucidated. New treatment strategies may be developed through technologies such as whole-genome sequencing combined with chromatin structure analysis. This review systematically summarizes the research progress in epidemiology, histopathology, clinical diagnosis, treatment, and prognosis of NFPAs, aiming to provide reference and guidance for clinical management.关键词：non-functional pituitary adenomas;pituitary function;transsphenoidal surgery;radiation therapy;dopamine receptor agonists
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发布时间：2024-12-05 - “据最新研究，肢端肥大症并发症筛查与管理对提高患者生存率和生活质量至关重要。”摘要：Acromegaly can cause chronic complications in multiple systems such as the cardiovascular, respiratory, digestive, and endocrine systems, increasing the risk of death and significantly shortening the patient's life expectancy. Timely screening and early diagnosis and treatment can significantly improve the prognosis of patients and indirectly reflect the level of diagnosis and treatment of hospitals or teams. Clinical communication and research have revealed that physicians, in the course of clinical practice, are frequently constrained by factors such as time, economic considerations, and patient compliance, which hinder their ability to perform comprehensive screening for acromegaly-related complications. This review draws on expert consensuses and guidelines from both domestic and international sources, integrating them with the specific realities of China, to provide a comprehensive summary of the key aspects of screening and management for acromegaly-related complications. These aspects include the incidence of complications, optimal timing for screening, treatment approaches, long-term monitoring, and strict management protocols. It emphasizes standardization, precision, and personalization in clinical diagnosis and treatment work, aiming to comprehensively improve the diagnosis and treatment level of acromegaly in China, enhance the survival rate of patients, and improve their quality of life.关键词：acromegaly;complications;screening;management
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发布时间：2024-12-05
Special Issue on Diagnosis, Treatment and Management of Pituitary Diseases
- “南京中医药大学附属医院研究揭示，ⅠSHU与股骨头塌陷进展相关，ARCO ⅢA分期、JIC C2分型是独立危险因素，具有预测价值。”
摘要：ObjectiveTo explore the influential factors and predictive value of early femoral head collapse progression following allogeneic fibula grafting (AFG) surgery.MethodsClinical and radiological data of 68 patients (75 hips) with osteonecrosis of the femoral head (ONFH) who underwent AFG between January 2008 and December 2022 at the Orthopedics and Traumatology Department, Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed. Seventy-five hips were divided into stable (n=40) and progressive (n=35) groups based on the presence or absence of postoperative collapse progression. Age, gender, etiology, location of the lesion, Association Research Circulation Osseous (ARCO) stage, Japanese Committee of Osteonecrosis Investigation (JIC) classification, China-Japan Friendship Hospital (CJFH) classification, and Hounsfield units (HU) value of anterolateral sclerosis rim (ⅠSHU) were collected. Univariate and multivariate logistic regression analyses were used to identify the factors influencing early collapse progression after AFG. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the identified factors influencing postoperative early collapse progression.ResultsOf the 75 hips, 35(46.7%) had postoperative collapse progression. Univariate logistic regression analysis showed that age, ARCO stage, JIC classification, and ⅠSHU were in fluencing factors for early femoral head collapse progression after AFG (P0.05). Multivariate logistic regression analysis showed that ARCO stage ⅢA and JIC classification C2 were independent risk factors for early femoral head collapse progression after AFG, while ⅠSHU was identified as an independent protective factor (P0.05). The ROC curve analysis showed that the sensitivities of ARCO stage, JIC classification, ⅠSHU, and the combined predictive model were 0.850, 0.725, 0.800, and 0.775, the specificities were 0.486, 0.657, 0.743, and 0.914, and the area under the ROC curve (AUC) were 0.668, 0.725, 0.811, and 0.896, respectively.ConclusionsⅠSHU is associated with early collapse progression after AFG in patients with ONFH. ARCO stage ⅢA, JIC classification C2, and ⅠSHU are independent factors influencing postoperative early collapse progression and have a certain predictive value.关键词：femoral head osteonecrosis;sclerosis rim;allogeneic fibula grafting;influential factors- 5
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发布时间：2024-12-05 - “最新研究发现，乳腺癌脑转移患者认知功能衰退与血清CXCL9水平降低密切相关，全脑放射治疗可能影响CXCL9水平。”
摘要：ObjectiveTo investigate the effect of chemokine CXC ligand 9 (CXCL9) on cognitive function impairment in patients with breast cancer brain metastases undergoing whole-brain radiotherapy (WBRT) using bioinformatics methods.MethodsThe mRNA of breast cancer brain metastases datasets GSE43837 and GSE12276 and Alzheimer's disease (AD) dataset GSE161199 were screened and downloaded from GEO database. Limma method and Venn diagrams were used to identify common differentially expressed genes (DEGs), and protein-protein interaction and functional prediction through GeneMANIA website assays were performed. A total of 42 patients with breast cancer brain metastases who first visited the Department of Radiotherapy at the First Affiliated Hospital of Hebei North University from January 2021 to January 2023 were selected. Patients were divided into normal cognitive function group and cognitive function impairment group based on cognitive status. Enzyme-linked immunosorbent assay (ELISA) was employed to detect serum CXCL9 levels one week before and three months after radiotherapy. The mini-mental state examination (MMSE) was used to assess patients' cognitive function.ResultsThe DEGs from datasets GSE43837 and GSE12276 included PKP1, POLDIP2, SPAG5, ALDOC, PTPRZ1, PKIA, TLCD1, CPE, PMP22 and CXCL9. The DEGs from GSE161199 included RPS16, CD79A, LYPD3, RPL28, HBG2, RPL23AP7, TRNR, CXCL9. Venn diagram showed that CXCL9 was a common DEG between breast cancer brain metastasis and AD. Functional enrichment analysis indicated that CXCL9 was involved in cellular responses to chemokines, negative regulation of immune system processes, negative regulation of vascular morphogenesis, Toll-like receptor signaling pathway, nucleotide oligomerization domain (NOD)‑like receptor signaling pathway, and JAK-STAT signaling pathway. Before radiotherapy, patients with cognitive function impairment and normal cognitive function accounted for 61.9% and 38.1%, respectively, with a statistically significant difference in MMSE scores [(24.53±2.19) vs. (28.89±1.36), P˂0.01]. Compared with normal cognitive function group, patients with cognitive function impairment had a significantly increased number of brain metastases and significantly lower Karnofsky performance status (KPS) scores and serum CXCL9 levels (P˂0.05). Three months after radiotherapy, patients with cognitive function impairment and normal cognitive function accounted for 47.6% and 52.4%, respectively, with a statistically significant difference in MMSE scores [(25.16±1.98) vs. (28.18±1.08), P˂0.01]. Compared with normal cognitive function group, patients with cognitive function impairment had significantly lower CXCL9 levels (P=0.003). In patients with normal cognitive function, CXCL9 levels were remarkably lower after radiotherapy compared to those before radiotherapy (P=0.009).ConclusionsPatients with cognitive function impairment had significantly lower CXCL9 levels than those with normal cognitive function, and whole-brain radiotherapy may be related to a certain degree of reduction in CXCL9 levels.关键词：breast cancer brain metastases;whole-brain radiotherapy;volumetric modulated arc therapy;chemokine CXC ligand 9;mini-mental state examination- 36
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发布时间：2024-12-05 - “最新研究显示，在前列腺癌治疗中，近距离放射治疗在保持性功能方面效果更佳，尤其在勃起功能和性欲方面优于手术切除和外照射治疗。”摘要：ObjectiveTo compare and explore the impact of radical prostatectomy, external beam radiation therapy, and prostate brachytherapy on sexual function of patients with prostate cancer.MethodsA total of 80 prostate cancer patients admitted to the Urology Department of Ji'an Central People's Hospital from January 2020 to December 2022 were retrospectively analyzed. According to the treatment plan, they were divided into a surgical resection group (n=26, underwent radical prostatectomy), an external beam irradiation group (n=28, treated with high-energy X-rays or particle beams directed at irradiate tumor cells from outside the body), and a brachytherapy group (n=26, radioactive material placed directly into the prostate to act on cancer cells). General data such as age, body mass index (BMI) and Gleason score were collected for all patients. Patients were assessed for erectile dysfunction using international index of erectile function (IIEF) scale, for sexual desire using sexual dysfunction index (SDI) scale, and for sexual function using male sexual health questionnaire (MSHQ) scale. Six months after the end of treatment, the patients' anxiety and depression were assessed using self-rating anxiety scale (SAS) and self-rating depression scale (SDS).ResultsThere were no statistically significant differences in age, BMI and Gleason score among patients in each group (P0.05). The brachytherapy group demonstrated a higher rate of no erectile dysfunction compared to surgical resection group and external beam radiation group (P0.05), and lower rates of mild and moderate to severe erectile dysfunction compared to surgical resection group (P0.05). The external beam irradiation group showed a higher rate of no erectile dysfunction and lower rates of moderate to severe erectile dysfunction compared to surgical resection group (P0.05). The brachytherapy group showed higher scores in sexual fantasy, sexual desire, sexual frequency and total SDI score than those in surgical resection group and external beam radiation group (P0.05). The external beam radiation group also had higher scores in these areas compared to surgical resection group (P0.05). The total sexual function score was higher in brachytherapy group compared to the other two groups (P0.05), and the external beam irradiation group had a higher sexual function score than surgical resection group (P0.05). The SAS and SDS scores in brachytherapy group were lower than those in surgical resection group and external beam radiation group (P0.05).ConclusionAmong the treatment methods for prostate cancer, prostate brachytherapy is relatively more effective in maintaining sexual function, especially in terms of erectile function and sexual desire, outperforming radical prostatectomy and external beam therapy.关键词：prostate cancer;radical resection;external beam radiation;brachytherapy;sexual function
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发布时间：2024-12-05 - “最新研究发现，红细胞体积分布宽度变异系数(RDW-CV)和血清白细胞介素-11(IL-11)、IL-31在间质性肺疾病(ILD)诊断中具有重要临床价值。”
摘要：ObjectiveTo explore the clinical value of red blood cell volume distribution width coefficient of variation (RDW-CV), serum interleukin-11 (IL-11) and interleukin-31 (IL-31) in the diagnosis of interstitial lung disease (ILD).MethodsProspectively selected 46 ILD patients admitted to the Department of Respiratory and Critical Care Medicine, the Affiliated Hospital of Chengde Medical University from November 2022 to October 2023 were set as ILD group, 40 patients with community-acquired pneumonia (CAP) as CAP group, and 35 healthy examiners as control group. The ILD group was further divided into idiopathic interstitial pneumonia (IIP) subgroup (n=30) and connective tissue disease-related ILD (CTD-ILD) subgroup (n=16) based on clinical diagnosis. General and clinical data of each group were recorded, and RDW-CV and serum IL-11 and IL-31 levels were detected in each group. The ILD group was tested for alveolar arterial oxygen pressure difference (AaDO2) and arterial blood oxygen pressure (PaO2), and calculated the oxygenation index (OI). The correlation between the levels of RDW-CV, IL-11 and IL-31 and the severity of ILD were analyzed to explore the value of the above indicators in the clinical diagnosis of ILD and the differential diagnosis of different types of ILD.ResultsCompared with control group, there was no statistically significant difference in general information such as age, gender, smoking history, and complications between the ILD and CAP groups (P0.05); RDW-CV, absolute values of neutrophil count (NEUT), and serum IL-11 and IL-31 levels in ILD group were significantly increased (P0.05). Compared with CAP group, the levels of RDW-CV and serum IL-11, IL-31 in ILD group were increased, while the level of serum C-reactive protein (CRP) was decreased, with statistically significant differences (P0.05). Correlation analysis results showed that RDW-CV and serum IL-31 in ILD patients were negatively correlated with OI (P0.05), and positively correlated with AaDO2 (P0.05). The area under the ROC curves (AUC) of RDW-CV and serum IL-11, IL-31 single and combined applications for diagnosing ILD were 0.770, 0.666, 0.646, and 0.854, respectively (P0.05). The AUC of serum IL-11 for differential diagnosis of CTD-ILD and IIP was 0.727(95%CI 0.580-0.874), with sensitivity of 62.5% and specificity of 73.3% (P0.05).ConclusionsRDW-CV and serum IL-31 have certain value in assessing the severity of ILD. RDW-CV and serum IL-11 and IL-31 have certain value in the diagnosis of ILD. Serum IL-11 has certain value in the differential diagnosis between CTD-ILD and IIP.关键词：interstitial lung disease;red blood cell volume distribution width;interleukin-11;interleukin-31- 19
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发布时间：2024-12-05 - “南方医科大学珠江医院研究显示，人工膝关节置换术后，血小板100×109/L时应用利伐沙班抗凝治疗，能降低DVT发生率。”
摘要：ObjectiveTo investigate the effects of rivaroxaban anticoagulant therapy on lower deep venous thrombosis (DVT) after artificial knee arthroplasty.MethodsOne hundred and forty-four patients who received artificial knee replacement in the Zhujiang Hospital of Southern Medical University from June 2020 to June 2022 were retrospectively analyzed. All the patients received rivaroxaban anticoagulant treatment after surgery. Among them, the patients who started anticoagulant therapy at platelets 100×109/L were included in the observation group (n=76), and the patients who started anticoagulant at platelets 300×109/L were included in the control group (n=68). The propensity score matching was used to adjust the balance, and each group included 56 patients. The changes of coagulation markers [D-dimer and plasma viscosity (PV)] before and after operation were compared between the two groups. The survival curve was drawn by Kaplan-Meier method to analyze the occurrence of DVT in the two groups within 30 days after operation. According to the presence or absence of lower limb DVT events after knee arthroplasty, the patients were divided into DVT group (n=36) and non-DVT group (n=76). Logistic regression model was used to analyze the independent correlation between platelet level before anticoagulant therapy and postoperative DVT. Multivariate logistic regression analysis was used to analyze the risk factors of DVT after knee arthroplasty. The nomogram was established by R software and verified 1000 times by Bootstrap method. The area under ROC curve (AUC) and calibration curve were used to evaluate the discrimination and accuracy.ResultsAfter matching, the baseline characteristics of the observation group and the control group were balanced (P0.05). Univariate analysis showed that compared with non-DVT group, BMI and the proportion of bilateral knee arthroplasty, intraoperative blood loss ≥400 ml, general anesthesia, use of bone cement, and triacylglycerol ≥1.7 mmol/L, and the levels of D-dimer and platelet increased, prothrombin time (PT) shortened, and activated partial thromboplastin time (APTT) extended in the DVT group (P0.05). After adjusting the confounding factors of age, sex, BMI, triglyceride, D-dimer, PT and APTT, the platelet level before anticoagulant therapy was still an independent risk factor for postoperative DVT (OR=3.858, 95%CI 1.849-6.054), and there was a significant difference in platelet trend test from low to high quintile (Ptrend0.001). The results of multivariate logistic regression analysis showed that BMI ≥25 kg/m2, bilateral knee arthroplasty, general anesthesia, D-dimer ≥190 μg, platelet ≥300×109/L were risk factors for DVT after knee arthroplasty (OR1, P0.05), while not using bone cement and PT ≥12 s were protective factors (OR1, P0.05). Before and after the verification of the nomogram, the AUC was 0.851(95%CI 0.773-0.912) and 0.813 (95%CI 0.736-0.894), and the average absolute error of the calibration curve was 0.015.ConclusionThe application of rivaroxaban anticoagulation therapy can quickly improve the coagulation function of patients with platelet 100×109/L after artificial knee replacement surgery and reduce the incidence of DVT.关键词：artificial knee replacement;rivaroxaban;lower limb deep vein thrombosis;platelets- 8
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发布时间：2024-12-05
Clinical Research
- “最新研究发现，miR-15b-5p通过靶向抑制FOXO1降低细胞自噬减缓缺氧/复氧诱导的HK-2细胞损伤。”
摘要：ObjectiveTo investigate the role and underlying mechanism of miR-15b-5p on hypoxia/reoxygenation (H/R) induced human renal tubular epithelial cell (HK-2) injury by targeting forkhead box O1 (FOXO1).MethodsHK-2 cells in the log growth phase were set up as follows: (1) control group (normal culture) and H/R group (H/R induced culture). The expressions of miR-15b-5p and FOXO1 mRNA were detected using qRT-PCR, and the protein expression of FOXO1 was detected using Western blotting. (2) Control group (normal culture), H/R group (H/R induced culture), H/R+mimic control group (cells transfected with mimic control then induced by H/R), H/R+miR-15b-5p mimic group (cells transfected with miR-15b-5p mimic then induced by H/R), H/R+miR-15b-5p mimic+OE-NC group (cells co-transfected with miR-15b-5p mimic and OE-NC plasmid, then induced by H/R), and H/R+miR-15b-5p mimic+OE-FOXO1 group (cells co-transfected with miR-15b-5p mimic and FOXO1 overexpression plasmid, then induced by H/R). The expression of miR-15b-5p was detected using qRT-PCR, and the protein expressions of FOXO1, cleaved caspase-3, Bax, and Bcl-2 were detected using Western blotting. CCK-8 assay was used to detect cell viability. Cell apoptosis was measured by the TUNEL method. (3) Control group (normal culture), H/R group (H/R induced culture), H/R+miR-15b-5p mimic group (cells transfected with miR-15b-5p mimic then induced by H/R), and H/R+miR-15b-5p mimic+OE-FOXO1 group (cellsco-transfected with miR-15b-5p mimic and FOXO1 overexpression plasmid, then induced by H/R). The protein expressions of LC3, p62 and Beclin1 were detected using Western blotting. LC3 immunofluorescence was used to detect the cell autophagy. The target reaction between miR-15b-5p and FOXO1 was assessed using dual luciferase reporting assay.ResultsUnder an inverted microscope, it was observed that the control group had a higher number of cells, most of which were in a typical cobblestone shape and grew in a cobblestone-like manner; most of the cells in the H/R group contracted and became round, with a significant decrease in the number of adherent cells. In H/R-induced HK-2 cells, miR-15b-5p was significantly down-regulated, while miRNA and protein expression of FOXO1 was up-regulated (P0.05). Luciferase assay results showed that miR-15b-5p directly targeted the 3'-UTR of FOXO1. Overexpression of miR-15b-5p increased cell viability, reduced cell apoptosis, and decreased autophagy in H/R-induced HK-2 cells (P0.05). Compared with H/R+miR-15b-5p mimic group, the viability of HK-2 cells was decreased, the apoptosis and autophagy level were increased in H/R+miR-15b-5p mimic+OE-FOXO1 group (P0.05).ConclusionmiR-15b-5p inhibited autophagy and alleviated H/R-induced HK-2 cell injury by targeting FOXO1.关键词：miR-15b-5p;forkhead box O1;human renal tubular epithelial cells;hypoxia/reoxygenation;autophagy- 23
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发布时间：2024-12-05 - “透明质酸基质金属蛋白酶响应性脑源性神经营养因子控释材料研制成功，为创伤性脑损伤干预及修复提供新方案。”
摘要：ObjectiveTo develop a matrix metalloproteinase (MMP)-responsive hyaluronic acid (HA)-based controlled-release material for brain-derived neurotrophic factor (BDNF) to provide a novel therapeutic strategy for intervention and repair of traumatic brain injury (TBI).MethodsHA was modified with amination, followed by condensation with Suflo-SMCC carboxyl group to form amide, and then linked with glutathione (GSH) to synthesize HA-GSH. The recombinant glutathione S-transferase(GST)-tissue inhibitor of metalloproteinase(TIMP)-BDNF (GST-TIMP-BDNF) expression plasmid was constructed using molecular cloning technique with double enzyme digestion by BamH Ⅰ and EcoR Ⅰ. The recombinant GST-TIMP-BDNF protein was expressed in the Escherichia coli prokaryotic expression system, and purified by ion exchange chromatography, confirmed by Western blotting. MMP diluents were supplemented with PBS, MMP inhibitor marimastat, and varing concentrations (0.4, 0.6, 0.8 mg/ml) of GST-TIMP-BDNF or GST-BDNF. MMP-2 activity was analyzed using an MMP activity detection kit to evaluate the inhibitory effect of the recombinant protein on MMP. Primary rat neurons were extracted and cultured to establish an iron death model induced by RSL3. The effect of recombinant protein GST-TIMP-BDNF on neuronal injury was detected by immunofluorescence staining.ResultsMRI hydrogen spectrum identification confirmed the successful synthesis of HA-GSH. Western blotting results showed the successful expression of the recombinant protein GST-TIMP-BDNF containing the GST tag using the E. coli prokaryotic expression system. MMP activity detection results indicated that the recombinant protein GST-TIMP-BDNF had a superior inhibitory effect on MMP-2 activity compared to GST-BDNF (P0.05). Immunofluorescence staining results showed a significant increase in fluorescence intensity in rat neurons treated with GST-TIMP-BDNF after RSL3 induction (P0.05).ConclusionA MMP-responsive HA-based BDNF controlled-release material has been successfully developed, exhibiting a protective effect on neuron damage.关键词：hyaluronic acid;matrix metalloproteinase;brain-derived neurotrophic factor;traumatic brain injury;controlled release- 17
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发布时间：2024-12-05
Basic Research
- “创伤性脑损伤后免疫细胞过度浸润诱发神经炎症，间充质干细胞免疫调节特性有望治疗脑损伤，为临床应用提供参考。”
摘要：Traumatic Brain Injury (TBI) is a significant global cause of mortality and disability, severely compromising public health and quality of life. TBI can be divided into primary and secondary brain injuries according to pathological mechanism, with excessive infiltration of immune cells post-injury triggering neuroinflammation being one of the crucial mechanisms in the cascade of secondary brain injury. Currently, There is a lack of targeted therapeutic agents for TBI, and treatment mainly relies on symptomatic care. Mesenchymal stem cells (MSCs) have shown promising potential in the treatment of brain injury through their immune-modulatory properties, which can mediate immune responses to reduce neuroinflammation and repair nerve damage. The review summarizes the recent research progress on immune responses following TBI and the immune regulatory effects of MSCs, aiming to provide references for subsequent research and clinical applications.关键词：traumatic brain injury;mesenchymal stem cells;immunomodulation;blood-brain barrier;action mechanism- 10
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发布时间：2024-12-05 -
Research progress on inflammatory mechanism and treatment in aneurysmal subarachnoid hemorrhage AI导读
“动脉瘤性蛛网膜下隙出血研究取得新进展，专家综述了免疫炎症反应在发病机制中的作用，为治疗方案探索提供参考。”
摘要：Aneurysmal subarachnoid hemorrhage (aSAH), primarily caused by the rupture of intracranial aneurysms with bleeding into the subarachnoid space, is an acute neurological disease associated with high disability and mortality. Brain injury after aSAH results from a combination of injury mechanisms, with early brain injury (EBI) occurring within 72 hours post-onset, laying the foundation for subsequent pathophysiological changes in the brain and poor prognosis of patients. Among them, the brain immunoinflammatory response, involving the interaction of various immune cells and active substances, plays a significant role in post-aSAH EBI, and is related to delayed brain injury and long-term prognosis. Systemic inflammatory response following aSAH can also affect the prognosis and outcome of patients. This review summarizes the role of local and systemic immune inflammatory responses in the occurrence and progression of aSAH, as well as the research progress on related inflammatory biomarkers and therapeutic prospects, aiming to provide a theoretical reference for new treatment for aSAH.关键词：subarachnoid hemorrhage;inflammatory pathogenesis;therapy;outcome- 13
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发布时间：2024-12-05
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