MicroRNA-4521基因在非小细胞肺癌中的表达分析研究

目的:初步探索非小细胞肺癌中差异表达microRNA,并对其靶基因进行预测及相关生物信息学分析。方法:通过mirExtra2.0数据库筛选非小细胞肺癌中差异表达microRNA,采用miRDB、miRWalk和TargetScan7三个数据库预测候选分子靶基因,并利用Metascapes数据库对预测靶基因进行功能注释、KEGG通路富集以及蛋白质网络互作分析。结果:非小细胞肺癌组织及对照组织表达谱中共筛选出634个差异microRNA,依据fold change比值及文献筛选microRNA-4521为候选基因。通过靶基因预测软件共获得235个潜在靶基因,其功能主要富集在细胞增殖和分裂及中心碳代谢信号通路等方面;蛋白质网络互作分析显示主要集中在非小细胞肺癌及中心碳代谢过程中。结论:筛选目标microRNA-4521在非小细胞肺癌中显著高表达,并可能通过参与中心碳代谢信号通路的调控从而影响非小细胞肺癌的发生发展。     

CPS1基因与肿瘤关系的研究进展

氨甲酰磷酸合成酶1（CPS1）是催化尿素循环限速酶之一,主要在肝细胞和肠上皮细胞中表达,正常生理情况下其在清除体内代谢废物氨的过程中起重要作用。研究表明,CPS1基因与肝癌、肺癌、结直肠癌等多种恶性肿瘤关系密切,通过多种信号转导通路或影响嘧啶合成等途径影响细胞增殖、凋亡、迁移等细胞生物学行为,从而影响肿瘤的发生发展或患者的预后。因此,研究CPS1基因与肿瘤的关系,对恶性肿瘤早期诊治、预后评价等方面有重要意义。该文就CPS1基因与肿瘤的关系进行综述。     

色氨酸代谢通路与精神分裂症的相关研究进展

目前,越来越多的证据表明精神分裂症患者体内可能存在色氨酸代谢通路的异常改变,其代谢产物及相关反映限速酶如5-羟色胺、犬尿氨酸、色氨酸羟化酶等可能在精神分裂症的发生发展中发挥重要作用。本文将对色氨酸代谢通路在精神分裂症中的相关研究进展进行综述。     

同型半胱氨酸及其代谢酶基因多态性与缺血性脑卒中的相关性研究进展

高同型半胱氨酸血症是缺血性脑卒中发病的独立危险因素之一。关于同型半胱氨酸代谢酶基因多态性研究,主要包括:5,10-亚甲基四氢叶酸还原酶基因、胱硫醚合成酶基因、甲硫氨酸合成酶基因和甲硫氨酸合成酶还原酶基因等。本文主要探讨同型半胱氨酸相关代谢酶的基因突变对缺血性脑卒中的影响。     

AdipoRon在心血管疾病中的作用研究进展

心血管疾病(cardiovascular diseases,CVDs)主要包括动脉粥样硬化、心肌梗死、心力衰竭、高血压等。CVDs病死率高,严重危害着人类的健康,针对CVDs的药物研究具有重要意义。AdipoRon是脂联素受体激动剂,通过作用于脂联素受体AdipoR1和AdipoR2,并激活AMP活化蛋白激酶、过氧化物酶体增殖物激活受体α等信号通路,在改善代谢综合征、减少缺血再灌注损伤和心肌肥大、促进血管舒张和血管生成、抗炎及抗氧化应激等方面发挥类似脂联素的作用。     

去乙酰化酶6与肿瘤的相关研究

关于肿瘤发生机制是近几年研究的重点,肿瘤的发生主要源自于相关基因突变,如原癌基因激活、抑癌基因失活等,这些基因突变使得相应的信号通路发生改变。据生物信息学研究发现,肿瘤相关的基因突变能影响许多核心的信号通路和肿瘤发生的进程。同时,最近科学家们也发现主要的致癌信号通路最后都会汇聚到肿瘤细胞代谢上来,因为肿瘤细胞的代谢决定着肿瘤细胞的生长和存活,所以细胞代谢的改变可以作为肿瘤的一个重要特点。     

COX-2在急性肺损伤中的作用

环氧化酶-2(eyelooxygenase-2,COX-2)属于还氧化酶类,该类酶是前列腺素合成过程中的限速酶,它将花生四烯酸代谢成各种前列腺素产物,后者参与维持机体的各种生理和病理过程.肺组织是前列腺素合成和灭活的主要部位,目前研究表明COX-2在肺癌、肺部炎症、肺纤维化等发病机制中发挥重要作用.本文将COX-2的基本特点及其在肺损伤中的作用机制作一综述.     

人细胞色素P450酶基因多态性与白血病

白血病发病机制及治疗的相关性研究历来是人们关注的焦点。作为人体内主要Ⅰ相代谢酶的细胞色素P450酶在血液系统恶性肿瘤发生、发展及转归方面的作用已经成为本领域中新的研究靶点。本文论述基因多态性与恶性肿瘤发生及治疗的相关性,尤其是与血液系统恶性肿瘤的关系,重点介绍国外近年有关细胞色素P450酶基因多态性及其与白血病易感性和治疗的相关研究进展。     

运动对骨代谢信号通路影响的研究进展

运动调控骨代谢的过程十分复杂,涉及多条信号通路。大量离体研究表明,机械应力通过Wnt、骨形态发生蛋白(BMP)及骨保护素(OPG)/核因子κB受体活化因子配体(RANKL)/核因子κB受体活化因子(RANK)等骨代谢信号通路对骨代谢进行调控,其强度、频率等均会对骨组织细胞产生不同的影响。众多在体实验也证实,运动通过调节相关骨代谢信号通路的关键因子进一步影响骨代谢。本文主要阐述运动对骨代谢信号通路的影响及其作用机制。     

肺癌患者脑代谢改变与分期的关系

目的：初步探讨无脑部转移的肺癌患者脑内葡萄糖代谢改变与肺癌分期的关系。方法：研究对象为143例因肺部占位而行全身正电子发射断层扫描（PET）检查以明确治疗前分期的首发肺癌患者,其中早期43例,中期42例,晚期59例,均经随访证实病理为恶性。比较143例不同分期肺癌患者与30例健康对照的大脑静息状态下葡萄糖代谢。结果：肺癌患者脑代谢改变以代谢减低为主。这些减低区主要有额叶、颞叶、顶下小叶,岛叶,扣带回皮质等;不同分期的患者的脑内代谢减低的程度不同,随病程加剧代谢减低相关脑区体素值增加。肺癌晚期组丘脑及豆状核区域代谢增加。结论：肺癌患者脑代谢改变与肺癌分期进展有关,脑代谢减低区域涉及多个与精神情绪有关的功能区,并且随病程进展扩大。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.