应用匹配矩阵、因子分析和聚类分析法研究冠心病痰瘀证候特征

目的研究冠心病痰瘀证候与临床四诊信息的相互关系,为其分类及规范化诊断提供参考。方法采用匹配矩阵、因子分析和聚类分析法,对200例冠心病患者痰证、瘀证、痰瘀互阻证及非痰非瘀证46项临床症状进行相关性分析。结果冠心病不同痰瘀证候舌、脉象与非痰非瘀证之间存在明显差异;中医病机脏腑定位于心和肾,以心气虚为主,兼肾气虚,痰证患者尚多伴脾气虚;在46项临床症状中,仅15项症状在痰证、瘀证和痰瘀互阻证中相伴出现频率较高。除共有的本虚证外,痰证的主要临床症状为白腻苔和滑脉,尚见胸脘痞满和腹胀等;瘀证则以紫舌、舌生瘀斑为主,尚见痛有定处;痰瘀互阻证则兼上述两种证候的主要症状。结论综合应用匹配矩阵、因子分析和聚类分析法,可以获得有关冠心病不同痰瘀证候主要临床特征及脏腑定位的信息,对冠心病不同痰瘀证候辨证及其分类研究具有一定的意义。     

利用RNA干扰技术抑制环氧合酶-2表达对人胃癌细胞系SGC-7901增殖和凋亡影响的实验研究

目的研究环氧合酶(COX)-2表达与肿瘤细胞增殖和凋亡的关系,探讨利用RNA干扰技术作为肿瘤基因治疗的方法。方法构建靶向COX-2的短发夹状双链RNA(shRNA)的真核表达质粒WBH1转染人胃癌细胞系SGC-7901,采用逆转录聚合酶链反应(RT-PCR)和Western印迹分别从mRNA和蛋白质水平检测抑制效果。四甲基偶氮唑蓝(MTT)和流式细胞仪检测COX-2表达被抑制后细胞的增殖和凋亡情况。15只裸鼠随机分为3组,每组5只,皮下接种胃癌细胞。抑制组接种转染抑制质粒的胃癌细胞;正常对照组接种未转染的胃癌细胞;阴性对照组接种转染阴性对照质粒的胃癌细胞。4周后观察比较各组裸鼠皮下形成瘤体的大体和病理情况并计算抑瘤率。结果WBH1高效特异地抑制了人COX-2的表达,抑制率达70.42%。COX-2表达被抑制后,细胞增殖受到明显抑制(P=0.002),细胞凋亡率明显增高,与未转染和转染阴性对照质粒的胃癌细胞的凋亡率相比有统计学意义(52.28%±17.91%、0.52%±0.27%、0.54%±0.16%,P=0.009,实验重复5次)。正常对照组和阴性对照组所有裸鼠均有瘤体形成,平均瘤重分别为(0.490g±0.017g,5只)和(0.490g±0.013g,5只)。抑制组仅2只有瘤体形成平均瘤重0.050g±0.003g,与正常对照组相比差异有统计学意义(P<0.01),抑瘤率为89.8%。结论COX-2与肿瘤细胞的增殖和凋亡密切相关,抑制细胞中COX-2的表达可以抑制肿瘤细胞增殖,促进肿瘤细胞凋亡。通过构建靶向COX-2的shRNA真核表达载体导入细胞可以高效特异地抑制人胃癌细胞中COX-2的表达。     

米非司酮在子宫黏膜下肌瘤宫腔镜术前的应用价值

目的：研究米非司酮（Ru486）在子宫黏膜下肌瘤宫腔镜术前的应用价值。方法：67例患者分两组。Ⅰ组31例服用Ru4863个月后实施经宫颈子宫肌瘤切除术（TCRM）．Ⅱ组36例直接行TCRM治疗。观察Ⅰ组Ru486治疗后不同时间肌瘤大小及血红蛋白变化；两组手术时间及术中出血量比较；子宫肌瘤大小与手术时间、术中出血量的相关性。结果：Ⅰ组治疗后1个月肌瘤较治疗前无明显缩小．治疗后两个月及3个月与治疗前比较肌瘤明显缩小，差异显著，P〈0．01；治疗后血红蛋白增高明显．P〈0．01；两组间手术时间、术中出血量比较差异显著．P〈0．05；子宫肌瘤大小与手术时间覆术中出血量均呈正相关。结论：Ru486作为TCRM术前的药物治疗可有效地缩小子宫肌瘤，相时扩大手术适应证，减少术中出血量，缩短手术时间；Ru486导致药物性闭经，有利于术前纠正岔血。     

RNA干扰及其技术的应用

RNA干扰(RNAi)是细胞内由双链RNA诱导降解与其配对的特定mRNA的过程。细胞内双链RNA在酶的作用下,形成20-25碱基大小的小干扰RNA(si RNAs),由si RNAs进一步掺入多组分核酸酶并使其激活,从而精确降解与si RNAs序列相同的mRNA,抑制该基因在细胞内的翻译表达。介绍了RNA干扰的分子机制、制备方法、以及RNA干扰技术在功能基因组学、微生物学、基因治疗和信号转导等研究领域里的应用。     

某外企流动人口风疹疫情爆发的调查

目的描述与分析某外企流动人口的风疹疫情,为制定预防控制策略提供科学依据。方法运用描述流行病学的研究方法。结果该次疫情确定为风疹的爆发,共发病15例,罹患率为3.19%;血清学检测结果,15例患者中有12例风疹抗体IgM阳性,阳性率为80.0%,经过采取环境消毒与应急预防接种等措施有效地控制了疫情。结论流动人口是传染病爆发的高危人群,应该加强对流动人口的公共卫生学监测,采取综合措施以减少风疹疫情的发生。     

Insular and anaplastic carcinoma of the thyroid: a 45-year comparative study at a single institution and a review of the significance of p53 and p21

OBJECTIVE: To analyze the clinicopathologic features of a large cohort of patients with insular or anaplastic carcinomas treated at a single institution. SUMMARY BACKGROUND DATA: Insular and anaplastic carcinomas of the thyroid, although uncommon, have more aggressive clinical behavior than well-differentiated carcinomas of the thyroid. In the literature, the incidence and features of these carcinomas have not been fully characterized. METHODS: The authors reclassified 740 primary thyroid carcinomas diagnosed and treated between January 1, 1954, and December 30, 1998, to select those with features that met the histologic criteria of insular or anaplastic carcinoma. The clinicopathologic features of these carcinomas were studied and compared. The expression of p53 and p21 in these tumors was analyzed by immunohistochemistry. RESULTS: Twenty-two patients (5 men, 17 women) with insular carcinoma and 38 patients (7 men, 31 women) with anaplastic carcinoma were found. Patients with insular carcinomas were younger (mean age 45 vs. 70 years) and had smaller tumors than those with anaplastic carcinomas (mean diameter 5 vs. 8 cm). Insular carcinomas were commonly mislabeled as other histologic subtypes, whereas anaplastic carcinomas might be overdiagnosed on pathologic examination. A history of longstanding goiter (>10 years) was noted in 27% of patients with insular carcinoma and 24% of patients with anaplastic carcinomas. Concomitant well-differentiated carcinomas of the thyroid were noted in 59% of patients with insular carcinoma and 39% of patients with anaplastic carcinoma. In anaplastic carcinomas, 13% of patients had concomitant insular carcinoma. Calcification or bone was noted in the stroma of 23% of patients with insular carcinomas and 47% of those with anaplastic carcinomas. The 10-year survival rates for patients with insular carcinoma and anaplastic carcinoma were 42% and 3%, respectively. Distant metastases were seen in 32% of patients with insular carcinoma and in 47% of patients with anaplastic carcinomas. In both types of carcinomas, metastatic tumors were often seen in bone and lung. Distant metastases were noted in a variety of organs in anaplastic carcinomas. In insular carcinoma, neither p53 nor p21 expression was present. In anaplastic carcinoma, p53 and p21 expression was identified in 69% and 3%, respectively. Concomitant expression of p53 and p21 was noted in one tumor. CONCLUSIONS: Insular carcinoma and anaplastic carcinoma had distinctive clinicopathologic features, and recognition of these histologic variants is important for better management of these tumors in the future. p53 overexpression might have a role in dedifferentiation from insular carcinoma to anaplastic carcinoma.     

1，3，5-三-甲酰基-2-去氧-2-氟-β-D-核糖的合成

目的 合成1，3，5-三-苯甲酰基-2-去氧-2-氟-β-D-核糖。方法以D-核糖为起始原料，经甲基化、苯甲酰化、溴代脱溴、乙酰化、重排、活化、氟代7步反应，合成目标化合物。结果产物的总收率14．1％，结构经熔点和核磁共振确认。结论所选合成路线减少了反应步骤，改善了反应条件，提高了反应收率。     

黄芪多糖对大鼠局灶性脑梗死的影响

目的:研究黄芪多糖对大鼠局灶性脑梗死的影响及其作用机制.方法:60只大鼠随机分为6组:假手术组,模型组,黄芪多糖大、中、小剂量(2,1,0.5g·kg-1·d-1,ig)组和阳性对照步长脑心通组(1 g·kg-1·d-1,ig),每组10只.治疗组于术后3 h,1 d,2 d,3 d和4 d给药,bid.用光化学诱导方法造成大鼠局灶性脑梗死,观察造模后各组大鼠的一般情况,进行神经功能评定;以及造模后5 d时各组大鼠的脑梗死体积及病理学变化,进行统计学分析.结果:神经功能评定各组大鼠间无统计学差异,脑缺血5 d后,黄芪多糖大、中剂量组与步长脑心通组脑梗死体积明显小于模型对照组及黄芪多糖小剂量组,梗死灶缺血性损伤明显减轻;黄芪多糖作为单药成分在大剂量给药时疗效可与步长脑心通复方制剂疗效相当.结论:黄芪多糖对光化学诱导大鼠局灶性脑梗死具有治疗作用.     

单、复凝聚法制备酮康唑微囊的性状和包封率比较

目的:比较单、复凝聚法制备微囊的外观性状和包封率,为进一步研究微囊的制备工艺打下基础。方法:以酮康唑作为囊芯物,用明胶和阿拉伯胶作囊材,采用常规的单、复凝聚法分别制备酮康唑微囊,并在光学显微镜下比较其外观性状;采用单波长紫外分光光度法建立微囊中酮康唑含量测定方法,在此基础上计算其药物包封率。结果:2种方法所得的微囊均为白色粉末,采用单凝聚法得到的微囊平均粒径为32.20μm, 相对包封率为56.11%;复凝聚法制备的微囊则分别为7.99μm和83.42%。结论:采用相分离-凝聚法制备微囊时,复凝聚法所得结果较好。