MT2-MMP expression associates with tumor progression and angiogenesis in human lung cancer

Matrix metalloproteinases (MMPs) are a family of important proteolytic enzymes that play an important role in the remodeling of the tumor microenvironment and associate with tumorigenesis and metastasis. We previously reported that membrane type-2 MMP (MT2-MMP) is highly expressed in human esophageal cancer tissues, and its expression level is positively correlated to tumor size and intratumoral angiogenesis. In order to reveal whether MT2-MMP expression is operative in human lung cancer and its underlying physio-pathological role, in the present study, we examined both mRNA and protein expression levels of MT2-MMP in non-small cell lung caner (NSCLC) tissues and in adjacent normal tissues by using real-time RT-PCR and immunohistochemistry respectively, which showed that both MT2-MMP mRNA (P=0.0359) and protein (P<0.0001) expression levels were significantly increased in cancer tissues in contrast to adjacent normal tissues. Moreover, we also found that the MT2-MMP protein level in cancer tissues positively correlated to lymph node metastasis (P=0.0483), tumor stage (P=0.0483), intra-tumoral microvessel density (MVD) (P=0.0445). We have not found statistically significant correlation between MT2-MMP expression and patients’ prognoses, but we found that the patients with both higher MT2-MMP protein expression and higher intra-tumoral microvessel density showed better prognoses than that of the patients with either higher MT2-MMP protein expression or higher intra-tumoral microvessel density (P=0.0311). Thus, our data suggest that MT2-MMP expression positively involves in NSCLC, and might play an important role in promoting the tumor progression and intra-tumoral angiogenesis in NSCLC.     

参麦注射液对兔肺缺血再灌注损伤时脂质过氧化的影响

目的 探讨兔肺缺血/再灌注损伤时脂质过氧化的变化和参麦注射液的影响,为临床防治提供理论依据.方法 实验兔70只,随机分为3组:假手术组(C组,n =10)、缺血/再灌注组(I/R1、3、5h组,n=10)和参麦注射液干预组(SM1、3、5h组,n=10).采用在体兔单侧肺原位缺血/再灌注损伤模型,参麦注射液干预组于缺血前20min经耳缘静脉注射参麦注射液15ml/kg,其余处理同缺血/再灌注组.分别于上述时间点抽取动脉血,检测血清超氧化物歧化酶(SOD)活性及丙二醛(MDA)浓度;提取肺组织,检测肺湿干重比(W/D)以及肺泡损伤数定量评价指标(IQA).结果 与C组比较,I/R3h组和I/R5h组SOD活性下降(P＜0.01),MDA浓度、W/D及IQA均升高(P＜0.01);与I/R组比较,SM组在相应时间点的SOD活性升高(P＜0.01),MDA浓度、W/D和IQA均下降(P＜0.01).结论 参麦注射液可通过抑制氧自由基的生成,减轻脂质过氧化对肺缺血/再灌注损伤的肺组织发挥积极的保护作用.     

难治性抑郁症脑局部葡萄糖代谢的初步研究

目的 探索难治性抑郁症的脑局部葡萄糖代谢模式.方法 对符合国际疾病分类标准第10版(ICD.10)抑郁症诊断标准的8例难治性抑郁症患者和8名正常对照进行静息态正电子发射计算机断层/18F-氟代脱氧葡萄糖(PET/FDG)扫描,利用参数统计图(SPM2)方法分析组间脑局部代谢差异.结果 患者组的双侧额中回、左侧眶额皮质、左顶下小叶、左腹侧前扣带回、右侧额下回、右颞是回和颞中回以及双侧背侧前扣带回FDG代谢水平明显低于对照组;而左侧中央前/后回、右侧额内侧回、右颞极、右岛叶以及双侧小脑等脑区代谢水平则明显高于对照组.上述差异均有统计学意义(P<0.005).结论 难治性抑郁症患者存在旁边缘系统代谢增高和皮质代谢降低的交互性改变的异常代谢模式.     

湖南省公立医院改革研究

2016年10月,湖南省14个市州全面启动公立医院综合改革,成效显著。以药补医局面已从根本上扭转,分级诊疗有序推进,医疗费用过快增长有所遏制,薪酬制度改革积极试点。但仍面临公立医院绩效管理不规范、居民个人医疗经济负担过重、医保资金浪费等问题。需以公益性为导向,严控公立医院规模扩张,硬化政策执行和责任追究,提高医保资金使用效率。     

医疗机构分类管理的几个问题探讨

在我国医疗卫生事业蓬勃发展的今天,客观上要求对医疗机构进行分类管理。要坚持主观和客观依据相结合,科学地区分非营利性和营利性医疗机构;借鉴国际医疗机构分类经验,合理地确定两类医疗机构的构成比例;认真解决改造医疗机构分类中的认识问题,转变政府对医疗卫生事业管理的职能,树立大卫生观念;采取优惠政策,为公立医院改造成营利性医院创造良好的社会环境。只有在积极稳妥的基础上对现有公立医疗机构分类改造,才能如期建立新的医疗机构分类管理制度。     

Recurrent pacemaker-mediated arrhythmia with a right bundle branch block pattern in a patient with a cardiac resynchronization therapy device

Under certain conditions, cardiovascular implantable electronic devices can be directly involved in initiating and sustaining pacemaker-mediated arrhythmias (PMA), of which repetitive reentrant ventriculoatrial synchrony (RRVAS) is the most well-known and common type. RRVAS, also known as pacemaker-mediated tachycardia, was commonly secondary to atrioventricular (AV) dissociation and subsequent ventriculoatrial (VA) conduction. RRVAS in a biventricular system is rare due to its less predisposition to the appearance of AV dissociation and subsequent VA conduction, but urgent in its adverse impact on cardiac resynchronization therapy (CRT), which may predispose to exacerbated heart failure. We present a rare case of recurrent PMA manifested as a right bundle branch block pattern in a patient with a CRT device. Notably, most episodes of PMA were triggered by a premature atrial contraction accompanied by the appearance of VA conduction with no prolongation of AV delay. In this study, we have demonstrated the impact of the appearance of VA conduction due to the loss of capture of right ventricular lead and its potential risk for inducing RRVAS in a CRT device.