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??As one of drug or gene carriers, peptide-modified pH-sensitive liposomes can actively target the tumor tissues, release anti-tumor drugs in specific areas, reduce side effects of drugs, and improve their therapeutic potency. In this review, the modification methods of peptide-modified liposomes and their anti-tumor applications by gene transfection and drug delivery are introduced. This paper is expected to provide a reference for the preparation of peptide-modified pH-sensitive liposomes and design of carriers for anti-tumor drugs.     

杜氏肌营养不良疾病模型及基因治疗研究进展

杜氏肌营养不良（DMD）是一种X连锁隐性致死性遗传病，通常由基因突变致病，其发病机制复杂多样。该病的致病基因是人类最大的基因，位于Xp21.2区，编码抗肌萎缩蛋白。目前，DMD患者尚无有效的治疗方案。DMD的基因突变及分子机制研究可为其治疗研究打下基础，而后者的进行又需建立在DMD疾病模型之上，如mdx小鼠模型等。随着研究的深入，DMD基因治疗策略不断提出，并在动物模型上取得了不错的效果。除此之外，诱导多能干细胞技术可提供患者特异的细胞来源，为DMD发病机制及治疗研究提供新的平台。     

先天性泪囊突出的CT影像特征及治疗

目的 探讨先天性泪囊突出的CT影像特征及其对治疗方式选择的指导作用。设计 回顾性病例系列。研究对象 2008年6月至2015年6月北京儿童医院眼科先天性泪囊突出患儿24例（38眼）。方法 分析患儿的CT影像特征，总结其手术方式及术后效果。主要指标 CT影像特征、治疗方式、术后效果。结果 所有患者CT显示患侧泪囊区呈类圆形囊性低密度肿物影像，骨性鼻泪管扩大，伴有或不伴有下鼻道肿物。5例（5眼，13.2%）行保守治疗2周后肿物消失。19例（33眼，86.8%）伴发急性泪囊炎、呼吸窘迫或经保守治疗2周后无效而手术治疗。其中，无下鼻道肿物的5例（8眼，21.1%），局麻下泪道探通术后内眦肿物消失。存在下鼻道肿物的14例（25眼，65.8%），全麻下鼻窦内窥镜下造口术，术后内眦及下鼻道肿物全部消失。结论 CT检查不仅可清晰显示先天性泪囊突出的解剖特征，也为手术治疗方式选择提供影像学支持。     

新医改形势下对某医院基层进修人员的教学管理研究

新医改形势下,基层卫生服务需求增加与供给能力不足的矛盾迫使基层医院选派更多的人外出进修。对比新医改前后,在某医院进修的基层卫生人员数量和结构的变化发现,进修人员呈现数量增长、学历升高、职称仍然偏低的特征,接收进修生的教学医院存在教学资源紧张、教学模式落后、监管力度不足等问题,针对这些问题提出加大教学投入、创新教学模式、加强教学过程管理的建议。     

Neuroendocrine carcinoma of cardia:one case report

Neuroendocrine carcinomas(NECs)are exceedingly uncommon,and its incidence rate is about 1/100 000,about 10% of them is originated from the gastrointestinal tract[1].Here wereport a case of neuroendocrine carcinoma of cardia.     

阻塞性睡眠呼吸暂停低通气综合征患者术后听觉功能的研究

目的通过成年人重度阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapnea-hypopneasyndrome,OSAHS)患者手术前后听觉功能检查的对照研究,了解OSAHS患者术后听力康复的情况。方法对73例手术治疗的成年人重度OSAHS患者在术前和术后6个月分别行多导睡眠监测(PSG)、纯音测听及声导抗、听性脑干电位(ABR)及耳声发射(OAE)检测。另对20例无打鼾的健康志愿者同样行上述各项检测。结果①73例OSAHS患者术后随访治疗6月,其中治愈48例,显效22例,有效3例,总有效率为100%。②两组250⁴000Hz气导纯音测听结果无显著差异(P>0.05),>4000Hz高频听阈有显著差异(P<0.05);术后患者主观听觉明显改善,高频区听域提高>30dB(P<0.05)。③OSAHS组听性脑干反应波l、V潜伏期较对照组显著延长(P相似文献   

宫颈癌HeLa细胞特异性结合肽的筛选及鉴定

背景与目的:宫颈癌的分子靶向治疗具有很好的疗效,同时可以显著减少抗癌药物对人体自身的损伤,因此备受关注。本研究利用噬菌体体内展示技术筛选及鉴定宫颈癌特异性结合肽,将有可能成为化疗药物的靶向载体,为宫颈癌靶向药物治疗奠定基础。方法:体外培养宫颈癌HeLa细胞接种裸鼠,建立肿瘤动物模型。将随机肽库尾静脉注入裸鼠体内,循环15 min,心脏灌注后回收肿瘤组织噬菌体扩增、纯化并以此作为起始物进行第2轮的筛选,如此进行3轮体内筛选后挑取噬菌体克隆,进行免疫组化及ELISA实验,初步鉴定噬菌体克隆对宫颈癌细胞的亲和力及特异性,并将具有强亲和力的克隆进行测序。结果:ELISA结果显示,随机挑选10个噬菌体单克隆中8个克隆对HeLa细胞具有很强的亲和力,将这8个克隆进行测序,获得相同短肽序列LLRSTGF。结论:利用噬菌体展示技术筛选出与宫颈癌细胞HeLa特异性结合的短肽,进一步与化疗药物结合,为宫颈癌靶向治疗提供新的方法。     

What Should We Focus on in Sepsis Fluid Resuscitation?--A Research Based on Scientometrics and Visual Analysis

Sepsis is a life-threatening condition and a global disease burden.Heterogeneous syndrome is defined as severe organ dysfunction caused by a dysregulated host response to infection,with renewed emphasis on the immune pathophysiology.Researchers worldwide constantly update the diagnostic criteria of sepsis and have introduced concepts such as“sepsis-3”“Surviving Sepsis Campaign(SSC)”“Early Goal-Directed Therapy(EGDT)”,the 3-h and 6-h bundles to an hour-1 bundle[1],“limited ventilation”“the best PEEP[2]”,and“Lung Protective-Ventilation”.Despite all efforts of experimental and clinical research during the last three decades,the ability to positively influence the course and outcome of the syndrome remains limited.     

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??Allergic hypersensitivity reactions (AHRs) are the most commonly reported adverse reactions of traditional Chinese medicine injections, mainly including skin and mucosa redness, itching, abdominal pain, chest tightness, dyspnea and nausea, blood pressure decline, with clinical symptoms, and even shock or death?? In this paper, we analyzed the characteristics of clinical adverse reactions and preclinical study results of traditional Chinese medicine injections, and proposed a view of point that the main adverse reactions of traditional Chinese medicine injections are nonallergic hypersensitivity reactions (NHRs) or pseudoallergic reactions (PARs) instead of real AHRs?? Because there are absolute differences in the characteristics and the pathogenesis mechanisms between PARs and AHRs, they should not be confused, otherwise, the clinical processing measures and the direction of basic research on the adverse reactions of traditional Chinese medicine injections would be misleading This paper also discussed the approaches for risk prevention and control of PARs of traditional Chinese medicine injections.     

肿瘤科护理人员职业防护现状调查与对策

目的通过对肿瘤科护士对职业防护相关认知水平及护士自我防护现状的调查,有效落实职业防护措施。方法采用自行设计的调查问卷,对某三甲医院肿瘤科在编护理人员进行职业防护相关知识及防护行为的调查,观察职业防护措施的实施情况。根据调查结果对肿瘤科护士进行培训,制定相应的对策并加以落实。结果调查问卷有效回收率100%,培训后较培训前护理人员职业危害知晓度情况及职业危害防护措施实施情况均有较大幅度提高。结论加强肿瘤专科各层级护士职业防护相关知识的培训,可提高护士职业防护的意识;制定相应的职业防护规范,可有效落实各种防护措施,降低病人之间的辐射和护理人员的职业危害。