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??OBJECTIVE To analyze the regularity, clinical reactions and outcomes of the adverse reaction of sorafenib to provide reference for safe medication in clinical practice. METHODS The case reports of sorafenib ADR which were published at international medical academic periodicals during 2006-2016 were collected and analyzed statistically in respect of gender, age, disease informations, clinical manifestation and RESULTS of treatment. RESULTS A total of 93 adverse reactions were identified and included in the analysis, 22 cases were unexpected ADR. The ADR happened in male was more than in female, and the age of 61-80 was the most common population (45.16%). The ADR was mostly happened in 1 month (71.11%) after therapy. Lesions of skin and its appendants were the most commonly reported ADRs (51.52%), followed by the lesions of digestive system (22.73%) ,which reported the most of the death cases (n=19 , 6 death). The ADR correlation rate was high in these case reports. CONCLUSION Multiple organ systems are involved in the ADRs of sorafenib, amd careful clinical observation and symptomatic treatment in time are necessary.     

非糜烂性反流病和糜烂性食管炎患者心理状况及生活质量调查

目的 比较非糜烂性反流病(NERD)和糜烂性食管炎(EE)患者的反流症状、心理状况和生活质量等情况,为更好的诊治胃食管反流病提供帮助.方法 对274例胃食管反流病(GERD)患者及75例正常对照者进行问卷调查,包括一般资料、反流症状、食管外症状、精神心理状况及生活质量评价.结果 274例GERD患者中EE患者97例(35.4%),NERD患者143例(52.2%),Barrett食管患者34例(12.4%);与EE比较NERD患者中女性多见(62.2%VS 47.4%,P＜0.05).EE组与NERD组患者年龄、体质量指数(BMI)及食管外症状发病率差异无统计学意义.GERD患者的反流症状评分、焦虑抑郁评分及食管外症状发病率均明显高于正常对照者(P＜0.01),且生活质量评分低于正常对照者;与EE组比较,NERD患者反流症状、精神心理异常更明显,生活质量下降也更严重(P＜0.01).结论 与EE患者相比,NERD患者有更明显的反流症状、更突出的精神心理因素,及更严重的生活质量损害,对NERD患者应重视包括心理治疗在内的综合治疗.     

糖基转移酶Colgalt2基因敲除对肝细胞再生过程中增殖和凋亡的作用研究

目的初步探讨Colgalt2基因敲除对小鼠肝细胞再生过程中细胞增殖和凋亡的作用。方法根据Higgins和Anderson于1931年提出的肝大部分切除模型,实施Colgalt2+/+野生型对照组小鼠和Colgalt2-/-小鼠(均为C57BL/6J品系)70%肝大部分切除术(PH),分别取正常小鼠和PH后1、3、7天的小鼠再生肝脏的右外叶,于10%中性福尔马林固定,石蜡包埋,切片。采用免疫组织化学方法比较细胞增殖核抗原(PCNA)在小鼠肝部分切除术后各时间点组间的表达阳性率差异;胶原酶两步灌注法分别分离正常和PH后1、3、5天的Colgalt2+/+小鼠和Colgalt2-/-小鼠的肝细胞。流式细胞仪检测各组肝细胞凋亡率。结果 PH后1、3、7天,Colgalt2-/-小鼠肝细胞PCNA阳性表达率显著高于Colgalt2+/+小鼠肝细胞PCNA阳性表达率,且差异有显著统计学意义(P0.01)。分离的肝细胞活细胞比率达94%,正常Colgalt2+/+小鼠和Colgalt2-/-小鼠分离的肝细胞凋亡率分别为(23.36±0.83)%、(21.04±1.16)%;PH后1天,Colgalt2+/+对照组小鼠肝细胞凋亡率和Colgalt2-/-小鼠肝细胞凋亡率分别为(8.27±0.33)%、(8.44±0.30)%,PH后1天肝细胞凋亡率均降至最低,随即肝细胞凋亡率逐渐升高;PH后3天,Colgalt2+/+小鼠和Colgalt2-/-小鼠肝细胞凋亡率分别为(15.92±0.56)%、(12.14±0.37)%,Colgalt2-/-小鼠的肝细胞凋亡率明显低于野生型对照组小鼠的肝细胞凋亡率(P0.01);PH后5天,Colgalt2+/+小鼠和Colgalt2-/-小鼠肝细胞凋亡率分别为(21.36±0.51)%、(18.92±0.92)%,Colgalt2-/-小鼠的肝细胞凋亡率仍低于野生型对照组小鼠的肝细胞凋亡率(P0.05),肝细胞凋亡率均接近于恢复正常水平。结论糖基转移酶Colgalt2基因敲除在肝再生过程中在一定程度上具有促进肝细胞增殖和抗肝细胞凋亡的作用,提示该基因介导的胶原Glcα1,2Galβ1-糖基化修饰对肝再生可能起着重要的调控作用。     

健康预期寿命研究进展

近年来,随着老年人口的增多和寿命的延长,寿命中的生命质量日益成为社会关注的热点.之前用于评估人群健康状态和决定老龄人口政策制订所采用的指标是预期寿命(life expectancy),但预期寿命只能反映生命的数量,无法反映生命的质量.     

慢性肾脏病患者贫血治疗与血红蛋白变异度研究

目的评价慢性肾脏疾病(CKD)患者在专科门诊规律随访的贫血治疗效果及血红蛋白变异度情况,为采取相应对策提供依据。方法对入选的129例(CKD)患者按照指南进行规范的贫血治疗,记录疾病信息,抽取血样标本化验相应指标,对观察结果进行分析。结果对129例调查对象进行分析,贫血治疗血红蛋白不达标者未使用促红细胞生成素和铁蛋白水平不达标者未使用铁剂的例数均显著降低,铁剂使用例数显著增加。经过规律随访治疗半年后,患者血红蛋白变异度指标显著降低。结论 CKD专科门诊随访可更加规范CKD患者贫血的治疗,经过规律随访治疗一段时间,可有效降低患者血红蛋白的波动水平。     

HPLC同时测定荜茇中胡椒碱和荜茇明宁碱含量

目的:采用HPLC同步测定荜茇中胡椒碱和荜茇明宁碱的含量,为荜茇药材多指标质量控制奠定基础.方法:以荜茇药材中胡椒碱和荜茇明宁碱为指标成分,应用C18(4.6 mm×250 mm,5μm)柱,流动相0.25％甲酸-甲醇(35∶65),流速为1 mL·min-1,检测波长343 nm,柱温40℃.结果:胡椒碱和荜茇明宁碱的峰面积与浓度的线性关系良好(r=0.999 9),平均加样回收率为100.4％,102.2％,RSD分别为2.6％,2.5％.建立了同时对荜茇中的2个成分进行定量的测定方法,并将此方法用于不同来源的荜茇各成分的测定.结论:该方法简便快捷,重复性良好,为中药材荜茇提供了更合理、可靠的质控方法.     

Hyaluronic acid hydrogel loaded with genetically-engineered brain-derived neurotrophic factor as a neural cell carrier

Cell transplantation is a potential therapy for central nervous disorders such as Parkinson's disease. However, the therapeutic effect is limited by the low viability of transplanted cells. To solve this problem, we synthesized hyaluronic acid (HAc)-based hydrogel to be used as a carrier for neural cells. Another feature of the hydrogel synthesized here is to incorporate brain-derived neurotrophic factor (BDNF) for enhancing cell survival in the hydrogel. The cross-linking of HAc and the incorporation of BDNF were both achieved by employing the ability of a hexahistidine peptide to form stable chelate with metal ions. HAc was reacted with N-(5-amino-1-carboxypentyl) iminodiacetic acid and chelated with Zn(II) ions. An alpha-helical peptide of 70 amino acid residues carrying a hexahistidine peptide (His) at the both termini and BDNF carrying a His at the C-terminus were synthesized by recombinant DNA technology. These polypeptides were coordinated with the Zn(II) ions chelated to HAc chains for both the cross-linking of HAc and the tethering of BDNF. Viscosity measurements revealed that intermolecular cross-links were introduced in the Zn(II)–chelated HAc chains upon mixing with the His-containing helical peptide. It was shown by release tests that the coordinated BDNF was firmly bound to the Zn(II)-chelated HAc for more than 12 days. The results of cell culture experiments combined with live/dead assays demonstrated that a significantly higher fraction of neural cells survived 3 days post-seeding in the HAc-based hydrogel incorporating BDNF than in the control hydrogel lacking BDNF. These results suggest that the HAc-based hydrogel developed here has potential to improve survival of transplanted neural cells.     

经瞳孔温热疗法(TTT)治疗脉络膜黑色素瘤实验研究

目的探讨人脉络膜黑色素瘤经瞳孔温热疗法(TTT)治疗后的组织病理学变化。方法选用5例经临床TTT治疗不能控制的脉络膜黑色素瘤病人摘除眼球,行组织病理学检查和免疫组织化学研究。结果TTT治疗后,在激光斑照射的肿瘤部位,最外层为湿性坏死区,其细胞结构消失。中间为干性坏死区,细胞核固缩,在干性坏死区及其激光斑基底部可见肿瘤毛细血管呈扩张状态。结论TTT治疗脉络膜黑色素瘤可以直接摧毁肿瘤组织导致坏死,但如果瘤体组织太厚,不能完全破坏,则肿瘤下方组织激光后会引起局部毛细血管扩张,是否会加重转移,应引起重视。     

多囊卵巢综合征患者C-反应蛋白、血脂与临床内分泌特点相关性研究

目的通过对多囊卵巢综合征(PCOS)患者和年龄、体重相匹配的正常妇女进行C-反应蛋白(CRP)、血脂的检测寻找多囊卵巢综合征妇女易患心血管疾病的风险因素。方法64例PCOS和20例年龄、体重匹配的正常健康妇女进行体重指数(BMI)计算、葡萄糖耐量试验(OGTT)、血清胰岛素(INS)、血脂和CRP的测定,比较肥胖、非肥胖;胰岛素抵抗、非胰岛素抵抗;高雄激素、雄激素正常的血脂、C-反应蛋白血中水平。结果PCOS患者总胆固醇(CHO)、CRP明显高于正常对照组,而高密度脂蛋白(HDL)却低于对照组;肥胖的PCOS患者CHO、CRP明显高于非肥胖PCOS患者和对照组,PCOS患者超敏C-反应蛋白(SCRP)水平高于对照组,肥胖的PCOS患者高密度脂蛋白(HDL)低于非肥胖PCOS患者和对照组;胰岛素抵抗的PCOS患者CRP、甘油三酯(TG)明显高于非胰岛素抵抗的PCOS患者,而HDL却低于非胰岛素抵抗者,SCRP高于对照组;高雄激素PCOS患者血清CRP、SCRP水平明显高于雄激素正常组,高雄激素PCOSTG高于雄激素正常组和对照组,而HDL却低于这两组。CRP与肥胖关系最为密切。结论PCOS患者的心血管疾病的风险不是某一个因素决定的,而是多种代谢异常综合作用的结果。肥胖、胰岛素抵抗、高雄激素均是PCOS患者易患心血管疾病的风险因素,但是肥胖与CRP的关系更为密切。     

代谢综合征组分与尿微量白蛋白、踝肱指数的相关性研究

目的:探讨代谢综合征(MS)组分与尿微量白蛋白排泄率(UAER)、踝肱指数(ABI)之间的关系。方法:选取227例住院2型糖尿病患者,所有受试者检测体重指数、血压、血脂、HOMA模型胰岛素抵抗指数(HOMA-IR)、UAER及ABI。MS诊断依据2004年中华医学会糖尿病学分会建议标准。根据MS组分的不同,分为MS1、MS2和MS3三组;根据糖尿病肾病诊断标准,UAER<20μg/min为MAU-组,>20μg/min为MAU+组;根据ACC/AHA制定的外周动脉病变(PAD)实践指南:1.0≤ABI<1.3为正常,0.9≤ABI<1.0为可疑PAD,0.6≤ABI<0.9为轻度PAD,ABI<0.6为中重度PAD。结果:随着代谢异常组分数的增加,ABI水平逐渐降低,依次为1.02(0.97～1.06)、0.98(0.91～1.03)、0.96(0.89～1.02),UAER水平逐渐升高,依次为7.64(5.30～14.17)μg/min、10.03(6.10～34.78)μg/min、18.67(8.70～54.80)μg/min,各组间比较差异均有统计学意义(P<0.05);MAU和PAD患病率逐渐增加,依次为18.7%、31.9%、50.0%和10.7%、20.2%、20.7%。与MAU-组相比,MAU+组高血压检出率(50.7%比73.3%,P<0.01)增加。与1.0≤ABI<1.3组相比,0.6相似文献