基孔肯雅热确诊患者81例临床分析

基孔肯雅热( chikungunya fever,chik)是以伊蚊为传播媒介的急性传染病,主要流行于东南亚和非洲的部分国家和地区[1].1987年,我国云南西双版纳曾发现chik患者,并从其血液中分离出病毒[2].2008年3月起,我国广东省广州市、茂名市,浙江省杭州市等先后出现了基孔肯雅热输入性散发病例[3-5].2010年10月,广东省东莞市报告了全国首起基孔肯雅热社区疫情.作为一种在我国新发的传染病,掌握其临床学特点可指导临床医师对患者的救治并为修订该病的防治指南提供参考.     

Antitumor effects of OSU-2S, a nonimmunosuppressive analogue of FTY720, in hepatocellular carcinoma

Accumulating evidence suggests the therapeutic potential of the immunosuppressive agent FTY720 (fingolimod) in hepatocellular carcinoma (HCC). Based on our previous finding that FTY720 mediates apoptosis in HCC cells by activating reactive oxygen species (ROS)-protein kinase Cδ (PKCδ) signaling independent of effects on sphingosine-1-phosphate (S1P) receptors, we embarked on the pharmacological exploitation of FTY720 to develop a nonimmunosuppressive analogue with antitumor activity. This effort led to the development of OSU-2S, which exhibits higher potency than FTY720 in suppressing HCC cell growth through PKCδ activation. In contrast to FTY720, OSU-2S was not phosphorylated by sphingosine kinase 2 (SphK2) in vitro, and did not cause S1P1 receptor internalization in HCC cells or T lymphocyte homing in immunocompetent mice. Although devoid of S1P1 receptor activity, OSU-2S exhibited higher in vitro antiproliferative efficacy relative to FTY720 against HCC cells without cytotoxicity in normal hepatocytes. Several lines of pharmacological and molecular genetic evidence indicate that ROS-PKCδ-caspase-3 signaling underlies OSU-2S-mediated antitumor effects, and that differences in the antitumor activity between FTY720 and OSU-2S were attributable to SphK2-mediated phosphorylation of FTY720, which represents a metabolic inactivation of its antitumor activity. Finally, OSU-2S exhibited high in vivo potency in suppressing xenograft tumor growth in both ectopic and orthotopic models without overt toxicity. CONCLUSION: Using the molecular platform of FTY720, we developed OSU-2S, a novel PKCδ-targeted antitumor agent, which is devoid of S1P1 receptor activity and is highly effective in suppressing HCC tumor growth in vivo. These findings suggest that OSU-2S has clinical value in therapeutic strategies for HCC and warrants continued investigation in this regard.     

改良经腹穿刺L2-5椎间盘髓核摘除术的可行性研究

目的研究和探索对L2-L5（L2/3-L5/S1）椎间盘突出和突出并髓核迁移病例安全有效的介入治疗新途径,拓宽适应证的范围。方法通过对3具尸体、3条杂种成年犬实验,确立经腹穿刺L2-5椎间盘髓核摘除术的可行性,并对28例病人施行了CT和/或C型臂监视下经腹前入路腰椎间盘摘除术。L5/S121例、L4/55例、L3/41例、L2/31例。结果28例手术病人总有效率为96%,未发现因损伤大血管造成大出血病例。结论经腹穿刺L2-5椎间盘可达直接减压的目的,手术切实可行,具有痛苦少、疗效可靠等优点,是一种可行的介入治疗方法。     

鼻内窥镜下微波电凝治疗鼻出血临床疗效

目的评价鼻内窥镜下微波电凝止血治疗鼻出血的临床疗效。方法选择84例鼻出血患者,随机分为两组,分别采用凡士林纱条填塞和鼻内窥镜微波电凝止血术,比较术后患者鼻腔疼痛或头痛状况,及抽取填塞物时的出血状况、术后复发情况。结果采用鼻内窥镜微波电凝止血术患者的鼻腔疼痛或头痛状况、抽取填塞物时的出血状况、术后复发情况,均优于采用凡士林纱条填塞的患者,其差异均有统计学意义(P<0.05)。结论经鼻内窥镜下微波电凝止血术,更为有效、安全,更能减轻患者的痛苦和不良刺激。     

Unexpected synergy between N-phosphonacetyl-l-aspartate and cytidine against human tumor cells

Cytidine, a non-toxic endogenous nucleoside, was found unexpectedly to augment the cytotoxicity of a pyrimidine antimetabolite N-phosphonacetyl-l-aspartate (PALA) in human ovarian carcinoma cells. The PALA/cytidine synergy is confirmed here in other human tumor cells (T242 melanoma, HL60 promyelocytic leukemia and SKOV3 ovarian carcinoma) in the cytidine concentration range of 1–10 micromolar. The synergy was not observed in Chinese hamster ovary (CHO) cells. Exogenous uridine (5–50 μM) completely reversed the PALA/cytidine cytotoxicity in a concentration-dependent manner. Measurements of cellular ribonucleotide levels revealed that the PALA treated cells had reduced UTP and CTP pools (10% and 40% of control respectively); and the PALA/cytidine treated cells had elevated CTP and GTP levels while their UTP levels remained at 10% of control. Deoxyribonucleotide levels were unremarkable except for a slight elevation of dCTP in the PALA/cytidine treated cells. Uridine competitively inhibited radioactive cytidine transport into 2008 cells, which may explain its ability to antagonize the PALA/cytidine synergy. These results suggest that the ribonucleotide biosynthetic mechanism is the primary cellular target for PALA/cytidine activity, and that the ratio of ribonucleotides to each other is an important determinant of tumor cell viability. The use of non-cytotoxic nucleosides to augment the activity of antimetabolites may have clinical relevance in cancer therapy.     

LASIK后角膜后表面形态的研究

目的：研究激光角膜原位磨镶术（LASIK）前后,角膜后表面屈光度及曲率半径的改变以及影响因素。方法：随机选择停戴隐形眼镜一月以上的中高度近视41眼进行LASIK治疗,依角膜光学区直径的不同,分3mm区及5mm区两组,应用Orbscan分别观察分析其术前及术后3天、3月角膜后表达屈光度和曲率半径。结果：各组术前与术后各期相比,角膜后表面屈光度和曲率半径的改变均有显著性意义（P＜0.05),角膜中央变化较周边明显（P＜0.05）,角膜3mm区术后3月与3天相比差异有显著性意义（P＜0.05),角膜后表面曲率半径的改变与患眼正常眼压无关,与 术后角膜厚度存在统计学相关性（r=-0.6,P＜0.05),厚度小于350μm时角膜后表面形态变化较厚度大于350μm时明显（P＜0.01)。结论：激光角膜原位磨镶术可引起角膜后表面屈光度增大,曲率半径减少,术后角膜厚度是主要影响因素,将术后角膜厚度大于350μm作为安全指标仍需作进一步的研究。     

鼻咽癌细胞中表达上调的新基因 NAG23 (FBXO 30) 的克隆与分析

目的：分离位于6号染色体长臂鼻咽癌高频等位基因不平衡位点D6S1581（6q25.3-27）附近与鼻咽癌相关的新基因。方法：运用差异RT－PCR检测定位于D6S1581附近的11个表达序列标签（expressed sequence tage,EST)在正常人鼻咽上皮细胞和鼻咽癌细胞系中的表达水平,并对其中一个表达上调的EST在鼻咽癌组织和正常鼻咽组织中的表达情况进行分析。用Northern杂交验证其表达差异并检测其在多脏器中的表达及所代表基因的转录本大小。利用生物信息学资源克隆并获得其全长cDNA ,对该序列进行初步分析。结果：获得了一个位于6q25．3－27的在鼻咽癌中表达上调的新基因,命名为NAG23（FBXO30）(GenBank收录编号：AF248640）。该基因在68．9％的鼻咽癌活检组织中表达上调,cDNA全长3301bp,预测其开放阅读框编码一个含390个氨基酸的胞浆蛋白,该蛋白含一个F－box基序。结论：NAG23基因是一个在鼻咽癌中表达上调的新基因,很可能编码一新的F－box蛋白。NAG23可能参与了鼻咽癌的发生发展。     

胃癌的局部免疫细胞反应

目的 观察胃癌局部免疫反应细胞与胃癌生物学行为的关系。方法 对107例有3－8年随访资料的胃癌根治性切除标本作局部免疫细胞反应程度的观察。淋巴－浆细胞反应和嗜酸性白细胞反应用图像分析系统作定量测定,肥大细胞在光镜下以下／nm^2作定量计数,然后以均数作界值分为高反应组和低反应组,并分析与临床病理参数的关系。结果 患者存活时间、肿瘤浸润深度和淋巴结构情况在胃癌局部免疫细胞反应的高反应组和低反应组间存在显著差异（P＜0．05）。结论 胃癌局部免疫细胞反应是宿主重要的抗瘤免疫防御机制。     

EGFr蛋白在原发性及AOH诱导的食管癌中的高表达

目的 探讨交链孢酚诱导食管癌的发生机制。方法 采用免疫组化ＡＢＣ法,分别对经ＡＯＨ处理２４ｈ、１周和３周的人胎儿食管上皮组织及原发性食管癌组织、癌旁“正常”上皮进行ＥＧＦｒ蛋白表达的检测。结果 ＡＯＨ诱导２４ｈ人胎儿食管上皮中即有ＥＧＦｒ蛋白过表达,并一直持续到第３周;原发性食管癌组织,两者具有显著性差异（Ｐ〈０．０５）。结论 ＡＯＨ可以激活ＥＧＦｒ,ＥＧＦｒ蛋白表达有是食管癌上皮变的启动变化,并