四君子汤对缺血再灌注损伤大鼠自由基代谢影响的实验研究

从抗氧化角度探讨了四君子汤抗氧化的作用机制。结果表明，显著提高缺彬再灌损伤大鼠脑、血清中SOD活力，降低MDA含量；在体外实验中，明显抑制脑过氧化脂质的生成，具有清除羟自由基、超氧阴离子的作用。结论是四君子汤具有一定的抗氧化作用，健脾化痰抗氧化理论有一定的实验依据。     

齿槽裂修复方法的研究进展

目的 探讨齿槽裂修复治疗的目的、方法以及治疗时机的选择。方法 查阅1950年至2006年有关齿槽裂修复的文献，归纳文献中报道的不同方法，并评价其各自的优缺点。结果 齿槽裂修复的主要目的：关闭口鼻瘘；建立稳定、连续的上颌骨牙弓；为牙齿萌出提供基础；为上唇和鼻底提供稳定支架。主要治疗方法：植骨术；牵引成骨技术；组织工程骨和生长因子应用；引导骨再生技术。患者最佳的手术治疗时机是9～11岁时混合牙列期。结论 在9～11岁混合牙列期手术，以髂骨松质骨为移植材料被认为是修复齿槽裂的主要手段。牵引成骨技术、组织工程技术和引导骨再生技术，将是齿槽裂修复的新方向。     

Five years experience of transrectal high-intensity focused ultrasound using the Sonablate device in the treatment of localized prostate cancer

BACKGROUND: High-intensity focused ultrasound (HIFU) is a minimally invasive technique used in achieve coagulation necrosis. We evaluated biochemical disease-free survival rates, predictors of clinical outcome and morbidity in patients with localized prostate cancer treated with HIFU. METHODS: A total of 181 consecutive patients underwent HIFU with the use of Sonablate (Focus Surgery, Indianapolis, IN, USA). Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The median age and pretreatment prostate-specific antigen (PSA) level were 70 years (range 44-88) and 9.76 ng/mL (range 3.39-89.60). A total of 95 patients (52%) were treated with neoadjuvant hormones. The median follow-up period for all patients was 18.0 months (range 4-68). RESULTS: The biochemical disease-free survival rates at 1, 3 and 5 years in all patients were 84%, 80% and 78%, respectively. The biochemical disease-free survival rates at 3 years for patients with pretreatment PSA less than 10 ng/mL, 10.01-20.0 ng/mL and more than 20.0 ng/mL were 94%, 75% and 35%, respectively (P<0.0001). Multivariate analysis identified pretreatment PSA (P<0.0001) as a independent predictor of relapse. CONCLUSION: High-intensity focused ultrasound therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/mL.     

激素间歇冲击及小剂量维持治疗IgA肾病的随机对照研究

目的:探讨激素间歇冲击及小剂量维持与血管紧张素转换酶抑制剂治疗中度蛋白尿IgA肾病的疗效及其影响因素。方法:47例IgA肾病患者随机分为实验组和对照组。对照组(21例)给予ACEI药物治疗,实验组(26例)在此基础上口服泼尼松0.5mg/kg,隔日给药,治疗12个月,并在治疗的第1、3、5个月初分别给予甲基泼尼松龙0.5g/d,冲击3d。对肾脏病理改变进行WHO分级并对各种病变进行半定量分析。结果:两组间在性别、年龄、临床及病理资料间无统计学差异。平均随访14个月后,实验组尿蛋白完全缓解8例(30.8%),部分缓解14例(53.8%),无缓解4例(15.4%);而对照组分别为4例(19.1%),3例(23.8%),12例(57.1%),有统计学差异(P<0.01)。治疗前后,实验组血肌酐分别为(89.9±30.3)μmol/L及(88.2±32.8)μmol/L;对照组分别为(89.5±37.9)μmol/L及(104.0±49.7)μmol/L,但两者比较均无统计学意义(P>0.05)。多因素分析显示疗效与肾小球硬化率及肾小管间质病变呈负相关。结论:激素间歇冲击及小剂量维持治疗能显著减少蛋白尿,维持肾功能稳定。影响疗效的主要因素为肾小球硬化率及肾小管间质病变程度。     

瘦素、C-反应蛋白与老年急性冠脉综合征患者的相关研究

目的探讨急性冠脉综合征(ACS)患者血浆瘦素(LP)及C-反应蛋白(CRP)水平的变化及其临床意义。方法测定急性心肌梗死组(AMI组)、不稳定型心绞痛组(UA组)、对照组(健康体检者)血浆LP及CRP浓度,分析LP、CRP与病情严重程度的关系以及LP与CRP的相关性。结果AMI组、UA组患者血浆LP、CRP浓度较对照组显著升高(P<0.01),2组患者血浆LP与CRP浓度之间均呈显著正相关;AMI组血浆LP、CRP浓度比UA组明显升高(P<0.05)。结论血浆LP及CRP浓度与ACS病情严重性呈正相关,且LP与CRP浓度呈正相关。说明LP与CRP共同参与组织炎症反应,是ACS重要的危险因素及预测因子。     

复方丹参注射液干扰素治疗乙肝后肝纤维化

目的探讨复方丹参注射液联合干扰素治疗慢性乙肝患者的疗效。方法110例慢性乙肝患者，按随机方法分成①对照组30例，应用普通保肝药物治疗，疗程6个月；②丹参组30例，应用复方丹参注射液（每ml含丹参、降香各1g）30ml加入10％葡萄糖溶液300ml中静脉注射1个月；③IFN组30例，应用IFN—α 3MU，隔日一次肌内注射，3个月；④联合组20例，应用复方丹参注射液30ml加10％葡萄糖溶液300ml静脉注射1个月，IFN-α 3MU，隔日一次肌内注射，3个月。丹参组，IFN组和联合组保肝药物治疗同对照组。四组病例在性别、年龄、病程，治疗前肝功能等方面均无统计学差异。治疗前检测肝功能，肝炎病毒标志，血清HA、IV—C、PCI—Ⅱ，部分病例进行肝穿病理检查。治疗开始后每月检测肝功能，3个月（治疗后）和6个月（随访时）时检测血清HA、IV—C、PCⅢ及乙肝病毒标志，治疗后1年行肝穿病理检查。结果治疗前四组患者血清HA、PCⅢ、IV—C水平无统计学差异；治疗后丹参组、IFN组、联合组血清HA、FCⅢ、IV—C水平较治疗前及对照组有不同程度的降低。结论复方丹参注射液联合IFN治疗可使血清HA、PCⅢ、IV—C有明显下降，肝组织病理改变明显改善，为目前有效的慢性乙肝治疗措施。     

对血脂异常人群实施生活方式干预后的观察

目的：探讨生活方式治疗在血脂异常人群中的作用，观察其效果。方法：100例在体检中发现的血脂异常者，随机分为实验组和对照组，对实验组进行生活方式治疗，对照组未进行生活方式治疗，两组均未使用药物降脂，随访6—9个月，平均7．6个月，复查血脂，以检测血脂结果是否达到目标值进行对比。结果：经统计学处理，两组血脂在达到目标值方面存在显著性差异（p〈0．01）。结论：生活方式治疗对血脂异常人群具有明显的防治作用。     

Immunogenicity and safety of a novel yeast Hansenula polymorpha-derived recombinant Hepatitis B candidate vaccine in healthy adolescents and adults aged 10–45 years

The aim was to determine whether the immunogenicity of an investigational hepatitis B vaccine (spHB) is at least as high as that of a licensed control vaccine, Engerix B^®, and to evaluate its safety before inclusion in new pediatric combination vaccines. Two randomized, controlled, blind-observer, Phase 3 trials were performed: one in Argentina (344 participants aged 10–15 years, 10 μg HBsAg/dose) and one in Uruguay (344 participants aged 16–45 years, 20 μg HBsAg/dose). Both vaccines were given in a 0, 1, 6 month schedule to all participants with a baseline anti-Hep B antibody titer <0.6 mIU/mL. Antibody titers were measured pre-dose 1, 1 month after dose 2, pre-dose 3, and 1 month after dose 3. Statistical non-inferiority analyses were performed on seroprotection rates (SP) post-dose 3 (% with anti-Hep B titers ≥10 mIU/mL; delta non-inferiority limit of −10%). In both studies, SP for the spHB vaccine was 100% and the spHB vaccine was non-inferior in terms of SP to the licensed control vaccine. GMTs post-dose 3 were approximately 1.8- and 4.1-fold higher for spHB in the 10–15 year and 16–45 year age groups, respectively. Reactogenicity was low for each vaccine, after each dose. This highly immunogenic hepatitis B candidate vaccine was selected for further investigation as a component of new pediatric combination vaccines.     

Bacterial ghosts (BGs)—Advanced antigen and drug delivery system

Bacterial ghosts (BGs) are empty bacterial envelopes of Gram-negative bacteria produced by controlled expression of cloned gene E, forming a lysis tunnel structure within the envelope of the living bacteria. BGs are devoid of cytoplasmic content and possess all bacterial bio-adhesive surface properties in their original state while not posing any infectious threat. BGs are ideally suited as an advanced drug delivery system (ADDS) for toxic substances in tumor therapy. The inner space of BGs can be loaded with either single components or combinations of peptides, drugs or DNA which provides an opportunity to design new types of (polyvalent) drug delivery vehicles. Uptake of BGs loaded with Doxorubicin (Dox) by CaCo2 cells led to effective Dox release from endo-lysosomal compartments and accumulation in the nucleus. Viability and proliferative capacity of the cells were significantly decreased (2–3 orders of magnitude) after internalization of Dox loaded BGs as compared to cells incubated with free Dox. The same effect was observed with leukemia cells. Melanoma cells also revealed a high capability to internalize BGs. These results indicate that BGs are able to target a range of types of cancer. BGs have also been investigated as DNA delivery vectors. Studies show DNA loaded BGs are efficiently phagocytosed and internalized by both professional APCs and tumor cells with up to 82% of cells expressing the plasmid-encoded reporter gene. Our studies with BGs as an ADDS system contribute (i) to optimize drug delivery for the treatment of cancer; (ii) define specific conditions for selection and preparation of BG formulations; (iii) and provide a background for the clinical application of BGs in cancer therapy.