县级公立医院补偿机制改革利益相关者的行为分析

以利益相关者理论为基础,通过对县级公立医院补偿机制改革利益相关者的行为分析,从目标函数、动力机制、约束机制和道德风险的角度构建利益相关者的一般均衡模型。模型表明,政策的价值取向以及政府的投入、监管等方面的责任是县级公立医院补偿机制帕累托改进的关键因素。     

Genetic polymorphisms in the Toll-like receptor signalling pathway in Helicobacter pylori infection and related gastric cancer

Background

Gastric cancer (GC) is a progressive process initiated by Helicobacter pylori-induced inflammation. Initial recognition of H. pylori involves Toll-like receptors (TLRs), central molecules in the host inflammatory response. Here, we investigated the association between novel polymorphisms in genes involved in the TLR signalling pathway, including TLR2, TLR4, LBP, MD-2, CD14 and TIRAP, and risk of H. pylori infection and related GC.

Methods

A case-control study comprising 310 ethnic Chinese individuals (87 non-cardia GC cases and 223 controls with functional dyspepsia) was conducted. Twenty-five polymorphisms were detected by MALDI-TOF mass spectrometry, PCR, PCR–RFLP and real-time PCR.

Results

Seven polymorphisms showed significant associations with GC (TLR4 rs11536889, TLR4 rs10759931, TLR4 rs1927911, TLR4 rs10116253, TLR4 rs10759932, TLR4 rs2149356 and CD14 −260 C/T). In multivariate analyses, TLR4 rs11536889 remained a risk factor for GC (OR: 3.58, 95% CI: 1.20–10.65). TLR4 rs10759932 decreased the risk of H. pylori infection (OR: 0.59, 95% CI: 0.41–0.86). Statistical analyses assessing the joint effect of H. pylori infection and the selected polymorphisms revealed strong associations with GC (TLR2, TLR4, MD-2, LBP and TIRAP polymorphisms).

Conclusions

Novel polymorphisms in TLR2, TLR4, MD-2, LBP, CD14 and TIRAP, genes encoding important molecules of the TLR signalling pathway, showed clear associations with H. pylori-related GC in Chinese.     

白藜芦醇衍生物RT-B与大鼠血浆蛋白结合率的测定

目的建立测定白藜芦醇衍生物RT—B与大鼠血浆蛋白结合率的方法。方法采用平衡透析法对RT-B与大鼠血浆蛋白结合率进行HPLC测定。结果低、中、高3种浓度下,RT-B的血浆蛋白结合率分别为(79.2±s 0.7)%,(80.1±0.9)%和(80.2±0.9)%。结论本方法灵敏度高,重现性好,操作简单,能满足分析要求。RT-B与大鼠血浆蛋白的结合率较高。     

氯化两面针碱人血浆蛋白结合率的测定

目的建立测定人血浆中氯化两面针碱的高效液相色谱法,并研究氯化两面针碱与人血浆蛋白的结合情况。方法离子对试剂萃取技术对样品进行预处理,乙腈-0.15%磷酸(36:64,V:V,用三乙胺调pH值至3.5)为流动相,C_(18)柱(250mm×4.6mm,5μm)为固定相,紫外检测波长271nm,以氯霉素为内标,采用平衡透析法对氯化两面针碱的人血浆蛋白结合率进行测定。结果氯化两面针碱与内标完全分离,样品中其他成份无干扰,在0.03188～2.040mg·L~(-1)范围内线性关系良好,低、中、高3种不同质量浓度的方法回收率>95%,日内、日间精密度均符合方法学要求。低、中、高3种药物浓度的血浆蛋白结合率分别为68.9%、67.4%、67.9%。结论方法简便、快速,结果准确、可靠,能满足生物样品分析要求。氯化两面针碱具有中等强度的蛋白结合率,蛋白结合率与透析液的药物浓度无关。     

复方鹿衔草胶囊临界相对湿度的测定

目的：测定复方鹿衔草胶囊临界相对湿度（CRH）。方法：采用过饱和溶液法，先测定复方鹿衔草颗粒吸湿平衡时间，再测定复方鹿仙草胶囊临界相对湿度（CRH），绘制吸湿平衡图，作为该药吸湿性的指标。结果：复方鹿衔草胶囊的临界相对湿度为55％（18℃～26℃）。     

The modulation by xanthines of the DNA-damaging effect of polycyclic aromatic agents. Part II. The stacking complexes of caffeine with doxorubicin and mitoxantrone

Recently accumulated statistical data indicate the protective effect of caffeine consumption against several types of cancer diseases. There are also reports about protective effect of caffeine and other xanthines against tumors induced by polycyclic aromatic hydrocarbons. One of the explanations of this phenomenon is based on biological activation of such carcinogens by cytochromes that are also known for metabolism of caffeine. In the accompanying paper [Kapuscinski et al., this issue] we provide evidence (flow cytometry and the cell cycle analysis) that the cytostatic effects of caffeine (CAF) on two DNA alkylating agents, which do not require the biological activation, depend on their ability to form stacking (pi-pi) complexes. In this study, we use physicochemical techniques (computer aided light absorption and microcalorimetry), and molecular modeling to examine previously published qualitative data. This is published both by our and other group's data, indicates that CAF is able to modify the cytotoxic and/or cytostatic action of the two well known antitumor drugs doxorubicin (DOX) and mitoxantrone (MIT). To obtain the quantitative results from the experimental data we used the statistical-thermodynamical model of mixed aggregation, to find the association constants K(AC) of the CAF-drug interaction (128+/-10 and 356+/-21M(-1) for DOX-CAF and MIT-CAF complex formation, respectively). In addition, the favorable enthalpy change of CAF-MIT (DeltaH=-11.3kcal/mol) was measured by microcalorimetry titration. The molecular modeling (semi-empirical and force field method) allowed us to obtain the geometry of these complexes, which indicated the favorable energy (DeltaE) of complex formation of the protonated drug's molecules in aqueous environment (-7.4 and -8.7kcal/mol for DOX-CAF.5H(2)O and MIT-CAF.8H(2)O complex, respectively). The molecular modeling calculation indicates the existence of CAF-drug complexes in which the MIT molecules are intercalated between two CAF molecules (DeltaE=-29.9kcal/mol). These results indicate that the attenuating effect of caffeine on cytotoxic or mutagenic effects of some polycyclic aromatic mutagens cannot be the result of metabolic activation in the cells, but simply is the physicochemical process of the sequestering of aromatic molecules (e.g. carcinogens or mutagens) by formation of the stacking complexes. The caffeine may then act as the "interceptor" of potential carcinogens (especially in the upper part of digesting track) where its concentration can reach the mM level). There is, however, no indication, both, in the literature or from our experiments, that the xanthines can reverse the damage to nucleic acids at the point when the damage to DNA has already occurred.     

重庆地区汉族人群CD14基因启动子区-159 T→C多态性及其与LPS反应分析

目的观察重庆地区汉族人群CDl4基因启动子区-159单核甘酸多态性（single nucleotide polymorphism，SNP）分布特征，及其与CDl4表达和脂多糖（1ipopolysaccharide，LPS）反应的关系。方法选择298例重庆地区汉族健康个体，采用限制性片段长度多态性法（restrictionfragment lengthpoly-morphism，RFLP）进行基因分型，检测LPS刺激前后外周血单核．巨噬细胞mCDl4荧光强度和血浆sCDl4浓度。结果重庆地区汉族人群CD14—159T／T、T／C、C／C基因型频率分别为32．21％、50．67％和17．11％，样本符合Hardy．Weinberg平衡，正常情况下，不同基因型mCD14水平差异不明显，而sCD14浓度有显著性差异（P＜0．05），LPS刺激能增强mCD14和sCD14的表达，但各基因型的增强幅度没有明显差异。结论重庆地区汉族人群CD14—159SNP等位碱基以T为主，T→C变异可抑制sCD14的表达，但对mCD14表达和LPS刺激反应的影响可能不明显。     

常见微量元素与人体健康(综述)

目的:介绍关于微量元素与人体健康的知识.方法:查阅总结文献、资料、书籍,专门对微量元素的缺乏和过量会引起人体各种疾病的相关知识作系统阐述.结果:提高人们对有微量元素和人体健康知识的了解,对人们的健康有益.结论:人体特别是成人体内的各种必需微量元素的含量是一定值,它们既不能缺少,也不能过量,否则均会引起生理异常,从而产生疾病.     

Stridor in an adult

A 34-year-old woman with a recent history of a influenza-like illness and signs of bronchopneumonia presented with many of the features of acute epiglottitis, a condition which still carries a high mortality in adults. Urgent laryngoscopy and bronchoscopy under inhalational anaesthesia were negative. The results of arterial blood gases, taken when stridor was at its worst, revealed marked hypocapnia and respiratory alkalosis. We conclude that the resultant acute reduction of serum ionised calcium produced stridor as a result of tetany of the vocal cords. Similar cases from the literature and the role of emotional factors in the aetiology are discussed.