单双极射频消融改良迷宫术用于瓣膜病合并心房颤动的疗效

目的：探讨单极与双极射频消融改良迷宫术在心脏瓣膜手术中治疗心房颤动（房颤）的疗效及安全性. 方法：连续入选2010年1月至2012年12月在我院行心脏瓣膜手术,同期行射频消融改良迷宫术的患者137例.根据射频消融系统的不同,分为单极射频消融组（n=56）及双极射频消融组（n=81）.比较两组患者术中射频消融时间、围术期严重并发症的发生率及死亡率、术后房颤消除率及心功能等临床指标. 结果：两组围术期严重并发症的发生率及死亡率无统计学差异.术中两组消融所需时间亦无统计学差异.两组患者术后1年的心功能分级均较术前改善,左房内径明显减小（P＜0.01）.与单极消融组相比,双极消融组同期的房颤消除率显著提高（P＜0.05）. 结论：心脏瓣膜手术同期行射频消融迷宫术是治疗心脏瓣膜疾病合并房颤安全、有效的方法.与单极射频消融相比,双极射频消融的房颤消除率更高,具有较好的临床应用价值.     

多西他赛和吉非替尼不同时序用药对人肺腺癌细胞株PC-9的作用机制研究

目的：观察吉非替尼与化疗药物多西他赛按不同时序用药对表皮生长因子受体（EGFR）突变的肺腺癌细胞株的作用,探索最佳时序用药模式。方法：人肺腺癌EGFR基因19号外显子天然缺失的PC-9细胞株,分别经吉非替尼和多西他赛单独或不同时序联合处理,采用CCK-8法测定各组细胞增殖抑制,FCM法检测细胞凋亡,免疫印迹法检测EGFR下游信号通路蛋白磷酸化EGFR（pEGFR）、磷酸化氨酸/苏氨酸激酶（pAkt）表达。结果：多西他赛作用24 h序贯吉非替尼作用48 h组的肿瘤细胞凋亡明显,Sub-G1期DNA达到34%±2%,同其他各组比较差异有统计学意义（P〈0.05）。结论：该序贯用药模式存在增效作用,促细胞凋亡的同时对信号通路中的pEGFR、pAkt有抑制作用。     

足阳明胃经与胃的相关性研究进展

从经络理论研究、机制研究和临床研究三方面对足阳明胃经与胃的相关性进行研究,发现胃在病理状态下,可出现阳明经穴物理特性的改变,而针刺可通过调节胃运动功能、平衡胃肠激素的分泌等途径改善胃肠功能,保护胃黏膜。针刺足阳明胃经穴位对胃调节作用具有相对特异性,可以有效治疗胃病。研究足阳明胃经与胃的相关性,对丰富经脉脏腑相关理论、指导针灸临床实践及提高疗效有着重要意义,能为阐明经络实质提供新的研究思路和方向。     

精神病学实习教学中融入人文教育的初步探索

目的：探索在精神病学实习教学中进行人文教育的模式。方法：在入科教育、医患沟通技能的教学、书写实习札记以及出科考核等教学环节融入人文教育。结果：93%的实习医生较认可目前的教学模式,出科考核人文成绩90%到达良好,实习札记反映出重视医患沟通、强调人文关怀等多方面人文内容。结论：在精神病学实习教学中融入人文教育的模式是可行的。     

金长娟主任善用七叶灵方治疗晚期非小细胞肺癌学术经验

金长娟,上海交通大学附属胸科医院中西医结合科主任医师,胸科医院＂十二五＂国家中医药管理局重点专科学科带头人,上海市中医药学会肿瘤分会委员,上海市中西医结合学会肿瘤分会委员。从事中医和中西医结合肺部肿瘤的治疗、科研30余年,医术精湛,尤其对于晚期非小细胞肺癌的中西医治疗积累了丰富的临床经验,拥有独到的见解,并在长期临床实践的基础上,总结出验方＂七叶灵方＂。     

Analysis of association between common variants in the SLCO6A1 gene with schizophrenia,bipolar disorder and major depressive disorder in the Han Chinese population

Objectives The SLCO6A1 gene belongs to a superfamily of genes which is known to be a solute carrier family of OATPs (SLCO). The SLCO6A1 gene encodes OATP6A1 protein in humans. A previous genome-wide association study (GWAS) of schizophrenia conducted in the Swedish population demonstrated a significant association of rs6878284, which is located in the SLCO6A1 gene, with schizophrenia. To further investigate whether this gene is also a risk locus for schizophrenia (SCZ), bipolar disorder (BPD) and major depressive disorder (MDD) in the Han Chinese population, a case–control study was designed. Methods In total 1,248 unrelated SCZ cases, 1,344 BPD cases, 1,056 unrelated MDD cases and 1,248 normal controls were analysed in this study. We genotyped five SNPs using the Sequenom MassARRAY platform. Results We found no association of rs6878284 with SCZ [Corrected P_allele= 0.969, Corrected P_genotype= 0.997]. Furthermore, we found a statistically significant association of the rs7734060 genotype with MDD after correction [rs7734060: Corrected P_allele = 0.114, Corrected P_genotype = 0.036] in the Han Chinese population. Conclusions This is the first study which reveals no association of rs6878284 with SCZ and also predicts that rs7734060 could be a risk locus for MDD in the Han Chinese population.     

Complex character analysis of heart rate variability following brain asphyxia

In the present study Renyi entropy and L-Z complexity were used to characterize heart rate variability (HRV) of rats that were suffered from brain asphyxia and ischemia. Two groups of rats were studied: (a) rats (n=5) injected with NAALADase inhibitor, 2-PMPA, which has been proven neuroprotective in asphyxia injury and (b) control subjects (n=5) without medication. Renyi entropy and L-Z complexity of the R-R intervals (RRI) at different experiment stages were investigated in the two groups. The results show that both measures indicate less injury and better recovery in the drug injection group. The dynamic change of 90 min RRI signal after the asphyxia was investigated. The sudden reduction of the two parameters shows their sensitivity to the asphyxia insult.     

超重孕妇低生糖负荷膳食干预对新生儿DNA甲基化影响的探索性研究

目的 通过对超重孕妇实施低血糖生成指数（GI）膳食的干预,探讨胎盘组织和脐血中与体重增长有关基因的甲基化的改变.方法 采用随机化单盲对照干预试验设计,研究对象为初次产检孕周≤12周且体重超重的孕妇.以研究对象纳入的顺序号为随机序列号,采用简单随机化的方法随机分为干预组和对照组.干预组在中国孕妇保健规范的基础上结合国家对孕妇的膳食和体力活动规范实施低GI膳食指导干预,对照组仅按照国家规范给予指导,不给予低GI膳食的指导.两组分别在孕早期、中期和晚期干预3次.干预组和对照组各纳入25例.孕妇分娩时收集胎盘组织和脐血,提取DNA,采用Illumina甲基化芯片进行两步法全基因组甲基化测定.结果 孕妇孕期相关暴露因素在干预组与对照组差异无统计学意义;胎儿出生体重干预组高于对照组[（3.7±0.5） vs（3.5±0.4）kg],但差异无统计学意义（P =0.248）.本研究结果结合生物信息数据库分析,筛选出19个基因位点,所属18个基因,其中5个基因位于1号染色体,2个基因位于7号染色体,其余基因分布分散.比较干预组与对照组甲基化的改变,发现脐血中2个差异的甲基化CpG位点,分别位于TEKT5和MIR378C基因上,胎盘组织中1个差异的甲基化CpG位点,所属PGBD5基因.结论 通过对超重孕妇采取低GI膳食干预,胎盘组织和脐血中基因的甲基化可以发生改变,为中国超重、肥胖孕妇疾病的预防提供新的方法,对子代的健康成长有重要的意义.     

Dysregulated activation of c-Src in gestational trophoblastic disease contributes to its aggressive progression

Introduction

Gestational trophoblastic disease (GTD) is a heterogeneous group of pregnancy-related disorders. Hydatidiform mole (HM) is the most common type of GTD, whereas gestational choriocarcinoma is the most aggressive. Non-receptor tyrosine kinase c-Src contributes to the transformation to a malignant phenotype in various cancers. However, the role of c-Src in the pathogenesis of GTD remains largely unknown.

Methods

The expression level of phosphorylated c-Src was determined by immunohistochemistry and Western blotting assay. JAR and JEG-3 cells were treated with hCG, specific c-Src inhibitor saracatinib and PP2, and PKA specific inhibitor, PKI. Cell growth rate and cell migration/invasion ability was determined by cell proliferation and transwell assays respectively.

Results

c-Src was highly activated in HM tissues and choriocarcinoma cells (JAR and JEG-3). c-Src was activated by hCG in a time and concentration-dependent manner, which was abrogated by specific c-Src and PKA inhibitors. Inhibition of c-Src activity in JAR and JEG-3 cells by saracatinib leaded to a decrease in the rate of cell growth and cell migration/invasion ability. Furthermore, inhibition of c-Src phosphorylation induced cell cycle arrest and reduced expressions of cyclin A2, cyclin B1, cyclin E1, FOXD3 and NANOG. Moreover, inhibition of c-Src activity resulted in decreased p-FAK^Tyr397 phosphorylation.

Discussion and conclusion

Our findings indicate an important role of c-Src in the pathogenesis of GTD, and we propose that c-Src inhibitors are potential adjuvant chemotherapeutic drugs for the treatment of GTD.