精神分裂症患者心理防御方式与述情障碍研究

目的探讨精神分裂症患者心理防御方式和述情障碍。方法分别运用防御方式问卷(DSQ)和述情障碍问卷(TAS-26)对60例精神分裂症患者和33例正常人进行防御方式和述情障碍评定。结果精神分裂症组评分的不成熟防御因子为(3.78±1.19)分、中间型防御因子为(4.32±0.75)分和成熟防御因子(5.16±1.23)分,正常对照组的不成熟防御因子(3.61±0.85)分、中间型防御因子(4.44±0.93)分和成熟防御因子(5.31±0.98)分,2组差异有统计学意义意义(P<0.05):精神分裂症组TAS评分分别为TASⅠ(2.72±0.7)分、TASⅡ(2.71±0.70)分和TASⅣ(2.57±0.47)分,正常对照组TAS评分分别为TASⅠ为(2.43±0.68)分、TASⅡ(2.28±0.60)分和TASⅣ(2.50±0.35)分,2组差异有统计学意义意义(P<0.01)。结论精神分裂症患者更多地采用不成熟及中间型防御方式,较少采用成熟防御方式,精神分裂症患者存在述情障碍。     

舰艇官兵意志力与防御方式的调查

目的对舰艇官兵意志力与防御方式调查,为战斗精神培养提供依据。方法对341名舰艇军人,选用意志力量表和防御方式量表调查,调查意志力分为意志力高分组(A组),意志力低分组(B组),防御方式量表结果按A、B组统计,两组间进行比较。结果意志力水平A组77%(263/341),B组23%(78/341)。不成熟的防御方式平均值3.18、3.47和成熟防御方式平均值5.86、4.94,组间差异显著(P<0.05),中间型防御方式平均值4.20、4.13和掩饰因子平均值4.69、4.66,两组比较无统计学意义(P>0.05)。结论投射、被动攻击、潜意识显现、抱怨、幻想、分裂、退缩、躯体化可能减低意志力,升华、压抑、幽默有助于意志力培养。     

滇南边防军人人格特征、应对方式对心理健康状况的影响

目的 了解滇南边防驻军官兵心理健康状况,为军事卫勤保障提供决策依据.方法 采用症状自评量表(SCL-90)、艾森克个性问卷(EPQ)和应对方式量表对驻滇某地270名边防军人进行调查.结果 滇南边防军人与我国军人常模比较,除人际关系、抑郁外,其余各因子评分均显著增高,差异有统计学意义(P<0.05,P<0.01).神经质与SCL-90各因子呈正相关,内外向与人际关系敏感、抑郁、偏执和精神病性呈负相关,精神质与人际关系敏感、抑郁、焦虑、敌对、恐怖、精神病性呈正相关;不成熟型应对方式与SCL-90量表各因子以及EPQ中的精神质和神经质呈正相关,成熟型应对方式与精神质呈负相关,与内外向呈正相关(P<0.05,P<0.01).结论 滇南边防军人呈现出较强的压力感,心理问题相对明显,应通过有效的心理卫生服务提高军人心理健康水平.     

军人精神疾病患者述情障碍及其影响因素

目的探讨恢复期精神分裂症、心境障碍军人患者的述情障碍及相关因素。方法应用多元相关分析,采用多伦多述情障碍量表(TAS),艾森克成人个性问卷(EPQ)、症状自评量表(SCL-90)测查了36例精神分裂症患者,32例心境障碍患者,并以30名正常人作对照。结果精神分裂症患者组与心境障碍患者组TAS量表的总分及Ⅰ、Ⅱ、Ⅳ因子得分分别为:78.27±6.98/79.42±7.21,3.42±0.56/4.04±0.68,3.23±0.64/3.36±0.58,2.87±0.56/2.61±0.59。均高于对照组的68.68±7.24,2.45±0.46,2.15±0.43,2.24±0.45,(P<0.05或0.01);心境障碍组Ⅲ因子得分(4.10±0.71)高于对照组(2.82±0.68)(P<0.01)。相关分析发现,个性特征与述情障碍间存在显著相关性。精神分裂症组,个性越内倾,描述情感能力越欠缺;心境障碍组,个性越内倾,越难以认识和区分情绪和躯体的感受。精神分裂症组SCL-90的人际关系敏感因子与TAS的I因子、抑郁因子与Ⅱ因子均呈显著正相关。心境障碍组SCL-90的偏执因子与TAS的Ⅲ因子、精神病性因子与Ⅳ因子均呈显著正相关。结论精神分裂症、心境障碍疾病患者均存在述情障碍,且与个性特征及心理卫生状况有密切关系。     

赴利比里亚初期维和官兵心理健康状况和人格特征相关分析

目的分析中国赴利比里亚维和官兵初期心理健康状况以及与人格特征的相关性。方法使用症状自评量表(SCL-90)和艾森克个性问卷(EPQ)对运输分队和工兵分队共463名维和官兵进行集中测试。结果①维和官兵在执行任务初期SCL-90各因子分均低于中国军人常模(P<0.01)。②维和官兵心理健康状况与人格特征相关。EPQ内外向维度与SCL-90强迫、抑郁、恐怖、偏执、精神病性因子呈负相关(P<0.05,P<0.01),与人际关系、焦虑、敌对因子呈正相关(P<0.05,P<0.01);神经质维度与SCL-90各因子呈正相关(P<0.05,P<0.01),除躯体化、强迫因子外,精神质维度与SCL-90其余各因子呈正相关(P<0.05,P<0.01);掩饰性维度与抑郁、焦虑因子呈正相关(P<0.05,P<0.01)。③运输分队的强迫、抑郁、焦虑及恐怖因子分显著高于工兵分队(P<0.05)。结论赴利比里亚初期,维和官兵心理健康状况良好;维和官兵心理健康状况与自身的人格特征相关;工兵分队相对运输分队心理健康状况要好。     

我国赴利比里亚维和官兵心理健康状况调查分析

目的:调查分析我国赴利比里亚维和官兵心理健康状况及相关影响因素.方法:使用症状自评量表(SCL-90)对277名官兵在训练期及执行任务初、中期进行集中测试.结果:①维和官兵在训练期及执行任务初、中期SCL-90各因子分均显著低于中国军人常模(P<0.01).②维和官兵执行任务初期焦虑因子分高于训练期,执行任务中期人际关系敏感和抑郁因子分高于训练期和执行任务初期.差异均有统计学意义(P<0.05).③维和官兵SCL-90总分以及强迫症状、焦虑、抑郁、恐怖因子和队员的年龄、文化程度、军龄和职务呈正相关(P<0.05,P<0.01).结论:我国赴利比里亚维和官兵心理健康状况良好,维和期间心理变化在正常范围波动;职务是影响维和官兵心理健康的主要因素,文化程度、年龄及军龄也影响维和官兵的心理健康.     

我国赴利比里亚维和官兵心理健康状况调查分析

目的:调查分析我国赴利比里亚维和官兵心理健康状况及相关影响因素.方法:使用症状自评量表(SCL-90)对277名官兵在训练期及执行任务初、中期进行集中测试.结果:①维和官兵在训练期及执行任务初、中期SCL-90各因子分均显著低于中国军人常模(P<0.01).②维和官兵执行任务初期焦虑因子分高于训练期,执行任务中期人际关系敏感和抑郁因子分高于训练期和执行任务初期.差异均有统计学意义(P<0.05).③维和官兵SCL-90总分以及强迫症状、焦虑、抑郁、恐怖因子和队员的年龄、文化程度、军龄和职务呈正相关(P<0.05,P<0.01).结论:我国赴利比里亚维和官兵心理健康状况良好,维和期间心理变化在正常范围波动;职务是影响维和官兵心理健康的主要因素,文化程度、年龄及军龄也影响维和官兵的心理健康.     

综合医院心理门诊来访者心理健康与防御方式相关性分析

目的探讨心理门诊不同程度症状来访者的心理障碍状况与其防御方式的相关性。方法采用症状自评量表（SCL-90）和防御方式问卷（DSQ）对199例心理门诊来访者进行测评。通过SCL-90区分不同程度症状的来访者并给予分组，考察不同程度症状组与其防御方式问卷相关性的关系。结果大部分来访者SCL-90各因子分显著高于国内常模（P〈0．01）。得分为轻度以上者其SCL-90各项症状与防御方式（DSQ）不成熟防御方式和中间型防御方式有明显相关。结论心理咨询门诊来访者存在不同程度的心理障碍，焦虑、抑郁、强迫症状最为常见和严重。来访者较多使用不成熟防御机制和中间型防御机制，而且与其症状程度呈明显相关。     

醉酒驾驶者人群心理健康状况和应付方式特征分析

目的:(1)调查北京某看守所在押醉酒驾驶者的心理健康状况和应付方式特点;(2)对其心理健康状况与应付方式、应付方式与酒精依赖程度进行相关性分析。方法:收集北京某看守所378名在押醉酒驾驶者为受试者,资料收集汇总后,采用SPSS17.0对SCL-90、应付方式、MAST等数据进行描述性统计分析、独立样本t检验和Pearson相关分析。结果:378名醉酒驾驶者SCL-90的躯体化、人际关系、焦虑、恐怖和精神病性五个因子分及总均分高于全国常模(P<0.05);醉酒驾驶者应付方式的自责、幻想、退避、合理化因子均与SCL-90的总分、躯体化、强迫症状、人际关系、抑郁、焦虑和敌对等因子呈显著正相关(P<0.05)或极其显著(P<0.01)。MAST总分与应付方式中解决问题因子呈非常显著负相关(P<0.01),而与消极的应付方式自责则呈显著正相关(P<0.05)。MAST总分与SCL-90的阳性项目数、强迫症状和其他项呈显著负相关(P<0.05)。结论:醉酒驾驶者人群的心理健康状况显著低于全国常模。醉酒驾驶者的应付方式均与酒精成瘾程度和心理健康状况有较大的相关性。高酒精成瘾组与低酒精成瘾组在应付方式和心理健康方面也呈现较大的差异。     

大学生心理防御机制和应付方式与心理健康状况的相关性研究

目的探讨大学生心理防御机制和应付方式与心理健康状况的的相关程度。方法采用心理健康量表SCL-90、防御方式问卷DSQ和应付方式问卷对751名大学生进行测查。结果 SCL-90测试显示大学生的心理卫生问题显得较为突出,751名大学生各因子分达到或超过中等严重程度（≥2分）者有183人,占24.37%,主要表现在人际敏感、焦虑、敌对、强迫、抑郁、恐怖、偏执等因子上的得分高于常模。成熟型心理防御机制和积极应付方式与SCI-90各因子得分呈负相关,中间型防御机制、不成熟型防御机制和消极应付方式与SC1-90各因子得分呈正相关。心理健康水平低下者在应激状态下常使用不成熟防御机制、中间型防御机制和消极应付方式;心理健康水平高者常使用成熟防御机制和积极应付方式。结论大学生心理防御机制和应付方式与心理健康存在相关性,应加强心理防御机制和应付方式的训练,进行有效的心理干预,以提高其心理健康水平。     

MicroRNA-378-3p/5p represses proliferation and induces apoptosis of oral squamous carcinoma cells via targeting KLK4

Oral squamous cell carcinoma (OSCC) is one of the most common types of head and neck neoplasm. Down-regulation of hsa-microRNA-378 (miR-378) has been proved in OSCC tissues, suggesting that miR-378 might play crucial roles in the progression of OSCC. The present study aimed to evaluate the effect of miR-378-3p/5p on the proliferation and apoptosis of OSCC in vitro and in vivo. According to the results, lentivirus-mediated overexpression of miR-378 lowered the colony formation efficiency, blocked cell cycle progression, and decreased the percentage of Ki-67 positive cells, whereas knockdown of miR-378-3p/5p led to the opposite results. Furthermore, the apoptosis of OSCC cells was induced by the overexpression of miR-378 as evidenced by decreasing Bcl-2/Bax ratio, increasing cleaved caspase-9, cleaved caspase-3, and cleaved PARP levels, and promoting the release of cytochrome c into the cytoplasm. However, the above results were reversed by miR-378-3p/5p silencing. In addition, the overexpression of miR-378 inhibited the activation of PI3K/AKT signalling pathway. Conversely, miR-378-3p/5p knockdown resulted in the inactivation of PI3K/AKT signalling pathway. Mechanically, we validated that miR-378-3p/5p could target kallikrein-related peptidase 4 (KLK4), and enforced overexpression of KLK4 counteracted miR-378 overexpression-induced apoptosis. Finally, tumourigenesis in nude mice was suppressed by the overexpression of miR-378, which was promoted by miR-378-3p/5p silencing. Taken together, these results suggest that miR-378 may be a potential target in the diagnoses and treatment of OSCC.     

Commentary on Using LNT for Radiation Protection and Risk Assessment

An article by Jerome Puskin attempts to justify the continued use of the linear no-threshold (LNT) assumption in radiation protection and risk assessment. In view of the substantial and increasing amount of data that contradicts this assumption; it is difficult to understand the reason for endorsing this unscientific behavior, which severely constrains nuclear energy projects and the use of CT scans in medicine. Many Japanese studies over the past 25 years have shown that low doses and low dose rates of radiation improve health in living organisms including humans. Recent studies on fruit flies have demonstrated that the original basis for the LNT notion is invalid. The Puskin article omits any mention of important reports from UNSCEAR, the NCRP and the French Academies of Science and Medicine, while citing an assessment of the Canadian breast cancer study that manipulated the data to obscure evidence of reduced breast cancer mortality following a low total dose. This commentary provides dose limits that are based on real human data, for both single and chronic radiation exposures.Jerome Puskin’s perspective on the use of the linear no-threshold (LNT) assumption for radiation protection and risk assessment (Puskin 2009) raises the question: does the U.S. Environmental Protection Agency (EPA) really protect the public or only the established worldwide practice of protecting people from radiation, which costs hundreds of billions of dollars a year? EPA exposure limits are many orders of magnitude below the levels where there is evidence of harm (Jaworowski 1999, Sanders 2010), leading to inappropriate restrictions on the use of nuclear energy to generate electricity and on the use of ionizing radiation in medicine to diagnose serious illnesses. Harmless and beneficial doses should not be regulated. Living organisms can adapt and have adapted to natural radiation, which ranges in intensity from about 0.1 to more than 70 rem per year.The assumptions and models employed by the EPA are not based on modern biological science. The LNT assumption of radiation carcinogenesis, formulated more than 50 years ago, was originally based on experiments that were carried out on fruit flies in the mid-1920s (Muller 1954). At that time, it appeared to be reasonable for estimating cancer risk because this risk was considered to be proportional to mutation rate, which was found to be proportional to radiation dose in high dose ranges. Radiobiologists now know that organisms have defenses against DNA damage and that these can be stimulated by low doses. Although the LNT assumption is still widely accepted, it does not reflect reality, and its continued use is causing great social harm, particularly by constraining wider use of nuclear energy and CT diagnostic scans (Scott et al. 2008).Since the mid-1980s, the Central Research Institute of the Electric Power Industry in Japan has been carrying out remarkable studies on health effects of radiation. Their recent research has demonstrated a threshold at about 1 Gy^† for x-ray-induced DNA mutations in fruit flies and activation of repair by low-dose irradiation, which reduced background mutation (Koana et al. 2004, Koana et al. 2007). Gamma ray irradiation of fruit flies at a dose rate of 22.4 mGy per hour reduced lethal mutation frequency below that in the control flies (Ogura et al. 2009), as shown in Figure 1. The original basis for the LNT assumption has therefore been shown to be invalid.Open in a separate windowFIGURE 1In selecting reports from scientific advisory bodies, the EPA appears to have omitted Scientific Annex B in UNSCEAR 1994, which assessed 192 scientific publications that provide evidence of beneficial health effects of low doses or low dose rates of radiation. The EPA also did not select the report of the French Academy of Science (Académie des sciences 1997), or the joint report of the French Academies of Medicine and Science (Tubiana et al. 2005) both of which raise doubts about the validity of the LNT hypothesis at low doses. A more recent publication in Radiology points out that the LNT relationship is inconsistent with data (Tubiana et al, 2009).Lauriston Taylor, former president of the National Council on Radiation Protection and Measurements (Taylor 2010), denounced the use of a procedure to calculate the expected number of deaths per year resulting from x-ray diagnoses, as follows (Taylor 1980): “These are deeply immoral uses of our scientific heritage.” Unfortunately, this advice was ignored when scientists assessing the Chernobyl accident projected up to 28,000 excess cancer deaths using the LNT assumption and high-dose Hiroshima-Nagasaki data (Catlin et al. 1987). “No one has been identifiably injured by radiation while working within the first numerical standards set by the ICRP in 1934 (safe dose limit: 0.2 rad per day)” (Taylor 1980). Yet members of the U.S. public are limited to 0.5 rem per year.The LNT methodology, as it is generally applied by radiation protection organizations, was tested by a comprehensive study of radon levels in U.S. homes. It failed the test (Cohen 1995).Puskin cites the Howe and McLaughlin 1996 assessment of the Canadian breast cancer study of tuberculosis (TB) patients (Miller et al. 1989) as support for the LNT model, which has been fitted to the Hiroshima-Nagasaki life span study data. However, this assessment manipulated the breast cancer mortality data in a manner that concealed the evidence of protection by low doses that Edward Webster revealed in his Lauriston S. Taylor lecture to the NCRP (Webster 1992). Figure 2 shows the configuration for the fluoroscopy examinations. Figure 3 is Webster’s graph of the Miller et al. data for patients treated for TB between 1930 and 1952. The Nova Scotia patients received a breast dose of 50 mGy (5 rad) per exposure. The patients in the other provinces received a dose of 2 mGy per exposure. Webster fitted straight lines to the high dose data points, and he extended the lines to the breast cancer death rate of the unexposed subjects. The number of exposed subjects in the “other provinces” is 12,094, while the number of unexposed subjects is 17,557. The graph suggests that women who received a total breast dose of 0.15 Gy (15 rad) have a death rate one-third lower than the breast cancer death rate for unexposed women.Open in a separate windowFIGURE 2Open in a separate windowFIGURE 3The Howe-McLaughlin study combined three low-dose data ranges, averaging risk over the wide dose interval 0.01 to 0.49 Gy, and thus obscured the evidence that low doses of radiation provide the benefit of reduced breast cancer mortality. This evidence is highly relevant to the risk of mammography performed repeatedly over a long period of time. This manipulation of low-dose data is one of several “tricks” that epidemiologists have been using over the years to obscure evidence of radiation hormesis (Scott et al. 2008, Scott 2008).A recent review of nuclear energy and health (Cuttler and Pollycove 2009) concludes: “Based upon human data, a single whole body dose of 150 mSv (15 rem) is safe. The high background of 700 mSv/year (70 rem/year) in the city of Ramsar, Iran is also a safe dose limit for continuous chronic exposure. Both dose limits are also beneficial.”     

Potent inhibition of the cytochrome P-450 3A-mediated human liver microsomal metabolism of a novel HIV protease inhibitor by ritonavir: A positive drug-drug interaction.

ABT-378 is a potent in vitro inhibitor of the HIV protease and is currently being developed for coadministration with another HIV protease inhibitor, ritonavir, as an oral therapeutic treatment for HIV infection. In the present study, the effect of ritonavir, a potent inhibitor of cytochrome P-450 (CYP) 3A, on the in vitro metabolism of ABT-378 was examined. Furthermore, the effect of ABT-378-ritonavir combinations on several CYP-dependent monooxygenase activities in human liver microsomes was also examined. ABT-378 was found to undergo NADPH- and CYP3A4/5-dependent metabolism to three major metabolites, M-1 (4-oxo) and M-3/M-4 (4-hydroxy epimers), as well as several minor oxidative metabolites in human liver microsomes. The mean apparent K(m) and V(max) values for the metabolism of ABT-378 by human liver microsomes were 6.8 +/- 3.6 microM and 9.4 +/- 5.5 nmol of ABT-378 metabolized/mg protein/min, respectively. Ritonavir inhibited human liver microsomal metabolism of ABT-378 potently (K(i) = 0.013 microM). The combination of ABT-378 and ritonavir was much weaker in inhibiting CYP-mediated biotransformations than ritonavir alone, and the inhibitory effect appears to be primarily due to the ritonavir component of the combination. The ABT-378-ritonavir combinations (at 3:1 and 29:1 ratios) inhibited CYP3A (IC(50) = 1.1 and 4.6 microM), albeit less potently than ritonavir (IC(50) = 0.14 microM). Metabolic reactions mediated by CYP1A2, CYP2A6, and CYP2E1 were not affected by the ABT-378-ritonavir combinations. The inhibitory effects of ABT-378-ritonavir combinations on CYP2B6 (IC(50) = >30 microM), CYP2C9 (IC(50) = 13.7 and 23.0 microM), CYP2C19 (IC(50) = 28.7 and 38.0 microM), and CYP2D6 (IC(50) = 13.5 and 29.0 microM) were marginal and are not likely to produce clinically significant drug-drug interactions.     

miR-224和 miR-378e在大肠癌组织中的表达及其临床意义

【摘要】 目的 探讨miR-224 和 miR-378e 在原位大肠癌癌组织和癌旁正常黏膜组织中的表达差异， 并分析其临床意义。 方法 miRNA 表达谱芯片技术检测大肠癌癌组织和癌旁组织标本中表达差异的miRNA， 运用荧光实时定量聚合酶链反应（real-time PCR）验证其结果，并分析其与临床病理资料之间的关系。 结果 miRNA 表达芯片分析发现， 与正常黏膜组织比较， miR-224在大肠癌组织中表达显著上调， miR-378e在大肠癌组织中表达显著下调， 并被 real-time PCR 所证实。 miR-224 在不同组织学类型癌组织中表达差异有统计学意义， miR-378e 在不同浸润深度癌组织中表达差异有统计学意义， miR-224 表达与组织学类型有关， miR-378e 表达与大肠癌浸润深度有关。 结论miR-224具有潜在的癌基因作用， miR-378e具有潜在的抑癌基因作用， miR-224和 miR-378e可作为     

In defense of the lung: surfactant protein A and surfactant protein D

The lung is repeatedly exposed to inhaled particles and pathogens that are cleared by the actions of a multi-component innate host defense system. The pulmonary collectins--surfactant proteins A (SP-A) and D (SP-D)--play important roles in innate host defense by binding and clearing invading microbes from the lung. SP-A and SP-D also influence surfactant homeostasis, contributing to the physical structures of lipids in the alveoli and to the regulation of surfactant function and metabolism. In addition to binding and opsonizing infectious pathogens, SP-A and SP-D bind to the surfaces of host defense cells, promoting or inhibiting immune cell activity through multiple cellular pathways. As a consequence of their physiologic functions, SP-A- and SP-D-dependent pathways are targets for clinical therapies designed to limit the proliferation of microoorgansims and to ameliorate inflammation following pulmonary infection.     

Synthesis and biological evaluation of 14-alkoxymorphinans. 17. Highly delta opioid receptor selective 14-alkoxy-substituted indolo- and benzofuromorphinans

14-Alkoxy analogues of naltrindole and naltriben differently substituted in positions 5 and 17 and at the indole nitrogen (compounds 28-44) have been synthesized in an effort to enhance the delta potency and/or delta selectivity and in order to further elaborate on structure-activity relationships of this class of compounds. Introduction of a 14-alkoxy instead of the 14-hydroxy group present in naltrindole resulted in somewhat lower delta binding affinity, while in many cases (compounds 31, 34, 37, 40, 41, 44, HS 378) the delta receptor selectivity was considerably increased. An ethoxy group in position 14 is superior to other alkoxy groups concerning delta affinity and selectivity (34, 41, 42, 44, HS 378). In [35S]GTP gamma S binding, compounds 34, 41, and HS 378 exhibited about one-tenth the antagonist potency of naltrindole at delta opioid receptors while their delta antagonist selectivity was considerably higher. 17-Methyl-substituted compounds 35 and 44 were found to be pure delta receptor agonists in this test.     

中山市5岁以下儿童死亡原因的调查与分析

目的探讨本市5岁以下儿童死亡的原因,并提出干预对策,以降低死亡率。方法对本市2008年7月～2012年7月5岁以下死亡儿童的资料进行回顾性分析。结果本市活产数92416例．5岁以下儿童死亡378例。占4．09％0,其中新生儿死亡212例,占56．08％（212／378）;婴儿（不包括新生儿）死亡84例,占22．22％（84／378）;1～4岁儿童死亡82例,占21．69％（82／378）。不同年间不同年龄儿童死亡率比较差异有统计学意义（x^2=11．79,P=0．003）。早产、先天异常、出生窒息、肺炎、溺水是5岁以下儿童死亡的独立危险因素（P〈0．05）。结论降低新生儿和婴儿死亡率是降低5岁以下儿童死亡率的重要环节,应加强孕期保健与产前评估。     

378例药品不良反应报告分析

目的:通过对药品不良反应(ADR)发生情况、特点及相关影响因素进行统计分析,为临床合理用药提供依据。方法:收集某医院2011—2013年上报的有效ADR报表进行统计分析。结果:378例ADR中,60岁以上老年患者及0~9岁儿童患者ADR发生率较高(分别占36.2%,14.8%);静脉给药途径相关ADR占76.7%;ADR涉及药物品种主要为抗感染药物、心血管药物;严重ADR主要涉及抗肿瘤药物;ADR临床表现以皮肤及其附件损害最常见。结论:抗感染药物、心血管药物及抗肿瘤药物是ADR监测重点药物类别,老年及儿童患者是ADR监测重点人群,静脉给药是ADR监测重点给药途径,皮肤及其附件病变是提示ADR发生的重要信号。     

Interactions of nanoparticles with plasma proteins: implication on clearance and toxicity of drug delivery systems

INTRODUCTION: Intravenously injected nanoparticles, like any other foreign pathogen that enters the body, encounter multiple lines of defense intended to neutralize and eliminate the invading substance. Adsorption of plasma proteins on the nanoparticle surface is the first barrier of defense, which could lead to physical changes in the formulation, such as aggregation and charge neutralization, biochemical activation of defense cascades, and trigger elimination by multiple types of phagocytic cell. AREAS COVERED: In this review, recent knowledge on the mechanisms that govern the interactions of nanoparticles (micelles, liposomes, polymeric and inorganic nanoparticles) with plasma proteins is discussed. In particular, the role of the nanoparticle surface properties and protective polymer coating in these interactions is described. The mechanisms of protein adsorption on different nanoparticles are analyzed and the implications on the clearance, toxicity and efficacy of drug delivery are discussed. The review provides readers with the biological insight into the plasma/blood interactions of nanoparticles. EXPERT OPINION: The immune recognition of nanoparticles can seriously affect the drug delivery efficacy and toxicity. There is at present not enough knowledge on the mechanisms that dictate the nanoparticle immune recognition and stability in the biological milieu. Understanding the mechanisms of recognition will become an important part of nanoparticle design.