替罗非班对急性心肌梗死患者PCI术后血清肌钙蛋白水平的影响

目的:观察盐酸替罗非班(欣维宁)对急性心肌梗死患者PCI术后肌钙蛋白I(cTnI)的影响.方法:将急性心肌梗死行PCI治疗成功患者分为替罗非班治疗组和对照组.以酶联免疫法检测每组患者PCI术前.术后1、6、24、48 h血清cTnI的水平.结果:术后应用替罗非班组较对照组TIMI血流明显改善(P<0.05),且血清cTnI迅速回落(P<0.01).结论:替罗非班可以迅速改善PCI术后冠状动脉TIMI血流,减轻心肌损伤,降低术后血清CTnI水平.     

替罗非班联合不同时间介入治疗对急性ST段抬高型心肌梗死的影响

目的 探讨替罗非班联合不同时间经皮冠状动脉介入治疗(PCI)对急性ST段抬高型心肌梗死(STEMI)冠脉血流的影响.方法 连续入选符合入选条件的412例STEMI患者,根据是否应用替罗非班分为替罗非班组(n＝195)和常规组(n＝217),两组患者均根据指南和实际情况进行急诊PCI、补救PCI、易化PCI、溶栓后PCI和单纯PCI.所有患者均进行PCI术前、术后TIMI血流和校正的TIMI帧数(cTFC)计算及比较.结果 虽然术前两组患者各种指标比较差异无统计学意义(P>0.05),但替罗非班组cTFC术后即刻明显小于常规组(P<0.05),尤其是在急诊PCI时,替罗非班组cTFC与常规组比较差异有统计学意义(P<0.01).结论 替罗非班联合介入治疗STEMI可以有效改善梗死心肌区微循环,提示替罗非班治疗STEMI安全、有效,尤其是对急诊PCI获益更大,值得临床进一步深入研究.     

血栓抽吸联合冠状动脉内替罗非班对急性ST段抬高型心肌梗死患者的疗效分析

目的:研究血栓抽吸联合冠状动脉内替罗非班对接受急诊PCI术的急性ST段抬高型心肌梗死(STEMI)患者预后的影响.方法:回顾性分析89例接受急诊PCI术的急性STEMI患者的临床资料,分析比较支架植入前行血栓抽吸后冠状动脉内注入替罗非班(A组,53例)与常规PCI后静脉应用替罗非班(B组,36例)两组的冠状动脉造影、UCG及心电图结果.结果:两组PCI术后冠状动脉造影显示的TIMI 3级血流、UCG所示的左心室舒张末期直径(LVEDd)、LVEF、术前及术后1h心电图所示的总ST段回落≥50％比率、梗死相关血管(IRA)无复流发生率比较差异均有统计学意义.两组的住院期间主要不良心血管事件(MACE)发生率比较无统计学意义.结论:对于急性STEMI明显血栓负荷的患者,血栓抽吸联合冠状动脉内替罗非班后PCI术的治疗方案安全有效.     

急性ST段抬高心肌梗死经皮冠状动脉介入治疗前应用替罗非班的效果

目的:观察早期应用替罗非班对急性ST段抬高心肌梗死(STEMI)急诊行经皮冠状动脉介入治疗(PCI)对梗死相关血管的血流及梗死区心肌灌注的影响.方法:将114例发病＜12小时急诊行PCI的急性STEMI患者随机分为早期组和晚期组,每组57例.早期组入急诊室PCI前即开始应用替罗非班,晚期组在PCI开始时应用替罗非班,替罗非班用法为10 μg/kg 静脉推注,继以0.15 μg·kg-1·min-1维持至PCI后36小时.观察两组PCI前后心肌梗死溶栓(TIMI)分级及梗死区心肌灌注(TMP)分级、PCI后90天主要心血管事件(MACE)及术后出血发生情况.结果:早期组PCI前TIMI 3级及TMP 3级的获得率分别为31.6%、33.3%,晚期组分别为 12.3%、14.0%;PCI后早期组分别为96.5%、75.4%,晚期组分别为 94.7%、57.9%,两组PCI前TIMI 3级、TMP 3级及PCI后TMP 3级比较差异均有统计学意义(P＜0.05).PCI后90天早期组3例发生MACE,占5.3%;晚期组9例发生MACE,占15.8%,差异无统计学意义(P＞0.05).结论:对急性STEMI急诊行PCI的患者,早期应用替罗非班能改善梗死相关血管的血流及心肌灌注.     

替罗非班在急性心肌梗死患者急诊介入治疗术中的疗效和安全性评价

目的观察盐酸替罗非班在急性ST段抬高型心肌梗死患者急诊介入治疗术中的疗效和安全性。方法58例急性ST段抬高型心肌梗死患者随机分为2组，其中盐酸替罗非班（欣维宁）组30例，对照组28例，均于发病12h内行急诊经皮冠状动脉介入治疗术（PCI）。盐酸替罗非班（欣维宁）组PCI术中即刻静脉予负荷量0．4ug/kg·min^-1×30min，维持量0．15ug／kg·min^-1×36h。两组患者PCI术中均给予肝素8000～10000U。PCI术前服用氯吡格雷300mg，阿司匹林300mg，术后各75mg／d，观察PCI术前、术后梗死相关血管TIMI血流情况、术后4周内并发症及主要不良心脏事件的发生情况。结果盐酸替罗非班组PCI术后慢复流发生率及主要不良心脏事件的发生率均低于对照组，差异有统计学意义。出血并发症的发生率高于对照组，差异无统计学意义。结论盐酸替罗非班能改善急性心肌梗死患者PCI术后梗死相关血管的TIMI血流，减少PCI术后主要不良心脏事件的发生率，临床应用安全有效。     

盐酸替罗非班联合药物洗脱支架治疗老年AMI患者的效果

目的探讨盐酸替罗非班联合药物洗脱支架治疗老年急性心肌梗死(AMI)患者的疗效及对血清肌钙蛋白(cTnI)、D-二聚体(D-D)、尿酸(UA)、肌酸激酶同工酶(CK-MB)的影响。方法选取医院收治的107例老年AMI患者,根据简单随机分组法将其分为两组,对照组(n=53)采用药物洗脱支架治疗,观察组(n=54)予以盐酸替罗非班联合药物洗脱支架治疗,对比两组治疗效果、血清c TnI、D-D、UA、CK-MB水平以及心脏不良事件。结果观察组临床疗效总有效率高于对照组,差异有统计学意义(P<0.05)。观察组治疗后TIMI血流分级优于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血清cTnI、D-D、UA、CK-MB水平均低于对照组,观察组治疗前后各指标差值均大于对照组,差异有统计学意义(P<0.05)。观察组主要不良心血管事件(MACE)发生率低于对照组,差异有统计学意义(P<0.05)。结论盐酸替罗非班联合药物洗脱支架治疗老年AMI患者疗效显著,能够有效降低血清c TnI、D-D、UA、CK-MB水平,减少心脏不良事件发生。     

盐酸替罗非班对心功能及BNP的影响探讨

目的研究急性ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入术(PCI)后联合盐酸替罗非班对心功能及血浆B型利钠肽(BNP)的影响。方法选取我院2012年6月~2014年6月直接PCI治疗的86例STEMI患者,并随机分为对照组和观察组各43例;对照组行PCI治疗,观察组联合PCI和盐酸替罗非班进行治疗;比较两组术后1、5w心功能,术前、术后1、5w BNP,心脏不良事件发生情况。结果两组术后5w心功能指标的比较具有统计学差异(P0.05),观察组术后5w较术后1w相比,LVEDD和LVEF的比较具有统计学差异(P0.05)。观察组术后1、5w较对照组相比,血浆BNP水平显著降低;观察组术后5w较术前及术后1w相比血浆BNP水平较低;组间比较具有统计学差异(P0.05)。观察组与对照组心脏不良事件发生率分别为7.0%和25.6%,两组比较具有统计学差异(P0.05)。结论直接PCI后联合盐酸替罗非班对急性STEMI患者进行治疗,可明显改善心功能及血浆BNP水平,且心脏不良事件发生率显著降低,值得临床应用及推广。     

盐酸替罗非班用于行PCI的ST段抬高型急性心肌梗死患者的临床护理研究

目的:探讨对ST段抬高急性心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)术中、术后应用盐酸替罗非班的效果、安全性及相关护理问题.方法:选择50例行急诊PCI的STEMI患者应用盐酸替罗非班(除有禁忌证),为盐酸替罗非班组.对照组为50例行急诊PCI的STEMI患者,未应用盐酸替罗非班,两组进行对照研究.观察两组患者心电图ST段下降幅度及出血情况,观察患者住院期间及出院后主要心脏不良事件(MACE,包括死亡、非致命性再梗死、靶血管再血管化治疗)的发生.结果:STEMI患者行PCI术应用盐酸替罗非班安全有效,能够较早改善STEMI患者直接PCI术后冠脉微循环灌注状态,但增加出血倾向,未增加大出血发生率,临床工作中应严密观察用药后穿刺部位和全身出血情况,采取有效的护理措施.结论:对STEMI行直接PCI治疗护理者,除充分给予阿司匹林、氯吡格雷和肝素外,还应联合应用盐酸替罗非班,采取有效的护理措施,有助于减少急诊PCI的STEMI患者血栓栓塞和无复流、慢复流现象发生,降低术后不良心脏事件的发生,改善患者症状和预后,使早期行介入治疗的ACS患者明显受益.     

替罗非班在急诊经皮冠状动脉介入治疗急性

目的 探讨替罗非班在急诊经皮冠状动脉介入治疗(PCI)急性ST段抬高型心肌梗死(STEMI)中的应用价值.方法 选择急性STEMI患者90例,随机分为观察组与对照组各45例,对照组给予常规PCI术治疗,观察组给予PCI术联合替罗非班治疗,观察两组疗效与出血事件等.结果 治疗后,两组患者均获得良好的血流灌注,且观察组显著优于对照组(P＜0.05);观察组ST段回落幅度显著优于对照组(P＜0.01);右室射血分数(LVEF)均显著优于治疗前(P＜0.05),且治疗后观察组显著优于对照组(P＜0.01);观察组血清肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTNT)及血小板聚集率均显著低于对照组(P＜0.01),且不良心血管事件(MACE)发生率显著低于对照组(P＜0.05);观察组术后出血并发症发生率略高于对照组,但无统计学差异(P＞0.05).结论 替罗非班在急诊PCI治疗急性STEMI中具有肯定的疗效,但可能增加出血风险,临床应用中应注意监测.     

肾功能不全的急性冠状动脉综合征患者应用替罗非班的安全性观察

目的评价伴有肾功能不全的急性冠状动脉综合征(ACS)患者应用血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂盐酸替罗非班(欣维宁)的安全性。方法经皮冠状动脉介入治疗(PCI)的ACS患者567例,根据患者肾小球滤过率(GFR)分为肾功能正常组、肾功能轻度受损组和肾功能中度受损组,分别比较各组服用替罗非班后的出血并发症,并通过logistic多因素回归和叉生分析综合分析伴有肾功能不全的患者应用替罗非班的安全性,评价两因素间有无交互效应。结果患者PCI术后出血并发症的发生率肾功能轻度受损组和中度受损组较肾功能正常组出血并发症升高(12.8%和31.0%vs 4.1%,均P<0.01),肾功能中度受损组又较肾功能轻度受损组出血并发症升高(12.8%vs31.0%,P<0.05)。伴有轻中度肾功能不全患者应用替罗非班的联合治疗出血风险并没有如预期的增加,两因素间无交互效应(交互作用指数S=1.057,P>0.05)。结论肾功能不全及应用盐酸替罗非班可以增加接受PCI的ACS患者出血并发症的发生风险,但肾功能轻中度受损组的ACS患者对替罗非班有很好的耐受性,肾功能轻中度受损患者应用替罗非班是安全的,二者之间没有交互作用。     

Atomic and electronic structure of solids of Ge2Br2PN,Ge2I2PN,Sn2Cl2PN,Sn2Br2PN and Sn2I2PN inorganic double helices: a first principles study

We report the results of density functional theory calculations on the atomic and electronic structure of solids formed by assembling A₂B₂PN (A = Ge and Sn, B = Cl, Br, and I) inorganic double helices. The calculations have been performed using a generalized gradient approximation for the exchange–correlation functional and including van der Waals interactions. Our results show that the double helices crystallize in a monoclinic lattice with van der Waals type weak interactions between the double helices. In all cases except Ge₂Cl₂PN, the solids are stable with a binding energy between the double helices ranging from 0.06 eV per atom to 0.09 eV per atom and inter-double helices separation of more than 3.33 Å. All the solids are semiconducting. Further calculations have been done by using meta-GGA with a modified Becke–Johnson functional to obtain better band gaps, which are found to lie in the range of 0.91 eV to 1.49 eV. In the case of Ge₂Br₂PN the solid is a direct band gap semiconductor although the isolated double helix has an indirect band gap and it is suggested to be interesting for photovoltaic, and other optoelectronic applications. The charge transfer between the atoms has been studied using Bader charge analysis and the DDEC6 method in the CHARGEMOL program, which suggests charge transfer from the outer helix to the inner helix.

We report the results of density functional theory calculations on the atomic and electronic structure of solids formed by assembling A₂B₂PN (A = Ge and Sn, B = Cl, Br, and I) inorganic double helices.     

Shape-dependent close-edge 2D-MoS2 nanobelts

Atomic-thin MoS₂ materials have attracted increasing attention due to their potentials in numerous fields. However, in 2D-MoS₂ sheets, the edge region usually has unique features differing from the interior region, which has potential application in enhancing catalysts and shape-dependent 2D-nanodevices. However, fabricating it cost-effectively is still very difficult. Here, we present one universal method to obtain various shape-dependent closed-edge 2D-MoS₂ nanobelts only using one simple step, and width of the MoS₂ nanobelts (minimum of 270 nm) were adjustable. Our strategy opens a new fabrication route for closed-edge 2D-MoS₂ nanobelts, and in principle, this method is also suitable for other CVD-grown 2D materials.

A very simple mechanical peeling method to obtain various closed and shape-dependent MoS₂ edge nanobelt.     

Efficient and stable transduction of dopaminergic neurons in rat substantia nigra by rAAV 2/1, 2/2, 2/5, 2/6.2, 2/7, 2/8 and 2/9

Dysfunction of the nigrostriatal system is the major cause of Parkinson's disease (PD). This brain region is therefore an important target for gene delivery aiming at disease modeling and gene therapy. Recombinant adeno-associated viral (rAAV) vectors have been developed as efficient vehicles for gene transfer into the central nervous system. Recently, several serotypes have been described, with varying tropism for brain transduction. In light of the further development of a viral vector-mediated rat model for PD, we performed a comprehensive comparison of the transduction and tropism for dopaminergic neurons (DNs) in the adult Wistar rat substantia nigra (SN) of seven rAAV vector serotypes (rAAV 2/1, 2/2, 2/5, 2/6.2, 2/7, 2/8 and 2/9). All vectors were normalized by titer and volume, and stereotactically injected into the SN. Gene expression was assessed non-invasively and quantitatively in vivo by bioluminescence imaging at 2 and 5 weeks after injection, and was found to be stable over time. Immunohistochemistry at 6 weeks following injection revealed the most widespread enhanced green fluorescence protein expression and the highest number of positive nigral cells using rAAV 2/7, 2/9 and 2/1. The area transduced by rAAV 2/8 was smaller, but nevertheless almost equal numbers of nigral cells were targeted. Detailed confocal analysis revealed that serotype 2/7, 2/9, 2/1 and 2/8 transduced at least 70% of the DNs. In conclusion, these results show that various rAAV serotypes efficiently transduce nigral DNs, but significant differences in transgene expression pattern and level were observed.     

Interleukin-2 (IL-2) immunotherapy

Various forms of immunotherapy have been employed for the treatment of cancer patients during the past 5 years, with recombinant interleukin-2 (IL-2) having been widely used in these treatment regimes. The progress of IL-2 immunotherapy is discussed.     

乳腺癌环氧合酶-2和基质金属蛋白酶-2及其抑制因子的表达

目的 研究环氧合酶(COX)-2、基质金属蛋白酶(MMP)-2及其抑制因子(TIMP-2)在乳腺癌组织中的蛋白表达及其相互关系.方法 建立组织芯片平台,应用免疫组织化学S-P法检测127例乳腺癌组织COX-2、MMP-2和TIMP-2蛋白的表达情况.结果 乳腺癌COX-2、MMP-2和TIMP-2阳性率分别为81.1%(103/127)、96.9%(123/127)和60.6%(77/127);COX-2的表达与乳腺癌腋淋巴结转移和TNM分期均呈正相关(P<0.01,P<0.05),与孕激素受体表达呈负相关(P<0.05);MMP-2蛋白表达与COX-2表达呈显著正相关(r=0.290,P<0.01).结论 乳腺癌COX-2表达状况与肿瘤侵袭转移有密切关系,COX-2可能通过调控MMP-2表达来促进肿瘤侵袭转移.