重组人血管内皮生长因子165腺病毒载体的构建与鉴定

目的 探讨构建携带人血管内皮细胞生长因子(hVEGF)的重组腺病毒载体,为进一步的基因转染构建组织工程骨的血管化提供实验基础.方法 采用RT-PCR扩增的方法获得人源性的hVEGF165,并克隆入穿梭质粒pAdTraek CMV.构建的质粒pAdTrack CMV-VEGF165经酶切及测序鉴定正确后,通过pAdeasy 1质粒的介导与腺病毒包装质粒pAdTrack CMV.VEGF165共转染至人胚肾细胞HEK293,经同源重组后获得携带人VEGF的重组腺病毒pAdTrack CMV.VEGF165.应用PCR鉴定重组腺病毒,空斑传代纯化病毒并反复冻融扩增病毒,测定病毒滴度.结果 PCR鉴定证实重组腺病毒含有人VEGF,病毒滴度为0.5×10"pfu/ml.结论 成功构建的携带人VEGF的重组腺病毒载体能在HEK293细胞内扩增获得足够高的病毒滴度,为基因治疗构建组织工程骨血管化的研究奠定基础.     

三元复合因子Net嵌合型重组腺病毒载体的构建及鉴定

目的:克隆人三元复合因子Net全长基因,构建其重组腺病毒载体。方法 :抽提正常人胰腺组织中总RNA,经RT-PCR扩增出全长Net基因,利用同源重组的方法将腺病毒骨架质粒pBHG35和穿梭质粒pDC316-Net共转染293细胞,获得腺病毒重组质粒Ad5/F35-Net,在293细胞中包装和扩增后,获得高滴度的腺病毒重组质粒Ad5/F35-Net。采用PCR和蛋白印迹法检测Net基因的表达。结果 :用RT-PCR方法 ,从人胰腺癌组织中扩增出1224 bp的cDNA片段,经测序证实为人Net基因。最终构建及包装出高滴度的重组腺病毒载体Ad5/F35-Net。结论:成功克隆了人Net全长基因,并构建其重组腺病毒表达载体,为进一步研究人Net基因在相关肿瘤疾病中的生物学作用奠定了基础。     

EEF1A2嵌合型重组腺病毒载体的构建及鉴定

目的:克隆人类真核翻译延长因子1A2(EEF1A2)基因全长,构建其重组腺病毒载体。方法:应用RT-PCR方法从人胰腺癌组织中扩增人EEF1A2基因全长,经T-A克隆后,亚克隆到腺病毒穿梭质粒pDC316,构建穿梭质粒pDC316-EEF1A2。利用同源重组的方法将腺病毒骨架质粒pBHG35和穿梭质粒pDC316-EEF1A2共转染293细胞,获得腺病毒重组质粒Ad5/F35-EEF1A2,经过在293细胞中包装和扩增之后,获得高滴度的腺病毒重组质粒Ad5/F35-EEF1A2。PCR、WesternBlot检测EEF1A2基因的表达。结果:用RT-PCR方法,从人胰腺癌组织中扩增出1400bp的cDNA片段,经测序证实为人EEF1A2基因。构建及包装出高滴度的重组腺病毒载体Ad5/F35-EEF1A2。结论:成功地克隆了人EEF1A2基因全长,并构建其表达的重组腺病毒载体,为进一步研究人EEF1A2基因在相关疾病中的作用奠定了基础。     

携带人血管内皮生长因子165基因的复制缺陷型腺病毒载体的构建和鉴定

目的:构建携带人血管内皮生长因子(VEGF)165基因的重组腺病毒载体。方法:应用EcoRⅠ和XbaⅠ酶切质粒PDC-VEGF和PDC315,连接DNA目的片段后转化大肠杆菌DH5α构建重组质粒PDC315-VEGF,对重组质粒进行酶切分析和测序鉴定。通过脂质体将质粒PDC315-VEGF与质粒pBHGE3共转染293细胞获取重组腺病毒,以重组腺病毒DNA为模板,PCR鉴定构建的重组腺病毒。扩增、浓缩纯化重组腺病毒,微量滴定法测定腺病毒滴度。结果:通过连接反应构建重组质粒PDC315-VEGF,酶切分析和测序证明构建正确。经细胞内同源重组构建携带人VEGF165基因的重组腺病毒,PCR扩增421bpVEGF165片段,证实VEGF165基因成功克隆到复制缺陷型腺病毒载体,腺病毒滴度为5.0×109pfu/mL。结论:通过双质粒细胞同源重组,生产携带人VEGF165基因的重组腺病毒,为动物试验奠定基础。     

血管内皮生长因子(VEGF165)真核表达载体的构建与鉴定

目的　构建人VEGF16 5腺病毒表达载体 ,探讨应用血管内皮生长因子 (VEGF)基因治疗脑梗死的可行性。方法　采用分子克隆技术 ,以质粒hVEGF16 5·SR为模板 ,扩增hVEGF16 5成熟cDNA。经穿梭质粒PShuttle克隆到腺病毒质粒上 ,构成Adeno VEGF16 5腺病毒重组质粒 ,经酶切及测序鉴定正确后 ,包装成为重组Adeno VEGF16 5腺病毒 ,并进行电镜观察及滴度测定。用免疫印迹及免疫组化方法检测VEGF蛋白的表达。结果　经酶切鉴定及基因测序证实重组腺病毒质粒构建成功 ,电镜显示包装细胞中有病毒存在 ,包装的病毒滴度为 8× 10 1 0 pfu ml,免疫印迹及免疫组化检测有VEGF16 5蛋白的表达 ,而对照未见VEGF16 5转录和表达。结论　构建的VEGF16 5腺病毒表达载体可在体外表达 ,VEGF基因有可能用于治疗脑梗塞     

VEGF165基因重组腺病毒载体的构建及其促血管形成作用

目的构建携带人血管内皮细胞生长因子165（VEGF165）基因的腺病毒表达载体（Ad—VEGF165）,并观察其感染QBI．293A靶细胞后目的基因的表达及促进血管形成的作用。方法以含有VEGF165基因片段的pSV-K3-VEGF165质粒为模板,PCR扩增获得的VEGF165目的片段（XhoI、EcoRV）亚克隆至GFP标记的pAdTrack—CMV载体中构建重组转移质粒pAdTrack．CMV．VEGF165,行PCR、双酶切和DNA测序鉴定。将测序正确的pAdTrack—CMV．VEGFl65质粒经PmeI线性化后与腺病毒骨架质粒pAdEasy．1共转化BJ5183细菌,获得同源重组腺病毒质粒pAdEasy-1．pAdTrack-CMV．VEGF165（pAd．VEGF165）,再经PacI线性化后用脂质体转染QBI．293A包装细胞,通过多轮扩增和氯化铯密度梯度离心纯化获得Ad．VEGFl65重组腺病毒。RT．PCR和ELISA检测腺病毒介导的外源性VEGFl65基因在QB｜．293A细胞中的转录和表达。将孵育8d的生长状态良好的鸡胚随机分成Ad空载体腺病毒组、Ad—VEGFI65重组腺病毒组、NS组。采用鸡胚尿囊膜（CAM）法检测VEGF165重组腺病毒促进尿囊膜血管形成活性。结果PCR、双酶切和测序鉴定结果证实成功构建了pAdTrack．CMV—VEGF165重组转移质粒,并获得了高滴度的Ad．VEGF165重组腺病毒,其病毒效价可达2×10^10pfu／mL。Ad-VEGFl65感染后,QBI．293A细胞中的VEGF165含量较QBI．293A细胞对照组和Ad空病毒感染组均明显升高（P〈0．05）。Ad-VEGF165组与Ad．空载体组和NS组比较,CAM三级分支血管生长更旺盛,毛细血管更丰富（P〈0．05）。结论成功获得了携带人VEGF165基因的腺病毒表达载体,具有明显的促CAM血管形成活性,为进一步开展VEGF165基因修饰干细胞的应用研究奠定了实验基础。     

重组腺病毒载体Ad5-hBDNF-EGFP的构建与鉴定

背景:基因治疗是目前脊髓损伤治疗的方向,目的基因和载体是基因治疗的关键.目的:构建携带增强型绿色荧光蛋白基因(Enhanced green fluorescence protein,EGFP)标志人脑源性神经营养因子(human brai-denved neurotrophic factor,hBDNF)基因重组腺病毒载体.设计、时间及地点:单.一样本观察,实验于2007-09/2008-06在福建医科大学附属第一医院完成.材料:感受态大肠杆菌DH-5 α购自美国Stratagene公司;pDC316-hBDNF、载体质粒pDC316-mCMV-EGFP、腺病毒骨架质粒pBHGlox_E1,3Cre 、腺病毒包装系统AdMax 和包装细胞株293购自加拿大Mixcrobixg- Biosysrerms公司.方法:以pDC316-hBDNF为模板,聚合酶链反应扩增酶切获得hBDNF基因片段,连接到带有EGFP标记基因的载体质粒pDC316-mCMV-EGFP上,构建穿梭质粒pDC316-hBDNF-mCMV-EGFP.利用AdMax包装系统.穿梭质粒与骨架质粒pBHGlox_E1,3Cre共转染293包装细胞,同源重组产生复制缺陷型重组腺病毒载体Ad5-hBDNF-EGFP,反复感染293细胞扩增病毒后,离子交换法纯化病毒,并测定病毒颗粒数及滴度.主要观察指标:①hBDNF基因原始质粒聚合酶链反应鉴定.②穿梭质粒pDC316-hBDNF-mCMV-EGFP的构建及鉴定.③重组腺病毒Ad5-hBDNF-EGFP的包装、扩增及纯化.④毒种目的基因的聚合酶链反应鉴定.⑤纯化病毒的滴度测定结果.结果:经聚合酶链反应鉴定、限制性酶切分析及序列测定,证明已正确构建重组穿梭质粒pDC316-hBDNF-mCMV-EGFP和重组腺病毒载体Ad5-hBDNF-EGFP;扩增纯化后,测得重组腺病毒颗粒数为2.4×1011VP/mL,A260/A280值约为2.0,滴度为0.8×1010 CCID50/mL.结论:已成功构建重组腺病毒载体Ad5-hBDNF-EGFP,为hBDNF基因功能及基因治疗的进一步研究奠定实验基础.     

人骨形态发生蛋白2基因重组腺病毒的构建与鉴定

背景:骨形态发生蛋白2是诱导成骨关键物质,参与调节从细胞增殖、决定种系分化方向到细胞死亡等一系列的生物过程。目的:利用AdMax系统构建人骨形态发生蛋白2基因的重组腺病毒载体并鉴定。方法:以人cDNA为模板PCR扩增人骨形态发生蛋白2基因,转化E.coli感受态细胞,经菌落PCR鉴定阳性转化子、阳性克隆测序无误后,扩增、抽提。将带有目的基因的腺病毒表达载体和携带有腺病毒大部分基因的辅助包装质粒共转染293细胞进行病毒包装扩增,PCR检测目的基因、Western Blot检测目的蛋白及终点稀释法检测病毒滴度。结果与结论:PCR获得长度为1223bp的人骨形态发生蛋白2目的基因片段,同源重组表达载体经阳性克隆PCR及测序鉴定,结果正确。293细胞内包装、扩增,经Westernblot及PCR鉴定无误后,获得病毒滴度为5×1013pfu/L的重组腺病毒。实验成功构建携带有人骨形态发生蛋白2基因的重组腺病毒载体。     

重组腺病毒载体Ad5-Olig1-eGFP的构建与鉴定

目的:转录因子Olig1调控了少突胶质前体细胞的分化和成熟,并参与了脱髓鞘损伤后的修复,是治疗脱髓鞘疾病的候选基因,在缺血性脑血管病的治疗中具有极大的应用价值。本实验旨在构建携带Olig1基因的重组腺病毒载体。方法:pDC315-Olig1为模板,聚合酶链反应扩增酶切Olig1片段,连接到带有eGFP标记基因的载体质粒pDC315-eGFP上,构建穿梭质粒pDC315-Olig1-eGFP,经PCR,酶切及测序鉴定后,利用AdMax包装系统,通过脂质体2000的介导与骨架质粒pBHGlox_E1,3Cre共转染HEK293细胞,同源重组后产生复制缺陷型重组腺病毒载体Ad5-Olig1-eGFP,应用PCR对毒种进行鉴定,传代纯化病毒并反复冻融扩增病毒。以50%组织培养感染剂量法(TCID50)测定病毒滴度。结果:经聚合酶链反应,酶切鉴定和测序分析,得到大小700bp(Olig1)目的片段,证实正确构建重组穿梭质粒pDC315-Olig1-eGFP和重组腺病毒Ad5-Olig1-eGFP,测得重组腺病毒颗粒数为2.3×1011v.p./mL。结论:成功构建携带Olig1的重组腺病毒载体Ad5-Olig1-eGFP,为缺血性脑血管病的基因治疗提供基因载体并奠定实验基础。     

EGFP标记的hVEGF165重组腺病毒构建新方法及其相关特性的体外研究

利用细菌内同源重组法快速构建增强型绿色荧光蛋白 (EGFP)标记的人血管内皮细胞生长因子 16 5(hVEGF165)重组腺病毒载体 ,并对其相关特性进行体外研究。首先将hVEGF165cDNA亚克隆到含EGFP基因的腺病毒穿梭质粒 pAdTrack CMV中 ,然后与腺病毒骨架质粒pAdEasy 1共同电击转化大肠杆菌BJ5183 ,同源重组获得重组腺病毒质粒 pAd EGFP/hVEGF165,鉴定后通过脂质体法转染HEK2 93细胞 ,产生重组腺病毒Ad EGFP/hVEGF165。通过体外试验观察病毒的形态、均一性和安全性 ,靶细胞的感染效率及hVEGF165的表达情况。结果显示 ,通过细菌内质粒间同源重组法在短期内成功地构建了复制缺陷型重组腺病毒载体Ad EGFP/hVEGF165;借助于EGFP的表达 ,直接在荧光显微镜下观测到靶细胞的感染效率和外源基因的表达。经纯化的病毒颗粒在电镜下成分均一 ,滴度可达 2× 10 12 pfu/ml。病毒感染Hela细胞后经多次传代未见细胞病变。以感染复数 (MOI) =10 0感染hUVEC可获得最大增殖刺激作用。同样浓度感染小鼠骨髓单个核细胞效率达 2 7.3% ,培养上清中hVEGF165蛋白含量达 1385± 332 pg/ 10 6cells。结论 :细菌内同源重组法构建腺病毒载体具有高效、省时、省力的特点 ,辅以EGFP为标记基因可以直观检测靶细胞感染和外源基因的表达情况。利用该     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.