Correlational Research of Platelet-derived Growth Factor（PDGF）-BB and Chronic Hepatitis B

Objective To explore the relevance of CHB patients＇ serum levels of PDGF-BB with their ages, sexes, medical histories, serum HBVDNA levels, liver function and Liver Fibrosis markers （HA, CⅣ, PCⅢ, LN）, and relevance between serum levels of PDGF-BB and CHB patients＇ liver fibrosis degrees. Methods （1） 74 CHB patients with serum levels of PDGF-BB and their ages, sexes, medical histories, serum HBVDNA levels, liver functions and serum hepatic fibrosis markers （HA, CⅣ, PCⅢ, LN） to conduct an analysis of their relations; （2） 74 CHB patients were divided into three groups： mild, moderate and severe, and analyzed the relevance of PDGF-BB levels and serum HBVDNA levels, hepatic fibrosis and liver functions. Results （1） serum levels of PDGF-BB have no significant correlation with CHB patients＇ ages, sexes, medical histories and HBVDNA （P〉0.05）; but liver function parameters and serum HA, PCIH, CIV, LN were significantly correlated （P〈0.01）; （2） PDGF-BB levels in serum and liver fibrosis markers： HA, PCⅢ, CⅣ, LN level and liver function were positively correlated （P〈0.01）; （3） PDGF-BB levels in serum and hepatic fibrosis markers： HA, PCⅢ, CⅣ, LN level were positively correlated （P 〈0.01）. Conclusions （1） The extent of the development of liver fibrosis in CHB patients is not determined by their ages, sexes, the length of a histories or the levels of HBVDNA. Liver inflammation activity is the beginning promote in the development of liver fibrosis, which decide the extent of fibrosis; the levels of serum PDGF-BB not only can reflect the CHB patients with liver damage but also can reflect the degree of liver fibrosis; （2） It can be used in CHB patients＇ liver function and fibrosis assessment.     

肺鳞状细胞癌和肺腺癌患者ERCC1、RRM1、TS表达差异的对照研究

1 文献来源 Maus MKH,Mack PC,Astrow SH,et al.Histology-related associations of ERCC1,RRM1,and TS biomarkers in patients with non-small-cell lung cancer:Implications for therapy [J].J Thorac Oncol,2013,8(5):582-586. 2证据水平 4. 3背景 肺鳞状细胞癌(squamous cell carcinoma,SCCA)和肺腺癌(adenocarcinoma,AC)患者的化疗疗效存在差异,而这种差异可能和核苷酸切除修复交叉互补基因1 (excision repair cross-complementation group 1,ERCC1)、核糖核苷酸还原酶M1 (ribonucleotide reductase M1,RRM1)、胸苷酸合成酶(thymidylate synthase,TS)表达差异相关.     

Evaluation on Antisperm Antibody in Infertile Men with Oligoasthenoteratozoospermia

To evaluate the level of antisperm antibody （ASA） in infertile men with oligoasthenoteratozoospermia （OAT）. Methods Forty-six infertile men with OAT were enrolled into this study. Sperm samples were screened by the direct immunobead test for ASA type IgG and lgA according to the WHO laboratory manual. Results Of the 46 patients with OAT assessed for ASA-IgG, 2 had immunobead binding which were 22% and 27%, respectively, and the sub-positive rate was 4.3%. No case had the clinical positive level according to the WHO criteria （ ≥ 50% of the motile sperm with immunobead binding）. ASA-IgA was not detected in all cases. Conclusion A significant incidence or high level of ASA could not be found in infertile men with OAT, which suggests that ASA is not associated with the pathogenesis of infertile men with OAT.     

Association of TNF-α-238G/A and 308 G/A Gene Polymorphisms with Pulmonary Tuberculosis among Patients with Coal Worker＇s Pneumoconiosis

Objectives Tumor necrosis factor-α （TNF-α） may play an important role in host＇s immune response to mycobacterium tuberculosis （M. tuberculosis） infection. This study was to investigate the association of TNF-α gene polymorphism with pulmonary tuberculosis （TB） among patients with coal worker＇s pneumoconiosis （CWP）. Methods A case-control study was conducted in 113 patients with confirmed CWP complicated with pulmonary TB and 113 non-TB controls with CWP. They were matched in gender, age, job, and stage of pneumoconiosis. All participants were interviewed with questionnaires and their blood specimens were collected for genetic determination with informed consent. The TNF-α gene polymorphism was determined with polymerase chain reaction of restriction fragment length polymorphism （PCR-RFLP）. Frequency of genotypes was assessed for Hardy-Weinberg equilibrium by chi-square test or Fisher＇s exact probability. Factors influencing the association of individual susceptibility with pulmonary TB were evaluated with logistic regression analysis. Gene-environment interaction was evaluated by a multiplieative model with combined OR. All data were analyzed using SAS version 8.2 software. Results No significant difference in frequency of the TNF-α-308 genotype was found between CWP complicated with pulmonary TB and non-TB controls （2,2=5.44, P=-0.07）. But difference in frequency of the TNF-α-308 A allele was identified between them （2,2-5.14, P=0.02）. No significant difference in frequencies of the TNF-α-238 genotype and allele （P=0.23 and P=0.09, respectively） was found between cases and controls either, with combined （GG and AA） OR of 3.96 （95% confidence interval of 1.30-12.09） at the -308 locus of the TNF-α gene, as compared to combination of the TNF-α-238 GG and TNF-α-308 GG genotypes. Multivariate-adjusted odds ratio of the TNF-α-238 GG and TNF-α-308 GA genotypes was 1.98 （95% CI of 1.06-3.71） for risk for pulmonary TB in patients with CWP. There was a synergic interaction between the TNF-a-308 GG genotype and body mass index （OR=4.92）, as well as an interaction between the TNF-α-308 GG genotype and history of BCG immunization or history of TB exposure. And, the interaction of the TNF-α-238 GG genotype and history of BCG immunization or TB exposure with risk for pulmonary TB in them was also indicated. Conclusions TNF-α-308 A allele is associated with an elevated risk for pulmonary TB, whereas TNF-α-238 A allele was otherwise.     

Analysis on Reverse of Atypical Endometrial Hyperplasia by Drugs in Patients with Polycystic Ovary Syndrome

Objective To analyze the efficacy and safety of drugs on reverse of atypical endometrial hyperplasia in patients with polycystic ovary syndrome （PCOS）. Methods Seventeen patients with PCOS complicated by atypical endometrial hyperplasia （9 patients who were treated with progestin but not reversed were considered as group A; 8 patients who were untreated were considered as group B） were retrospectively analyzed Both groups received oral glucose tolerance test （OGTT） and insulin release test, to check whether the patients had insulin resistance （IR） or hyperinsulinemia. The 17 patients were treated with oral contraceptives combined with metformin. Results After the 17 patients with PCOS complicated by IR and hyperinsulinemia received drug treatment for 3 -6 cycles, atypical endometrial hyperplasia was success- fully reversed Conclusion Oral contraceptives combined with metformin is a clinically practical and effective method for treatment of PCOS complicated by atypical insulin-resistant endometrial hyperplasia.     

Which is the Best Protocol of Ovarian Stimulation Prior to Artificial Insemination by Donor

Objective To compare the different ovarian stimulation protocols, clomiphene citrate （CC）, letrozole, human menopausal gonadotropin （hMG） only or combined with CC or letrozole in women undergoing artificial insemination by donor （AID）. Methods In this prospective clinical trial, 671 couples prepared for AID cycles were randomly allocated to 6 groups according to receive different protocols for the first time, natural cycle （group A, n=l14）, CC （group B, n=lOl）, CC and hMG （group C, n=124）, letrozole （group D, n=97）, letrozole and hMG （group E, n=123） and hMG only （group F, n=l12）. Outcomes including total dose of hMG, duration of hMG therapy, dominant follicles number, endometrial thickness, rates of clinical pregnancy, miscarriage, ovarian hyperstimulation syndrome （OHSS）, multiple pregnancy and can- celation were compared among the 6 groups. Results The total doses and duration of administered hMG were significantly lower in group C and group E than in group F. Dominant follicle number was significantly less in group A and more in group C than in other groups. Endometrial thickness of group B was significantly lower than that of other groups. Clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, OHSS rate and cancelation rate were not statistically different among the stimulation groups. Conclusion AID cycles in which both CC and letrozole had been administered may require shorter duration and a lower total gonadotropin dose, while the clinical out-comes were similar.     

Comparison of the Effects and Safety of Mild Ovarian Stimulation and Conventional Ovarian Stimulation with A Long GnRH Agonist Protocol on IVF Outcomes

Objective To conduct a Meta-analysis of studies that compared the efficacies of mild ovarian stimulation and conventional long GnRH agonist protocol in patients under- going IVF or intracytoplasmic sperm injection （ICSI）. Methods Meta-analysis was performed. All studies were published by July 2012 with data related to outcomes following mild ovarian stimulation compared with the conventional protocol. Odds ratios （ORs） and weighted/standardized mean difference （WMD/SMD） from individual study were pooled in fixed and random effect models. Main outcome measure was the efficacy of mild ovarian stimulation. Results Six articles were included in this Meta-analysis. The number of oocytes retrieved was lower, the cycle cancellation rate was higher and the incidence of ovarian hyperstimulation syndrome （OHSS） was lower in the mild stimulation group than in conventional ovarian stimulation group. Clinical pregnancy rates were similar in both mild and conventional stimulation groups. Conclusions The level of evidence supporting the use of mild stimulation protocols in IVF is low, considering the fewer oocytes retrieved and the higher rates of cycle cancellation.     

低剂量螺旋CT联合PET筛查重度吸烟人群早期肺癌的研究—来自2年的临床试验结果

1文献来源Pastorino U,Bellomi M,Landoni C,et al．Early lung-cancer detection with spiral CT and positron emission tomography in heavy smokers：2-yearresults[J]．Lancet,2003,362：593-597．2证据水平2b。3背景在欧洲,肺癌的总体5年生存率仅有10％,     

心理疗法及中医药在围绝经期抑郁症治疗中的应用进展

围绝经期是妇女自生育功能旺盛走向衰退的过渡时期，包括从出现与绝经有关的内分泌、生物学和临床特征起，至最后一次月经后1年。围绝经期抑郁症是指初次发病于围绝经期，以焦虑不安、情绪低落、思维迟钝为主要症状的疾病，属于情感性精神障碍。大多数病人表现为心情压抑、悲伤、焦虑，常伴有失眠、躯体不适等植物神经紊乱的症状和内分泌功能尤其是性腺功能减退或衰老的表现。     

T3098C and T53C Mutations of HBV Genotype C Is Associated with HBV Infection Progress

Objective To analyze the association between mutation（s） in preS region of HBV and hepatitis B disease progress in Chinese patients with genotype C chronic HBV infection. Methods Ninety-three patients with chronic genotype C HBV infection, including 24 asymptomatic carriers （ASC）, 26 patients with chronic hepatitis B （CHB）, 22 patients with liver cirrhosis （LC） and 21 HCC patients were investigated. Levels of HBV DNA, HBeAg, alanine aminotransferase （ALT）, asparate transaminase （AST） were measured. HBV preS region was analyzed by PCR direct sequencing. Results The prevalence of preS T3098C and T53C mutations ofgenotype C HBV was significantly higher in LC and HCC patients than ASC and CHB patients. The rate ofT3098C mutation in ASC, CHB, LC, and HCC patients were 0.00% （0/24）, 3.85% （1/26）, 9.09% （2/22）, and 30.77% （8/22）, respectively （P=0.0015）, while the rate of T53C mutation was I2.50% （3/24）, 3.85% （1/26）, 40.91% （9/22）, and 42.31% （11/26）, respectively （P=0.0012）. Conclusion The frequency of genotype C HBV preS T3098C and T53C mutations is associated with hepatitis B infection progression.     

Determination of Conversion Coefficient to Evaluate Couple-year of Protection （CYP） for Tubectomy and Vasectomy in Urban and Rural Regions of Iran： IMES Study

Objective To calculate couple-year of protection （CYP） by conversion coefficient （F） of tubectomy and vasectomy in urban and rural regions of Iran. Methods A total of 103 450 married women aged 10-49 years in 2005 across urban and rural regions of lran were sampled by multi stage cluster sampling. The data were collected by household survey and direct interview and analyzed by STATA8.0 software and survey analysis commands. Results Mean age of the women at the time of tubectomy estimated 31.9 years and conversion coefficient of tubectomy was 17.1 ±0.1. Mean age of women at the time of her husband vasectomy estimated 31.48 years and its conversion coefficient was 17. 5 ± 0. 1. Cluster analysis defined different regions of Iran on the basis of evaluated conversion coefficients of tubectomy and vasectomy which both of them presented seven clusters. Literacy of women and total coverage of family planning in a region had a direct relationship with this conversion coefficient （P〈0.05）. Conclusion The variations observed in the conversion coefficients and their dissimilarity among different regions of Iran may be due to a variety of fundamental factors of which literacy and culture are of important factors.     

Effects of Growth Hormone Supplementation in Patients Undergoing IVF/ICSI-ET with Poor Ovarian Response to Gonadotropin

Objective To analyze the effects of growth hormone （GH） supplementation during IVF/ ICSI-ET in Chinese patients who had prior IVF cycle with poor response to gonadot- ropin （Gn）. Methods Ovulation was stimulated in 389 consecutive patients who all had poor ovarian response, among them, 102 patients （GH cycle） received 4 IU GH and the other 287 patients （non-GH cycle） underwent IVF without GH. Fisher＇s exact test, Chi square test and Student＇s t-test were used to analyze IVF/ICSI-ET outcomes. Results After GH treatment, 102 patients had significantly more large- and medium- sized follicles, oocytes retrieved, 2 pronucleus oocytes, metaphase H stage （M~I） oocytes, and high-quality embryos than in previous cycles without GH. However, the number of embryos transferred, clinical pregnancy rate, transfer rate and biochemical pregnancy rate were not significantly different. Furthermore, the 102 patients given GH had significantly lower luteinizing hormone levels and biochemical pregnancy rates; thicker endometrium and more Gn administration days; and more large- and medium-sized follicles and M~I oocytes than 287 other patients undergoing IVF/ICSI-ET without GH. However, these groups did not differ significantly in clinical pregnancies, high-quality embryos, Mn oocytes, and embryo implantation rates. Conclusion GH may improve some IVF/ICSI-ET outcomes for women with poor ovarian response.     

Analysis of Translocation of the CagA Protein and Induction of a Scattering Phenotype in AGS Cells Infected with Helicobacterpylori

Objective To investigate whether the presence of structured CagA proteins in Western- and Eastern-type Helicobacter pylori （H. pylori） induces different incidences of gastric diseases. Methods CagA and phosphorylatd CagA were expressed in AGS gastric epithelial cells infected with wild type and mutant strains. The ability of individual CagA was determined by immunoprecipitation and Western blot assay. Morphological changes of these cells were observed under microscope to evaluate the appearance of elongation hummingbird phenotype. Results The sizes of CagA proteins in different strains were different, and no phosphorylated CagA proteins were detected in wild-type strains. Meanwhile, the kinetics of CagA status in AGS infected with H. pylori was detected. The molecular weight of phosphorylated CagA with the same size of CagA proteins in H. pylori was different in infections with different wild-type strains. CagA and phosphorylated CagA increased in a time-dependent manner after the infection. The hummingbird phenotype with H. pylori for time-course was observed under microscope. Instead of HPK5 strain, the wild-type 26695 strain induced hummingbird phenotype in a time-dependent manner. Conclusion Translocation and phosphorylation of CagA are necessary, but not sufficient, for the induction of hummingbird phenotype in AGS cells.     

肺部孤立结节患者处理新策略的效价比

1文献来源Gould，MK，Sanders GD，Barnett PG，etal．Cost-effectiveness of alternative management strategies for patients with solitary pulmonary nodules[J]．Ann Intern Med，2003，138（9）：724-735．2证据水平1a。     

射频消融治疗肝细胞肝癌疗效的系统评价

3背景 肝细胞癌（hepatoeellular carcinoma,HCC）作为世界上最常见的恶性肿瘤死因之一．仅有20％的患者可以接受根治性治疗（手术切除或肝移植）。对于无法手术切除的肝细胞癌,     

Evaluation of Current Termination of Pregnancy and Related Services at Grimsby （UK） and Recommendations for Service Improvement

Objective To develop local termination of pregnancy （TOP） dataset and to identify ＂hotspots＂ for highest activity and gaps in our fertility control services. Methods This was a retrospective analysis of 305 women who received TOP under section C of the Abortion Act 1967 over a period of 9 consecutive months from 1st March through to 31st October 2012. Results There were 275 （90.2%） British White （BW） and 30 non-BW women. Among 30 non-BW women, 10 （3.3%） were British Asian, 8 （2.6%） were Polish, 6 （2.0%） were British Black or Black, 5 （1.6%） were Chinese and i （0.3%） was White Latvian. The TOP rate was 8.9% in the under 18 years old and 27.9% in the over 30 years old. Totally 240 TOPs （78. 7%） occurred in 〈10 weeks and 276 TOPs （90.5%） occurred under 13 weeks of gestation. Eight-five women who received TOP-service have had one or more previous termination（s） in the last 3 years. The contraception use was low pre-TOP and none of the women were on long-acting reversible contraception （LARCs） pre- TOP, including those who had repeat terminations. Conclusion There are inequalities and gaps in the TOP and related services in Grimsby which must be addressed to reduce the rate of TOP. This is a major challenge involving multiple agencies. Provision of contraception across all age and ethnic groups, improving sex education, engaging with parents and women to improve their negotiation skills for safer sex, supporting vulnerable women, reducing risk factors e.g. alcohol and substance misuse and raising aspirations across the region will contribute to a reduction in termination rate.     

学术自述

1978年,我调往中国社会科学院哲学研究所。到了哲学所,我面临着科研方向的重要抉择。我决定选择科学哲学和生命伦理学作为我今后科研的主要方向。由于闭关多年,我们对世界科学哲学的长足发展一无所知,对波普尔、库恩等科学哲学家一无所知。实际上,自然辩证法是中国马克思主义派的科学哲学,但不参加科学哲学的国际对话,是无法进一步发展自己的。对新出现的生命伦理学这一新领域也一无所知。     

EGFR-TKI有效肺癌经“药物间歇”后再获TKI敏感

1文献来源Becker A, Crombag L, Heideman DA, et al. Retreatment with Erlotinib: Regain of TKI sensitivity following a drug holiday for patients with NSCLC who initially responded to EGFR-TKI treatment [J]. Eur J Cancer, 2011,47(17):2603-2606. 2证据水平1c。     

Apoptosis of macrophages induced by human papollimavirus tgpes 18 E2 protein

Objective To investigate the effect of over-expression of E2 protein GFP-E2,GFP-TAD （N-extremity domain of HPV18 E2） and GFP-DBD （C-extremity domain of HPV18 E2） fusion proteins on the apoptosis of macrophages in uterine cervix cancer was studied. Methods TAD or DBD gene was amplified by PCR from pEGFP--C1/HPV18 E2, and cloned into pEGFP-CI vector. Then the subclone of pEGFP-CI/TAD or pEGFP-C1/DBD was screened respectively. Forty-eight hours after transfection of pEGFP-CI/HPV18 E2,pEGFP-C1/TAD,pEGFP-C1/DBD or pEGFP-C1 into macrophages,the localization or expression of them was analyzed by fluorescent microscope or western blot,respectively. The apeptotic rate of macrophages was detected by flow cytometry. Results The plasmid of pEGFP-C1/TAD or pEGFP-C1/ DBD was constructed respectively. Macrophages transfected with different plasmid, over-expression of GFP-E2 or GFP-TAD fusion protein up-regulated apoptotie rate of macrophages. Furthermore,the effect of GFP-TAD was more powerful than GFP-E2. But the GFP-DBD over-expressed had not the same effects. Conclusion Over-expression of GFP-E2 or GFP- TAD fusion protein could induce apeptosis of macrophages.