内皮抑素和血管抑素表达与大肠肿瘤侵袭转移的关系

目的探讨内皮抑素和血管抑素在大肠肿瘤组织中的表达,与大肠癌不同阶段的关系及临床意义。方法应用免疫组织法检测20例正常大肠组织、20例大肠腺瘤和60例大肠癌及其组织中内皮抑素和血管抑素的表达情况。应用χ2检验对内皮抑素和血管抑素两者在大肠肿瘤不同阶段的表达关系进行统计分析,两者表达间的相关性探讨采用spearman相关分析。结果内皮抑素和血管抑素阳性表达与大肠肿瘤不同阶段的关系spearman相关系数分别为-0.438、-0.362,两者的表达与大肠癌的Dukes分期、淋巴结转移显著相关(P<0.05),均与腺瘤的类型无相关性。结论内皮抑素和血管抑素可以抑制大肠癌的侵袭转移。内皮抑素和血管抑素在大肠癌组织中呈低表达,且两者的阳性表达率随着临床分期的进展而降低,提示其与大肠癌的发生、发展、浸润及转移有明显关系。两者在大肠癌组织中的表达呈明显的一致性,对两者进行联合检测,有助于大肠癌的早期诊断、治疗及预后的评估。     

硝酸甘油对哮喘患者一氧化氮内皮素的影响及机制

目的　了解哮喘患者肺泡巨噬细胞（ＡＭ） 、支气管上皮细胞（ＢＥＣ） 源性一氧化氮（ＮＯ）、内皮素（ＥＴ）的分泌状态及硝酸甘油（ＮＴＧ）对哮喘患者ＡＭ、ＢＥＣ产生ＮＯ、ＥＴ的影响及机制。方法　分离纯化了１５ 例轻、中度哮喘发作期患者、７ 名健康受试者ＡＭ、ＢＥＣ,并分为哮喘未干预组、哮喘ＮＴＧ干预组和健康对照组,用放射免疫法和镀铜镉还原法分别测定ＡＭ、ＢＥＣ培养４８ 小时上清液中ＥＴ、ＮＯ·２／ＮＯ·３ 浓度,用原位杂交的方法检测ＡＭ、ＢＥＣｉＮＯＳｍＲＮＡ、ＥＴｍＲＮＡ 的表达。结果　（１） 健康受试者ＡＭ、ＢＥＣ分泌少量ＮＯ和ＥＴ及少量ｉＮＯＳｍＲＮＡ 、ＥＴｍＲＮＡ表达;（２）哮喘患者ＡＭ、ＢＥＣ源性ＮＯ、ＥＴ水平及ＡＭ、ＢＥＣｉＮＯＳｍＲＮＡ、ＥＴｍＲＮＡ表达与各组比较差异有显著性（ Ｐ均＜ ０－０５）;（３）ＮＴＧ 促进哮喘患者ＡＭ、ＢＥＣ源性ＮＯ产生（ Ｐ均＜０－０５）,明显抑制ＥＴ产生和ＥＴｍＲＮＡ 的表达,与对照组比较差异均无显著性（ Ｐ均＞ ０－０５） ,ＮＴＧ同时抑制哮喘患者ＡＭ、ＢＥＣｉＮＯＳｍＲＮＡ的表达,与健康对照组、哮喘未干预组比较差异有显著性（Ｐ均＜０－０５） ;（４） 除哮喘ＮＴＧ     

高血压病患者右心室结构和功能的变化及相关因素分析

本文研究高血压病患者右心室结构和功能变化、影响因素及其与左室结构和功能变化的关系。分析８９例未经治疗的Ⅰ或Ⅱ期高血压病患者与８２例正常对照者之间按超声心动图测算的右室解剖结构和功能指标的差异、相关关系及其与左室对应指标及其他影响因素的相关性。结果显示:高血压病患者右室前壁厚度增加,舒张期充盈受损,经协方差分析将年龄、性别、体重指数及心率等的影响剔除之后,差异仍存在显著性。收缩功能指标无显著性变化。右室结构和功能变化与血压水平和高血压所致的左室结构和功能变化之间有显著性相关关系。年龄、性别、体重指数及心率也是影响右室结构和功能测值的可能因素。     

Lipid disorders and their relevance to outcomes in chronic kidney disease

Cardiovascular disease is the major cause of death in patients with chronic kidney disease (CKD). Cardiovascular disease and many other complications of CKD are mediated by oxidative stress, inflammation, and dyslipidemia. This review provides a concise overview of the nature and mechanisms of CKD-induced lipid disorders and their adverse consequences. Lipid abnormalities in end-stage renal disease are characterized by: (a) reduced serum apoA-1 and high-density lipoprotein (HDL) concentrations, impaired HDL maturation and defective HDL antioxidant, anti-inflammatory and reverse cholesterol transport properties; (b) impaired clearance of very low-density lipoprotein and chylomicrons by the muscle and adipose tissue and of their remnants by the liver leading to hypertriglyceridemia, accumulation of intermediate-density lipoprotein and chylomicron remnants, and (c) oxidative modification of LDL and lipoprotein remnants favored by their structural abnormalities, oxidative stress, and impaired HDL antioxidant activity. Together these abnormalities result in: (a) uptake of oxidized LDL and remnant particles by macrophages and resident cells in the artery wall which along with impaired HDL-mediated reverse cholesterol transport causes foam cell formation and atherosclerosis, (b) production of inflammatory mediators and reactive oxygen species by leukocytes and macrophages in response to stimulation by oxidized LDL and phospholipids leading to intensification of oxidative stress and inflammation, (c) dissemination of oxidative stress by circulating oxidized lipids and lipoproteins via lipid peroxidation chain reaction, (d) heightened injurious effects of oxidative stress and inflammation due to diminished antioxidant, anti-inflammatory and antithrombotic activities of HDL, and finally (e) impaired ability of very low-density lipoprotein and chylomicron to deliver lipid fuel to muscle and adipose tissue contributing to muscle weakness and cachexia which commonly occur in end-stage renal disease patients.     

Measuring the communication of social support from adult children

Further knowledge of the nature and significance of the relationships of elderly persons to their adult children requires the application of social support scales tapping the quality and content of their interactions. Scaling efforts must further address conceptual and operational specification, the differentiation of sources and dimensions of support, the objectification of self-report scales, and construct validity. Respondents to this survey are a community, stratified probability sample of adults aged 50 and older (N = 1,174). Measures employed include 2 items reflecting instrumental support and 17 items designed to tap Cobb's (1976) definition of expressive support as consisting of information that one is loved, esteemed, and embedded in a social relationship characterized by mutual caring and obligation. Factor analyses consistently discern one instrumental and three expressive dimensions of support: Caring and Concern, Social Integration, and Love and Affection. These subscales are differentially correlated with sociodemographic characteristics of the parents and adult children, as well as with depression and disability. Implications of these and other findings are discussed.     

不同地区孕妇缺碘状况及干预补碘效果的调查研究

目的研究新疆生产建设兵团3个不同地区（轻度、中度、重度缺碘地区）4组孕妇碘营养水平,及采取干预补碘前后尿碘的变化,分析评价干预效果。方法选择碘盐覆盖率、尿碘水平不同的三类缺碘地区,调查孕妇服碘化油胶丸前后的尿碘水平。结果干预前4组孕妇的尿碘中位数分别为119.90、147.20、214.00和167.10μg/L,尿碘值〈100μg/L的比例分别是30.0%、4.3%、42.9%和20%;干预后1个月4组孕妇中位数分别为172.25、148.70、164.50和229.80μg/L;尿碘值〈100μg/L的比例分别是25.0%、22.2%、19.5%和0;干预后3个月中位数分别为150.00、103.60、176.60和219.60μg/L;尿碘值〈100μg/L的比例分别是25.0%、47.8%、13.8%和13.8%;干预后6个月中位数分别为119.90、147.20、214.00和167.10μg/L;尿碘值〈100μg/L的比例分别是25.0%、15.4%、13.8%和0;干预后9个月中位数分别为173.95、185.20、208.50和262.21μg/L;尿碘值在〈100.0μg/L的比例分别是21.9%、10.3%、26.1%和0。结论干预补碘可以使缺碘地区的孕妇尿碘中位数向高值偏移,能明显改善碘缺乏地区碘营养状况;在中度缺碘地区的孕妇用较小剂量200mg能满足自身的碘需求,在重度缺碘地区的孕妇用较大剂量400mg能满足自身的碘需求,特别是在干预后1个月、3个月,干预措施对尿碘的升高影响明显。     

新疆阿拉山口口岸城区鼠类近况调查研究

目的 掌握阿拉山口口岸城区鼠、蚤密度、种群构成、季节消长规律等,为鼠疫防制提供依据.方法 2006年4月～2007年3月采用夹夜法对口岸鼠情进行监测,并利用微量血凝法检测F1抗体及抗原.结果 通过1年的调查,在城区布放有效板夹6 845个,捕获鼠形动物290只,鼠密度为4.2%,居民生活区高于作业区(P＜0.01),经过鉴定隶属2目4科6属6种,优势种为褐家鼠和小家属,分别占41.3%和34.3%;从口岸城区捕获鼠体表采集蚤288只,隶属3科5属6种;捕获鼠平均染蚤率为13.5%,总蚤指数为1.0,其中褐家鼠的染蚤率和印鼠客蚤指数分别为22.5%和2.4;共检测鼠血清52份,鼠脏器材料86份,结果均为阴性.结论 新疆阿拉山口口岸灭鼠灭蚤工作应把重点放在居民区,同时兼顾作业区;加强对城区褐家鼠和印鼠客蚤的监测和控制;密切关注口岸郊区的鼠、蚤情况,这对疫情的早发现、早控制具有现实意义.     

我国新时期水利血防面临的挑战与对策

血吸虫病的传播与流行严重威胁我国人民身体健康、阻碍经济社会发展。水利血防是指在血吸虫病流行区,利用水利工程结合血吸虫病防治措施,发挥控制钉螺孳生繁殖和扩散等防治作用,从而有效控制血吸虫病传播与流行的一种防治策略。本文回顾了我国血吸虫病防治策略和水利血防的历史沿革,以及水利血防在推进我国血吸虫病防治进程中的重要作用,分析了在当前我国的血吸虫病防治工作正在向传播阻断和消除阶段推进的新时期,水利血防工作所面临的问题和挑战,并提出了相应的水利血防对策建议:开展水利血防新策略研究;加强水利血防新技术研究,提高水利血防工程的效率和适用性;加强水利血防工程技术指导,完善工程评估体系建设等。     

Human, small round structured viruses, caliciviruses and astroviruses

Epidemiological studies on SRSVs, human calicivirus and astroviruses have been limited by the problems of establishing them in cell culture and the inability to transmit them to animals or to use strains from animals as a source of antigen for diagnostic tests. The use of EM and the subsequent development of RIAs and EIAs in a few research centres has shown that they are a cause of outbreaks and sporadic cases of diarrhoea and vomiting. SRSVs have increasingly been recognized as a major cause of outbreaks of gastroenteritis in the community and in hospital wards. The symptoms of illness are generally mild and of short duration and patients seldom require medical attention. However, because of the high attack rates and large numbers of persons of all age groups involved, there is often considerable economic loss and disruption of services. Evidence is accumulating that polluted water, molluscan shellfish, and contaminated cold foods are major sources of infection. Recently a SRSV has been shown to be the cause of epidemics and sporadic cases of waterborne enterically transmitted non-A, non-B hepatitis (hepatitis E virus) which have occurred in the USSR, India, Mexico and Africa. Astroviruses and human caliciviruses are occasional causes of outbreaks of vomiting and diarrhoea in infants and the elderly which can necessitate the closure of hospital wards and cause considerable disruption. Symptoms are generally mild and of short duration and therefore the majority of cases are unlikely to be investigated by laboratories. Diagnosis of infections is at present limited to the few laboratories that have developed their own assays or have access to electronmicroscopy facilities.     

Smoking cessation or reduction in pregnancy treatment methods: a meta-evaluation of the impact of dissemination

Active and passive exposure to tobacco smoke during pregnancy and infancy is the most serious and preventable cause of adverse maternal, fetal, and infant outcomes in the United States. The multiple risks of tobacco exposure to mothers and infants are definitive, and the clinical and economic benefits of cessation have been documented. This article provides a synopsis of the state of the science and art in this specialized area and reviews the evidence for validity of patient assessment methods and the effectiveness of smoking cessation/reduction treatments for pregnant women. A synthesis of 4 topics is presented: (1) the validity of patient reports of smoking status and recent trends during pregnancy and postpartum; (2) definition of "Best Practice" smoking cessation methods for pregnant women; (3) the effect of dissemination of effective clinical practice methods among the 800,000+ pregnant US smokers each year; and (4) the evidence for the cost-benefit of improved maternal and infant outcomes from cessation.     

胆管癌细胞无自分泌CCK、胃泌素机制

目的明确胆管癌细胞是否存在胆囊收缩素（ｃｈｏｌｅｃｙｓｔｏｋｉｎｉｎ,ＣＣＫ）、胃泌素（ｇａｓｔｒｉｎ）自分泌机制。方法采用免疫组织化学及放射性免疫分析技术,探测了胆管癌细胞ＱＢ、ＯＣ及４２例胆管癌标本中ＣＣＫ８和Ｇａｓｔｒｉｎ１７的表达,胆管癌细胞ＱＢ、ＯＣ培养上清及细胞提取液中ＣＣＫ８和Ｇａｓｔｒｉｎ１７的含量,胆管癌患者手术前后空腹血浆ＣＣＫ８和Ｇａｓｔｒｉｎ１７浓度的改变。结果发现胆管癌细胞ＱＢ和ＯＣ及胆管癌标本中均无ＣＣＫ８和Ｇａｓｔｒｉｎ１７的表达;ＱＢ和ＯＣ中未检测到ＣＣＫ８和Ｇａｓｔｒｉｎ１７的存在;胆管癌患者手术前后空腹血浆胆囊收缩素、胃泌素含量无明显变化。结论胆管癌细胞无自分泌胆囊收缩素、胃泌素现象存在。     

人参及其主要成分抗糖尿病作用机制

临床和实验研究表明人参及其活性成分具有调节糖脂代谢,抗糖尿病和肥胖的作用。由于有效成分组成和含量的不同,导致其作用机制具有复杂性和多样性,涉及糖脂代谢的多个方面,主要与抑制食欲和肠道葡萄糖与脂肪的吸收;影响糖脂代谢通路,增加能量消耗;调节过氧化物酶体增殖物活化受体γ（PPARγ）活性和表达,改善胰岛素抵抗;促进胰岛素合成和释放以及抗胰岛β细胞凋亡;抗氧化应激和抗炎作用有关。今后需要对人参不同有效部位和单体成分进行进一步的研究,明确其抗糖尿病和肥胖的确切有效成分和作用机制。     

Disability determination and the social conscience

The unfit and the unneeded! The miserable and despised and forgotten, dying in the social shambles. The progeny of prostitution–of the prostitution of men and women and children, of flesh and blood, and sparkle and spirit; in brief the prostitution of labor. If this is the best that civilization can do for the human, then give us howling and naked savagery. Far better to be a people of the wilderness and desert, of the cave and the squatting-place, than to be a people of the machine and the Abyss. (1).     

Attitudes and preferences of Korean-American older adults and caregivers on end-of-life care

A growing body of literature suggests that diverse attitudes toward the end of life exist across and within ethnic minority groups. This focus-group pilot study examined social and cultural factors influencing views of Korean-American older adults and caregivers on advance care planning and hospice care. A total of 20 older adults and 16 caregivers in west central Florida participated in one of four focus groups. This study found diverse attitudes among Korean Americans toward end-of-life care and cultural and structural barriers to advance care planning and hospice use. Older adults and caregivers both expressed a lack of knowledge about advance care planning and hospice and agreed that the family would make the final decision about the end-of-life care, while acknowledging the challenge of initiating communications about treatment preferences. They interpreted the Korean value of filial piety to support both curative and palliative treatment. The traditional norm of home death and importance of physician communication influenced preferences for hospice and advance care planning, respectively. Future outreach and education efforts should include development of culturally sensitive educational and communication tools and collaboration with ethnic community organizations and healthcare providers in the dissemination and education of these instruments.     

基于AGREEⅡ工具评价冠心病中西医临床实践指南的质量

目的基于AGREEⅡ工具评价国内冠心病临床实践指南的方法学及质量。方法计算机检索中国知网(CNKI)、维普(VIP)、万方(Wanfang Data)和中国生物医学文献数据库(CBM),收集国内冠心病临床实践指南,检索时间从建库至2019年10月。由4名研究者独立筛选文献、提取资料后,采用AGREEⅡ工具评价纳入指南的方法学质量。结果共纳入7部国内机构制订的指南或专家共识,包括急性心肌梗死中西医结合诊疗指南、冠心病稳定型心绞痛中医诊疗专家共识、冠心病心绞痛介入前后中医诊疗指南、动脉粥样硬化中西医结合诊疗专家共识、急性心肌梗死中西医结合诊疗专家共识、中医内科常见病诊疗指南(西医疾病部分)冠心病心绞痛、胸痹心痛中医诊疗指南。AGREEⅡ评价结果表明,多数指南在“范围和目的”“参与人员”“表达的清晰性”方面较完整,但“制订的严谨性”“应用性”“编辑的独立性”方面欠佳。急性心肌梗死中西医结合诊疗指南和急性心肌梗死中西医结合诊疗专家共识欠缺的两方面得分最高,其中“应用性”平均得分为46.3%,急性心肌梗死中西医结合诊疗专家共识得分最高,为59.4%,其次为急性心肌梗死中西医结合诊疗指南得分为52.1%;“编辑的独立性”方面,平均得分为47.3%,急性心肌梗死中西医诊疗指南得分最高,为75.0%,急性心肌梗死中西医结合诊疗专家共识得分次之,为62.5%。全面评价结果显示,强烈推荐使用的指南包括2个,推荐(补充或改进)的指南包括3个,不能确定是否推荐使用的指南包括2个。结论急性心肌梗死中西医结合诊疗指南和急性心肌梗死中西医结合诊疗专家共识在国内冠心病中西医临床实践指南的方法学质量均较高,可为临床诊疗提供指导性意见。     

胃癌组织COX-2、nm23-H1蛋白及其mRNA表达与胃癌浸润转移的关系

目的 探讨胃癌组织中环氧合酶-2（COX-2）、转移抑制基因23-H1（nm23-H1）蛋白及其mRNA表达与胃癌浸润转移的关系。方法 采用免疫组化SP法和原位杂交技术,检测57例胃癌组织中COX-2、nm23-H1蛋白及其mRNA。结果 COX-2、nm23-H1蛋白及其mRNA的表达均与胃癌浸润深度、淋巴结转移及TNM分期有关;COX-2、nm23-H1蛋白及其mRNA的表达均无相关性。结论 COX-2促进胃癌浸润转移,nm23-H1抑制胃癌浸润转移,两者通过各自独立的途径发挥作用。     

TIMP-1和TIMP-2在原发性肝癌生长、浸润及转移中的作用

目的：了解基质金属蛋白酶组织抑制因子-1(tissue inhibitou of metalloproteinase-1，TIMP-1)和基质金属蛋白酶组织抑制因子-2(TIMP-2)mRNA及相关抗原在肝癌组织中的定位和表达状态，探讨TIMP-1和TIMP-2在肝癌组织生长、浸润及转移中所起的作用。方法：以TIMP-1和TIMP-2探针及单克隆抗体（McAb）为试剂，采用原位杂交技术及免疫组织化学法检测原发性肝癌、肝高分化腺癌的肝组织中TIMP-1和TIMP-2mRNA及相关抗原的表达，并与10例正常肝组织做对照。结果：20例原发性肝癌患者的肝组织中TIMP-1和TIMP-1mRNA及相关抗原表达的阳性率为90%;9例肝高分化腺癌的腺癌组织中无TIMP-1和TIMP-2mRNA及相关抗原的表达；10例正常肝组织中TIMP-1和TIMP-2mRNA及相关抗原表达均为阴性；TIMP-1和TIMP-2mRNA及相关抗原阳性信号呈现为棕黄色颗粒状，分布在肝细胞浆内，未见细胞核着色；无论是原发性肝癌癌组织还是癌周组织中,TIMP-1的表达强于TIMP-2的表达，癌周组织中TIMP-1和TIMP-2mRNA和相关抗原的表达与肝组织病理改变相关，即肝硬化者表达强，慢性肝炎者表达弱，正常肝组织无表达。结论：原发性肝癌的癌组织中存在TIMP-1和TIMP-2mRNA及相关抗原的表达，其表达强度可能与原发性肝癌的分型有关，它可能通过抑制MMP的活性使ECM降解减少从而阻止癌细胞通过基底膜移出而抑制肝癌细胞向周围浸润及转移。     

Development of main disturbances of hemostasis in patients with obesity

According to current views obesity especially with increased amount of visceral fat is characterized by prothrombogenic changes of hemostasis and fibrinolysis. This combined with insulin resistance, compensatory hyperinsulinemia, disturbances of carbohydrate metabolism, atherogenic dyslipidemia and hypertension substantially increases risk of origination and progression of cardiovascular diseases. Results of our study demonstrate high prevalence of various prothrombogenic abnormalities in coagulation and anticoagulation systems in patients with visceral obesity and metabolic syndrome (MS). Disturbances of hemostasis were detected by such screening methods as measurement of APTT, INR and concentration of fibrinogen in blood plasma. We received data on positive association of severity of some abnormalities of hemostasis with anthropometric and biochemical parameters of obesity and MS, parameters of lipid and carbohydrate metabolism. Revealed disturbances of hemostasis create prerequisites for development of thrombophilia and make additional contribution to increase of cardiovascular risk in this category of patients. This dictates necessity of more thorough and deepened examination of patients with visceral obesity and MS with the aim of detection and correction of pathological changes of lipid and carbohydrate metabolism, system of hemostasis and fibrinolysis at earliest stages.     

PTTG、VEGF-C 的表达及微淋巴管密度与非小细胞肺癌临床病理特征的关系

目的检测非小细胞肺癌（non-small cell lung cancer,NSCLC）、癌旁组织及肺良性病变组织中垂体瘤转化基因（pituitary tumortrans-forming gene,PTTG）及血管内皮生长因子-C（vascular endothelial growth factor,VEGF-C）的表达和微淋巴管密度（lymphatic microvessel density,LMVD）值,并探讨三者间的相互关系。方法应用实时荧光定量PCR和免疫组织化学方法检测非小细胞肺癌组织中PTTG、VEGF-C mRNA和蛋白及LM-VD的表达,分析PTTG、VEGF-C及LMVD与NSCLC临床病理特征的关系,以及PTTG、VEGF-C和LMVD三者之间的相互关系。同时,对随访资料进行生存分析,绘制生存率曲线,探讨PTTG、VEGF-C对肺癌患者预后的影响。结果PTTG、VEGF-C mRNA和LMVD值在不同性质的肺病变组织中的表达均有显著性差异（P均〈0.05）,在不同年龄、性别、是否吸烟、肿瘤大小、组织学类型及分化程度间无显著性差异（P均〉0.05）,在TNM分期、淋巴结转移与否及预后组间有显著性差异（P均〈0.05）。PTTG、VEGF-C蛋白表达在淋巴结转移与否及预后组间有显著性差异（P均〈0.05）。生存率曲线显示PTTG、VEGF-C高表达者生存时间均短于低/无表达者（P=0.030,0.027,n=65）。PTTG在肺癌组织中的表达与VEGF-C、LMVD密切相关,随着PTTG强度增加,VEGF-C分级及LMVD值亦增加。结论PTTG、VEGF-C的过度表达促使肿瘤微淋巴管的生成,进而促进了肿瘤细胞淋巴结转移。PTTG和VEGF-C表达可作为判断NSCLC生物学行为及肺癌患者预后的良好指标,VEGF-C有望成为肺癌抗淋巴管治疗的新靶点。