姜黄素对Raji细胞黏附侵袭的调节作用

目的研究姜黄素调节FN/β1整合素和SDF1/CXCR4途径对B淋巴瘤细胞系Raji细胞黏附和迁移的影响,探讨姜黄素抑制淋巴瘤侵袭的机制。方法本实验共分8组,阴性对照、FN、SDF、FN 抗β1整合素抗体、SDF 抗β1整合素抗体、SDF 抗CXCR4抗体、姜黄素 FN、姜黄素 SDF各组,采用黏附、迁移试验检测各组Raji细胞侵袭能力的差异。结果在体外SDF1和FN均能增加Raji细胞黏附、浸润能力,并且此作用能分别被抗β1整合素抗体和抗CXCR4抗体阻断。姜黄素能显著抑制Raji细胞在FN上的黏附以及FN诱导的迁移,并且呈剂量依赖性。低剂量的姜黄素对SDF1诱导的Raji细胞黏附和趋化作用不明显,仅25μmol/L姜黄素能显著抑制SDF1诱导的Raji细胞黏附和趋化。结论FN/β1整合素和SDF1/CXCR4途径在Raji细胞的黏附迁移过程中起重要作用,姜黄素主要通过抑制FN/整合素途径激活来降低Raji细胞的侵袭能力,具有良好的临床应用潜力。     

姜黄素抗肿瘤作用研究进展

姜黄素可以降低多种肿瘤的患病率.本文综述了姜黄素对不同肿瘤的杀伤和抑制效果,总结其抗肿瘤机制为:抗氧化,阻滞肿瘤细胞周期并诱导肿瘤细胞凋亡,抑制环氧合酶,与抗肿瘤药物协同作用,抗血管生成和抑制肿瘤的侵袭与转移等.针对姜黄素的剂型发展现状和使用安全性也做了探讨,为姜黄素作为抗肿瘤药物的临床应用提供理论依据.     

姜黄素抗肺纤维化作用及机制研究进展

姜黄素是姜黄属植物根茎中分离出来一种多酚类化合物,也是中药姜黄发挥药理作用的主要成分,具有抗肿瘤、抗氧化、抗炎、抗纤维化等广谱的药理活性。近年来学者们系统深入地研究了姜黄素抗肺纤维化作用,文章归纳总结了姜黄素抗肺纤维化作用的研究概况,为其进一步的实验及临床研究提供理论参考。     

正交法优化莪术中姜黄素提取工艺研究

莪术具行气破血,消积止痛的功效.临床常用于血气心痛,饮食积滞,脘腹胀痛,血滞经闭,痛经,徵瘕痞块,跌打损伤.莪术中含挥发油、姜黄素等成分,挥发油为其抗肿瘤有效成分[1],姜黄素为莪术降血脂、抗氧化、抗炎的主要有效成分[2].……     

姜黄素抗诱变作用的实验研究

采用Ａｍｅｓ实验和微核实验研究姜黄素的抗诱变作用，旨在为进一步研究姜黄素的抗癌作用打下基础。结果表明：姜黄素（６０～２５０微克／皿）在Ｓ－９存在的情况下能有效地控制二氨基芴所致ＴＡ９８、ＴＡ１００的回复突变；抑制率分别为２９％～５５．９％；３７．５％～５９．１％；在给环磷酰胺前，经口投与小鼠６０、１２０、２４０ｍｇ／ｋｇ姜黄素一周，每日一次。结果显示：此剂量范围内，姜黄素能明显地抑制环磷酰胺诱发的小鼠骨髓细胞微核的形成。抑制率分别为４３．９％、５６．９％、６３．９％，与阳性对照相比微核形成率有极显著性差别（Ｐ＜０．０１）。上述结果提示，应拓宽姜黄素其它生物学作用，如抗致癌作用的研究     

姜黄素对金属毒性的抑制作用及机制研究进展

<正>姜黄素是从姜黄根茎中提取的一种黄色色素,也是一种拥有多个生物靶位和多重细胞效应的复杂分子,具有抗炎、抗癌和抗氧化等多种药理学效应[1]。由于姜黄素所含的特殊的二酮类结构,最近有研究发现姜黄素可结合Fe2+和Fe3+,能阻断铁的氧化还原循环[2],提示姜黄素具有铁鳌合的活性,并且可能是姜黄素预防或治疗Alzheimer’s病等神经退行     

姜黄素与氟尿嘧啶抗人结肠癌细胞株HT-29增殖的协调作用研究

目的:检测姜黄素能否增强氟尿嘧啶(fluorouracil,FU)抗结肠癌细胞的增殖作用,并探讨其与环氧合酶-2(cyclooxygenase-2,COX-2)蛋白表达的关系。方法:应用中位效应原理和联合作用指数法来定量姜黄素与FU的联合作用。应用Westernblot分析联合应用两种药物之后对于COX-2蛋白表达的影响。结果:姜黄素和FU的半数生长抑制率(IC50)分别为15.9±1.96和17.3±1.85μmol/L。当姜黄素与FU联合应用时,在较高的作用水平可以定量地观察到对HT-29细胞的协同抑制作用。并且这种协同作用随COX-2蛋白表达水平下调。结论:姜黄素可以增强FU的化学治疗效果,在结肠癌的临床治疗方面联合应用这两种药物可能具有实际意义。     

探究中药成分在抗肝癌研究中的应用

肝癌是一个长期的多基因积累改变病变的结果,肝癌的临床治疗具备相当的复杂性.因此,药物抗肝癌作用的机理也是多层次多方面的.中药作为我国的传统医学,因具备多靶点、多效应、不良反应低、能提升机体免疫力和不易产生患者耐药性等等优点,其在肝癌的临床治疗过程中占据着相当重要的地位.本文基于中药成分青蒿素、姜黄素在抗肝癌研究中的应用分析,探讨了中药成分在抗肝癌研究中应用意义及实验方法.     

姜黄素对溃疡性结肠炎小鼠结肠组织病变及细胞因子表达水平的影响

目的探讨姜黄素对溃疡性结肠炎(UC)小鼠结肠病变及促炎细胞因子、抗炎细胞因子表达水平的影响,为姜黄素防治UC提供依据。方法将50只SPF级BALB/c小鼠随机分为空白对照组、模型对照组、柳氮磺胺吡啶(SASP)对照组、姜黄素低剂量组和姜黄素高剂量组,每组10只。采用右旋葡聚糖硫酸钠(DSS)诱导法建立UC小鼠模型。观察小鼠临床症状,末次给药后处死小鼠,进行结肠大体形态损伤指数(CMDI)评分,光镜下观察结肠组织的病理学变化并评估组织损伤指数(TDI),采用酶联免疫吸附试验检测小鼠结肠组织中促炎细胞因子IL-6、IL-17和抗炎细胞因子IL-10、TGF-β的表达水平。结果姜黄素低剂量组和高剂量组的CMDI评分分别为(2.32±1.12)和(2.17±1.10)分,均低于模型对照组的(3.86±1.47)分(P0.01);姜黄素低剂量组和高剂量组的TDI评分分别为(6.34±1.01)和(6.01±1.02)分,均低于模型对照组的(8.91±0.89)分(P0.01)。姜黄素低剂量组和高剂量组的IL-6含量分别为(78.74±13.29)和(72.28±12.33) pg/m L,IL-17含量分别为(30.23±0.89)和(29.72±1.26) pg/mL,均低于模型对照组的(108.64±17.24)和(36.11±1.36) pg/mL (P0.01);姜黄素低剂量组和高剂量组的IL-10含量分别为(136.66±16.49)和(146.26±17.59) pg/mL,TGF-β含量分别为(274.21±27.46)和(286.32±28.65) pg/mL,均高于模型对照组的(33.96±6.68)和(249.96±42.98) pg/mL (P0.01)。结论姜黄素可以改善UC小鼠的临床症状,减轻结肠组织损伤,上调IL-10、TGF-β表达水平并抑制IL-6、IL-17表达水平,纠正促炎-抑炎细胞因子失衡状态。     

姜黄素的抗诱变、抗癌作用

近年来 ,随着癌症发病率的增高及发病年龄的提前 ,开发天然存在的防癌抗癌剂已成为癌症化学预防的新途径。姜黄素是一种植物多酚 ,具有抗诱变、抗癌作用。其诱导细胞凋亡的作用日益受到重视 ,具有广阔的开发前景。本文从姜黄素的主要化学结构及活性基团、抗诱变及抗肿瘤作用、作用的机制等三方面做一综述。     

药师参与20例难治性感染患者的临床用药疗效观察

目的:为了规范临床用药,减轻患者痛苦,提高患者的临床疗效。方法:通过收集分析2009年1月-2011年1月在我院进行治疗的并由临床药师参与治疗的20例难治性感染患者的临床资料,统计此组患者的临床疗效。结果:本文所观察的20例难治性感染患者经过临床合理用药后,所有患者均康复出院。结论:在治疗临床难治性感染患者中,临床药师合理使用抗菌药物,可以有效减少细菌耐药性和医药资源的浪费,促进临床的合理用药,体现药师参与临床药物治疗的价值。     

New perspective and new challenges in clinical trial regulation in Italy

Since 2004 the European Directive 2001/20/EC concerning the implementation of good clinical practice in the conduct of clinical trials on medicinal products has become operative in Italy (Decreto legislativo 24 giugno 2003, n. 211). It is therefore the intention of the Ministry of Health to obtain through an intelligent application of the recent national decree clear indications on how to conduct and to monitor transparent and useful clinical trials and to best exploit the results emerging from clinical studies in our country, both and equally from "commercial" and "non commercial" clinical studies. Using data coming from the National Register on Clinical Trials, we have observed that the absolute number of clinical research has significantly increased raising 845 interventional trials in 2008. Even if the total number of researches seems to have a positive trend and the well designed clinical trials remain the most reliable way to get unbiased information, probably we need to integrate clinical trial data with other type of clinical research, in order to better manage the post-marketing uses. Furthermore, a new pathway for "from clinical trials to the market" has to be explored through a scientific debate among the scientific community.     

Patient-Centeredness in the Design of Clinical Trials

Evidence from clinical trials should contribute to informed decision making and a learning health care system. People frequently, however, find participating in clinical trials meaningless or disempowering. Moreover, people often do not incorporate trial results directly into their decision making. The lack of patient centeredness in clinical trials may be partially addressed through trial design. For example, Bayesian adaptive trials designed to adjust in a prespecified manner to changes in clinical practice could motivate people and their health care providers to view clinical trials as more applicable to real-world clinical decisions. The way in which clinical trials are designed can transform the evidence generation process to be more patient centered, providing people with an incentive to participate or continue participating in clinical trials. To achieve the transformation to patient-centeredness in clinical trial decisions, however, there is a need for transparent and reliable methods and education of trial investigators and site personnel.     

培养高质量临床医学专业学位研究生的实践

加速培养临床医学的高质量是人才是临床医师的一项重要历史史命。实践证明，临床高质量人才的培养、成长到成才离不开临床实践。因此，一是临床工作者，必须依照培养目标严格过程管理：①依照目标，严格抓培养制度的落实；②依照目标，实施严格考核；③依照目标培养科研和论文撰写能力。二是提高研究生整体素质。三是建立研究生档案。四是加强临床医学专业学位研究生培养工作的体会为：加强组织管理、明确目标要求等。     

Reproducibility probability in clinical trials

For marketing approval of a new drug product, the United States Food and Drug Administration (FDA) requires that substantial evidence of the effectiveness of the drug product be provided through the conduct of at least two adequate and well-controlled clinical trials. The purpose of conducting the second clinical trial is to study whether the clinical result from the first trial is reproducible in the second trial with the same study protocol. Under certain circumstance, the FDA Modernization Act of 1997 includes a provision to allow data from one adequate and well-controlled clinical trial investigation and confirmatory evidence to establish effectiveness for risk/benefit assessment of drug and biological candidates for approval. In this paper, we introduce the concept of reproducibility probability for a given clinical trial, which is useful in providing important information for regulatory agencies in deciding whether a single clinical trial is sufficient and for pharmaceutical companies in adjusting the sample size in a future clinical trial. Three approaches, the estimated power approach, the method of confidence bounds and the Bayesian approach, are studied in evaluating reproducibility probabilities under several study designs commonly used in clinical trials.     

抗生素临床使用中应注意的问题

目的总结抗生素临床应用中的注意问题,以期更好地指导临床。方法对抗生素临床应用中的各个环节遇到的问题进行总结,并提出针对性意见。结果抗生素临床应用过程中,问题较多,必须引起临床医生的高度重视。结论对临床中抗生素的使用,应规范、有针对性,以期保障患者用药的安全及有效和经济。     

骨科围手术期患者临床护理路径管理的效果评价

目的探讨护理临床路径管理对骨科围手术期患者的临床效果。方法选取我院骨科围手术期患者124例,按照护理方式的不同分为观察组和对照组,每组62例。观察组给予护理临床路径管理,对照组给予传统的护理干预,观察两组患者的临床护理效果。结果两组患者病情均有改善,但观察组的住院时间与住院费用显著优于对照组;观察组患者对健康知识的掌握情况、并发症及满意度显著高于对照组,结果具有统计学意义（P〈0.05）。结论对骨科围手术期患者实施护理临床路径管理,能够有效提高患者对疾病的认知程度,提高临床护理的工作效率,确保临床护理的质量,值得推广。     

加强医院药物临床试验质量管理的探索

新药研究是临床医学研究的重要组成部分,也是衡量一个医院科研能力的重要标志之一。近年来,本院逐步认识到加强药物临床试验的管理,完善质控的重要性。因此,为了规范药物临床试验的开展,提高质量,严格按照国家药监局颁布的GCP的相关规定,严格遵循GCP“安全性和科学性”的原则,并实施了一系列的举措,包括制定完善各项制度及标准操作规程,加强全员的GCP知识和相关技能的培训,并逐步推行“三级质控”制度,加强试验药物的管理等等。本文总结了近几年本院实施开展药物临床试验管理及质控方面的经验及不足,力求在今后的药物临床试验工作的开展中,确保各项操作规范,数据完整准确,充分保护受试者的利益,并不断强化过程管理,提高药物临床试验质量。     

Representation of older patients in clinical trials for drug approval in Japan

To examine how target patients seen in clinical practice are represented in clinical trials for approved drugs in Japan, we compared the age distribution of older patients enrolled in confirmatory clinical trials for regulatory approval with that of the estimated actual patient population. Drugs for 6 chronic conditions common among older patients (diabetes mellitus, hypertension, rheumatoid arthritis, non-small cell lung cancer, depression and Alzheimer’s disease) launched by 2012 in Japan were selected. The disparity in age distribution between patients in trials and patients seen in clinical practice varied depending on the disease, but older patients, especially those aged 75 or older, were generally underrepresented in clinical trials for regulatory approval in Japan. Under-representation of older patients in hypertension trials was particularly marked compared to other conditions, despite the similarity in age distribution of patients seen in clinical practice. One factor causing this disparity may be an upper age limit in clinical trial protocols. More effort is needed to properly characterize the benefits and risks of drugs for older patients. This should include the active enrollment of older patients in clinical trials, the establishment of better assessment tools such as pharmacometric approaches, and the appropriate planning and conducting of post-marketing surveys and studies.     

眼科学临床教学的新思路

为了提高眼科学临床教学效果，通过对教学课时及内容的合理安排、优化教学多媒体、加强实践环节、培养学生自我挑战意识、启发和锻炼临床逻辑思维、及正视和处理反移情现象，总结出眼科学临床教学应建立的教学新思路一加强实践，重视临床思维启发和培养，防范反移情促进师生之间的互动情感?