安庆市2008～2013年孕产妇死亡状况分析

孕产妇死亡是指在妊娠期或妊娠终止后42d之内的妇女,不论妊娠时间和部位,由于任何与妊娠或妊娠处理有关的或由此而加重了的原因导致死亡,但不包括意外原因如车祸、中毒、自杀等导致的死亡。孕产妇死亡率是衡量一个国家和地区社会经济、文化发展的重要指标,也是反映母婴安全的重要指标[1]。为了解安庆市孕产妇死亡原因及影响因素,现对2008~2013年安庆市孕产妇死亡监测资料进行汇总分析,报道如下。     

Comparison of biological characteristics of marrow mesenchymal stem cells in hepatitis B patients and normal adults

AIM: To establish a culture system of marrow mesenchymal stem cells (MSCs)from hepatitis B patients and normal adults and to compare their biological characteristics. METHODS: MSCs were isolated from bone marrow in 34 male hepatitis B patients and 15 male normal adults and cultivated in vitro. Their biological characteristics including surface markers, shapes and appearances, growth curves, first passage time and passage generations were compared. RESULTS: Cultivation achievement ratio of hepatitis B patients was lower than that of normal adults, no statistical significance (82.35% vs 100%, P > 0.05). Compared with MSCs of normal adults, MSCs of hepatitis B patients presented a statistical lower growth curve, longer first passage time (13.0 ± 1.6 d vs 11.4 ± 1.5 d, P < 0.05), fewer passaging generation numbers (10.5 ± 1.4 generations vs 12.3 ± 1.7 generations, P < 0.05), though both shared same appearances, shapes and surface markers. MSCs in hepatitis B patients would expand, spread out and age more easily and there were more refractive particles in the cytoplasm. CONCLUSION: MSCs from hepatitis B patients can be cultured in vitro. Although their appearance, shape and surface marker are similar to those of MSCs from normal adults, there are differences in their biological characteristics.     

DNA甲基化酶1在乙肝相关性肝癌中的表达及意义

目的:探讨DNA甲基化酶1(DNMT1)在乙肝相关性肝癌中表达的临床意义。方法:免疫组化检测66例乙肝相关性肝癌组织术后DNMT1表达,并对患者临床病理资料进行分析。结果:DNMT1在乙肝相关性肝癌组织中阳性率为40.9%,DNMT1高表达组与低表达组在性别、年龄及肿瘤大小方面无明显差异(P=0.900,P=0.509,P=0.347),在肿瘤结节、包膜及微血管浸润方面亦无明显差异(P=0.385,P=0.690,P=0.149),DNMT1高表达组与低表达组在Edmondson分级、BCLC分期及复发方面有明显差异(P=0.014,P=0.032,P=0.014)。结论:在乙肝相关性肝癌组织中存在DNMT1蛋白高表达,DNMT1高表达与患者恶性病理特征及复发具有一定作用,与患者具有较差的预后有关。     

Androgen receptor (AR) suppresses miRNA-145 to promote renal cell carcinoma (RCC) progression independent of VHL status

Mutational inactivation of the VHL tumor suppressor plays key roles in the development of renal cell carcinoma (RCC), and mutated VHL-mediated VEGF induction has become the main target for the current RCC therapy. Here we identified a signal pathway of VEGF induction by androgen receptor (AR)/miRNA-145 as a new target to suppress RCC progression. Mechanism dissection revealed that AR might function through binding to the androgen receptor element (ARE) located on the promoter region of miRNA-145 to suppress p53''s ability to induce expression of miRNA-145 that normally suppresses expression of HIF2α/VEGF/MMP9/CCND1. Suppressing AR with AR-shRNA or introducing exogenous miRNA-145 mimic can attenuate RCC progression independent of VHL status. MiR-145 mimic in preclinical RCC orthotopic xenograft mouse model revealed its efficacy in suppression of RCC progression. These results together identified signals by AR-suppressed miRNA-145 as a key player in the RCC progression via regulating HIF2α/VEGF/MMP9/CCND1 expression levels. Blockade of the newly identified signal by AR inhibition or miRNA-145 mimics has promising therapeutic benefit to suppress RCC progression.     

Enolase-1 is a therapeutic target in endometrial carcinoma

ENO1 plays a paradoxical role in driving the pathogenesis of tumors. However, the clinical significance of ENO1 expression remains unclear and its function and modulatory mechanisms have never been reported in endometrial carcinoma (EC). In this study, ENO1 silencing significantly reduced cell glycolysis, proliferation, migration, and invasion in vitro, as well as tumorigenesis and metastasis in vivo by modulating p85 suppression. This in turn mediated inactivation of PI3K/AKT signaling and its downstream signals including glycolysis, cell cycle progression, and epithelial-mesenchymal transition (EMT)-associated genes. These effects on glycolysis and cell growth were not observed after ENO1 suppression in normal human endometrial epithelial cells (HEEC). Knocking down ENO1 could significantly enhance the sensitivity of EC cells to cisplatin (DDP) and markedly inhibited the growth of EC xenografts in vivo. In clinical samples, EC tissues exhibited higher expression levels of ENO1 mRNA and protein compared with normal endometrium tissues. Patients with higher ENO1 expression had a markedly shorter overall survival than patients with low ENO1 expression. We conclude that ENO1 favors carcinogenesis, representing a potential target for gene-based therapy.     

Methylated arsenic metabolites bind to PML protein but do not induce cellular differentiation and PML-RARα protein degradation

Arsenic trioxide (As₂O₃) is one of the most effective therapeutic agents used for patients with acute promyelocytic leukemia (APL). The probable explanation for As₂O₃-induced cell differentiation is the direct targeting of PML-RARα oncoprotein by As₂O₃, which results in initiation of PML-RARa degradation. However, after injection, As₂O₃ is rapidly methylated in body to different intermediate metabolites such as trivalent monomethylarsonous acid (MMA^III) and dimethylarsinous acid (DMA^III), therefore, it remains unknown that which arsenic specie is actually responsible for the therapeutic effects against APL. Here we have shown the role of As₂O₃ (as iAs^III) and its intermediate metabolites (i.e., MMA^III/DMA^III) in NB4 cells. Inorganic iAs^III predominantly showed induction of cell differentiation, while MMA^III and DMA^III specifically showed to induce mitochondria and endoplasmic reticulum-mediated apoptosis, respectively. On the other hand, in contrast to iAs^III, MMA^III showed stronger binding affinity for ring domain of PML recombinant protein, however, could not induce PML protein SUMOylation and ubiquitin/proteasome degradation. In summary, our results suggest that the binding of arsenicals to the ring domain of PML proteins is not associated with the degradation of PML-RARa fusion protein. Moreover, methylated arsenicals can efficiently lead to cellular apoptosis, however, they are incapable of inducing NB4 cell differentiation.     

护患关系行为模式对剖宫产后母亲行为影响的研究

目的 :研究比较两种护患关系行为模式对剖宫产产后母亲行为的影响。方法 :对 2 0 0 0年 1 2月至 2 0 0 1年 3月在我院接受剖宫产的 70例产妇实施整体护理。其中 35例护患关系行为模式为护患共同参与模式 (参与组 ) ;另外 35例为护患指导合作模式 (指导组 )。两组产妇在术后自理能力、进入母亲执行期时间及主动寻求知识提问率三方面进行对比研究。结果 :参与组产妇比对照组产妇术后自理能力强 ,进入母亲执行期时间短 ,主动提问率高。结论 :护患关系的行为模式对剖宫产产后母亲行为有重要影响。共同参与模式对产后母亲行为在自理能力、母亲角色转化及寻求知识方面起积极作用优于指导模式     

Effects of pioglitazone on metabolic abnormalities,psychopathology, and cognitive function in schizophrenic patients treated with antipsychotic medication: A randomized double-blind study

BackgroundSchizophrenic patients treated with antipsychotic drugs (AP) have an increased frequency of glucose–lipid metabolic abnormalities and diabetes. Pioglitazone has been shown to be effective in the treatment of glucose and lipid abnormalities in diabetes and decreasing longer-term conversion of impaired glucose tolerance to frank diabetes. Some studies also suggest possible pro-cognitive and antidepressant effects of pioglitazone. We studied the effects of pioglitazone on potential metabolic, symptomatic and cognitive benefits in schizophrenic patients treated with AP.Methods54 schizophrenic patients with at least both a)impaired glucose and b) triglycerides ≥ 120 mg/dL and/or low HDL levels, participated in a double-blind placebo controlled study of 3 month treatment with Pioglitazone (30–45 mg/day) or matched placebo, at 5 sites (4 U.S., 1 China). Fasting glucose and lipid parameters, and psychopathology (PANSS scale) were assessed monthly, and patients had a glucose tolerance test and cognitive testing (RBANS and CPT) at baseline and at the end of study. Statistical analysis used mixed model repeated measures analysis, supplemented by completer and LOCF analysis.ResultsIn the total sample there was an overall effect (P's < .05 to < .01) of pioglitazone on preventing deterioration in fasting glucose and improving HDL and PANSS depression scores; in the pioglitazone group comparison of baseline vs 3 month values also showed significant (P < .05) decreases in fasting insulin, 2 h glucose in GTT and insulin resistance (HOMA-IR). However there were marked differences between the responses of patients in the U.S. sites vs the China site. In the U.S. sample, patients treated with pioglitazone, when compared to placebo treated patents, had significantly lower fasting glucose (F = 3.99, P = 0.02), improved insulin sensitivity (lower H0MA-IR, F = 6.24, P = .002), lower triglycerides (F = 2.68, P = .06) and increased HDL (F = 6.50, P = .001). By the end of the study 52% of the pioglitazone treated patients compared to 15% of the placebo patients had fasting glucose in the normal range (Fisher's exact test P = .02). Pioglitazone also significantly improved PANSS depression factor scores (F = 2.82, P = 0.05). It did not improve cognitive performance on the RBANS or CPT tasks. Pioglitazone did not increase weight or produce any other significant side-effects. In the small mainland China site sample, pioglitazone treatment, as compared to placebo, did not show greater improvement in metabolic parameters or psychopathology ratings.ConclusionsIn the sample of patients from the U.S., pioglitazone was an efficacious and safe treatment for glucose and lipid metabolic abnormalities in schizophrenic patients treated with AP, and it may also have beneficial effects on depressive symptoms. It may be particularly useful in patients whose weight gain effects from antipsychotics have plateaued and where weight loss is not the primary goal. The risk vs. benefits of longer term treatment with pioglitazone has to be carefully evaluated for individual patients.     

重症急性胰腺炎治疗护理进展

从非手术治疗（建立有效循环通道、抑制胰腺分泌、防治感染、营养支持、腹腔灌洗、血液灌洗和内镜介入治疗）、手术治疗方面对重症急性胰腺炎的治疗和护理进展进行了综述。