人乳腺癌患者外周血循环肿瘤细胞与Sipal基因多态性的关系

目的 探讨Sipal基因rs931127和rs746429多态性与乳腺癌外周血循环肿瘤细胞的关系.方法 采用基因测序的方法,对124例原发性乳腺癌患者以及120例健康人进行Sipal基因rs931127和rs746429多态性分析.实时荧光定量聚合酶链反应(RT-qPCR)检测其中92例患者外周血循环肿瘤细胞,比较Sipal基因rs931127和rs746429多态性与外周血循环肿瘤细胞之间的关系.采用Fisher精确检验及非条件Logisitic同归法计算各组P值及相对危险度比(OR)及95％可信区间(95％ CI).结果 Sipal基因rs931127和rs746429多态性与乳腺癌患者外周血循环肿瘤细胞无明显相关(P＞0.05).Sipal基因rs931127和rs746429多态性与乳腺癌患者的年龄、肿块大小、雌激素受体(ER)、孕激素受体(PR)、C-erb-B2蛋白的表达以及乳腺癌分子分型均无明显相关(P＞0.05).但Sipal rs931127野生型GG淋巴转移率22.6％,低于杂合型GA 48.3％和突变型AA71.0％(P＜0.01),Sipal rs746429野生型CC的淋巴结转移率为31.4％,也低于杂合型CT 64.2％及突变型TT44.4％(P＜0.01).结论 Sipal基因rs931127多态性和rs746429多态性与乳腺癌患者外周血循环肿瘤细胞无明显相关,但与淋巴结转移有关.提示rs931127 GA或AA以及rs746429 CT或TT基因型可能与乳腺癌淋巴转移有关.     

前列平胶囊联合α-受体阻滞剂治疗慢性前列腺炎220例分析

目的:探讨前列平胶囊联合α-受体阻滞剂(坦索罗辛)治疗慢性前列腺炎的临床疗效。方法:分析220例慢性前列腺炎患者的病史、临床表现和实验室检查,依据美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI),分别治疗6周。联合治疗组98例采用前列平胶囊加α-受体阻滞剂坦索罗辛联合用药(前列平胶囊:中成药,2.0 g、口服、3次/d,西安千禾药业有限公司产品,药品批号10090812;坦索罗辛:0.2 mg、口服,1次/d,阿斯泰莱,药品批号10081321);单用坦索罗辛组56例采用坦索罗辛单药治疗(坦索罗辛用法同联合治疗组);单用前列平胶囊组66例单纯口服前列腺平胶囊治疗(前列平胶囊用法同联合治疗组)。根据治疗前后慢性前列腺炎症状指数(NIH-CPSI)评分、前列腺液中卵磷脂小体改善情况判断疗效。结果:单用前列平胶囊组6周即可明显提高患者前列腺液中的卵磷脂小体数目(SPL有效率46.9%),降低NIH-CPSI(下降率24.4%);联合治疗组与单用坦索罗辛组相比,联合治疗组患者前列腺液中卵磷脂小体数目提高更明显(联合治疗组SPL有效率61.4%;单用坦索罗辛组SPL有效率33.7%),NIH-CPSI评分降低更显著(联合治疗组下降率42.3%;单用坦索罗辛组下降率28.6%),两者比较有显著性差异(P<0.01)。结论:单用前列平胶囊治疗慢性前列腺炎患者疗效确切;前列平胶囊联合坦索罗辛较单用坦索罗辛治疗效果更理想。     

加强医疗卫生装备质量控制的探讨

医疗卫生装备的质量控制事关医疗质量和患者的安全保障,是确保医药卫生系统使用的仪器设备准确、有效、安全、可靠的必要手段,是医药卫生现代化建设中一项必不可少的、重要的技术工作。卫生装备质量控制工作是医院安全发展的客观需要,在开展卫生装备质量控制工作中,应以体系建设、能力建设和条件建设为着力点,从建全组织领导、强化质控意识、加强基础建设、创新质控手段等方面提出一系列有效的做法和举措,确保实现医院卫生装备全过程、全寿命的质量控制。     

四逆汤(附子、干姜、甘草)对肾血管性高血压大鼠血压调节作用的实验研究

目的探讨四逆汤对肾血管性高血压大鼠血压的调节作用和可能的机制。方法健康雌性Wistar大鼠24只,随机分为正常组、对照组和治疗组,每组8只。根据双肾动脉夹闭法建立肾性高血压动物模型,应用四逆汤(附子、干姜、甘草)灌胃治疗2周,RBF-2型鼠尾动脉血压计测量血压,放射免疫法测定血浆中血管紧张素Ⅱ(AngⅡ)和降钙素基因相关肽(CGRP)的含量,TUNEL法检测肾组织细胞凋亡,免疫组化法测定肾组织中AngⅡ和CGRP的表达。结果(1)对照组和治疗组大鼠血压较正常组明显升高,四逆汤能明显降低血压[(131.6±14.2vs116.2±8.3)mmHg,P<0.05]。(2)各组动物血浆AngⅡ水平无显著性变化(P>0.05),治疗组CGRP含量较对照组明显升高[(75.2±12.2vs54.8±18.1)pg/mL,P<0.05]。(3)四逆汤治疗明显减少肾小球凋亡阳性细胞数(12.6±3.5vs29.4±3.5细胞个数/10个视野,P<0.05);治疗组明显降低AngⅡ表达水平,显著升高CGRP表达水平(P<0.05)。结论四逆汤可能通过调节肾血管性高血压大鼠血浆和肾组织中血管活性物质AngⅡ和CGRP的水平,发挥其血压调节和保护高血压靶器官的作用。     

应用终末期肝病模型对慢性重型肝炎患者的预后评估

目的 探讨终末期肝病模型（MELD）在慢性重型肝炎患者的预后评估与治疗策略中的意义。方法 回顾性分析135例慢性重型肝炎患者的临床资料,计算患者入院时的MELD分值和接受治疗2周后的MELD分值与入院时MELD分值的差值（△MELD分值）,分析MELD分值和△MELD分值与患者3个月病死率的关系。结果 入院时MELD分值死亡组患者为37．00±6．50,存活组为25．80±5．20,死亡组患者入院时的MELD分值远高于存活组,两组间差异有统计学意义（x^2=72.00,P〈0．01）,接受治疗2周后△MELD分值死亡组患者为1．57±0．89,存活组为-0．99±0．73,两组间差异有统计学意义（x^2=56．35,P〈0．01）。患者入院时MELD分值和接受治疗2周后△MELD分值预测慢性重型肝炎患者3个月内病死率的c-统计值分别为0．90和0．76。MELD分值〈25组,患者3个月后病死率为2％,25≤MELD分值≤30组病死率为7％,300组和≤0组的病死率分别为51％和13％,两组间病死率差异有统计学意义（P〈0.01）。结论 MELD分值和△MELD分值越高,慢性重型肝炎患者的病死率越高,MELD能较准确地预测慢性重型肝炎患者的预后,可以结合患者入院时的MELD分值和接受治疗后的△MELD分值来决定慢性重型肝炎患者的治疗方案。     

Concomitant methicillin‐resistant Staphylococcus aureus pericaditis,Cryptococcus neoformans pneumonia and invasive cytomegalovirus pneumonitis in a lupus patient with rare homozygous structural mutant variant at codon 54 of mannose binding lectin gene

Mannose‐binding lectin (MBL) is a mediator of innate immunity. Individuals with exon 1 structural mutant genotypes are associated with unusual and recurrent infections. We describe a lupus patient who had life‐threatening, concomitant infections – methicillin‐resistant staphylococcal aureus (MRSA) pericarditis with tamponade, cryptococcal pneumonia and cytomegalovirus (CMV) pneumonitis. Tests were negative for complements or immunoglobulins deficiencies. There was no human immunodeficiency virus (HIV) infection. She has a homozygous structural mutant variant at codon 54 of the MBL gene. We surmised the severe multiple infections are related to this rare mutant variant, and may be triggered off by corticosteroid therapy.     

Effect of iodine intake on serum thyroglobulin——A five-year prospective epidemiological study

Objective To clarify the effect of iodine intake on serum thyroglobulin (Tg). Methods A 5-year prospective study was conducted in the 3 different iodine intake areas in China [Panshan (miht deficiency) ,Zhangwu (more than adequate) and Huanghua (excess)]. A total of 3 099 people with normal serum levels of Tg in 1999 were followed and 2 448 of these participants were feasible to be observed in 2004 and included in the present study. The serum levels of Tg, thyraglobulin antibody(TgAb), thyroid peroxidase antibody(TPOAb) and TSH, thyroid volume, family and personal histories of thyroid diseases were measured and inquried. The general linear model (GLM) was used to explore the determinants of Tg. Results Among the study population at baseline, serum Tg were significantly different in three areas [7.5 (4.4-13. 1) μg/L at Panshan, 6.8 (3.6-11.2)μg/L at Huanghua, 5.9 (3.2-10.7) μg/L at Zhangwu, P<0.01]. They were associated with age, sex and the rate of positive TgAb, abnormal thyroid volume, abnormal TSH and positive personal history of thyroid diseases, in order to control the effects of confounding factors, the data from 1856 subjects with thyroid-related indexes all in normal range and without personal history of thyroid diseases were analyzed to clarify the effect of iodine intake on Tg. The serum Tg among three areas were significantly different in both 1999 and 2004, they were all increased in 5 years with significant augment (△ Tg) among the three areas[3.1 (-0.2-8.0) μg/L at Panshan, 3.5 (0.5-9.0)μg/L at Huanghua vs 2. 5(0.3-6.1) μg/L at Zhangwu,P<0.01]. The GLM analysis revealed that age, Tg and TSH levels at baseline were the determinants of △Tg in addition to iodine intake. Conclusion Iodine intake is a dominant determinant of serum Tg. Age and TSH should also be considered while indicating iodine intake by serum Tg.     

生物信息学专业新生专业认知度调查分析

预设调查问卷对中南大学23名生物信息学专业新生的专业认知度进行调查,从专业录取意愿、重新选择专业意愿、专业了解程度、专业喜欢程度和专业预期等角度进行分析,提出有针对性的对策和建议,包括加强招生宣传开展新生入学教育、职业规划教育、适时进行心理沟通、丰富学习方式、建立合理的课程体系等方面。     

医疗器械邀请招标的组织

本文简要介绍了医疗器械邀请招标的组织程序,评标原则、方法、内容、标准、要求和注意事项,具有较强的操作性.