丙泊酚对胆道感染患者髓样细胞触发受体-1表达的影响

目的探讨丙泊酚对胆道感染患者外周血髓样细胞触发受体-1(TREM-1)的影响。方法 48例严重胆道感染患者,随机分为两组:丙泊酚处理组(P 组,n=28),术中用丙泊酚6 mg·kg~(-1)·h~(-1)及异氟醚(呼气末异氟醚浓度维持在1%)维持麻醉;对照组(N 组,n=20),术中用异氟醚维持麻醉(呼气末异氟醚浓度维持在2.5%)。上述两组术中均间断静脉注射阿曲库铵、芬太尼维持麻醉.且用量无差异。两组分别在手术前及手术后12、24、48、72 h 留取血液标本,用流式细胞术检测外周血 TREM-1蛋白的表达;用酶联免疫吸附实验法(ELISA)检测血肿瘤坏死因子α(TNF-α)表达水平。结果术前两组患者的 TREM-1及 TNF-α含量差异无统计学意义;P 组患者术后12、24、48、72 h 的 TREM-1及 TNF-α水平均明显低于 N 组(P<0.05)。结论严重胆道感染患者可致外周血TREM-1蛋白高水平表达。丙泊酚可降低 TREM-1蛋白表达水平.减轻炎症反应。     

人膀胱移行细胞癌各种透明质酸合成酶基因亚型的表达及意义

目的:研究各种透明质酸合成酶亚型(HASs)mRNA在人膀胱移行细胞癌中的表达及其潜在的临床价值.方法:运用半定量RT-PCR方法,对145例不同恶性度的人膀胱移行细胞癌、22例正常人膀胱黏膜组织标本和4种人BTCC细胞系的HAS亚型mRNA的表达情况进行研究.结果:PCR 23循环后,正常膀胱黏膜组织中7例扩增出微弱的HASl mRNA条带(28%,7/25),其余无任何条带扩增出来;所有膀胱移行细胞癌组织标本和细胞系有一种以上的HAS亚型mRNA被扩增出来.不同膀胱癌组织、细胞系表达的HASs mRNA的种类及表达程度各不相同,但随着肿瘤恶性程度的增高,其表达的各种HASs mRNA的种类趋向相同.每个膀胱癌组织、细胞系均有一种HASs mRNA优势表达,但其类型及优势表达程度互不相同.结论:人膀胱移行细胞癌出现了HAS亚型mRNA的异常高表达,可能与肿瘤的发生、发展有密切关系,是BTCC生物治疗潜在的靶点;同时进一步证实了尿透明质酸作为膀胱癌的"标志物"的可靠性.     

乳腺超声弹性成像BI-RADS 4 级肿块校正及穿刺活检的诊断价值*

目的：对比分析乳腺BI-RADS 分级中4 级肿块经超声弹性成像应变率比值校正及超声引导下穿刺活检术的诊断价值。方法：收集2014年1 月至2016年6 月120 例承德医学院附属医院行乳腺肿块手术切除患者的资料,术前全部肿块BI-RADS 分级为4级,经超声弹性成像应变率比值校正后行超声引导下穿刺活检术,以病理为金标准对比超声弹性成像应变率比值与穿刺活检的诊断价值。结果：120 例乳腺患者BI-RADS 4 级肿块经超声弹性成像应变率比值校正后,其中46例BI-RADS 4 级不变、59例降为BI-RADS3 级、15例升为BI-RADS5 级,与病理结果对照,经超声弹性成像应变率比值校正及穿刺活检诊断的灵敏度、特异度及准确率分别为90.7% 、81.8% 、85.5% 及88.8% 、98.5% 、95.0% ,经超声弹性成像应变率比值校正与穿刺活检诊断乳腺恶性肿块的差异具有统计学意义（P < 0.05）,诊断良性肿块的差异无统计学意义（P > 0.05）。 结论：超声引导下穿刺活检术对乳腺BI-RADS4 级肿块有较高定性诊断价值,仅次于病理诊断,超声弹性成像应变率比值对乳腺 BI-RADS4 级肿块分级校正及指导穿刺活检具有一定的临床价值。     

媒体医药信息对辽宁省居民自我诊疗行为影响

目的 了解媒体医药信息对居民自我诊断、自我药疗行为的影响。方法 采用多阶段分层整群随机抽样方法对辽宁省2981名城乡居民进行问卷调查。结果 43.8%和11.7%的居民关注或信任媒体健康信息,11.6%的居民曾参加过商家举办的产品推广活动;根据媒体信息进行自我诊断和自我药疗的发生率分别为36.8%和43.2%;单因素分析显示,城市户籍、40~59岁、高收入、高中文化水平的居民自我诊断、自我药疗和诊断治疗发生率均明显高于其他人群;关注、信任、参加活动居民的自我诊疗率明显高于无以上行为居民;经多因素分析,城市居民自我诊疗行为是农村居民的1.50~2.87倍,自我诊疗行为随健康状况的下降而升高,关注、信任媒体医药信息、参加相关推广活动使自我诊疗行为增加0.48~2.14倍。结论 媒体医药信息对居民自我诊疗行为产生明显影响,政府应加大信息发布的审批和监管力度,减少居民不合理用药的行为。     

盘锦市2013-2014年呼吸道症候群病原学分析

目的 了解辽宁盘锦市发热呼吸道症候群的病原普构成,对临床诊断、治疗与预防提供依据。方法 采集2013-2014年盘锦市中心医院呼吸道临床患者标本,运用荧光定量PCR技术进行检测。结果 150份样品中,检出12种病原核酸共76份,检出率为50.7%,多重感染占14.5%(11/76)。流感病毒16例(10.7%),肺炎链球菌13例(8.7%),金黄色葡萄球菌9例(6.0%),腺病毒8例(5.3%),鼻病毒7例(4.7%),肺炎支原体6例(4.0%),副流感病毒6例(4.0%),合胞病毒3例(2.0%),冠状病毒3例(2.0%),流感嗜血杆菌2例(1.3%),偏肺病毒2例(1.2%),肺炎支原体1例(0.7%)。结论 构成盘锦地区呼吸道感染病原种类繁多,主要以流感病毒、肺炎链球菌、金黄色葡萄球菌、腺病毒为主,在监测月份中,呼吸道感染均高位流行。     

胫前黏液水肿

患者男,40岁. 主诉:头晕、头痛、心悸伴多汗、乏力3年,双下肢出现结节、肿块2年余. 现病史:患者2年前双下肢胫前皮肤肿胀,出现肿块、结节,伴有轻度疼痛及瘙痒,于2007年9月20日至我科就诊.3年前患甲状腺功能亢进症,一直未接受正规治疗.     

并发肺转移的头面部血管肉瘤

报告1例并发肺转移的头面部血管肉瘤.患者男,81岁.头面部出现多发性紫红色丘疹、结节和斑块10个月.皮损组织病理学检查:真皮梭形细胞增生,形成不规则管腔.免疫组化染色示CD31、Ⅷ因子、CD34阳性.患者近3个月出现胸闷,胸部X线及CT检查见肺内有多发性结节影.提示右肺内和左胸膜下肿瘤转移可能,最后诊断为头面部血管肉瘤并发肺转移.     

Glutathione and its metabolizing enzymes in patients with different benign and malignant diseases

Objectives: Evaluation of glutathione (GSH) system in different tumors to reveal its potential usefulness in a clinical setting.

Design and methods: In addition to 10 normal controls, blood and tissue samples (85 benign and 109 malignant) from patients with breast, ovarian, prostatic, and liver neoplasms were investigated. The GSH concentration, glutathione S-transferase, glutathione peroxidase, and glutathione reductase activities were biochemically measured.

Results: Whereas all the components of the GSH system increased in patients with breast tumors, few components were significantly changed in patients with malignant ovarian, prostatic as well as metastatic liver diseases. GSH had the highest Z scores in ovarian and breast tumors. It was correlated (p < 0.05) with both glutathione S-transferase, glutathione peroxidase in breast cancer and with glutathione S-transferase only in prostate cancer. No correlation could be found in the expression of the GSH system in the blood and tissues of the same group of patients.

Conclusion: This work revealed that measurement of some and/or all components of the GSH system might be of clinical value in some malignant cases.     

Inhibition of epidermal growth factor receptor-mediated signaling by "Combi-triazene" BJ2000, a new probe for Combi-Targeting postulates

The Combi-Targeting concept postulates that a molecule termed combi-molecule (C-molecule) with binary epidermal growth factor receptor (EGFR) targeting/DNA-damaging properties and with the ability to be hydrolyzed to another EGFR inhibitor should induce sustained antiproliferative activity in cells overexpressing EGFR. Because we postulate that the EGFR affinity of the C-molecule and that of its hydrolytic metabolites are critical parameters for sustained potency against EGFR-overexpressing cells, we synthesized BJ2000 (IC(50) = 0.1 microM, competitive binding at ATP site), a novel C-molecule that can decompose into a 6-amino-4-anilinoquinazoline FD105 (IC(50) = 0.2 microM). Studies using the EGFR-overexpressing A431 cells revealed that BJ2000 could damage DNA and block epidermal growth factor-stimulated EGFR autophosphorylation by a partially irreversible mechanism. Blockade of EGFR autophosphorylation subsequently induced inhibition of mitogen-activated protein kinase activation and c-fos gene expression. Enzyme-linked immunosorbent assay and growth factor-mediated stimulation of proliferation assays in the EGFR-expressing NIH3T3HER14 demonstrated the preferential EGFR-targeting properties of BJ2000, and more importantly suggest that blockade of EGFR phosphorylation by this drug translate into significant growth inhibitory effects. These properties culminated into irreversible antiproliferative effects as confirmed by a sulforhodamine B assay. Five days after a 2-h treatment, BJ2000 retained significant antiproliferative effect in A431 cells, whereas its reversible metabolite FD105 almost completely lost its activity. This result in toto lend support to the Combi-Targeting concept according to which a molecular conjugate kept small enough to interact with EGFR and designed to degrade into another inhibitor of the same target plus a DNA-damaging species may induce sustained growth inhibitory effect in EGFR-overexpressing cells.