慢性阻塞性肺疾病动物模型建立研究进展

慢性阻塞性肺疾病是一组慢性呼吸系统疾病,严重影响患者的生活质量。建立标准的动物模型,有助于研究COPD的发病机制,有效地指导临床实践。该文对近年来COPD模型的建立进行了系统的回顾,为COPD病因、发病机制和防治等研究奠定基础。     

胃肠道间质瘤中E-cadherin和Ki-67的表达及临床意义

目的:探讨胃肠道间质瘤(GIST)中E-cadherin和Ki-67在GIST中的表达和意义,以及对GIST预后的影响.方法:回顾性分析2002年6月～2008年6月,我院78例GIST手术患者的临床和病理资料,分析其临床特征、病理分级以及免疫表达对GIST术后2年复发转移率和5年生存率的影响.结果:全组患者E-cadherin的阳性表达率为65.38%(51/78),Ki-67的阳性表达率为55.13%(43/78).E-cadherin和Ki-67的表达在不同性别和年龄组中无显著性差异(P>0.05),高危组与其他组比较,有显著性差异(P<0.05).肿瘤的原发部位、直径大小、核分裂象、E-cadherin和Ki-67的表达对肿瘤的预后影响显著(P<0.05).结论:E-cadherin及Ki-67在GIST中的表达与肿瘤的发展及预后密切相关,E-cadherin表达情况是独立预后因素,E-cadherin可作为预测术后转移及复发的可靠指标.     

Dlx1, Dlx2, Pax6, Brn3b,and Chx10 homeobox gene expression defines the retinal ganglion and inner nuclear layers of the developing and adult mouse retina

Distal-less homeobox genes are expressed in the developing forebrain. We assessed Dlx gene expression in the developing and adult mouse retina. Dlx1 and Dlx2 are detected in retinal neuroprogenitors by embryonic day (E) 12.5 (Eisenstat et al. [1999] J. Comp. Neurol. 217-237). At E13.5, the expression of four homeodomain proteins, DLX2, BRN3b, PAX6, and CHX10, define distinct yet overlapping domains in the retinal neuroepithelium. By postnatal day (P) 0, DLX2 is expressed in the neuroblastic layer and the ganglion cell layer (GCL) consisting of ganglion and displaced amacrine cells. DLX1 expression resembles DLX2 to P0 but decreases postnatally. In the adult, DLX2 is localized to ganglion, amacrine, and horizontal cells as determined by coexpression with retinal cell-specific markers. There is coincident expression of DLX2 with gamma-aminobutyric acid (GABA), glutamic acid decarboxylase (GAD)65, and GAD67 in the inner nuclear layer (INL) and GCL. In the adult, DLX2 is coexpressed with BRN3b in ganglion cells; PAX6 in amacrine, horizontal, and ganglion cells; and Chx10 in some bipolar cells. We predict that a combinatorial code of these homeobox genes and others specify retinal cell fate. Our results support a possible role for Dlx1 and Dlx2 in inner retinal development and in the terminal differentiation and/or maintenance of INL interneurons and ganglion cells in the adult. The correlation of DLX2 with GABA expression in the mouse retina closely mirrors the relationship of DLX2 to GABAergic neuronal differentiation in the embryonic forebrain, including neocortex, olfactory bulb and hippocampus, signifying a conservation of function of Dlx genes in the developing central nervous system.     

Cellular FLICE-inhibitory protein down-regulation contributes to celecoxib-induced apoptosis in human lung cancer cells

The cyclooxygenase-2 (COX-2) inhibitor celecoxib is an approved drug in the clinic for colon cancer chemoprevention and has been tested for its chemopreventive and therapeutic efficacy in various clinical trials. Celecoxib induces apoptosis in a variety of human cancer cells including lung cancer cells. Our previous work has shown that celecoxib induces death receptor 5 expression, resulting in induction of apoptosis and enhancement of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis in human lung cancer cells. In the current study, we further show that celecoxib down-regulated the expression of cellular FLICE-inhibitory protein (c-FLIP), a major negative regulator of the death receptor-mediated extrinsic apoptotic pathway, through a ubiquitin/proteasome-dependent mechanism independent of COX-2 in human lung cancer cells. Overexpression of c-FLIP, particularly FLIP(L), inhibited not only celecoxib-induced apoptosis but also apoptosis induced by the combination of celecoxib and TRAIL. These results thus indicate that c-FLIP down-regulation also contributes to celecoxib-induced apoptosis and enhancement of TRAIL-induced apoptosis, which complements our previous finding that the extrinsic apoptotic pathway plays a critical role in celecoxib-induced apoptosis in human lung cancer cells. Collectively, we conclude that celecoxib induces apoptosis in human lung cancer cells through activation of the extrinsic apoptotic pathway, primarily by induction of death receptor 5 and down-regulation of c-FLIP.     

脑立体定向多靶点毁损术治疗海洛因依赖的术后分析

目的:探讨立体定向毁损术治疗海洛因依赖的手术方法并评估其手术疗效.方法:应用PET、fMRI和多排螺旋CT及手术计划系统进行靶点定位,对158例海洛因依赖者多个成瘾相关脑区进行三种不同靶点组合的定向毁损术,术后随访6～12月,评价手术疗效.结果:术前脑PET、fMRI异常分别为145例和141例.全部病例手术顺利,术中无死亡.术后近期共有47例(29.7%)发生不同程度手术并发症和副作用,其中嗅觉或味觉减退21例,性格改变10例,短时记忆减退17例,智力下降7例,脑缺血脑梗死致偏瘫3例,其中2例合并大小便失禁,并发颅内出血及血肿2例,伤口感染2例.随访6～12月,108例(68.4%)获较完整资料,手术疗效优52例(48,1%),良19例(17.6%),差35例(32.4%),死亡2例(1.9%);共29例(26.9%)存在手术并发症和副作用.病例手术前后神经心理评估比较无统计学意义(P＞0.05),但与正常人比较具有统计学意义(P＜0.05),复吸病例与正常人和未发生复吸病例比较也有统计学意义(P＜0.05).不同手术组间手术并发症和副作用发生率及复吸率无差异,但手术并发症和副作用的类型与手术方式有关.结论:海洛因依赖者存在脑功能异常区及异常精神心理行为.定向毁损术治疗海洛因依赖近期安全有效,无严重并发症,复吸率较低.发生复吸与患者精神心理因素和特定环境等有关.     

P300和脑功能成像在定向术治疗海洛因依赖中的应用

目的探讨定向毁损术治疗海洛因依赖者手术前后P300和脑功能成像的变化及其关系。方法对77例海洛因依赖者定向术术前和术后6~12个月随访期内进行P300和正电子发射断层摄影术(PET)、功能磁共振成像(fMR I)检查,评估P300和脑功能成像的变化及其与手术疗效的关系,并与30名正常人比较,进行相关统计学分析。结果海洛因依赖者术前及术后随访复吸者P300中的P3波潜伏期延长和波幅降低,与术后未复吸者和正常对照组比较均存在显著性差异(P<0.01)。P300、PET、fMR I异常术前分别为63例、69例和54例,而随访时分别为32例、18例和13例,其中,疗效优者异常分别有9例、3例和2例,疗效差者有23例、15例和11例;而且,fMR I异常病例PET和P300均异常,PET异常病例P300均异常。各检查项目术前和随访时比较,及手术疗效优与手术疗效差组间比较均具有统计意义(P<0.05)。结论海洛因依赖者存在一定认知障碍和脑功能异常区,定向手术可以改善患者认知功能。手术前后事件相关电位P300和PET、fMR I的改变具有一定相关性并可以作为评估海洛因依赖者手术治疗效果的客观指标。     

寻常性天疱疮临床治疗初步分析

本文报告寻常性天疱疮26例,用激素与激素加免疫抑制剂治疗,其治愈率分别为26.67％与54.55％,经统计学处理,P>0.05,两组差别无显著性,并对寻常性天疱疮的诱因、症状及治疗作了探讨。     

医疗费上涨对决经济发展水平

群众就医费用上涨速度,快到何种程度?全国政协委员、安徽省政协副主席俞祖彭在去年的政协大会上说,现在中国个人年均医疗费用的支出已由1980年的14．51元上涨到512．5元,26年增加了30多倍!医疗费用的上涨幅度与经济发展水平不相符,“到了老百姓难以承受的地步”。     

刘晓程:医改探路先行者

先行者就像打仗派出的先头部队,在古代,其首领叫做先锋官,其职责是逢山开路,遇水搭桥。身为先行者,必须身先士卒、官兵一心;为首者更需智勇双全,方能为大部队完成战略部署、为实现战略目标提供制胜的先决条件。