重组人脑利钠肽治疗心力衰竭安全性和疗效的开放性随机对照多中心临床研究

Objective To explore the safety of intravenous recombinant human brain natriuretic peptide (rhBNP) in treating acute decompensated heart failure and acute exacerbation of chronic heart failure, and to compare the differences in efficacy with different dosage and administration time. Methods A total of 2160 patients characterized of acute decompensated heart failure and acute exacerbation of chronic heart failure were enrolled in this multicenter, randomized, open, dose-control study. The patients were randomly allocated to four groups with different doses and administration time on top of standard therapy. Results In the safety respect, the rate of hypotension is 1.44% at 5 -7 days after treatment, the serum creatinine level was reduced compared to baseline( P values were 0. 0437, 0. 0087 and 0. 0116)except in the group of 0. 015 μg at 24 h (P =0. 7054). The rate of 30-day readmission is 5.65%, mortality rate is 9. 44%. In terms of efficacy, dyspnea was significantly improved at 30 min after administration, and at 24 h after administration ( all P ＜ 0. 01 ). Urine output and LEVF were also significantly increased by 76. 59% (P ＜0. 01 ) and 12. 08% respectively ( all P ＜ 0. 01 ) compared to baseline. Plasma NT-proBNP decreased by 40. 29% at 5 - 7 days after administration ( P ＜ 0. 01 ). Conclusion The clinical application of intravenous rhBNP is safe and effective for treatment of acute decompensated heart failure and acute exacerbation of chronic heart failure in this large patient cohort.     

宠物对人类健康的潜在威胁

宠物是多种人兽共患病病原的宿主和传播媒介,由于传统宠物、另类宠物和进口宠物的增多,宠物来源的感染性疾病有了高发的趋势。本文总结了狗、猫、啮齿类、鸟类、鱼和爬行类宠物可能带有的人兽共患病病原,引发的疾病和传播途径。并概括了防控宠物源性感染性疾病的防控措施。     

张磊老师成为时代名医的思考

张磊老师是国家第二批师承制导师,在当今国家大力发展中医的情况下,如何遵循中医药科学自身的发展规律,继承弘扬传统中医特色和优势,培养和造就一批名中医,是新形势下的一个重要命题。本文根据作者侍医过程中的心得体会,从写实的角度,思考张磊成为名医的必然性;文章从他艰苦勤奋的学习历程、充满强烈事业心和责任感的工作经历出发,结合其知识结构,治学态度,高尚情操,敬业精神,专业素养,以及个人人格魅力,展示张磊多才多艺的丰富医学人生,从而为大家学习中医树立榜样。     

Biochemical characterisation and novel classification of monofunctional S-adenosylmethionine decarboxylase of Plasmodium falciparum

Plasmodium falciparum like other organisms is dependent on polyamines for proliferation. Polyamine biosynthesis in these parasites is regulated by a unique bifunctional S-adenosylmethionine decarboxylase/ornithine decarboxylase (PfAdoMetDC/ODC). Only limited biochemical and structural information is available on the bifunctional enzyme due to the low levels and impurity of an instable recombinantly expressed protein from the native gene. Here we describe the high level expression of stable monofunctional PfAdoMetDC from a codon-harmonised construct, which permitted its biochemical characterisation indicating similar catalytic properties to AdoMetDCs of orthologous parasites. In the absence of structural data, far-UV CD showed that at least on secondary structure level, PfAdoMetDC corresponds well to that of the human protein. The kinetic properties of the monofunctional enzyme were also found to be different from that of PfAdoMetDC/ODC as mainly evidenced by an increased K(m). We deduced that complex formation of PfAdoMetDC and PfODC could enable coordinated modulation of the decarboxylase activities since there is a convergence of their k(cat) and lowering of their K(m). Such coordination results in the aligned production of decarboxylated AdoMet and putrescine for the subsequent synthesis of spermidine. Furthermore, based on the results obtained in this study we propose a new AdoMetDC subclass for plasmodial AdoMetDCs.     

ESHRE PGD consortium best practice guidelines for organization of a PGD centre for PGD/preimplantation genetic screening

In 2005, the European Society for Human Reproduction and Embryology (ESHRE) PGD Consortium published a set of Guidelines for Best Practice PGD to give information, support and guidance to potential, existing and fledgling PGD programmes. Subsequent years have seen the introduction of new technologies as well as the evolution of current techniques. Additionally, in light of recent advice from ESHRE on how practice guidelines should be written/formulated, the Consortium believed it was timely to update the PGD guidelines. Rather than one document that covers all of PGD, the new guidelines are separated into four documents, including one relating to organization of the PGD centre and three relating to the methods used: DNA amplification, fluorescence in situ hybridization and biopsy/embryology. Here, we have updated the sections on organization of the PGD centre. One area that has continued to expand is Transport PGD, in which patients are treated at one IVF centre, whereas their gametes/embryos are tested elsewhere, at an independent PGD centre. Transport PGD/preimplantation genetic screening (PGS) has a unique set of challenges with respect to the nature of the sample and the rapid turn-around time required. PGS is currently controversial. Opinions of laboratory specialists and clinicians interested in PGD and PGS have been taken into account here. Current evidence suggests that PGS at cleavage stages is ineffective, but whether PGS at the blastocyst stage or on polar bodies might show improved delivery rates is still unclear. Thus, in this revision, PGS has been included. This document should assist everyone interested in PGD/PGS in developing the best laboratory and clinical practice possible.     

重组腺病毒载体vAd-tat的构建及其在细胞中的表达

目的 构建含HIV-1 tat基因重组腺病毒,观察在不同细胞中外源蛋白Tat的表达,作为DC抗HIV疫苗的基础.方法 通过PCR扩增,获得HXB2 tat的cDNA片段,定向克隆入腺病毒转移载体pTrack-CMV,线性化后转化含有腺病毒骨架pAd-easy-1的大肠杆菌BJ5183,获得同源重组的质粒prAd-tat,Pac Ⅰ酶切纯化后转染293细胞,包装成具有感染力的复制缺陷型重组腺病毒vAd-tat.结果 经PCR、酶切及DNA序列测定,插入片段大小、方向正确,获得具有感染力的含有HIV-1 tat基因的重组腺病毒;通过Western blot方法 检测,重组腺病毒在293细胞中表达出Mr,为15 000的蛋白.结论 成功构建了含有HIV-1 tat基因的腺病毒,并观察到该基冈在细胞中的表达.     

Generation of conditional knockout alleles for PRL-3

Phosphatase of regenerating liver-3 (PRL-3) is a member of the protein tyrosine phosphatase (PTP) superfamily and is highly expressed in cancer metastases. For better understanding of the role of PRL-3 in tumor metastasis, we applied a rapid and efficient method for generating PRL-3 floxed mice and investigated its phenotypes. A BAC retrieval strategy was applied to construct the PRL-3 conditional gene-targeting vector. Exon 4 was selected for deletion to generate a nonfunctional prematurely terminated shor...     

Health-related quality of life in patients with locally advanced prostate cancer after 76 Gy intensity-modulated radiotherapy vs. 70 Gy conformal radiotherapy in a prospective and longitudinal study

PURPOSE: To compare quality of life (QoL) after 70 Gy conformal radiotherapy with QoL after 76 Gy intensity-modulated radiotherapy (IMRT) in patients with locally advanced prostate carcinoma. METHODS AND MATERIALS: Seventy-eight patients with locally advanced prostate cancer were treated with 70 Gy three-field conformal radiotherapy, and 92 patients received 76 Gy IMRT with fiducial markers for position verification. Quality of life was measured by RAND-36, the European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30(+3)), and the prostate-specific EORTC QLQ-PR25, before radiotherapy (baseline) and 1 month and 6 months after treatment. Quality of life changes in time (baseline vs. 1 month and baseline vs. 6 months) of > or =10 points were considered clinically relevant. RESULTS: Differences between the treatment groups for QoL changes over time occurred in several QoL domains. The 76-Gy group revealed no significant deterioration in QoL compared with the 70-Gy group. The IMRT 76-Gy group even demonstrated a significantly better change in QoL from baseline to 1 month in several domains. The conformal 70-Gy group revealed temporary deterioration in pain, role functioning, and urinary symptoms; for the IMRT 76-Gy group a better QoL in terms of change in health existed after 1 month, which persisted after 6 months. For both treatment groups temporary deterioration in physical role restriction occurred after 1 month, and an improvement in emotional role restriction occurred after 6 months. Sexual activity was reduced after treatment for both groups and remained decreased after 6 months. CONCLUSIONS: Intensity-modulated radiotherapy and accurate position verification seem to provide a possibility to increase the radiation dose for prostate cancer without deterioration in QoL.