社区护士工作压力与应对措施

目的：减轻社区护士工作压力,重视社区护士心理健康,肯定社区护士价值,让社区护士保持积极健康的心态,搞好基层卫生服务工作。该文针对社区护理工作现存的状态,从多方面分析了社区护士的压力来源,并提出解压的干预措施,以期为各级医疗机构管理者提供参考。     

雌、孕激素受体和C-erbB-2在原发胆囊癌中的表达及意义

目的　探讨雌、孕激素受体 (ER、PgR)和C erbB 2癌基因蛋白产物在原发胆囊癌发生、发展中的作用及相互关系 ,研究它们的表达与肿瘤的病理类型、分级 ,临床分期及预后的关系 ,并为该病的临床诊治提供参考依据。方法　应用免疫组织化学法 ,检测 3 5例原发胆囊癌 ,2 0例慢性胆囊炎组织中ER、PgR和C erbB 2癌基因蛋白的表达水平。结果　在原发胆囊癌中ER、PgR和C erbB 2阳性表达率分别为 60 %、4 5 .7%和 65 .7%。ER的阳性表达与浸润及淋巴结转移密切相关 (P <0 .0 5 )。C erbB 2过度表达与胆囊癌淋巴结转移有关 (P <0 .0 5 )。ER或PgR阳性患者的累计生存率明显低于阴性者。结论　ER、PgR及C erbB 2在原发胆囊癌中的表达率显著高于其在胆囊良性病变中的表达率。ER或PgR阳性者积累生存率显著低于ER或PgR阴性者。ER可能有希望成为反映胆囊癌恶性程度和预后的一项生物学指标     

基于脑血管重建的血管内皮生长因子缓释微球制备及性质研究

目的制作用于脑血管重建研究的血管内皮生长因子(VEGF)缓释微球并研究其性质。方法采用W1/O/W2复乳溶剂挥发法制作VEGF-聚乳酸-羟基乙酸共聚物(PLGA)微球和载罗丹明B微球;使用扫描电镜观察其表面形态结构;采用微量蛋白测定法测定微球中药物的载药量和包封率,并对微球的体外释药性能进行研究;将用罗丹明B标记的微球注入大鼠颞肌组织,分别于第10天和第30天取颞肌组织行冰冻切片,倒置荧光显微镜下观察。结果扫描电镜观察到微球表面光滑无孔隙,粒径为4~10μm;微球载药量及包封率的测定显示其平均载药量为(25.50±1.57)%,平均包封率为(85.07±0.15)%,累积释放率可达80%以上;微球在颞肌组织中可持续存在30 d以上。结论 VEGF-PLGA微球能稳定长时间释放VEGF,可用于脑血管重建研究。     

基于慢性缺血应激建立血管性抑郁症动物模型

目的 旨在建立血管性抑郁症(vascular depression, VD)的理想动物模型。方法 选用SD大鼠40只,采用数字表法随机分为4组:1手术组:双侧颈总动脉结扎(ligation of bilateral common carotid arteries, LBCCA);2假手术组:同手术组处理,但不结扎;3抑郁组:慢性不可预见性温和应激(chronic unpredictable mild stress, CUMS)结合孤养,不进行手术;4模型组:LBCCA叠加CUMS,结合孤养。连续观察21 d,观测大鼠体质量变化、行为学改变、脑血流量变化以及大鼠大脑基质金属蛋白酶(matrix metalloproteinases, MMPs)、脑源性神经营养因子(brain-derived neurotrophic factor, BDNF)、酪氨酸激酶受体B(tropomyosin related kinase B, TrkB)蛋白及其mRNA表达水平的变化。结果 与假手术组比较,模型组和抑郁组大鼠体质量、糖水消耗百分率、旷场试验运动距离及站立次数均明显降低(P<0.05或P<0.01),手术组及模型组大鼠脑血流量明显降低(P<0.01),手术组及模型组MMP-2及MMP-2 mRNA表达水平显著增高(P<0.01),抑郁组及模型组海马内BDNF/TrkB及BDNF/TrkB mRNA表达均明显降低(P<0.01或P<0.05)。结论 LBCCA叠加CUMS结合孤养方法较好地模拟了抑郁核心症状快感缺乏、运动和探索能下降的行为特征和神经血管单元(neurovascular unit, NVU)稳态失衡的病理机制,是较为理想的血管性抑郁模型,可用于药理实验及治疗效果机制研究。     

Aqueous Extracts of Tribulus terrestris Protects Against Oxidized Low-Density Lipoprotein-Induced Endothelial Dysfunction

Objective:To investigate the role of aqueous extracts of Tribulus terrestris(TT) against oxidized low-density lipoprotein(ox-LDL)-induced human umbilical vein endothelial cells(HUVECs) dysfunction in vitro.Methods:HUVECs were pre-incubated for 60 min with TT(30 and 3 μg/mL respectively) or 10~(-5) mol/L valsartan(as positive controls) and then the injured endothelium model was established by applying 100 μg/mL ox-LDL for 24 h.Cell viability of HUVECs was observed by real-time cell electronic sensing assay and apoptosis rate by Annexin V/PI staining.The cell migration assay was performed with a transwell insert system.Cytoskeleton remodeling was observed by immunofluorescence assay.The content of endothelial nitric oxide synthase(eNOS) was measured by enzyme-linked immunosorbent assay.Intracellular reactive oxygen species(ROS) generation was assessed by immunofluorescence and flow cytometer.Key genes associated with the metabolism of ox-LDL were chosen for quantitative real-time polymerase chain reaction to explore the possible mechanism of TT against oxidized LDL-induced endothelial dysfunction.Results:TT suppressed ox-LDL-induced HUVEC proliferation and apoptosis rates significantly(41.1%and 43.5%after treatment for 3 and 38 h,respectively;P0.05).It also prolonged the HUVEC survival time and postponed the cell's decaying stage(from the 69 th h to over 100 h).According to the immunofluorescence and transwell insert system assay,TT improved the endothelial cytoskeletal network,and vinculin expression and increased cell migration.Additionally,TT regulated of the synthesis of endothelial nitric oxide synthase and generation of intracellular reactive oxygen species(P0.05).Both 30 and 3 μg/mL TT demonstrated similar efficacy to valsartan.TT normalized the increased mRNA expression of PI3Kα and Socs3.It also decreased mRNA expression of Akt1,AMPKα1,JAK2,LepR and STAT3 induced by ox-LDL.The most notable changes were JAK2,LepR,PI3 K α,Socs3 and STAT3.Conclusions:TT demonstrated potential lowering lipid benefits,anti-hypertension and endothelial protective effects.It also suggested that the JAK2/STAT3 and/or PI3K/AKT pathway might be a very important pathway which was involved in the pharmacological mechanism of TT as the vascular protective agent.     

苯中毒性再生障碍性贫血患者免疫细胞及免疫相关因子的检测

目的通过苯中毒性再生障碍性贫血患者免疫细胞及免疫相关因子的检测,探讨其发病机制。方法用ELISA方法对100例苯中毒性再生障碍性贫血患者血清中肿瘤坏死因子(TNF)、可溶性白介素(sIL-2、sIL-3)、白介素2受体(sIL-2R)含量进行检测,用流式细胞仪对患者外周血T细胞进行分群。结果苯中毒性再生障碍性贫血患者血清中TNF、sIL-2含量增高,sIL-3、sIL-2R含量降低;T细胞亚群比例异常。结论苯中毒性再生障碍性贫血患者存在免疫功能异常。     

肝门部胆管癌的外科治疗及预后影响因素分析

目的总结肝门部胆管癌的治疗并探讨其预后的影响因素。方法回顾性分析2000年1月至2010年12月期间笔者所在医院收治的189例肝门部胆管癌患者的临床资料,采用Cox比例风险模型进行预后影响因素的多因素分析。结果189例肝门部胆管癌患者中,行根治性手术切除62例,行姑息性手术切除54例,行非切除I生手术73例。多因素分析结果显示,手术方式（RR=0．165）、分化程度（RR=2．692）、淋巴结转移（RR=3．014）、神经浸润（RR=2．857）和血管浸润（RR=2．365）均是预后的独立影响因素（P〈0.05）。结论根治性切除术是治疗肝门部胆管癌的最佳手术方法,有效的肝十二指肠韧带“骨骼化”、受侵神经和血管的彻底切除是改善患者预后的重要因素。     

HPTLC method development, validation, and stress degradation studies for atorvastatin and ezetimibe in multicomponent tablet dosage form

A simple, precise, rapid, selective, and economic high performance thin-layer chromatography method has been established for simultaneous analysis of atorvastatin (ATV) and ezetimibe (EZE) in tablet dosage forms. The chromatography separation was performed on precoated silica gel 60 GF₂₅₄ plates with toluene–ethyl acetate–methanol 12:5:3 (v/v/v) as mobile phase. The plate was developed to a distance of 8.0?cm at ambient temperature. The retention factors for ATV and EZE were 0.31 and 0.57, respectively. The detection band was carried out at 254?nm. The calibration curve was linear in the concentration range of 200–1200?ng/spot for both ATV and EZE. For ATV, the recovery study results ranged from 99.44 to 99.54% with RSD value ranging from 0.067 to 0.107%. For EZE, the recovery results ranged from 98.88 to 99.00% with RSD value ranging from 0.154 to 1.756%. The assay was 99.89% for ATV and 99.84% for EZE. The calibration plots revealed a good linear relationship with r ²?=?0.9991 for ATV and 0.9992 for EZE. Both ATV and EZE were subjected to different stress conditions—acid, alkaline hydrolysis, oxidation, photo degradation, dry, and wet heat treatment—as prescribed by ICH. The degradation products were well resolved from the pure drug with significantly different R _f values. The method was validated for precision, accuracy, specificity, ruggedness, and robustness.