Frequency of under-corrected refractive errors in elderly Chinese in Beijing

Purpose The aim of the study was to evaluate the prevalence of under-corrected refractive error among elderly Chinese in the Beijing area.Methods The population-based, cross-sectional, cohort study comprised 4,439 subjects out of 5,324 subjects asked to participate (response rate 83.4%) with an age of 40+ years. It was divided into a rural part [1,973 (44.4%) subjects] and an urban part [2,466 (55.6%) subjects]. Habitual and best-corrected visual acuity was measured. Under-corrected refractive error was defined as an improvement in visual acuity of the better eye of at least two lines with best possible refractive correction.Results The rate of under-corrected refractive error was 19.4% (95% confidence interval, 18.2, 20.6). In a multiple regression analysis, prevalence and size of under-corrected refractive error in the better eye was significantly associated with lower level of education (P<0.001), female gender (P<0.001), and age (P=0.001).Conclusions Under-correction of refractive error is relatively common among elderly Chinese in the Beijing area when compared with data from other populations.     

355例晚期非小细胞肺癌预后因素分析

目的 回顾分析355例晚期非小细胞肺癌（NSCLC）的预后因素，为探索个体化治疗提供参考依据。方法 1988年3月至2000年10月35例经组织学或细胞学确诊的、未经治疗的晚期NSCLC患者（Ⅲ期134例，37.75%；Ⅳ期221例，62.25%），至少接受2周期化疗。观察疗效和生存期，分析预后因素。结果 全组无CR病例，PR101例，SD147例，有效率为28.45%，肿瘤控制率为69.86%，中位生存期为16月。1、2、3和5年生存率分别为58.41%、29.35%、14.60%和8.60%。Ⅳ期患者只闰生存期为14月，1、2、3和5年生存率分别为54.62%、25.59%、12.70%和6.73%。COX比例风险模型分析显示治疗后ECOG评分改善＋稳定（P＝0.0440)和二线化疗失败后原方案加用γ－IFN或TAM及原发灶放疗等可能有利于生存期的改善。     

步态水平对髋关节假体周围骨重建的影响

目的 针对髋关节置换术后患者步态运动水平变化,研究假体周围骨密度（bone mineral density, BMD）变化率的变化趋势,揭示置换初期、长期运动变化对骨重建的影响规律。方法 基于自适应骨重建理论,建立股骨-假体有限元模型,以术后初期、长期步态水平作为重建参数计算假体周围BMD分布,采用Gruen分区方法量化BMD的变化。结果 术后初期,恒定步态组与变化步态组BMD存在明显差异,最大差异发生在低步态组中,造成大转子区域BMD减小41%;步态运动提高促进假体近端、中端BMD变化,显著影响发生在大转子区域,造成BMD增加47%;术后长期阶段,步态运动提高促进假体中端、末端区域BMD恢复,BMD增加2%～9%。结论 研究结果为髋关节置换后患者康复过程提供指导。     

“双一流”背景下综合性大学医学学科建设初探

目的 探讨在“双一流”建设背景下,我国综合性大学医学学科应该采取怎样的发展策略,从而在尊重医学学科发展特殊性的同时,迸发原始创新力,建设世界一流学科。方法 本文采用文献研究法以及数量研究法对国内综合性大学医学学科的建设体系进行研究。通过查阅相关期刊论文了解医学学科的特殊规律以及目前的发展现状。在此基础上,收集ESI、QS Ranking以及教育部学科评估数据,进一步揭示问题并提出建设策略。结果 未来医学发展具有系统性(整体性)、技术依赖性、异质性等特点,在建设世界一流学科、一流大学的新形势下,对标国际一流学科,我国高校医学类学科“高峰”仍相对匮乏。综合性大学医学学科应秉承“内涵式发展”的原则与发展路径。充分重视交叉融合,优化学科体系;加强新兴学科建设,打造突出特色;加强顶层设计,培育优势高峰;重视人才队伍建设,打造高层次人才梯度;加强医学教育,提高人才培养质量;促进机制体制创新,激活融合发展活力;构建有效评价体系,以评促建。结论 综合性大学医学学科建设应在充分尊重医学学科特殊规律与特点的前提下,以医学未来发展模式为指导,以临床需求为导向,坚持内涵式发展。以医学学科的发展带动临床诊疗水平的提高,提升原始创新力,提升综合性大学的社会服务能力,有效对接科学发展前沿与国家战略发展需求。     

透明细胞型脑脊膜瘤的临床病理分析

报道2例发生在脊柱和颅内具有幼稚性特征的透明细胞型脑脊膜瘤(CCM)患者,与经典的透明细胞型脑脊膜瘤不同的是2例患者肿瘤都有显示罕见的细胞核异型性、分裂活跃、坏死等原始化现象。肿瘤细胞对上皮膜抗原和Vimtine有免疫反应,MIB-1指数高达40%。对2例患者均实行肿瘤完整切除术。其中男性患者后3个月有局部复发和心室外侧转移。本文对脑脊膜病临床病理特点、诊断及预后进行探讨,并建议术后进行辅助放疗或化疗,并且在随访第1阶段每3~6个月复查磁共振。     

晚期非小细胞肺癌初始治疗后再次应用EGFR-TKI的疗效观察

背景与目的表皮生长因子受体酪氨酸激酶抑制剂(epidermalgrowthfactorreceptortyrosinekinaseinhibi-tor,EGFR-TKI)是化疗失败的晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的标准二三线治疗方案,亦是EGFR突变患者一线治疗的最佳选择,但对初始治疗后进展的患者,在治疗过程中能否再次使用TKI是目前的关注热点。本研究旨在探讨晚期NSCLC初始治疗后再次应用EGFR-TKI的疗效。方法本研究回顾性分析了71例晚期或术后复发的NSCLC初始EGFR-TKI治疗后,再次应用TKI的疗效。结果 71例再次应用TKI的患者中,部分缓解(par-tial response,PR)为7%,稳定(stable disease,SD)为36.6%,(progressive disease,PD)为56.3%,疾病控制率(diseasecontral rate,DCR)为43.7%,无进展生存期(progression free survival,PFS)>3个月者26例(36.6%)。EGFR21外显子突变、初始TKI缓解期6个月、两次TKI的间隔期3个月与更长的PFS相关,单因素COX回归分析,P值分别为0.034、0.013、0.046。结论 TKI治疗失败的NSCLC患者再次应用TKI,部分患者仍可获得疾病控制。EGFR21外显子突变、初始TKI缓解期6个月、两次TKI间隔期3个月的患者更可能从再次应用TKI中获益。     

Chronic exposure to low-intensity magnetic field improves acquisition and maintenance of memory

Although past research has suggested that acute exposure to extremely low-frequency magnetic field (ELF MF) impairs learning and memory function, data on chronic exposure remain scarce. In this study, we examined the changes in spatial learning and memory by the Morris water maze test after 4 weeks of daily exposure of rats to a 50-Hz magnetic field of 2 mT for either 1 or 4 h. We found that chronic exposure to ELF MF reduced the latency to find the hidden platform and improved long-term memory of former location of platform without affecting the short-term memory and motor activity. These findings for the first time indicate that chronic exposure to ELF MF exerts a positive effect on the acquisition and maintenance of spatial memory.     

旋光法测定复方环丙沙星注射液中三氮唑核苷的含量

采用旋光法测定复方环丙沙星注射液中三氮唑核苷的含量，回收率９９．６％，ＲＳＤ为０．０８４．     

Repeated measures analyses of dose timing of antiretroviral medication and its relationship to HIV virologic outcomes

Medication adherence is a critical predictor of the effectiveness of antiretroviral medications in the treatment of HIV/AIDS. Studies of adherence, however, have focused primarily on the per cent of prescribed doses taken (per cent adherence). In the Adherence and Efficacy of Protease Inhibitor Therapy study, we collected detailed adherence data including dose timing information as well as data regarding patients' virologic responses. For 48 weeks, adherence data and virologic outcomes were collected every 4 weeks, and demographics and other measures were collected at baseline and at weeks 8, 24, and 48. We constructed eight different dose timing error (DTE) measures and evaluated their associations with virologic outcomes using longitudinal analyses. Repeated measures mixed effect models were fitted to evaluate the predicting power of each of the DTE measures. Among 52 036 electronically measured doses obtained from 122 patients, DTE measures significantly predicted virologic outcomes. Of the eight different DTE measures, the six DTE measures were significantly predictive of virologic outcomes even after controlling for per cent adherence. In conclusion, we identified several measures of DTE that explain HIV virologic outcomes not captured by traditional adherence measures. Investigations of adherence to antiretrovirals would benefit from measuring not only per cent adherence but dose timing adherence.     

Up-regulation of human cervical cancer proto-oncogene contributes to hepatitis B virus-induced malignant transformation of hepatocyte by down-regulating E-cadherin

Hepatocellular carcinoma (HCC) is one of the most fatal human malignancies, Human cervical cancer proto-oncogene (HCCR) aberrantly expressed in a number of malignant tumors, including HCC. HCC is associated with Hepatitis B virus (HBV) infection in a large percentage of cases. To explore the regulation and function of HCCR expression in the development of HCC, we detected HCCR expression in HBV expressing hepatocytes. Results showed that the expression of HCCR was higher in HBV-expressing hepatocytes than that in control cells. Examining different components of HBV revealed that the HBx promotes HCCR expression in hepatocytes via the T-cell factor (TCF)/β-catenin pathway. HCCR expression in HBx transgenic mice increased with as the mice aged and developed tumors. We also found that overexpression of HCCR in hepatocytes promoted cell proliferation, migration, and invasion and reduced cell adhesion. Suppressing HCCR expression abolished the effect of HBx-induced hepatocyte growth. In addition, HCCR represses the expression of E-cadherin by inhibition its promoter activity, which might correlate with the effects of HCCR in hepatocytes. Taken together, these results demonstrate that HBx-HCCR-E-cadherin regulation pathway might play an important role in HBV-induced hepatocarcinogenesis. They also imply that HCCR is a potential risk marker for HCC and/or a potential therapeutic target.