唯物辩证法在医学检验形态学实验教学中的应用与思考

本文探讨了在医学检验形态学实验教学中应用内因与外因、局部与整体、一般与特殊、量变与质变、认识论与方法论等唯物辩证法哲学范畴和观点,融知识传授与哲学思维的培养于一体,不断提高学生的学习兴趣和分析问题、解决问题的能力,同时培养学生的科学辩证思维,使他们学会用科学的态度和方法指导自身的工作、学习,逐步成为具有创新精神和实践能力的高素质应用型检验医学人才.     

RNA干扰及其技术的应用

RNA干扰(RNAi)是细胞内由双链RNA诱导降解与其配对的特定mRNA的过程。细胞内双链RNA在酶的作用下,形成20-25碱基大小的小干扰RNA(si RNAs),由si RNAs进一步掺入多组分核酸酶并使其激活,从而精确降解与si RNAs序列相同的mRNA,抑制该基因在细胞内的翻译表达。介绍了RNA干扰的分子机制、制备方法、以及RNA干扰技术在功能基因组学、微生物学、基因治疗和信号转导等研究领域里的应用。     

Gemcitabine plus carboplatin versus mitomycin, ifosfamide, and cisplatin in patients with stage IIIB or IV non-small-cell lung cancer: a phase III randomized study of the London Lung Cancer Group.

PURPOSE: This phase III randomized trial compared two chemotherapy regimens, gemcitabine plus carboplatin and mitomycin, ifosfamide, and cisplatin, in chemotherapy-naive patients with advanced non-small-cell lung cancer (NSCLC). The regimens were compared with regard to effects on survival, response rates, toxicity, and quality of life. PATIENTS AND METHODS: Eligible patients had previously untreated stage IIIB or IV NSCLC suitable for cisplatin-based chemotherapy. Randomly assigned patients were to receive four cycles, each at 3-week intervals, of carboplatin area under the curve of 5 on day 1 plus gemcitabine 1,200 mg/m(2) on days 1 and 8 (GCa) or mitomycin 6 mg/m(2), ifosfamide 3g/m(2), and cisplatin 50 mg/m(2) on day 1 (MIC). RESULTS: Between February 1999 and August 2001, 422 patients (GCa, n = 212; MIC, n = 210) were randomly assigned in the United Kingdom. The majority of patients received the intended four cycles (GCa, 64%; MIC, 61%). There was a significant survival advantage for GCa compared with MIC (hazard ratio, 0.76; 95% CI, 0.61 to 0. 93; P = .008). Median survival was 10 months with GCa and 7.6 months with MIC (difference, 2.4 months; 95% CI, 1.0 to 4.0), and 1-year survival was 40% with GCa and 30% with MIC (difference, 10%; 95% CI, 3% to 18%). Overall response rates were similar (42% for GCa v 41% for MIC; P = .84). More thrombocytopenia occurred with GCa (P = .03), but this was not associated with increased hospital admission or fatality. GCa caused less nausea, vomiting, constipation, and alopecia and was associated with fewer admissions for administration and better quality of life. CONCLUSION: In patients with advanced NSCLC, GCa chemotherapy was shown to be a better-tolerated treatment that conferred a survival advantage over MIC.     

护士与截瘫患者的沟通技巧

在医学法律纠纷中，由于心理因素造成的纠纷并不少见。例如在康复科，截瘫患者康复治疗的期望值与实际效果的差距，可能会成为医疗纠纷的背景因素，而有效的沟通则是化解矛盾、减少纠纷的重要手段之一。护士作为患者和医生的第一接触人，掌握良好的沟通技巧是基础。我康复科在3年里共收治截瘫患者10例。在患者的法律意识日渐增强的情况下，我们针对其主观愿望和客观实际，探讨与截瘫患者沟通的技巧，以取得良好效果，现报告如下。     

Ifosfamide, carboplatin, and etoposide with midcycle vincristine versus standard chemotherapy in patients with small-cell lung cancer and good performance status: clinical and quality-of-life results of the British Medical Research Council multicenter randomized LU21 trial.

PURPOSE: Ifosfamide, carboplatin, etoposide, and vincristine, alone and in combination, are highly active against small-cell lung cancer (SCLC). This trial was designed to investigate whether survival could be improved by a regimen of all four drugs (ICE-V) compared with standard chemotherapy in patients with SCLC and good performance status, and to assess the patients' quality of life (QL). PATIENTS AND METHODS: Patients were randomly assigned to receive six cycles of either ICE-V at 4-week intervals without dose reduction or standard chemotherapy administered according to local practice. The recommended standard control regimens were cyclophosphamide, doxorubicin, and etoposide; and cisplatin and etoposide. RESULTS: A total of 402 patients were randomly assigned, and 350 (87%) patients have died. Overall survival was longer in the ICE-V group (hazard ratio, 0.74; 95% CI, 0.60 to 0.91; P = .0049), median survival was 15.6 months in the ICE-V group and 11.6 months in the control group, and 2-year survival rates were 20% and 11%, respectively. There was no evidence that the relative survival benefit for ICE-V was less in extensive-stage than in limited-stage patients. An increased rate of septicemia was reported in the ICE-V group (15% v 7% in the control group), but this did not result in an increase in reported treatment-related deaths (four patients [2%] in both groups). The findings on QL were broadly similar in both groups, with some benefit in favor of ICE-V. CONCLUSION: Compared with standard chemotherapy, the ICE-V regimen improves overall survival without QL penalties, despite an increased but manageable level of toxicity.     

Calpastatin participates in the regulation of cell migration in BAP1-deficient uveal melanoma cells

AIM: To detect how BRCA-associated protein 1 (BAP1) regulates cell migration in uveal melanoma (UM) cells. METHODS: Wound healing and transwell assays were performed to detect UM cell migration abilities. Protein chip, immunoprecipitations and surface plasmon resonance analyses were applied to identify BAP1 protein partners. Western blot and calpain activity assays were used to test the expression and function of calpastatin (CAST). RESULTS: CAST protein was confirmed as a new BAP1 protein partner, and loss of BAP1 reduced the expression and function of CAST in UM cells. The overexpression of CAST rescued the cell migration phenotype caused by BAP1 loss. CONCLUSION: BAP1 interacts with CAST in UM cells, and CAST and its subsequent calpain pathway may mediate BAP1-related cell migration regulation.     

小脑参与认知功能机制的研究进展

认知是指人脑为获取和应用知识,将外界信息转化成内在心理活动的复杂过程。自 1998年Schmahmann和Sherman提出“小脑认知-情感综合征”起,小脑认知功能的研究越来越受到关注。 本文通过回顾国内外相关研究,从小脑的解剖与认知功能、小脑的神经网络机制以及交叉性小脑神经 机能联系不能 3 个角度探讨了小脑在认知神经网络中的作用及机制,旨在提高对小脑参与认知功能的 认识。     

Challenging surgical treatment of giant retroperitoneal liposarcoma: A case report

Liposarcoma is a rare malignant tumor type and surgical resection is the gold standard treatment. The present study reported on the case of a 51-year-old woman who presented with a mass in the left upper abdomen. Computed tomography revealed a 32-cm giant retroperitoneal liposarcoma. Complete tumor resection was performed without the removal of other organs. Postoperative pathological examination indicated retroperitoneal well-differentiated liposarcoma and immunohistochemistry revealed S-100(−), MDM2(+), vimentin(+), CDK4(+), p16(+) and STAT6(+) results. The patient recovered well after the surgery. Complete tumor resection during the first surgery is key to cure liposarcoma. The present case report will be helpful for clinical oncologists to fully understand giant retroperitoneal liposarcoma and treat it accordingly.     

AQP1、AQP2和AQP3在人膀胱尿路上皮癌组织中的表达及其意义

目的：观察水通道蛋白1（Aquaporin 1,AQP1）、水通道蛋白2（Aquaporin 2,AQP2）、水通道蛋白3（Aquaporin 3,AQP3）在膀胱尿路上皮癌组织及正常膀胱组织中的表达与分布,探讨其意义。方法：取膀胱尿路上皮癌组织25例及正常膀胱组织25例,应用免疫组织化学方法检测AQP1 、AQP2和AQP3在膀胱尿路上皮癌和正常膀胱组织中的表达及分布。结果：AQP1散在表达于正常膀胱组织中微血管和小动脉的内皮细胞的细胞膜及细胞质,在膀胱尿路上皮癌组织中AQP1大量表达于肿瘤的血管内皮细胞的细胞膜及细胞质;膀胱尿路上皮癌中AQP1表达水平较正常膀胱组织明显增高,差异有统计学意义(P<0.05);AQP2主要表达于膀胱尿路上皮癌组织及正常膀胱组织的细胞间质中,两者表达强度基本相同,差异无统计学意义(P＞0.05);AQP3主要表达在膀胱尿路上皮癌组织及正常膀胱组织的黏膜上皮细胞的胞质及胞膜,在癌组织中的表达强度明显增高,差异有统计学意义(P<0.05)。结论：AQP1 、AQP3在膀胱尿路上皮癌组织中表达明显增高。提示AQP1、AQP3可能与膀胱尿路上皮癌的发生和发展密切相关,其机制需要进一步深入研究。