RASSF2A Promoter Methylation in Hepatitis B Virus-related Hepatocellular Carcinogenesis and Its Correlation with Elevated Serum α-Fetoprotein Level

Loss of the RASSF2A expression induced by methylation-mediated silencing has been reported in several human cancers, but the methylation status of RASSF2A in hepatocellular carcinoma （HCC） is rarely studied so far. In this study, we investigated the RASSF2A expression and its methylation status in a cohort of 45 hepatitis B virus-associated HCC tissues and their adjacent non-carcinoma tissues by using RT-PCR and MS-PCR. Promoter methylation of RASSF2A was found in 31 （68.9%） out of 45 HCC tissues and 12 （40%） out of 30 adjacent normal tissues, respectively （P〈0.05）. The methylation status of PASSF2A was closely associated with the loss of RASSF2A expression and elevated serum α-fetoprotein level, but not significantly with clinical stage, hepatic fibrosis and K-ras mutation. It was concluded that aberrant methylation of the RASSF2A gene with the subsequent loss of RASSF2A expression plays an important role in the pathogenesis of HCC.     

全国多中心类风湿关节炎患者门诊用药费用的调查

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.     

造血干细胞移植后早期细菌感染的临床分析

目的:分析造血干细胞移植(HSCT)患者移植后早期(30d内)细菌感染的临床特点、病原菌分布等情况,为HSCT患者经验性治疗的选择提供依据。方法:回顾性分析我院305例HSCT患者,总结其移植后早期细菌感染的发生率、临床表现、病原菌分布及药敏试验结果。结果:305例患者中共计发生细菌感染256例(83.93%),其中68例(26.56%)患者移植前即发生感染,229例(89.45%)患者感染时处于粒缺期。256例发生细菌感染患者中,细菌培养阳性患者83例(32.42%),分离出致病菌106株,其中革兰氏阳性细菌52株(49.06%),革兰氏阴性细菌54株(50.94%)。致病菌前3位分别为大肠埃希菌30株(28.30%)、表皮葡萄球菌14株(13.21%)和肺炎克雷伯菌10株(9.43%),其中多重耐药菌41株。结论:我院HSCT患者移植后早期细菌感染以革兰氏阴性菌多见,革兰氏阳性菌和革兰氏阴性菌分别对于替加环素和亚胺培南耐药率最低,中性粒细胞和血小板植入时间≥14d是HSCT后发生细菌感染的危险因素。     

孙氏旋转手法治疗神经根型颈椎病临床研究

目的：观察孙氏旋转手法治疗神经根型颈椎病的临床疗效。方法：采用电脑随机数字表法进行随机分配,将60例患者分为2组,每组30例。治疗组采用孙氏旋转手法治疗,对照组采用颈部牵引治疗。两组疗程均为2周。评定2组临床疗效,疼痛评分。结果：2组疗效比较差异有统计学意义（P〈0.05）,治疗组优于对照组。2组治疗前、后症状体征积分自身差值比较：治疗组在颈肩部的疼痛与不适、上肢疼痛与麻木、远端感觉、肌力、spurlnig试验自身积分差值的改善与对照组相比较差异有统计学意义（P〈0.05）,治疗组明显优于对照组;在工作和生活能力受影响、上肢腱反射减弱或消失方面比较差异无统计学意义（P〉0.05）。结论：孙氏旋转手法改善神经根型颈椎病疗效优于牵引疗法。     

通腑健脏煎剂对慢性肾衰竭患者贫血和凝血改善的研究

通腑健脏六联疗法已在首届国际中医肾病尿毒症会议上作了重点讲座，通腑健脏六联疗法确实是治疗慢性肾功能衰竭的一个有价值、有前途方法，开创用复杂联合的疗法治疗疑难病的先河，改变了单一模式治疗疑难病的方式。     

疣脱欣加复方干扰素α—2b霜外用治疗尖锐湿疣38例临床分析

对38例尖锐湿疣患者在应用0.5%疣脱欣疣体消失后,外用复方干扰素α-2b霜15天,3个月后复查,结果34例治愈,4例复发;而对照组36例中,23例治愈,13例复发.两组经统计学处理x2=6.84,P＜0.01,两组差别有显著性.提示外用复方干扰素α-2b霜能在局部发挥抗病毒、局部免疫调节作用,可减少该病复发.     

对精神病病人突发冲击行为的原因分析及防护措施

精神科是一个比较特殊的科室,精神科病人是一个特殊的群体,大部分病人不仅否认患病,且在失去正常理智的情况下突发冲击行为,可对医护人员造成很大的危害。本文对2008年1月-2009年7月在我院发生突发冲击行为的33例病人的资料进行分析,现报告如下。     

Kaneda固定治疗胸腰椎骨折截瘫失误和并发症分析

自１９９３年１２月至１９９８年２月共收治胸腰椎骨折并截瘫病人４８例,其中２９例进行了侧前路椎管减压Ｋａｎｅｄａ内固定椎间植骨融合术,取得了明显的效果。现就手术操作中的失误和并发症进行总结。临床资料一、一般资料　本组２９例中男性１８例,女性１１例。年龄１８至４９岁,平均３２．２岁。高处跌落伤１７例,车祸伤１２例。脊柱骨折脱位分类按Ｄｅｎｉｓ标准［１］：爆裂型骨折２５例,骨折脱位４例。损伤部位：Ｔ１２５例,Ｌ１１５例,Ｌ２６例,Ｌ３３例。截瘫Ｆｒａｎｋｅｌ分级［２］：Ａ级５例,Ｂ级１６例,Ｃ级６例,…