Uterine effects of 3-year raloxifene therapy in postmenopausal women younger than age 60

OBJECTIVE: To assess the uterine effects of 3 years of therapy with raloxifene in healthy, postmenopausal women under age 60. METHODS: Integrated data from two identically designed, randomized, double-masked, placebo-controlled clinical trials were analyzed. Nine hundred sixty-nine healthy women with uteri (ages 45 through 60, 2 to 8 years postmenopausal) were assigned randomly to raloxifene 30, 60, or 150 mg per day, or an identical placebo for 3 years. Endometrial thickness was evaluated with transvaginal ultrasonography every 6 months for 2 years and again after 3 years. Further uterine evaluation, including endometrial sampling if necessary, was initiated for vaginal bleeding or findings of endometrial thickness greater than 5 mm. RESULTS: Endometrial thickness was unchanged by raloxifene and not significantly different from placebo at any time. One hundred seventy-two women had at least one episode of endometrial thickness greater than 5 mm or vaginal bleeding distributed equally among all groups. A total of 102 (10.5%) women underwent endometrial sampling at least once: 15 (1.5%) for vaginal bleeding, 78 (8.0%) for endometrial thickness greater than 5 mm, and nine (0.9%) for other reasons. There were no significant treatment differences in the proportion of women sampled, in the clinical findings, or in the histologic diagnoses. CONCLUSION: Raloxifene given to healthy postmenopausal women at doses from 30 to 150 mg per day does not stimulate uterine growth and does not cause vaginal bleeding, spotting, or discharge through 3 years of therapy. Thus, any bleeding during therapy should be deemed unexpected and prompt a clinical evaluation.     

hTEFT重组绿色荧光表达载体的构建与表达

目的构建人端粒酶逆转录酶(hTERT)片段的真核表达质粒。方法用RT-PCR方法从肝癌组织中提取总RNA扩增出hTERT基因片段,将其连接pGEM-TEasy质粒上,将重组质粒pGEM-T-hTERT和pEGFP-C3真核绿色荧光蛋白表达载体同时用HindⅢ和BamHⅠ双酶切后进行连接,再将重组的pEGFP-C3-hTERT基因片段转染NIH3T3细胞,经G418筛选获得稳定转染的细胞系,荧光倒置显微镜观察并检测转染细胞的hTERTmRNA表达水平。结果DNA序列分析证实了重组载体pGEM-T-hTERT和pEGFP-C3-hTERT内插入片段的碱基组成与公开发表的hTERT序列一致。转染pEGFP-C3-hTERT的NIH3T3细胞可见绿色荧光,并检出高水平表达的hTERT。结论成功构建高效表达hTERT的真核表达载体,为以hTERT为靶点的肿瘤治疗打下实验基础。     

急性肺损伤幼鼠肺泡Ⅱ型上皮细胞和SP-A变化相关性的研究

目的：该实验旨在研究急性肺损伤（ALI）时肺泡Ⅱ型上皮细胞（AEC-Ⅱ）超微结构变化和肺组织表面活性蛋白SP-A含量的变化关系，从而探讨ALI的发病机制。方法：48只Sprague-Dawley幼鼠被随机分为正常对照组和ALI组。 腹腔注射脂多糖（LPS，4 mg/kg）建立ALI模型，正常对照组注射等量生理盐水。 LPS注射后24，48，72 h每亚组各处死8只大鼠。 取左肺下肺组织待透射电镜检查。 用Western blot方法测定肺组织SP-A的相对含量。结果：ALI 24 h时，AEC-Ⅱ微绒毛消失。24 h及48 h时板层小体（lamellar body, Lb）数量增加，体积增大，密度减低，排空明显增强，呈指环状绕核排列，细胞增生活跃，代谢旺盛。48 h时Lb呈巨大空泡样变性。肺组织SP-A含量明显高于对照组（24 h时ALI组为6.52±0.62，对照组为5.02±0.35， P< 0.01；48 h时ALI组为6.65±0.62，对照组为5.01±0.36，P< 0.01）。72 h时Lb破溃，数目明显减少，细胞核形态不规则，部分核边界不清，肺组织SP-A含量下降(ALI组为3.87±0.50，对照组为5.22±0.36，P<0.01)。结论： LPS致幼鼠ALI时AEC-Ⅱ和肺组织SP-A的变化为时间依赖性，随AEC-Ⅱ损伤程度的加重肺组织SP-A由代偿转为失代偿，可能是发生ARDS的重要机制之一。     

细化药品采购环节，全方位保障药品供应

通过探讨细化药品采购环节：包括建立和完善采购制度，优选药品配送企业，制定合理的采购时间、合理采购价格和合理的库存结构及库存水平。以便及时、准确地为临床用药提供安全、有效、经济的药品以及全方位保障药品供应。     

儿童癌症幸存者成年后的慢性疾病

由于治疗方法的进步,近80%的儿童和青少年癌症患者能够长期生存。在美国,约有270000例儿童癌症的幸存者,即每640名20至39岁成年人中就有一名幸存者。大量的幸存者有利于儿童癌症治疗后长期健康结果的研究。现在可以明确的是,化疗和放疗所致的儿童各器官系统损害在临床上可能潜伏多年。为了全面了解治疗儿童癌症而继发的健康问题,重要的是衡量三项长期结果:健康状况、死亡率和患病率。这三项中,关于前两项已有相当好的研究报道。在一项对20227例癌症5年生存者的回顾性分析中,Mertens等发现以下原因导致的超额死亡率具有统计学意义:继发癌症(…     

Mutations in Emery-Dreifuss muscular dystrophy and their effects on emerin protein expression

Seventeen families with Emery-Dreifuss muscular dystrophy (EDMD) have been studied both by DNA sequencing and by emerin protein expression. Fourteen had mutations in the X-linked emerin gene, while three showed evidence of autosomal inheritance. Twelve of the 14 emerin mutations caused early termination of translation. An in-frame deletion of six amino acids from the C-terminal transmembrane helix caused almost complete absence of emerin from muscle with no localization to the nuclear membrane, although mRNA levels were normal. This shows that mutant emerin proteins are unstable if they are unable to integrate into a membrane. A 22 bp deletion in the promoter region was expected to result in reduced emerin production, but normal amounts of emerin of normal size were found in leucocytes and lymphoblastoid cell lines. This shows that DNA analysis is necessary to exclude emerin mutations in suspected X-linked EDMD. Emerin levels in female carriers often deviated from the expected 50% and this was due, in at least two families, to skewed emerin mRNA expression from the normal and mutated alleles. In one family with a novel deletion of the last three exons of the emerin gene, a carrier had a cardiomyopathy and very low emerin levels (<5% of normal) due to skewed X-inactivation. In the three autosomal cases of EDMD, emerin was normal on western blots of blood cells, which suggests that autosomal EDMD is not caused by indirect reduction of emerin levels.      

Catch-up growth up to ten years of age in children born very preterm or with very low birth weight

Background  

Improved survival due to advances in neonatal care has brought issues such as postnatal growth and development more to the focus of our attention. Most studies report stunting in children born very preterm and/or small for gestational age. In this article we study the growth pattern of these children and aim to identify factors associated with postnatal catch-up growth.