巨噬细胞移动抑制因子与鼻咽癌微血管生成和淋巴结转移的关系

[目的]研究巨噬细胞移动抑制因子(macrophage migration inhibitory factor,MIF)和血管内皮生长因子(vascular endothelial growth factor,VEGF)在鼻咽癌组织中的表达水平及其与肿瘤新生血管的关系,探讨细胞因子在鼻咽癌细胞侵袭转移过程中的作用.[方法]收集1999-2003年期间45例确诊未治的鼻咽原发癌活检组织标本,用LSAB免疫组化法检测鼻咽癌组织中MIF和VEGF表达,计数癌组织中新生血管热区的CD34阳性微血管密度(intratumoral microvessel density,IMD),并将各检测指标与患者的病理及临床资料相联系.[结果]鼻咽原发癌组织中,癌细胞MIF和VEGF的阳性表达率分别为78%(35/45)和71%(32/45),伴有淋巴结转移的癌组织中MIF和IMD水平均高于无淋巴结转移的癌组织,P=0.029,P=0.026,MIF阳性组的IMD计数为(35.1±13.3)/高倍视野,明显高于MIF阴性病例的(20.9±10.2)/高倍视野,P=0.003.以Schmincke型生长方式分布的癌细胞MIF表达水平(67.4%±35.2%)高于以Regaud型方式分布的癌细胞(32.9%±29.7%),P=0.007.癌细胞MIF与VEGF表达以及IMD计数均显示正相关关系,P＜0.05.但癌细胞VEGF的表达与患者性别、年龄、病理组织学分型以及临床分期无统计学显著意义.[结论]MIF在鼻咽癌细胞的淋巴结转移过程中可能具有重要的促进作用,并可能是影响肿瘤性微血管生成和癌细胞VEGF表达的重要因素.     

Estimated research and development costs of rotavirus vaccines

Diseases like rotavirus afflict both upper- and lower-income countries, but most serious illnesses and deaths occur among the latter. It is a vital public health issue that vaccines for these types of global diseases can recover research and development (R&D) costs from high-priced markets quickly so that manufacturers can offer affordable prices to lower-income nations. Cost recovery depends on how high R&D costs are, and this study attempts to replace high, unverified estimates with lower, more verifiable estimates for two new vaccines, RotaTeq (Merck) and Rotarix (GlaxoSmithKline or GSK), based on detailed searches of public information and follow-up interviews with senior informants. We also offer a new perspective on “cost of capital” as a claim for recovery from public bodies. Our estimates suggest that companies can recover all fixed costs quickly from affluent markets and thus can offer these vaccines to lower-income countries at prices they can afford. Better vaccines are a shared project between companies and public health agencies; greater transparency and consistency in reporting of R&D costs is needed so that fair prices can be established.     

上睑下垂的术前评估及改良提上睑肌缩短术矫治的疗效评价

目的评价改良提上睑肌缩短术矫治上睑下垂的效果。方法采用改良提上睑肌缩短术[此改良术式与常规术式不同之处在于增加分离提上睑肌腱膜的长度(22mm)和宽度(16mm),腱膜在睑板上固4对缝线,以增加其牢固度],共治疗上睑下垂57例68眼,其中轻度13例13眼,中度38例47眼,重度6例8眼。结果术后4～36个月随访,治愈48例59眼,欠矫9例9眼,无过矫病例。结论该提上睑肌缩短术与常规手术比较有改进,术后的睑缘高度易保持在上方角膜缘,弧度与健侧对称,不易形成眼角畸形,能较好提高矫治效果。     

急性大血管闭塞性轻型卒中血管内治疗的疗效及安全性观察

目的 观察急性大血管闭塞性轻型卒中患者血管内治疗的疗效及安全性。
方法 回顾性分析2018年1月-2019年5月行血管内治疗的急性大血管闭塞性轻型卒中（NIHSS评分
≤5分）患者的临床资料。观察术后血管成功再通率（mTICI≥2b级）、围手术期并发症、90 d良好预后率
（mRS评分≤2分）等。
结果 共纳入13例患者，平均年龄58.7±14.5岁，男性11例（84.6%）。术后血管成功再通率100%；围
手术期并发症2例，假性动脉瘤1例、无症状性颅内出血1例；90 d良好预后率100%。
结论 急性大血管闭塞性轻型卒中行血管内治疗可能是安全、有效的。