卵巢移植在宫颈癌治疗中的临床应用价值

目的:探讨卵巢移植在宫颈癌患者中应用的可行性、临床价值、并发症及其预防。方法:应用计算机检索中国全文期刊数据库1985/2006卵巢移植相关的文献,检索词为“卵巢移植、宫颈癌”,限定语言种类为中文,同时检索Pubmed数据库1995/2006有关宫颈癌卵巢移植的文献,检索词为“cervical cancer,ovarian transplantation”,限定语言种类为“English”,共收集51篇文献,进行归纳总结。结果:①对于年轻的宫颈鳞癌患者,保留卵巢并行自体异位移植手术是安全的,也是必要的。②宫颈癌患者卵巢自体移植的方法有卵巢组织移植术、带蒂卵巢器官移植术(卵巢移位术)、游离卵巢器官移植术等术式。③移位术后卵巢的功能较原位卵巢下降,卵巢器官移植术后较移位术后下降显著,辅以放疗后进一步加重卵巢功能的损伤。④卵巢移植术后常见的并发症有移植部位结节和包块、症状性卵巢囊肿、移植部位疼痛和卵巢功能衰退,但是可以预防的。结论:卵巢移植术使年轻宫颈癌患者的卵巢得以保留,但由于移植后卵巢功能减退及术后辅助放疗对卵巢的影响、移植后宫颈癌卵巢转移等问题限制了临床应用,如能对上述问题加以预防和治疗,卵巢移植术在宫颈癌患者中会有广阔的应用前景。     

罗格列酮对伴有糖尿病冠状动脉粥样硬化性心脏病患者纤溶系统的影响：预防支架术后再狭窄的可行性

目的:观察罗格列酮对伴有糖尿病的冠状动脉粥样硬化性心脏病(冠心病)患者纤溶系统的影响,由此对罗格列酮防止支架术后再狭窄机制作初步探讨。方法:选择2006-02/12于苏州大学附属第一医院就诊的伴有2型糖尿病的冠心病患者78例,均知情同意。①实验分组及方法:按随机数字表法分为两组(n=39),常规治疗组对其基础疾病进行治疗,包括常规针对冠心病和糖尿病治疗;罗格列酮组在此基础上加用罗格列酮口服,4mg/d。②实验评估:两组观察对象均在入院时及治疗3个月后分别抽取外周血,分离血浆,检测一氧化氮、组织型纤溶酶原激活物和纤溶酶原激活物抑制剂1含量。测定一氧化氮采用硝酸还原酶法,测定组织型纤溶酶原激活物和纤溶酶原激活物抑制物1采用酶联免疫法。结果:78例患者全部进入结果分析,无脱落。①罗格列酮组患者外周血浆一氧化氮含量升高的幅度显著高于常规治疗组(P<0.01)。②罗格列酮组患者外周血浆组织型纤溶酶原激活物含量升高的幅度显著高于常规治疗组(P<0.01)。③罗格列酮组患者外周血纤溶酶原激活物抑制物1含量降低的幅度显著高于常规治疗组(P<0.01)。结论:对于伴有糖尿病的冠心病患者,在常规治疗基础上加用罗格列酮能促进纤溶系统的激活,防止血栓的形成,有效防止支架术后再狭窄。     

Postpartum smoking behaviors and immune response in mothers of term and preterm infants

Infants exposed to secondhand smoke, especially preterm infants with a very low birth weight (VLBW), have an increased risk for developing health problems. Smoking has been associated with numerous health problems in mothers and may reduce immune functioning as well. The purposes of this study were to examine smoking in postpartum mothers of term and preterm infants and to examine the relationship between smoking and immune status. Peripheral blood was drawn on 142 women at four data-collection points and tested for cotinine, immune cell phenotypes, and immune functioning. Overall, 39% of the participants smoked in the postpartum period, but 49% of mothers who delivered preterm infants smoked compared to only 28% of mothers who delivered term infants. There was no difference in cotinine levels between the smokers in both groups of postpartum mothers, nor was smoking related to immune phenotypes or immune function. Given the documented health risks to the mother and infant and the significant number of women who continue to smoke in the postpartum period, it is imperative that health care providers continue to assess smoking status and provide smoking-cessation counseling at every encounter.     

Epigenetic silencing of microRNA-199b-5p is associated with acquired chemoresistance via activation of JAG1-Notch1 signaling in ovarian cancer

Epithelial ovarian cancer is a highly lethal and aggressive gynecological malignancy. The high mortality rate is due in part to the fact that many advanced cancer patients become refractory to current chemotherapeutic agents, leading to tumor recurrence and death. However, the underlying mechanisms leading to chemoresistance remain obscure. Here, we report that the loss of miR-199b-5p due to progressive epigenetic silencing leads to the activation of the JAG1-mediated Notch1 signaling cascade, thereby leading to the development of acquired chemoresistance in ovarian cancer. Using miRCURY LNA™ microRNA array and Q-PCR analyses of two pairs of cisplatin-sensitive and –resistant ovarian cancer cell lines, we identified miR-199b-5p as significantly down-regulated in cisplatin-resistant ovarian cancer cells and confirmed that miR-199b-5p is clinically associated with advanced and poor survival ovarian cancers. Interestingly, the loss of miR-199b-5p could be restored by 5-Aza-dC-mediated demethylation, and methylated specific PCR (MS-PCR), bisulfite-sequencing and pyrosequencing revealed that the promoter region of miR-199b-5p was hypermethylated. Computational and mechanistic analyses identified JAG1 as a primary target of miR-199b-5p. Notably, the reduced expression of miR-199b-5p was found to be inversely correlated with the increased expression of JAG1 using an ovarian cancer tissue array. Enforced expression of miR-199b-5p sensitized ovarian cancer cells to cisplatin-induced cytotoxicity both in vitro and in vivo. Conversely, re-expression of miR-199b-5p and siRNA-mediated JAG1 knockdown or treatment with Notch specific inhibitor γ-secretase (GSI) attenuated JAG1-Notch1 signaling activity, thereby enhancing cisplatin-mediated cell cytotoxicity. Taken together, our study suggests that the epigenetic silencing of miR-199b-5p during tumor progression is significantly associated with acquired chemoresistance in ovarian cancer through the activation of JAG1-Notch1 signaling.     

Impact of gender on asthma in childhood and adolescence: a GA2LEN review

A number of studies have shown gender differences in the prevalence of wheeze and asthma. The aim of this review was to examine published results on gender differences in childhood and adolescent asthma incidence and prevalence, define current concepts and to identify new research needs.
A Medline search was performed with the search words (gender OR sex) AND (child OR childhood OR adolescence) AND (asthma). Articles that reported on abscence or prescence of gender differences in asthma were included and reviewed, and cross-references were checked. Boys are consistently reported to have more prevalent wheeze and asthma than girls. In adolescence, the pattern changes and onset of wheeze is more prevalent in females than males. Asthma, after childhood, is more severe in females than in males, and is underdiagnosed and undertreated in female adolescents. Possible explanations for this switch around puberty in the gender susceptibility to develop asthma include hormonal changes and gender-specific differences in environmental exposures. This aspect needs consideration of the doctors and allergists who diagnose and treat asthmatic individuals.
In conclusion, sex hormones are likely to play an important role in the development and outcome of the allergic immune response and asthma in particular. By obtaining functional data from appropriate models, the exact underlying mechanisms can be unravelled. To examine the effect of gender-specific differences in environmental exposures and changes of asthma prevalence and severity in puberty, larger populations may need to be investigated.     

Getting ready for user involvement in a systematic review

Objective  This paper aims to support the critical development of user involvement in systematic reviews by explaining some of the theoretical, ethical and practical issues entailed in 'getting ready' for user involvement.
Background  Relatively few health or social care systematic reviews have actively involved service users. Evidence from other research contexts shows that user involvement can have benefits in terms of improved quality and outcomes, hence there is a need to test out different approaches in order to realize the benefits of user involvement and gain a greater understanding of any negative outcomes.
Design  Setting up a service-user reference group for a review of user involvement in nursing, midwifery and health visiting research involved conceptualizing user involvement, developing a representation framework, identifying and targeting service users and creating a sense of mutuality and reciprocity.
Setting and participants  Recruitment was undertaken across England by two researchers. Members from 24 national consumer organizations were selected to participate in the review.
Main variables studied  Learning was gained about finding ways of navigating consumer networks and organizations, how best to communicate our goals and intentions and how to manage selection and 'rejection' in circumstances where we had stimulated enthusiasm.
Results and conclusions  Involving service users helped us to access information, locate the findings in issues that are important to service users and to disseminate findings. User involvement is about relationships in social contexts: decisions made at the early conceptual level of research design affect service users and researchers in complex and personal ways.     

AMG－1对突触体内游离钙水平及大鼠尾动脉收缩力的影响

观察了ＡＭＧ－１对高钾所致大鼠脑突触体内游离钙浓度［Ｃａ２＋］ｉ升高，及去甲肾上腺素引起的离体大鼠尾动脉环收缩力的影响。结果表明，ＡＭＧ－１１０和１００μｍｏｌ·Ｌ－１可对抗高钾（３０ｍｍｏｌ·Ｌ－１）引起的［Ｃａ２＋］ｉ升高，使分别降低１９±１１％及５７±１２％；在无钙Ｋｒｅｂｓ－Ｈｅｎｓｌｅｌｅｉｔ液中，ＡＭＧ－１能抑制去甲肾上腺素引起大鼠尾动脉收缩力的作用。