股骨干骨折合并胸部损伤患者326例观察

目的探讨股骨干骨折合并胸部损伤患者的疗效方式。方法回顾分析1998年5月至2010年10月该院收治的326例股骨骨折合并胸部损伤患者的临床资料。结果术中、术后患者均未出现脂肪栓塞综合征(FES),2例病情不稳定患者外固定架固定后出现急性呼吸窘迫综合征(ARDS)。结论股骨干骨折合并胸部损伤患者应根据实际情况选择不同的术式和手术时机。     

Identification and verification of Hsp90-beta as a potential serum biomarker for lung cancer

Background: Hsp90-beta was investigated as prognostic factor because of its apparent association with tumorigenesis. The aim of this study was to investigate the expression of Hsp90-beta in lung cancer patients, to analyze the relationship with respect to the clinicopathological features and to assess whether Hsp90-beta as a potential serum marker for lung cancer. Methods: Expression of Hsp90-beta was examined using immunohistochemistry, in-situ hybridization, western blot and enzyme-linked immunosorbent assay. Sensitivities and specificities for Hsp90-beta serum test were determined using receiver operator characteristic curve and cutoff was defined based on 95% and 85% sensitivities. Results: Lung cancer tissues exhibited higher expression of Hsp90-beta than the normal tissues (P < 0.05) and the serum Hsp90-beta of lung cancer patients also exhibited higher level than control groups (P < 0.05). Moreover, increased serum Hsp90-beta was significantly associated with the pathological grade and clinical stage of lung cancer patients (P < 0.05). Using receiver operator characteristic curve analysis, the cutoffs for distinguishing lung cancer from normal and benign groups were 1.155 and 1.158 ng/ml respectively. The sensitivities of Hsp90-beta for distinguishing lung cancer from normal and benign groups were 98.77% and 95.9%, and specificities were 88.33% and 72.7%. Conclusion: Up-regulation of serum Hsp90-beta was associated with pathological grade and clinical stage of lung cancer patients, which indicated that it could be considered molecular biomarker for diagnosis and prognosis of lung cancer.     

In vivo diffusion MRI detects early spinal cord axonal pathology in a mouse model of amyotrophic lateral sclerosis

Diffusion magnetic resonance imaging (MRI) exhibits contrast that identifies macro‐ and microstructural changes in neurodegenerative diseases. Previous studies have shown that MR diffusion tensor imaging (DTI) can observe changes in spinal cord white matter in animals and humans affected with symptomatic amyotrophic lateral sclerosis (ALS). The goal of this preclinical work was to investigate the sensitivity of DTI for the detection of signs of tissue damage before symptoms appear. High‐field MRI data were acquired using a 9.4‐T animal scanner to examine the spinal cord of an ALS mouse model at pre‐ and post‐symptomatic stages (days 80 and 120, respectively). The MRI results were validated using yellow fluorescent protein (YFP) via optical microscopy of spinal cord tissue slices collected from the YFP,G93A‐SOD1 mouse strain. DTI maps of diffusion‐weighted imaging (DWI) signal intensity, mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD) and radial diffusivity (RD) were computed for axial slices of the lumbar region of the spinal cord. Significant changes were observed in FA (6.7% decrease, p < 0.01), AD (19.5% decrease, p < 0.01) and RD (16.1% increase, p < 0.001) at postnatal day 80 (P80). These differences were correlated with changes in axonal fluorescence intensity and membrane cellular markers. This study demonstrates the value of DTI as a potential tool to detect the underlying pathological progression associated with ALS, and may accelerate the discovery of therapeutic strategies for patients with this disease.     

温阳补肾法治疗骨质疏松性骨折

目的 探讨温阳补肾法治疗骨质疏松性骨折对患者疼痛介质及血清sVCAM-1、PDGF、BGP水平的影响.方法 选择骨质疏松性骨折患者106例作为研究对象,通过随机数字表法分为研究组与对照组,各53例.对照组采用常规保守治疗,研究组在对照组的基础上予温阳补肾法进行治疗,2组均治疗3个月.比较2组治疗3个月后的临床疗效;对比2组治疗前、治疗3个月后的骨痂生长评分、中医证候积分、血清疼痛介质及骨代谢指标水平.结果 治疗3个月后,研究组总有效率(96.23％,51/53)高于对照组(75.47％,40/53)(P<0.05).治疗3个月后,2组骨痂生长评分、中医证候积分、血清PGE2、5-HT、NO、sVCAM-1水平较治疗前降低,研究组低于对照组(P<0.05);2组血清PDGF、BGP水平较治疗前升高,研究组高于对照组(P<0.05).结论 温阳补肾法治疗骨质疏松性骨折,可明显降低患者血清疼痛介质水平,减轻疼痛,并能降低血清sVCAM-1水平,升高血清PDGF、BGP水平,促进骨折愈合,有助于提高临床疗效.     

Precise engineering of cetuximab encapsulated gadollium nanoassemblies: in vitro ultrasound diagnosis and in vivo thyroid cancer therapy

We report the formulation of nanoassemblies (NAs) comprising C225 conjugates Gd-PFH-NAs (C-Gd-PFH-NAs) for low-intensity focused ultrasound diagnosis ablation of thyroid cancer. C-Gd-PFH-NAs showed excellent stability in water, phosphate-buffered saline (PBS), and 20% rat serum. Transmission electron microscopy (TEM) images also revealed the effective construction of C-Gd-PFH-NAs as common spherical assemblies. The incubation of C625 thyroid carcinoma with C-Gd-PFH-NAs triggers apoptosis, as confirmed by flow cytometry analysis. The C-Gd-PFH-NAs exhibited antitumor efficacy in human thyroid carcinoma xenografts, where histopathological results further confirmed these outcomes. Furthermore, we were able to use low-intensity focused ultrasound diagnosis imaging (LIFUS) to examine the efficiency of C-Gd-PFH-NAs in thyroid carcinoma in vivo. These findings clearly show that the use of LIFUS agents with high performance imaging in different therapeutic settings will have extensive potential for future biomedical applications.     

阿尔茨海默病病人家属心理负担及影响因素的研究进展

对阿尔茨海默病病人家属产生负面心理负担的原因及影响因素进行综述,以期为解决病人家属心理问题,为提高病人生活质量提供理论依据和参考。     

O2O互动型教学模式在住院医师规范化培训中的应用

目的探讨线上线下（online to offline，O2O）互动型教学模式在住院医师规范化培训中的应用效果。方法以首都医科大学宣武医院医师规范化培训的36名学生作为试验组，每组成员6〖FGS〗~〖FGN〗8人，另外36名前期住院医师作为对照组，试验组采用O2O互动教学法，对照组按照传统教学模式。教学完成后比较两组理论和临床实践技能成绩以及问卷调查结果。结果试验组理论和临床实践技能成绩均优于对照组（P<0.05）,且各项效果评价也优于对照组（P<0.05）。结论O2O互动型教学模式能够为住院医师规范化培训教学提供更优化的教学。     

Melatonin promotes sorafenib‐induced apoptosis through synergistic activation of JNK/c‐jun pathway in human hepatocellular carcinoma

Melatonin has been shown to exert anticancer activity on hepatocellular carcinoma (HCC) through its antiproliferative and pro‐apoptotic effect in both experimental and clinical studies, and sorafenib is the only approved drug for the systemic treatment of HCC. Thus, this study was designed to investigate the combined effect of melatonin and sorafenib on proliferation, apoptosis, and its possible mechanism in human HCC. Here, we found that both melatonin and sorafenib resulted in a dose‐dependent growth inhibition of HuH‐7 cells after 48 hours treatment, and the combination of them enhanced the growth inhibition in a synergistic manner. Colony formation assay indicated that co‐treatment of HuH‐7 cells with melatonin and sorafenib significantly decreased the clonogenicity compared to the treatment with single agent. Furthermore, FACS and TUNEL assay confirmed that melatonin synergistically augmented the sorafenib‐induced apoptosis after 48 hours incubation, which was in accordance with the activation of caspase‐3 and the JNK/c‐jun pathway. Inhibition of JNK/c‐jun pathway with its inhibitor SP600125 reversed the phosphorylation of c‐jun and the activation of caspase‐3 induced by co‐treatment of HuH‐7 cells with melatonin and sorafenib in a dose‐dependent manner. Furthermore, SP600125 exhibited protective effect against apoptosis induced by the combination of melatonin and sorafenib. This study demonstrates that melatonin in combination with sorafenib synergistically inhibits proliferation and induces apoptosis in human HCC cells; therefore, supplementation of sorafenib with melatonin may serve as a potential therapeutic choice for advanced HCC.