舌下含服米索前列醇配伍米非司酮在终止早孕中的应用

目的 :探讨舌下含服米索前列醇配伍米非司酮用于早孕流产的可行性、安全性及有效性。方法 :将孕周在 7wk内的孕妇随机分为舌下组、口服组各 12 0例。 2组均经米非司酮预治疗后 ,舌下组含服米索前列醇 2 0 0 μg ,1h后重复 ,总量不超过6 0 0 μg ;口服组单次口服米索前列醇 6 0 0 μg。 结果 :舌下组完全流产率比口服组高 ,清宫率比口服组低 (P均 <0 0 1) ,引 -流时间缩短 (P <0 0 1) ,阴道流血及药物不良反应两者无明显差异。结论 :舌下组终止早孕具有简便、有效 ,引 -流时间短等优点     

PXR activation impairs hepatic glucose metabolism partly via inhibiting the HNF4α–GLUT2 pathway

Drug-induced hyperglycemia/diabetes is a global issue. Some drugs induce hyperglycemia by activating the pregnane X receptor (PXR), but the mechanism is unclear. Here, we report that PXR activation induces hyperglycemia by impairing hepatic glucose metabolism due to inhibition of the hepatocyte nuclear factor 4-alpha (HNF4α)‒glucose transporter 2 (GLUT2) pathway. The PXR agonists atorvastatin and rifampicin significantly downregulated GLUT2 and HNF4α expression, and impaired glucose uptake and utilization in HepG2 cells. Overexpression of PXR downregulated GLUT2 and HNF4α expression, while silencing PXR upregulated HNF4α and GLUT2 expression. Silencing HNF4α decreased GLUT2 expression, while overexpressing HNF4α increased GLUT2 expression and glucose uptake. Silencing PXR or overexpressing HNF4α reversed the atorvastatin-induced decrease in GLUT2 expression and glucose uptake. In human primary hepatocytes, atorvastatin downregulated GLUT2 and HNF4α mRNA expression, which could be attenuated by silencing PXR. Silencing HNF4α downregulated GLUT2 mRNA expression. These findings were reproduced with mouse primary hepatocytes. Hnf4α plasmid increased Slc2a2 promoter activity. Hnf4α silencing or pregnenolone-16α-carbonitrile (PCN) suppressed the Slc2a2 promoter activity by decreasing HNF4α recruitment to the Slc2a2 promoter. Liver-specific Hnf4α deletion and PCN impaired glucose tolerance and hepatic glucose uptake, and decreased the expression of hepatic HNF4α and GLUT2. In conclusion, PXR activation impaired hepatic glucose metabolism partly by inhibiting the HNF4α‒GLUT2 pathway. These results highlight the molecular mechanisms by which PXR activators induce hyperglycemia/diabetes.Key words: Pregnane X receptor, Hepatocyte nuclear factor 4-alpha, Glucose transporter 2, Hepatic glucose uptake, Diabetes, Drug-induced hyperglycemia     

男男性行为者艾滋病暴露前预防用药性行为去抑制化情况

目的：了解男男性行为者（men who have sex with men,MSM）在参加暴露前预防用药（pre-exposure prophylaxis,PrEP）临床试验中是否存在性行为去抑制化现象及其影响因素。方法：采用非概率抽样法招募并筛选出108名MSM,随机分为77名服用药物组和31名空白对照组,第12、24、36、48周进行临床随访和问卷调查,问卷调查主要包括社会人口学特征,艾滋病相关知识、态度和行为等相关情况。采用单因素和多因素的广义估计方程分析MSM在参与PrEP中是否存在性行为去抑制化现象及其影响因素。结果：药物服用组MSM在参与PrEP的第12、24、36、48周的性伴个数中位数分别为1（0,6）、1（0,6）、1（0,10）、1（0,3）、1（0,3）,高危性行为次数中位数分别为1（0,26）、1.5（0,8）、1（0,12）、1（0,9）、2（0,30）;空白对照组性伴个数中位数分别为1（0,21）、1（0,2）、1（0,3）、1（0,3）、1（0,3）,高危性行为次数中位数分别为1（0,9）、1（0,6）、0.5（0,15）、0（0,10）、1（0,10）;多因素广义估计方程分析发现MSM在参与PrEP过程中性伴个数及高危性行为次数均没有发生改变（Z=-0.24,P=0.811;Z=0.93,P=0.355）,性行为方式为“1”和“0.5”的较性行为方式为“0”的拥有更多的性伴（Z=2.47,P=0.014;Z=2.24,P=0.025）;发生过商业性行为的MSM较没有发生过的拥有较少的性伴和高危性行为（Z=-2.82,P=0.005;Z=-2.28,P=0.023）;已婚较离异MSM发生较少的高危性行为次数（Z=-2.34,P=0.019）。结论：本研究中暂未发现PrEP中存在性行为去抑制化现象,性行为方式为“1”和“0.5”的MSM拥有较多性伴,是后期随访中的重点管理人群。还需进一步加强对艾滋病相关知识的科普。     

儿童屈光不正与立体视觉

目的探讨儿童屈光不正对立体视觉的影响。方法采用颜少明等《立体视觉检查图》对60例正常儿童及115例矫正视力正常的屈光不正患儿进行立体视阈值检查并进行统计学处理。结果远视眼立体视阈值明显高于正常组及近视眼组（P＜0．005），且随屈光度增高而增高，随发生年龄增高而降低，近视眼组与正常组之间无差异（P＞0．05）。近视眼之间戴眼镜前后立体视阈值无显著性，而远视眼戴镜后立体视阈值明显下降（P＜0．005）。结论屈光不正对立体视功能影响是由于视力下降引起。提示及早发现屈光不正，及时预防、矫正屈光不正性弱视，对保证立体视功能的正常发育具有重要意义     

Fertility regulating agents from traditional Chinese medicines

Chinese scientists have capitalized on the rich flora and the ethnomedical experience in China, in their pursuit of fertility regulating agents from natural products. Discoveries range from anti-implantation agents to abortifacient and pregnancy-terminating compounds, as well as a male contraceptive. Chemistry and bioactivity of these compounds and materials are reviewed in this paper, with the hope that further research and collaboration will take place to help solve the problem of population explosion.     

Emerging Roles of Human Prostatic Acid Phosphatase

Prostate cancer is one of the most prevalent non-skin related cancers. It is the second leading cause of cancer deaths among males in most Western countries. If prostate cancer is diagnosed in its early stages, there is a higher probability that it will be completely cured. Prostatic acid phosphatase (PAP) is a non-specific phosphomonoesterase synthesized in prostate epithelial cells and its level proportionally increases with prostate cancer progression. PAP was the biochemical diagnostic mainstay for prostate cancer until the introduction of prostate-specific antigen (PSA) which improved the detection of early-stage prostate cancer and largely displaced PAP. Recently, however, there is a renewed interest in PAP because of its usefulness in prognosticating intermediate to high-risk prostate cancers and its success in the immunotherapy of prostate cancer. Although PAP is believed to be a key regulator of prostate cell growth, its exact role in normal prostate as well as detailed molecular mechanism of PAP regulation is still unclear. Here, many different aspects of PAP in prostate cancer are revisited and its emerging roles in other environment are discussed.     

小檗胺在升高白细胞的同时对乳酸脱氢酶的影响

采用酶细胞化学及平板聚丙烯酰胺凝胶电泳法观察小檗胺(Ber)在升高白细胞的同时,是否对细胞内酶代谢及其同工酶有影响。结果表明:ip Ber的小鼠粒细胞内LDH酶反应明显增强,酶反应的强弱与用药时间长短成正比。LDH同工酶谱分析,所有标本均显示5条区带,LDH_2比例发生变化,对照组及Ber组中出现LDH’_5亚带。提示,Ber在升高白细胞的同时对细胞内酶的代谢有一定影响,同时伴有同工酶谱比例改变。     

胆碱乙酰化酶在人体耳蜗的定位

应用免疫细胞化学方法，研究胆碱乙酰化酶在人体耳蜗的定位。结果发现，胆碱乙酰化酶定位于人体耳蜗传出神经系统。实验表明，乙酰胆碱是人体耳蜗的传出神经递质