抗癌作用新靶点及其抑制剂的研究进展

针对靶点分子或某种发生发展机制来设计抗肿瘤药物的研究工作已取得了相当大的成就.这类药物的特异性强,疗效显著,因此,针对这些新靶点进行药物设计可以使抗肿瘤药物的研究产生一次新的革命.本综述旨在讨论目前抗肿瘤药物研究的潜在的新靶点以及它们相应的抑制剂或拮抗剂.     

白细胞介素6和肿瘤坏死因子—α在分泌性中耳炎渗出液中表达及…

Using enzyme-linked immunosorbant assay (ELISA), we measured levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) in middle ear effusions (MEE) from patients with secretory otitis media (SOM) undergoing auripuncture to study the role of cytokines in the pathogenesis of the disease. Significant levels of IL-6 (> 62.5 ng/L) were found in 19 (86.36%) of 22 MEEs and those of TNF-alpha (> 37.5 ng/L) in 19 (70.37%) of 27 MEEs. The mean (+/- s) levels of IL-6 and TNF-alpha were 507.68 +/- 813.11 ng/L and 186.86 +/- 166.93 ng/L, respectively. It revealed that the shorter the course, the higher the concentration of IL-6 in MEE: the longer the course, the higher the concentration of TNF-alpha in MEE. These findings suggested that during the early stages of SOM, IL-6 might participate in the defensive reaction of organism, while TNF-alpha might be closely related to the persistence of SOM, resulting in an excessive inflammatory reaction with a potential for pathological changes. It is concluded that the immunological mechanisms probably play a significant role in the pathogenesis of SOM.     

再次尿道成形术治疗先天性尿道下裂术后严重并发症

目的：了解先天性尿道下裂行各种尿道成形术失败后，利用膀胱粘膜行尿道成形术的疗效。方法：将严重狭窄和（或）无法修补的尿瘘瘢痕组织彻底切除，取膀胱粘膜片形成尿道，正位开口于龟头，新尿道内置多孔硅胶支架管作引流。结果：２８例中，２３例治愈，３例有小尿瘘需作尿瘘修补，２例完全失败，再次作粘膜尿道成形术治愈。结论：各种类型先天性尿道下裂尿道成形失败后，可用膀胱粘膜移植尿道成形，效果良好     

双特异性抗体治疗肿瘤的可行性研究

肽图分析是验证rhIL-2的重要手段之一.rhIL-2具有133个氨基酸,在其一级结构的序列中有四个甲硫氨酸切点,可用化学裂解的方法将甲硫氨酸肽键打开,进行肽谱分析,以对其进行验证.为了有效地对甲硫氨酸进行裂解,我们用70%甲酸溶解CNBr~2,保持CNBr的高浓度小体积,使rhIL-2在1.5mlEppedorf管中,室温条件下有效地打开甲硫氨酸肽键.同时比较了CNBr浓度、裂解时间以及在不同浓度的梯度胶中作SDS-PAGE对实验结果的影响,确定了最佳的实验条件,获得了良好的实验结果.本文虽以rhIL-2为例,但对所有带甲硫氨酸的细胞因子均可用本方法进行肽图分析.     

内皮素受体拮抗剂治疗充血性心衰一项meta分析

目的初步评价内皮素拮抗剂治疗心衰的效果和安全性。方法借助循证医学检索途径和方法筛选出临床随机对照试验(RCTs),数据用Revman4.2软件进行分析。结果共入选13个临床随机对照试验(RCT)4137名患者,其中3个试验评价了心脏指数改善情况,5个试验评价死亡和心衰恶化,4个试验评价其它副作用。心脏指数改善的总效应为:WMD(加权均数差)0.47,95%可信区间(CI)[0.36,0.57](P<0.00001)。Tezosentan<50mg/h、50mg/h和100mg/h三组比较具有相似的效果及副作用,而副作用有随剂量增加的趋势。作为主要终点指标死亡率和心衰恶化两组相似(RR=1.00,95%CI[0.89,1.13](P=0.89),而其它副作用事件发生率则存在明显差异(RR=1.28,95%CI[1.13,1.44](P<0.0001)。结论内皮素拮抗剂可改善心衰患者的心脏指数,但长期效应尚未得到证实。治疗组患者副作用发生常见,并呈剂量依赖性。内皮素拮抗剂的长期效果还需要设计更完善、纳入例数更多的临床随机对照试验加以阐明。     

Protein kinase C iota protects neural cells against apoptosis induced by amyloid beta-peptide

Protein kinase C (PKC) isoforms are increasingly recognized as playing important roles in the regulation of neuronal plasticity and survival. Recent findings from studies of non-neuronal cells suggest that atypical isoforms of PKC can modulate apoptosis in various paradigms. Because increasing data support a role for neuronal apoptosis in the pathogenesis of Alzheimer's disease (AD), we tested the hypothesis that PKCiota (PKCiota) can modify vulnerability of neural cells to apoptosis induced by amyloid beta-peptide (ABP), a cytotoxic peptide linked to neuronal degeneration in AD. Overexpression of PKCiota increased the resistance of PC12 cells to apoptosis induced by ABP. Associated with the increased resistance to apoptosis were improved mitochondrial function and reduced activity of caspases. In addition, ABP-induced increases in levels of oxidative stress and intracellular calcium levels were attenuated in cells overexpressing PKCiota. These findings suggest that PKCiota prevents apoptosis induced by ABP by interrupting the cell death process at a very early step, thereby allowing the cells to maintain ion homeostasis and mitochondrial function.     

香菇多糖联合抗生素治疗恶性肿瘤围化疗期肺部感染120例临床观察

目的：本文观察香菇多糖对恶性肿瘤患者围化疗期肺部感染抗生素治疗的增效作用。方法：120例围化疗期发生肺部感染恶性肿瘤患者在接受抗生素治疗的同时，随机分成加用香菇多糖针和不加香菇多糖针静脉滴注两组。每组各60例。结果：接受抗生素及香菇多糖联合治疗的患者的有效率显著提高（P〈0．05）．临床症状、体征与X光胸部片改善时间大幅缩短。结论：香菇多糖对恶性肿瘤患者围化疗期肺部感染抗生素治疗有明显增效作用。     

尺桡骨中段旋转截骨术治疗先天性上尺桡关节融合及并发症探讨

目的探讨尺桡骨中段旋转截骨术治疗先天性上尺桡关节融合的优越性及并发症。方法对7例先天性上尺桡关节融合的患儿，行尺桡骨中段旋转截骨术，Ⅰ期旋转至所需位置。结果7例患儿随访2个月～3年，平均1年，7例中1例1侧术后发生缺血性肌挛缩，1例1侧发生钢板断裂，其余病例均于3个月内截骨处达骨性愈合，患肢功能满意。结论此术式是治疗先天性上尺桡关节融合的较理想的方法。     

更昔洛韦治疗特发性血小板减少性紫癜应用指征

目的探讨更昔洛韦(GCV)治疗人巨细胞病毒(HCMV)感染相关的特发性血小板减少性紫癜的(ITP)应用指征。方法选择血清HCMV DNA PCR和(或)HCMV IgM检测呈阳性ITP患儿46例,采用逆转聚合酶扩增反应(RT-PCR)检测巨核系祖细胞中HCMV晚期抗原mRNA,并行GCV治疗,判定其疗效及应用指征。结果46例血清HCMV-DNA PCR阳性和(或)血清HCMV-IgM阳性的ITP骨髓巨核祖细胞HCMV晚期抗原基因mRNA阳性19例,GCV治疗有效16例,mRNA阴性27例,GCV治疗有效4例。阳性组疗效高于阴性组,有显著性差异(P<0.01)。结论HCMV感染的ITP患儿,若对常规治疗无效,应检测其巨核祖细胞内HCMV晚期抗原基因mRNA,阳性者是应用更昔洛韦的有效指征。     

重型颅脑损伤救治的临床伦理学问题探析

重型颅脑损伤病人病情危急，致残率、死亡率高，而医护人员的医德修养直接影响危重病人的治疗效果．也关系着医疗卫生行业的社会声誉，因而对临床伦理学有着更高、更严的要求，作者对在救治重型颅脑损伤病人过程中的伦理学问题进行了探讨。