长沙市基层医疗卫生机构公共卫生服务能力提升路径探索

深入学习新公共服务理论和健康中国战略,针对长沙的社情、民情,从区域内医疗体系联动角度优化可及资源配置,遵循关联效应提出主次分明、层层递进的“政策支持—财政投入—完善设施—配置人员—区域联动”路径,提升长沙基层医疗卫生机构公共卫生服务能力,增强居民信任感,促进双向转诊制度实施,充分发挥基层医疗卫生机构作为居民健康防护“守门人”的作用。     

卵巢癌耐药细胞株的P38MAPK活性与凋亡关系的研究

目的 研究卵巢癌细胞耐药过程中P38MAPK活性与凋亡的关系,探讨P38MAPK信号转导途径在卵巢癌细胞耐药中的作用.方法 流式细胞技术分析P38MAPK特异性抑制剂SB203580对A2780/Taxol细胞凋亡的影响;利用免疫细胞化学法观察SB203580处理后细胞内P38MAPK表达水平.四甲基偶氮唑蓝检测细胞对紫杉醇的半数抑制浓度(IC50),Western blot检测细胞内P-gp蛋白表达.结果 与未干预组和对照组比较,SB203580(10μmol/L)干预24h后A2780/Taxol细胞凋亡率为23.7%(P＜0.01);A2780/Taxol细胞的P38MAPK表达颗粒密度减低,数量减少;紫杉醇对A2780/Taxol细胞的IC50显著降低(P＜0.01);P-gp蛋白表达水平明显降低.结论 P38 MAPK信号转导途径与卵巢癌耐药密切相关,可能参与卵巢癌耐药的形成.其可能机制为P38MAPK通路起到保护A2780/Taxol细胞逃避凋亡的作用.因此,阻断该通路可增强卵巢癌耐药细胞发生凋亡.     

TCIS和TCRS两种术式治疗部分子宫纵隔疗效对比

目的 探讨经宫颈宫腔镜下子宫纵隔切开术(TCIS)和经宫颈宫腔镜下子宫纵隔切除术(TCRS)对部分子宫纵隔患者生殖预后改善情况.方法 比较TCIS组(n=40)和TCRS组(n=40)部分子宫纵隔患者一般资料及术中情况、术后并发症(包括残隔、宫腔粘连、内膜上皮化不满意)及生殖预后随访结果.结果 TCIS组手术所需时间、术中出血量及术后并发症发生率明显低于TCRS组,差异有统计学意义(P<0.05),TCIS组术后分娩率高于TCRS组,且足月分娩率明显高于TCRS组,差异有统计学意义(P<0.05).结论 TCIS与TCRS相比可减少部分子宫纵隔的手术时间及术中出血量,降低术后并发症,提高足月分娩率.     

恩替卡韦治疗慢性乙型肝炎病毒感染患者临床疗效分析

目的 对恩替卡韦治疗慢性乙型肝炎病毒感染患者临床疗效进行分析.方法 方便收集广东省兴宁市人民医院感染性疾病科2015年3月—2016年7月慢性乙型肝炎病毒感染患者50例随机分两组,每组25例.阿德福韦酯组采用阿德福韦酯进行治疗,恩替卡韦组采用恩替卡韦治疗.比较两组患者慢性乙型肝炎病毒感染治疗总有效率;用药后不良反应发生率、HBeAg转阴率;治疗前和治疗后患者HBeAg效价水平、HBV-DNA水平、ALT水平的差异.结果 恩替卡韦组患者慢性乙型肝炎病毒感染治疗总有效率96.00%高于阿德福韦酯组76.00%(P<0.05);恩替卡韦组用药后不良反应发生率8.00%低于阿德福韦酯组28.00%、HBeAg转阴率96.00%高于阿德福韦酯组76.00%(P<0.05);治疗前两组HBeAg效价水平、HBV-DNA水平、ALT水平比较差异无统计学意义(P>0.05);治疗后恩替卡韦组HBeAg效价水平、HBV-DNA水平、ALT水平改善幅度更大(P<0.05).结论 恩替卡韦治疗慢性乙型肝炎病毒感染患者临床疗效确切,可有效对肝炎病毒复制以及繁殖进行抑制,降低血清转氨酶水平,长期用药不良反应,安全性高,值得推广.     

Targeting of p38 Mitogen-activated Protein Kinases to Early Growth Response gene 1 （EGR-1） in the Human Paclitaxel-resistance Ovarian Carcinoma Cells

To investigate the relationship between the expression of early growth response gene 1 (EGR-1) and p38MAPK pathway in the paclitaxel resistance of ovarian carcinoma cells, the effect of p38MAPK inhibitor SB203580 on cell apoptosis was examined by using Hoechst 33258 staining. The intracellular Rh123 (Rhodamine 123) accumulation was detected by the flow cytometry (FCM). The 50% inhibition concentration (IC50) of paclitaxel for A2780/Taxol cells was determined by MTT method. Electrophoretic motility shift assay (EMSA) was employed to examine the EGR-1DNA binding activity. MDR1 and EGR-1 mRNA were assessed by RT-PCR. The expressed of p-gp, phos- phorylated p53 and p38 were detected by Western blotting. SB203580 could remarkably promote the apoptosis of A2780/Taxol cells, and the cell apoptosis was in a time-dependent manner. Cellular Rh123 accumulation was increased, and the IC50 of paclitaxel for A2780/Taxol cells was decreased significantly. A2780/Taxol cell line after SB203580 treatment was shown to have a significantly higher level of EGR-1 DNA binding activity. SB203580 down-regulated the activity of p38MAPK pathway, but up-regulated EGR-1 expression. SB203580 significantly increased the level of cellular phosphorylated p53 protein, but decreased the p-gp protein level and MDR1 mRNA level in A2780/Taxol cells. There existed a close relationship between p38MAPK pathway and the paclitaxel resistance of ovarian carcinoma cells. The expression of EGR-1 mediated by p38MAPK pathway plays a critical role in paclitaxel resistance of ovarian carcinoma cells.     

乳腺癌耐药性与MAPK信号转导关系的研究

目的探讨乳腺癌细胞阿霉素耐药性与p38MAPK通路的关系。方法用流式细胞术检测SB203580(15μmol/L)干预后细胞的凋亡、细胞内阿霉素浓度的改变、细胞对阿霉素敏感性。结果经SB203580(15μmol/L)干预24h和48h后,流式细胞仪检测见MCF-7/Adr细胞发生显著凋亡,凋亡率分别为25.36±1.17%和38.21±1.25%,并呈一定时间依赖性(P<0.05);显著高于空白对照组及DMSO组MCF-7/Adr细胞的0.65±0.21%和0.81±0.16%(P<0.01);细胞内阿霉素浓度亦显著增加,平均荧光强度分别为32.45±2.36及41.66±3.12,均显著高于空白对照组及DMSO组的14.17±1.45及16.28±0.63(P<0.01);另外,SB203580干预48h使MCF-7/Adr细胞内阿霉素浓度增加的作用强于24h组,两者间差异有统计学意义(P<0.05)。结论提示p38MAPK通路与乳腺癌细胞阿霉素耐药密切相关。     

促排卵治疗后宫外三胎妊娠1例

1 病例介绍患者30岁,因停经43 d,腹痛4d,于2010年8月7日入院.末次月经2010年6月25日,6月29日始口服克罗米芬50 mg/d,共5d,7月7日B超示卵泡最大直径20mm,肌注HCG 5 000U,7月8日同房,7.29测尿HCG阳性,无阴道流血,4h前感右下腹胀痛,来我院行阴道彩超示:"右附件区宫外孕,三活胎,均约孕6+周大小;盆腔积液,宫腔少量积液(图1)."     

Aurora B基因沉默对卵巢癌细胞A2780紫杉醇化疗敏感性的影响

目的 研究RNA干扰(RNA interference,RNAi)抑制Aurora B基因表达对卵巢癌细胞A2780细胞紫杉醇化疗敏感性的影响.方法 采用RNAi方法,将不同浓度AURKB siRNA转入A2780细胞(实验组),同时设阴性对照组和空白对照组,并以不同浓度紫杉醇作用各组细胞.采用MTT检测细胞存活率;AnnexinⅤ-FITC/PI检测细胞凋亡率;Western blot检测细胞内Caspase-3蛋白水平;Hoechst染色观察细胞凋亡.结果 A2780细胞转染不同浓度siRNA后,随着siRNA浓度增加,细胞存活率逐渐下降,至50 pmol/L时,实验组与空白对照组和阴性对照组相比差异有统计学意义(P＜0.05);不同浓度紫杉醇处理各组细胞,随着紫杉醇浓度增加,细胞存活率明显下降,当紫杉醇浓度至10 μmol/L时,实验组与空白对照和阴性对照组相比,差异有统计学意义(P＜0.05或P＜0.01);50 pmol/L siRNA 转染A2780细胞48 h,再以10 μmol/L 浓度紫杉醇处理细胞,实验组细胞凋亡率明显增加,与空白对照组和阴性对照组相比,差异有统计学意义(P＜0.01);50 pmol/L浓度siRNA转染A2780 细胞48 h,再以10 μmol/L 浓度紫杉醇处理细胞,实验组细胞内Caspase-3蛋白表达明显上调,细胞凋亡明显增加.结论 Aurora B的抑制可增强A2780细胞对紫杉醇的化疗敏感性,并使细胞凋亡增加.     

The role of SDF-1/CXCR4 axis in ovarian cancer metastasis

This study was aimed to explore the role of stromal-derived factor 1 （SDF-1）/CXC chemokine receptor 4 （CXCR4） axis in mediating the metastasis of ovarian cancer cells through activation of extracellular signal-regulated kinase-1/2 （ERK-1/2） signaling pathway. A highly metastatic ovarian cancer cell line, SKOV3, was used in the study. Intracellular calcium mobilization was detected by using laser scanning confocal fluorescence microscopy. Western blotting was used to detect the phosphorylation of ERK1/2 in SDF-1α-treated SKOV3 cells. Adhesion capability and matrix metalloproteinase （MMP） activity of ovarian cancer cells after exposure to SDF-1 a were measured by adhesion assay and gelatin zymography. The results showed that SDF-1α induced rapid intracellular calcium mobilization in SKOV3 cells, as well as the phosphorylation of ERK-1/2. The adhesion of ovarian cancer cells to fibronectin and collagen Ⅳ was increased after SDF-1α treatment. An inhibitor of ERK-1/2 signaling, PD98059, could antagonize such effects of SDF-1α. SDF-1α could also increase the secretion of active MMP-2 and MMP-9. It was concluded that the SDF-1/CXCR4 axis played a critical role in the metastasis of human ovarian cancer by increasing the adhesion capability of cancer cells and the activity of MMP-2 and MMP-9 via ERK1/2 signaling pathway.     

2016-2019年乌鲁木齐市城市高危人群乳腺癌筛查结果分析

目的 探讨乌鲁木齐地区城市高危人群乳腺疾病检出情况及分布特征,为乌鲁木齐地区乳腺癌的预防与控制提供科学依据.方法 选取2016-2019年在新疆医科大学附属肿瘤医院进行常规体检的女性作为目标人群,采用防癌风险问卷筛选乳腺高危人群,40～44岁乳腺癌高危女性采用彩色超声检查,45岁及以上的乳腺癌高危女性采用超声检查结合钼...