Survivin基因在胃癌中表达的研究

目的研究凋亡抑制基因survivin在胃癌组织中的表达。方法运用S-P免疫组化技术,检测survivin基因在93例胃癌组织、20例正常胃黏膜组织以及胃癌细胞株MGC-803中的表达。结果Survivin基因在20例正常胃黏膜组织中不表达,而93例胃癌组织中有66例表达阳性,占71%,两者差异有统计学意义(P<0.01),胃癌细胞株MGC-803中survivin呈高表达。Survivin基因表达阳性率与胃癌组织的分化程度、淋巴结转移、TNM分期相关,而与浸润程度不相关。结论Survivin基因的特异性高表达在胃癌的发生发展中起重要作用,其过度表达可能提示胃癌预后不良。     

塞来昔布对人鼻咽癌CNE-2细胞生长抑制及放射增敏研究

Objective To investigate the growth inhibition and radiosensitization of Celecoxib in hu-man nasopharyngeal carcinoma cell line CNE-2. Methods CNE-2 growth inhibition by Celecoxib was eval-uated by MTT method. Apoptosis-related changes in morphology were observed by transmission electron mi-croscopy (TEM). Cell cycle distribution and apoptosis rate were measured by flowcytometry (FCM). The ex-pression of COX-2 protein was observed by SP method after the treatment of Celecoxib. Cells were randomly planted into four groups: irradiation control(Ci), drug group(Cd), irradiation group(R), and Celecoxib plus irradiation group(D+R). Single irradiation of 2,4,6,8,and 10 Gy were administered for colonogenic assay. Cell cycle distribution and apoptosis rate were analyzed at 6 Gy irradiation. Results The growth of CNE-2 cell was inhibited by celecoxib in a dose-and time-dependent manner, the IC50 was 80 μmol/L After the treatment, cell ratio of GO and G, phases was increased (47.03±2.76 vs 56.17±1.95, t=4.68, P= 0.010), whereas the ratio of S and G2/M phases was decreased (33.07±1.86 vs 24.87±1.76, t=5.54, P = 0.010; 19.30±0.53: 17.73±0.83, t=2.75, P=0.050), and the apoptosis rate was increased (1.57±0.47:10.47±0.31, t = 27.39, P = 0.000) in a dose-dependent manner. Apoptosis with nuclear chromatin condensation, fragmentation and cell shrinkage was found by TEM. SP method showed that Celeib decreased COX-2 expression (17.48±0.34 vs 12.82±0.51,t=13.20,P =0.00). The sensitivity ratio(D0) was 1.15. FCM showed that the percentage of cells in G2/M phase was significanty more in R and D+R groups than in Ci and Cd groups (68.00±1.65,54.27±5.74,17.60±0.80,14.86±1.23, t=47.70,P=0.000; t=11.63, P=0.000), and also significantly different between R group and D + R group (t=3.99, P= 0.020). The apoptosis rate was higher in R and D + R groups than Ci and Cd groups(4.83±0.97,9.50± 1.35,1.33±0.86 and 2.28±0.42,t=4.67,P=0.010;t=8.81, P=0.000), D + R group than R group(t =4.85,P=0.010). Conclusions Celecoxib can markedly inhibit the growth and induce apoptosis in CNE-2 cells,which may depend on COX-2 pathway. Celeeoxib potently enhances the radiosensitivity of CNE-2 cells,which may due to the repair inhibit of radiation-induced DNA damage, inhibit of cell proliferation,and enhancement of cell apoptosis after irradiation.     

口服和静注丹参素在兔体内的药动学

目的:研究家兔灌胃丹参提取物和静注丹参素溶液后丹参素在体内药动学特征.方法:用高效液相色谱(HPLC)法测定了16只家兔按丹参素10 mg·kg-1单剂量灌胃丹参提取物和静脉注射丹参素溶液后,丹参素血药浓度变化情况.结果:HPLC法的线性范围为0.114～5.68 mg·L-1,r=0.999 8.平均相对回收率为96.8%～101.3%,RSD为1.7%～6.2%,日内、日间精密度RSD分别为3.2%～8.1%和3.3%～8.8% ;经口给药丹参素主要药动学参数T1/2(Ke)为(1.24±0.20 )h,Tmax为(1.25±0.15) h,Cmax为(0.86±0.19 )mg·L-1,AUC(0-7)为(2.95±0.71) mg·h·L-1.静注丹参素主要药动学参数T1/2β为(1.69±0.38) h,AUC(0-7)为(4.37±0.49) mg·L-1·h.结论:经口给药丹参素在兔体内过程符合一室开放模型,吸收较完全,可作为口服应用.     

RP-HPLC法研究塔斯品碱在大鼠体内的药代动力学

目的:建立大鼠血浆中塔斯品碱浓度的 RP-HPLC 分析方法,并研究其药代动力学特性。方法:用液液萃取技术对血浆中的塔斯品碱进行纯化、浓集,用 RP-HPLC 法进行测定。色谱柱:Kromsil C_(18)ODS 柱(150mm×4.6mm,5μm);流动相:甲醇-60 mmol·L~(-1)磷酸二氢钠-20 mmol·L~(-1)SDS(70:30);流速:1.0 mL(min~(-1);检测波长:245nm;柱温:室温。结果:方法线性范围为15.63～903.7 ng·mL~(-1)(r=0.994 0),日内、日间精密度的 RSD 分别为3.8%～4.9%和4.2%～7.6%,平均回收率为(107.33±7.3)%～(97.30±4.8)%。塔斯品碱在大鼠体内的达峰时间约2.84 h,平均峰浓度为64.15 ng·mL~(-1),药时曲线下面积为1214.98 ng·mL~(-1)·h,消除半衰期为10.96 h。结论:分析方法灵敏、准确,适合于塔斯品碱的药代动力学研究。塔斯品碱经大鼠口服吸收较慢,而消除很慢。     

先秦弓箭制作技艺考

射箭是我国最早的体育活动之一,是我国民族传统体育的典型代表,在中国古代历史发展过程中占有重要的地位,中国人也是世界上最早掌握射箭技术的人类群体之一。先秦时期,从王公贵族到普通百姓都喜好这项运动,这使得先秦时期的弓箭制作工艺非常高超。但由于种种原因,传统弓箭的制作工艺也逐渐走向了衰败,甚至濒临失传。因此,重新翻开历史长卷,整理和研究先秦时期弓箭制作技艺无疑是一件具有深远意义的工作。     

长疗程利妥昔单抗治疗难治性幼年型特发性炎症性肌病3例

特发性炎症性肌病是一组具有临床表现异质性的自身免疫性疾病,以骨骼肌无力和肌肉炎症病变为特征.临床分型包括皮肌炎、多发性肌炎、散发的包涵体肌炎、免疫介导的坏死性肌病和抗合成酶抗体综合征等[1-3].在儿童期,皮肌炎为最常见的临床类型,约占80％[4].特发性炎症性肌病为临床罕见病,年发病率约为每年每百万人1 ～ 19例[5].美国儿童皮肌炎的发病率约为每年每百万人2.5～4.1例[6],国内尚未见流行病学资料.特发性炎症性肌病的治疗一直非常具有临床挑战性,尤其是一线治疗药物失败的病例[7].近年来,对难治性病例的精准治疗成为特发性炎症性肌病领域的研究重点[8].自20世纪初期开始,利妥昔单抗在国外就被尝试用于难治性特发性炎症性肌病的治疗,但关于利妥昔单抗的应用剂量和疗程,目前尚无统一认识[9],国内也尚未见相关临床研究报道.本文分享了3例传统药物治疗反应欠佳、经长疗程(2年7个月至3年2个月)利妥昔单抗联合治疗后获得临床缓解的特发性炎症性肌病患者的治疗过程,以期为该疾病的治疗提供参考.本观察研究开始前获北京大学第一医院生物医学研究伦理委员会审查批准(批准号:2021科研263).     

One‐Year Clinical Outcome of a Randomized Trial of Polymer‐Free Paclitaxel‐Eluting Stents Versus Biodegradable Polymer‐Based Rapamycin‐Eluting Stents in Patients with Coronary Heart Disease

Background: More widespread use of drug‐eluting stents (DES) to treat coronary heart disease (CHD) has recently generated more attention to thrombosis, which was relative to the polymer. Polymer‐free and biodegradable polymer‐based stents are more frequently studied, but their efficacy on preventing detrimental clinical events is unclear. Methods and Results: To assess whether polymer‐free paclitaxel‐eluting stent (YINYI stent) was noninferior or equivalent to biodegradable polymer‐based rapamycin‐eluting stents (EXCEL stent) in preventing detrimental clinical cardiovascular events, a total of 167 consecutive CHD patients requiring DES implantation were randomly divided into the YINYI group (n = 82) and the EXCEL group (n = 85). The primary end‐point was major adverse cardiac events (MACE). The secondary end‐points included stent thrombosis events, all‐cause mortality, and rehospitalization. The study was designed to test the noninferiority or equivalence of the YINYI stent compared with the EXCEL stent with respect to one‐year MACE according to a noninferiority or equivalence margin of 0.1. One‐year MACE was 6.10% in the YINYI group versus 5.88% in the EXCEL group. The lower limit of the one‐sided 95% confidence interval was ?0.0582 (P = 0.002 from the test for noninferiority). The 95% confidence interval for the equivalence test was [?0.0698, 0.0742] (P₁=0.004 and P₂=0.007 from 2 times the 1‐sided test for equivalence). There was no statistically significant difference in thrombosis events, all‐cause death, and rehospitalization (all P > 0.05). Conclusions: In this small randomized trial, polymer‐free paclitaxel‐eluting stents appear to be noninferior or equivalent to biodegradable polymer‐based rapamycin‐eluting stents. (J Interven Cardiol 2012;25:604–610)     

耳石复位联合药物治疗良性阵发性位置性眩晕

目的 观察耳石复位联合药物治疗良性阵发性位置性眩晕( BPPV)的疗效.方法 40例BPPV患者随机分为两组,对照组20例应用西药及中药治疗,治疗组20例在应用西药及中药的同时结合耳石复位法治疗.治疗7d后进行疗效评定,3个月后电话随诊,观察复发情况.结果 治疗组痊愈率90％,总有效率100％,均高于对照组的50％、95％(x2=6.483、4.326,均P＜0.001)；经电话随诊治疗组20例3个月内未复发,对照组有1例复发,予耳石复位法配合药物治疗后症状好转.结论 耳石复位法治疗BPPV有效、简便、安全,可作为BPPV首选治疗方法,配合中西药物综合治疗可明显缓解患者症状,减少复发.     

新医改形势下对某医院基层进修人员的教学管理研究

新医改形势下,基层卫生服务需求增加与供给能力不足的矛盾迫使基层医院选派更多的人外出进修。对比新医改前后,在某医院进修的基层卫生人员数量和结构的变化发现,进修人员呈现数量增长、学历升高、职称仍然偏低的特征,接收进修生的教学医院存在教学资源紧张、教学模式落后、监管力度不足等问题,针对这些问题提出加大教学投入、创新教学模式、加强教学过程管理的建议。