非体外循环冠状动脉搭桥术临床分析（附11例报告）

（1）目的 总结探讨11例非体外循环冠状动脉搭桥术（OPCAB）的经验。（2）方法 2001年6－12月对11例冠心患采用非体外循环心脏不停跳方法完成冠状动脉搭桥术。（3）结果 共搭桥35支，平均3．17支／例，其中左乳内动脉桥8支，大隐静脉桥27支。6例患（54．5％）未血，无手术死亡及并发症。（4）结论 非体外循环搭桥术克服了体外循环搭桥术（CABG）的诸多缺点和弊端，手术简化，时间缩短，适应证扩大，并发症明显减少，效果满意。     

TD清洗消毒剂对口腔科器械消毒效果探讨

通过实验室和口腔科临床观察表明:TD清洗消毒剂(氯化磷酸三钠)对金黄色葡萄球菌、绿脓杆菌和枯草杆菌黑色变种的平均杀菌率为100.0％,对口腔科器械消毒无菌率为100％,对被HBsAg阳性血清污染的器械浸泡30分钟转阴率为98.1％。其消毒效果优于新洁尔灭,与戊二醛相同。在口腔科使用两年,未见金属器械有锈斑生成。     

Synchronous ileal and colonic adenocarcinomas associated with Crohn's disease: report of a case with a focus on genetic alterations and carcinogenesis

Patients with Crohn's disease have an increased risk of developing intestinal tumours. However, the carcinogenic mechanisms remain poorly understood. To address this question, this report describes an unusual case of Crohn's disease complicated by synchronous small intestinal and colonic adenocarcinomas. Genetic events in both the tumours and their adjacent mucosae were evaluated and the tumorigenesis of these cancers is discussed.     

钱学森同志谈中医学的科学水平及其发展

我国科学家钱学森同志十分关心中医学的发展,多次从科学技术全局的战略高度发表具有深远意义的见解。一九八五年六月,他看了我院马列主义教研室讲师祝世讷编写的教材《中医系统论导论》后,来信给予热情鼓励。九月,祝世讷同志在给钱学森同志的一封信中谈了两个问题:(一)关于中医学是经验科学还是理论科学,目前存在争论。提出,恩格斯在《自然辩证法》和《路德维希·费尔巴哈和德国古典哲学的终结》两书中有三段话,论述了十九世纪自然科学从经验科学向理论科学的转变,根据恩格斯的论断,中医学的发展处于经验科学阶段。但是,迄今还没有人就什么是经验科学、什么是理论科学以及两者之间的联系和区别作出系统的理论说明,因而,对于中医学科学水平的认识,往往由于缺乏必要的理论根据而产生一些模糊观念,建议钱学森同志在适当场合从理论上作较系统的论述。(二)关于中医学发展阶段的“断代”问题。提出,自然科学的各学科,在发展中大都划分出经典科学阶段与现代科学阶段,如欧氏几何学与非欧几何学,经典物理学与现代物理学等等,中医学也应当划分出“经典中医学”与“现代中医学”,现在实际上已出现了这样的分化趋势,自觉地认识和处理,可能更有利于中医学的发掘和发展。钱学森同志接信后,回信较系统地谈了一些原则性意见,对于正确认识中医学的科学水平及其发展,具有十分重要的意义。现将钱学森同志的这封信全文发表,供大家学习和研究。     

Correction to: Cichorium intybus L. promotes intestinal uric acid excretion by modulating ABCG2 in experimental hyperuricemia

The study of sex differences in hyperuricemia can provide not only a theoretical basis for this clinical phenomenon but also new therapeutic targets for urate-lowering therapy. In the current study, we aimed to confirm that estradiol can promote intestinal ATP binding cassette subfamily G member 2 (ABCG2) expression to increase urate excretion through the PI3K/Akt pathway. The estradiol levels of hyperuricemia/gout patients and healthy controls were compared, and a hyperuricemia mouse model was used to observe the urate-lowering effect of estradiol and the changes in ABCG2 expression in the kidney and intestine. In vivo and in vitro intestinal urate transport models were established to verify the urate transport function regulated by estradiol. The molecular pathway by which estradiol regulates ABCG2 expression in intestinal cells was explored. The estradiol level of hyperuricemia/gout patients was significantly lower than that of healthy controls. Administering estradiol benzoate (EB) to both male hyperuricemic mice and female mice after removing the ovaries confirmed the urate-lowering effect of estradiol, and hyperuricemia and estradiol upregulated the expression of intestinal ABCG2. Estradiol has been confirmed to promote urate transport by upregulating ABCG2 expression in intestinal urate excretion models in vivo and in vitro. Estradiol regulates the expression of intestinal ABCG2 through the PI3K/Akt pathway. Our study revealed that estradiol regulates intestinal ABCG2 through the PI3K/Akt pathway to promote urate excretion, thereby reducing serum urate levels.     

进展期胃癌多药耐药基因表达的临床意义

目的 探讨多药耐药基因（MDR1基因）在人胃癌组织中的表达及其与临床病理的关系。方法 采用逆转录－多聚酶链反应（RT－PCR）法检测了215例手术切除的进展期胃癌组织中的MDR1基因的表达。实验数据采用SAS软件中的χ^2检验和Fisher’s exact P做统计学处理。结果 MDRI基因的阳性率为31．63％（68／215）,与年龄、性别、组织学类型、分化程度、淋巴结转移、Borromann分型及TNM分期等无关,但在分化差的肿瘤中有增高趋势,如黏液腺癌及印戒细胞癌中达41．67％及50．00％。结论 化疗前胃癌组织中MDRI基因即存在较高的表达率,这为选用化疗药物和MDR逆转剂提供了参考指标,但不能作为制定化疗方案的唯一指标。     

Targeting NF-κB c-Rel in regulatory T cells to treat corneal transplantation rejection

The relevance of Tregs in the induction of tolerance against corneal allografts has been well established. Although it is well known that the conversion of Tregs into effector-like cells contributes to the loss of corneal immune privilege, the underlying mechanism is still not fully understood. Using heterologous penetrating keratoplasty model, we found that Tregs from corneal allograft rejected mice (inflam-Tregs) exhibit impaired function and characteristics of effector T cells. Further study showed that the expression of NF-κB c-Rel, a key mediator of effector T cell function, was significantly increased in inflam-Tregs. Mechanistic study revealed that elevated NF-κB c-Rel level in inflam-Tregs impaired Treg function through the promotion of inflammatory cytokine production and glycolysis. More importantly, we demonstrated that targeting NF-κB c-Rel was able to improve the immune suppressive function of inflam-Tregs in vitro and enhance the potential of them to suppress corneal transplantation rejection. Therefore, our current study identified NF-κB c-Rel as a key mediator of the conversion of Tregs into effector-like cells when under inflammatory environment.     

A nationwide post-marketing survey of knowledge,attitude and practice toward human papillomavirus vaccine in general population: Implications for vaccine roll-out in mainland China

BackgroundHuman papillomavirus (HPV) vaccine has been increasingly discussed in mainland China since its first approval in 2016. To date, nearly all studies assessing HPV vaccine perceptions and attitudes were implemented during pre-licensure period. Therefore, the nationwide post-marketing survey was conducted to update knowledge, attitudes and practice on HPV vaccine among general population in mainland China.MethodsParticipants aged 18–45 years living in mainland China were recruited in April 2019 by multi-stage non-randomized sampling. Sociodemographic factors, HPV and HPV vaccine related awareness, knowledge, attitudes, vaccine uptake and potential obstacles were assessed in questionnaires. Bivariate analysis and multivariate regression were used to identify disparity among subgroups with different sociodemographic characteristics.Results4,000 women (32.1 ± 7.81y) and 1,000 men (31.8 ± 7.96y) were included in final analysis. Less than one third of participants had heard of HPV (female: 31%; male: 22%) and HPV vaccine (female: 34%; male: 23%). Knowledge score was also unfavorable on HPV (female: 3 out of 13; male: 1.8 out of 13) and HPV vaccine (female: 3 out of 6; male: 2 out of 5). Only 3% females had been vaccinated three years after HPV licensure in China, although willingness to get vaccinated among those unvaccinated were high (mean willingness score ± SD: female: 3.3 ± 0.97; male: 3.0 ± 0.98). Industry of employment and household income were the major factors related to awareness and knowledge of vaccine, whereas HPV and HPV vaccine awareness were key influential factors for willingness. The main obstacles of vaccination were safety concerns, lack of knowledge, and high price of HPV vaccines.ConclusionsFindings highlight a lack of vaccine awareness, knowledge, and poor uptake in mainland China and underscore the necessity of health education campaigns. The identified priority groups, contents to be delivered and practical obstacles could furthermore provide insight into health education to reduce disparities and accelerate HPV vaccine roll-out in China.