胃肠反流与残胃癌发生的研究进展

残胃癌发病率呈上升趋势,其发生机制目前仍不十分明确,一般认为残胃癌的发生与多种因素有关,其中胃术后胃肠反流被认为是最重要因素。本文就胃肠反流与残胃癌发生的相关性及作用机制加以综述。     

Retrospective study of the clinical characteristics and risk factors of rheumatoid arthritis-associated interstitial lung disease

This study aims to explore the clinical characteristics and risk factors of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD). This is a retrospective study of 550 patients with RA. All patients underwent chest high-resolution computed tomography (HRCT) scanning. (1) Two hundred thirty-seven out of five hundred fifty (43.1%) patients with RA were diagnose with ILD. 13.5% ILD occurred before RA onset, 69.6% ILD occurred within 10 years of RA onset, and 16.9% ILD occurred more than 10 years after RA onset. (2) The most common chest CT characteristics of RA-ILD included reticular patterns (57.8%), pleural thickening (57%), ground-glass attenuation (53.2%), followed by interlobular septum thickening, nodules, emphysematous bullae, honeycombing, and bronchiectasis. The proportion of the UIP pattern and NSIP on HRCT was 18.6% and 57.8%. (3) RA-ILD was often associated with other lung lesions, including pleural disease, bronchiectasis, and pulmonary hypertension. (4) the comparisons between RA with ILD and RA without ILD showed that male, smoking, age, disease duration, number of swelling joints, globulin levels, erythrocyte sedimentation rate, C-reactive protein levels, lactate dehydrogenase, the positive rate of rheumatoid factor (RF) and the absolute value of RF, forced vital capacity, forced expiratory volume in 1 s, and carbon monoxide diffusion rate, were statistically different (P < 0.05). Logistic regression analysis showed that age, smoking, elevated lactate dehydrogenase, and RF positive were closely correlated to RA-ILD. RA-ILD occurs more often within 10 years of RA onset and coexists with other lung lesions. The elevated lactate dehydrogenase, RF positive, smoking, and advanced age are closely correlated with RA-ILD.     

HPLC法测定天龙抗痿胶囊中阿魏酸的含量

目的 建立天龙抗痿胶囊中阿魏酸的含量测定方法.方法 采用HPLC法,色谱条件为:色谱柱:Eclipse XDB-C18;流动相:乙腈-0.085%磷酸溶液(17:83);流速:0.8 ml·min-1 ;检测波长:316nm.结果 阿魏酸在0.0456～0.1824μg范围内线性关系良好(r=1.0000),平均回收率为98.54%,RSD=1.08%(n=6).结论 本方法操作简便,专属性强,结果准确,可用于天龙抗痿胶囊的质量控制.     

儿童睡眠呼吸暂停低通气综合征呼吸事件时间判定的研究

目的通过分析阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapneahypopneasyndrome,OSAHS)患儿的多导睡眠监测(polysomnogram,PSG)结果,探讨OSAHS患儿的呼吸事件(呼吸暂停/低通气)时间的判定标准。方法随机抽取107例自2004年1月至2006年5月间行多导睡眠监测后被诊断为OSAHS患儿的原始多导睡眠图,在排除了伪差后,观察每次血氧饱和度的下降值(△SaO2)及其伴随的呼吸事件时间。结果①△SaO2与呼吸暂停/低通气时间高度相关(P<0.01);②学龄前儿童与学龄期儿童在身高、体重、人体质量指数(bodymassindex,BMI)之间的差异具有显著性(P<0.01);③学龄前儿童与学龄期儿童在快动眼(rapideyemovement,REM)睡眠期及慢动眼(nonrapideyemovement,NREM)睡眠期之间的氧减指数具有显著性差异(P<0.01);④不同性别的患儿在REM期NREM期之间氧减指数也有显著性差异(P<0.01);⑤血氧饱和度下降3个百分点时(△SaO2=3%)呼吸事件的持续时间为5.4秒。结论①对儿童多导睡眠监测图的分析可为探索儿童呼吸事件判定标准提供方法;②△SaO2=3%时呼吸事件的时间与年龄有一定的相关性(r呼吸暂停=0.213,r低通气=0.225,P<0.05);③5.4秒可以作为儿童呼吸事件的判定依据,统一的儿童呼吸事件的判定标准应尽早制定。     

Predictive performance of adding platelet reactivity on top of CRUSADE score for 1-year bleeding risk in patients with acute coronary syndrome

CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress Adverse outcomes with Early implementation of the ACC/AHA guidelines) risk score can independently predict major bleeding events in patients with non-ST elevation myocardial infarction whereas the discriminative capacity is moderate. Whether adding platelet reactivity on top of CRUSADE score improves the prognostic performance for bleeding remains unclear. 512 patients with acute coronary syndrome (ACS) underwent successful percutaneous coronary intervention were enrolled and 1-year data were available. CRUSADE risk score was calculated at hospital admission and P2Y₁₂ reaction unit (PRU) value was measured by VerifyNow P2Y₁₂ assay. Thirty-five (6.8 %) patients experienced major bleeding events within 1-year follow-up. Patients who developed bleeding complications had higher CRUSADE score (37.5 ± 9.4 vs. 29.0 ± 10.2, p < 0.001) and lower PRU value (149.7 ± 57.1 vs. 196.4 ± 51.4, p < 0.001) than those did not. Both CRUSADE score and platelet reactivity were independently associated with bleeding. Kaplan–Meier analysis showed that patients with high CRUSADE score plus low platelet reactivity had significantly elevated risk for bleeding (HR 7.905, 95 % CI 2.623–23.822, p < 0.001). Compared to CRUSADE score alone, adding platelet reactivity on top of CRUSADE score offered a discriminative increment which was demonstrated by c-statistic (0.827 vs. 0.732, p = 0.011), as well as net reclassification improvement (NRI = 0.258, p < 0.001) and integrated discrimination improvement (IDI = 0.022, p = 0.002). After successful coronary stent implantation in patients with ACS, combining CRUSADE score with platelet reactivity yielded more accurate predictive value for 1-year bleeding risk.     

PinX1是抑癌基因吗?

端粒及端粒酶在肿瘤的永生化和演进中起着重要作用.PinX1是一种新基因,它是潜在的抑癌基因,其产物是端粒酶的强力抑制剂.然而,另外也有研究表明PinX1不是抑癌基因.本文就近年来有关该基因的研究进展作一综述.