补肾固本方对大鼠骨质疏松模型中PI3K/AKT/mTOR信号通路表达的调控研究

目的观察补肾固本方对去卵巢骨质疏松(osteoporosis,OP)大鼠骨组织中PI3K/AKT/mTOR信号通路的影响,探讨补肾固本方干预OP的作用机制。方法将100只SD大鼠随机分为5组:正常组(C组)、模型组(M组)、补肾固本方组(B组)、补肾固本方+PI3k受体特异性阻断剂LY294002组(B+L组)、PI3k受体特异性阻断剂LY294002组(L组),除正常组外,其余4组建立去卵巢大鼠OP模型。药物连续干预12周后,采用ELISA方法检测血清中E2、BGP、ALP水平,实时荧光定量聚合酶链式反应(Real-time PCR)检测各组股骨组织中LC3、Beclin1、caspase-9 mRNA的表达情况,蛋白质印迹法(Western blot)检测各组股骨组织中PI3K、AKT、mTOR蛋白的表达。结果补肾固本方可显著增高OP大鼠血清E2水平,降低BGP、ALP水平,显著上调LC3、Beclin1表达水平,降低caspase-9、PI3K、p-AKT、mTOR的表达;而上述变化能够被PI3k受体特异性阻断剂LY294002所阻断,且其差异具有统计学意义(P0.05)。结论补肾固本方减少去卵巢后大鼠OP的发生,其机制可能与抑制PI3K/AKT/mTOR信号通路及其下游基因蛋白表达有关。     

建立高校教材质量学生评价指标体系的探索

全面评价教材除了有赖于专家学者的意见外,从教材使用者那里采集第一手的反馈信息也很有必要,本研究参考教育部的教材评价指标体系,结合参评人的实际情况,建立了适合高校学生的“高等学校文字教材质量学生评价指标体系”,通过对该指标体系的试评,认为该指标体系基本上反映了教材的全貌,具有较好的操作性。     

A meta-analysis for assessing the value of MR spectroscopy in the diagnosis of prostate cancer

Objective： To assess the value of MR spectroscopy （MRS） in the diagnosis of prostate cancer by meta-analysis. Methods： Prospective studies were selected from the MEDLINE, Ovid, Embase databases, Springer, Elsevier, China National Knowledge Infrastructure. According to the suggestion, results were determined by the ratio of （Cho＋Cr）/Cit. If this ratio was less than 0.75, negative result was respectively determined, and the definitive tumor was diagnosed as this threshold. According to the assessment standard of Evidence-based Medicine, English and Chinese literature in Grade A and B on MRS imaging was included. According to homogeneity test, different effect models were chosen to calculate different pooled weighted values of sensitivity, specificity and the corresponding 95% confidence intervals （95% CI）. Summary receiver operating characteristic （SROC） curves were used to assess the results. Funnel plot was used to analyze publication bias. Results： According to the assessment standard of Evidence-based Medicine, only 5 papers in Grade B were included in this research. The pooled weighted sensitivity and its 95% confidence interval is 82% （73%, 89%） and the pooled weighted sensitivity and its 95% confidence interval is 68% （58%, 76%）. The AUC （area under curve） is 83.40%. An asymmetric funnel plot suggested two missing studies leading to publication bias. Conclusion： If the ratio of （Cho＋Cr）/Cit is regarded as the diagnostic criteria in detecting prostate cancer by MRS, meta-analysis suggests this method has a better diagnostic value to detect the malignant prostate mass but the sensitivity needs to be improved. We hope to support a method and requirement about diagnostic test. Performing perspective register and improving quality of study design is the only way to reduce the bias and get real information of disease.     

美洛昔康不诱导胃癌细胞耐药

目的旨在了解环氧合酶-2(cyc looxygenase-2,COX-2)抑制剂美洛昔康对胃癌细胞的长期作用能否导致胃癌细胞对其产生耐药性。方法采用浓度递增法结合大剂量冲击法,美洛昔康长期作用于胃癌SGC7901细胞,时间达6个月,尝试诱导胃癌美洛昔康耐药株,命名为SGC7901/M,并用MTT法测定药物敏感性,光镜、电镜观察细胞形态学改变,活细胞计数法和克隆形成技术了解其生物学特性。结果药物敏感分析显示,胃癌细胞经过美洛昔康长期作用,对美洛昔康并没有出现抗性,其IC50与亲代细胞比较差异无统计学意义(P>0.05),分别为4.6×10-4±2.23×10-4mol.L-1,3.54×10-4±2.34×10-4mol.L-1。SGC7901/M细胞对美洛昔康的耐药指数约为1.3。SGC7901/M细胞与亲代细胞形态学比较,光镜及电镜均未显示差异,两种细胞在经1×10-3mol.L-1美洛昔康作用24 h后,均表现出细胞受到明显损伤和凋亡的形态。无论从生长曲线上还是克隆形成率上都显示SGC7901/M细胞与亲代细胞的生长特性无差异。结论美洛昔康可抑制胃癌细胞生长,长期用药不诱导胃癌细胞产生耐药性。     

Polycomb家族基因Nspcl在斑马鱼早期发育的表达

目的 探讨Polycomb家族基因Nspel在模式生物斑马鱼发育早期的表达模式.方法 根据GenBank中斑马鱼Nspcl的cDNA序列设计Nspcl原位杂交探针片断,并制备地高辛标记的探针.收取单细胞期、双细胞期、胚芽期及不同时间点的体节期斑马鱼胚胎,用制备好的探针作原位杂交,显微镜下拍照,获得信号适当的杂交结果.结果 在斑马鱼体节期前,Nspcl在全身表达;从体节期开始,其表达逐渐表现出特异性,主要在头部的神经系统中表达.结论 Nspcl在模式生物斑马鱼的早期发育、尤其是神经系统发育的过程中可能扮演重要角色.     

Clinical Effects of Acupuncture after Surgical Operation in Patients with Prolapse of the Lumbar Intervertebral Disc

Objective;To investigate the clinical effects of acupuncture after surgical operation in patients wim prolapse of the lumbar intervertebral disc(PLID).Methods;Sixty-nine patients in this series,who had undergone the removal of nucleus pulposus and the intervertebral fusion as well,were randomly divided into a treatment group of 35 cases and a control group of 34 cases.The former was treated by acupuncture and conventional rehabilitation therapy,and the latter only by the rehabilitation therapy.The therapeutic effects were evaluated according to the scoring system stipulated by Japanese Orthopedics Association(JOA).Results;In the treatment group,the average functional recovery rates in 3-month,6-month and one-year periods were respectively 49.93 ,90.3 1%and 95.08%;while the rates were repesctively 26.24%,63.42%and 71.36%in the control group,showing statistically significant difference between the two groups(P＜0.05).Conclusions;Acupuncture can confirmatively promote the functional recovery for patients with prolapse of the lumbar intervertebral disc after surgical removal of nucleus pulposus and with intervertebral fusion.     

医疗服务流程管理的绩效评价

文章就如何评价医疗服务流程管理的绩效,从评价原则、评价指标、评价步骤等方面进行了探讨。     

游离PSA与总PSA比值在前列腺癌鉴别诊断中的应用

目的:进一步了解前列腺特异性抗原(PSA)、游离前列腺特异性抗原(FPSA)与总前列腺特异性抗原(TPSA)比值(FPSA/TPSA)的测定在诊断前列腺癌的临床价值。方法:采用化学发光免疫分析法(CLIA)对前列腺癌患者57例,前列腺增生患者147例血清PSA、FPSA和FPSA/TPSA在各组中的改变情况及取不同界值时对前列腺癌的诊断意义。结果:在诊断灰区外高值区,TPSA、F/T在两组间的差别均有显著性意义(P<0.05,P<0.05);在诊断灰区患者间TPSA差别无显著性意义(P>0.05),而F/T值的差别有显著性意义(P<0.05);在灰区外低值区TPSA、F/T值在两组间差别无显著性意义(P>0.05)。如果以血清PSA值4 ng/ml为阈值,诊断前列腺癌的灵敏度为100%,特异性为52.6%,如果以血清PSA 4 ng/ml为阈值,同时结合FPSA/TPSA并以16为阈值,诊断前列腺癌的灵敏度为100%,而特异性为87.5%。结论:PSA与FPSA联合检测可以提高对前列腺癌诊断的特异性。     

分类决策树辅助CT诊断孤立性肺结节的方法学研究

目的 应用分类与回归决策树(CART)算法构建CT显像鉴别良恶性孤立性肺结节(SPN)预测模型,探讨数据挖掘技术在SPN影像诊断中的应用价值.方法 分别提取12个临床指标和22个CT征象指标作为CART预测SPN良恶性的输入指标.连续性纳入自2003年7月至2006年7月间经病理证实的SPN,且术前行CT检查的患者116例,其中良性结节62例,恶性结节54例.采用CART建立用于预测良恶性SPN的分类决策树模型,并通过交互印证的方法计算该模型的诊断准确性.同时设低年资医师诊断组和高年资医师诊断组,采用盲法进行独立阅片判断SPN的良恶性.采用受试者操作特征(ROC)曲线比较3组间的诊断效能.结果 (1)成功建立了能够判断SPN良恶性的CART诊断模型,其中含有8条诊断规则,最低相对错误代价为0.199,CART对SPN具有决策意义的最重要的前3位决策指标为结节的毛刺征、患者年龄和病灶部位.(2)CART、高年资医师和低年资医师对SPN良恶性诊断的ROC曲线下面积分别为0.910±0.029、0.827±0.038、0.612±0.052.CART与低年资医师ROC曲线下面积差(DBF)=0.297,P＜0.01;与高年资医师DBF=0.083,P＜0.05;高年资医师与低年资医师DBF=0.214,P＜0.01.CART诊断效能高于高年资医师和低年资医师,高年资医师高于低年资医师.结论 CART是具有强大学习能力的数据挖掘工具,可以对SPN的良恶性进行正确判断,为实现人工智能在影像诊断中的应甩提供重要的方法学依据.