论个案研究的思路拓展

以个案研究在中医心理学、中医遗传学中的应用为切入点,深入剖析了个案研究的特点、存在的哲学基础及重要意义,并从计量、时态、比较、典型等几个方面提出了个案研究的思路拓展。     

Basal and residual lower esophageal pressures increase in old age in classic achalasia,but not vigorous achalasia

Background and Aim: The relationship between age and esophageal motility parameters (i.e. basal and residual pressure of the lower esophageal sphincter [LES]) remains to be established in achalasia patients, possibly because most previous studies did not distinguish between classic and vigorous achalasia patients. We investigated the relationship between age and esophageal motility parameters in both classic and vigorous achalasia patients. Methods: A retrospective review of esophageal manometry data in a single center was undertaken. Basal and residual pressure for LES was analyzed. A total of 103 achalasia patients were enrolled, comprising 84 classic and 19 vigorous types. They were subdivided into three different age groups as follows: 21–40 years old (group A), 41–60 years old (group B), and over 60 years old (group C). Results: In classic achalasia patients (M : F = 27:57, mean age = 44 ± 15 years old) the older age group showed a significantly higher basal LES pressure (49.62 ± 19.63 mmHg) than the younger age group (P < 0.0001). Moreover, the older age group also showed significantly high residual LES pressure (20.46 ± 8.61 mmHg) than the younger age group (P = 0.0006). In contrast, in vigorous achalasia patients (M : F = 12:7, mean age: 47 ± 15 years old) there were no difference between age and motility indices (all P > 0.05). Conclusion: In classic achalasia patients there appears to be a correlation between age and esophageal motility indices, especially basal and residual LES pressure. Such correlations do not appear to exist for vigorous achalasia patients.     

Increased expression of MAP2 inhibits melanoma cell proliferation,invasion and tumor growth in vitro and in vivo

Please cite this paper as: Increased expression of MAP2 inhibits melanoma cell proliferation, invasion and tumor growth in vitro and in vivo. Experimental Dermatology 2010; 19 : 958–964. Abstract: Malignant melanoma (MM) is characterized by aggressive metastasis and high mortality rate. Microtubule‐associated proteins 2 (MAP2) is expressed abundantly in majority of melanocytic nevi and primary melanomas, but absent in metastatic melanomas. To determine whether MAP2 correlates with tumor progression of MM, we investigated the effects of MAP2 inhibition on the biological behaviour of metastatic melanoma in vitro and in vivo. Our results demonstrated that adenovirus‐mediated MAP2 induced apoptotic cell death and cell cycle arrest in metastatic human and mouse melanoma cell lines in vitro, and substantially inhibited the growth of melanomas in nude mice in vivo. In addition, intracellular expression of MAP2 was found to induce the morphologic alteration, suppress the migration and invasion and affect the assembly, stabilization and bundling of microtubules in melanoma cells. This is the first study that MAP2 expression significantly inhibits the growth of MM in vivo. Our results suggest that MAP2 may serve as a promising molecular target for therapy and chemoprevention of MM in humans.     

扩大联合脏器切除治疗T4b期胃癌的临床分析

目的探讨扩大联合脏器切除T4b期胃癌的疗效,总结手术经验。方法对2012年1月至2015年12月在哈尔滨医科大学附属第一医院手术治疗的128例T4b期胃癌临床资料进行回顾性分析。结果 85例行扩大联合脏器切除术(extended multi-organ resection,ER组),43例行姑息性手术(non-extended multi-organ resection,NER组)。随访ER组1年、2年、3年的生存率分别为65.38%、44.87%和38.46%,均高于NER组的35.13%、16.21%和5.41%,两者之间的差异均有统计学意义(P0.05)。ER组的并发症发生率为18.82%,高于NER组的4.65%,两组之间的差异有统计学意义(P0.05);ER组的围手术期病死率为2.35%,NER组为2.33%,两者之间的差异无统计学意义(P0.05)。结论扩大联合脏器切除是安全可行的,可以延长病人生存期,改善临床症状,提高生存质量。     

对围绝经期妇女激素补充治疗的认知度调查

目的探讨医护人员和妇女主任对激素补充治疗(HRT)的知晓率及培训需求情况。方法采用自行设计的调查问卷,对桐乡市医护人员和妇女主任进行问卷调查,调查表的主要内容分为一般情况、对HRT的利弊认知度、推荐与否、培训需求等方面。结果共调查医护人员430人、妇女主任206人,两组人员在平均年龄、工作年限、文化程度等基本特征方面无统计学差异。68.9%的妇女主任认为围绝经期妇女有必要应用HRT,明显高于医护人员。只有8.6%的医护人员表示一定会推荐患者使用HRT,明显低于妇女主任。医护人员不推荐使用HRT的原因主要是对副作用的担心。医务人员组更倾向于从相关书籍、期刊获得信息,而妇女主任组更倾向于从医生及媒体获得相关信息。结论桐乡市部分医护人员对HRT的相关知识了解不够,担心HRT发生不良反应,HRT的推荐率低。医护人员和妇女主任在HRT的认知上存在差异。针对不同人群,开展形式多样的HRT知识宣教及培养妇女主任成为HRT知识的传播者是提高HRT应用的关键措施。     

Nardostachys jatamansi extract protects against cytokine-induced β-cell damage and streptozotocin-induced diabetes

AIM: To investigate the anti-diabetogenic mechanism of Nardostachys jatamansi extract (NJE). METHODS: Mice were injected with streptozotocin viaa tail vein to induce diabetes. Rat insulinoma RINm5F cells and isolated rat islets were treated with interleukin1β and interferon-γ to induce cytotoxicity. RESULTS: Treatment of mice with streptozotocin resulted in hyperglycemia and hypoinsulinemia, which was conf irmed by immunohistochemical staining of the islets. The diabetogenic effects of streptozotocin were c...     

A Case of Primary Cutaneous Mucinous Carcinoma with Neuroendocrine Differentiation

Primary cutaneous mucinous carcinoma is a rare malignant tumor that originates from the deepest portion of the eccrine sweat duct. Common sites of involvement are the face and scalp. Biopsy shows dermal epithelial cell islands embedded in mucin pools separated by fibrous septae. It is difficult to differentiate this tumor histologically from metastatic adenocarcinoma. Recurrence after excision is common but metastases are rare. We report a primary cutaneous mucinous carcinoma with neuroendocrine differentiation on the right cheek of a 63-year-old man.     

Role of Aggregatibacter actinomycetemcomitans in glutathione catabolism

Introduction:  Our previous studies demonstrated that three enzymes, γ-glutamyltransferase (GGT), cysteinylglycinase (CGase) and cystalysin, are required for the catabolism of glutathione to produce hydrogen sulfide (H₂S) in Treponema denticola . In this study, we examined glutathione catabolism in Aggregatibacter actinomycetemcomitans .
Methods:  The GGT and CGase of A. actinomycetemcomitans were determined by biological methods and GGT was characterized using a molecular biological approach.
Results:  A. actinomycetemcomitans showed GGT and CGase activity, but could not produce H₂S from glutathione. The addition of recombinant T. denticola cystalysin, an l -cysteine desulfhydrase, to whole cells of A. actinomycetemcomitans resulted in the production of H₂S from glutathione. Subsequently, we cloned A. actinomycetemcomitans GGT gene ( ggt ) and overexpressed the 63 kDa GGT protein. The recombinant A. actinomycetemcomitans GGT was purified and identified. The K _cat/ K _m of the recombinant GGT from N -γ- l -glutamyl-4-nitroaniline as substrate was 31/μ m /min. The activity of GGT was optimum at pH 6.9–7.1 and enhanced by thiol-containing compounds.
Conclusion:  The results demonstrated that A. actinomycetemcomitans had GGT and CGase activities and that the GGT was characterized. The possible role of A. actinomycetemcomitans in glutathione metabolism and H₂S production from oral bacteria was discussed.     

糖尿病病人胰岛素泵应用及相关知识调查

[目的]探讨糖尿病病人应用胰岛素泵强化治疗的相关知识及需求情况.[方法]采用自行设计的问卷调查表,对60例糖尿病胰岛素泵强化治疗病人进行调查.[结果]病人对胰岛素泵了解甚少,相关知识缺乏,希望接受胰岛素泵知识教育.[结论]胰岛素泵应用现状存在较多问题,影响病人血糖的良好控制,应提高病人对胰岛素泵的认可程度和依从性,提高生活质量.