某院中药制剂不良反应2年回顾性研究

目的了解我院中成药不良反应发生情况及规律,为临床合理用药提供参考。方法采用回顾性分析方法分别按照患者性别及年龄、给药途径及药物剂型分布、药物类别构成、ADR发生时间、涉及器官和(或)系统及临床表现、ADR发生类型及转归、联合用药、ADR因果关系评价项目进行统计及分析我院2014—2015年共86例中成药不良反应报告。结果 86例中成药不良反应中,男38例(44.19%),女48例(55.81%),女性略高于男性;60岁以上人群发生率最高(52.3%);注射剂引起的有43例(50%);以活血祛瘀剂的发生率最高(40.7%);1例患者使用中药注射剂后30 min内发生严重不良反应;不良反应主要为消化系统损害;不良反应程度主要为一般和新的一般。结论中成药的不良反应与多种因素相关,临床药师应发挥药学监护作用,加强对ADR的监测、报告、分析和预警,以促进临床中成药的使用安全、有效、经济。     

张杲《医说》版本知见录

南宋医家张杲的《医说》有国内出版本和国外出版本2类。国内出版本可分为宋本、明本、清本、民国以来诸本,目前可以知见宋本1种、明本14种、清本3种、民国以来诸本25种。国外出版本主要有日本刊本、朝鲜活字本2类。《医说》的版本,在明代产生了原本传承本和增补本2个分支。原本传承本有顾定芳刊本、张尧德刊本、吴勉学刊本、吴中珩刊本、王肯堂刊本、《四库全书》诸本、清宣统三年（1911）上海文明书局铅字排印本、日本万治二年（1659）刊本等。增补本有张子立刊本、沈藩刊本、傅凤翱刊本、北京大学图书馆藏明末抄本、朝鲜活字本等。     

Coronary artery anomalies: the left main coronary artery or left anterior descending coronary artery originating from the proximal of right coronary artery

Coronary artery anomalies （CAAs） are present at birth, but are usually asymptomatic and are found during coronary angiography or multi-slice computed tomography （MSCT） examinations. Their prevalence is less than 1.3% based published series.1＇2 The most common coronary anomaly is separate origin of the left anterior descending coronary artery （LAD） and left circumflex coronary artery （LCX） from the left sinus of the Valsalva. The second most common anomaly is the origin of the LCX artery from the right coronary artery （RCA） or right sinus of the Valsalva. We present two cases of coronary artery anomalies： one is the left main coronary artery （LMCA） arising from the proximal RCA, the other is the LAD originating from the proximal RCA.     

我国北方两地区小学生沙眼衣原体检测及基因分型研究

目的 对我国北方两地区小学生沙眼患者结膜样本进行聚合酶链反应（PCR）检测,并分析其病原流行株的基因类型.方法 按照世界卫生组织沙眼分期标准,在宁夏回族自治区银川市和河北省武强县两地采集临床诊断为沙眼的小学生结膜样本共213份.同时在两地分别采集正常小学生结膜样本作对照.利用PCR检测沙眼衣原体质粒片段,对质粒PCR检测阳性者通过套式PCR扩增沙眼衣原体主要外膜蛋白（MOMP）基因（omp-1）第4可变区片段,再经序列分析进行基因分型.结果 银川市45份样本中,质粒PCR检测阳性22份,检出率为48.9%;对17份样本进行套式PCR基因分型,显示B型为16份（94.1%）,C型为1份（5.9%）.武强县168份样本中,质粒PCR检测阳性109份,检出率为64.9%;对34份样本进行套式PCR基因分型,显示B型为28份（82.4%）,C型为6份（17.6%）.结论 沙眼在中国西北部银川市和华北部武强县的小学生中仍有流行,其流行株的基因类型以B型为主.     

Increased chemotactic migration and growth in heparanase-overexpressing human U251n glioma cells

Heparanase is an endoglycosidase that degrades heparan sulfate, the main polysaccharide constituent of the extracellular matrix (ECM) and basement membrane. Expression of the heparanase gene is associated with the invasion and metastatic potential of a variety of tumor-derived cell types. However, the roles of heparanase in the regulation of gene expression and the subsequent cell function changes other than invasion are not clear. In the current study, we overexpressed the human heparanase gene in a human U251n glioma cell line. We found that heparanase-overexpression significantly increased cell invasion, proliferation, anchorage-independent colony formation and chemotactic migration towards fetal bovine serum (FBS)-supplied medium and stromal cell-derived factor-1 (SDF-1). These phenotypic appearances were accompanied by enhanced protein kinase B (AKT) phosphorylation. Focal adhesion kinase (FAK) and extracellular signal-regulated kinase 1 (ERK1) signaling were not altered by heparanase-overexpression. These results indicate that heparanase has pleiotropic effects on tumor cells.     

Delivery of AAV2-CYP2J2 protects remnant kidney in the 5/6-nephrectomized rat via inhibition of apoptosis and fibrosis

The cytochrome P450 epoxygenase, CYP2J2, converts arachidonic acid to four regioisomeric epoxyeicosatrienoic acids (EETs), which are highly abundant in the kidney and considered renoprotective. Accumulating evidence suggests that EETs are important in regulating renal and cardiovascular function. Further, EETs have been confirmed to exert diverse biological activities including potent vasodilation; fibrinolytic properties; and antiinflammatory, antiapoptotic, and mitogenic effects. In the current study, we investigated the effects of overexpression of CYP2J2 via recombinant adeno-associated virus (rAAV) in protection against renal damage in a rat 5/6 nephrectomy (5/6-Nx) model of chronic renal failure. The rAAV-CYP2J2 gene delivery in vivo increased EET generation; attenuated the rise in blood pressure; and reduced the levels of proteinuria, serum creatinine, and blood urea nitrogen. Morphological analysis indicated that rAAV-CYP2J2 gene delivery reduced 5/6 nephrectomy-induced glomerular sclerosis, tubular dilatation, luminal protein cast formation, and tubulointerstitial fibrosis. rAAV-CYP2J2 gene delivery also significantly lowered collagen I and IV deposition, as well as renal cell apoptosis detected by TUNEL staining, caspase-3 activity, and the loss of mitochondrial membrane potential (ΔΨ(m)). Furthermore, rAAV-CYP2J2 gene delivery regulated the level of protein expression including transforming growth factor (TGF)-β(1)/SMADs; matrix metalloproteinases (MMPs); mitogen-activated protein kinases (MAPKs); and apoptosis-related proteins Bax, Bcl-2, and Bcl-x(L). Together, these findings demonstrated that rAAV-CYP2J2 gene delivery can protect remnant kidney against renal injury in 5/6-Nx rats by inhibiting apoptosis and fibrosis via regulation of protein expression including TGF-β(1)/SMADs, MMPs, MAPKs, and apoptosis-related proteins.     

Use of nerve conduits for peripheral nerve injury repair A Web of Science-based literature analysis

OBJECTIVE: To identify global research trends in the use of nerve conduits for peripheral nerve injury repair. DATA RETRIEVAL: Numerous basic and clinical studies on nerve conduits for peripheral nerve injury repair were performed between 2002-2011. We performed a bibliometric analysis of the institutions, authors, and hot topics in the field, from the Web of Science, using the key words peripheral nerve and conduit or tube. SELECTION CRITERIA: Inclusion criteria: peer-reviewed published articles on nerve conduits for peripheral nerve injury repair, indexed in the Web of Science; original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items. Exclusion criteria: articles requiring manual searching or telephone access; documents not published in the public domain; and several corrected papers. MAIN OUTCOME MEASURES: (a) Annual publication output; (b) publication type; (c) publication by research field; (d) publication by journal; (e) publication by funding agency; (f) publication by author; (g) publication by country and institution; (h) publications by institution in China; (i) most-cited papers. RESULTS: A total of 793 publications on the use of nerve conduits for peripheral nerve injury repair were retrieved from the Web of Science between 2002-2011. The number of publications gradually increased over the 10-year study period. Articles constituted the main type of publication. The most prolific journals were Biomaterials, Microsurgery, and Journal of Biomedical Materials Research Part A. The National Natural Science Foundation of China supported 27 papers, more than any other funding agency. Of the 793 publications, almost half came from American and Chinese authors and institutions. CONCLUSION: Nerve conduits have been studied extensively for peripheral nerve regeneration; however, many problems remain in this field, which are difficult for researchers to reach a consensus.     

Corneal subbasal nerve fiber regeneration in myopic patients after laser in situ keratomileusis

A total of 26 myopic patients(52 eyes) underwent laser in situ keratomileusis.In vivo confocal microscopy revealed that most of the regenerated corneal subbasal nerve fibers in the corneal flap originated from the stump of corneal subbasal nerve fibers outside the ablation zone and extended towards the center of the cornea in all patients.Meanwhile,new fibers were also found to directly regenerate from deep in the stroma in some cases.Approximately 94% of regenerated corneal subbasal nerve fibers(73/78 eyes) regrew vertically into the peripheral central 6-mm circle area 1 month after surgery,78%(28/36 eyes) grew into the central 3-6 mm area at 2 months,and 23% into the central 3-mm circle area at 3 months.In addition,there was no significant difference in corneal subbasal nerve fiber regenerative capacity between the basic fibroblast growth factor group and the 20%(v/v) deproteinized extract of calf blood group.The majority of corneal subbasal nerve fiber regeneration occurred from the stump of corneal subbasal nerve fibers outside the corneal flap,and the remaining growth occurred deep within the stroma.     

Sensitization of cerebral tissue in nude mice with photodynamic therapy induces ADAM17/TACE and promotes glioma cell invasion

In the present study, we tested the hypothesis that a mild cerebral tissue injury promotes subsequent glioma invasion via activation of the ADAM17-EGFR-PI3K-Akt pathway. Mild injury was induced by photodynamic therapy (PDT), which employs tissue-penetrating laser light exposure following systemic administration of a tumor-localizing photosensitizer. Athymic nude mice were treated with sublethal PDT (80 J/cm2 with 2 mg/kg Photofrin). Hypoxic stress and ADAM17-EGFR-PI3K-Akt were measured using Western blot and immunostaining. Additional groups with/without pro-sublethal PDT were subsequently implanted with U87 glioma tumor cell. Tumor invasion and ADAM17-EGFR-PI3K-Akt pathway in tumor area were measured. After a sublethal dose of PDT, HIF-1alpha expression was increased by a factor of three in PDT-treated normal brain tissue compared to contralateral control brain tissue. PDT-treated brain tissue exhibited a significant increase in ADAM17, p-EGFR, p-Akt expression compared to non-treated tissue. ADAM17 positive area significantly increased from 1.78% to 10.89%. The percentage of p-EGFR and p-Akt positive cells significantly increased from 9.50% and 14.50% to 21.31% and 32.29%, respectively, PDT treatment significantly increased subsequent implanted U87 glioma cell invasion by 3.68-fold and increased ADAM17, EGFR, p-EGFR, Akt, p-Akt expression by 178%, 43.9%, 152.7%, 89.6%,and 164.2%, respectively, compared to control group. Our data showed that a sublethal sensitization of cerebral tissue with PDT significantly increased U87 cell invasion in nude mice, and that glioma cell invasion is highly correlated with activation of the ADAM17-EGFR-PI3K-Akt pathway (r=0.928, 0.775, 0.870, 0.872, and 0.883, respectively), most likely via HIF-1alpha.