重组腺病毒Ad-EGFP-mdr-1转染大鼠骨髓细胞模型的构建

目的 构建转染多药耐药基因-1 （multidrug resistance gene-1,mdr-1）的骨髓细胞.方法 将重组腺病毒Ad-EGFP-mdr-1转染大鼠骨髓细胞.RT-PCR法和Western blot法检测mdr-1 mRNA及蛋白的表达水平 柔红霉素排出试验检测转染mdr-1基因后的骨髓细胞有无功能表达.结果 骨髓细胞病毒转染率为30.14%,存活率为89.25%,转染后骨髓细胞mdr-1的mRNA及蛋白质水平都存在功能性表达,导入的mdr-1表达产物P-gp有药物外排泵功能.结论 转染mdr-1的大鼠骨髓细胞模型的成功构建,为进一步研究肿瘤的多药耐药提供实验基础.     

Using intra-operative GeneSearchTM Breast Lymph Node Assay to detect breast cancer metastases in sentinel lymph nodes: results from a single institute in China

Background  Sentinel lymph node (SLN) biopsy has become a common procedure for early breast cancer patients. The GeneSearch^TM Breast Lymph Node (BLN) Assay is a real-time RT-PCR assay for the detecting nodal metastases larger than 0.2 mm. China Breast Cancer Clinical Study Group (CBCSG)-001a is a prospective multi-center clinical trial that was conducted to validate the GeneSearch^TM BLN Assay in China.

Methods  The SLNs from 90 consecutive patients were identified and dissected, and then sectioned along the short axis into multiple blocks. Intra-operatively, the odd blocks were tested by BLN assay and the even ones were used for frozen section, while all the blocks were evaluated by touch imprint cytology. Post-operatively, the remaining tissues were assessed by histological evaluation.

Results  A total of 189 SLNs was tested by BLN assay. The sensitivity, specificity, positive predictive value, and negative predictive value were 88.9%, 97.4%, 88.9% and 97.4%, respectively, for BLN assay, 75.0%, 100%, 100% and 94.4%, respectively, for frozen section, and 63.9%, 100%, 100% and 92.2%, respectively, for touch imprint cytology. The sensitivity of BLN assay was higher than that of touch imprint cytology (P=0.01) and frozen section (P=0.13). When assessing the nodes with micro-metastases, BLN assay had a significant higher sensitivity than frozen section (P=0.023) and touch imprint cytology (P=0.005).

Conclusion  The GeneSearch^TM BLN Assay is an accurate and rapid intra-operative assay for breast SLNs and it is suitable for application in general medical practice.

     

职业性噪声对工人听力损伤影响因素的研究

随着现代工业生产的不断发展,职业性噪声已经成为一种常见的危害人类身心健康的环境因素,可引起多系统和多功能的损伤,其中听觉系统是噪声对机体最主要的危害,具有特异性。研究表明,噪声能减少流经耳内听觉细胞和听神经的血量,使听     

口腔矫治器的两种加力作用对OSAHS患者舌骨位置变化的影响

目的研究戴用两种力作用的自行调节式口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征（Ob-structive sleep apnea hypopnea syndrome,OSAHS）患者舌骨发生的位置变化。方法用X线头影测量法比较50例成年OSAHS患者戴用自行调节式口腔矫治器前,矫治器加力350g及矫治器加力500g时,舌骨位置变化情况。结果两种力作用下舌骨相对于颅面,颌面以及颈椎各个平面及标志点的垂直向、相对于眶点的水平向位置较未带用时均发生变化,且500g力作用下舌骨发生位置移动较350g力时大,差异均有统计学意义。结论两种不同大小的力作用于自行调节式口腔矫治器均使OSAHS患者舌骨位置发生向前上移动,可能力值越大舌骨前上方位置移动越大。     

重庆某贫困县居家康复治疗救助政策实施情况及问题探讨

针对因病致贫的现象,我国健康扶贫的地方创新政策不断涌现。目前健康扶贫的经济扶助政策主要围绕大病住院费用的筹资解决,而少见对大病之后居家康复所维持健康的必要成本,如药品费用予以帮扶。从卫生经济学而言,预防和康复比治疗是对于穷人更有效的卫生投资,也能节省卫生资源开支。围绕大病贫困患者的康复精准帮扶,重庆某贫困县创新"居家康复治疗救助"政策以降低贫困人口医药费用负担。针对执行存在监控力度不足、医方激励不足、患者满意度不够高的问题,围绕大病贫困患者的需求,提出相应对策,包括拓宽补助的多种方式,提高对医生的激励设计,允许报销的合理弹性,加强多部门协同监管。