不同模式教学法在临床教学查房中的运用

临床教学查房是结合具体病例分析判断,使学生理论联系实际的教学方法,是临床与教学的有机结合。目前传统的教学法存在许多弊端,故介绍三种新的教学模式PBL教学法、临床路径式教学法、循证医学教学法,旨在提高临床教学查房效果,最终达到教学质量的提高。     

Postoperative chemoradiotherapy in gastric cancer: a phase I study of radiotherapy with dose escalation of oxaliplatin, 5-fluorouracil, and leucovorin (FOLFOX regimen)

Concurrent chemoradiotherapy begins to be more and more widely accepted as a standard adjuvant treatment in gastric cancer. And oxaliplatin, leucovorin, and 5-fluorouracil (FOLFOX) also reveals to be a very effective regimen in gastric cancer. But the safety and the dosages of FOLFOX combining with radiotherapy are still unknown. This study was to determine the maximum-tolerated dose and the dose-limiting toxicity of FOLFOX with higher-dose concurrent radiotherapy (RT) as adjuvant treatment in patients with gastric cancer. Patients with Stage II/III gastric cancer after surgery were recruited. They received one cycle of induction chemotherapy (standard FOLFOX4). Then, they received 50.4 Gy in 1.8-Gy fractions in combination with two cycles of concurrent FOLFOX, and oxaliplatin among this regimen was administered with escalating doses. Dose-limiting toxicity including grade 3 or grade 4 hematologic and nonhematologic toxicities was investigated. Fifteen patients were enrolled at the following dose levels: oxaliplatin 55 mg/m(2) (3 patients), 65 mg/m(2) (6 patients), and 75 mg/m(2) (6 patients). Dose-limiting toxicity was observed in 1 patient at 65 mg/m(2) (grade 4 leukopenia) and in 3 patients at 75 mg/m(2) (1 patient had grade 4 leukopenia, 1 had grade 3 thrombocytopenia, and 1 had grade 3 stomatitis). Combination chemotherapy FOLFOX with oxaliplatin 65 mg/m(2), d 1; leucovorin 200 mg/m(2), 2 h, d1-2; 5-fluorouracil 400 mg/m(2), iv, d 1-2 and 600 mg/m(2) civ, 22 h, d 1-2 given concurrently with RT (50.4 Gy) can be recommended as a safer and preferable regimen for the adjuvant treatment of patients with gastric cancer.     

Overexpression of Nampt in gastric cancer and chemopotentiating effects of the Nampt inhibitor FK866 in combination with fluorouracil

Nicotinamide phosphoribosyltransferase (Nampt), an enzyme involved in the NAD? salvage pathway, is over-expressed and important in the carcinogenesis in several types of cancers. The expression of Nampt and its role in gastric cancer remain largely unknown. In this study, using real-time PCR and Western blotting we found that Nampt was overexpressed at the mRNA and protein levels, respectively, in established gastric cancer cells and human gastric cancer tissues. The specific Nampt inhibitor FK866 repressed gastric cancer cell proliferation, as assessed by MTT assay. Using transwell and soft agar clonogenic assays, we also found that FK866 suppressed gastric cancer cell migration and anchorage-independent growth, respectively. These inhibitory effects of FK866 were accompanied by significantly decreased expression of VEGF, MMP2, MMP9 and NF-κB. As determined by MTT assay and flow cytometry, FK866 also increased the chemo-sensitivity of gastric cancer cells to fluorouracil by greater inhibition of cell proliferation and the induction of apoptosis. Our findings indicate that Nampt may be a new therapeutic target for gastric cancer.     

Vitapex配合超声治疗窦道型根尖周炎的临床分析

目的观察Vitapex配合超声治疗窦道型根尖周炎的临床疗效。方法 Vitapex糊剂＋超声震荡治疗窦道型根尖周炎。治疗后2～3周、6个月、1年后回访,通过临床和X线检查评价其疗效。结果经治156例患牙,成功142例,2～6周窦道消失,6个月后经X线片检查可见尖周稀疏区减少或消失,成功率达91.03%,14例失败,6例出现牙根纵裂,后行牙半切术后部分保留,8例为多窦道患牙拔除。结论 Vitapex配合超声震荡法治疗窦道型根尖周炎疗效确切。     

IL-18 overexpression promotes vascular inflammation and remodeling in a rat model of metabolic syndrome

Although considerable evidence implicates the cytokine interlukin-18 (IL-18) in metabolic syndrome (MetS), the direct effect of IL-18 on vascular changes of MetS remains unknown. We investigated the chronic in vivo effect of IL-18 on development of MetS and vascular inflammation and remodeling by overexpressing IL-18 protein in fructose-fed rats (FFR), a model of MetS using intravenous administration of an adenovirus encoding rat IL-18. Increased serum IL-18 and vascular inflammatory response were found in FFR. Overexpression of IL-18 aggravated insulin resistance and enhance vascular inflammation and remodeling, which can be reflected by increased aortic expressions of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) and enhanced infiltration of macrophages and increased aortic wall thickness and wall-to-lumen ratio. Interestingly, the levels of interleukin-1 receptor-associated kinase 1 (IRAK1) and the activity of nucleus factor-κB (NF-κB) were also significantly increased. Together, these results indicated that chronic elevated IL-18 levels at a supraphsiological concentration aggravated insulin resistance, enhanced vascular inflammation and remodeling, probably by increasing the level of IRAK1 and the activity of NF-κB. Targeting expression of IL-18 or its specific downstream mediators may retard the progression of MetS and its complications.     

生物柴油产业化现状综述及工艺简介

生物柴油是指利用各类动植物油脂为原料,与甲醇或乙醇等醇类物质经过交脂化反应改性,使其最终变成可供内燃机使用的可再生燃料资源。本文阐述了世界柴油产业现状和生物柴油在世界范围内的应用情况,提出了使用及推广生物柴油的必要性和理念。同时介绍了生物柴油的几种生产方法：碱催化和酸催化（化学法）、脂肪酶或生物酶法、超临界萃取法。并就各个生产方法进行了优劣对比。     

轻度认知障碍患者血浆蛋白磷酸酯酶-2A的活性变化

目的:探讨轻度认知功能障碍(Mild Cognitiv Impairment,MCI)患者血浆蛋白磷酸酯酶-2A(protein phosphotase-2A,PP-2A)的活性变化.方法:用放射性配体结合实验检测不同病程MCI患者及正常老年人对照组血浆PP-2A的活性变化.结票:1年MCI组(0.94±0.09)PP-2A的活性与对照组(1.01±0.08)比较无明显降低(P>0.05),而2年MCI组(0.89±0.07)及3年MCI组(0.86±0.10)血浆PP-2A活性与对照组相比明显降低(P<0.05,P<0.01),与1年MCI组的PP-2A的活性比较无明显差别(P>0.05).结论:病程延长的MCI患者血浆PP-2A的活性降低,对MCI的诊断可能有潜在的价值.     

Bioremediation of Nitrobenzene-Polluted Sediments by <Emphasis Type="Italic">Pseudomonas putida</Emphasis>

Natural attenuation, biostimulation and bioaugmentation of nitrobenzene (NB) contaminated sediments were investigated and compared. The removal rate of NB from contaminated environments with bioaugmentation was much faster than with biostimulation and natural attenuation. Within 10 days, 6 mg/kg and 53 mg/L nitrobenzene in sediment and water, respectively, was degraded with the augmentation of Pseudomonas putida isolated from the contaminated sediment. There was no distinct performance difference between natural attenuation and biostimulation, demonstrating that addition of nutrients had no effect on the bioremediation process. The information on the current phase is a crucial step in making policy decisions for the application of bioremediation.     

激励性薪酬制度对医院核心竞争力的影响

在日趋激烈的竞争中,医疗机构如何才能保证可持续发展、增强核心竞争能力,是新形势下每一个医院管理者亟需面对的重要问题.现代医院的竞争,归根结底是人才的竞争,从人力资源管理的激励原则出发,分析了激励性薪酬制度对医院核心竞争力的影响.     

赴东南亚某国抗强热带风暴医疗救援准备

2008年5月初,东南亚某国遭受强热带风暴袭击,造成巨大破坏。医院按上级要求紧急抽组一支医疗队实施医疗救援。在严密分析当地医疗救援行动特点的基础上,认真做好人员选派、关系协调、物资筹措、应急培训等方面的准备,仅用2天时间,就完成抽组医疗队的各项准备,为医疗队顺利完成任务打下了坚实基础。