利培酮联合小剂量万拉法新治疗精神分裂症阴性症状临床观察

目的探讨利培酮联合小剂量万拉法新治疗精神分裂症阴性症状的临床疗效和安全性。方法将40例精神分裂症患者随机分为治疗组(利培酮 文拉法辛)和对照组(利培酮)各20例,利培酮治疗剂量2~6mg·d-1,万拉法新75~100mg·d-1,疗程8w。治疗前后采用阴性症状量表和副反应量表评定临床疗效与不良反应。结果两组治疗后阴性症状量表总分和因子分均显著下降,差异有显著或极显著性(P<0.05,0.01);治疗组阴性症状量表总分、情感平淡、思维贫乏、意志缺乏、兴趣缺乏等因子分较对照组下降明显,差异有显著或极显著性(P<0.05或0.01)。不良反应两组无显著性差异。结论利培酮联合小剂量万拉法新治疗精神分裂症阴性症状疗效优于单用利培酮治疗。     

Transforming brain signals related to value evaluation and self‐control into behavioral choices

The processes involved in value evaluation and self‐control are critical when making behavioral choices. However, the evidence linking these two types of processes to behavioral choices in intertemporal decision‐making remains elusive. As the ventromedial prefrontal cortex (vmPFC), striatum, and dorsolateral prefrontal cortex (dlPFC) have been associated with these two processes, we focused on these three regions. We employed functional magnetic resonance imaging during a delayed discounting task (DDT) using a relatively large sample size, three independent samples. We evaluated how much information about a specific choice could be decoded from local patterns in each brain area using multivoxel pattern analysis (MVPA). To investigate the relationship between the dlPFC and vmPFC/striatum regions, we performed a psychophysiological interaction (PPI) analysis. In Experiment I, we found that the vmPFC and dlPFC, but not the striatum, could determine choices in healthy participants. Furthermore, we found that the dlPFC showed significant functional connectivity with the vmPFC, but not the striatum, when making decisions. These results could be replicated in Experiment II with an independent sample of healthy participants. In Experiment III, the choice‐decoding accuracy in the vmPFC and dlPFC was lower in patients with addiction (smokers and participants with Internet gaming disorder) than in healthy participants, and decoding accuracy in the dlPFC was related to impulsivity in addicts. Taken together, our findings may provide neural evidence supporting the hypothesis that value evaluation and self‐control processes both guide the intertemporal choices, and might provide potential neural targets for the diagnosis and treatment of impulsivity‐related brain disorders.     

护理差错原因分析与对策

目的:探讨护理差错发生的原因及对策,最大限度地控制和防范护理差错的发生.方法:采用自行设计的问卷,对我院31个临床科室护士长进行填表式问卷调查,以了解我院2008-2010年护理差错发生情况,并进行原因分析.结果:护理差错的发生与护理人员紧缺、护士业务素质和技术水平、护士长管理、规章制度执行不严以及护士工龄、职称、责任心等因素有关.结论:全面分析发生护理差错的原因,采取有效的防范措施,对减少护理差错的发生,确保医疗安全,有着十分重要的意义.     

Efficacy and safety of thrombopoietin receptor agonists in children with chronic immune thrombocytopenic purpura: meta-analysis

Immune thrombocytopenic purpura (ITP) is an autoimmune disorder presenting with low platelet count <100 × 10⁹/L. The condition affects both adults and children. Thrombopoietin receptor agonists (TPO-RAs) are second-line of therapy that includes Romiplostim and Eltrombopag, which stimulate the production of normally functioning platelets. Although the biological effect of these drugs is well established, there has not been a meta-analysis in children. To estimate the efficacy and safety of Romiplostim and Eltrombopag, we performed a systematic review and meta-analysis in children with chronic ITP. Systematic literature search was conducted in the following database: PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). Review Manager 5.3 for Windows was used to analyze the data. Five randomized controlled trials with total of 261 pediatric patients from 1–17 years of age were included. The efficacy and safety analysis showed TPO-RA groups were superior over placebo, and there was no difference in adverse event occurrence between TPO-RA (Romiplostim and Eltrombopag) and placebo groups. The efficacy and safety of Eltrombopag did not differ significantly from those of Romiplostim. Both drugs were effective in treatment of children with chronic ITP. Our findings extend the currently available data on ITP treatment and is helpful for pediatric health providers and for the design of future clinical trials.     

Suppression of Human Liver Cancer Cell Migration and Invasion via the GABAA Receptor

Objective To investigate the roles of theγ-aminobutyric acid(GABA) in the metastasis of hepatocellular carcinoma(HCC) and to explore the potential of a novel therapeutic approach for the treatment of HCC. Methods The expression levels of GABA receptor subunit genes in various HCC cell lines and patients’ tissues were detected by quantitative real-time polymerase chain reaction and Western blot analysis.Transwell cell migration and invasion assays were carried out for functional analysis.The effects of GABA on liver cancer cell cytoskeletal were determined by immunofluorescence staining. And the effects of GABA on HCC metastasis in nude mice were evaluated using an in vivo orthotopic model of liver cancer. Results The mRNA level of GABA receptor subunits varied between the primary hepatocellular carcinoma tissue and the adjacent non-tumor liver tissue.GABA inhibited human liver cancer cell migration and invasion via the ionotropic GABAa receptor as a result of the induction of liver cancer cell cytoskeletal reorganization.Pretreatment with GABA also significantly reduced intrahepatic liver metastasis and primary tumor formation in vivo. Conclusions These findings introduce a potential and novel therapeutic approach for the treatment of cancer patients based on the modulation of the GABAergic system.     

一种新的链霉菌表达载体启动子

eryA基因直接控制着红霉素母环6-脱氧-红霉内酯B的合成,在红霉素生物合成过程中具有重要作用。本文克隆了eryA基因的启动子PeryA,以绿色荧光蛋白基因为报告基因,构建了大肠埃希菌-糖多孢红霉菌穿梭型质粒。PEG介导原生质体转化法将穿梭型质粒分别转入糖多孢红霉菌A226与变铅青链霉菌JT46,荧光显微镜检测发现,此启动子在两菌株中都具有功能。随后,以变铅青链霉菌JT46为宿主,对PeryA启动子区域进行了深入研究,结果发现该启动子的-35区并不是必需的,仅有-10区、长度为41bp的该启动子在链霉菌中仍具有功能。定点突变证明-10区对于该启动子是必不可少的。因此,41bp的该启动子片段可作为链霉菌的有效启动子,这是迄今为止所发现的最短的启动子之一,可用于构建新的链霉菌表达载体。     

Homeostatic proliferation plus regulatory T-cell depletion promotes potent rejection of B16 melanoma.

PURPOSE: To investigate the antitumor efficacy of T-cell anergy reversal through homeostatic proliferation and regulatory T-cell (Treg) depletion in a clinically relevant murine adoptive immunotherapy model. EXPERIMENTAL DESIGN: B16 melanoma cells were engineered to express the model SIYRYYGL (SIY) antigen to enable immune monitoring. Tumor-specific T cells expanded in tumor-challenged wild-type hosts but became hyporesponsive. To examine whether lymphopenia-induced homeostatic proliferation could reverse tumor-induced T-cell anergy, total splenic T cells were transferred into lymphopenic RAG2-/- mice or control P14/RAG2-/- mice. Tumor growth was measured, and SIY-specific immune responses were monitored using ELISPOT and SIY/K(b) tetramers. To determine whether Treg depletion could synergize with homeostatic proliferation, RAG2-/- mice received total or CD25-depleted T cells, followed or preceded by B16.SIY challenge. This approach was further investigated in wild-type mice lymphodepleted with sublethal total body irradiation. RESULTS: Adoptive transfer of total splenic T cells into RAG2-/- mice moderately affected the growth rate of B16.SIY. As Treg expansion occurred in tumor-bearing mice, CD25+ T cells were depleted from total T cells before adoptive transfer. Interestingly, transfer of CD25-depleted T cells into RAG2-/- mice resulted in potent rejection of B16 melanoma in both prophylactic and short-term preimplanted tumor settings and was associated with maintained T-cell effector function. Using a clinically applicable approach, wild-type mice were lymphodepleted using sublethal total body irradiation, which similarly supported tumor rejection upon transfer of CD25-depleted T cells. CONCLUSIONS: Our results indicate that combined CD25 depletion and homeostatic proliferation support a potent antitumor immune response--an approach with potential for clinical translation.     

Evaluation of high-risk Human papillomaviruses type distribution in cervical cancer in Sichuan province of China

Background  

Infection with high-risk human papillomavirus is an important factor associated with cervical cancer, and the distribution of HPV types varies greatly worldwide. Determination of type-specific HPV prevalence constitutes an important step towards the development of vaccines for the prevention of cervical cancer.     

臂丛神经自控镇痛对断肢(指)再植患者免疫功能的影响

目的:探讨臂丛神经自控镇痛对断肢(指)再植患者免疫功能的影响。方法:断肢(指)再植30例术后随机分为患者臂丛神经自控镇痛(PCRA)和患者静脉自控镇痛(PCIA)组,分别于术前(T0)、术后即刻(T1)、术后第1天(T2)、术后第3天(T3)、术后第5天(T4)测定血液中细胞因子、C-反应蛋白(CRP)、皮质醇以及免疫细胞(中性粒细胞、单核细胞、淋巴细胞)以了解免疫功能状况。结果:与PCIA组比较,PCRA组循环细胞因子白细胞介素-6(IL-6)、IL-8、IL-10、肿瘤坏死因子-α(TNF-α)和应激反应指标CRP和皮质醇等的浓度均无明显变化。此外单核细胞数差异也无统计学意义,但PCRA组术后B淋巴细胞和T-辅助细胞明显减少,自然杀伤(NK)细胞也明显减少。结论:术后臂丛神经自控镇痛对单核细胞功能没有影响,但可使自然杀伤细胞数减少。因此臂丛神经自控镇痛可影响特异性免疫系统,而对先天性免疫系统无影响,并可能减轻与抗感染能力有关的术后淋巴细胞抑制。     

Study on the effect of compound quinesterol on plasma cortisol concentration in fertile women]

This research reports on the concentration of plasma cortisol and the results of an oral glucose tolerance test in 60 fertile women taking quinestrol for between 4 and 13 years. In these women, the mean plasma cortisol concentration was 27.72 +or- 1.05 mcg/100 ml, which was significantly higher than 19.76 +or- 0.86 mcg/100 mg in 20 cases with a history of taking shortacting oral contraceptives and 15.53 +or- 0.50 mcg/100 ml in the normal volunteers. There was no significant difference in mean blood glucose levels between the group taking quinestrol and the control group. The above results indicated that the effect of quinestrol on adrenal cortisol function may be through the negative feedback of t pituitary-adrenal cortex axis. As a result, the levels of plasma cortisol were increased. Small doses of quinestrol had no apparent effect on carbohydrate metabolism.