CD47-retargeted oncolytic adenovirus armed with melanoma differentiation-associated gene-7/interleukin-24 suppresses in vivo leukemia cell growth

Our previous studies have suggested that harboring a soluble coxsackie-adenovirus receptor-ligand (sCAR-ligand) fusion protein expression cassette in the viral genome may provide a universal method to redirect oncolytic adenoviruses to various membrane receptors on cancer cells resisting to serotype 5 adenovirus infection. We report here a novel oncolytic adenovirus vector redirected to CD47+ leukemia cells though carrying a sCAR-4N1 expression cassette in the viral genome, forming Ad.4N1, in which 4N1 represents the C-terminal CD47-binding domain of thrombospondin-1. The infection and cytotoxicity of Ad.4N1 in leukemia cells were determined to be mediated by the 4N1-CD47 interaction. Ad.4N1 was further engineered to harbor a gene encoding melanoma differentiation-associated gene-7/interleukin-24 (mda-7/IL-24), forming Ad.4N1-IL24, which replicated dramatically faster than Ad.4N1, and elicited significantly enhanced antileukemia effect in vitro and in a HL60/Luc xenograft mouse model. Our data suggest that Ad.4N1 could act as a novel oncolytic adenovirus vector for CD47+ leukemia targeting gene transfer, and Ad.4N1 harboring anticancer genes may provide novel antileukemia agents.     

Co-expression of guanine-nucleotide exchange factor DOCK180 and ELMO1 in ovarian cancer cells

目的 寻找卵巢癌细胞中鸟嘌呤核苷交换因子Dock 180与Elmo1呈相互协同作用的依据.方法 采用Westem blot检测人卵巢癌组织、良性肿瘤组织及正常卵巢组织中的Dock 180与Elmo1的表达水平；免疫组化检测卵巢癌组织中Dock 180与Elmol的分布；免疫荧光检测Dock180与Elmo1在卵巢癌细胞SKOV3中的定位分布；检测Dock180表达缺失的SKOV3细胞中内源性Elmo1的表达水平.结果 Dock 180与Elmo1在人卵巢癌组织中的表达水平呈明显正相关(r=0.829,P＜0.05),在卵巢癌组织中二者的表达水平显著高于卵巢良性肿瘤组织组和卵巢正常组织组(P＜0.05)[Dock180:(1.054±0.114)、(0.518 ±0.126)、(0.425±0.072); Elmo1:(0.864 ±0.114)、(0.374±0.076)、(0.300±0.105)].免疫组化及细胞化学染色均显示二者在人卵巢癌组织和细胞内的分布具有一致性.而且在Dock180表达缺失细胞中,Elmol的表达水平也同时降低.结论 Dock180与Elmo1在促进卵巢癌的癌变过程中可能具有相互协同作用.     

高职临床医学专业基于工作过程课程体系的构建与实践

通过对河北省基层医疗机构临床医学专业人才需求的调研，对乡镇基层卫生机构医师岗位职业能力分析，并根据基层医师工作过程的实际需要，确定了相对应的教学内容，设计了“工学结合”的教学情境，构建了以工作过程为导向的课程体系，从而为培养高素质技能型临床医学专业人才提供了支持。     

应用知信行模式提高ICU护士对多重耐药菌感染防控的效果

目的观察应用知信行模式提高ICU护士对多重耐药菌感染防控的效果。方法成立防控小组,组织学习多重耐药菌感染相关知识,建立防控制度并逐一实施。结果实施后护士知信行问卷得分较实施前提高,多重耐药菌防控知识能力专项测评成绩也高于实施前,手卫生依从性由实施前59.8%提高到91.3%。结论知信行模式可提高ICU护士对多重耐药菌感染防控的效果。     

Impact of severe tricuspid regurgitation on accuracy of systolic pulmonary arterial pressure measured by Doppler echocardiography: Analysis in an unselected patient population

Pulmonary arterial pressure is an important index in cardiovascular disorders, especially for pulmonary hypertension (PH). Doppler echocardiography (DE) is widely used as a noninvasive method to assess pulmonary arterial pressure. However, recent studies have found several hemodynamic factors that affect its accuracy in estimating systolic pulmonary arterial pressure (sPAP). But the effect of tricuspid regurgitation (TR) has not been investigated. Therefore, our study is aimed to determine whether the severity of TR will affect the accuracy of sPAP measured by DE in an unselected patient population. We retrospectively studied 177 patients who underwent DE and right heart catheterization (RHC) examinations. Patients were categorized into 3 groups according to the severity of TR (mild, moderate, and severe). The discrepancy in sPAP measured by DE and RHC was calculated and compared in each group. Determinants of discordant results between two methods were also evaluated. Age, gender, interval between DE and RHC, sequence of DE and RHC were similar among groups (all P>.05). Differences in sPAP, RAP, and tricuspid regurgitation pressure gradient (TR‐PG) were similar in group 1 and 2 (all P>.05), while all significantly higher in group 3 (all P<.05). The difference in sPAP between DE and RHC was affected independently by severe TR and severe PH (both P<.05). Severe TR and severe PH affect the accuracy of sPAP measured by DE. Modification of echocardiographic sPAP measurements by taking into consideration of these factors may lead to reduced systemic errors.     

Retrograde access via the popliteal artery to facilitate the re‐entry technique for recalcitrant superficial femoral artery Chronic total occlusions

Subintimal recanalization is beneficial in selected patients with peripheral chronic total occlusions (CTO). However, in complex cases, re‐entry into the true arterial lumen may prove to be unsuccessful with a conventional guidewire or a re‐entry catheter when using standard femoral artery access. Our case series describes these technical dilemmas along with strategies that can be utilized to overcome these challenges. © 2011 Wiley‐Liss, Inc.     

护士心理压力的调查分析研究

目的调查了解医院护士心理的心理卫生和压力情况及发生的原因,寻找可以缓解护士心理压力的良好办法和对策,以提高心理健康,保证良好的工作状态。方法依据SCL-90自评症状量表,自行设计了问卷调查表,对我院所有护士的心理压力情况进行调查和抽样访问。结果经过问卷回收后统计显示,由于工作、专业知识和心理卫生等原因,我院护士都存在各种各样的心理压力,面对不同程度的心理压力,护士的自我调节方式不尽如意。结论针对我院护士面临的心理压力和产生原因,提倡护士要进行适当的自我调整,进行定期的知识技能培训,减轻工作量,建立专业的心理咨询机构进行心理辅导。