尿皮素对体外培养的人脐静脉内皮细胞一氧化氮及一氧化氮合酶的影响

目的:通过检测尿皮素(UCN)对人脐静脉内皮细胞(HUVEC)一氧化氮(NO)生成及一氧化氮合酶(NOS)表达的影响,探讨UCN调节胎儿-胎盘血管张力的分子机制。方法:在离体培养的HUVEC中加入不同浓度的UCN(0、0.1、1、10nmol/L)、10nmol/L促肾上腺皮质激素释放激素(CRH)及向以上各组UCN/CRH同时加α-helical-CRH进行体外培养,用硝酸还原酶法检测细胞上清液中NO的水平,蛋白印迹法检测内皮型一氧化氮合酶(eNOS)和诱导型一氧化氮合酶(iNOS)蛋白表达水平的变化。结果:在与UCN共同培养4~8h后,HUVEC细胞上清液中NO水平呈时间和剂量依赖性变化,随着培养时间的延长,UCN浓度增加,NO水平逐渐升高;UCN组HUVEC iNOS表达水平比对照组明显升高(P<0.05),且呈浓度依赖性升高。而各组eNOS表达水平与对照组比较无明显变化(P>0.05)。UCN/CRH α-helical-CRH组HUVEC上清液中NO水平和HU-VEC iNOS表达水平与对照组比较无明显变化,差异无统计学意义(P>0.05),与相同浓度UCN/CRH组比较NO水平和iNOS蛋白表达水平明显降低,差异有统计学意义(P<0.05)。结论:UCN可促HUVEC合成及释放NO,NO生成增多与UCN通过促进肾上腺皮质激素释放激素2β受体(CRH-R2β)正相调节iNOS蛋白表达有关,这可能是UCN调节胎儿-胎盘血管张力的分子机制之一。     

儿童肾癌的临床及CT和病理特点分析

目的 探讨儿童肾癌的临床、CT及病理特点,积累其临床诊治经验.方法 回顾性分析2014年至2016年单中心收治的7例儿童肾癌患儿的临床、CT、病理资料,并随访其生存情况.就诊时年龄5～12岁,女4例,男3例,左侧5例,右侧2例.临床表现多为血尿(4/7)、腹部包块(3/7)、腰痛(1/7).CT平扫肿瘤呈低密度,多位于上下极,可见钙化(6/7)及坏死区,增强特点多为“快进快出”(4/7),部分为“快进慢出”(2/7).结果 7例患儿全部获得随访,随访时间8～35个月.1例肿瘤位于左腹膜后,确诊时已发生腹膜后及颈部淋巴结转移,行肿瘤部分切除活检,术后5个月死亡.1例为复发性肾癌,行肾窝肿瘤切除加腹膜后淋巴结清扫,术后5个月出现淋巴结转移,予放化疗后带瘤生存.余5例患儿均行根治性肾切除加淋巴结清扫,术后均无瘤生存.病理多为肾透明细胞(5/7)及乳头状肾细胞癌(2/7),癌细胞呈巢团状、乳头状、腺管样结构分布,可见砂粒体(6/7),核级多为3～4级.4例患儿淋巴结转移,共清扫出60枚淋巴结,淋巴结阳性率为16.7％.5例加做免疫组化,TFE3 (4/5)、CD10 (5/5)、Kb67 (4/5)、E-cardherin (4/5)、Vinentin (3/5)、CK(3/5)阳性率较高,4例确诊为MiT家族异位性肾癌.结论 儿童肾癌多发生于年长患儿,有其特有的临床、CT及病理特点,MiT家族异位性肾癌常见,病理及免疫组化是确诊和分型的主要手段.     

雷珠单抗联合光动力疗法对年龄相关性黄斑变性CNV的治疗效果

目的:探讨雷珠单抗联合光动力疗法治疗年龄相关性黄斑变性对脉络膜新生血管(choroidal neovascularization,CNV)渗漏及视力的影响.方法:选取2012-01/2015-12在我院接受治疗的78例86眼年龄相关性黄斑变性患者作为研究对象,采用随机数字表分为联合组(雷珠单抗联合光动力疗法)39例42眼、对照组(单用雷珠单抗治疗)39例44眼,对比两组患者治疗前后的视力、CNV渗漏情况变化.结果:治疗后第6、12wk,联合组患者的最佳矫正视力(best corrected visual acuity,BCVA)测定值均大于对照组,差异具有统计学意义(P<0.05);联合组患者的黄斑中心凹视网膜厚度(central macular retinal thick,CRT)测定值均小于对照组,差异具有统计学意义(P<0.05);治疗12wk后,联合组的CNV渗漏治疗总有效率(90%)与对照组(82%)比较,差异无统计学意义(P>0.05).结论:雷珠单抗联合光动力疗法治疗年龄相关性黄斑变性对CNV渗漏、视力及CRT均具有较好的改善作用.     

Three-year follow-up in advanced pediatric keratoconus: thin corneas may not have pachymetry properly assessed after crosslinking

AIM: To analyze the crosslinking (CXL) effects in pediatric keratoconus, and to identify the patients’ corneal characteristics whose pachymetry could not be adequately evaluated by Scheimpflug method after procedure. METHODS: Consecutive pediatric patients with progressive keratoconus underwent CXL were included. Best-corrected visual acuity (BCVA) and spheric equivalent (SE) were measured before and after CXL. After CXL, groups 1 and 2 were divided based on the posterior surface Pentacam quality specifications (QS): “OK” (Group 1) and “not OK” (Group 2). The mean (RmF and RmB) and minimum (RminF and RminB) radius of curvatures of the anterior and posterior corneal surfaces, and the thinnest pachymetry (Pmin) were measured preoperatively at 3, 6, 12, 24, and 36mo. Haze was annotated. RESULTS: Twenty-six patients (14 men, mean age 14±1.8y) and median Kmax of 59.9 D initially and 61.4 D preoperatively were treated. BCVA was not different before and 24mo after CXL. Group 2 statistically differed to group 1 in that SE was more myopic before and with no difference 24mo after CXL; RmF and RmB were steeper and Pmin was thinner pre-surgically. Group 2, in which pachymetric changes could not be adequately evaluated after surgery, presented with significant RmF flattening, a shift to hyperopia, and more haze after CXL. CONCLUSION: Patients whose pachymetry could not be adequately evaluated after CXL had steeper and thinner corneas before surgery. The predictive factors for impaired QS after CXL are RmF, RmB, and Pmin. In advanced keratoconus, alternative methods to analyze pachymetry and the posterior surface should be considered.     

Intestinal Peptide Transport Systems and Oral Drug Availability

The intestinal peptide transport system has broad substrate specificities. In addition to its physiological function of absorbing di- and tripeptides resulting from the digestion of dietary proteins, this transport system also absorbs some orally administered peptidomimetic drugs, including -lactam antibiotics, angiotensin converting enzyme inhibitors, renin inhibitors, bestatin, thrombin inhibitors, and thyrotropin-releasing hormone and its analogues. There have been several studies on the mechanism and substrate structure-affinity relationship for this transport system. Rapid progress has been made recently in studies on the molecular basis of the intestinal peptide transport system. A protein apparently involved in peptide transport has been isolated from rabbit small intestines, and genes for human intestinal peptide transporters have been cloned, sequenced and functionally expressed. This review summarizes these studies and addresses the pharmaceutical potential of the intestinal peptide transport system.     

奥氮平的国内临床应用概况

目的：总结奥氮平在国内的临床应用情况。方法：汇总国内公开发表的9种杂志中刊登的临床应用文献27篇，综合其治疗方法、疗效和不良反应等情况。结果：经PANSS，BPRS，SANS，SAPS，和TESS等量表测试和临床观察，认为奥氮平对治疗精神分裂症有相当的疗效；临床疗效等同或优于氯氮平、利培酮和舒必利；对精神分裂症的思维障碍和敌对猜疑疗效显著；对精神分裂症的阳性症状、阴性症状有效。不良反应小，安全性高，患者依从性好。结论：奥氮平可选用于精神分裂症等精神病的治疗，是目前比较满意的抗精神病药物。     

多靶点抗肿瘤新药索拉非尼的药理作用及临床研究进展

索拉非尼(sorafenib)是一种口服多激酶抑制剂,为一新的多靶点抗肿瘤药,能抑制肿瘤血管形成及肿瘤细胞增殖。临床研究表明,索拉非尼能有效治疗肾细胞癌晚期患者,并延长其无疾病进展期和总生存期,索拉非尼对其他癌症的作用也正在研究中。索拉非尼的常见不良反应有皮疹、手足综合征、高血压及腹泻等。     

鱼腥草类注射液临床严重不良反应的原因研究（Ⅰ）

由于鱼腥草类注射液在临床应用中多次出现严重不良反应,我们利用豚鼠及 Beagle 犬进行了有关动物实验研究,结果证明助溶剂聚山梨酯80是引起鱼腥草类注射液临床严重不良反应的主要原因之一。     

缩泉丸与琥珀酸索利那新联合治疗肾虚型膀胱过度活动症72例临床观察

目的:观察中药缩泉丸汤剂联合琥珀酸索利那新治疗肾虚型膀胱过度活动症临床疗效.方法:将72例肾虚型膀胱过度活动症患者随机分为2组,对照组36例予琥珀酸索利那新治疗,治疗组36例在对照组治疗基础上加用中药缩泉丸汤剂治疗.2组均服药6周.结果:治疗组治疗后24 h平均排尿次数少于对照组(P＜0.05),每次排尿量多于对照组(P＜0.05).2组治疗后平均24 h尿失禁次数比较差异无统计学意义(P＞0.05).治疗组不良反应率低于对照(P＜0.05).结论:缩泉丸联合琥珀酸索利那新治疗肾虚型膀胱过度活动症疗效确切.