DC-CIK细胞联合化疗治疗广泛期小细胞肺癌的临床疗效

目的:评价DC-CIK细胞联合化疗对广泛期小细胞肺癌(small cell lung cancer,SCLC)的有效性及安全性.方法:收集2012年2月至2015年1月就诊于上海东方肝胆外科医院的15例广泛期SCLC患者,采用EP方案(依托泊甙+顺铂)化疗结束后3～5d进行DC-CIK细胞治疗,每21 d为一周期,观察联合治疗前后患者外周血中T细胞亚群的变化、临床疗效、生活质量和不良反应等.结果:15例患者均可评价疗效,获CR 3例、PR 8例、SD 3例、PD 1例、RR为73.3％,DCR为93.3％,PFS为6.8个月,OS为14.9个月,其中2例获CR的患者OS分别为29.1个月、37.2个月,2年生存率达13.3％;联合治疗后较治疗前CD4+ CD25+ CD127-调节性T细胞、CD4+T细胞减少[(5.42±0.70)％ vs (6.16±0.77)％,P＜0.05;(28.74±1.92)％ vs (33.06±2.69)％,P＜0.05],CD3+ CD56+细胞因子诱导的杀伤细胞、CD8 +T细胞增加[(5.58±0.94)％ vs (4.94±0.77)％,P ＜0.05;(43.26±3.87)％ vs(39.92±2.78)％,P＜0.01],CD4 +/CD8+T细胞比值明显下降[(0.67±0.09)％vs (0.83±0.10)％,P＜0.01];治疗后患者KPS评分提高20分2例、10分9例,有效率为73.3％,不良反应主要表现为轻中度骨髓抑制、胃肠道反应,给予对症处理后可恢复正常.结论:DC-CIK细胞联合化疗可提高广泛期SCLC患者的临床缓解率,延长生存期,明显改善生活质量,增强免疫功能,安全有效.     

中弓韧带压迫综合征外科手术治疗进展

中弓韧带压迫综合征为正中弓状韧带压迫腹腔干动脉导致的一种罕见疾病。对于症状严重且影像学检查明确的患者,必须采用手术治疗。正中弓状韧带松解术是手术治疗的基石。多数情况下,术后即刻可恢复腹腔干的血运。可选方式有开放式手术、腹腔镜手术或者机器人协助手术。其中,腹腔镜手术因其创伤小、恢复快的优势而成为首选方案。同时,辅助腹腔神经丛切除术可减少患者的不适感。若术后腹腔干动脉持续狭窄,可进一步行血运重建术,如腔内治疗或动脉搭桥手术。腔内治疗创伤更小,而动脉搭桥手术的再狭窄率更低。本文将梳理总结中弓韧带压迫综合征的外科治疗的共识以及最新进展,希望有助于为本病的外科治疗提供思路。     

Traditional Chinese medicine in the treatment of acute respiratory tract infections

AIMS: To review the evidence from Cochrane systematic reviews for the effectiveness of traditional Chinese medicinal (TCM) herbs for treating acute respiratory tract infections (ARTIs) and to discuss the limitations of current clinical trials of TCM. FINDINGS: Evidence from six Cochrane systematic reviews was weak owing to the lack of high-quality TCM trials. Limitations were usually due to biases that influenced the validity of results. CONCLUSIONS: TCM is widely used for treating ARTIs. However, none of the identified studies has been well designed or conducted. In this overview, we suggest that clinical trials of TCM for ARTIs need to be re-run in accordance with internationally recognized standards.     

不同医生两次读X线直视摄影术牙片结果的一致性研究

目的：研究不同医生两次读Ｘ线直视摄影术（ＲＶＧ）牙片结果的一致性。方法：１００张ＲＶＧ牙片经３位医生的２次盲法读片，以尖周是否有破坏为标准进行判断，用卡帕值来分析结果。结果：３位医生两两比较的卡帕值分别为０．４９、０．５７和０．５１；每位医生间隔２周的２次读片结果卡帕值分别为０．６３、０．６５和０．５８，均属中度或高度一致。结论：ＲＶＧ牙片应充分利用但不能依赖，要参考多方面的信息，才能对尖周组织是否有破坏作出正确的判断     

Serotonin transporter transgenic (SERTcre) mouse line reveals developmental targets of serotonin specific reuptake inhibitors (SSRIs)

The serotonin transporter gene (SLC6A4; synonyms, SERT, 5-HTT) is expressed much more broadly during development than in adulthood. To obtain a full picture of all sites of SERT expression during development we used a new mouse model where Cre recombinase was inserted into the gene encoding the serotonin transporter. Two reporter mouse lines, ROSA26R and the Tau^mGFP, allowed to map all the cells that express SERT at any point during development. Combined LacZ histochemistry and GFP immunolabelling showed neuronal cell bodies and axon fiber tracts. Earliest recombination in embryos was visible in the periphery in the heart and liver by E10.5 followed by recombination in the brain in raphe serotonergic neurons by E12.5. Further, recombination in non-serotonin neurons was visible in the choroid plexus, roof plate, and neural crest derivatives; by E15.5, recombination was found in the dorsal thalamus, cingulate cortex, CA3 field of the hippocampus, retinal ganglion cells, superior olivary nucleus and cochlear nucleus. Postnatally, SERT mediated recombination was visible in the medial prefrontal cortex and layer VI neurons in the isocortex. Recombined cells were co-labelled with Neu-N, but not with GAD67, and were characterized by long range projections (corpus callosum, fornix, thalamocortical). This fate map of serotonin transporter expressing cells emphasizes the broad expression of SERT in non-serotonin neurons during development and clarifies the localization of SERT expression in the hippocampus and limbic cortex. The identification of targets of SSRIs and serotonin releasers during embryonic and early postnatal life helps understanding the very diverse physiological consequences of administration of these drugs during development.     

Gender-Dependent Pharmacokinetics of Veratramine in Rats: <Emphasis Type="Italic">In Vivo</Emphasis> and <Emphasis Type="Italic">In Vitro</Emphasis> Evidence

Veratramine, a major alkaloid from Veratrum nigrum L., has distinct anti-tumor and anti-hypertension effects. Our previous study indicated that veratramine had severe toxicity toward male rats. In order to elucidate the underling mechanism, in vivo pharmacokinetic experiments and in vitro mechanistic studies have been conducted. Veratramine was administrated to male and female rats intravenously via the jugular vein at a dose of 50 μg/kg or orally via gavage at 20 mg/kg. As a result, significant pharmacokinetic differences were observed between male and female rats after oral administration with much lower concentrations of veratramine and 7-hydroxyl-veratramine and higher concentrations of veratramine-3-O-sulfate found in the plasma and urine of female rats. The absolute bioavailability of veratramine was 0.9% in female rats and 22.5% in male rats. Further experiments of veratramine on Caco-2 cell monolayer model and in vitro incubation with GI content or rat intestinal subcellular fractions demonstrated that its efficient passive diffusion mediated absorption with minimal intestinal metabolism, suggesting no gender-related difference during its absorption process. When veratramine was incubated with male or female rat liver microsomes/cytosols, significant male-predominant formation of 7-hydroxyl-veratramine and female-predominant formation of veratramine-3-O-sulfate were observed. In conclusion, the significant gender-dependent hepatic metabolism of veratramine could be the major contributor to its gender-dependent pharmacokinetics.     

福建柏化学成分研究

目的对福建柏Fokienia hodginsii枝叶的化学成分进行研究。方法采用色谱法分离纯化化合物,经波谱数据鉴定化合物结构。结果从福建柏95%乙醇提取物中分离得到14个化合物,分别鉴定为桧脂素(1)、gadain(2)、双氢芝麻脂素(3)、扁柏脂内酯(4)、7-氧代扁柏脂内酯(5)、puviatilol(6)、伞形花内酯(7)、植醇(8)、儿茶素(9)、穗花杉双黄酮(10)、槲皮素-3-O-α-L-鼠李糖苷(11)、水杨醇(12)、香草醛(13)、松柏醛(14)。结论化合物1~14均为首次从该植物中分离得到。     

中药大品种成长规律探讨

本文简要分析了2009年以来医药市场关键成功因素的变化,并以麝香保心丸为例,阐述了中药大品种成长的客观规律:从关系营销过渡到品牌营销,并进一步上升为学术营销。     

杭白菊新品种“金菊3号”的选育及品种特性

目的:育成高黄酮含量杭白菊优良品种。方法:采用系统育种方法从杭白菊芽变单株中选育出优异新品种,测定其农艺性状和品质特征。结果:从变异单株选育出优异株系,建立株系圃,经小区品比试验、区域试验后最终审定成为新品种。两年区域试验结果表明"金菊3号"[浙(非)审字2013002]产量指标和品质指标均优于对照,干花平均产量为2 335.5 kg·hm~(-2);平均总黄酮含量为6.81%。结论:"金菊3号"是高黄酮含量杭白菊优良品种,综合性状表现突出,能够为保健品、饮品生产提供优质原料。     

价格和学术对中药大品种市场表现的影响

本文通过A、B两个产品的比较分析认为,在产品力、领导力、营销力等市场关键影响因素旗鼓相当的情况下,价格竞争力和学术影响力可能是造成产品市场表现差异的主要原因。从长远来看,学术因素的影响可能大于价格因素。因为,影响医生处方的根本原因是循证医学证据,是科技支撑和学术影响力。这是产品能够保持高速、持续增长的核心动力,也是中药大品种培育工作的重点所在。而且,获得更多西医研究机构和使用单位的认同、应用和支持是中药大品种持续增长的重要因素。