胃癌组织中粘蛋白1和基质金属蛋白酶9的表达与临床病理特征的关系

目的探讨胃癌组织中粘蛋白1（MUC1）和基质金属蛋白酶9（MMP-9）的表达与临床病理特征的关系。方法采用免疫组织化学SP法检测r52例胃癌组织、31例良性胃溃疡组织中MUC1和MMP-9的表达。结果MUC1和MMP-9在胃癌组织中的阳性表达率分别为63．46％、76．92％,在良性胃溃疡组织中均无表达。MUC1和MMP-9在胃癌组织中的表达与组织学分级、临床分期、有无淋巴结转移密切相关。结论MUC1和MMP-9在胃癌组织中高表达与胃癌的侵袭性行为有关,有可能成为判断胃癌预后的标志物及基因治疗的潜在靶点。     

替米沙坦与那格列奈在比格犬体内的药动学相互作用

目的:研究那格列奈与替米沙坦联用在犬体内的药动学相互作用。方法:采用自身对照随机交叉的试验方法,将比格犬分为3组,每组3只,分别按试验周期服用替米沙坦、那格列奈、替米沙坦加那格列奈。高效液相色谱-串联质谱(HPLC-MS/MS)法测定不同时间点的血药浓度,计算药动学参数。结果:替米沙坦单用与联用相比,其tmax(h)(1.7±0.4)vs(3.1±0.8)(P<0.05),其余药动学参数变化不大;那格列奈单用与联用相比,其AUC(0-t)(mg.h.L-1)(24.7±3.5)vs(15.2±1.7),AUC(0-∞)(mg.h.L-1)(29.8±4.3)vs(18.1±2.1),Cmax(mg.L-1)(4.4±0.6)vs(3.1±0.4),CL/F(L.kg-1.h-1)(0.43±0.21)vs(0.06±0.02)and V/F(L.kg-1)(2.7±0.9)vs(0.33±0.16)(P<0.05)。结论:替米沙坦与那格列奈联合用药时彼此影响其药动学参数。     

影响严重感染和感染性休克集束化治疗预后的多因素分析

目的分析严重感染和感染性休克集束化治疗中影响预后的相关因素。方法选择宁夏医科大学总医院ICU149例进行6h、24h集束化治疗的严重感染和感染性休克患者为研究对象进行回顾性调查,记录集束化治疗完成的情况,将研究对象以28d存活与否分别分为存活组和死亡组,将6h和24h集束化治疗的各指标进行多因素非条件Logistic回归分析,分析集束化治疗中影响严重感染预后的独立相关因素。结果单因素分析显示:集束化治疗中1h抗生素、留取病原学标本、2h CVP监测、HCT和气道压5项与严重感染预后相关,Logistic回归分析显示:集束化治疗中6h早期目标导向治疗(early goal directedtherapy,EGDT)是影响严重感染预后的独立保护因素。结论集束化治疗可以改善严重感染和感染性休克患者的预后,其中6hEGDT治疗达标,可以明显改善严重感染和感染性休克患者的预后。     

Block-copolymer micelles as carriers of cell signaling modulators for the inhibition of JNK in human islets of Langerhans

Here we investigate the potential of PCL-b-PEO micelles in preventing the cell death of isolated human islets of Langerhans. PCL-b-PEO micelles were loaded with c-Jun NH₂-terminal kinases inhibitor SP600125 to rescue the isolated islets. Mechanistic studies of the uptake were conducted in PC12 cells. Incorporation of SP600125 afforded 8.2 fold greater solubility of SP600125 in micelle suspension. To investigate the effectiveness of micelle-incorporated SP600125 in preventing the islet cell death, we challenged the islets with TNF-alpha, IL-1, and IFN gamma. Micelle-incorporated SP600125 did not lose its inhibitory activity during incorporation into micelles, and it protected the islets against cytokine-induced loss of viability to the same extent as control SP600125. Moreover, the concentration of micelle-incorporated SP600125 used was 13-fold lower, demonstrating the greater efficacy of micelle delivered SP600125. Micelles maintained their cytoplasmic distribution without detectable nuclear localization in islets. The inhibition of JNK was confirmed by western blots. This study suggests that micelle-based intracellular delivery of potent, poorly water soluble, cell-death-pathway inhibitors may represent a valuable addition to established delivery of cytocidal block-copolymer micelle-incorporated bioactives.     

我院363份药品说明书中有关【药物-食物相互作用】信息的标注情况分析

目的:了解药品说明书中有关【药物-食物相互作用】(DFI)项目信息的标注情况。方法:参考《化学药品非处方药说明书规范细则》、《化学药品和治疗用生物制品说明书规范细则》等的规定项目,对2010年我院共363份常用药物的药品说明书中有关DFI信息的标注情况进行统计、分析。结果:共涉及化学药269份,中成药94份;其中口服药161份,外用药43份,注射剂159份。调查中仅1份药品说明书明确标注了DFI信息,无任何DFI信息的占调查总数的63.6%,其余只能通过散列于多个项目中的内容获取DFI信息,如【用法用量】、【注意事项】等项目。结论:建议相关部门在药品说明书中增加DFI项目,为临床用药提供更明确的信息,避免食物与药物不良相互作用发生,以提高药物的安全性、有效性。     

~(125)I粒子姑息治疗IIIB期非小细胞肺癌的近期疗效观察

目的探讨术中植入放射性125I粒子治疗IIIB期非小细胞肺癌的近期疗效和可行性。方法对2008年4月至2010年5月期间我科术中确诊的IIIBNSCLC59例患者随机分为两组,A组:外放疗组,30例;B组:125I粒子植入组,29例。两组患者均在接受外照射治疗或125I粒子植入术后接受2～4个周期GP方案化疗。应用RECIST(实体瘤治疗疗效评价标准)判断疗效,RTOG(急性放射反应分级标准)评价放射损伤及并发症,比较两组的近期疗效(总有效率)和并发症。结果对两组患者随访超过6个月,并行影像学检查以了解肿瘤大小及评价近期疗效。两组患者半年生存率均为100%,差异无统计学意义(P>0.05)。A组和B组总有效率分别为63.3%和86.2%,差异有统计学意义(P<0.05)。A组和B组并发症发生率分别为36.4%和13.8%,差异有统计学意义(P<0.05)。结论 125I组织间永久植入姑息治疗IIIB期非小细胞肺癌具有疗效高、并发症发生率低等优点,可作为IIIB非小细胞肺癌综合治疗的方法之一。     

我国7个地理区域哮喘急性发作住院患者季节性分布特征

目的 了解我国7个地理区域内哮喘急性发作住院患者的季节性分布特征。方法 对全国7个地理区域（东北、华北、华中、华东、华南、西北、西南）内的29家三甲医院2013－2014年间因哮喘急性发作住院的患者例数及同期该院呼吸内科总住院患者例数进行统计,逐月计算因哮喘急性发作住院患者占总住院患者的比例。对各个地区之间及每个地区不同月份之间哮喘急性发作患者的住院情况进行了统计学分析。结果 在研究的时间范围内,29家医院的呼吸科总住院患者为206 135例次,其中因哮喘急性发作住院患者为6 480例次,占同期总住院数的3.14%。不同地区间因哮喘急性发作住院人数占同期总住院人数的比例差异较大,东北地区比例最高（5.61%）,华东地区比例最低（1.97%）。不同地区之间哮喘患者住院比例的差异均有统计学意义（P<0.000 1）。多数地区因哮喘急性发作住院患者例数及比例都有两个高峰,分别位于2－4月及9－10月,东北、华东及华南地区的春季高峰更为显著,而华北及西南地区的秋季高峰更为明显,西北地区的高峰则位于冬季（12－1月）及夏季（6－8月）。东北、华北及西南地区各月份之间哮喘急性发作住院情况的差异有统计学意义（P<0.005）。结论 不同地区哮喘急性发作住院患者存在一定的季节波动性,多数地区存在春季及秋季两个高峰。     

Comparison of transanal total mesorectal excision (TaTME) versus laparoscopic TME for rectal cancer: A case matched study

BackgroundTransanal total mesorectal excision (TaTME) has been developed to improve the quality of laparoscopic TME for patients with rectal cancer. Recently, international concern on TaTME was raised by a national cohort study showing an increased rate of local recurrences. This study aimed to compare clinicopathological and mid-term oncological outcomes of TaTME versus laparoscopic TME (LaTME) for mid and low rectal cancer of a high volume center.MethodsFrom August 2014 to October 2019, patients with mid or low rectal cancer who received TaTME procedure were identified. The cases were matched with patients treated with LaTME. Data were retrospectively collected including operative details, postoperative morbidity, pathologic results, and oncologic outcomes. Primary endpoint was the local recurrence (LR) rate.ResultsPropensity score matching yielded 70 patients in each of the groups. There were no statistically significant differences between the 2 groups in terms of postoperative complications, conversion rate to open surgery and circumferential resection margin. Local recurrence occurred in 2 patients (2.9%) in the transanal group, whereas 1 patient developed a local recurrence in the laparoscopic group (1.4%)(p = 0.559). Kaplan–Meier survival analysis showed a 2 year Local recurrence rate 1.5% VS 1.6%(p = 0.934), DFS 88.0% VS 87.7%, OS 94.0% vs 100% for transanal and laparoscopic group, respectively.ConclusionsIn a high volume center the transanal total mesorectal procedure is feasible, and appears to be safe alternative to laparoscopic surgery. Oncological outcomes were acceptable and no increased multi or unifocal local recurrence rate was found.