从6种核心期刊论文关键词看我国公共卫生学科研究发展动态

目的了解我国2005~2009年公共卫生学科研究发展动态与趋势。方法运用词频分析法对6种影响力较强的综合类公共卫生核心2005~2009年刊登文献的所有关键词进行整理统计分析。结果在研究对象中,儿童一直是关注的焦点,而农民工和农村居民得到了更多的关注。在研究领域方面,水、(室内)空气一直是重点,而心理健康的重视程度上升很快。在影响因素中侧重于从危险因素的角度考虑,氧化损伤的研究有上升趋势。艾滋病与中毒是主要的社会性难题,微观物质研究中主要研究的是重金属及类金属。结论 2005～2009年公共卫生学科研究的广度与深度均在增加。     

含反药配伍的海藻玉壶汤临床应用分析

目的:;分析临床研究报道的海藻玉壶汤中海藻与甘草的配伍规律与特点,以便为反药配伍的深入研究提供参考依据。方法:;甘草”反药药对的文献,针对其主治病证、证候类型、随证配伍使用的中药及成方、海藻与甘草用法用量等进行数据分析。结果:;检索得到海藻玉壶汤文献共计1137篇,其中含有“海藻甘草”反药配伍的文献共计60篇,占总数的5.28%;以海藻玉壶汤为主方,随症加减用于妇科、男科、皮肤科等多种疾病,而并非单纯局限于对瘿病的治疗;其主治病证中证候类型以气滞痰凝型为主;海藻玉壶汤应用于临床,多与化痰药、活血化瘀药、理气药、清热药、补益药等配伍使用;海藻与甘草比例以2∶1~5∶1之间的较为常见,占文献总数的74.60%,均未见不良反应报道。结论:;含有反药配伍的海藻玉壶汤在临床应用中范围较广;其主治病证中证候类型仍以气滞痰凝型为主,与原方应用相吻合;海藻与甘草配伍比例与原方有明显差异。      

Effect of oophorectomy and exogenous estrogen replacement on liver injury in experimental obstructive jaundice

AIM： To investigate the role of estrogen on liver injury in an experimental obstructive jaundice model.
METHODS： Three groups of female rats were constituted; group 1 was oophorectomized and given E2 （n = 14）, group 2 was oophorectomized and given placebo （n = 14）, and group 3 was sham operated （n = 14）. Fourteen days following constitution of bile duct ligation, all groups were compared in terms of serum tests, histopathologic parameters, and tissue levels of IFN-γ and IL-6.
RESULTS： The parameters representing both the injury and/or the reactive response and healing were more pronounced in groups 1 and 2 （χ^2= 17.2, χ^2= 10.20; χ^2= 12.4, P 〈 0.05）. In the sham operated or E2 administered groups significantly lower tissue levels of IFN-γ and higher IL-6 levels were found. In contrast, high IFN-γ and low IL-6 tissue levels were found in the oophorectomized and placebo group （P 〈 0.001）. Kupffer cell alterations were observed to be more pronounced in the groups 1 and 3 （χ^2= 6.13, P 〈 0.05）.
CONCLUSION： Our study indicates that E2 impaired liver functions, accelerated both the liver damage and healing. In the conditions of bile duct obstruction, estrogen significantly changed the cytokine milieu in the liver.     

Effect of hypotonic medium on aquaporin-4 expression in cultured astrocytes

BACKGROUND: Aquaporin-4 (AQP4) is abundant in astrocytes, ependymal cells, and the choroid plexus, and is associated with cerebrospinal fluid formation and osmoregulation. AQP4 is speculated to be the hypothalamic osmoreceptor and regulator of water balance. OBJECTIVE: To examine AQP4 expression and its role in cultured rat astrocytes after exposure to hypotonic medium. DESIGN, TIME AND SETTING: Randomized control experiment. This experiment was carried out in the Research Room of Neurobiology, Chongqing Un...     

静电纺壳聚糖/胶原蛋白复合纳米纤维的细胞相容性

BACKGROUND： Due to the lack of autograft transplant rejection, Schwann cells （SCs） can promote the proliferation of embryonic stem cells and the induction of dopaminergic neurons. Mesencephalic stem cells can be induced to produce dopaminergic neurons. The therapeutic effects of co-grafts of SCs and neural stem cells （NSCs） deserves further study and verification in Parkinsonian animal models. OBJECTIVE： To investigate the effects of Schwann cells and mesencephalic NSC co-grafts in Parkinsonian animal models on animal behavior and histology. DESIGN： Randomized controlled experiment. SETTING： Fudan University; Institute of Neuroscience, Chinese Academy of Sciences. MATERIALS： The following animals were obtained from the Experimental Animal Center, Shanghai Institute for Biological Science, Chinese Academy of Sciences： 5 Sprague-Dawley rats, embryonic day （E） 13-16; 16 neonatal Sprague-Dawley rats, postnatal day 1-3; and 18 adult SD rats of both genders. Animal experimentation met animal ethical approval. METHODS： The experiment was performed at the Department of Anatomy, Histology and Embryology, Shanghai Medical Center, Fudan University from September 2005 to January 2007. The mesencephalic NSCs were obtained from the brains of SD rats at E 13-16, and SCs were harvested from the sciatic nerves of neonatal rats at day 1-3. Hemiparkinsonian rats （n =18） were selected for transplantation after estimating rotational behavior in response to apomorphine and were randomly assigned to three groups： control group, NSC group, and co-graft group. There were 6 rats in each group. Either phosphate buffered saline （PBS）, NSCs, or SCs plus NSCs were transplanted into the right neostriatum of Parkinsonian rats, respectively. MAIN OUTCOME MEASURES： （1） Rotational behavior was induced by apomorphine （0.05 mg/kg, i.p.） 2, 4, 6, 8, and 10 weeks after transplantation, and the number of rotations were counted. （2） Differentiation and survival of dopaminergic neurons in the right neostr     

Cochlear reimplantation in children: soft signs,symptoms and results

Abstract

Objectives Cochlear implant device failures and reimplantation have mainly been reported on in adults. The purpose of this study was to isolate precursors of device failures and assess the effects of reimplantation in children.

Methods From 1997 to 2003, 27 children underwent cochlear reimplantation at our institution. The pre-failure complaints were categorized and correlated with actual failure modes and postimplantation results. Speech-recognition tests were used to evaluate preand post-reimplantation performance.

Results Pre-failure length of usage ranged from 0 to 12 years. Symptoms including pain, intermittence, reduced performance, noise and the need for frequent device adjustments were associated with device failures, although not with a particular mode of failure. Post reimplantation performance was equal to but not immediately better than pre-failure results in children who received upgraded devices.

Conclusions Specific complaints, frequent need for device adjustments and reduced speech recognition can be precursors to device failures, underscoring the need for routine follow-up evaluations. Reimplantation with newer technology does not guarantee improved speech understanding and often requires an adjustment period to reach prereimplantation levels.     

PI3K/Akt/mTOR信号通路抑制剂在乳腺癌中的研究进展

目的:总结PI3K/Akt/mTOR信号通路靶向治疗在乳腺癌中的研究进展.方法:以“PI3K/Akt/mTOR、信号通路和乳腺癌”等为关键词,检索2000-01-2011-06 PubMed、Ovid和Springer等数据库的相关文献.纳入标准:1)关于PI3K/Akt/mTOR信号通路的组成、功能特点;2)PI3K/Akt/mTOR信号通路与乳腺癌的关系研究;3)以PI3K/Akt/mTOR信号通路中关键分子为靶点的乳腺癌治疗.根据纳入标准,符合分析的文献40篇.结果:信号转导通路的异常是肿瘤发生、发展的重要步骤,PI3K/Akt/mTOR信号通路与人类多种肿瘤密切相关,其在肿瘤细胞的增殖、存活、抵抗凋亡、血管发生和转移以及对放化疗抵抗中发挥了重要作用.乳腺癌中常见PI3K/Akt/mTOR信号通路的异常激活,以此通路为靶点的药物已成为乳腺癌治疗的研究热点.结论:靶向PI3K/Akt/mTOR通路中关键分子的众多药物在乳腺癌开展了一系列相关的临床试验研究,一部分显示出较好的安全性和有效性.随着对PI3K/Akt/mTOR通路的分子生物学机制的深入研究,期待靶向此通路的抑制剂将会在乳腺癌治疗中发挥巨大的作用,进一步提高乳腺癌患者的疗效和改善预后.     

Long-term Results,Late Complications and Quality of Life in a Series of Adjustable Gastric Banding

Background: Adjustable gastric banding is currently the most common bariatric operation. This study is a retrospective analysis of the Finnish experience with this procedure over the last 10 years. Methods: Between March 1993 and June 1999, 123 patients underwent either open (36) or laparoscopic (87) surgery for morbid obesity by the application of an adjustable gastric band. Data on preoperative clinical characteristics and postoperative outcome and weight-loss patterns up to 9 years (mean 55 months) are presented and also evaluated by the Bariatric Analysis and Reporting Outcome System (BAROS). Sex ratio was 31% males / 69% females, mean age 44 years and mean ± SD preoperative BMI 49 ± 8 kg/m² (range 33.6-85.1). Results: During the evaluation period (March 1993 December 2002), 54% of patients experienced postoperative complications requiring hospital treatment ≥ 7 days, and 52% underwent a reoperation. 33% of bands were removed. The most important late complications were esophagitis (30%), obstruction due to slippage / pouch dilatation (21%), incisional hernia (9%) and band erosion (9%).Mean excess weight loss at 1 and 2 year follow-up was 36% and 38%, which later stabilized to 30%. During the evalution period, there were 10 deaths, 2 of which were 30-day deaths, and the remainder were not associated with the band. According to BAROS, the outcome was regarded as "very good" in 3%, "good" in 7%, "fair" in 40% and "failure" in 50%. Conclusion: Our long-term data found that weight reduction is acceptable,but the incidence of late complications and reoperations was high.     

Preoperative Resting Energy Expenditure Does Not Predict Weight Loss and Maintenance after Vertical Banded Gastroplasty

Background: The authors evaluated the predictive efficacy of preoperative resting energy expenditure (REE) on long-term weight loss maintenance following vertical banded gastroplasty (VBG). In the long-term following VBG, low energy expenditure could lead to regain of weight, and thereby REE data might be a reliable predictor of long-term weight outcomes. Methods: A prospective study was conducted, taking into account the relationship between preoperative REE values and the results at 3 and 5 years following VBG in terms of both weight loss and success of the operation. Results: Long-term weight loss and outcome following VBG appeared to be completely independent of the preoperative REE. Conclusion: Preoperative REE cannot predict long-term weight outcome following VBG.     

Laparoscopic Adjustable Gastric Banding at a U.S. Center with up to 3-Year Follow-up

Background: We present our results from the "B" trial (the 2nd U.S. FDA-approved clinical trial) with the laparoscopic adjustable gastric band (LAGB) or Lap-Band? System, regarding weight loss, complications, and effect on co-morbidities with up to 3-year follow-up. Methods: Between March 1999 and June 2001, 63 morbidly obese patients underwent LAGB following accepted ASBS/SAGES guidelines and protocol requirements. All bands were placed via the classic high peri-gastric dissection above the lesser sac, corresponding to the equator of the calibration-tube balloon. Frequent follow-up by a multidisciplinary program was maintained. Results: All procedures were performed laparoscopically with no conversion to laparotomy. Operative time decreased from a mean of 197 minutes for the first 10 patients to 120 minutes for the last group. Average hospital stay was 1.4 days. Perioperative complications included 1 intraoperative gastric perforation, which was closed and did not prevent band placement, and 5 port problems. Gastric slippage occurred in 9 patients (14.2%), 3 of whom were revised to a gastric bypass and 6 who had the band removed.Three additional bands were removed due to infection (1), band erosion (1) and a cluster of gastric symptoms (1). Percent excess weight loss averaged 27.2 at 6 months (range 1-68), 38.3 at 1 year (range 10-77), 46.6 at 2 years (range 16- 89), and 53.6 at 3 years (range 21-94). Before surgery, 46 of 63 patients (73%) suffered from a serious comorbidity. Following LAGB, all categories showed marked improvement. Conclusions: In this study up to 3 years, LAGB provided a safe and sustainable weight loss. Significant resolution of serious co-morbidities was common. A U.S. bariatric practice achieved results comparable to those in the international literature. The primary requisites to achieve optimal results include careful patient selection, the refined surgical technique, and a comprehensive long-term patient management program.