荷人肝细胞肝癌裸鼠模型的建立及其MRI研究

目的　建立一种裸鼠移植性人肝细胞肝癌模型 ,观察其MRI表现。材料与方法　将对数生长期人肝细胞肝癌FHCC 98制成细胞悬液 (1× 10 7/ml ) ,取 0 .2ml分别注射于裸鼠胁部皮下 ,建立裸鼠肝癌动物模型。应用MR平扫及静脉注射钆 喷替葡甲胺 (Gd DTPA)后增强扫描T1WI观察其生长及影像学表现。扫描后处死裸鼠 ,对应扫描切面取肿瘤标本行病理学观察。结果　裸鼠模型于 1周左右生长出可触及的肿瘤 ,3周左右肿瘤生长直径可达 0 .5～ 0 .8cm。 10例裸鼠移植性人肝细胞肝癌模型成瘤率为 10 0 % (10 / 10 )。MRI上表现为长T1长T2 信号 ,边缘较清晰 ,有轻微～中等强化。病理学检查示裸鼠移植性人肝细胞肝癌与人体肝细胞肝癌肿瘤标本所见相似。结论　本研究所建立的裸鼠移植性人肝细胞肝癌模型成瘤率高 ,移植瘤生长良好 ,便于MRI观察 ,是一种适合于分子影像学研究的动物模型。     

大鼠舌鳞癌诱变过程中MMP-3、TIMP-1的表达变化及相关性研究

目的:研究基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶组织抑制因子-1(TIMP-1)在大鼠舌鳞癌诱变过程中转录水平表达变化及两者之间的相关性。方法:60只SD大鼠随机分为3组,每组20只,正常对照组,给予正常饮食;另2组每天喂养0.002%4-硝基喹啉-1-氧化物(4NQO),于16周和24周处死;16周组可见上皮异常增生,而24周组已经为舌鳞癌,分别选取8个标本作检测。各组利用定量逆转录聚合酶链反应(qRT-PCR)检测MMP-3、TIMP-1在不同病变时期舌组织中转录水平的表达变化。结果:MMP-3及TIMP-1的mRNA于正常对照组相对表达量较少,上皮异常增生组相对表达量较正常组显著增加,舌鳞癌组的相对表达量最高。MMP-3与TIMP-1的mRNA表达之间成显著相关性。结论:MMP-3与TIMP-1随癌变的发生表达显著上调,两者间平衡失调可导致舌鳞癌的发生及发展。     

多种营养素干预与胎儿生长受限的关联研究

目的：探讨胎儿生长受限（FGR）的危险因素,评价多种营养素干预对FGR的预防作用。方法：研究数据来源于全国4省18县进行的营养素社区干预性研究,对纳入研究妇女进行问卷调查并追踪随访其妊娠结局。FGR定义为妊娠满37周、出生体质量低于同妊娠时间平均出生体质量的2个标准差者。结果：共记录妊娠结局52 043例,其中单胎、活产、无畸形的新生儿50 769例。本研究单胎、活产、无畸形新生儿有FGR者共计628例,占1.24%。多因素Logistic回归分析显示,与FGR发生有关的因素包括母亲年龄、妊娠周数、胎儿性别、经济状况、被动吸烟、饮茶习惯和妊娠期贫血等。多种营养素干预减少了FGR的发生。结论：母亲年龄、妊娠周数、胎儿性别、经济状况、不良生活习惯、妊娠期疾病等是发生FGR的危险因素,而多种营养素干预可预防FGR的发生。     

苯丙胺诱发小鼠激怒反应及其机制

苯丙胺15mg/kg ip能诱发小鼠激怒反应,使小鼠出现攻击和殴斗行为。强安定药、弱安定药和利血平有明显拮抗效果。镇静剂如巴比妥类、抗胆碱药及抗肾上腺素药均无拮抗作用。金刚胺、左旋多巴和阿扑吗啡均能增强苯丙胺的激怒效应。因苯丙胺激怒小鼠的方法简便易行,可作为筛选抗精神病药的动物模型。苯丙胺产生激怒作用的机制与增强多巴胺能神经的功能有关,推测可能是促进边缘系统多巴胺释放的结果。     

金纳多(银杏叶提取物)对大鼠实验性肝纤维化的防治作用

目的研究金纳多(银杏叶提取物)对大鼠实验性肝纤维化的防治作用。方法应用CCl4诱导大鼠实验性肝纤维化,以金纳多防治。实验分金纳多组(n=12);CCl4组(n=12);正常对照组(n=12)。金纳多组和CCl4组分别用40% CCl4橄榄油溶液制备大鼠肝纤维化模型。金纳多组按8 mL/(kg·d)腹腔注射金纳多液,共12Wk。观察肝脏组织学改变、肝羟脯氨酸(HYP)、丙二醛(MDA)含量、血清PC-Ⅲ、HA、血栓烷B2 (TXB2)及6-酮-前列腺素Fla (6-keto-PGFla)水平。结果金纳多组大鼠肝纤维化程度明显轻于CCl4组;肝羟脯氨酸及丙二醛含量(166.0±27.0μg/g 肝和206.3±1.2μmol/g)显著低于CCl4组(248.0±45.0μg/g 肝和273.5±47.6μg/g);PC-Ⅲ和HA(113.0±42.0μg/L和258.0±92.0μg/L)水平亦显著低于CCl4组(256.0±68.0μg/L和479.0±116.0μg/L),且接近于正常对照组大鼠;TXB2降低,6-keto-PGFla增高。结论金纳多可保护肝细胞、减轻肝细胞坏死,对大鼠实验性肝纤维化具有防治作用。     

Role and value of laparoscopic training devices in assessing nondominant and two-handed dexterity

Background and objectives: To determine improvement in hand dexterity with targeted laparoscopic skill exercises desirable for use in the operating rooms among in-training laparoscopic gynaecological surgeons and medical students. Design: Cross-sectional study with paired analysis. Setting: Kiel School of Gynaecological Endoscopy and Reproductive Medicine, Germany, between February and April 2005. Subjects: Twenty third-year medical students and 20 in-training gynaecological endoscopic surgeons from various parts of the world. Interventions: Demonstration and explanation of a set of five laparoscopic skill exercises desirable for use in the operating rooms before administering a pretest. This was followed by voluntary practice of these exercises for at least 10 times over 1 day. The posttest was performed the next day once the participant was comfortable performing the skill. Pre- and posttest assessments were conducted by independent supervisors. Main outcome measures: Time to completion of tasks with minimal errors. Results: There was significant reduction in mean time for all the laparoscopic skill exercises performed with dominant, nondominant, and both hands, before and after the training and practice (p-value <0.01; paired t-test). Moderate to high correlation (0.617–0.901) was seen with the intermediate and complex/difficult tasks, whereas low correlation was seen with the simple/easy task (0.200–0.336). Medical students and gynaecologists both showed improvement in performance from pretest to posttest in terms of reduction in mean time taken to perform all the tasks with minimal errors. Conclusions: Simple laparoscopic training devices can substantially help an individual hand’s improvement and acquisition of laparoscopic skills. Simple laparoscopic training devices along with animal models will continue to provide an efficient and effective environment for learning and teaching laparoscopic surgical skills. With this training, performance improves progressively with practice.     

Cost-effectiveness of stroke treatments and secondary preventions

Introduction: Stroke is one of the leading causes of morbidity and mortality worldwide. It imposes a significant burden in terms of costs, premature death, long-term disability, restricted social functioning and reduction in patient's quality of life. Effective interventions in stroke treatment and prevention have long-term clinical and economic consequences.

Areas covered: This review focuses on the cost-effective evaluations regarding the medical treatments of acute stroke and long-term secondary prevention of stroke. A comprehensive electronic search for economic evaluations in this area was conducted. Different economic modeling approaches, evidence considered in the evaluations and the key findings are all reviewed and discussed.

Expert opinion: Intravenous thrombolysis is consistently shown to be the most cost-effective option for acute stroke treatment. Clopidogrel, statin, warfarin and dabigatran are considered as the most cost-effective treatments for secondary stroke prevention. However, lack of long-term outcome data and long-term resource use data adds tremendous uncertainty to the cost-effectiveness stories of these treatments. Economic studies that are updated with more recent clinical findings and studies that seek to identify the cost-effective combinations of different types of treatments are warranted. Also, few of the published economic evaluations considered the economic impact of these treatments on subgroups and individuals with different risks.     

The influence of attachment and emotional support in end-stage cancer

The impact of attachment style and emotional support on negative affect in 67 end-stage cancer patients was examined via self-report inventory. Path analysis revealed high levels of both attachment anxiety and attachment avoidance were associated with lower levels of emotional support which, in turn, had a major adverse influence on patients' negative affect. In addition, attachment anxiety was also directly associated with distress. The discussion emphasises the importance of attachment theory and emotional support within the context of terminal cancer.