盐酸高乌甲素通过pRb通路介导人宫颈癌Hela细胞周期阻滞

目的 对《药品质量抽查检验管理办法》中监督管理和信息公开方面的新要求进行解读,为相关工作提供参考。方法 对比研究2019年8月颁布的《药品质量抽查检验管理办法》和2006年7月颁布的《药品质量抽查检验管理规定》中监督管理和信息公开相关内容,分析新要求的必要性及意义,并提出实施建议。结果 《药品质量抽查检验管理办法》在监督管理方面新增了追溯不合格药品来源、风险研判及处理、流通环节处罚、工作督促指导、生产经营和使用单位的义务和责任等要求,在信息公开方面新增了公开内容、重大影响研判、信息化管理等要求。结论 新增的要求有利于加强假劣药品和潜在风险的控制处置,改进抽检结果信息公开,应得到药监部门的重视并落实到位。     

连锁药店和单体药店药学服务现状对比分析初探

目的:调查济南市长清区连锁药店和单体药店药学服务开展现状并进行对比分析。方法:基于系统性、科学性、层次性和可操作性四个原则,选取济南市长清区四家单体药店和八家连锁药店,通过实地发放问卷,指导填写的方式对84位购药顾客进行问卷调查。结果:连锁药店和单体药店在药店提供的药学服务内容、药学服务形式、建立顾客用药档案和顾客选择药店依据四个方面存在差异,连锁药店药学服务在药店人员配备、药店优惠经营和药学服务仪器配备方面占优势,单体药店药学服务在药店社区化管理方面占优势。结论:济南市长清区连锁药店和单体药店药学服务仍需进一步提高,两种性质的药店应利用自身优势,相互借鉴,共同完善药学服务模式。     

Comparative genomic hybridization: comparison between esophageal squamous cell carcinoma and gastric cardia adenocarcinoma from a high-incidence area for both cancers in Henan, northern China

Esophageal squamous cell carcinoma (SCC) remains the leading cause of cancer related deaths in Linzhou (formerly Linxian), the highest incidence area for esophageal cancer (EC) in Henan, northern China. In China, gastric cardia adenocarcinoma (GCA) shares very similar geographic distribution with SCC, suggesting the possibility of similar risk factors involved in SCC and GCA carcinogenesis in these areas. However, the underlying genetic alterations for esophageal and gastric cardia carcinogenesis, especially for the molecular difference between SCC and GCA, are largely unknown. The present study was thus undertaken to determine the difference in chromosomal aberrations in SCC (n = 37) and GCA (n = 31) using the comparative genomic hybridization method (CGH). All the patients were from Linzhou, Henan, a high-risk geographic region for both SCC and GCA. CGH results showed that chromosomal aberrations with different degrees were identified both in SCC and GCA. In SCC, chromosomal profile of DNA copy number was characterized by most frequently detected gains at 8q (29/37, 78%), 3q (24/37, 65%) and 5p (19/37, 51%); and frequently detected losses at 3p (21/37, 57%), 8p and 9q (14/37, 38%). In GCA, the frequently detected gains were identified at 20q (13/31, 42%), 6q (12/31, 39%) and 8q (11/31, 35%); the DNA copy number losses in GCA occurred frequently at 17p (17/31, 55%), 19p (15/31, 48%) and 1p (14/31, 45%). Statistically, there were evident differences between SCC and GCA in DNA copy number gains at 8q, 3q, 5p and 20q (P < 0.05) and in losses at 3p, 8p, 5q, 17p and 18q (P < 0.05). Gains at 8q were frequently observed in both SCC and GCA. Gains at 3q and 8p were frequently observed in TNM stage III of both SCC and GCA. The present CGH results provide candidate regions that may contain specific related genes involved in SCC and GCA in the Linzhou population. Gains at 8q, 3q and 5p and losses at 3p, 8p and 9q were specifically implicated in SCC; gains at 20q, 6q and 8q and losses at 17p, 19p and 1p were specifically implicated in GCA; gains at 8q were implicated in both SCC and GCA.     

Laparoscopic liver resection for hepatocellular carcinoma with cirrhosis in a single institution

Background

In a statement by the second International Consensus Conference for Laparoscopic Liver Resection (LLR), minor LLR was confirmed to be a standard surgical practice, as it has become adopted by an increasing proportion of surgeons. However, it is unclear whether this applies to the more complex group of patients suffering from cirrhosis. Therefore, the aim of this retrospective study was to compare the feasibility and safety of LLR for hepatocellular carcinoma (HCC) between non-liver cirrhosis (NLC) patients and liver cirrhosis (LC) patients at a single high-volume laparoscopy center.

Methods

From the beginning of 2000 to the end of 2013, open liver resection (OLR) was performed in 99 HCC patients, and LLR was in 118. The HCC patients who underwent LLR were divided into NLC-LLR (n=60) and LC-LLR (n=58) groups, and we compare the short-term outcomes between them.

Results

There was no significant difference in the incidence of blood loss and transfusion requirements between the NLC-LLR group and the LC-LLR group, although wedge resection was mainly performed in the LC-LLR group. There was no significant difference in the complication rate between the two groups, and the remarkable finding was that there was a significantly lower incidence of postoperative ascites in the LC-LLR group than in the NLC-LLR group.

Conclusions

According to our experience, it appears that LLR for selected HCC patients with cirrhosis is a feasible and promising procedure that is associated with less blood loss and fewer postoperative complications, especially the incidence of postoperative ascites. Further investigations are clearly warranted.     

动态对比增强磁共振对急性脑梗死患者血脑屏障通透性的研究

目的通过动态对比增强(dynamic contrast-enhanced,DCE)MRI定量评估血脑屏障(blood-brain barrier,BBB)的通透性,探讨急性缺血性脑卒中患者BBB通透性的变化及相关影响因素。方法将50例急性缺血性脑卒中患者根据不同治疗方案,分为常规药物组12例,静脉溶栓组19例和取栓组19例,患者在发病72 h内完成DCEMRI(基线时),8例患者发病14 d复查影像检查,发病3个月随访时行改良的Rankin量表(mRS)评分,将mRS评分0~2分为预后良好。使用T1DCE-MRI Extend模型计算BBB通透性指标容积转运常数(Ktrans)值,并计算脑梗死侧与脑梗死对侧Ktrans值的比值(Ki/c)。比较所有患者脑梗死侧与脑梗死对侧、发病14 d复查与基线时、3组Ktrans值和Ki/c值差异,用多因素线性回归分析lg(Ki/c)值的相关影响因素。结果所有患者脑梗死侧Ktrans值较脑梗死对侧明显增高[0.0047(0.0019,0.0087)/min vs 0.0011(0.0003,0.0016)/min,P=0.000];发病14 d复查Ki/c值较基线时明显增高[70.77(13.43,399.43)vs 5.31(3.58,12.64),P=0.012]。常规药物组lg(Ki/c)值为0.42±0.49,静脉溶栓组lg(Ki/c)值为0.77±0.32,取栓组lg(Ki/c)值为0.85±0.41,静脉溶栓组和取栓组lg(Ki/c)值较常规药物组明显升高(P=0.021,P=0.005),静脉溶栓组与取栓组lg(Ki/c)值比较,差异无统计学意义(P=0.534)。常规药物组、静脉溶栓组和取栓组发病3个月预后良好比例比较,差异无统计学意义(66.7%vs 52.6%vs 52.6%,P=0.695)。多因素线性回归分析显示,lg(Ki/c)值与治疗方案(P=0.017)和脑梗死病史(P=0.030)有关。结论急性缺血性脑卒中患者BBB通透性与不同治疗方法、既往脑梗死病史有关,并且发病14 d BBB通透性较72 h内明显增高。     

内镜黏膜下剥离术与外科手术治疗表浅食管癌的对比研究

目的：探究内镜黏膜下剥离术（endoscopic submucosal dissection,ESD）与传统外科手术治疗表浅食管癌的疗效并比较其有效性及安全性,为表浅食管癌的治疗提供借鉴和指导。方法：回顾性分析2013月1月—2018年12月于南京医科大学第一附属医院就诊的表浅食管癌患者共920例,其中ESD组和外科手术组各460例,收集、分析其临床资料并密切随访。结果：ESD组平均手术时间［（74.05±1.84）min］、住院天数［（8.13±0.20）d］和术后并发症总发生率（9.6%）均明显低于外科手术组［（240.90±6.88）min、（18.96±0.42）d、29.6%］,差异均有统计学意义（P＜0.05）。两组均有较高的完全及治愈性切除率,组间差异无统计学意义（P＞0.05）。ESD组中满足ESD手术绝对或相对适应证的患者较外科手术组具有更低的术后并发症发生率（P＜0.05）,其中符合绝对适应证的ESD组患者术后并发症发生率更低。多因素分析结果表明,淋巴结转移及非治愈性切除是诱发表浅食管癌患者死亡的独立危险因素（P＜0.05）。结论：ESD治疗表浅食管癌的临床效果与传统外科手术相当,术后并发症更少,生存率更高,可以作为满足ESD适应证的表浅食管癌的首选治疗方法。     

比较基因组杂交技术分析结直肠癌远处转移的遗传变异

目的 应用微阵列比较基因组杂交技术分析结直肠癌远处转移的遗传变异。方法 收集47例结直肠癌患者（发生/未发生远处转移=18/29）的临床数据以及新鲜组织标本,进行微阵列比较基因组杂交分析,筛选出与远处转移相关的基因组改变。进行功能富集分析和蛋白质-蛋白质相互作用（protein-protein interaction, PPI）网络分析,探索结直肠癌远处转移的分子机制。结果 47例肠癌标本都存在广泛的遗传变异。研究发现,218个DNA拷贝数改变与结直肠癌的远处转移相关,且它们主要位于17q、22q、12p。功能富集分析显示这些基因组改变与免疫反应、Wnt信号通路、同源染色体重组、趋化因子信号通路和MAPK信号通路等密切相关。通过PPI网络分析获得了39个关键基因,包括TP53、EP300、MDM2、BRCA1、MAPK1等。结论 与结直肠癌远处转移相关的遗传变异主要位于17q、22q、12p,其基因组改变与免疫反应、Wnt信号通路、MAPK信号通路等密切有关。