建设具有中国特色的网络化创烧伤救治体系以提高救治成功率的理论与实践

严重创烧伤由于其突发性、群体性、惨烈性和对公众的巨大冲击,一直是国家防控的重点。本文就建立我国网络化的创烧伤救治体系的重要性和必要性进行了系统论述,特别就这一网络化救治体系建设的规划和重点进行了讨论。在此基础上就存在的问题和今后的发展方向进行了展望。     

Anti-ageing gene therapy: Not so far away?

Improving healthspan is the main objective of anti-ageing research. Currently, innovative gene therapy-based approaches seem to be among the most promising for preventing and treating chronic polygenic pathologies, including age-related ones. The gene-based therapy allows to modulate the genome architecture using both direct (e.g., by gene editing) and indirect (e.g., by viral or non-viral vectors) approaches. Nevertheless, considering the extraordinary complexity of processes involved in ageing and ageing-related diseases, the effectiveness of these therapeutic options is often unsatisfactory and limited by their side-effects. Thus, clinical implementation of such applications is certainly a long-time process that will require many translation phases for addressing challenges. However, after overcoming these issues, their implementation in clinical practice may obviously provide new possibilities in anti-ageing medicine. Here, we review and discuss recent advances in this rapidly developing research field.     

IP-10 contributes to the inhibition of mycobacterial growth in an ex vivo whole blood assay

Interferon-γ inducible protein 10 (IP-10), is a potent chemoattractant that promotes migration of monocytes and activated T-cells to inflammation foci. IP-10 is elevated in serum of patients with chronic hepatitis C virus (HCV) and tuberculosis (TB) infections, although it remains to be determined the contribution of IP-10 in restricting Mycobacterium tuberculosis (Mtb) replication. Here, we investigated the impact of IP-10 on mycobacteria replication using the ex vivo model of human whole-blood (WB) assay. In particular, we compared the levels of IP-10 upon infection with different Mtb clinical strains and species of non-tuberculous mycobacteria (NTM) and evaluated how IP-10 may contain bacterial replication. Interestingly, we observed that the inhibition of the host enzyme dipeptidyl peptidase IV (DPP-IV), which inactivates IP-10 through cleavage of two amino acids at the chemokine N-terminus, restricted mycobacterial persistence in WB, supporting the critical role of full length IP-10 in mediating an anti-Mtb response. Addition of recombinant IP-10 expressed in eukaryotic cells enhanced the anti-mycobacterial activity in WB, although no differences were observed when IP-10 containing different proportions of cleaved and non-cleaved forms of the chemokine were added. Moreover, recombinant IP-10 did not exert a direct anti-mycobacterial effect. Our results underscore the clinical relevance of IP-10 in mycobacteria pathogenesis and support the potential outcomes that may derive by targeting the IP-10/CXCR3 pathway as host directed therapies for the treatment of Mtb or NTM infections.     

初始耐药肺结核调查分析

目的掌握信宜市肺结核病人初始耐药疫情,分析耐药的原因,制定预防对策。方法以胸片、痰涂片诊断为肺结核的初治患者为对象,进行结核菌培养,阳性者做链霉素（S）、异烟肼（I）、利福平（R）、乙胺丁醇（E）四种药敏试验。结果共检测188例,初始耐药62例,占32．98％。其中耐1种药物51例,占耐药总数的82．26％;耐2种以上药物11例,占耐药总数的17．74％。41—50岁为耐药最高峰,四种耐药次序为I〉R〉S〉E。结论信宜市耐药肺结核疫情相当严峻,应进一步分析耐药原因,探讨预防对策。     

低温常压等离子技术在肿瘤学中的应用

等离子医学是研究等离子技术在医学领域应用的一门新兴科学。简述低温常压等离子技术,着重介绍其在肿瘤学中的应用。在肿瘤学领域中,等离子技术通过直接处理肿瘤细胞,产生大量活性物质引起肿瘤细胞的凋亡、坏死和自噬,从而发挥对肿瘤组织的直接致死性作用;等离子技术也可通过活化液体,使活化液体具备细胞毒性作用,从而发挥对肿瘤组织的间接致死性作用;同时等离子技术也具有诸多对肿瘤组织的非致死性作用;此外等离子技术也可参与构建化疗药物的缓释系统,协助药物跨生物膜转运,与传统化疗药物产生协同抗肿瘤的作用等,在肿瘤药物学领域发挥重要作用。     

中医药治疗干眼症研究进展

近年来人们对干眼症的关注与日俱增,中医药发挥其传统优势,运用内治,外治,针灸等方法,达到机体脏腑功能平衡,气血津液充足,化生泪液有源,泪液不乏。但是,目前中医学对于干眼症的研究还存在一些问题。第一,干眼的疗效评价标准参照西医学标准,中医方面尚无统一标准。第二,干眼症的中医辨证分型也无统一标准,数据可信度难以保证。第三,临床的研究设计多为小样本,科研设计不够严谨,缺乏相关的动物实验研究。干眼症是多种原因诱发的疾病,已经逐步引起人们的重视,但就其发病的病因及机制应更进一步的深入研究。治疗上应在中医整体观念的指导下,运用辨证施治同时结合现代医学理论。应统一干眼症的辨证分型及疗效评价标准,增加临床观察指标的客观性及可信度,同时临床学者及科研工作者应尝试采取大样本,多中心的随机对照实验,让研究结果更有说服力,也应该尝试更多的动物实验研究,运用先进的科学技术及方法研究本病的病理生理状况,预防等,将其结果转化为临床可用的知识,为干眼症的诊疗开辟新的篇章。     

建构主义理念下的《医古文》趣味互动教学设计

《医古文》课程的传统教学模式存在较大问题,难以达到良好的教学效果。为了改进教学方法,提升教学质量,现以建构主义和形成性教学评价为理论基础,举例采用两种趣味互动教学方式,培养学生对传统文化的兴趣,夯实学生的基础知识,提高学生的古文应用能力。证明趣味互动教学法符合当今学生的认知规律,具有独到的优势,并值得推广。