抗癫痫药基因多态性研究进展

临床医学上一致认为药物的基因多态性对于抗癫痫药的个体差异有着重要的意义,基因多态性导致个体出现不同的药理和毒理作用。遗传药理学是一门遗传学学科,随着人们对遗传药理学的深入研究,个体化用药有了新的局面。本文首先分析了抗癫痫药的种类及其疗效,然后详细介绍了当前基因多态性对抗癫痫药疗效研究进展。     

肝转移出现的时段对非小细胞肺癌预后的影响

目的：探讨肝脏转移出现的时段对非小细胞肺癌患者生存的影响。方法：选择1999-01/2006-09在我院死亡的非小细胞肺癌238例,回顾分析肝转移出现时间对预后的影响。结果：肺癌患者初诊时出现肝转移20例,中位生存期7（5,9）个月;初次诊断无肝转移253例,中位生存期13（12,14）个月,差异显著（P=0.008 5）。而总患病期间出现肝转移以及首发肝转移对预后影响不显著。结论：初诊时出现肝脏转移是非小细胞肺癌患者显著影响预后的因素。     

缺氧诱导因子1和Survivin蛋白在食管鳞癌中的表达及其意义

目的：探讨缺氧诱导因子1（HIF-1α）和Survivin蛋白表达与食管癌浸润及转移预后生物学行为的关系。方法：应用免疫组化SP法检测37例食管癌中HIF-1α和Survivin蛋白的表达。结果：从正常上皮组织、轻度不典型增生组织、重度不典型增生组织到原位癌、浸润癌，HIF-1α和Survivin蛋白表达的阳性率呈逐渐增高趋势，差异均有显著性（P〈0．05）。结论：HIF-1α与Survivin蛋白可作为判断食管癌生物学行为的客观指标，对判断食管癌的预后具有重要意义。     

The Suitability of Maltose for Parenteral Nutrion

Maltose infusion were performed in rats and normal human subjects. Utilisation of maltose in a rat is fairly good. Blood glucose and lactic acid concentrations are elevated during the high dose of maltose in the rat and renal loss is limited to less than 5 % of the total amount infused. In the human subject no steady state is reached during the 4 hour continuous infusion and the renal loss of maltose and glucose was 31 % of the intravenous load. In contrast to the rat the blood glucose concentration in man did not increase. The metabolic utilisation of maltose in man was however demonstrated by a decrease in inorganic phosphate and serum free fatty acid concentration. It is concluded that maltose is not suited as a fuel for parenteral nutrition because of its low metabolic rate in the human being.     

增龄性变化对大鼠骨质量、血清骨代谢指标影响研究

[目的]探讨增龄性变化对大鼠骨质量、血清骨代谢指标的影响。[方法]14只新生雄性Sprague Dawley（SD）大鼠，同等条件下饲养，饲养至6个月按体重随机分为老龄骨质疏松组（AO组）和青年对照组（YC组），将YC组安乐处死，AO组继续饲养至22个月，两组大鼠均取左侧股骨，测量骨密度、骨组织形态计量学指标，以及骨矿水平及骨代谢指标。[结果]腰椎及股骨密度（BMD）在老龄大鼠均下降，其中股骨密度下降尤其显著（P〈0.01）。与YC组比较，AO组大鼠骨钙素水平显著降低（P〈0.01），抗酒石酸酸性磷酸酶（TRACP）水平显著升高（P〈0.05）；骨生物力学测定发现，AO组大鼠的股骨最大受力负荷下降。骨形态计量学测定发现，AO组大鼠骨小梁体积、骨小梁宽度、骨皮质厚度显著下降（P〈0.05或P〈0.01），骨小梁间隙增大（P〈0.01），AO组大鼠骨小梁普遍变薄、变细甚至断裂穿孔。[结论]22月龄雄性大鼠发生了骨质疏松的变化，骨形成降低，骨矿含量下降，骨微观组织结构破坏。     

Blood pressure targeting by partial REBOA is possible in severe hemorrhagic shock in pigs and produces less circulatory,metabolic and inflammatory sequelae than total REBOA

BackgroundResuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective adjunct in exsanguinating torso hemorrhage, but causes ischemic injury to distal organs. The aim was to investigate whether blood pressure targeting by partial REBOA (pREBOA) is possible in porcine severe hemorrhagic shock and to compare pREBOA and total REBOA (tREBOA) regarding hemodynamic, metabolic and inflammatory effects.MethodsEighteen anesthetized pigs were exposed to induced controlled hemorrhage to a systolic blood pressure (SBP) of 50 mmHg and randomized into three groups of thoracic REBOA: 30 min of pREBOA (target SBP 80–100 mmHg), tREBOA, and control. They were then resuscitated by autologous transfusion and monitored for 3 h. Hemodynamics, blood gases, mesenteric blood flow, intraperitoneal metabolites, organ damage markers, histopathology from the small bowel, and inflammatory markers were analyzed.ResultsSevere hemorrhagic shock was induced in all groups. In pREBOA the targeted blood pressure was reached. The mesenteric blood flow was sustained in pREBOA, while it was completely obstructed in tREBOA. Arterial pH was lower, and lactate and troponin levels were significantly higher in tREBOA than in pREBOA and controls during the reperfusion period. Intraperitoneal metabolites, the cytokine response and histological analyses from the small bowel were most affected in the tREBOA compared to the pREBOA and control groups.ConclusionPartial REBOA allows blood pressure titration while maintaining perfusion to distal organs, and reduces the ischemic burden in a state of severe hemorrhagic shock. Partial REBOA may lower the risks of post-resuscitation metabolic and inflammatory impacts, and organ dysfunction.