北京市三级甲等医院结直肠癌患者就医流向规律分析

目的 分析不同特征的结直肠癌患者就医行为选择在中医院（含中西医结合医院）、西医院及肿瘤专科医院间的差异，为合理引导结直肠癌患者适宜就医及制订相关政策提供依据。方法 收集北京地区2018年1月-2019年12月17家三级甲等医院21894例首诊结直肠癌成年住院患者的病案首页数据，采用EmpowerStats 2.0对数据进行描述性分析。结果 21894例结直肠癌患者中就诊于中医院的有862例（3.93%），西医院的有8723例（39.85%），肿瘤专科医院的有12309例（56.22%）。对于不同医疗机构，男性占比均大于女性，58-68岁患者占比最大。且结直肠癌患者年龄、医疗付款方式及肿瘤分期在不同医疗机构间的分布存在差异（P<0.001）。西医院及肿瘤专科医院结直肠癌Ⅲ期患者占比最大，而就诊于中医院患者中结直肠癌Ⅳ期最多。从地域分布来看，异地就诊比例（57.32%）大于本地，且就诊于肿瘤专科医院的患者中73.66%来自外地。患者来源前三名分别是北京市、河北省及内蒙古自治区。而在北京市内，西医院患者主要来源于朝阳区、海淀区及西城区，中医院患者主要来源于海淀区、朝阳区及丰台区，肿瘤专科医院则主要来源于朝阳区、海淀区及丰台区。结论 应大力倡导年轻以及早期结直肠癌患者向中医院分流，充分施展中医药在结直肠癌患者中的治疗优势；发挥三级医院带动作用，建立对口帮扶医院，减少不必要的跨省流动及提倡结直肠癌的早筛早治，以降低结直肠癌死亡率。     

Porocarcinoma coexisting at a site of Bowen disease in a 63‐year‐old woman

Porocarcinoma is an unusual, locally aggressive and potentially fatal neoplasm. Several cutaneous malignancies have been described in association with porocarcinoma, including squamous cell carcinoma, basal cell carcinoma and tricholemmal carcinoma. Previous reports have indicated that the occurrence of malignant tumours in combination with porocarcinoma is extremely rare, in particular with regard to Bowen disease (BD). We report an uncommon case of porocarcinoma occurring synchronously in a single BD lesion in a 63‐year‐old woman with multiple BD lesions. The clinical and histological findings confirmed this diagnosis.     

染料木黄酮对前列腺癌细胞增殖、迁移和侵袭的影响及机制

本研究拟探讨染料木黄酮对前列腺癌细胞LNCaP和CWR22RV1的增殖、迁移和侵袭能力的影响。一、材料与方法1.材料:前列腺癌细胞株LNCaP和CWR22RV1(中国科学院上海生命科学研究院);Genistein(天津科瑞泰科技有限公司);RPMI 1640、胎牛血清(FBS)、胰蛋白酶(美国Gibco公司);E-钙黏蛋白(E-cadherin)、N-钙黏蛋白(N-cadherin)、波形蛋白(Vimentin,Abcam公司);聚氰基丙烯酸正丁酯(BCA)试剂盒、十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)上样缓冲液(×5)及蛋白质印迹法(Western blot)试剂盒(上海市碧云天生物公司);2.实验方法:采用噻唑蓝(MTT)实验、划痕实验和Transwell实验检测Genistein对细胞增殖、迁移及侵袭能力的影响。采用Western blot检测E-cadherin、N-cadherin、Vimentin、CD44和Oct-4的表达水平。     

The quality of spontaneous adverse drug reaction reports from the pharmacovigilance centre in western China

Background: High-quality adverse drug reaction (ADR) reports are essential for conducting drug safety monitoring in pharmacovigilance. The study aim was to assess the current quality of ADR reports in western China, and to identify problems with ADR report quality.

Research design and methods: A sample of 1139 reports received by the Shaanxi ADR Monitoring Center from January 2015 to December 2017 was selected. ADR report quality was evaluated using an ADR report quality evaluation system.

Results: None of the reports were rated as excellent and 1.40% (n = 16) as good. Report quality was better for new and serious reports than for general reports. Medical institutions generated higher quality reports than pharmaceutical manufacturers. Nurses generated higher quality reports than doctors, pharmacists, and other professionals. Reporters of different occupations showed significant differences in the quality of the indicators Reporting time limit, Intervention ADR time, ADR termination time, ADR intervention measures, Original disease, and Cause of medication (P = 0.000).

Conclusions: The ADR data quality was poor in western China, and of lower quality than reported data from previous research in other regions. Improvements in the quality and availability of ADR reports are urgently needed.     

现代中医药产业化发展探讨(四)——中医医疗部分

现代中医药产业化发展在经历过一个漫长的过程之后,取得了可喜的成就。回顾了中医药在改革开放以后所取得的成就;对我国中医药目前的现状进行了分析,并根据国家提出的中医药事业“十五”计划的目标和内容进行了进一步的阐述和展望。     

胰岛素样生长因子-Ⅰ在非酒精性脂肪肝病变中的变化

目的研究血清胰岛素样生长因子Ⅰ(IGFⅠ)与非酒精性脂肪肝的关系。方法采用夹心酶联免疫分析的方法测定60例非酒精性脂肪肝患者和40名健康对照血清IGFⅠ水平,并比较两组IGF1、血脂[胆固醇(Chol)、三酰甘油(TG)]、空腹血糖(Glu)、丙氨酸转氨酶(ALT)的测定结果。结果脂肪肝组的血清IGF1水平为(162.0±46.6)ng/ml,健康组血清IGF1水平为(189.0±37.4)ng/ml,结果差异具有显著性(P<0.01)。两组的TG、Glu差异也有显著性(P<0.05),其他指标差异无显著性。结论非酒精性脂肪肝患者的IGF1水平下降与脂肪肝的形成有关,同时可能加重凋亡对已发生脂肪变性的肝细胞的损伤。     

Activity-dependent Decay of Early LTP Revealed by Dual EPSP Recording in Hippocampal Slices from Young Rats

The early maintenance of long-term potentiation (LTP) was studied in the CA1 region of hippocampal slices from 12- to 18-day-old rats in a low-magnesium solution (0.1 mM). The α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) and N-methyl-D-aspartate (NMDA) receptor-mediated components of the field excitatory postsynaptic potential were estimated in parallel using early and late measurements of the composite potential. At the normal test stimulus frequency of 0.1 Hz, LTP was seen initially as a predominant increase in the AMPA component, but converted, via a substantial decay of this component and a gradual growth of the NMDA component, into nearly equal changes of the two components. Interrupting the test stimulation for 10 min, changing the test stimulus frequency to 1/60 Hz after LTP induction, or using a test stimulus frequency of 1/60 Hz during the entire experiment significantly reduced the decay of the potentiation of the AMPA component while enhancing the potentiation of the NMDA one. The ratio between the magnitudes of the two excitatory postsynaptic potential (EPSP) components showed a decaying time course that was independent of the manipulations used. Application of the NMDA antagonist D(-)-2-amino-5-phosphonopentanoic acid (50μM) after LTP induction stabilized the LTP of the AMPA component until washout was started. On the other hand, the phosphatase inhibitor okadaic acid (1 μM) resulted in decay of the potentiation of both EPSP components back to around baseline and altered the time course of the ratio between the components. Our results show that the early maintenance of LTP is controlled in an activity-dependent and NMDA-dependent manner. This process accelerates the decay of LTP of both AMPA and NMDA components in parallel, suggesting that it is similar to homosynaptic long-term depression, although it operates at the normal test stimulus frequency. The data support a scenario in which LTP ensues as a selective AMPA receptor modification and subsequently converts to another modification, possibly a presynaptic one.     

中国汉译西医学著作在日本的流传和影响

调查了十九世纪汉译西洋医学著作在日本的出版和流传情况，有９种汉译西洋医学著作曾在日本出版，其中６种曾多次再版，７种有和训或和译本，这些著作曾在日本医生中广泛流传，促进了西洋医学在日本的传播和普及，对日本医学从传统医学向现代医学的转变起过一定的作用。本文还分析了汉译西洋医学著作能够在日本广泛流传的原因