巨噬细胞自噬在动脉粥样硬化发病中作用的研究进展

<正>自噬是真核细胞利用溶酶体降解细胞内受损的细胞器及蛋白等大分子物质的过程,在营养缺乏、组织缺氧、氧化应激、DNA损伤等环境压力下被激活。机体可通过自噬回收利用内源性细胞成分(氨基酸、游离脂肪酸、核苷酸)以维持细胞稳态~([1])。动脉粥样硬化(AS)是以脂质积累、炎症细胞浸润为特征的慢性炎症过程。巨噬细胞能够摄取脂蛋白,使脂质积聚,形成泡沫细胞,并释放多种酶和炎性介质,影响AS斑块进展。斑块中巨噬细胞凋亡以及胞葬作用缺陷,也会促进斑块坏死,从而导致斑块的不稳     

肺鳞癌治疗新靶点FGFR的研究进展

肺癌是目前全球发病率和死亡率均居前列的恶性肿瘤，其中肺鳞癌经手术、放化疗等综合治疗后，其疗效仍不满意。随着分子靶向治疗在肺腺癌中取得了令人瞩目的成果，而肺鳞癌患者中EGFR基因突变及ALK融合基因少见，急需探索新的靶点指导肺鳞癌患者的临床治疗。研究表明，FGFR家族（FGFR1-4）是肺鳞癌中突变频率较高的基因，FGFR基因的激活突变和扩增与肺鳞癌的发生和发展密切相关，同时许多小分子 FGFR 抑制剂在临床应用中已经取得较好的治疗效果。目前，许多FGFR抑制剂治疗肺鳞癌的临床试验也正在进行研究，针对FGFR靶点的基因治疗可为肺鳞癌的治疗提供一种新的策略。本文就FGFR在肺鳞癌的靶向治疗中的最新研究进展进行综述。     

烛灯霓裳

闲暇时，想感受另一种浪漫，让自己与心爱的房间更加融合。这时候，最佳的方法莫过于在烛光中闭目休憩。何不用你灵巧的双手，为家中的烛灯制作一件美丽的衣裳？让温馨的烛火与你的优雅同存。[编者按]     

产后产妇300例心理状态调查及应对措施

根据现代医学模式，健康的标准是躯体健康，心理健康和社会适应良好。妇女在妊娠期、分娩期和产褥期承受着躯体和精神上的巨大压力；产后由于身体的变化、社会角色的改变，对产妇的认知、情感、行为具有明显影响。焦虑是人们对环境中一些即将面临的，可能会造成危险和威胁的重大事件，或者要做出重大努力的情况中进行适应时，心理上出现紧张和一种不愉快的期待。探讨产后产妇的心理状态变化及其原因，采取有效的应对措施，以保证产妇的健康及至婴幼儿的健康成长。     

Pediatric intracranial aneurysms——clinical characteristics and therapeutic strategies

Objective To assess the radiological characteristics and therapeutic strategies of intracranial aneurysms in children. Methods From our dedicated neurovascular databank of patients, we reviewed 23 consecutive children who had 24 intracranial aneurysms. There were 14 boys and 9 girls with a mean age of 9.09 years ( range 1 - 14 years ). Results Intracranial aneurysms in children ≤ 14 years constituted 1.3% of all intracranial aneurysms. Internal Carotid artery (ICA) and middle cerebral artery (MCA) were the most frequent sites for aneurysms. About 58.3% of the aneurysms were complex, including dissecting, pseudoaneurysm, giant and fusiform aneurysm. 1/3 of all aneurysms were located in posterior circulation. Only 1 case had multiple aneurysms in this case series. Almost half of all cases presented with subarachnoid hemorrhage and others presented with mass effect. 14 cases underwent endovascular treatment. 4 patients received microsurgical therapy. 5 cases did not receive microsurgical or endovascular therapy, 2 of them whose aneurysms spontaneously thrombosed during follow up. One boy with left vertebral artery giant aneurysm died after endovascular therapy owing to gradual thrombosis in basilar artery. Another child had poor outcome because of rerupture of aneurysm before operation. Whereas the majority had a favorable outcome. Conclusions Intracranial aneurysms in children had many clinical and radiological characteristics different from those in adults : ( 1 ) remarkable male predominance; ( 2 ) ICA and MCA were the most common sites for aneurysms; (3) high incidence of large, traumatic, infectious, dissecting and fusiform aneurysms. (4)For pediatric intracranial aneurysms, both microsurgical approaches and endovascular treatment were effective. Endovaacular therapy was the best choice for complex aneurysms.     

血管性痴呆的危险因素

血管性痴呆(vascular dementia,VD)是老年期痴呆的另一个主要类型,国内外研究结果显示,VD的发病率和患病率均随着年龄的增长而显著增高[1,2],VD占欧美老年期痴呆的15%～20%。亚洲国家如中国和日本VD的发生率较高,     

手榴弹片伤5例治疗分析

目的 探讨手榴弹片伤后的救治方法和效果。方法 分析5例手榴弹片炸伤患者的临床资料及治疗情况。结果 5例患者均康复出院，住院时间3～5周，无任何后遗症。结论 手榴弹片炸伤应遵循早期处理原则，根据异物大小所处部位决定是否取出，经上述处理，患者预后良好。     

诺和锐胰岛素治疗儿童1型糖尿病的临床观察

目的:观察诺和锐胰岛素治疗儿童1型糖尿病的疗效。方法:对10例应用诺和灵短效胰岛素联合诺和灵中效胰岛素治疗的1型糖尿病患儿以超短效胰岛素诺和锐等量替代短效胰岛素联合诺和灵中效胰岛素治疗1个月,观察HbA1c等代谢指标变化。结果:用诺和锐治疗后患儿餐后2 h血糖、HbA1c显著下降,P<0．01,平均下降值分别为3．51±1．10 mmol／L与0．64％±0．19％。胰岛素用量与血脂无明显变化,P>0．05。治疗期间未发现明显低血糖。结论:超短效胰岛素诺和锐替代短效胰岛素可进一步控制餐后血糖．并显著降低HbA1c,有利于血糖控制。