替罗非班治疗支架辅助弹簧圈栓塞动脉瘤术中急性血栓形成

目的探讨动脉内灌注盐酸替罗非班在处理支架辅助弹簧圈栓塞颅内动脉瘤时术中急性血栓的有效性及安全性。方法收集2013年1月至2017年6月11例行颅内动脉瘤栓塞术中发生血栓患者,发生血栓后,均于微导管内靶向灌注盐酸替罗非班6ml,同时静脉泵注5ml/h,然后每5~10分钟造影观察血管溶通情况,直至血栓消失或血管开通。术后进行CT或MRI随访,观察有无脑梗塞或脑出血。结果 11例术中造影血管均完全再通,术后第1天、第7天及术后1月行头颅CT或MRI检查,均未发现与手术相关脑梗塞和脑出血的发生。结论支架辅助弹簧圈栓塞颅内动脉瘤时,术中出现急性血栓并发症时,经动脉靶向灌注盐酸替罗非班是一种安全、有效的方法。     

Evaluation of three methods for measurement of hemoglobin and calculated hemoglobin parameters with the Sysmex KX-21 and ADVIA 120 in Beagle dogs and Sprague Dawley (SD) rats

The Sysmex KX-21 uses a novel cyanide-free colorimetric method to detect hemoglobin (HGB) concentration. This measurement has not been compared with the cyanmethemoglobin method on the ADVIA 120 which is recommended as the reference method by the International Committee for Standardization in Hematology. Additionally, ADVIA 120 uses flow cytometric method to detect cellular HGB concentration. The aim of this study was to compare the three methods of HGB analysis on the two analyzers. Fresh K₃EDTA blood samples from 32 dogs and 27 rats were included. A complete blood count (CBC) was performed on each sample using the Sysmex KX-21 and ADVIA 120. Colorimetric and cellular HGB concentrations and all calculated variables based on HGB measurement were compared using linear regression, Passing–Bablok regression, and Bland–Altman plots, using the cyanmethemoglobin method as the reference method. In samples from both species, an excellent correlation was found between the HGB results measured with the cyanide-free method and the cyanide-based method (r?=?0.97); however, a slight mean proportional bias of 3.8 % (dogs) and 1.9 % (rats) was observed. The correlation of flow cytometric cellular HGB concentration and extracellular total HGB concentration on the ADVIA 120 was excellent (r?=?0.97), and no significant bias was observed. Additionally, excellent to fair agreement was evident for all calculated erythrocyte and HGB variables. Thus, the cyanide-free HGB method and flow cytometric method could be used with blood samples from dogs and rats; however, the proportional bias should be considered.     

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??OBJECTIVE To establish an interferon-resistant hepatitis B virus cell model and provide experimental basis for further investigating the mechanism of HBV resistance to interferon. METHODS HepG2.2.15 was continuously grown in the presence of 10,30,50 and 70 u??mL^-1 of interferon ??-2b for up to 48 weeks. The HepG2.2.15/IFN??-2b cell model was constructed after 48 weeks of induction. The cells were treated with the best-effect concentration. Then, the levels of HBsAg, HBeAg, and HBV DNA in the supernatant of cell culture medium before and after the treatment were compared. RESULTS After stimulation with low concentrations of IFN??-2b for 12 weeks, the 50 u??mL^-1 group showed significant resistance to the best-effect concentration of IFN??-2b. Compared with the levels before stimulation, the inhibition rate on HBsAg, HBeAg, and HBV DNA decreased by 25.48%, 8.40%, and 15.43%, respectively, suggesting that 50 u??mL^-1 was the best-stimulation concentration. After stimulated with 50 u??mL^-1 IFN??-2b for 12-48 weeks, the results showed that the inhibition rate on HBsAg, HBeAg, and HBV DNA after 36 weeks was the most significant. CONCLUSION Continuous induction with 50 u??mL^-1 IFN??-2b for 36 weeks could most easily induce drug resistance in HepG2.2.15 cells.     

加强设备配置管理,遏制“以械养医”

本文针对"就医贵"中可能出现的"以械养医"现象进行了分析和探讨,并结合国内外的有效管理经验提出了建议。     

福州口岸及出入境船舶鼠形动物及携带病原的研究

目的掌握福州口岸鼠形动物的种群分布及季节消长变化，以及入出境船舶截获鼠形动物携带病原微生物的差别，对相关疾病的流行风险进行评估。方法在2011年1月到2012年12月之间，实施13岸鼠形动物调查及船舶鼠形动物笼日法监测，并对截获的鼠形动物携带鼠疫菌采用国标法检测抗原、抗体，用RT—PCR方法检测肾综合征出血热病毒（HFRS）RNA，用PCR方法检测钩端螺旋体DNA。结果口岸共捕获鼠形动物373只，年平均密度0．0326只／笼·d，经鉴定隶属2目2科3属5种，褐家鼠为优势种群。7—11月份鼠密度较高，其中9月份达到高峰，12月份最低，鼠形动物活动为单峰型。鼠疫菌抗原、抗体均为阴性，肾综合征出血热RNA阳性55份，阳性率15．90％，钩端螺旋体DNA阳性14份，阳性率3．70％。结论福州口岸鼠体肾综合征出血热、钩端螺旋体阳性率高，有传播相关传染病的风险，有必要对口岸采取灭鼠措施，并对鼠间、人间相应传染病感染情况实施监测。     

混合方法研究评价工具的介绍——MMAT

混合方法研究（MMR）作为第三种研究范式，是指将定量和定性研究混合或结合到一个单一的研究中。近年来，MMR在医疗领域的应用已成为一种趋势。与单独使用定性或定量研究相比，MMR可以用来说明某一特定现象的不同方面或从不同的角度阐明问题，获得各种不同类型的信息。而MMR系统综述（MMSR）也被研究者青睐，因为通过MMSR可以综合与特定主题相关的大量信息，并产生指导决策的证据。严格评价工具使MMSR研究人员能够评估所纳入原始研究的可信度和相关性。混合方法评价工具（MMAT）为MMSR严格评价阶段的一种工具，可以对定性研究、随机对照试验、非随机研究、定量描述研究和MMR 5类研究的方法学质量进行评价。针对每个纳入的研究，在回答两个筛选问题后，选择适当的研究类别进行评估，然后依照所选类别的标准进行评分。本文全面介绍新版MMAT，以进一步规范和完善MMR和MMSR在我国的应用。     

The influence of AKT isoforms on radiation sensitivity and DNA repair in colon cancer cell lines

In response to ionizing radiation, several signaling cascades in the cell are activated to repair the DNA breaks, prevent apoptosis, and keep the cells proliferating. AKT is important for survival and proliferation and may also be an activating factor for DNA-PKcs and MRE11, which are essential proteins in the DNA repair process. AKT (PKB) is hyperactivated in several cancers and is associated with resistance to radiotherapy and chemotherapy. There are three AKT isoforms (AKT1, AKT2, and AKT3) with different expression patterns and functions in several cancer tumors. The role of AKT isoforms has been investigated in relation to radiation response and their effects on DNA repair proteins (DNA-PKcs and MRE11) in colon cancer cell lines. The knockout of AKT1 and/or AKT2 affected the radiation sensitivity, and a deficiency of both isoforms impaired the rejoining of radiation-induced DNA double strand breaks. Importantly, the active/phosphorylated forms of AKT and DNA-PKcs associate and exposure to ionizing radiation causes an increase in this interaction. Moreover, an increased expression of both DNA-PKcs and MRE11 was observed when AKT expression was ablated, yet only DNA-PKcs expression influenced AKT phosphorylation. Taken together, these results demonstrate a role for both AKT1 and AKT2 in radiotherapy response in colon cancer cells involving DNA repair capacity through the nonhomologous end joining pathway, thus suggesting that AKT in combination with DNA-PKcs inhibition may be used for radiotherapy sensitizing strategies in colon cancer.     

分泌性中耳炎病人中耳积液及血清相关炎性递质检测

目的探讨分泌性中耳炎病人中耳积液及血清中白细胞介素-1β(IL-1β)、白细胞介素-5(IL-5)、白细胞介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)的变化情况。方法选取分泌性中耳炎病人80例为观察组,同期健康查体人员80例为对照组,检测两组中耳积液及血清炎性递质IL-1β、IL-5、IL-8及TNF-α水平并进行比较。结果观察组血清炎性递质IL-1β、IL-5、IL-8及TNF-α水平均高于对照组,差异有显著性(t=2.97~3.83,P<0.05)。观察组中不同分类及积液性质病人的血清及中耳积液IL-1β、IL-5、IL-8及TNF-α水平比较,差异均有显著性(F=3.97~10.06,t=2.73~3.93,P<0.05)。结论对分泌性中耳炎病人中耳积液及血清IL-1β、IL-5、IL-8及TNF-α水平进行检测有重要价值。