借鉴美国的先进经验发展中国的卫生保健体系

〔目的〕学习和借鉴美国旅行卫生保健体系的经验,促进我国旅行卫生保健事业的发展。〔方法〕通过在华盛顿大学卫生保健中主的学习,对美国旅行卫生保健体系的结构、职能和特点进行研究,并对中国旅行卫生保健事业的进一步发展提出建议。〔结果〕在美国,旅行卫生保健属于初级卫生保健的范畴。其在设置机构时,需按照国家规定的标准经过严格的资质认证。卫生保健机构的职能主要包括:预防保健、免疫接种、安全行为保健、普通疾病的诊断、伤害的评估与治疗、旅行者旅行前的健康评估和拟定接种计划、旅途中的健康提示等;在医务人员配备上,重视业务素质和继续教育;人性化的环境布置和服务是美国卫生保健机构的突出特点;工作流程井然有序,有始有终。〔结论〕中国旅行卫生保健工作在制度管理、学术研究、队伍素质、信息化建设、服务理念方面存在着很大的差距,应尽快改进。     

N-取代苄基氟哌啶醇氯化物的合成及扩血管活性

目的:合成N-取代苄基氟哌啶醇氯化物及其还原物并研究它们的扩血管活性.方法:氟哌啶醇、氢化氟哌啶醇在回流的情况下分别与取代氯苄反应依次得到N-苄基氟哌啶醇氯化物和N-苄基氢化氟哌啶醇氯化物;并测定其对KCl诱导的大鼠胸主动脉条收缩抑制作用.结果:合成了11个新化合物(ⅠF 8 ～F 13 ,ⅡFB 8 ～FB 11 ,FB 13 ).离体扩血管活性实验表明,多数目标化合物表现为不同程度地阻滞KCl所致鼠胸主动脉条收缩血管的活性.结论:初步构效关系表明,N-取代苄基氟哌啶醇氯化物中苄基苯环上取代基的电性效应和取代位置可能为影响此类化合物扩血管活性的重要因素.氟哌啶醇母体上羰基被还原为羟基一般对其扩血管活性影响不大.     

p53 Codon 72 polymorphism predicts the pathologic response to neoadjuvant chemotherapy in patients with breast cancer.

PURPOSE: Recent studies have highlighted that the p53 codon 72 polymorphism plays a crucial role in modulating wild-type p53 apoptotic capacity, and as such may influence the response to chemotherapy. Thus, the purpose of this study was to investigate whether the p53 codon 72 polymorphism might influence pathologic response to neoadjuvant chemotherapy in primary breast cancer. EXPERIMENTAL DESIGN: One hundred and ten operable breast cancer patients received anthracycline-based neoadjuvant chemotherapy and p53 codon 72 polymorphism status was analyzed by PCR-RFLP. RESULTS: The distribution of initial clinical stage, tumor size, estrogen receptor or progesterone receptor status, menopausal status, or erbB2 expression was not significantly different among the polymorphic variants. However, we found that only 13% (3 of 23) of patients with the Pro/Pro variant had a good pathologic response, defined as a complete pathologic response or minimal residual disease. In comparison, 40% (22 of 55) or 37.5% (12 of 32) of patients with the Pro/Arg or Arg/Arg variant had a good pathologic response (P = 0.019). Moreover, patients with the Pro/Pro variant were more likely to have a positive axillary lymph node status than those with the Pro/Arg or Arg/Arg variant (P = 0.007). Furthermore, in multivariate analysis, p53 codon 72 polymorphism was found to be a strong predictor of pathologic response (odds ratio 6.7, 95% confidence interval, 1.4-31.2; P = 0.016). CONCLUSION: Our study indicates that breast cancer patients with the Pro/Pro variant may be less sensitive to anthracycline-based treatment than those with the Pro/Arg or Arg/Arg variant and suggests that analysis of p53 codon 72 polymorphism may provide a simple predictive marker for selecting the right breast cancer patients to anthracycline-based neoadjuvant chemotherapy in clinical setting.     

Challenging surgical treatment of giant retroperitoneal liposarcoma: A case report

Liposarcoma is a rare malignant tumor type and surgical resection is the gold standard treatment. The present study reported on the case of a 51-year-old woman who presented with a mass in the left upper abdomen. Computed tomography revealed a 32-cm giant retroperitoneal liposarcoma. Complete tumor resection was performed without the removal of other organs. Postoperative pathological examination indicated retroperitoneal well-differentiated liposarcoma and immunohistochemistry revealed S-100(−), MDM2(+), vimentin(+), CDK4(+), p16(+) and STAT6(+) results. The patient recovered well after the surgery. Complete tumor resection during the first surgery is key to cure liposarcoma. The present case report will be helpful for clinical oncologists to fully understand giant retroperitoneal liposarcoma and treat it accordingly.     

剪切波弹性成像与FNA-Tg对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值

目的：探讨剪切波弹性成像(shear wave elastography,SWE)与细针穿刺洗脱液甲状腺球蛋白(fine-needle aspiration washout thyroglobulin,FNA-Tg)对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值。方法：回顾性分析159例经病理证实为甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的患者资料,对颈部211枚可疑淋巴结进行常规超声、SWE参数平均值(E_mean)、FNA-Tg检查,以术后病理结果为金标准,比较各检测方法的诊断效能。结果：(1)SWE E_mean转移组[(50.96±27.66) kPa]高于非转移组[(32.20±17.34) kPa],差异有统计学意义(t=8.761,P<0.01)。受试者工作特征(receiver operating characteristic,ROC)曲线分析表明,SWE E_mean最佳诊断阈值为40.42 kPa时对PTC颈部淋巴结转移预测价值较高,曲线下面积(area under...     

广东土牛膝及咽炎方合剂中12,13-二羟基泽兰素对照品的制备

目的 从广东土牛膝中制备咽炎方合剂中的特征成分12,13-二羟基泽兰素对照品.方法 结合液液萃取、硅胶柱色谱、制备型高效液相色谱(HPLC)对广东土牛膝醇提物进行分离纯化,通过紫外光谱(UV)、红外光谱(IR)、质谱(MS)、核磁共振(NMR)等进行结构鉴定,分析型HPLC和薄层色谱(TLC)进行含量测定.结果 制得的对照品为12,13-二羟基泽兰素,含量大于98.0%.结论 该化合物可作为广东土牛膝及咽炎方合剂的质量控制以及药效物质基础研究用的化学对照品.     

蒽酮-硫酸法测定灵芝破壁孢子粉中多糖含量的研究

目的 建立灵芝破壁抱子粉中多糖含量的测定方法。方法 采用紫外分光光度法,检测波长为625nm,用葡萄糖为对照品,测定灵芝破壁抱子粉中多糖含量。结果 不同的提取方法对于多糖的提取率不同。最佳提取方法为沸水浴提取8h。结论 本法稳定可靠,简便快捷,适用于灵芝破壁抱子粉多糖含量测定。     

UBE2C promotes the progression of pancreatic cancer and glycolytic activity via EGFR stabilization-mediated PI3K-Akt pathway activation

BackgroundPancreatic cancer (PC) is among the most prevalent and deadliest endocrine tumors, yet the mechanisms governing its pathogenesis remain to be fully clarified. While ubiquitin-conjugating enzyme E2C (UBE2C) has been identified as an important oncogene in several cancers, its importance in PC has yet to be established.MethodsUBE2C expression in PC tumor samples and cell lines was examined via quantitative real-time polymerase chain reaction (qRT-PCR), while appropriate commercial kits were used to assess lactate production, ATP generation, and the uptake of glucose.ResultsUBE2C was found to be upregulated in PC patient tumors and correlated with poorer survival outcomes. In PC cell lines, the silencing of this gene suppressed the malignant activity of cells, thus supporting its identification as an oncogene in this cancer type. Mechanistically, UBE2C was found to promote enhanced matrix metalloproteinase (MMP) protein expression via activating the PI3K-Akt pathway. Moreover, it was found to bind to the epidermal growth factor receptor (EGFR), stabilizing it and driving additional PI3K-Akt pathway activation. UBE2C knockdown in PC cells impaired their uptake of glucose and their ability to produce lactate and ATP.ConclusionsIn conclusion, the results of this study support a role for UBE2C as a driver of metastatic PC progression owing to its ability to bind to EGFR and to induce signaling via the PI3K-Akt pathway.     

关节镜辅助复位内固定与切开复位内固定治疗胫骨平台骨折的疗效比较

目的:比较关节镜辅助复位内固定（ARIF）和切开复位内固定（ORIF）治疗胫骨平台骨折的疗效。方法:回顾性分析2016年1月至2018年8月华中科技大学附属协和医院骨科收治的75例胫骨平台骨折患者的资料。男58例,女17例;年龄20~54岁,平均47岁。左侧42例,右侧33例。骨折根据Schatzker分型：Ⅰ型23例...