目的 基于数据库分析ETS变异转录因子4(ETS Variant Transcription Factor 4,ETV4)在肺腺癌中的表达及作用,为深入研究ETV4在肺腺癌中的作用提供理论依据.方法 通过Oncomine数据库分析ETV4在肺腺癌中的表达,在ulcan数据库中分析ETV4表达与肺腺癌分期、淋巴结转移、性别、年龄等临床特征之间的关系,通过Kaplan-Meier Plotter分析ETV4表达与肺腺癌预后之间的关系,探讨其作为肺腺癌预后评估的可能性,最后通过cBioPortal分析ETV4基因在肺腺癌中的变异情况并通过STRING在线构建ETV4的蛋白互作网络.结果 筛选Oncomine数据库中有关肺腺癌与正常肺组织表达ETV4的有关数据,共得到10项符合条件的数据,荟萃分析提示ETV4在肺腺癌中的表达水平明显高于肺正常组织(P=0.005).ulcan数据分析结果显示ETV4的表达与肺腺癌患者的性别、年龄、种族、淋巴结转移、分期及吸烟史等临床特征没有明显相关性.Kaplan-Meier Plotter分析肺腺癌生存曲线显示与ETV4高表达的肺腺癌患者相比,ETV4低表达患者的总生存率(OS)、第一次疾病进展(FP)、后进展生存期(PPS)并没有显著改善.cBioPortal数据库分析提示ETV4基因在肺腺癌中的变异率较低,仅为0.8％,主要以基因突变及基因扩增为主.结论 ETV4在肺腺癌中高表达,ETV4的表达与肺腺癌患者的种族、年龄、吸烟史等因素并无直接关系,ETV4对肺腺癌的淋巴结转移、临床分期及预后没有明显影响.

肺癌是目前最常见的恶性肿瘤之一,非小细胞肺癌(non-small cell lung cancer,NSCLC)占肺癌的85％,随着分子生物学的快速发展,越来越多的癌驱动基因被发现,靶向治疗取得了显著进展.2007年首次在NSCLC患者中发现ALK受体酪氨酸激酶的基因组重排,约占NSCLC患者的3～7％.随后ATP竞争性ALK抑制剂相继问世,显著延长了ALK阳性NSCLC患者的生存期.然而,治疗1～2年内出现快速耐药并导致肿瘤复发限制了ALK抑制剂应用,促使下一代ALK抑制剂及一些新的治疗方法不断被研发.而ALK阳性NSCLC治疗方案的优化实施需要解决的关键问题包括靶向抑制剂的高成本和联合治疗增加的毒性反应.本文将围绕ALK在NSCLC靶向治疗的研究进展及耐药机制展开综述.

Rab25蛋白是一种小GTPase,属于Rab蛋白家族中Rab11亚家族中的一员,仅在上皮组织中呈特异性表达,在调节细胞内物质运输过程中起着“分子开关”的关键作用.Rab25蛋白的异常表达与肿瘤的发生、发展及远处转移有密切的关系.Rab25蛋白在不同肿瘤中发挥的作用亦不相同,有文献报道Rab25在卵巢癌、乳腺癌、肾癌、膀胱癌、非小细胞肺癌、肝癌、胃癌、前列腺癌等多种恶性肿瘤中发挥癌基因的作用,但在结直肠癌、头颈部鳞癌、激素不敏感乳腺癌、食管鳞状细胞癌等肿瘤中扮演抑癌因子的角色.本文就Rab25蛋白在消化系统肿瘤中的研究进展做一综述.

肿瘤的发生是一个复杂的过程,为多种因素综合作用的结果.其中炎症反应起着至关重要的作用,炎性细胞分泌的各种炎性因子通过不同途径促进肿瘤的增殖及转移,同时影响肿瘤的预后.目前已有研究表明,慢性炎症反应在胃癌的发生、进展及预后中亦起着重要作用.

目的:观察同步放化疗联合热疗治疗局部晚期非小细胞肺癌(NSC LC)的近期临床疗效和耐受性.方法:将60例局部晚期NSCLC患者随机分为同步放化疗联合热疗组(热放化疗组)和同步放化疗组(放化疗组),放疗采用三维适形放疗(3DCRT),总剂量50 ～56Gy/25 ～28次,5次/周,放疗同期给予NP周方案化疗:DDP30mg/m2d1,NVB20mg/m2 d1,每周1次.热放化疗组:于放疗后1h内开始热疗,预设温度42℃～43℃,每周2次,每次50min,直至全部放化疗结束.比较二组近期客观疗效及早期毒副反应.结果:近期疗效评价:热放化疗组的总有效率(CR+ PR)83.3％,同步放化疗组73.3％,差异有统计学意义(P＜0.05).早期毒副反应:在放射性肺炎、放射性食管炎及粒细胞减少等方面,二组无显著差异(P＞0.05).结论:热放化疗三联综合方案治疗局部晚期NSCLC近期疗效好,优于同步放化疗组,患者可以耐受,是局部晚期NSCLC治疗的一种安全有效模式,具有临床推广价值,远期疗效需进一步评估.

Colorectal cancer is one of the most serious threaten disease to human health. It is the result of many factors, the abnormal expression of the genes which regulate apoptosis play an important role in the development of colorectal cancer. Survivin and Caspase-9 are associated with the regulation of apoptosis, their abnormal activation and inactivation are closely related to the occurrence of colorectal cancer. Previous studies have indicated that the relationship between Caspase-9、Survivin and the invasion, differentiation, staging and lymph node metastasis of colorectal cancer remain exist controversy. There are clnical value in both of them in the aspects of diagnosis, prognosis and targeted therapy colorectal cancer.

目的 分析医院感染的铜绿假单胞菌(PAE)临床分布和药敏性,总结耐药现状和提出应对策略.方法 对2011年1月-2012年12月医院住院患者送检的痰液、血液和分泌物等各类标本,应用美国BD-CTEC9120全自动血培养和法国VITEK-2 Compact全自动细菌检定仪分析铜绿假单胞菌的耐药特点.结果 791株铜绿假单胞菌有63.0％来源于痰,主要分布于呼吸内科、ICU和神经内外科等科室;对氨基糖苷类中庆大霉素、妥布霉素的耐药率均较高,分别为65.9％、64.3％,阿米卡星较低为19.1％;对喹诺酮类药物较敏感,对环丙沙星、左氧氟沙星的耐药率分别为23.0％、18.1％,对第四代头孢吡肟耐药率为46.5％;对头孢他啶的耐药率达到了50.6％;对碳青霉烯类抗菌药物亚胺培南、美罗培南较为敏感,其耐药率分别为14.3％和12.9％,对哌拉西林/他唑巴坦的耐药率为13.4％.结论 铜绿假单胞菌在医院表现出多药耐药和泛耐药;医院应重视抗菌药物的合理使用,加强耐药性监测和医院感染的防治;临床应结合药敏结果采用有效药物单一或联合、足量、足疗程治疗,以控制细菌耐药性的增长.

目的:探讨外照射(三维适形放疗)与化疗同步治疗中晚期鼻咽癌的近期疗效及相关副作用.方法:初治Ⅱ～Ⅳa期鼻咽癌患者共60例,随机分为单放组和放化组各30例.放疗采用直线加速器6MV-X线三维适形放疗(3D-CRT)体外照射,鼻咽部及颈部淋巴结转移病灶剂量DT:70～80Gy/7～8周,颈部预防量DT:40～50Gy/4～5周.化疗方案顺铂(DDP) 30mg/m2×3,第1～3天,氟尿嘧啶(5-Fu )0.5 g/m2×5,第1～5天,21d为一周期,共3周期.结果:单放组CR:50.0%(15/30),PR:20%(6/30),放化组CR:70.0% (21/30),PR:20%(6/30),两组总有效率单放组70.0%,放化组90.0%(P<0.05).副作用以口腔炎、骨髓抑制和胃肠道反应为著,放化组较单放组重(P<0.05).结论:中晚期鼻咽癌同步放化疗的疗效优于单纯放疗,毒副作用增加,但可耐受.

目的:提高临床医生、护士对药品不良反应的诊断和鉴别诊断的能力,以便更好地开展药品不良反应监测工作。方法:临床药师开展药品不良反应专项查房工作。结果:临床药师在一起频发的"输液反应"事件中,采取逐项排查措施,确诊为一起药品不良反应并合理、及时地得到处理。结论:临床药师通过积极主动的开展药品不良反应专项查房工作,在用药安全中发挥了积极地作用,并得到了院领导及临床医护的认可。

Objective:To observe the effect of Huaier granule combined with chemotherapy on TCM symptoms and life quality in advanced colorectal cancer patients.Methods:60 advanced colorectal cancer patients were randomly divided into two groups.30 patients in the treatment group were treated with Huaier granule and chemotherapy and the controlled group was treated with chemotherapy only.The two groups were both given FOLFOX4 regiment treatment.The changes in their TCM symptoms,KPS,weight and appetite were observed.The following data must be measured before the chemotherapy and 4 courses after it.Results:There was significant difference in their syndrome scores,KPS,weight and appetite(P<0.05).Conclusion:Huaier granule could improve TCM symptoms and life quality indeed.It was effective for advanced colorectal cancer patients.

Objective: To observe the clinical application value of Kuier in the patients with advanced colorectal cancer.Method: 60 cases of advanced colorectal cancer patients were divided into the treatment group and the control group with 30 cases each.The treatment group was with the chemotherapy treatment and Kuier granules,and the control group was with the chemotherapy treatment only.The chemotherapy was with the FOLFOX4 protocols.The changes in T cell subgroup(CD3+,CD4+,CD8+ and CD4+/CD8+),the tumor size,liver and kidney functions,and the other safety indicators before and after the treatment were recorded.Result: Compared with those of the control group,the values of CD8+ in the treatment group were decreased,while CD4+/CD8+ was increased significantly(P<0.05).The differences in the tumor size and adverse reactions were not significant(P>0.05).Conclusion: Kuier granules combined with chemotherapy in the treatment of advanced colorectal cancer can obviously improve the immune function with mild toxicity and high safety,suggesting promising application value in clinics.

OBJECTIVE To observe the effect of Aidi injection combined with chemotherapy on life quality in advanced colorectal cancer patients. METHODS Sixty advanced colorectal cancer patients were randomly divided into two groups.The treatment group with 30 patients were treated with Aidi injection and chemotherapy.The control group with 30 patients were treated with chemotherapy only.The two groups were both given FOLFOX4 regiment treatment.The change in TCM symptoms,KPS,weight and appetite was observed after chemotherapy was given for four courses. RESULTS There were significant differences in syndrome scores,KPS,weight and appetite of the two groups(P0.05). CONCLUSION Aidi injection can indeed improve TCM symptoms and life quality in advanced colorectal cancer patients.

1资料患者,男,40岁,因“头部外伤后头昏、头痛1h”于2011年3月27日收入我院脑外科.人院诊断为“右顶部枕骨凹陷性骨折,多处头皮裂伤”,遂行凹陷性骨折整复术,手术顺利,术后恢复良好.5月11日,医嘱给予患者吡拉西坦氯化钠注射液[山东威高药业有限公司,规格:50mL(吡拉西坦10 g:氯化钠0.45g)/瓶,批号21101113031]100 mL,iv,bid,改善脑代谢;5％葡萄糖注射液250 mL+舒血宁注射液5 mL,iv,qd,改善微循环;10％葡萄糖注射液500 mL+维生素C针3g+氯化钾10mL,支持治疗.吡拉西坦氯化钠注射液为当日第一组静脉用药.

以北京市为例,通过对房地产价格影响因素的分析,研究各种因素对房地产价格的作用机理,并通过对影响我国现阶段房地产价格的主要包括土地价格指数、房地产市场供给、房地产需求、房地产租赁价格指数等因素,利用统计方法,与房地产销售价格指数的历史数据进行实证检验。实证检验表明目前北京市的房地产政策能够很好的把握当前经济形势,能够使用经济手段调节房地产市场。

B2B电子商务是我国医药电子商务最主要的形式。本文在国内外医药电子商务发展状况和发展特点的基础上,对我国可选的三种B2B医药电子商务发展模式进行了比较,认为跨越式发展第三方电子商务市场是符合我国情况的B2B电子商务发展模式。并就未来发展,提出了充分发挥政府作用;加大医药电子商务的市场环境和制度建设;积极培育第三方物流;整合现有资源建立覆盖全国的第三方电子交易网络等战略对策。

OBJECTIVE:To discuss the ways to improve the drug control outcome in China and to facilitate the related system reform.METHODS:The causes and countermeasures for the failure of drug control policy in China were analyzed comparatively using economic theory.RESULTS CONCLUSIONS:Information dissymmetry in the medicine area,monopoly of medical institution and their evasion of control etc all resulted in the failure of price control policy.To avoid this failure,it is necessary to take reform measures in many aspects,enhance the scientificity of price control,and improve the conduction mechanism of price control policy.

职业资格证书是反映劳动者专业知识和职业技能水平的证明,是劳动者通过职业技能鉴定进入就业岗位的凭证。本文通过分析餐饮服务行业从业人员的现状结合餐饮服务行业推行职业资格证书的意义,提出了在餐饮服务行业推行职业资格证书应须注意的几个问题。

目的探讨对溶出数据进行多种曲线拟合的简便方法。方法用Excel软件对溶出数据进行多种曲线拟合,并求出T50、TD等溶出参数。结果用Excel软件对统计数据进行处理,方法简便,结果准确,图文并茂。结论同以往的手工处理和查表计算相比,用软件处理大大加快了数据处理速度,操作简便,便于推广。