目的 分析疫情防控期间某院药物临床试验研究参与者的情绪状态及随访情况,以期在特殊情况下尽最大可能保障研究参与者的权益.方法 采用金数据问卷调查方式,由在研研究参与者在线填写一般资料、抑郁筛查量表(PHQ-9)、焦虑筛查量表(GAD-7)及研究参与者依从性评估量表,同时收集2021年11月1日至12月8日及2021年12月9日至2022年1月24日在研药物临床试验状况及在研研究参与者的随访情况,使用Excel及SPSS18.0进行数据统计与分析.结果 疫情防控期间,院内在研的药物临床试验项目共20项,2021年12月9日至2022年1月24日,计划访视人次数161,实际来院访视人次数84(52.2％),加上邮寄药物人次数24,访视率为67.1％,其中口服药、非口服药、口服药联合非口服药项目访视率分别为79.3％、71.9％、41.0％.2021年11月1日至12月8日,计划访视人次数166,实际来院访视人次数157(94.6％),电话访视人次数占计划访视总人次数的1.8％,未用药人次数和延期用药人次数均为0.研究参与者总依从性高达80.0％.共收回有效问卷40份,研究参与者抑郁、焦虑情绪的检出率分别为42.5％,30.0％.结论 疫情防控期间,在研研究参与者的随访在短期内受到了较大的影响,应制定相关随访措施,进行分类管理,一定程度上不仅可以改善研究参与者的情绪,还可维护研究参与者的权益,以期为未来突发公共卫生事件中研究参与者的随访工作提供建议.

植物外泌体是由植物细胞分泌的纳米级小囊泡,内含DNA、小RNA(small RNA,sRNA)、微小RNA(microRNA,miRNA)和蛋白质等物质,介导细胞间的通讯.其中miRNA是高效的基因表达调控因子,可进行跨界基因表达调控;sRNA通过胞间连丝在宿主和生物之间转移并诱导基因沉默.植物外泌体通过所含物质发挥抗炎、抗病毒、抗纤维化、抗肿瘤等作用,参与病原体侵袭的防御反应.植物外泌体纳米粒大多可食用,可作为递送特定药物的载体,无毒性及副作用,因此已成为研究热点之一.本文整理了近年植物外泌体研究相关的文献报道进展,对药用植物外泌体的来源和作用进行了总结和分析,以期为将来植物外泌体的研究提供新的思路与方法.

A型激酶锚定蛋白12作为一种支架蛋白,能锚定细胞中的蛋白激酶A(PKA)、蛋白激酶C(PKC)、磷酸酯酶(PDE4D)等关键信号分子形成复合物,并动态调节β2肾上腺素受体(β2AR)复合物.调控肿瘤发生发展过程中的多条信号转导通路,在多种肿瘤中表达下调,A型激酶锚定蛋白12(AKAP12)的甲基化水平与肿瘤分期分级相关,有望成为肿瘤治疗的潜在靶标.

莪术醇是莪术油的最有效成分之一,具有抗肿瘤、抗病毒及抗菌消炎的作用.莪术油临床主要用于治疗呼吸系统疾病、消化系统疾病和癌症等,但有一定的不良反应,因此提取自莪术挥发油中的莪术醇日益成为研究热点.现有研究表明,莪术醇对体外肿瘤细胞及移植瘤小鼠肿瘤有明显的抑制作用,抗癌机制可能与抑制肿瘤细胞的生长及RNA的合成、增强机体特异性免疫、产生明显的免疫保护作用有关.本文对莪术醇的抗癌作用进行了总结,为其作为潜在抗癌药的基础和临床研究提供参考.

目的 制备雄黄乳膏,观察其治疗带状疱疹的临床疗效.方法 将雄黄利用水飞法进行炮制,采用乳剂型基质制成O/W型乳膏剂;以阿昔洛韦乳膏为对照组,共治疗带状疱疹患者200例,观察其临床疗效.结果 雄黄乳膏制备工艺和质量控制方法可行;雄黄乳膏组临床观察总有效率为93％,起效时间和治愈时间较短,不良反应少,差异均具有统计学意义(P＜0.05).结论 雄黄乳膏制剂工艺科学合理,使用方便,疗效比阿昔洛韦更优,不良反应少,值得临床推广使用.

目的 本文系统评价了宫血宁治疗置宫内节育器后月经过多的疗效.方法 采用计算机检索中国知网全文数据库、万方数据库、中文科技期刊数据库自2000年至2016年公开发表的有关宫血宁治疗置宫内节育器后月经过多的随机对照试验(randomized controlled trial,RCT),按照纳入和排除标准筛选,对文献进行质量评价,采用RevMan 5.3软件对纳入的实验结果进行统计学分析.结果 共纳入26篇文献,5547例患者.Meta分析结果显示,与对照组比较,宫血宁治疗后观察组患者明显缩短了经期、提高了血红蛋白含量、减少了月经量、月经恢复正常的总有效率高.结论 宫血宁治疗置宫内节育器月经过多较单纯常规基础治疗疗效更好,值得临床推荐使用.

Objective To investigate the correlation between the expression of IL-17 and CD105 in prostate cancer and clinical significance.Methods The expression of IL-17 and CD105 was detected with two-step irnmunohistochemical staining technique in 34 cases with prostate cancer and 5 cases with Normal prostate and MVD marked with CD105 was also measured.The relationship between the expressions of IL-17 and MVD and chnical pathological characteristics was analyzed.Results Immuno-staining and immunohistochemisty showed that the IL-17 was mainly expressed in tumor cell membrane and cytoplasm,and its positive expression rate was significantly higher in prostate cancer tissue than that in normal prostate (82.35％ vs 20.00％).The MVD in prostate cancer was significantly higher than that in normal prostate[(40.51 ± 14.86) vs (19.55 ± 7.55)] (P＜0.01).The MVD in IL-17 positive cases was significantly higher than that in IL-17 negative cases(t=10.35,P＜0.01).IL-17 and MVD were not related with age and lymphatic metastasis(P＜0.05),but they were related with tumor diferentiation degree and clinical grades(P＞0.05).Conclusion IL-17 may participate in the development of prostate cancer by promoting tumor angiogenesis.

Objective To make a systematic evaluation of the efficacy and safety of Eszopiclon and Alprazolam in the treatment of insomnia.Methods By searching the PubMed,Cochrance Library,CNKI, WANFANG,and VIP database,we studied the literature published between 2005 to 2016 on the efficacy and safety of Eszopiclon and Alprazolam in the treatment of insomnia.We collected the randomized controlled trials (RCTs), evaluated the quality of methods and then analyzed the data using RevMan5.3 software.Results A total of 18 RCTs were included,involving 2088 patients.According to Meta-analysis,Eszopiclon group had a significantly higher total efficacy rate [RR=1.07,95% CI (1.02,1.11),P=0.003],lower severity of adverse reactions [MD=-0.43,95% CI(-0.75,-0.12),P=0.008]and incidence of adverse reactions [RR=0.46,95% CI(0.32, 0.66),P<0.0001]than Alprazolam group.However,the two groups did not significantly differ in sleep quality scores after 4-week teatment [MD=-0.05,95% CI(-0.22,0.12),P=0.54].Conclusion Eszopiclon is more effective on insomnia than Alprazolam,with better safety,and it deserves wide clinical use.

癌症是人群健康和生命威胁最大的恶性肿瘤之一 ,随着人口的增长和老龄化 ,癌症的发生率不断增加 ,肺癌的发病率和病死率增长最快 ,已经成为发展中国家及发达国家沉重的经济负担.

目的 评价埃索美拉唑联合莫沙必利治疗反流性食管炎的疗效和安全性.方法 检索PubMed、VIP、CNKI、万方等数据库,检索时间2000～2017年,纳入埃索美拉唑联合莫沙比利治疗反流性食管炎的随机对照试验,独立评价纳入研究的质量并提取资料,用RevMan 5.3软件进行统计分析.结果 纳入29篇随机对照试验,包含患者2657名,Meta分析结果显示:埃索美拉唑联合莫沙比利组的临床症状有效率[RR =1.21,95％CI(1.17,1.26),P＜0.000 01]、电镜下观察治愈率[RR=1.53,95％CI(1.32,1.77),P＜ 0.000 01]和电镜下观察有效率[RR=1.23,95％CI(1.14,1.34),P＜0.000 01]均显著高于奥美拉唑联合莫沙比利组,不良反应发生率[RR=0.68,95％CI(0.47,0.97),P=0.04]埃索美拉唑联合莫沙必利低于奥美拉唑联合莫沙必利,并且有统计学意义.结论 埃索美拉唑联合莫沙比利治疗反流性食管炎疗效比奥美拉唑联合莫沙比利显著,并且不良反应发生率低.

Objective To investigate the expression of ADM in human liver carcinoma and its relationship with tumor angiogenesis.Methods The expression level of ADM was detected in 26 cases of normal liver tissues and the level of ADM in 58 cases of liver carcinoma by immunohistochemical method.At the same time,the number of CD105-1abelled micro vessel density (MVD) was counted,so as to investigate the relationship between ADM,MVD and their clinical pathological features.Results The expression levels of ADM and MVD in liver carcinoma were significantly higher than those in normal tissues (P ＜ 0.01).MVD in liver carcinoma was obviously higher than that of the normal liver(P ＜ 0.01).Their expression levels were not clearly correlated with the patient age and the pathological type (P ＜ 0.01),while tumor differentiation was correlated with the degrading of TNM to some extent (P ＜ 0.05).Conclusion The high expression of ADM in liver carcinoma was positively correlated with the formation of tumor vessels,which played a certain role in the occurrence and development of liver carcinoma,and might be important biological indicator of liver carcinoma.

目的 探讨纳米雄黄对卵巢癌细胞COC1的凋亡作用.方法 0.6 μmol/L浓度的纳米雄黄作用于COC1细胞,于不同时间收集的细胞.倒置显微镜下观察细胞形态,流式细胞仪检测细胞凋亡率,RT-PCR检测细胞中Bax、Bcl-2和Caspase-3的mRNA的表达水平,蛋白免疫印迹法(Western blot)检测细胞中Bax、Bcl-2和Caspase-3蛋白的表达水平.结果 0.6μmol/L浓度的纳米雄黄作用于COC1细胞48 h后出现显著的凋亡形态改变;纳米雄黄显著的促进细胞凋亡,并随着纳米雄黄处理COC1细胞时间的延长凋亡率显著性增加(P＜0.05);随着纳米雄黄处理间的延长COC1细胞中的Bax和Caspase-3的mRNA和蛋白表达水平显著增加(P＜0.05),Bcl-2的mRNA和蛋白表达水平显著降低(P＜0.05).结论 纳米雄黄对COC1细胞有显著的促凋亡作用,其作用机制可能与升高Bax和Caspase-3的表达和降低Bcl-2的表达有关.

OBJECTIVE:To evaluate the anesthesia effect of etomidate and propofol on painless abortion surgery. METHODS:After screening the Cochrane Library, Pubmed, China National Knowledge Infrastructure (CNKI), WANFANG, VIP database, the literatures regarding the anesthesia effect of etomidate and propofol on painless abortion surgery were collected from 1995 to 2014. The randomized controlled trials (RCTs) were selected, the quality evaluation was performed and the data was analyzed by using RevMan5.3 software. RESULTS:A total of 1 130 patients were included in 9 RCTs. The results of Meta analysis were as follows: the anesthesia induction time in the etomidate group was less than that in propofol group (MD=-0.14, 95% CI -0.24 to -0.04, P=0.004); there were more adverse reactions, such as myoclonus, nausea and vomiting, in the etomidate group compared with the propofol group (P<0.001); the incidence of pain in the etomidate group was less than that in the propofol group (P<0.001); there was no significant difference in the incidence of respiratory depression between the 2 groups (P>0.05); the surgery time, analgesia and duration from withdrawal to the wake-up was not significantly different between the 2 groups (P>0.05). CONCLUSION:Etomidate had a shorter anesthesia induction time than propofol in the painless abortion surgery. The incidence of reverse reactions such as myoclonus, nausea and vomiting, was more common in application of etomidate, whereas the incidence of injection pain was more common in the use of propofol group. There was no significant difference in respiratory depression between the 2 drugs. The comprehensive efficacy of propofol is better than etomidate.

Objective To investigate the expression of adrenomedullin (ADM) in human liver cancer and to evaluate its clinical signigicance.Methods A total of 54 patients with liver cancer who underwent surgery between January 2012 and November 2013 and another 18 benigh tissue samples were selected.Immuohistochemical staining (SP staining) was performed to detect the expression of ADM in liver cancer,and enzyme-linked immunosorbent assay was applied to determine the concentration of ADM in the patients and controls,and the relationship was retrospectively analyzed between the expression of ADM in liver cancer and the clinicobiological features.Besides,60 inpatients with liver cancer and 40 health people under went physical examination between January and June 2013 were selected,whose expression of ADM in plasma was deteced.Results The expression of ADM in liver cancer was significantly higher than that in the normal tissues (P ＜ 0.01).There was a significant relationship between the expression of ADM and the differentiation grade in liver cancer (P ＜ 0.05),and there was no relationship between the expression of ADM and age,histological type and American Joint Committen on Cancer (AJCC) stage (P ＞ 0.05).The expression of ADM in the plasma in liver cancer group was significantly higher than that in the control group (P ＜ 0.05).There was a significant relationship between the expression of ADM in the plasma and AJCC stage (P ＜ 0.05).Conclusions The expression of ADM significantly increases in patients with liver cancer,which is associated with the differentiation grades of the liver cancer.ADM may play an important role in the occurrence and development of liver cancer.

This work was to obtain differentially-expressed genes with hepatoma cell HepG (HepG2-X)Y of stable transfected HBx and non-transfected hepatoma cell HepG2using gene chip technology. The preliminary bioinformatic analysis demonstrated that the gene of the protein encoded 673 amino acids with a predicted molecular weight of 17.06 kD and pI 4.83. URG11 were mainly localized in the nuclear and played the role in transcription regulation,growth factor and signal transducer,and it showed76%-97% identity with the others reported 12 species,as well as was consistent with the evolutionary relationship between species.

To systemically evaluate the clinical efficacy of Fuke Qianjin tablets combined with antibiotics in the treatment of endometritis. The databases such as PubMed, CNKI, VIP and WanFang Data were searched to collect the randomized controlled trials(RCTs) about Fuke Qianjin tablets combined with antibiotics for endometritis since 2010. According to the Cochrane Reviewer's Handbook, two reviewers independently screened the literature, extracted the data and assessed the methodological quality of the included studies. Then the Meta-analysis was performed by using RevMan 5.3 software. 16 RCTs were included, involving 2 299 patients. Meta-analysis showed that after endometritis was treated by Fuke Qianjin tablets combined with antibiotics, the thickness of endometrium was higher than that in antibiotics group[MD=1.20, 95％CI (1.10, 1.29), P<0.000 01]; the occurrence rate of normal menstrual cycle[OR=1.46,95％CI (1.21, 1.77), P=0.000 1] and total effective rate [OR=1.19, 95％CI (1.15, 1.24), P<0.000 01] were increased ; the irregular vaginal bleeding [OR=0.21, 95％CI (0.14, 0.30), P<0.000 01] and inflammatory reactions[OR=0.19, 95％CI (0.10, 0.37)] were reduced. In short, Fuke Qianjin tablets combined with antibiotics have better effects than antibiotics alone for endometritis, so it is worthy to be recommended for clinical application.

Objective To examine the expressions of AQP1 and VEGF in human hepatitis B associated hepatocellular c arcinoma and to investigate its relationship with the occurrence and development of hepatocellularcarcinoma. Methods AQP1 and VEGF expressionsin the cancer tissues and AQP1 and VEGF levels in the serum were detected in 62 cases of hepatocellula carcinomaby immunohistochemistry and ELISA , respectively. Results The expressions of AQP1 and VEGF in the liver cancers were significantly higher than in the normal tissues (P<0.01). The higher expression was related to pathologic type,degrees of differentiation and lymph node metastasis, but not related to sex, age and TNM stages. In the serum of liver cancer, the concentrations of AQP1 and VEGF were significantly higher than those in the control group. Conclusion High expressions of AQP1 and VEGF in the patients with liver cancer may be correlated to the occurrence and development of liver cancer. Plasma levels ofAQP1 and VEGF may be more meaningful for the evaluation of clinical prognosis.

目的 检测肿瘤坏死因子-α (TNF-α)在前列腺癌组织中的表达,探讨其与前列腺癌临床病理特征和肿瘤血管生成的关系.方法 采用免疫组织化学二步法检测2010年1月-2012年1月20例前列腺增生组织、50例前列腺癌组织中TNF-α蛋白和CD105的表达情况,并计数CD105标记的微血管密度(MVD).结果 免疫组织化学结果显示TNF-α在前列腺癌组织的肿瘤细胞膜及细胞质中表达较高(41.72±8.67),而在前列腺增生组织中表达较低(21.01±3.85),差异有统计学意义(t'=13.990,P＜0.001);CD105在前列腺癌中阳性染色定位于肿瘤微血管内皮细胞膜表达较高(20.15±2.67),而在前列腺增生组织中表达较低(4.34±1.67),差异有统计学意义(t'=29.771,P＜ 0.001).TNF-α和CD105的表达与患者年龄、肿瘤大小无关,与前列腺癌的临床分期呈正相关(rs=0.847,P＜0.001;rs=0.776,P＜0.001),与病理分级呈负相关(rs=-0.769,P＜0.001;rs=-0.842,P＜0.001).结论 前列腺癌组织中存在TNF-α的高表达,其可能在前列腺癌的血管生成和肿瘤的发生、发展中起重要作用.

目的 探讨人类表皮生长因子受体2(human epidermalgrowth factor receptor-2,HER2)在食管癌中的表达及意义.方法 用免疫组化方法检测食管癌组织、远癌组织中HER2的蛋白表达.结果 HER2在食管癌组织中未见强阳性表达.结论 HER2在食管癌组织中有表达,但其表达强度未达到赫赛汀靶向治疗的标准.

Objective To detect the protein expression of human epidermal growth factor receptor-2 (HER2) andβ-catenin in esophageal carcinoma and to analyze the role of their abnormal expression .Methods Expression of HER2 andβ-catenin was detected by immunohistochemical techniques in esophageal carcinoma and far carcinoma .Results The strong positive expression of HER2 has not been observed in esophageal carcinoma ;the abnormal expression of β-catenin has been observed in esophageal carcinoma .The expression of HER2 andβ-catenin in esophageal carcinoma had no relationship .Conclusion We can observe the expression of HER2 in e-sophageal carcinoma ,but the expression has not achieve the standard of targeted therapy of Herceptin .β-catenin was aberrant expressed in patients with esophageal carcinoma ,which suggested that β-catenin may play an impor-tant role in oncogenesis in esophageal carcinoma .It could be an index for metastasis prognosis of patients with e-sophageal carcinoma .The expression of HER2 andβ-catenin in esophageal carcinoma was not related to each oth-er .