以肺部病变为主要表现的韦格纳肉芽肿1例并文献复习

目的:促进韦格纳肉芽肿的早期诊断和治疗,提高患者的生存率.方法:回顾性分析我院收治的1例韦格纳肉芽肿患者的发病诊治过程的临床资料并结合文献进行复习.结果:入院后行胸部CT、抗中性粒细胞胞浆抗体(ANCA)等检查,明确诊断后给予糖皮质激素、细胞毒类药物等治疗后短期缓解,5个月后死亡.结论:韦格纳肉芽肿的临床表现多种多样,诊断困难,实验室检查无特异性,临床上对于多系统受累的疾病应警惕此病,应结合患者临床表现及辅助检查做出早期诊断,及早治疗,从而提高患者的生存率.     

医学研究生临床生化专题全英教学的改革与实践思考

为培养高质量国际化有才能的医学研究生,对于已经学习过生物化学的国际医学留学研究生,开展了以与临床密切相关的生物化学专题为主要教学内容的全英文授课的教学实践和课程建设,取得了很好的教学效果.临床生化专题全英教学课程也可能适用于国内生物化学和医学相关专业的研究生,在今后的教学实践中需要继续研究和探索,以提高国内医学相关研究生的专业综合素质.     

An immune response profile model for immunogenicity quantitation

We propose an analytical model, which can simultaneously depict many fundamental characteristics of the immunogenicity of various vaccines. This model, the Immune Response (IR) profile, conveniently expresses the mathematical relation between pre- and post-vaccination titers. A vaccine's IR profile is antigen-specific, dose-dependent and post-vaccination interval-dependent. The maximal capability for serological response to a vaccine can be determined using this model irrespective of the dose administered, the post-vaccination assay interval, or the live or killed state of the vaccine. The IR profile obtained from analysis of booster vaccine responses in a limited number of seropositive study subjects can be used to predict maximal antibody titers which are expected after vaccination and can predict the geometric mean post-vaccination antibody titer of a cohort of subjects undergoing primary immunization. Using this model, it is anticipated that the immunoregulation implied by the IR profile may also prove to be correlated with cellular subpopulations and idiotypic antibody functions. Although derived from influenza vaccines analyses, the model successfully describes immune response characteristics following natural infection with malaria and following diphtheria and rubella vaccine administration.     

Differentiation of a Human Neural Stem Cell Line on Three Dimensional Cultures,Analysis of MicroRNA and Putative Target Genes

Neural stem cells (NSCs) are capable of self-renewal and differentiation into neurons, astrocytes and oligodendrocytes under specific local microenvironments. In here, we present a set of methods used for three dimensional (3D) differentiation and miRNA analysis of a clonal human neural stem cell (hNSC) line, currently in clinical trials for stroke disability ({"type":"clinical-trial","attrs":{"text":"NCT01151124","term_id":"NCT01151124"}}NCT01151124 and {"type":"clinical-trial","attrs":{"text":"NCT02117635","term_id":"NCT02117635"}}NCT02117635, Clinicaltrials.gov). HNSCs were derived from an ethical approved first trimester human fetal cortex and conditionally immortalized using retroviral integration of a single copy of the c-mycER^TAMconstruct. We describe how to measure axon process outgrowth of hNSCs differentiated on 3D scaffolds and how to quantify associated changes in miRNA expression using PCR array. Furthermore we exemplify computational analysis with the aim of selecting miRNA putative targets. SOX5 and NR4A3 were identified as suitable miRNA putative target of selected significantly down-regulated miRNAs in differentiated hNSC. MiRNA target validation was performed on SOX5 and NR4A3 3’UTRs by dual reporter plasmid transfection and dual luciferase assay.     

脑脊液分流术治疗64例脑肿瘤临床效果分析

目的:通过观察脑脊液分流术在64例脑肿瘤患者中的临床应用效果,探讨其临床应用的价值。方法:收集2009年1月-2010年3月我院64例脑肿瘤患者病例资料,其临床诊断均有颅内高压,对照组32例患者给予常规手术进行肿瘤切除;观察组在对照组的基础上给予脑脊液分流术,比较两组治疗效果。结果:治疗后两组颅内压均降低,观察组降低更为明显(P0.05)。对照组完全缓解率为15.6%,部分缓解率为21.8%,病程稳定率为31.3%,病程进展率为31.3%。观察组分别为28.1%、31.3%、25%和15.6%。观察组完全缓解率和部分缓解率明显高于对照组(P0.05.),病程进展率对照组明显高于观察组(P0.05)。对照组术后两年内复发5例,生存超过三年的17例,生存超过五年的12例。观察组术后两年内复发的2例,生存超过三年的20例,生存超过5年的15例。和对照组比较,观察组术后病情复发率更低,生存指数更高,比较有明显差异(P0.05)。结论:脑脊液分流术在伴颅内高压或脑积水的脑肿瘤手术中的使用效果显著,后期的手术成功率和患者生存率提高,临床上可予以更为深入的探索。     

埃索美拉唑对糜烂性胃溃疡患者血清ERK1/2及EGFR水平的影响

目的:探讨埃索美拉唑对糜烂性胃溃疡患者血清ERK1/2及EGFR水平的影响及临床疗效。方法:收集我院糜烂性胃溃疡患者106例,随机分为实验组和对照组。对照组予以奥美拉唑治疗,实验组予以埃索美拉唑治疗。检测并比较两组患者治疗前后血清ERK1/2及EGFR水平变化,观察患者溃疡面积、愈合情况以及临床症状的改善情况等。结果:与治疗前比较,治疗后两组患者血清ERK1/2及EGFR水平上升,差异有统计学意义(P0.05);与对照组比较,实验组治疗后ERK1/2及EGFR水平较高,差异有统计学意义(P0.05)。与治疗前比较,治疗后两组患者溃疡面积均减小,差异有统计学意义(P0.05);与对照组比较,实验组治疗后溃疡愈合情况更显著,差异有统计学意义(P0.05)。与治疗前比较,治疗后两组患者临床症状均获得缓解,差异有统计学意义(P0.05);与对照组比较,实验组治疗后症状改善更明显,差异有统计学意义(P0.05)。结论:埃索美拉唑可调节糜烂性胃溃疡患者血清ERK1/2及EGFR水平,改善溃疡情况,缓解临床症状,提高临床疗效,值得临床推广应用。     

大剂量瑞舒伐他汀钙治疗老年冠心病合并高脂血症的疗效观察

目的:研究大剂量瑞舒伐他汀钙治疗老年冠心病合并高脂血症的临床疗效。方法:选取2013年10月到2014年10月我院收治的老年冠心病合并高脂血症患者110例,按照随机数字表法将患者分为研究组和对照组,每组55例。两组患者均给予常规治疗方法进行治疗,对照组增加5 mg瑞舒伐他汀钙进行治疗,研究组增加20 mg瑞舒伐他汀钙进行治疗,均每天1次,晚餐后应用,治疗时间为4个月。比较治疗前后两组血脂水平(胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C))及高密度脂蛋白(HDL-C)及其达标率以及不良反应。结果:治疗后两组TC、TG以及LDL-C均显著降低,HDL-C显著升高,且研究组优于对照组,比较差异具有统计学意义(P0.05);研究组治疗后TC和LDL-C达标率显著高于对照组,两组比较差异具有统计学意义(P0.05);两组不良反应发生率比较差异无统计学意义(P0.05)。结论:大剂量瑞舒伐他汀钙治疗老年冠心病合并高脂血症具有较好的临床疗效,能显著降低患者的血脂水平。     

吗啡联合有创呼吸机辅助通气治疗重症急性左心衰竭的疗效

目的:探讨吗啡联合有创呼吸机辅助通气治疗重症急性左心衰竭的临床疗效。方法:将2012年5月-2014年5月我院收治的82例重症急性左心衰竭患者随机分为观察组和对照组,各41例。两组患者均因常规药物治疗无效再行经口气管插管机械通气及对症治疗,观察组在此基础上加用吗啡静脉注射。对比两组患者的体征、症状、动血气指标及临床疗效。结果:两组治疗后血压、心率(HR)、呼吸频率(BR)、血气指标明显优于治疗前,比较差异有统计学意义(P0.05),且观察组各指标改善明显优于对照组,比较差异有统计学意义(P0.05);治疗后观察组总有效率为92.7%(38/41),高于对照组的82.9%(34/41),比较差异有统计学意义(P0.05)。结论:吗啡联合有创呼吸机辅助通气治疗重症急性左心衰竭可有效缓解患者症状,改善临床体征,临床疗效显著,值得推广。