实施临床路径的医院概况及其成因分析

目的 通过对我国实施临床路径的医院的情况进行描述、分析,发现其中存在的问题,提出建议。方法 文献研究法,即分析以“临床路径”为关键词,在维普中文科技期刊数据库中搜索到的1 051篇相关文献,同时结合查阅互联网上的相关信息以及电话回访核对信息的方法。结果 我国实施临床路径的医院有162家,占全国医院总数的0.82%;162家医院在全国的分布情况为：华东、华中、华北、华南、东北、西南和西北分别占37.7%、17.9%、14.8%、13.0%、7.4%、4.9%和4.3%;实施临床路径的医院在级别和隶属关系上存在不同,三级医院实施的数量要多于其他级别的医院;82.7%的医院实施临床路径的病种数量少于10个,4.8%的医院实施的病种数量在50个以上;临床路径实施的持续时间平均为2.02年。结论 我国实施临床路径的医院数量少,区域分布不平衡,进入临床路径的病种数量相对较少,病种较单一;临床路径实施的持续时间较短。我国临床路径的实施与推广,需要政府政策、医院、患者多方面的努力,为临床路径的实施与推广奠定更好的基础。     

Cellulose-bound Peptide Arrays: Preparation and Applications

Spatial organization of metabolic enzymes may represent a general cellular mechanism to regulate metabolic flux. One recent example of this type of cellular phenomenon is the purinosome, a newly discovered multi-enzyme metabolic assembly that includes all of the enzymes within the de novo purine biosynthetic pathway. Our understanding of the components and regulation of purinosomes has significantly grown in recent years. This paper reviews the purine de novo biosynthesis pathway and its regulation, and presents the evidence supporting the purinosome assembly and disassembly processes under the control of G-protein-coupled receptor (GPCR) signaling. This paper also discusses the implications of purinosome and GPCR regulation in drug discovery.     

Enhanced prostacyclin formation and Wnt signaling in sclerostin deficient osteocytes and bone

We show that prostacyclin production is increased in bone and osteocytes from sclerostin (Sost) knockout mice which have greatly increased bone mass. The addition of prostacyclin or a prostacyclin analog to bone forming osteoblasts enhances differentiation and matrix mineralization of osteoblasts. The increase in prostacyclin synthesis is linked to increases in β-catenin concentrations and activity as shown by enhanced binding of lymphoid enhancer factor, Lef1, to promoter elements within the prostacyclin synthase promoter. Blockade of Wnt signaling reduces prostacyclin production in osteocytes. Increased prostacyclin production by osteocytes from sclerostin deficient mice could potentially contribute to the increased bone formation seen in this condition.     

Hrr25 kinase promotes selective autophagy by phosphorylating the cargo receptor Atg19

Autophagy is the major pathway for the delivery of cytoplasmic material to the vacuole or lysosome. Selective autophagy is mediated by cargo receptors, which link the cargo to the scaffold protein Atg11 and to Atg8 family proteins on the forming autophagosomal membrane. We show that the essential kinase Hrr25 activates the cargo receptor Atg19 by phosphorylation, which is required to link cargo to the Atg11 scaffold, allowing selective autophagy to proceed. We also find that the Atg34 cargo receptor is regulated in a similar manner, suggesting a conserved mechanism.     

Sulforaphene enhances radiosensitivity of hepatocellular carcinoma through suppression of the NF‐κB pathway

Sulforaphene (SFE), a naturally occurring isothiocyanate found in cruciferous vegetables, has attracted increasing attention for its anti‐cancer effect in many cancers, including hepatocellular carcinoma (HCC). However, the precise role of SFE in the radiosensitivity of HCC is still unclear. Here, cell proliferation and apoptosis were detected by MTT and flow cytometry assay, respectively. The activity of NF‐κB was further evaluated by ELISA. We also observed the effect of SFE and/or radiation on tumor growth. The results showed that SFE inhibited cell proliferation and induced apoptosis in HCC cells. Radiation increased NF‐kB activity, while PDTC, a NF‐kB inhibitor, enhanced radiation‐induced cell death. SFE inhibited NF‐kB activity and the downstream gene expressions of the NF‐kB pathway in HCC cells. Moreover, SFE enhanced the inhibitory effect of radiation on tumor growth both in vitro and in vivo. This study indicated that SFE sensitized the radiosensitivity of HCC by blocking the NF‐kB pathway.