本文针对二分类变量结局指标相对（而非绝对）治疗效果的不一致性。证据本身不会因不同研究结果具有一致性而升级，但可能因不一致而降低质量级别。衡量一致性的标准包括点估计值的相似性、可信区间的重叠程度以及统计学判定标准包括异质性检验和I2。系统评价作者应提出并检验少数几个与患者、干预措施、结局指标以及方法学相关的先验假设以探寻异质性来源。当不一致性很大且无法解释时，因不一致性而降低质量级别是恰当的，特别当某些研究显示有显著益处而其他显示无益甚至有害时（而非仅是疗效大与疗效小的比较）。明显的亚组效应可能不可靠。如果亚组效应满足以下条件，其可信度将会增加：基于少数几个有具体方向的先验假设、亚组比较来自研究内而非研究间、交互检验的P值小、结果有生物学意义。
【摘要】 目的 研究纳米银体外抗H3N2流感病毒的作用，并初步探索其作用机制。 方法 在H3N2流感病毒吸附细胞后加入纳米银和吸附前用纳米银预处理犬肾细胞（MDCK），在体外用细胞病变效应（cytopathic effect，CPE）观察法和3-（4，5-二甲基-2-噻唑）-2，5-二苯基溴化四唑（3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyltetrazolium bromide，MTT）测值法，分析纳米银对H3N2流感病毒感染MDCK细胞的预防作用、直接灭活作用以及对流感病毒子代病毒体生成的抑制作用，运用RT-PCR法研究纳米银对H3N2流感病毒HA基因复制的干扰作用。 结果 纳米银能明显杀伤H3N2流感病毒，50、25 μg/mL的纳米银溶液与H3N2流感病毒充分作用2 h后感染MDCK细胞，细胞存活率分别为94.38%和92.17%，纳米银能有效抑制流感病毒对MDCK细胞的侵入和侵入后病毒的继续增殖，25 μg/mL纳米银溶液通过上述两种方式处理细胞，细胞存活率分别为85.39%和83.28%，与病毒对照组相比，差异均有统计学意义（Plt;0.001）；400、200 μg/mL纳米银溶液分别与流感病毒H3N2充分混合作用15、30、60、120 min后，病毒液的HA基因均未能成功扩增，纯病毒液和溶剂对照组在1 700 bp处均出现明显条带。 结论 通过3种不同的给药方式，纳米银在体外均能明显抑制流感病毒对细胞的感染，纳米银抑制流感病毒的机制可能是通过干扰H3N2流感病毒和吸附、穿入和基因的复制，从而抑制子代病毒体的生成。【Abstract】 Objective To explore the anti-viral effects of silver-nanoparticles (silver-nps) on H3N2 influenza virus in vitro and to evaluate its mechanism. Methods Silver-nps was added to canine kidney cells (MDCK) before and after the cells was adsorpted by H3N2 influenza virus. Cytopathic effect (CPE) assay and the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay were used to analyze the preventive effect, directly off deactivation, and the inhibit formation of progeny virions of silver-nps on H3N2 viruses. The interference of HA gene replication was observed by the RT-PCR assay. Results The survival rate of MDCK cells was 94.38% and 92.17% after 50 and 25 μg/mL silver-nps were mixed with 100 TCID50 H3N2 virus in 2 hours, and the survival rate of MDCK cells was 85.39% and 83.28% before and after the cells was adsorpted by H3N2 influenza virus when 25 μg/mL silver-nps was added to the cells (all compared to virus control, Plt;0.001), which showed that silver-nps could inactivate H3N2 virus, prevente them invasing to the cells and reproducting when H3N2 entered the cell remarkedly. The HA gene was not amplified successfully when 50 and 25 μg/mL silver-nps were mixed with 100TCID50 H3N2 virus in 15, 30, 60, and 120 minutes later, but both pure virus solution and solvent control group appeared a significant bright band in the 1 700 bp area. Conclusion Under three different administration modes, silver-nps has an obvious effect against H3N2 in vitro, which could interfere the HA gene replication and inhibit the formation of H3N2 progeny virions.
通过分析护理研究生在我院近5年撰写的科研项目申报书、中标与参与课题研究、在国内外学术期刊论文的发表、协助指导论文和参与国内外学术交流活动的情况,从而探讨护理研究生在医院临床科研工作中的角色和作用。
目的：替扎尼定是具有解痉作用的α２肾上腺能受体激动剂，并具有一定的胃肠道保护作用，适用于单一治疗或与非甾体消炎药（NSAIDs）联合治疗急性痉挛性疼痛。通过替扎尼定和非甾体类抗炎药物的联合应用，临床观察和评估联合用药能否增强疗效和增加安全性。方法：急性痉挛性疼痛70例，随机分为两组，一组服用替扎尼定2mg,bid+双氯芬酸50 mg,bid，一组服用双氯芬酸50 mg,bid+安慰剂2mg,bid。观察药物疗效和不良反应。结果：联用组的总有效率为70％，胃肠道不良反应发生率为12%,中枢神经系统不良反应发生率为18％；单用组的总有效率为56％，胃肠道不良反应发生率为32％，中枢神经系统不良反应发生率为10％。结论：替扎尼定和非甾体类药物联用具有更好的疗效以及更高的药物耐受性。
为了促进药物的合理应用，本文从药物相互作用、配伍禁忌、药物选用、用法用量等方面对临床常见的不合理用药医嘱进行了探讨，指出用药不当的原因和可能的后果，帮助临床有效地防范不合理用药的发生，有利于针对性地提高临床合理用药水平。
Objective To study the effect of genistein (Gen) in combination with 5-fluorouracil (5-FU) on human gastric carcinoma cells in vitro. Methods Human gastric carcinoma cell line SGC-7901 was t reated with Gen and 5-FU alone or in combination for 24 , 48 and 72 hours , respectively. MTT assay was used to investigate the inhibitory effect of Gen and 5-FU on SGC-7901 cells. Transmission electron microscopy was used to observe the ultramicrost ructure changes of cancer cells and the flow cytometry was used to detect the distribution of cell cycle. Results Gen and 5-FU alone or in combination inhibited the proliferation of SGC-7901 cells significantly in both time-dependent and dose-dependent manner. The combination of Gen with 5-FU had synergistic effect on the growth of SGC-7901 cell line when the inhibition ratio was 20 % to 80 %. When SGC-7901 cells exposed to 18. 8μmol/ L Gen , 8. 84μmol/ L 52FU , and 3. 06μmol/ L Gen combined with 7. 96μmol/ L 5-FU for 72 hours , 62. 97 % , 63. 76 % and 67. 46 % SGC-7901 cells were arrested in G2 / M , S and G0 / G1 phrase , respectively. Gen and 5-FU could both induce apoptosis and arrest cell cycle of SGC-7901 cells. Conclusion Combination therapy of Gen with 5-FU may take synergistic inhibitory effect on the proliferation of gastric cancer cells by resting cell cycle and inducing cell apoptosis at a certain range of concent ration.
ObjectiveTo compare tacrolumus (FK506) with cyclosporine A (CsA) in clinical application to organ transplantation.MethodsThe literature in recent years has been reviewed and compared. ResultsFK506 was a powerful immunosuppression with a mechanism of action similar to that of CsA, but significantly superiori to CsA in terms of prophylaxis and treatment of allograft acute rejection, delay of chronic rejection, and withdrawal of steroid in early period. The cardiovascular mortality and chronic graft nephropathy (CGN),such as hypertension and hyperlipidemia were less frequently seen in FK506treated patients and FK506 also had an acceptable safety profile, including a low incidence of hypertrichosis,gingival hyperplasia and infections.However, CsA had been showed a better result in prevention of posttransplantation diabetes mellitus (PTDM ) and more economic agent than FK506. Pharmacokinetic studies showed CsA in the form of Sandimmun Neoral showed less inter an intrapatient variability than FK506.Meanwhile, the combination of MMF and FK506 or CsA has been proved effectively with excellent graft and patients survival. Conclusion FK506 and CsA are safe and effective long term maintenance immunosuppressive agents in organ transplantation with wonderful prospect.
Objective To summarize the recent development on chondroprotective effect of alendronate (ALN) on articular cartilage in osteoarthritis (OA). Methods The related literature was reviewed and the main achievements in vitro/vivo studies in the fields were summarized. Results ALN can improve the metabolic microenvironment of the articular cartilage in OA, inhibit subchondral bone remodeling, so it has potential protective effect on articular cartilage. Conclusion ALN is expected to become a disease-modifying OA drug in future, but OA treatment still lack a uniform basic and clinical evaluation criteria, so it has guiding significance in development and application of ALN to develope a uniform standard and obtain the clinical data.
Objective To investigate the effect of monocyte chemoattractant protein 1 (MCP-1) on the migration of the induced and differentiated mouse bone marrow mesenchymal stem cells (BMSCs) for raising the efficacy of intravenous transplantation of BMSCs. Methods The BMSCs were cultured with the method of differential adhesion and density gradient centrifugation of C57/BL10 mice, and were identified by alkal ine phosphatase Gomori modified staining after osteogenic inducing. At the 3rd passage, the BMSCs were induced to the myoblasts with 5-azacytidine (5-Aza). The chemotaxis of MCP-1 in the induced and differentiated BMSCs in vitro at concentrations of 25, 50, 100, 200, and 400 ng/mL was observed through the migration test, by counting the number of the migrated cells. The expression of the chemokine receptor 2 (CKR-2) in the induced and differentiated BMSCs was detected with the flow cytometry. Results The cells could be cultured with the methods of differential adhesion and density gradient centrifugation and still had higher prol iferative and differentiative potency; the induced cells at the 3rd passage could differenciate to the osteoblasts, confirming that the cells were BMSCs; the myogenic induced BMSCs possesed the sarcotubule structure. The number of the migrating BMSCs at MCP-1 concentrations of 25-400 ng/ mL were respectively 35.066 7 ± 6.584 2, 43.200 0 ± 6.460 8, 44.466 7 ± 4.823 5, 45.600 0 ± 8.650 3, and 50.733 3 ± 7.582 5; showing significant difference when compared with control group (28.333 3 ± 8.917 6, P lt; 0.05), and presenting significant difference among 25, 50, 400 ng/mL groups compared with each other (P lt; 0.05). The expression of CKR-2 in the mouse BMSCs (48.0%) was significantly higher (P lt; 0.001) than those of blank control (0.6%) and negative control (17.0%). Conclusion The results indicate that the MCP-1 can induce the migration of mouse BMSCs by MCP-1/CKR-2 pathway.
Objective Titania and Ag containing nano-hydroxyapatite/polyamide 66 (TiO2-Ag-nHA/PA66) composite bone fill ing material has good biocompatibil ity and biological safety. To investigate the antibacterial effect and Ag+ release characteristics of TiO2-Ag-nHA/PA66 composite bone fill ing material containing different concentrations of Ag+ in vitro. Methods The n-HA/PA66 composite bone fill ing material A1 (material A1) was prepared by co-polymerization method, and TiO2-Ag-nHA/PA66 composite bone fill ing materials A2 and A3 (materials A2 and A3) were prepared by thesame way containing Ag+ of 0.22wt% and 0.64wt%, respectively, and the TiO2 content was 2.35wt%. The materials A2 and A3 were respectively immersed in 50 mL simulated body fluid (SBF), and Ag+ concentration was measured by atomic absorption spectrometry at 1, 3, 7, 14, 21, and 49 days. The inhibition ring test and colony count method were used to evaluate antibiotic effect against Staphylococcus aureus and Escherichia coli, the anti-adhesion capacity of Staphylococcus aureus and Escherichia coli was observed by scanning electron microscope (SEM). Results There was no significant difference in the Ag+ concentration between materials A2 and A3 at 1 day and 3 days (P gt; 0.05); and there were significant differences in the Ag+ concentration between materials A2 and A3 after 7 days (P lt; 0.05). The inhibition ring diameters of materials A2 and A3 to Staphylococcus aureus and Escherichia coli reached the maximum at 1 day, which were (13.40 ± 2.88), (9.40 ± 1.14) mm and (23.60 ± 1.14), (18.80 ± 0.84) mm, showing significant difference (P lt; 0.05) between materials A2 and A3 respectively; and then, the diameter of inhibition ring reduced with the time. The antibacterial effect of materials A2 and A3 against Staphylococcus aureus and Escherichia coli lasted 15, 33 days and 9, 24 days, respectively. No inhibition ring was observed around material A1 all the time. And the inhibitory rates of materials A2 and A3 were 89.74% ± 3.62%, 94.18% ± 2.05% and 78.65% ± 5.64%, 85.96% ± 2.50%; showing significant differences (P lt; 0.05) among materials A1, A2, and A3. SEM showed that bacterial adhesion of materials A2 and A3 was obviously fewer than that of material A1. Conclusion TiO2-Ag-nHA/PA66 composite bone fill ing material has antibacterial property against Staphylococcus aureus and Escherichia coli, and it has a good release effect in SBF.