AIM To understand the characteristics and investigate the diagnosis, treatment of intrahepatic biliarypapillomatosis.METHODS Two cases were confirmed operatively and pathologically, and the literature reviewed.RESULTS The causes of the disease are not clear, but the long-term irritations of stone and inflammationmay be considered. Despite being histologically benign, it has low-grade malignant potential, characterizedby multiple and diffusive manner, and has high rates of recurrence and malignant transformation. Jaundiceand cholangitis are the dominant manifestations. Imaging modalities are beneficial in it's diagnosis, and thescanning of choledochoscopy is of great value.CONCLUSION The management of the disease is difficult. Curative resection is the primary therapy.Curettage and drainage may lead to high recurrence. The chemotherapy and lasertherapy represent othermodalities in the treatment. Biliary papillomatosis may become a new indication for liver transplantation.

Site-specific delivery of therapeutic drugs to their target cells is a major scientific challenge for the pharmaceutical sciences. It offers a number of advantages over conventional drug administration. With drug targeting, high local concentrations of the drug can be achieved, thus circumventing many unwanted side effects. Various carriers have been suggested for the delivery of drugs, including liposomes[1 - 5] and (neo ) glycoproteins[6-8]. The asialoglycoprotein receptor (ASGP-R) has frequently been utilized for targeting drugs to the parenchymal liver cell[6- 12]. Liposomes have several advantageous characteristics as drug carrier, and particularly, ligandtacked liposomes achieve a highly effective targeting[13]. Hara et al reported that asialofetuin (AF)-tacked liposomes distributed to rat hepatocytes selectively in vivo[14], and ASGP-R mediated the uptake of AF-liposomes encapsulating IFN-γ by isolated rat hepatocytes in vitro[15]. Lactosaminated human serum albumin (L-HSA) is a neoglycoprotein taking number of galactose residue as terminal sugar[6].

心力衰竭的药物治疗新进展

心力衰竭是一种严重威胁人类健康的疾病,以老年人居多.据统计美国有500万心力衰竭患者,且每年新增患者55万,住院率更是逐年增长,从1979年的40万增长到2004年的大于100万,而仅2007年,美国用于心力衰竭治疗的费用就大于330亿美元~([1]).我国心力衰竭患者住院率占同期心血管病的20%,病死率为40%,且其发生率随增龄逐渐增加.

预防心房颤动患者脑卒中的药物治疗新进展

心房颤动(房颤)是常见的心律失常,有较高的发病率和病死率.患病率随增龄而增加,年龄＜60岁的患者有1%受累,而年龄＞80岁的患者为10%\[1-2].房颤可使栓塞或脑卒中风险增加5倍,每年的绝对风险为1%~20%,取决于患者的年龄和是否存在危险因素,如充血性心力衰竭、高血压、糖尿病和既往栓塞事件[3].

中国高血压防治指南2010

序言高血压是常见的慢性病,也是心脑血管病主要的危险因素,其脑卒中、心肌梗死、心力衰竭及慢性肾脏病等主要并发症,不仅致残、致死率高,而且严重消耗医疗和社会资源,给家庭和国家造成沉重负担.国内外的实践证明,高血压是可以预防和控制的疾病,降低高血压患者的血压水平,可明显减少脑卒中及心脏病事件,显著改善患者的生存质量,有效降低疾病负担.

大麻素系统在骨科中的应用进展

大麻素是一类存在于大麻花梢和花瓣中，具有药理学作用的亲脂类化合物。19世纪末欧洲，人们将大麻用来治疗疼痛、肌肉痉挛、哮喘、失眠、抑郁、厌食等，但其主要有效成分△9-四氢大麻酚( THC )直到1964年才通过立体化学被确认[1]。之后，学者们又发现了约60种植物源性大麻素，并合成了众多结构和功能相似的大麻素类化合物。1990年，Matsuda等[2]从大鼠脑基因库中克隆出 THC 的受体 CB1，从而揭示了大麻素生理功能的分子机制。随后，1993年，Munro 等[3]从人早幼粒细胞白血病细胞系HL60基因库中克隆出受体CB2。CB1和CB2现在被证实是大麻素经典的两类受体。1992年，Devane等[4]首次在猪脑中发现了内源性大麻素N-花生酰乙醇胺( AEA )，之后2-花生四烯酸甘油(2-AG )和2-花生四烯酸甘油乙醚等内源性大麻素也相继被发现[5-7]。随着内源性大麻素的发现，越来越多的实验开始关注内源性大麻素的生理功能和作用机制，并逐渐探索其临床应用价值。

骨肉瘤的靶向治疗

骨肉瘤是一种起源于间叶组织的恶性肿瘤，其血行转移发生率高且早[1]。新辅助化疗已成为肉瘤治疗的常见手段。骨肉瘤是对化疗不敏感的恶性肿瘤，化疗药物缺乏对肿瘤的特异亲和性，终只有少量药物到达肿瘤部位。要提高肿瘤内化疗药物浓度就必须提高全身循环系统的药物浓度，必须加大药物剂量，从而也加大化疗药物的毒副反应。为减少全身毒性，提高肿瘤的化疗有效率，鉴于肿瘤内的药物浓度与组织学坏死程度有直接关系，因此局部动脉化疗、高温隔离灌注化疗是一种可供选择的方法，但长期随访发现，动脉灌注并不比系统性静脉化疗更能改善预后[2]。故骨肉瘤的治疗，关键在于“靶向”，高效、准确地命中癌靶标，在杀伤癌细胞的同时基本上不或很少损伤正常组织细胞[3]，这是骨肉瘤得以治愈的关键所在。

降钙素在骨质疏松骨折治疗中的应用

降钙素作为抗骨吸收药物在骨质疏松临床治疗中已有广泛应用，大多数研究认为降钙素临床疗效主要表现在抑制破骨细胞，缓解疼痛，骨质量(骨结构、骨力学性能)改善比骨密度上升明显，且能有效地降低骨质疏松椎体骨折的发生率[1]。著名的PROOF研究和降钙素改善骨质量的研究(qualitativeeffectsofsalmoncalcitonintherapy， QUEST)证明，降钙素能有效降低绝经后妇女椎体压缩性骨折风险，在骨质量改善的同时伴或不伴有骨密度的增加[2]。

应对骨质疏松维护骨骼健康

2010年我国第六次人口普查的结果显示：60岁以上人口数为1亿7千7百万，占总人口的13.26%，比2000年上升2.93个百分点；65岁以上人口数为1亿1千8百万，占总人口的8.87%，比2000年上升1.91个百分点。这个结果表明：我国已快速进入老龄社会。预计未来40年，到本世纪中叶，老龄、高龄人口数量会更加快速增长，人口形势严峻。

强直性脊柱炎的治疗指南介绍

强直性脊柱炎( ankylosing spondylitis，AS )是一种累及中轴及外周关节的慢性炎性进展性风湿病，AS 是脊柱关节炎( spondyloarthritis，SPA )的原型。2010年欧洲抗风湿病联盟( EULAR )及国际脊柱关节炎协会( assessments in ankylosing spondylitis international society，ASAS )共同更新了AS的治疗指南，该指南同样适用于SPA的治疗[1]。同年中华医学会风湿病分会也更新了我国 AS 诊断及治疗指南，两个指南的更新对于AS及SPA的治疗具有指导意义。近年来，随着传统药物及生物制剂治疗 AS 研究的深入，国内外又发表了许多关于 AS 治疗的研究。现综合介绍如下。

胰腺癌放化疗及分子靶向药物治疗进展

胰腺癌是较常见的恶性肿瘤之一,其发病率和死亡率近年来明赤上升.美国的胰腺癌发病率达10/10万人,我国几个主要城市近20年来该病的发病率增加了4倍左右,接近欧美国家.

遗传药理学对癫(癎)药物治疗的影响

癫(癎)是小儿常见的中枢神经系统慢性疾病,全球约五千万患者[1].药物治疗为首选的治疗方法,约70%患者可通过药物治疗控制发作[2].药物治疗过程面临诸多问题,例如:如何选择合适的个体化治疗剂量?如何预测可能出现的药物不良反应?如何解释相同癫(癎)综合征患儿的不同药物治疗效果?虽然许多因素会影响药物的治疗过程,但遗传因素肯定在其中发挥了重要作用[3].遗传药理学(pharmacogenetics)是研究个体基因的变异对药物代谢、功效和不良反应的不同影响的学科,其终目的是在患者用药之前可以根据个体的基因型预测药物的疗效以及不良反应的发生风险,从而实现个体化用药.本文主要从遗传变异对抗癫(癎)药(antiepileptic drugs,AEDs)临床疗效的影响以及对不良反应风险的影响两个角度进行综述.

Objective To detect the cell viability and the expressions of stem cell surface markers after chemotherapeutic drug treatment. Methods We observed the cytotoxic effects of three chemotherapeutic agents [ epirubicin ( Epi ) , fluorouracil ( 5-FU ) and cyclophosphamide ( Cyc ) ] in three cell lines, and the cell viabilities after removed these chemotherapeutic agents. Expressions of stem cell surface markers CD44, CD24, CD90, CD14 and aldehyde dehydrogenase1(ALDH1) in breast cancer cells were analyzed by real-time PCR. The post hoc analysis (Tukey’s tests) in conjunction with one-way ANOVA was used for statistical analysis. Results The initial cytotoxic efficacy was most notable. After the treatment of the same therapeutic agents, cell viability was decreased by 64. 8% 35. 14%, 32. 25% in BT-483 cells, 66. 4%, 22. 94% and 45. 88% in MDA-MB-231 cells, 97. 1%, 99. 5% and 76. 4% in MCF cells. The difference was significant compared with that before treatment ( P=0. 000 ) . However, the inhibitory effects were diminished after chemotherapeutic agent withdrawal. Cell viabilities were increased to 167. 9%, 212. 04% and 188. 66% in MDA-MB-231 cells at 48 h after withdrawal. At 72 h after withdrawal, cell viability was increased with a significant difference in three cell lines (all P values=0. 000). Expressions of CD44 and ALDH1 were most prevalent for MDA-MB-231, BT-483 and MCF-7 cells. ALDH1 mRNA level was significant higher in BT-483 ( HER-2 overexpression cell line) than MDA-MB-231 ( triple negative cell line ) ( P = 0. 012 ) . CD14 mRNA level in MCF-7 cells were significantly lower than that in MDA-MB-231 and BT-483 (P=0. 003, 0. 001). BT-483 showed significantly higher level of CD44 than MDA-MB-231 and MCF-7 cell line (P= 0.013, 0.020), and no significant difference was detected between MDA-MB-231 and MCF-7 breast cancer cells ( P=0. 955 ) . CD90 mRNA expressions were detected in MDA-MB-231 cells and MCF-7 cells, but not in BT-483 cells. Conclusion Some malignant cells could survive in vitro and begin to proliferate again between cycles of chemotherapy.

基于证候病理生理学的病证结合的个体化诊疗

所谓个体化治疗(individualized drug therapy)是以每个患者的信息为基础决定治疗方针,从基因组成或表达变化的差异等来把握治疗效果或毒副作用等应答的个性,对每个患者进行适宜药物疗法的治疗.个体化治疗是医学人性化发展的重要标志,个体化治疗也是中医的一个特点,笔者从病理生理学角度讨论个体化诊疗的内涵.

痴呆药物治疗的临床研究进展

痴呆是一种造成智力、人格和行为能力不断恶化且不可逆转的疾病.阿尔茨海默病(Alzheimer disease,AD)和血管性痴呆(vascular dementia,VD)是老年人中常见的痴呆,但许多其他疾病亦可产生相似征象[1,2].随着老年人口比例的不断增高,痴呆患病率呈现上升趋势.目前65岁以上老人中痴呆患病率至少5%,而85岁以上则达30%[1].

产后功能性消化不良病人心理干预的探讨

产后功能性消化不良(functional dyspepsia,FD)是产后常见的消化系统疾病,部分病人症状严重或持久,严重影响其生活质量[1].而精神、心理异常和社会压力在FD发病中起着越来越重要的作用,因此药物疗法及心理干预治疗已逐渐成为FD的一些重要治疗措施.

沙蒿散缓解阻生牙拔除术后日常生活活动能力影响因素的效果评价

AIM:To investigate the effect of locally used Shahaosan on preventing the complication of extraction of impacted tooth.METHODS: 274 cases patients with extraction of impacted teeth were randomly devided into 3 groups named A,B and C.Shahaosan and Yunnan white drug were processed into drug A and B by department of pharmacy with the same color, shape and quality which are blind to doctors and patients.When the impacted teeth were extracted, administed group A(92 cases) with drug A,group B(86 cases) with drug B and group C(96 cases ) was a blank control. After the operation,incidence and severe intensity of dry socket in each group were observed and evaluated by scores.RESULTS: The incidence of dry socket in group A,B and C were 0.09% (1/92),2.32% (2/86),8.33% (8/96).There was no significant difference between group A and B, group B and C, while a significant difference showed between group A and C.The PoSSe score in group A, B and C was 19.36, 27.80 and 22.83 respectively.Afer the experiment the department of pharmacy informed that drug A is Shahaosan and drug B is Yunnan white drug.CONCLUSTON:Compiments of dry socket induced by extracting of lower jaw impacted teeth can be prevented by locally administered with Shahaosan, but no significant effect of alleviating the symptom of dental extraction.