第六屆亞太地區循證醫學研討會組委會： 欣聞第六屆亞太地區循證醫學研討會首次在中國深化醫療體制改革的中部重鎮——安徽省蕪湖市皖南醫學院隆重召開，邀請了世界上最富盛名的高質量醫學證據生產的兩大非盈利學術組織Cochrane協作網和Campbell協作網前主席、WHO國家臨床試驗注冊平臺技術負責人和Cochrane協作網英國中心、南非中心、南亞中心和韓國分中心主任及培訓部主任赴會，與國內800余名會議代表齊聚一堂，就當前為實現“2020 Health for All”的世紀目標的探索與實踐中，共同面臨的醫療衛生改革、醫學教育改革、決策模式、服務體系、運行機制、政策環境、人才培訓、公眾教育等難題，以及為解決當前這些難題開發的種種決策模式、研究方法、評價標準等前沿，通過大會專題報告，分會場口頭報告，工作會當堂切磋等多種形式充分交流，共享信息，可喜可賀！ 1997年7月27日，衛生部科教司發文批準建立衛生部中國循證醫學中心。13年來，在衛生部兩屆指導委員會的宏觀指導和大力幫助下，中國循證醫學中心圓滿完成了創建衛生部中國循證醫學中心、Chinese Cochrane Center的任務。并按照1997年衛生部批建時確定的目標，學習美國/加拿大建立13個循證醫學實踐中心，為美國衛生保健政策和研究委員會（Agency for Healthcare Research and Quality，AHRQ）生產高質量決策證據的經驗，同時學習英國國家臨床評價研究所（National Institute for Health and Clinical Excellence，NICE）、蘇格蘭地區學院指南網絡（Scottish Intercollegiate Guideline Network，SIGN）作為非盈利學術機構生產循證臨床指南和合成高質量證據的經驗，與中心領導創辦的循證醫學教育部網上合作研究中心及其分中心合作，共同為推動中國的循證醫學事業，服務于中國的醫療改革、醫學教育改革，做出了寶貴的貢獻。 中國的醫療改革正處于關鍵之年，中國的衛生事業發展正面臨前所未有的挑戰和機遇，“2020健康中國”的政府承諾，建立國家基本藥物制度、臨床指南生產和審查制度、國家戰略性新興產業、衛生技術和產品的臨床轉化……，急需大量訓練有素的EBM人才團隊，應衛生部要求，有組織、有計劃地生產高質量決策依據，并及時將政府的各種科學決策迅速轉化到實踐中，用于提高當地的醫療服務質量。 正是從這個意義上講，您們的存在和發展，對保障此項工作的國際接軌和可持續發展，意義重大！ 我謹代表衛生部預祝大會圓滿成功！衛生部副部長 黃潔夫2010.9.24
Objective To probe into the roles of inositol 1, 4, 5-trisphosphate (IP3) and bcl-2 gene expression in inhabiting hepatocellular carcinoma of nude mice by quercetin. Methods Animals with hepatocellular carcinoma in quercetin group were treated with injection peritoneum of quercetin 50 mg/（kg·d ） for 3 weeks, while which in control group were treated with 0.4% DMSO of RPMI 1640 0.05 ml/（g·d）. Then the volume and the weight of tumors were measured, IP3, bcl-2 mRNA and bcl-2 protein were assayed by IP3-［3H］ Birtrak Assay, RT-PCR and Western blot respectively. Results The volume and weight of tumors in quercetin group were lower than those in control group 〔（15.8±10.1） mm3 vs. （52.3±26.5） mm3 in volume, （44.8±10.4） mg vs.（91.3±31.4） mg in weight， P＜0.01〕. Content of IP3 in quercetin group was lower than that in control group 〔（13.4±1.4） pmol/mg prot vs. （35.3±6.6） pmol/mg prot， P＜0.01〕. There was no significant difference in bcl-2 mRNA expression between quercetin group and control group 〔RI （the gray degree multiply area of bcl-2 /the gray degree multiply area of β-actin）： 0.55±0.05 vs. 0.79±0.19， P＞0.05〕， but the expression of bcl-2 protein in quercetin group was lower than that in control group (RI: 1.07±0.12 vs. 6.69±1.80, P＜0.01). Conclusion Quercetin can inhabit the growth of hepatocellular carcinoma tansplanted into liver of nude mice by reducing IP3 production and down-regulating bcl-2 gene expression.
【Abstract】Objective To study the antitumor activity of HSVtk/CD combinative gene toward human cholangiocarcinoma in vivo. Methods Nude mouse models with transplanted subcutaneous cholangiocarcinoma were constructed and divided into 4 groups randomly, each group had 8 mice. Adenovirus solution free from suicide gene was injected in subcutaneous tumors of each mouse of control group. Adenovirus solution containing cytosine deaminase (CD), thymidine kinase (tk) and HSVtk/CD fusional gene were injected into single suicide gene either HSVtk or CD was transinfected into the tumor cells by injecting viras into subcutaneous tumor of mice of CD gene,tk gene and fused CD and tk gene group respectively. 24 hours after the injection, 5fluorocytosine (5FC) and ganciclovir (GCV) were injected introabdominally in each mouse. Growth of the tumors were monitored.Results Tumor growth of the genetransfection groups was suppressed in different degrees. Compared with the control group, the suppressing rates of the genetransfection groups were 41.2%, 55.7% and 70.0% respectively (P＜0.05). Histological examination showed good tumor growth in the control group, and tumor necrosis in the other 3 groups, particularly obvious in the group transfected with pAd(HSVtk/CD).Conclusion Combinative gene system has a b antitumor effect on cholangiocarcinoma in vivo. But it’s not powerful enough to eliminate tumor thoroughly because of insufficient “Bystander effect”.
Objective To investigate the effect of S-adenosylmethionine (SAM) on mitochondrial injury that was induced by ischemia-reperfusion in rat liver. Methods Fifty-four rats were randomly divided equally into 3 groups: control group, ischemia-reperfusion group (I/R group), and SAM-treated group (SAM group). Hepatic ischemia had been only lasted for 30 min by obstructing the blood stream of hepatic portal vena (the portal vena was only separated but not obstructed in control group). The rats of SAM group received SAM intraperitoneally 2 h prior to ischemia. Blood samples of each group were collected from the inferior cava vena at 0, 1 and 6 h after reperfusion and the serum levels of AST and ALT were detected. Mitochondrial super oxidedismutase (SOD), malondialdehyde (MDA), adenosine triphosphate (ATP) and energy charge (EC) in samples of liver tissue were detected, and the mitochondrial ultrastructure was observed with electronmicroscope. Results The serum levels of AST, ALT and mitochondrial MDA at 0, 1 and 6 h after reperfusion in the I/R group were significantly higher than those in the control group, whereas the levels of mitochondrial SOD, ATP and EC were significantly lower than those in the control group (P＜0.01). Except the value of 0 h, when it comes to SAM group, the levels of AST, ALT and mitochondrial MDA were significantly lower (P＜0.05) and the levels of mitochondrial SOD, ATP and EC were significantly higher (P＜0.05, P＜0.01) than those in the I/R group, respectively. The mitochondrial ultrastructure was injured obviously in I/R group when compared with that in control group. The number of mitochondria decreased and the mitochondria swelled, making the crista became obscure and the density of matrix became lower. The above changes in SAM group were less obvious when compared with those in I/R group. Conclusion SAM may protect mitochondrion against hepatic ischemia injury, since it may prevent mitochondrial lipid peroxidation, increase ATP, and eventually improve energy metabolism after ischemia-reperfusion.
Objective To analyze the surgical techniques for the procurement and back-table surgery of the graft in living-related small bowel transplantation. Methods Eligible donor was chosen according to the donor selection criteria of living-related small bowel transplantation, and preoperative plan was designed. A segment of ileum of 120 cm was procured 20 cm proximal to the ileocecal valve which was preserved in the donor. The techniques for the procurement and back-table surgery of the graft were summarized, which included measurement of entire small bowel length from Treitz to ileocecal valve, palpation and transillumination to identify the distal branch of the superior mesenteric artery， and transient blockage of isolated blood vessels with vascular clamps in order to observe the influence on the blood circulation of graft and residual ileum. The detailed manipulation techniques in processing the graft blood vessels were discussed. Results The operations were successful both on the donor and the recipient. The functions of implanted segment of bowel were well. The donor had no other complications, such as mesenteric thrombi and anastomosis leakage of intestine, except for transient moderate diarrhea. She was discharged 14 days after operation. In the next 8 months of following-up, the donor has not experienced significant alteration in bowel habits or weight loss. Now she is in good appetite, without any changes in the habit and amount on diet. No changes have been found in lifestyle, work habits, or psychosocial conditions after the small bowel donation. Conclusion The procurement of a segment of ileum as graft and preservation of 20 cm proximal to the donor ileocecal valve may be ideal protocol. Using a standardized technique with attention presents little recent or long-term risks for the donor and brings satisfied effect for the recipient.
