當前國際形勢的變化及中國經濟社會的發展為生物醫藥產業提供了難得的歷史機遇，抓住這個歷史機遇，實現國內與國際、產業與市場的兩個有效對接，是推動我國生物醫藥產業發展的關鍵和有效手段。為了探索國內與國際對接的有效方式，我們發起“王朝計劃”，并于今年6月17日在深圳第五屆中國生物產業大會上，由衛生部醫藥衛生科技發展研究中心與英國MRCT、武漢光谷生物產業基地及上海新生源集團公司分別簽訂了共同推進“王朝計劃”和共建“衛生部科技中心國際臨床醫學基地”的戰略合作協議。 “王朝計劃”的核心思想是將英國領先的醫藥研發能力與中國巨大的市場需求相對接，實現技術和項目的雙向轉移。“王朝計劃”有3個重要特點：① 民間發起的國際合作計劃，而非政府間合作計劃；② 商業合作計劃，而非單純的科技合作計劃；③ 開放的合作計劃，是集成技術、成果、人才、資本各種資源的計劃。 為了探索產業與市場對接的有效方式，我們啟動了“衛生部科技中心國際臨床醫學基地”的建設工作。其宗旨是利用科技手段，努力解決長期存在的產業與臨床應用兩張皮的問題；加快和規范生物醫藥技術和產品的市場推廣；實現醫療技術水平和生物醫藥產業相互促進，共同發展。其建設思路緊緊圍繞1個重點，針對2個需求，開展3項業務，實現4個目標。圍繞1個重點：重點開展上市后醫藥技術和產品的臨床研究，而不是主要承擔以上市申報為目的的臨床試驗。與通常的CRO不同，我們的主要產出是臨床研究的科研成果，而不是臨床試驗的申報資料。針對2個需求：① 已上市的產品或技術對開拓市場的需求；② 廣大醫務工作者開展科學研究，提高醫療水平的需求。開展3項業務：① 吸納多方投入，建立臨床科研基金，組織開展臨床科研項目，探索既實現科研投入多元化，又確保具體的科研活動不受商業利益牽制的有效機制；② 建立針對不同疾病或癥候群的臨床研究數據庫，實現醫學知識的系統積累，產出更多的高水平科研成果，推動流行病學、循證醫學和轉化醫學的發展；③ 將衛生技術評估體系與產業對接，完善我國醫藥技術和成果的評價體系，提高醫藥企業的技術決策能力。實現4個目標：① 做強優勢技術、成果和企業；② 推動臨床科技進步和技術水平提升；③ 催生新的服務產業模式；④ 是完善園區的技術孵化和產業促進體系，增強園區的招商引資能力。 “國際臨床醫學基地”將由衛生部科技發展中心與武漢光谷生物基地共建，在湖北省衛生廳等有關方面的支持下，實行理事會領導下的主任負責制，依托由園區直屬國有企業與其他企業合資設立的專門公司進行具體運作。衛生部科技中心主要負責整體設計、宏觀決策、政策支持和監督把關，不參與實體公司的股份和單純市場運作。“王朝計劃”和“國際臨床醫學基地”既密切相關，相互促進，又各有獨立的業務發展方向。這兩項事業都是全新的探索，要走的路還很長，還有許多困惑和挑戰，都需要政府、企業、臨床醫療機構和投資機構等多方面的大力支持。為了生物技術能向信息技術那樣，真正實現全方位、大規模的產業化，真正全面改變我們的世界和生活，讓我們共同努力！ 收稿日期：2011–12–06 本文編輯：杜亮
ObjectiveTo investigate the negative emotions of patients before cardiac surgery in West China Hospital in order to analyze the related factors.MethodsThe Huaxi emotional-distress index (HEI), a screening tool for mood disorders developed by the Mental Health Center of West China Hospital, was used for preoperative psychological evaluation of 1 968 adult patients hospitalized in cardiac surgery from March 2016 to July 2014. There were 835 males and 1 133 females at age of 49±13 years.Results Fifty-one patients (2.6%) had negative emotions, among whom 6 patients were screened for suicide risk. After intervention, none of them had serious consequences caused by adverse emotions, such as automatic discharge from hospital, avoidance of surgery and suicide.ConclusionThis study found that most of the cardiac surgery patients in West China Hospital have good psychological status before surgery, and a few suffered from negative emotions. “Huaxi emotional-distress index” is simple, effective and worth promoting.
ObjectiveTo review the current progresses in purification strategies, biological characters, and functions of endothelial progenitor cells (EPCs) derived extracellular vesicles (EVs) (EPC-EVs). MethodsRecent relevant publications on the EPC-EVs were extensively reviewed, analyzed, and summarized. ResultsEPC-EVs are usually isolated by differential centrifugation and exhibit a homogenous pattern of spheroid particles with a diameter ranging from 60 to 160 nm under transmission electron microscopy. EPC-EVs are positive for cell-surface markers of EPCs (CD31, CD34, and CD133), and negative for markers of platelets (P-selectin and CD42b) and monocytes (CD14). Recent studies have shown the effectiveness of EPC-EVs in ischemic injuries, anti-Thy1 glomerulonephritis, and cardiomyocyte hypertrophy, and also shown their predictive role in cardio-cerebral-vascular diseases. ConclusionAn alluring prospect exists on the EPC-EVs-related research. Further studies are required to decipher the composition of EPC-EVs and their precise role in pathophysiological processes, and to investigate the molecular mechanisms for their targeting and function.
目的 總結反復黏膜感染的IgA腎病的臨床病理特點。 方法 采用單中心流行病學調查及回顧性研究，收集2006年1月－2009年12月253例經腎活檢確診為IgA腎病的住院患者的臨床病理資料，對114例反復黏膜感染的IgA腎病患者（A組）及139例偶發或從未發生黏膜感染的IgA腎病患者（B組）的臨床病理指標進行比較。 結果 A組患者年齡較B組小（t=2.913，P=0.004），臨床表現無明顯癥狀者比例較B組多，臨床分型以反復發作肉眼血尿型為多，病理分級較B組輕（Z=?2.042，P=0.041），IgA+IgM+C3沉積率高（P＜0.001）；B組IgA+IgG+C3沉積率高（P＜0.001），纖維連接蛋白沉積率高（P＜0.001）。 結論 反復黏膜感染的IgA腎病組患者年齡小，反復發作肉眼血尿型多，臨床表現及病理分級較輕；兩組FN沉積及免疫球蛋白沉積的主要類型不同，提示兩組發病機制可能有所不同。
ObjectiveTo observe the prevalence of ocular ischemic appearance (OIA) associated with carotid artery stenosis, and to explore the correlation between the ocular ischemic appearance and the carotid stenosis degree and location. MethodsA total of 132 patients with carotid artery stenosis diagnosed by color Doppler ultrasound and CT angiography were enrolled in this prospective study. The carotid stenosis degree and location were identified. The ophthalmic symptoms was inquired. The corrected vision, diopter, intraocular pressure, slit lamp microscope and fundus examination were used to determine if OIA exists. The correlation between the OIA and the carotid stenosis degree and location were analyzed. The carotid stenosis degree was divided into 4 types: mild (≤50%), moderate (<50% but ≤75%), severe (<75% but ≤99%) and occlusion (100%). ResultsThe distribution of carotid stenosis degree as follow: mild in 16 patients (12.1%), moderate in 46 patients (34.8%), severe in 50 patients (37.9%) and occlusion in 20 patients (15.2%). The stenosis located in the external carotid artery in 21 patients (15.9%), in internal carotid artery in 46 patients (34.8%), in crotch of extracranial internal carotid artery in 55 patients (41.7%), and in common carotid artery in 10 patients (7.6%). There were 54 patients (40.9%) with ocular ischemic diseases, which including retinal arterial obstruction (5 patients, 9.2%), retina change of venous stasis (13 patients, 24.1%), neovascular glaucoma (7 patients, 13.0%), ischemic optic neuropathy (19 patients, 35.2%), ocular ischemia syndrome (10 patients, 18.5%). The ophthalmic symptoms included transient amaurosis, decreased visual acuity, eye and periorbital pain, retinal hemorrhage and exudation, diplopia, rubeosis iridis and increased intraocular pressure. There was highly positive correlation between the carotid stenosis degree and OIA (r=0.287, P=0.018). There was no correlation between the carotid stenosis location and OIA (P>0.05). Conclusion40.9% carotid stenosis patients has OIA. There is relationship between the carotid stenosis degree and OIA, but carotid stenosis location showed no correlation with OIA.