彩色超声多普勒引导器官移植术患者颈内静脉穿刺及对并发症的监控效应

目的:为提高器官移植术患者颈内静脉穿刺置管的成功率及其安全性,减少并发症,应用彩色多普勒超声引导颈内静脉穿刺置管,并与采用传统的体表标志法穿刺者进行对比观察。方法:选择2004-11/2007-04南京医科大学附属无锡第一医院收治,预计穿刺较困难的肝移植及肾移植手术患者70例,根据患者意愿分为彩超定位组和对照组各35例。彩超定位组应用HDI5000型彩色多普勒超声显像仪进行实时立体定位,引导行颈内静脉穿刺置管并定期监控;对照组采用传统的体表标志法定位行颈内静脉穿刺置管。记录穿刺置管时间、成功率和并发症,穿刺置管成功后定期监控置入导管所在血管的血流情况、有无血栓形成或栓塞及飘浮导管的位置是否合适等。结果:70例均进入结果分析。①彩超定位组穿刺置管操作时间少于对照组(P<0.001)。②彩超定位组46次穿刺操作均一次成功,43次经颈内静脉单壁直接穿入,3例次穿过双壁,经稍退针后成功穿入,无一例次发生误穿动脉或其他并发症;对照组45次穿刺中,一次直接成功者20例次,6例次曾误穿入动脉。③21例肝移植患者均成功置入飘浮导管全程行有创心功能监测,术后监测发现4例有早期血栓形成。结论:①将彩色多普勒超声技术用于器官移植术患者颈内静脉穿刺时进行立体定位,引导穿刺置管,可明显提高穿刺置管的成功率和安全性。②通过术后定期监控,可了解导管位置是否保持准确及有无血栓形成等并发症发生。     

壳聚糖纳米粒制备及表征与其抗肿瘤的生物学效应

目的:近期研究发现,壳聚糖纳米化后,不仅可改善其溶解性,还可提高其生物学功能。拟建立壳聚糖纳米粒的制备方法,并对壳聚糖纳米粒的表征及抗肿瘤生物学效应进行初步研究。方法:实验于2006-08/2007-05在浙江省医学科学院生物工程所完成。①建立壳聚糖纳米粒的制备方法:将壳聚糖粉末溶于乙酸溶液,用NaOH调节其pH为5,采用三聚磷酸钠为凝聚剂,进行离子交联来制备壳聚糖纳米颗粒。通过离心和冷冻干燥得到壳聚糖纳米粒粉末。②纳米粒的表征:经超声得到壳聚糖的悬浊液,用透射电镜来观察纳米颗粒的外观形态;用动态光散射仪来测定纳米颗粒的粒径大小与分布。③采用MTT法对壳聚糖纳米粒体外抗肿瘤生物学效应进行了初步研究。结果:①透射电镜下观测到了稳定、均一的颗粒;激光粒度分析仪测量发现纳米粒粒径大小在300nm左右,粒径分布较窄。②500mg/L的壳聚糖纳米粒对Hela细胞的抑制率为27%;对SMMC-7721细胞的抑制率为23%;对BGC-823细胞的抑制率为29%;对MCF-7细胞的抑制率最高,达55%。结论:建立的壳聚糖纳米粒的制备方法可靠,并证明其体外具有较好的抗肿瘤作用。     

CD44v6 expression in patients with stage II or stage III sporadic colorectal cancer is superior to CD44 expression for predicting progression

Background: Currently, it is difficult to predict the prognosis of patients exhibiting stage II or stage III colorectal cancer (CRC) and to identify those patients most likely to benefit from aggressive treatment. The current study was performed to examine the clinicopathological significance of CD44 and CD44v6 protein expression in these patients. Study design: We retrospectively investigated 187 consecutive patients who underwent surgery with curative intent for stage II to III CRC from 2007 to 2013 in the Beijing Civil Aviation Hospital. CD44 and CD44v6 protein expression levels were determined using immunohistochemistry and compared to the clinicopathological data. Results: Using immunohistochemical detection, CD44 expression was observed in 108 (57.75%) of the CRC patients; and its detection was significantly associated with greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological tumor-lymph node-metastasis (TNM) stage. CD44v6 expression was observed in 135 (72.19%) of the CRC patients; and its expression was significantly associated with a poorly differentiated histology, greater invasion depth, lymph node metastasis, angiolymphatic invasion, and a more advanced pathological TNM stage. Expression of CD44v6 was higher than that of CD44 in stage II and stage III sporadic CRC. Conclusion: CD44v6 is a more useful marker for predicting a poor prognosis in stage II and stage III sporadic CRC as compared to CD44.     

Dependence of the permanent deformation of red blood cell membranes on spectrin dimer-tetramer equilibrium: implication for permanent membrane deformation of irreversibly sickled cells

Red blood cells (RBCs) in sickle cell anemia, transformed into a sickled shape by prolonged deoxygenation, or normal RBCs deformed by a prolonged micropipette aspiration become permanently stabilized in their abnormal shape. This semisolid plastic behavior is thought to involve an irreversible reorganization of the membrane skeleton, but the exact nature of this skeletal rearrangement is not known. In this study, we first asked whether the irreversible deformation is associated with a permanent stretching of the skeletal network, and then whether it is due to a rearrangement of skeletal components involving a disruption of pre-existing protein associations and the subsequent reassociation of new protein contacts. Having found no ultrastructural evidence of stretching of the skeletal lattice in membranes derived from permanently deformed RBCs, we addressed the possibility of reorganization of the proteins of the membrane skeleton. We examined the temperature dependence of irreversible cell deformation to see if it correlated with the known temperature dependence of spectrin tetramers to dimer dissociation and reassociation. Testing the shape irreversibility of both deoxygenated reversibly sickled cells and Nucleopore-aspirated normal cells, we found that both types of cells became permanently deformed when the prolonged incubation of applied force or deoxygenation was performed at 37 degrees C, the temperature at which spectrin tetramers were free to dissociate and reassociate. In contrast, both types of cells were able to regain their original discocytic shape if the prolonged incubation was performed at the lower temperature: at less than 13 degrees C instead of 37 degrees C. Furthermore, normal RBCs were incubated with inosine and pyruvate to elevate intracellular 2,3-diphosphoglycerate, the polyanion shown to destabilize spectrin-actin-protein 4.1 association. This did not result in a promotion of irreversible deformation of these cells. We conclude that the irreversible cell deformation observed at physiologic temperature is associated with a skeletal rearrangement through dissociation of spectrin tetramers to dimers and a subsequent reassociation of dimers to tetramers in the new (deformed) configuration. These findings may explain a permanent stabilization of irreversibly sickled cells in their abnormal shape in vivo.     

Short-term effect of Salvia miltiorhiza in treating rat acetic acid chronic gastric ulcer and long-term effect in preventing recurrence

ＳｈｏｒｔｔｅｒｍｅｆｅｃｔｏｆＳａｌｖｉａｍｉｌｔｉｏｒｈｉｚａｉｎｔｒｅａｔｉｎｇｒａｔａｃｅｔｉｃａｃｉｄｃｈｒｏｎｉｃｇａｓｔｒｉｃｕｌｃｅｒａｎｄｌｏｎｇｔｅｒｍｅｆｅｃｔｉｎｐｒｅｖｅｎｔｉｎｇｒｅｃｕｒｅｎｃｅＷＡＮＧＧｕｏＺｈｏ...     

Risk and significance of endoscopic/radiological evidence of recurrent Crohn's disease

BACKGROUND & AIMS: The aim of this study was to determine the risk of endoscopic/radiological recurrence of Crohn's disease postoperatively and the long-term outcome. METHODS: A randomized placebo-controlled trial was performed to determine the effectiveness of mesalamine in preventing recurrent Crohn's disease postoperatively. Patients in the control group were examined endoscopically/radiologically before entry into and annually during the trial. Findings were classified as minimal or severe. RESULTS: There were 76 patients (49 men and 37 women; mean age, 37.1 +/- 13.2 years). Fifty (61.7%) had terminal ileal resections. Overall, 55 endoscopic/radiological recurrences were observed in 51 patients (67.1%). Expressed actuarially, the recurrence rate was 27.5% at 1 year (95% confidence interval [CI], 15.8%-37.6%), 60.8% at 2 years (95% CI, 46%-71.3%), and 77.3% at 3 years (95% CI, 62.7%-86.3%). Nineteen (37%) were symptomatic and 12 (24%) were initially asymptomatic but later became symptomatic (mean, 13.0 +/- 8.8 months), whereas 20 (39%) remained asymptomatic (mean, 16.9 +/- 17.4 months). Patients with severe endoscopic/radiological disease were significantly more likely to be or become symptomatic than those with minimal disease (23 of 32 vs. 8 of 19, respectively; P = 0.0437). CONCLUSIONS: This study suggests that postoperative endoscopic/radiological recurrences occur later than previously reported. Furthermore, many of these patients, especially with minimal disease, will remain asymptomatic. (Gastroenterology 1997 Dec;113(6):1823-7)     

Enhanced metabolism of 1-beta-D-arabinofuranosylcytosine in Down syndrome cells: a contributing factor to the superior event free survival of Down syndrome children with acute myeloid leukemia

Down syndrome (DS) children with acute myeloid leukemia (AML) have significantly higher event-free survival (EFS) rates compared with non- DS children when treated with protocols containing 1-beta-D- arabinofuranosylcytosine (ara-C). Sensitivity and metabolism of ara-C was examined in myeloblasts from DS and non-DS patients with AML, DS infants with the transient myeloproliferative disorder, and Epstein- Barr Virus (EBV) transformed lymphoblastoid cell lines with and without trisomy 21. DS myeloblasts were approximately 10-fold more sensitive to ara-C (measured by the 3-[4,5-dimethyl-thiazol-2-yl]-2,5-diphenyl tetrazolium bromide (MTT) colorimetric sensitivity assay), compared with non-DS myeloblasts, following exposure to ara-C for 72 hours. Mean levels of l-beta-D-arabinofuranosylcytosine 5'-triphosphate (ara-CTP) were significantly higher in DS myeloblasts compared with non-DS myeloblasts after incubation with 5 micromol/L ara-C (621.4 v 228.4 pmol/mg protein). DS cell lines also generated higher levels of ara-CTP compared with cell lines with diploid chromosome numbers (66.5 v 13.6 pmol/mg protein and 137.6 v 41.7 pmol/mg protein at 1 and 5 micromol/L ara-C, respectively). Elevated ara-CTP levels in the DS cells were accompanied by slightly lower levels of endogenous deoxycytidine triphosphate (dCTP) pools, slightly greater extent of ara-C incorporation into DNA, and increased relative numbers of double strand DNA strand breaks. There were no significant differences in the cell cycle distributions of DS and non-DS cells. These in vitro studies support our hypothesis that enhanced metabolism of ara-C in DS cells may be a contributing factor to the superior survival rate of DS children with AML and is possibly based on a gene dosage effect of genes localized to chromosome 21 including cystathionine-beta-synthase. Further study of the mechanisms (ie, alterations in dCTP pools and DNA methylation) involved may lead to improvements in the treatment of all AML patients.     

Corrosion of lead shielding in a radiology department

Corrosion of lead sheet used for structural radiation protection in the Princess Alexandra Hospital radiology department has been identified. The corrosion is thought to have been caused by organic acid vapours released from oregon timber wall panelling. Non-destructive testing (NDT) and X-ray transmission measurements were used to define the extent and severity of damage, and subsequently to provide the data necessary for estimation of staff and public radiation doses. Although radiation dose limits have not been exceeded, corrective actions including structural modifications and staff information sessions have been undertaken.     

Radiology interventions in patients receiving low molecular weight heparin: Timing is critical

Recent advances in diagnosis and treatment of venous thromboembolism have been associated with increasing use of low molecular weight heparins (LMWH) for treatment and prophylaxis of this disease. Despite this trend for more widespread use of LMWH, little is known of their safety in patients undergoing radiology interventions. Differences between LMWH and unfractionated heparin and the implications of these differences on use of LMWH in the setting of radiological interventions are outlined.     

氧瓶燃烧-紫外分光光度法测定硒灵胶囊中硒的含量

目的：控制本品中硒的含量。方法：采用氧瓶燃烧法使本样品中的主要成份硒酯多糖成四阶硒离子,并与２,３－二氨基萘（ＤＮＡ）络合生成４,５－苄苯并硒二唑,然后采用紫外分光光度法测定其含量,结果：硒的浓度在０．２～２．０μｇ／ｍｌ之间线性范围良好。结论：该法具有简便,快速,准确的优点。