阴式与腹式子宫切除术的临床应用比较

目的评价非脱垂子宫阴式和腹式全切术的临床效果。方法选择2005年1月～2008年12月在我院妇产科住院的非脱垂子宫患者。其中行阴式子宫全切术31例为实验组,以30例行常规腹式子宫全切术患者为对照组。对两组手术时间、术中出血量、术后病率、术后肛门排气时间、术后平均住院天数等方面进行前瞻性研究。结果阴式组的手术时间、术后病率、肛门排气时间、术后住院天数明显少于腹式组,差异有显著性意义（P〈0．01）。阴式组的术中出血量和腹式组相比差异无显著性意义（P〉0．05）。结论非脱垂子宫行阴式全切术优于行腹式全切术。     

Paclitaxel delivery from PLGA foams for controlled release in post-surgical chemotherapy against glioblastoma multiforme

Paclitaxel loaded biodegradable poly-(dl-lactic-co-glycolic) acid (PLGA) foams with microporous matrix were fabricated by a novel pressure quenching approach to provide a sustained paclitaxel release. The foams with micropores provided increased surface area to volume ratio and were also implantable for post-surgical chemotherapy applications. The two formulations 5% (w/w) paclitaxel loaded PLGA 85:15 foam (F1) and 10% (w/w) paclitaxel loaded PLGA 50:50 foam (F2), were evaluated in vitro and in vivo. Both the foams were found to provide a paclitaxel release beyond a month in vitro with a near zero-order kinetics and with minimum burst release. Furthermore, apoptosis of C6 glioma cells in vitro demonstrated the benefits of sustained paclitaxel release by the foams in comparison to acute Taxol^® exposure. Both the foams exhibited continuous paclitaxel release in an in vivo (subcutaneous) environment up to a month which correlated well with the in vitro release profiles. Bio-distribution results in the rat brain showed paclitaxel penetration at therapeutic levels up to 3 mm into the tissue from the site of foam implantation. Hence these foams could be employed as potential implants for post-surgical chemotherapy against malignant glioma.     

Anti-diabetic effects of Centratherum anthelminticum seeds methanolic fraction on pancreatic cells, β-TC6 and its alleviating role in type 2 diabetic rats

Ethnopharmacological relevance

Seeds of Centratherum anthelminticum (Asteraceae) have been popularly used in Ayurvedic medicine to treat diabetes and skin disorders. Folk medicine from Rayalaseema (Andhra Pradesh, India) reported wide spread usage in diabetes.

Aim of the study

To investigate the hypoglycemic properties and mechanism of the methanolic fraction of C. anthelminticum seeds (CAMFs) on mouse β-TC6 pancreatic cell line and streptozotocin (STZ)-induced diabetic rat models.

Materials and Methods

We investigated the crude methanolic fraction of C. anthelminticum seeds (CAMFs) on β-TC6 cell line and confirmed its effects on type 1 and type 2 diabetic rats to understand its mechanism in managing diabetes mellitus. CAMFs were initially tested on β-TC6 cells for cytotoxicity, 2-NBDG glucose uptake, insulin secretion and glucose transporter (GLUT-1, 2 and 4) protein expression. Furthermore, streptozotocin (STZ)-induced type 1 diabetic and STZ-nicotinamide-induced type 2 diabetic rats were intraperitoneally (i.p) injected or administered orally with CAMFs daily for 28 days. The effect of CAMFs on blood glucose and insulin levels was subsequently evaluated.

Results

In cell line studies, CAMFs showed non-cytotoxic effect on β-TC6 cell proliferation compared to untreated control cells at 50 μg/ml. CAMFs increased glucose uptake and insulin secretion dose-dependently by up-regulating GLUT-2 and GLUT-4 expression in these cells. Further in vivo studies on streptozotocin induced diabetic rat models revealed that CAMFs significantly reduced hyperglycemia by augmenting insulin secretion in type 2 diabetic rats. However, CAMFs displayed less significant effects on type 1 diabetic rats.

Conclusions

CAMFs demonstrated anti-diabetic potential on β-TC6 cells and type 2 diabetic rat model, plausibly through enhancing glucose uptake and insulin secretion.     

张锡纯诊识弦脉探析

张锡纯所著《医学衷中参西录》详细记载了其医学理论及临床经验,在其医案及方剂中可以看到许多有关弦脉的记载.张锡纯认为弦脉与脾虚、寒气、痰饮、肝火、冲气、胃气上冲、血脉痹阻、风气等有关.此外,弦脉还可因复杂的病因病机而出现.     

切应力对人骨髓间充质干细胞增殖的影响

目的：探讨切应力作用于人骨髓间充质干细胞（HMSCs）后,对细胞增殖的影响。方法：将HMSCs种植于平板流动腔中,待贴壁后对其施加1dyne／cm^2的切应力作用6h,用MTT法测细胞增殖曲线,并用流式细胞仪测定细胞周期,计算增殖指数。结果：发现HMSCs在1dyne／cm^2切应力作用6h后,增殖曲线抬高,G2＋S期细胞明显增加。结论：HMSCs在切应力作用下,增殖能力增强,是组织工程血管种子细胞的理想选择。     

Movement disorders induced by peripheral trauma

Movement disorders induced by central nervous system trauma are well recognized. However, over the last few years, attention has been drawn to the role of peripherally induced movement disorders. We describe three patients presenting respectively dystonia, tremor and choreoathetosis associated with tremor and dystonia of the body parts previously exposed to traumatic injuries. Pathophysiological mechanisms underlying these phenomena are not entirely known, but functional changes in afferent neuronal input to the spinal cord and secondary affection of higher brain stem and subcortical centers are probably involved.     

Transesophageal echocardiography in critically ill patients

OBJECTIVE: To evaluate the safety and utility of transesophageal echocardiography performed by intensive care physicians in critically ill patients. DESIGN: Retrospective chart review. SETTING: A 24-bed multidisciplinary adult intensive care unit in a 692-bed tertiary referral teaching hospital. PATIENTS: Two hundred fifty-five intensive care patients. INTERVENTIONS: We studied 255 consecutive intensive care patients who underwent transesophageal echocardiography between January 1996 and January 2000. MEASUREMENTS AND MAIN RESULTS: Three hundred eight transesophageal echocardiography studies were successfully performed; the probe could not be passed in one patient with a cervical fracture. The indications included unexplained hypotension (40%), known or suspected endocarditis (27%), assessment of ventricular function (15%), pulmonary edema (5%), source of embolus (4%), assessment of aorta (4%), and other (5%). In 67% of hypotensive patients, transesophageal echocardiography revealed the cause of hemodynamic instability, leading to a management change and improvement in blood pressure in 31%. This included surgery in 22% without the need for additional tests. Overall, transesophageal echocardiography findings led to a significant change in management in 32% of all studies performed. One patient receiving continuous positive airways pressure suffered pulmonary aspiration during tracheal intubation before transesophageal echocardiography, two patients had hypotension associated with sedative medication, and there was one case of oropharyngeal bleeding after probe insertion. CONCLUSION: Transesophageal echocardiography when performed by intensive care physicians is a safe procedure and provides useful information for the evaluation and management of critically ill patients.     

小鼠骨髓间充质干细胞体外诱导分化为神经元样细胞的实验研究

目的:探讨体外诱导小鼠骨髓间充质干细胞(mouse marrow mesenchymal stem cells,mMSCs)分化为神经元样细胞的条件.方法:密度梯度离心结合差异贴壁法分离、纯化mMSCs,胰蛋白酶消化传代扩增mMSCs.用最适浓度的β-疏基乙醇(BME) 神经生长因子(NGF)、NGF 全反式维甲酸(ATRA)、NGF BME ATRA作为诱导剂,观察诱导期间细胞的形态变化,并用免疫细胞化学法鉴定神经元烯醇化酶(NSE)、神经丝蛋白(NF)的表达,行甲苯胺蓝染色显示尼氏小体.结果:(1)免疫细胞化学显示NGF BME ATRA诱导组诱导效率最高,78%细胞表达NSE,80%细胞表达NF;(2)各诱导组尼氏染色均出现尼氏小体.结论:NGF、BME、ATRA能诱导mMSCs分化为神经元样细胞,其中以NGF(10μg/L) BME(2.5mM/L) ATRA(2.5M/L)组效率最高.     

心肌病患者线粒体DNA异常的探讨

心肌病的病因至今未明,它被认为是一种多原因、多因素的疾病。其中,线粒体DNA缺失也是原因之一。本文采用PCR法,对12例心肌病者的血细胞以及其中4例患者骨骼肌细胞的线粒体DNA,进行了在第11012—11980位片段内的检测,均未见有缺失,对此结果进行了初步讨论,为从分子水平进一步探讨心肌病的病因打下基础。