兔背部皮下注射法建立增生性瘢痕动物模型

目的探索无水乙醇皮下注射后对皮肤外形及形态的影响,建立简便易重复的瘢痕动物模型。方法选取体质量均为1.5 kg的新西兰大白兔27只,雌雄不限,随机分为甲、乙、丙3组。将浓度为99.5%的乙醇按照1、2、3 mL/kg 3种剂量分别注入甲、乙、丙3组兔子背部皮肤真皮层,观察注射后7、30、90 d注射位点的变化,得出最佳造模方法。结果乙组兔子30 d后肉眼可见类似人增生性瘢痕样组织形成,HE染色镜下可观察到表皮层增厚明显,真皮层中胶原纤维排列紊乱,Ⅰ型胶原纤维免疫组织化学染色,可见组织内Ⅰ型胶原蛋白染成棕黄色,细胞质内可见棕黄色颗粒,Ⅰ型胶原纤维数量明显增多。结论2 mL/kg无水乙醇兔子背部皮下注射,经自然愈合后形成的增生性瘢痕与人体增生性瘢痕相似, 可作为研究增生性瘢痕的发生机制及评估其治疗方法的动物模型之一。     

多层螺旋CT在新生儿缺氧缺血性脑病诊断及预后评估中的应用

目的多层螺旋CT在新生儿缺氧缺血性脑病中的临床诊断效果。方法选取2016年5月—2019年8月期间本院接收的52例新生儿缺氧缺血性脑病患儿,所有患儿均进行多层螺旋CT扫描,将临床分度作为"金标准",并对多层螺旋CT分度效能进行评估。结果经过对52例患儿进行多层螺旋CT扫描,可知其轻度为26例,中度为18例,重度为8例;多层螺旋CT分度诊断效能中轻度、中度以及重度的准确率分别为90.9%、90.0%以及80.0%,其数据与临床分度进行对比,P>0.05,差异不具有统计学意义。结论多层螺旋CT可有效辨别新生儿缺氧缺血性脑病的具体情况,对其病症的轻度、中度以及重度予以分辨,为临床诊断提供可参考依据,便于及时为患儿提供有效治疗,临床应用价值显著。     

A special type of endovascular stent repair with complicated thoracic aneurysm and chronic type B dissection aligned in tandem: double perfusion in true and false distal aorta lumen

Aortic dissection and aortic aneurysm are two of the most common catastrophic events involving the aorta. Thoracic endovascular aortic repair is now considered as a promising alternative to open surgical graft replacement. The aim of endovascular repair of a thoracic aneurysm is to exclude, and thus depressurize, the aneurismal wall and the aim of the endovascular repair of type B aortic dissection is to obliterate all of the false lumen through thrombosis after sealing the primary entry tears, thus to ensure the true lumen perfusion. But in some special pathologies, such as when the aneurysm and chronic type B dissection are aligned in tandem, or when a visceral branch originates from the false lumen, how should the endovascular repair strategy proceed in this situation？ For the endovascular stent repair of some special chronic type B aortic dissection, the false lumen cannot be obliterated, and the true and false lumens in the dissected but with a normal diameter distal aorta need to be perfused at the same time, as practiced in the surgery treatment. In this report, we present a case of endovascular stent repair for a special thoracic aneurysm and chronic type B aortic dissection aligned in tandem.     

Expressions of voltage-gated K+ channel 2.1 and 2.2 in rat bladder with detrusor hyperreflexia

Background Voltage-gated K^＋ channel （Kv） plays a critical role in the modulation of detrusor contraction. This study was conducted to investigate the expressions of Kv2.1 and Kv2.2 in rat bladder with detrusor hyperreflexia （DH）. Methods Thirty adult female Sprague-Dawley rats （200-220 g） were randomly divided into the control group and the experimental group. The experimental group was subjected to spinal cord injury （SCI）. In the controls, the surgical procedure was identical with the exception that dura and spinal cord were transected. Four weeks after SCI, in vivo cystometry and mechanical pulling tests of isolated detrusor strips were performed, mRNA was extracted from the detrusors of normal and DH rats for the detection of expression of Kv2.1 and Kv2.2 by RT-PCR. Differences in expression between normal and overactive detrusors were identified by gel imaging. Results Fourteen rats in the experimental group exhibited uninhibited bladder contraction （〉8 cmH20） before voiding after SCI. One rat died from infection. The frequency of DH in the experimental group was significantly different from that in the control group with or without treatment with 4-aminopyridine （4-AP） （P 〈0.05）, while the amplitude of DH did not change markedly. The rates of variation of the automatic contractile frequency and amplitude were （66.8±12.4）% and （42.6±12.6）% respectively in the control group, and （38.4±9.8）% and （28.0±4.6）% respectively in the DH group. 4-AP increased the automatic contractile frequency apart from the automatic contractile amplitude in both the control and DH groups （P 〈0.05）. 4-AP increased the rate of variation of the automatic contractile frequency more markedly in the control group than in the DH group （P 〈0.05）. Significant expression of Kv2.2 was not detected in bladders in the control group. Compared to the mRNA levels of 13-actin, the mRNA level of Kv2.1 was 1.26±K）.12 in the control group and 0.66±0.08 in the DH group. SCI signific     

活化的STAT3蛋白质抑制剂PIAS3在前列腺癌中的表达及意义

目的 比较活化的STAT3蛋白质抑制剂(PIAS3)在人雄激素依赖性前列腺癌(ADPC)和雄激素非依赖性前列腺癌(AIPC)中的表达情况,探讨其表达与前列腺癌发生雄激素非依赖的关系.方法 应用cDNA芯片技术筛选出AIPC中的上调基因PIAS3.分别用免疫组织化学、Western印迹及半定量RT-PCR技术检测PIAS3在ADPC和AIPC组织及细胞系中的差异表达.结果 (1)基因芯片结果显示PIAS3基因在ADPC和AIPC中表达有显著性差异,在AIPC中明显高表达.(2)半定量RT-PCR显示PIAS3mRNA在AIPC细胞中的表达水平高于ADPC细胞.(3)Western印迹结果显示:PIAS3蛋白质在AIPC细胞系中表达水平显著高于ADPC细胞系.(4)免疫组化检测结果显示PIAS3在前列腺癌中表达阳性,在AIPC中PIAS3阳性表达率明显高于ADPC,两者差异有统计学意义(P＜0.05).结论 PIAS3的表达水平和前列腺癌的雄激素依赖情况相关,在AIPC中表达水平显著高于ADPC.提示PIAS3基因对雄激素受体的调节发挥了重要作用,使前列腺癌细胞在无雄激素的条件下继续增殖,可能是雄激素非依赖发生的关键.     

Risk factors related to hospital mortality in patients with isolated traumatic acute subdural haematoma: analysis of 308 patients undergone surgery

Background Acute subdural haematoma （ASDH） is a common traumatic brain injury with a relatively high mortality rate. However, few studies have examined the factors predicting the outcome of isolated traumatic ASDH. This clinical study examined the hospital mortality and analyzed the risk factors for mortality in patients treated surgically for isolated traumatic ASDH.
Methods We collected 308 consecutive patients who underwent neurosurgery for isolated traumatic ASDH between January 1999 and December 2007 and used multivariate Logistic regression analysis to evaluate the influence of 11 clinical variables on hospital mortality.
Results The overall hospital mortality was 21.75% （67/308）. Age （OR=1.807）, preoperative Glasgow Coma Score （OR=0.316）, brain herniation （OR=2.181） and the time from trauma to decompression （OR=1.815） were independent predictors of death, while no independent association was observed between hospital mortality and haematoma volume, midline shift, acute brain swelling or brain herniation duration, although these variables were correlated with hospital mortality in univariate analyses.
Conclusions This study identified the risk factors for hospital mortality in patients who underwent surgical treatment for isolated traumatic ASDH. An increased risk of death occurs in patients who are over 50 years of age and have lower preoperative Glasgow Coma Scores, the presence of brain herniation and a long interval between trauma and decompression. The findings should help clinicians determine management criteria and improve survival.     

Risk factors of mortality in road traffic injury patients with acute respiratory distress syndrome

Background Among the deaths due to trauma, about one half of the patients suffer from road traffic injury （RTI）. Most of RTI patients complicate acute respiratory distress syndrome （ARDS） and severe multiple injuries. ARDS is a major contributor to morbidity and mortality in trauma patients. Although many injuries and conditions are believed to be associated with ARDS independent risk factors in trauma patients, their relative importance in development of the syndrome are undefined. We hypothesize that not all of the traditional risk factors impacting mortality are independently associated with patients strictly identified by traffic injury. This study aimed to sieve distinctive risk factors in our RTI population, meanwhile, we also hypothesize that there may exist significantly different risk factors in these patients.
Methods This was a retrospective cohort study regarding RTI as a single cause for emergency intensive care unit （EICU） admission. Patients identified as severe RTI with post-traumatic ARDS were enrolled in a prospectively maintained database between May 2002 and April 2007 and observed. Twenty-three items of potential risk impacting mortality were calculated by univariate and multivariate Logistic analyses in order to find distinctive items in these severe RTI patients.
Results There were 247 RTI patients with post-traumatic ARDS admitted to EICU during the study period. The unadjusted odds ratio （OR） and 95% confidence intervals （CI） of mortality were associated with six risk factors out of 23： APACHE II score, duration of trauma factor, pulmonary contusion, aspiration of gastric contents, sepsis and duration of mechanical ventilation. The adjusted ORs with 95% Cl were denoted with respect to surviving beyond 96 hours EICU admission （APACHE II score, duration of trauma factor, aspiration of gastric contents）, APACHE II score beyond 20 EICU admission （duration of trauma factor, sepsis, duration of mechanical ventilation） and mechanical ventilation beyond 7 days EIC     

溶血磷脂酸对体外血脑屏障模型通透性的影响

目的 探讨溶血磷脂酸(LPA)对血脑屏障通透性影响及其可能机制.方法 将体外建立的血脑屏障模型随机分为空白对照组、LPA组和蛋白激酶C抑制剂(Ro31-8220)+LPA组.γ计数仪检测模型对125I-BSA的通过率;流式细胞仪检测PKC-α表达阳性的微血管内皮细胞(BMEC)比例;类鬼笔环肽染色观察BMEC的F-肌动蛋白变化;电子显微镜观察血脑屏障-紧密连接(BBB-TJ)改变;Western印迹法检测BBB-TJ内闭合蛋白5表达.结果 LPA组125I-BSA通过率(364 cmp±15cmp)和PKC-α阳性细胞率(77%±7%)均高于空白对照组和Ro31-8220+LPA组(184 cmp±10 cmp、223 cmp±9 cmp,42%±4%、52%±3%,均P＜0.01);闭合蛋白5表达则低于空白对照组和Ro31-8220+LPA组(0.353±0.04、1.00±0.03、0.574±0.07,均P＜0.01),同时LPA使BBB-TJ开放、F-肌动蛋白重组.结论 LPA可促使BBB-TJ开放,增加血脑屏障通透性,其机制可能与PKC-α信号途径激活进而促使闭合蛋白5表达下调以及F-肌动蛋白重组有关.     

帕金森病患者眼球运动预测性控制的临床观察

目的 研究帕金森病(PD)患者眼球运动预测性控制能力,探讨其临床意义.方法 利用视频眼震电图(VNG)对早中期原发性PD患者和年龄、性别相匹配的正常人做可预测性眼球扫视运动,比较两组的扫视潜伏期.结果 在随机性扫视方案中,PD组和对照组扫视潜伏期分别为284ms±58 ms和236 ms±37 ms,两者比较差异有统计学意义(P=0.003);在可预测性扫视方案中,PD组和对照组的扫视潜伏期分别为150 ms±138 ms和59 ms±102 ms,两组差异有统计学意义(P=0.002);在可预测扫视方案中,PD组出现预见性扫视的次数占21%,对照组则占31%,两者相比,差异有统计学意义(P=0.003).结论 PD患者存在眼球运动预见性机制缺陷,表明PD在疾病早期可能出现部分认知功能障碍.