大鼠脑血肿周围组织半胱氨酸天冬氨酸蛋白酶3表达变化与尼莫地平的影响

目的：观察脑出血后血肿周围半胱氨酸天冬氨酸蛋白酶3的表达。及尼莫地平对其的影响。方法：实验于2004—07在大连医科大学中心实验室进行。取120只SD雄性大鼠随机分为3组：①尼莫地平组（n=50）：尾壳核注射自体股动脉血50μL复制脑出血模型，造模即刻腹腔注射尼莫地平1．6mg／kg（即8μL／g），以后每天1次。②模型组（n=50）：同前造模，术后腹腔注射等量生理盐水。③假手术组（n=20）：手术，但进针人尾壳核后不注血。各组分为术后6，24，48，72h、5d 5个时间点。造模动物醒后进行Bederson评分，评估其行为和神经功能缺陷（0—3分。评分越高，神经功能缺陷越重，评分≥2分为造模成功）。人组动物在以上5个时间点进行Bederson评分后，麻醉状态下处死取脑，经尾壳核行冠状切片，行免疫组化测定半胱氨酸天冬氨酸蛋白酶3表达。结果：80只大鼠进入结果分析。①Bederson评分：模型组、尼莫地平组大鼠醒后迅速出现偏瘫，24h后评分趋于稳定，至72h之间评分最高，然后逐渐下降，5d时仍有体征。模型组、尼莫地平组各时间点评分均高于对照组（P〈0．01），尼莫地平组术后48，72h评分低于模型组（P〈0.05）。②血肿周围组织半胱氨酸天冬氨酸蛋白酶3表达：假手术组进针侧脑组织表达很少，模型组6h后即有表达，24h达高峰，持续72h后逐渐下降，5d后仅有少量表达；尼莫地平组动态变化趋势与模型组相同，但各时间点的数值均较低，尤其是术后24～72h（P〈0．01）。结论：①脑出血后血肿周围组织中半胱氨酸天冬氨酸蛋白酶3表达升高，提示其与脑出血血肿周围组织损伤有一定关系。②尼莫地平降低脑出血后血肿周围组织中半胱氨酸天冬氨酸蛋白酶3表达，从而减轻细胞凋亡程度，对神经细胞起到保护作用，降低神经功能缺陷。     

铜绿假单胞菌噬菌体PaP3生物学特性的研究

目的测定铜绿假单胞菌噬菌体PaP3的最佳感染复数、一步生长曲线和吸附K值及交叉吸附K值等基本生物学特性。方法按照感染复数（MOI）分别为0．0001、0．001、0．01、0．1、1和10加入噬菌体纯培养液和宿主菌，充分裂解细菌后，测定噬菌体滴度；以MOI=10的比例加入噬菌体及宿主菌，进行一步生长实验；纯化PaP3颗粒，免疫家兔，获得抗血清，通过中和反应实验测定PaP3和其抗血清之间的吸附反应常数K值。同时，利用抗血清交叉中和试验确定本室分离的三株噬菌体之间的血清学关系。结果当MOI=0．001时PaP3感染其宿主菌产生的子代噬菌体滴度最高；根据一步生长实验结果绘制一步生长曲线；通过血清交叉中和反应得出不同的吸附常数。结论PaP3最佳感染复数为0．001，感染宿主菌的潜伏期是20min，爆发期是60min，平均爆发量约为31，其抗血清反应的吸附常数K值为262。     

影响颅脑外伤术后颅内感染的危险因素分析

目的探讨影响颅脑外伤开颅术后颅内感染的危险因素。方法采用回顾性研究比较分析了912例颅脑损伤术后出现颅内感染与未出现颅内感染组间的差异因素。结果非感染 770例,颅内感染142例(15．6％)。感染类型有无菌性脑膜炎、细菌性脑膜炎、脑室炎及脑室积脓、脑脓肿、硬膜下腔积脓、术区皮下或(和)骨瓣下化脓或合并骨髓炎、切口感染。细菌检出率占感染的27．5％。颅脑外伤术后感染与高温季节、高龄、重度以上损伤、短期内两次以上手术、连续两侧开颅术、长时间 (>5 h)手术、显微外科手术、颅底与后颅凹手术、脑室外引流、皮下或硬膜外积液以及急诊手术等因素相关(P<0．05)。结论对具有上述危险冈素的易感患者应给予更密切的关注和预防性的处理。     

缬沙坦治疗糖尿病肾病的疗效观察

目的:观察血管紧张素Ⅱ,Ⅰ型受体拮抗剂(AT1Ra)缬沙坦(Valsartan)对伴大量白蛋白尿的临床糖尿病肾病的治疗作用。方法:32例2型糖尿病患者,24h尿白蛋白排泄率(24hUAER)>200μg/min,均伴高血压,维持原糖尿病治疗不变,分组比较应用缬沙坦(80mg/d)或贝那普利(10mg/d)治疗8周前后平均动脉压(MAP)、24hUAER、HbA1c、尿酸(UA)等指标的变化。结果:缬沙坦治疗组和贝那普利治疗组24hUAER分别由703.2±987.9μg/min降至664.2±970.6μg/min(P<0.01)和由778.6±1005.0降至734.9±996.0μg/min(P<0.01)。二者疗效相似,且均与血压变化不相关。结论:AT1Ra缬沙坦可以降低临床糖尿病肾病的蛋白尿,其肾脏保护作用除了与降血压有关,还有不依赖降压效应的其他机制。     

胃癌前哨淋巴结临床意义的研究

目的 观察胃癌前哨淋巴结的分布，探讨其临床意义。方法 回顾性分析288例胃癌前哨淋巴结术中染色后显影的范围及特征。术中向肿瘤边缘的正常胃壁浆膜下肌层、黏膜下层注射亚甲蓝，观察淋巴结显影的情况；切取各站淋巴结行病理检查。结果 288例胃癌术后病理诊断为T1期102例，T2期126例，T3期60例。术中成功显影270例，阳性率为93．8％。102例患者有淋巴结转移，其中前哨淋巴结（SNs）与非前哨淋巴结（non—SNs）均有转移者66例，仅前哨淋巴结有转移者18例，仅非前哨淋巴结有转移者18例。结论 通过前哨淋巴结，术中能准确预测胃癌淋巴结转移状况。在手术治疗淋巴结转移阴性的胃癌患者中，前哨淋巴结术中标识有望免除常规淋巴清扫。     

IL-1Ra和IL-10真核表达质粒载体的构建及其表达检测

目的:构建人IL-1Ra和人IL-10真核表达质粒载体并检测其表达。方法:用双酶切方法切取PCDI-IL-1Ra和PCDI-IL-10质粒中包含人IL-1Ra和人IL-10 CDS全长序列的cD-NA片段,并分别连接到真核表达质粒pcDNA3.1上,然后用壳聚糖转染上述质粒到原代软骨细胞,RT-PCR检测其mRNA水平的表达。结果:成功将人IL-1Ra和IL-10 CDS全长序列的cDNA片段克隆到真核表达载体,mRNA水平检测到目的基因的表达明显提高。结论:真核表达质粒可以用于外源基因的原代软骨细胞导入和表达,为进一步的基因治疗研究提供依据。     

还原型谷胱甘肽联合甘草酸二铵对腹部开放伤后海水浸泡犬肝功能损伤的治疗作用

Objective To investigate effect of reduced glutathione and diammonium glycyrrhizinate on the treatment of hepatic damage in experimental dogs following open abdominal injuries coupled with seawater immersion. Methods Twenty-four dogs with open abdominal injuries were randomly divided into 3 groups: the control group (given with simple observation after 1.5 h seawater immersion); the routine treatment group (given routine care and fluid transfusion after 1.5 h seawater immersion) ; the hepatic treatment group (given routine are, fluid transfusion and hepatic treatment as well, after 1.5 h seawater immersion). Each group consisted of 8 dogs. Blood samples were taken at different time points to measure total bilirubin (TB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), prothromin time (PT), endotoxin, tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), and pathological examination was also made at the same time. Results For the control group, contents of TB, ALT, AST and LDH increased significantly and survival time was less than 24 hours. Contents of TB, ALT, AST and LDH of the routine treatment group also increased significantly, but survival time of all the experimental animals was mere than 24 hours. Reduced glutathione and diammonium glycyrrhizinate could reduce the extent of lesion quite significantly 12～24 hours following open abdominal injuries. Conclusions Reduced glutathione and diammonium glycyrrhizinate seemed to have good effects on the treatment and prevention against hepatic damage induced by trauma coupled with seawater immersion. It could be used as a primary means for the treatment of such kind of hepatic damage.     

医学摄影用光

根据医学摄影不同拍摄对象,结合各种光源特点,介绍了用光的一般方法和掌握的基本原则,对物体的反光控制、透明物体内部结构与质感的表现等难点问题进行了研讨,并对荧光摄影作了简要介绍。     

Implant wear induces inflammation, but not osteoclastic bone resorption, in RANK(-/-) mice.

Signaling of RANK (receptor activator of nuclear factor kappa B) through its ligand RANKL appears critical in osteolysis associated with aseptic loosening (AL). The purpose of this study was to investigate the role of RANK in a murine osteolysis model developed in RANK knockout (RANK(-/-)) mice. Ultra high molecular weight polyethylene (UHMWPE) debris was introduced into established air pouches on RANK(-/-) mice, followed by implantation of calvaria bone from syngeneic littermates. Wild type C57BL/6 (RANK(+/+)) mice injected with either UHMWPE or saline alone were included in this study. Pouch tissues were collected 14 days after UHMWPE inoculation for molecular and histology analysis. Results showed that UHMWPE stimulation induced strong pouch tissue inflammation in RANK(-/-) mice, as manifested by inflammatory cellular infiltration, pouch tissue proliferation, and increased gene expression of IL-1beta, TNFalpha, and RANKL. However, the UHMWPE-induced inflammation in RANK(-/-) mice was not associated with the osteoclastic bone resorption observed in RANK(+/+) mice. In RANK(+/+) mice subjected to UHMWPE stimulation, a large number of TRAP(+) cells were found on the implanted bone surface, where active osteoclastic bone resorption was observed. No TRAP(+) cells were found in UHMWPE-containing pouch tissues of RANK(-/-) mice. Consistent with the lack of osteoclastic activity shown by TRAP staining, no significant UHMWPE particle-induced bone resorption was found in RANK(-/-) mice. A well preserved bone collagen content (Van Gieson staining) and normal plateau surface contour [microcomputed tomography (microCT)] of implanted bone was observed in RANK(-/-) mice subjected to UHMWPE stimulation. In conclusion, this study provides the evidence that UHMWPE particles induce strong inflammatory responses, but not associated with osteoclastic bone resorption in RANK(-/-) mice. This indicates that RANK signaling is essential for UHMWPE particle-induced osteoclastic bone resorption, but does not participate in UHMWPE particle-induced inflammatory response.     

以失用为主要表现的胼胝体梗死

目的探讨胼胝体梗死的临床表现、病因及鉴别诊断特点。方法对2005年7月收治的1例53岁男性胼胝体梗死患者的临床表现、影像学特点、病因机制及其治疗过程进行回顾分析。结果临床主要表现为发作性黑蒙、言语不利,既往有高血压、糖尿病、脑梗死、吸烟、饮酒史,体格检查以失用为主要表现。头部MRI检查可见左侧脑室旁、胼胝体梗死,右侧基底节、脑桥陈旧性腔隙性梗死;脑血管造影检查显示为多发性血管狭窄,其中以左侧大脑中动脉、右侧颈内动脉及基底动脉最为严重。经颈内动脉内膜剥离术及颈内动脉支架植入术治疗,临床症状缓解。结论失用可以是胼胝体梗死的主要表现,其病因是在脑动脉粥样硬化基础上的血流动力学改变,患者预后良好。