大鼠海马神经元脂肪酸构成中长链多不饱和脂肪酸的功能及其机制

目的:观察长链多不饱和脂肪酸花生四烯酸(AA)和/或二十二碳六烯酸(DHA)对体外培养新生大鼠海马神经元脂肪酸构成的影响。方法:采用无血清培养液培养新生大鼠海马神经元,实验组分别在对照组的无血清培养液中添加4μmol/LAA,4μmol/LDHA或总浓度为4μmol/L、比例为1:2～16:1的AA和DHA。采用毛细管气相色谱法分析神经元中脂肪酸的构成。结果:培养液中AA和DHA总浓度为4μmol/L、比例为1:2～16:1,海马神经元中AA百分含量、AA/DHA比值与培养液中AA和DHA比例均呈正相关(P均<0.001)。结论:培养液中海马神经元中AA百分含量、AA/DHA比值与培养液中AA和DHA比例均呈正相关。     

电针对大脑中动脉闭塞大鼠脑内神经元特异性烯醇化酶及胶质纤维酸性蛋白表达的影响

目的：研究电针治疗对脑梗死病灶周围及海马神经元特异性烯醇化酶(NSE)及胶质纤维酸性蛋白(GFAP)表达的影响。方法：采用易卒中型。肾性高血压大鼠(RHRSP)，电凝法凝闭大脑中动脉(MCAO)。MCAO后给予电针治疗，在治疗5d、2周后分别处死，行免疫组化染色，计算NSE、GFAP的阳性单位值。结果：梗死边缘NSE表达在梗死5d时处于低水平，梗死2周组增高，电针治疗2周后海马的NSE表达明显增加；梗死5d时病灶周围GFAP阳性细胞数目增多，染色加深，胞体增大，突起增粗、增长，2周时变化更明显。电针治疗5d后，梗死边缘GFAP阳性单位值明显增高。结论：早期电针治疗能够提高海马区NSE及梗死灶周围GFAP的表达，促进了缺血后脑的可塑性变化，构成了脑梗死功能恢复的物质基础。     

他克莫司胶囊和缓释胶囊预防肝移植急性排斥反应的效果和安全性

Objective To evaluate the efficacy and safety of tacrolimus exposure in stable liver transplant recipients converted from FK506 twice a day to Advagraf (tacrolimus extended-release capsules) once daily. Methods This was an open-label, random, control and multi-center study.Eligible patients were 19 to 70 years of age, 6 months post-transplant with stable renal and hepatic function and receiving stable doses of tacrolimus twice a day for 2 weeks prior to enrollment. There were 86 patients in the experimental group and the control group, separately. The average age of experimental group and control group was 46 ± 10 and 49 ± 9, respectively. Patients in experimental group received Advagraf, once daily, and the dose was adjusted according to the drug concentration,and the drug concentration was between 2 to 10 μg/L. The control group given tacrolimus, twice daily, and the drug concentration was between 2 to 10 μg/L. Results The incidence of acute rejection reaction was 1.20 % and 1.18 % respectively in experimental group and control group, and the 95 %confidence interval was -3.25% ～3.31 % and -3.26% ～ 3.34 %, individually. There was 1 case of acute rejection reaction in experimental group and control group, respectively. The patient and organ survival rate was 100%. Sixteen adverse events occurred in 15 patients (17.65 %) of the experimental group, and 10 adverse events occurred in 10 patients (11.63 %) of control group. Severe adverse events relating to the test drug in experimental group occurred in 4 patients (4. 71 %). and 2 patients (2. 33) in control group.Conclision Clinical trials indicated that Advagraf has efficacy and safety profiles similar to those of tacrolimus. The drug is safe and may improve patient compliance.     

肝移植进展 在院庆60周年“院士讲学周”活动中的专题讲座

0 引言 肝移植手术的设想最早于1956年提出.在动物实验的基础上,1963年,美国Starzl施行了第1例人类肝移植.1989年澳大利亚Strong对1例先天胆道闭锁的患儿成功实施了世界上第1例成人对儿童左外测叶活体肚移植(living donor liver transplantation,LDLT).     

肝癌肝移植受者的选择标准

肝细胞肝癌(简称肝癌)是肝移植的主要适应证之一,但肝移植术后肝癌的复发和转移严重制约了肝移植治疗的效果.如何降低移植术后肝癌的复发率和提高长期生存率成为各个移植中心非常关心的问题.对于肝癌肝移植受者的选择,世界上各个肝移植中心纷纷提出了各自的标准.     

WWOX基因在肝细胞癌及手术切缘中的表达意义

目的 探讨WWOX基因在肝细胞癌(HCC)和切缘中的表达状况和术后复发及预后的关系及其临床意义.方法 用免疫组化方法检测76例肝癌组织及其切缘组织、20例正常肝组织中WWOX基因蛋白产物表达水平,用TUNEL法检测76例肝细胞癌的细胞凋亡水平,结合临床病理指标和术后生存率进行分析.结果 WWOX基因蛋白产物在HCC中定位于细胞核,在癌旁组织中定位于细胞核与细胞浆.肝癌组织中WWOX基因蛋白表达指数为(35.2±20.1)%,低于癌旁组织和正常肝组织(P<0.05).并与肝癌的细胞凋亡率下降、PCNA增高、肿瘤较大、门脉分支浸润、低分化高恶性度以及术后复发等指标有关(P<0.05).肝癌切缘ww0X基因蛋白表达水平与术后复发率和生存率有关(P<0.05),而与1 cm以上切缘距离无关.结论 肝癌组织和手术切缘存在低WWOX表达和定位异常,并可能与影响肿瘤进展、预后的生物学行为有关.肝癌组织和手术切缘WWOX表达水平测定有望成为评估肝癌进展等生物学行为和预后的有用指标之一,并有助于确定较为安全的根治切除分子切缘.     

他克莫司胶囊和缓释胶囊预防肝移植急性排斥反应的效果和安全性

Objective To evaluate the efficacy and safety of tacrolimus exposure in stable liver transplant recipients converted from FK506 twice a day to Advagraf (tacrolimus extended-release capsules) once daily. Methods This was an open-label, random, control and multi-center study.Eligible patients were 19 to 70 years of age, 6 months post-transplant with stable renal and hepatic function and receiving stable doses of tacrolimus twice a day for 2 weeks prior to enrollment. There were 86 patients in the experimental group and the control group, separately. The average age of experimental group and control group was 46 ± 10 and 49 ± 9, respectively. Patients in experimental group received Advagraf, once daily, and the dose was adjusted according to the drug concentration,and the drug concentration was between 2 to 10 μg/L. The control group given tacrolimus, twice daily, and the drug concentration was between 2 to 10 μg/L. Results The incidence of acute rejection reaction was 1.20 % and 1.18 % respectively in experimental group and control group, and the 95 %confidence interval was -3.25% ～3.31 % and -3.26% ～ 3.34 %, individually. There was 1 case of acute rejection reaction in experimental group and control group, respectively. The patient and organ survival rate was 100%. Sixteen adverse events occurred in 15 patients (17.65 %) of the experimental group, and 10 adverse events occurred in 10 patients (11.63 %) of control group. Severe adverse events relating to the test drug in experimental group occurred in 4 patients (4. 71 %). and 2 patients (2. 33) in control group.Conclision Clinical trials indicated that Advagraf has efficacy and safety profiles similar to those of tacrolimus. The drug is safe and may improve patient compliance.     

移动医疗在医院管理中的突破

一直以来,浙江大学医学院附属第一医院秉承“严谨求实、科教强院、规范服务、管理增效”的理念,力求不断进步,为成就“值得信赖的医院”而努力。近十年来,我院以科技创新提高医疗质量,在实施科教强院战略方面进行了较为成功的探索,尤其在医院信息化建设方面,基本实现“无纸”和“无片”化,促进了医疗质量和服务质量的提高,在省内乃至全国建立了良好的品牌和广泛的影响力。2008年,获得了“卫生部数字化试点示范单位”的荣誉称号,在卫生部公布的首批20家数字化试点示范医院中,我院是浙江省唯一获此殊荣的医院。     

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目的 总结单纯性乳头溢液的诊断和治疗经验。方法 回顾性分析了对３２例单纯性乳头溢液病人行双功能超声、相靶摄片、乳管造影的检查结果。结果 双功能超声和乳管造影对本病均有较高的诊断价值，敏感性分别为６６．７％和６８．４％（Ｐ〉０．０５）。相靶摄片对诊断无帮助。病变乳管内置管灵兰注射有助于病灶的探查和切除。结论 影像学检查只可做出病灶的定位诊断，术中冰冻切片才是定性诊断的唯一方法。病变区乳腺的区段切除应     

白细胞介素-15在器官移植中的研究进展

IL-15能调节树突状细胞、T细胞和NK细胞的功能,对效应性T细胞、记忆性T细胞、调节性T细胞和NK细胞的产生、增殖和长期存活具有重要作用。IL-15广泛表达于发生急性或慢性排斥的移植物中。本文概述了IL-15在器官移植中的作用机制,IL-15与目前临床上使用的免疫抑制剂的关系,以及针对IL-15/IL-15R信号传导通路诱导免疫耐受的方法。