烧伤后小鼠海马糖皮质激素受体的变化

目的观察严重烧伤应激后糖皮质激素受体(GR)的变化特点以及兴奋性氨基酸谷氨酸的3类受体(代谢型受体、离子型NMDA受体、离子型非NMDA受体)对其表达的调节,以期寻找创伤后GR的可靠调节手段。方法以小鼠背部造成30%总体表面积Ⅲ度烧伤,利用RT-PCR技术,检测烧伤后小鼠海马GR转录水平的变化特点;通过Western-blot方法检测GR蛋白水平的变化特点;选取烧伤后GR表达最明显的时相点,分别检测烧伤前腹腔注射谷氨酸的3种受体拮抗剂[NMDA受体拮抗剂(MK-801)、非NMDA受体拮抗剂(CNQX)、代谢型受体拮抗剂(MCPG)]对伤后GRmRNA水平的影响。结果烧伤各组海马GRmRNA水平明显降低;各组海马GR蛋白水平的表达亦明显降低;烧伤前30min腹腔注射MK-801可显著抑制伤后(2h)GRmRNA水平的下降,而腹腔注射CNQX,MCPG却无此作用。结论严重烧伤可导致海马GR减少,谷氨酸的离子型受体NMDA受体参与了这种变化,提示调控NMDA受体活性可调节创伤后GR的改变。     

新生儿乙肝疫苗长期免疫后抗-HBs动态观察

本文观察了６１１例新生儿全程免疫接种忆肝疫苗后５年及１０年的血清抗ＨＢｓ变化。结果表明，新生儿免疫后５岁抗－ＨＢｓ低水平者在１０岁时有２２例升至高水平。５岁时抗－ＨＢｓ幼儿在１０岁时有５２例达到低水平，有１７例达到高水平。提示生活在启东这个肝炎高发地区环境中，幼儿受ＨＢＶ侵袭的机会很多，免疫乾体内特异性抗体下降或消失后再暴露于ＨＢＶ时，就会发生自然加免现象或迟发的免疫回忆反应。     

应激性溃疡大出血的治疗体会

目的 总结外科手术后应激性溃疡大出血的临床特点和治疗经验。方法 回顾分析1997～2003年期间我院治疗的32例应激性溃疡大出血患者的临床资料。结果 28例患者采用非手术治疗，其中12例患者接受急诊胃镜检查；手术治疗4例。奉组患者总的治愈率为87．50％．死亡率为15．62％。结论 急诊胃镜检查有助于明确诊断及止血治疗，应激性溃疡大出血首选非手术治疗，无效者可选择于术治疗。     

2.5μg乙型肝炎疫苗的免疫效果分析

1983年11月1日至30日,我们对启东大兴等乡出生的188名婴儿,随机分3组进行乙型肝炎疫苗免疫效果考核,其中甲组64名,每次上臂三角肌皮下注射Pasteur 疫苗2.5μg(其中37名注射3次,27名注射2次);乙组62名,每次上臂三角肌注射 Merck 疫苗2.5μg;丙组62名未注射疫苗,作为对照。免疫程序为分娩后立即、1、6个月各注射1次。3组孕妇均于产     

鱼豆粉喂养婴儿试验——与“5410”代乳粉的比较

本实验根据“5410”代乳粉的营养成分,配出鱼豆代乳粉,并分析比较了两种代乳粉的营养成分,包括蛋白质、必需氨基酸、脂肪、醣、热能、钙、磷及粗纤维。以年龄53～148天的女婴12名分成两组喂以“5410”及鱼豆代乳粉,观察四个月,实验期间婴儿平均每人每日每公斤体重摄入100～120千卡热量。食用代乳粉婴儿生长发育良好,原来发育稍差的婴儿经食用代乳粉后身长增长曲线坡度大,很快进入正常值范围。血清蛋白及血钙恢复效果良好,但碱性磷酸酶活力及无机磷还是偏低,但没有佝偻病患者那种过高现象,钙及磷比值正常。蛋白质表观消化率两组比较接近,在80%左右。鱼豆代乳粉同“5410”代乳粉一样能满足婴儿营养需要。     

水溶性脂聚体介导NR2B siRNA治疗神经病理性痛的实验研究

目的 探讨水溶性脂聚体(WSLP)介导含2B亚基的N-甲基-D-天冬氨酸受体小干扰RNA(NR2B siRNA)治疗大鼠神经病理性痛的可行性.方法 健康雄性SD大鼠100只,周龄6周,体重180～200 g,采用随机数字表法,将大鼠随机分为5组(n=20):对照组(C组)、假手术组(S组)、神经病理性痛组(NP组)、WSLP-NR2B siRNA组(W组)、WSLP-阴性对照NR2B siRNA(WN组).采用坐骨神经分支部分结扎法制备大鼠神经病理性痛模型.C组不予任何处理;S组仅暴露坐骨神经,不牵拉和损伤神经;NP组于制备模型后即刻鞘内注射生理盐水20μl;W组和WN组于制备模型后即刻分别鞘内注射相应的siRNA 20μl.于模型制备前1 d及制备后3、7、14和21 d时测定机械缩足反应阈值(MWT)及热缩足反应持续时间(TWD),模型制备后3 d,痛阈测定结束后,每组取10只大鼠,取L4-6节段背根神经节,测定NR2B mRNA及其蛋白的表达水平.结果 与S组比较,NP组、W组和WN组MWT降低,TWD延长,NR2B mRNA及其蛋白表达上调(P＜0.05或0.01),C组上述指标差异无统计学意义(P＞0.05);与NP组比较,W组MWT升高,TWD缩短,NR2B mRNA及其蛋白表达下调(P＜0.01),WN组上述指标差异无统计学意义(P＞0.05).结论 WSLP不仅成功介导NR2B siRNA,抑制NR2B的表达,还可减轻大鼠神经病理性痛.

Abstract：

Objective To investigate the feasibility of NR2B small interference RNA(NR2B siRNA)carried by water-soluble lipopolymer(WSLP)for treatment of neuropathic pain in rats.Methods One hundred healthy male SD rats weighing 180-200 g were randomly divided into 5 groups(n=20 each):normal control group (group C),sham operation group(group S),neuropathic pain group(group NP),group WSLP-NR2B siRNA (group W)and group WSLP-negative NR2B siRNA(group WN).Neuropathic pain was induced by partial ligation of sciatic nenre.WSLP-NR2B siRNA complex was formed by binding WSLP and NR2B siRNA.Normal saline.WSLP-NR2B siRNA complex and WSLP-negative NR2B siRNA 20μl were injected intrathecally after operation in NP,W and WN groups respectively.Mechanical withdrawal threshold(MWT)and thermal withdrawal duration (TWD)were measured before(baseline)and at 3,7,14 and 21 days after operation.Ten animals in each group were sacrificed on the 3rd day after operation and the lumbar segment(L4-6)of the dorsal root ganglia was removed for determination of the expression of NR2B mRNA and protein using RT-PCR and Western blot analysis.Results Sciatic nerve ligation significantly decreased MWT and prolonged TWD and increased NR2B mRNA and protein expression in group NP as compared with group C.WSLP-NR2B siRNA complex significantly reduced sciatic nerve ligation-induced hyperalgesia and decreased NR2B mRNA and protein expression in group W as compared with group NP.Conclusion WSLP not only mediates NR2B siRNA successfully and inhibits the expression of NR2B,but also reduces neuropathic pain in rats.     

超声对创伤骨科下肢近端急性亚急性深静脉血栓的诊断价值

创伤骨科围手术期下肢深静脉血栓形成临床较常见,而下肢近端急性血栓多发生隐匿,诊断棘手,预后凶险。本组对深静脉血栓形成高危的创伤骨科患者进行围手术期彩色多普勒超声检仓,探讨其在下肢近端急性亚急性深静脉血栓中的诊断价值。     

星状神经节阻滞对内毒素血症小鼠炎性细胞因子水平及死亡率的影响

目的:探讨星状神经节阻滞(SGB)对内毒素血症小鼠血清炎性细胞因子及死亡率的影响,明确SGB可否成为系统性炎性反应综合征(SIRS)简单有效的辅助治疗手段。方法:内毒素血症小鼠分为SGB治疗组(颈部注射利多卡因)及对照组(颈部注射生理盐水),观察两组动物腹腔注射脂多糖(LPS)后2、7、14d血清TNF-α、IL-1β、IL-6的变化及2、4、7、10、15、20d累积死亡率的变化。结果:SGB治疗使内毒素血症小鼠2、7、14d的血清炎性细胞因子TNF-α、IL-1β、IL-6水平显著下降;注射LPS后2、4、7、10、15、20d的死亡率显著降低。结论:SGB可抑制内毒素血症小鼠过度的炎性反应,降低内毒素血症小鼠的死亡率,从而成为有益于SIRS治疗的简单有效的新手段。     

Vimentin significantly promoted gallbladder carcinoma metastasis

Background  The precise molecular mechanisms underlying the gallbladder carcinoma (GBC) metastasis has not been fully elucidated.

Methods  In the present study, metastasis-associated proteins were identified by comparative proteomic analysis. The functional study of the candidate protein vimentin was further investigated. First, a pair of higher and lower metastatic sublines (termed GBC-SD/M3 and GBC-SD, respectively), originated from the same parental cell line, was screened by spontaneous tumorigenicity and metastasis in vivo in animal study and further characterized by metastatic phenotypes analysis in vitro. Subsequently, a proteomic approach comprised two-dimensional gel electrophoresis analysis and mass spectroscopy was used to identify and compare the protein expression patterns between higher metastatic GBC-SD/M3 and lower metastatic GBC-SD cell lines. Then twenty-six proteins were identified.

Results  Among the 26 proteins identified, fourteen proteins were up-regulated and 12 proteins were down-regulated in GBC-SD/M3. Vimentin was identified and found to be overexpressed in GBC-SD/M3 as compared with GBC-SD. This result was further confirmed by quantitative PCR and Western blotting analysis. Furthermore, the cell migration and invasion potency of GBC-SD/M3 in vitro was remarkably suppressed after small interference RNA-mediated knockdown of vimentin. Moreover, immunoblot and immunohistochemical analysis on 12 human GBC specimens showed consistently increased vimentin expression in metastases compared with primary tumors.

Conclusion  Tumor vimentin level may reflect the pathological progression in some GBC and may be a useful marker for predicting tumor metastasis and a therapeutic target for the treatment of GBC patients with metastases.

     

切除脾血管保留脾脏的胰体尾切除术后胃脾区血流情况的改变

目的 观察切除脾血管保留脾脏的胰体尾切除术后胃脾区血流情况的改变.方法 上海交通大学医学院附属新华医院于2005年7月-2010年3月间对11例患者行切除脾血管保留脾脏的胰体尾切除术,于术后第3、12个月进行上腹部CT血管造影(CTA)成像和纤维胃镜检查,观察脾脏大小、胃食管及周围静脉情况.结果　术后平均随访(37.4±17.7)个月.术后3个月时CTA检查示,脾脏肿大4例(4/11),胃周静脉曲张3例(3/11),胃黏膜下静脉曲张1例(1/11).术后12个月时复查CTA示,4例脾脏肿大患者中,1例缓解,3例基本保持稳定,无新发脾脏肿大;3例胃周静脉曲张患者的情况稳定无进展,无新发胃周静脉曲张;1例胃黏膜下静脉曲张患者的情况稳定无明显进展.术后3个月胃镜检查示胃壁静脉曲张1例,术后12个月复查胃镜示胃壁静脉曲张无进展.结论　切除脾血管保留脾脏的胰体尾切除术后脾胃区血流发生改变,但无证据证实上消化道出血是其远期并发症.