miR-124a基因甲基化状态在人胃癌组织中的作用

目的探讨人胃癌组织中hsa-miR-124a基因启动子区的DNA甲基化状态与Rb和CDK6蛋白表达及临床病理因素的关系。方法用甲基化特异性PCR（MSP）方法检测手术切除的30例胃癌及相应癌旁组织的hsa-miR-124aDNA甲基化状态：采用免疫组织化学染色研究Rb和CDK6蛋白在胃癌组织中的表达情况。结果胃癌组织中hsa-miR-124a总体甲基化率为73．3％（22／30）,明显高于癌旁组织的10．0％（3／30）（P〈0．05）,其甲基化状态与肿瘤大小、分化程度、淋巴结转移、侵犯程度等临床病理因素有关（P〈0．01）。hsa-miR-124a甲基化与Rb蛋白和CDK6蛋白表达之间呈正相关（P〈0．05）。结论胃癌组织中hsa-miR-124a处于高甲基化状态,这种高甲基化可能通过增强Rh及CDK6蛋白的表达来促进胃癌的恶性增殖。     

Submucosal tunneling endoscopic resection for submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a feasibility study (with videos)

Background

The esophagogastric junction (EGJ) is a difficult location for endoscopic resection due to its narrow lumen and sharp angle. Potential increased risks of perforation and mediastinal infection exist, especially for submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. We previously demonstrated the safety and efficacy of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal SMTs, but the feasibility of STER for the removal of SMTs at the EGJ requires systematic investigation. The aim of the investigation was to evaluate the clinical impact of STER on the removal of SMTs at the EGJ.

Methods

A prospective study was carried out which included a consecutive cohort of 57 patients who underwent STER for 57 SMTs of the EGJ originating from the MP layer between July 2010 and August 2012 in a single academic medical center. Adverse events, en bloc resection rate, and local recurrence were evaluated.

Results

The average maximum diameter of the lesions was 21.5 mm (range 6–35 mm). The en bloc resection rate was 100 % (57/57). No delayed hemorrhage or severe adverse events occurred in any of the 57 patients following STER. No local recurrence and distant metastasis occurred during 24 months’ follow-up. Less subcutaneous emphysema and pneumomediastinum absorption time (p = 0.005) occurred with CO₂ versus air insufflations.

Conclusions

Our study showed that STER was safe and effective, provided accurate histopathologic evaluation, and was curative for SMTs of the deep MP layers at the EGJ. CO₂ gas insufflation is recommended.     

不同血液净化方式对尿毒症皮肤瘙痒的疗效观察

目的探讨不同血液净化方式对尿毒症皮肤瘙痒的治疗效果。方法选择70例尿毒症规律性血液透析伴皮肤瘙痒患者,分为血液灌流串联血液透析（HP／HD组）、血液透析滤过（HDF组）、高通量透析（HFD组）、普通血液透析（HD组）进行治疗。观察皮肤瘙痒等临床症状缓解情况及血清甲状旁腺素等指标变化。结果HP／HD组、HDF组、HFD组治疗前后,血清PTH水平下降,皮肤瘙痒明显缓解;与HD组比较差异有统计学意义（P〈0．01或P〈0．05）。结论血液灌流串联血液透析和血液透析滤过、高通量透析较普通血液透析能更有效的清除PTH,可有效缓解皮肤瘙痒等症状。     

PFN治疗股骨粗隆间骨折46例分析

目的评价应用AO股骨近端髓内钉(Proximal femoral nail,PFN)治疗股骨粗隆间骨折的临床疗效。方法2003年2月至2008年8月,采用AO股骨近端髓内钉闭合复位内固定治疗46例股骨粗隆间骨折患者,评价其骨折愈合情况和并发症及优点。结果44例获随访患者经6～24个月(平均13.5个月)随访,所有患者均获得骨性愈合。术后骨折延迟愈合伴防旋髋螺钉切出1例、髋内翻1例、股骨颈螺钉松出2例。根据Harris髋关节评分,优良率达93.2%。结论PFN闭合复位内固定治疗股骨粗隆间骨折,具有手术创伤小、固定可靠、应力分布分散、适合早期功能锻炼、愈合效果好等优点,是股骨粗隆间骨折较理想的内固定物。     

脑脂肪栓塞早期诊断及治疗

目的探讨脑脂肪栓塞的早期诊断及治疗。方法回顾性分析我院收治的颅脑外伤并发脑脂肪栓塞2例。结果患者MRI提示两侧大脑半球、基底节区、卵圆中心及脑干可见多发斑点斑块状等T1、长T2异常信号影,液体衰减反转成像（FLAIR）呈高信号,弥散加权成像（DWI）呈高信号。患者凝血机制也发生改变。结论通过早期的MRI结合凝血机制改变可以尽早诊断脑脂肪栓塞,使患者得到有效救治。     

中医药在脊髓损伤神经源性肠道功能障碍的研究进展

脊髓损伤(spinal cordin jury,SCI)后神经源性肠功能障碍对患者身心健康和生活质量的严重影响,目前越来越受到国际关注.但国内对此尚未普遍开展.中医理论在SCI及SCI后出现的排便异常尚未作相关总结.现有研究中医药对肠道自主神经系统已经成熟,其有效性获得国内外普遍承认,并较药物更易接受.为SCI肠功能障碍的研究打下基础.但目前国内对SCI后排便异常缺乏专业认识、项目资助和人员管理,临床研究欠规范,中医理论有待完善.现主要针对SCI神经源性肠功能障碍出现的排便异常,在中医病名、病机、主要方法、有效性、优势及存在问题作一综述.     

便携式颈椎、腰椎综合治疗仪的研制

目的：研制一种便携式颈椎及腰椎综合治疗仪。方法：将生物力学、人体工程学、电子技术相结合,以间歇式加热、间歇式自动充放气牵引为特点进行设备研制。结果：该产品可有效治疗颈椎及腰椎病,并能缓解部分不良症状。结论：便携式颈腰椎治疗仪采用间歇式加热,在牵引的功能上增加了热疗及振动按摩功能,可使治疗效果更佳。     

Hepatitis B virus X protein boosts hepatocellular carcinoma progression by downregulating microRNA-137

BackgroundHepatocellular carcinoma (HCC) is a frequent diagnosed malignancy. microRNAs (miRs) are involved in various cellular processes during cancer development. This study attempted to probe the miR-based mechanism in hepatitis B virus X protein (HBx) small interfering RNA (siRNA)-treated HCC cells.MethodsHBx expression in hepatocyte and HCC cells was detected, and cells with highest HBx expression were screened out and transfected with HBx-siRNAs. Then the effect of HBx on HCC cell proliferation was detected. miRs differentially expressed in HBx-siRNA-transfected MHCC97H cells were analyzed and verified. miR-137 methylation was analyzed by bioinformatics, and miR-137 restoration was detected after Aza treatment. Furthermore, miR-137 methylation in MHCC97H cells with HBx knockdown or HBx overexpression was detected by methylation specific PCR. The targeting relationship between miR-137 and Notch1 was verified. Then the gain-and-loss functions of miR-137 or/and Notch1 were performed to estimate their roles in HCC cell proliferation. The effects of HBx-siRNA and overexpressed miR-137 in vivo were observed by tumor xenograft in nude mice and immunohistochemistry.ResultsHBx-siRNA weakened MHCC97H cell proliferation and tumor growth. miR-137 was highly expressed in HBx-siRNA-treated HCC cells and targeted Notch1. HBx knockdown decreased miR-137 methylation and restored miR-137 expression. miR-137 overexpression prevented HCC cell proliferation and tumor growth, while miR-137 downregulation reversed the repressing effects of HBx-siRNA on HCC cell proliferation. Inhibition of Notch1 reversed HCC cell proliferation induced by miR-137 downregulation.ConclusionOverexpression of miR-137 blocks HCC cell proliferation in HBx-siRNA-treated MHCC97H cells by targeting Notch1. This study may offer novel target for HCC treatment.     

Sulforaphane enhances the activity of the Nrf2–ARE pathway and attenuates inflammation in OxyHb-induced rat vascular smooth muscle cells

Aim

A growing body of evidence indicates that the nuclear factor erythroid 2-related factor 2–antioxidant response element (Nrf2–ARE) pathway plays a protective role in many physiological stress processes such as inflammatory damage, oxidative stress, and the accumulation of toxic metabolites, which are all involved in the cerebral vasospasm following subarachnoid hemorrhage (SAH). We hypothesized that the Nrf2–ARE pathway might have a protective role in cerebral vasospasm following SAH.

Materials and methods

In our study, we investigate whether the oxyhemoglobin (OxyHb) can induce the activation of the Nrf2–ARE pathway in vascular smooth muscle cells (VSMCs), and evaluate the modulatory effects of sulforaphane (SUL) on OxyHb-induced inflammation in VSMCs.

Results

As a result, both the protein level and the mRNA level of the nuclear Nrf2 were significantly increased, while the mRNA levels of two Nrf2-regulated gene products, both heme oxygenase-1 and NAD(P)H: quinone oxidoreductase-1, were also up-regulated in VSMCs induced with OxyHb. A marked increase of inflammatory cytokines such as IL-1β, IL-6 and TNF-α release was observed at 48 h after cells were treated with OxyHb. SUL enhanced the activity of the Nrf2–ARE pathway and suppressed cytokine release.

Conclusions

Our results indicate that the Nrf2–ARE pathway was activated in OxyHb-induced VSMCs. SUL suppressed cytokine release via the activation of the Nrf2–ARE pathway in OxyHb-induced VSMCs.