全胃切除术后不同消化道重建方式对比格犬小肠动力影响的机制研究

目的研究全胃切除术后不同消化道重建术式对犬小肠动力的影响。方法将13只比格犬分为对照组（3只,仅行假手术）,全胃切除后采用功能性间置空肠进行消化道重建（FJI组,7只）和全胃切除后采用Roux-en-Y吻合进行消化道重建（RY组,3只）。手术后48h处死比格犬。处死前1h灌人活性炭,检测小肠转运率。取吻合口上下5cm的小肠,分别应用苏木精一伊红染色、免疫组织化学染色和干涉显微镜观察和检测小肠炎性反应,小肠组织卡哈尔细胞（ICC）分布及上皮凋亡情况。结果对照组和FJI组的小肠转运率分别为0．14±0．03和0．32±0．11,显著低于RY组（0．52±0．21,P〈0．05）。FJI组较RY组的小肠分布更多的ICC;FJI组的小肠浆膜炎性反应（包括出血、纤维渗出、溃疡）、中性粒细胞和巨噬细胞浸润以及小肠上皮细胞凋亡情况均不如RY组明显。结论减少手术创伤、保持小肠连续性的功能性间置空肠吻合消化道重建方式,具有更好的食物储存功能,有利于术后小肠动力的恢复。     

胶囊内镜在小肠疾病中的临床诊断价值

目的：探讨胶囊内镜在小肠疾病中的诊断价值.方法：分析2009年9月-2012年5月114例行胶囊内镜检查患者的临床资料.结果：113例患者完成检查.胶囊内镜回盲瓣通过率为90.3%（102/113例）;胃内运行时间3～187 min,平均（55.6±26.0）min;小肠内运行时间为24～640 min,平均（303±106） min;胶囊平均排出体外的时间为9～96 h,平均（29±10）h.63例发现小肠病变（55.7%）,病变分别为非特异性炎症24例,血管畸形13例,小肠克罗恩病12例,小肠息肉7例,小肠肿瘤3例,小肠钩虫2例,小肠憩室1例.消化道出血患者小肠病因检出率最高,为80.8%（42/52例）,其次是腹痛45.2%（14/31例）,消瘦33.3%（1/3例）,腹泻20.0%（1/5例）,腹胀14.3%（1/7例）.结论：胶囊内镜对小肠疾病有较高的诊断价值.     

ERADICATION OF METASTATIC ANGIOSARCOMA OF THE LOWER EXTREMITY: Case report

A 47-year-old man with an angiosarcoma of the right lower extremity was cured with mainly surgery and radiotherapy despite an inguinal metastasis. Histologically, the amputation stump of the metastatic tumour showed invasion by tumour. Radiotherapy, chemotherapy, and treatment with interleukin-2 was added. Ten years later he has had no recurrence.     

A defect of the abdominal wall with intestinal fistulas after the repair of incisional hernia using Composix Kugel Patch

INTRODUCTIONIn the present paper, we show a rare case of the large abdominal wall defect and enterocutaneous fistulas after the tension free repair using prostheses for incisional hernia.PRESENTATION OF CASEThe patient, a 70-year-old man, had a history of a hemicolectomy for a perforating colon cancer, complicated by a large incisional hernia that was closed primarily but recurred. Three years later, the hernia was repaired at the time of a second colectomy using a Composix Kugel Patch. His course was complicated by a chronic postoperative wound infection with eventual development of enterocutaneous fistulas. The patient was successfully treated with extirpation of the prosthesis, resection of the fistulized bowel, and placement of a tensor fasciae latae myocutaneous flap.DISCUSSIONEnterocutaneous fistulas are a known complication of incisional hernia repairs using prostheses. Additional clinical data are required to confirm the safety and efficacy of this procedure as it becomes more widely adopted.CONCLUSIONExtirpation of the prosthesis should be performed without delay to prevent serious complications. Reconstruction with a tensor fasciae latae myocutaneous flap was useful for the large abdominal wall defect.     

The effect of cyclic mechanical strain on the expression of adhesion-related genes by periodontal ligament cells in two-dimensional culture

Saminathan A, Vinoth KJ, Wescott DC, Pinkerton MN, Milne TJ, Cao T, Meikle MC. The effect of cyclic mechanical strain on the expression of adhesion‐related genes by periodontal ligament cells in two‐dimensional culture. J Periodont Res 2012; 47: 212–221. © 2011 John Wiley & Sons A/S Background and Objective: Cell adhesion plays important roles in maintaining the structural integrity of connective tissues and sensing changes in the biomechanical environment of cells. The objective of the present investigation was to extend our understanding of the effect of cyclic mechanical strain on the expression of adhesion‐related genes by human periodontal ligament cells. Material and Methods: Cultured periodontal ligament cells were subjected to a cyclic in‐plane tensile deformation of 12% for 5 s (0.2 Hz) every 90 s for 6–24 h in a Flexercell FX‐4000 Strain Unit. The following parameters were measured: (i) cell viability by the MTT assay; (ii) caspase‐3 and ‐7 activity; and (iii) the expression of 84 genes encoding adhesion‐related molecules using real‐time RT‐PCR microarrays. Results: Mechanical stress reduced the metabolic activity of deformed cells at 6 h, and caspase‐3 and ‐7 activity at 6 and 12 h. Seventy‐three genes were detected at critical threshold values < 35. Fifteen showed a significant change in relative expression: five cell adhesion molecules (ICAM1, ITGA3, ITGA6, ITGA8 and NCAM1), three collagen α‐chains (COL6A1, COL8A1 and COL11A1), four MMPs (ADAMTS1, MMP8, MMP11 and MMP15), plus CTGF, SPP1 and VTN. Four genes were upregulated (ADAMTS1, CTGF, ICAM1 and SPP1) and 11 downregulated, with the range extending from a 1.76‐fold induction of SPP1 at 12 h to a 2.49‐fold downregulation of COL11A1 at 24 h. Conclusion: The study has identified several mechanoresponsive adhesion‐related genes, and shown that onset of mechanical stress was followed by a transient reduction in overall cellular activity, including the expression of two apoptosis ‘executioner’ caspases.     

GABAA receptors can initiate the formation of functional inhibitory GABAergic synapses

The mechanisms that underlie the selection of an inhibitory GABAergic axon's postsynaptic targets and the formation of the first contacts are currently unknown. To determine whether expression of GABA_A receptors (GABA_ARs) themselves – the essential functional postsynaptic components of GABAergic synapses – can be sufficient to initiate formation of synaptic contacts, a novel co‐culture system was devised. In this system, the presynaptic GABAergic axons originated from embryonic rat basal ganglia medium spiny neurones, whereas their most prevalent postsynaptic targets, i.e. α1/β2/γ2‐GABA_ARs, were expressed constitutively in a stably transfected human embryonic kidney 293 (HEK293) cell line. The first synapse‐like contacts in these co‐cultures were detected by colocalization of presynaptic and postsynaptic markers within 2 h. The number of contacts reached a plateau at 24 h. These contacts were stable, as assessed by live cell imaging; they were active, as determined by uptake of a fluorescently labelled synaptotagmin vesicle‐luminal domain‐specific antibody; and they supported spontaneous and action potential‐driven postsynaptic GABAergic currents. Ultrastructural analysis confirmed the presence of characteristics typical of active synapses. Synapse formation was not observed with control or N‐methyl‐d ‐aspartate receptor‐expressing HEK293 cells. A prominent increase in synapse formation and strength was observed when neuroligin‐2 was co‐expressed with GABA_ARs, suggesting a cooperative relationship between these proteins. Thus, in addition to fulfilling an essential functional role, postsynaptic GABA_ARs can promote the adhesion of inhibitory axons and the development of functional synapses.     

Enamel demineralization and bracket bond strength when etching with acid and /or Er:YAG laser

Background:  Enamel etching for brackets is usually done with phosphoric acid. Er:YAG lasers have been recently used for this purpose with conflicting results. The effects of lasers on tooth demineralization and the effects of different combinations of laser treatments and bonding agents were evaluated in this study. Methods:  The enamel contents of fluorine, calcium oxide and phosphorus pentoxide (P₂O₅) were analysed using acid etching, laser treatment or both. The tensile bond strength of metallic and ceramic brackets using Transbond^® XT and Fuji Ortho^® LC were also tested, using acid etching, laser treatment or a combination of both. Results:  All treatments reduced the contents of fluorine, P₂O₅ and calcium oxide, and acid reduced P₂O₅ levels more than laser. The bond strength with laser was weaker than with acid, and stronger when combining both. When using laser, the best adhesive was the Fuji Ortho^® LC. The combination of laser and acid produced the best results when using Transbond^® XT. Conclusions:  The demineralization promoted by laser was lower than the one produced with acid. Laser treatment produced lower tensile stress strength than acid, but still enough to produce clinically efficient retention. The combination of laser and acid produced the best retention results.     

维持性血液透析终末期肾病患者肠道菌群特点探讨

 目的 探讨维持性血液透析终末期肾病(end stage renal disease,ESRD)患者肠道菌群的特点。方法 收集维持性血液透析的稳定ESRD患者和健康对照组受试者各22例粪便样本,提取样本DNA,进行16S rRNA基因测序,对肠道菌群的分布情况进行分析。结果 (1)维持性血液透析ESRD组观察到的各样品微生物物种量、物种多样性较健康对照组低,物种多样性在18～44岁组有统计学差异;(2)两组在纲、目、科、属、种分类水平上分别发现2、4、9、29、28个相对丰度有统计学差异的物种(P<0.05); 其中Negatibicutes纲、粪球菌属-3相对丰度维持性血液透析ESRD组低于健康对照组,而丹毒丝纲、目、科、属、种水平相对丰度维持性血液透析ESRD组高于健康对照组;(3)通过KEGG代谢途径的差异分析,推测两组间有3个存在统计学差异的代谢途径(P<0.05),其中与碳水化合物代谢途径相关基因在健康对照组粪便样品中显著富集,而与细胞运动性及药物耐药途径相关基因在维持性血液透析ESRD组粪便样品中显著富集。结论 维持性血液透析ESRD组患者肠道微生物群落多样性降低,与健康对照组比较在微生物群落相对丰度、KEGG功能预测相关基因代谢途径上存在差异。     

中药多糖体外抗胃肠肿瘤作用的研究进展

肿瘤是严重危害人体健康的疾病之一,胃肠肿瘤是我国人口中消化系肿瘤的多发病种,而针对其进行放疗、化疗治疗的同时对正常细胞毒性不容忽视。中药多糖抗肿瘤的同时,能提高人体免疫功能,且对正常细胞无伤害,使其成为抗肿瘤研究的热点。对中药多糖体外抑制人胃癌细胞系MGC-803、SGC-7901,人结直肠腺癌细胞LoVo、HCT-116、HT-29的增殖和促凋亡作用及相关作用机制进行综述,旨在为中药多糖的抗胃肠肿瘤的临床研究提供依据。     

肠道菌群对石榴皮鞣质的分解代谢作用研究

目的考察肠道菌群对石榴皮鞣质的分解代谢作用,阐明石榴皮鞣质在肠道的代谢途径。方法将石榴皮鞣质与大鼠肠道菌液共同孵育4、6、8、12、24、48 h后,检测不同时间点溶液中的代谢成分。结果通过LC-MS/MS从石榴皮鞣质肠道菌群孵育液中共鉴别出了10个代谢产物,分别为尿石素B、没食子酸、焦性没食子酸、3-O-甲基没食子酸、尿石素A、甲基化尿石素A、尿石素C、尿石素-M6、葡萄糖醛酸化尿石素A、葡萄糖醛酸化尿石素C。结论石榴皮鞣质在肠道菌群中主要通过代谢酶的水解、还原等作用将其代谢成具有生理活性的小分子化合物,这些化合物有可能是石榴皮鞣质在机体内发挥药理活性的物质基础。