NF-κB靶向性哑铃形“圈套”寡核苷酸对体外肾小球系膜细胞细胞因子表达的影响

目的:设计合成靶向NF-κB的哑铃形“圈套”ODNs,并检测其对NF-κB转录活性和肾小球系膜细胞细胞因子(TNF-α和IL-6)表达的抑制效应。方法:以NF-κB顺式作用元件κB序列为模板,设计包含两个拷贝的κB序列,长度为58个碱基的环状ODNS,合成后部分序列做FAM标记,行转集效率鉴定实验。采用电泳迁移率改变实验(EMSA)体外检测哑铃形圈套ODNs对NF-κB转录活性的抑制效应。提取大鼠肾小球系膜细胞,随机分为正常对照组、LPS刺激组、哑铃形圈套ODNs处理组、无关圈套ODNs处理组和脂质体处理组。采用阳离子脂质体将2、4、8mg/L不同剂量哑铃形圈套ODNs转染大鼠肾小球系膜细胞,6h后用LPS刺激,收集转染后8、12、18上清和细胞。用酶联免疫吸附试验(ELISA)法检测上清细胞因子蛋白表达,逆转录PCR(RT-PCR)法检测细胞因子mRNA转录。结果:阳离子脂质体可将哑铃形圈套ODNs高效转集入肾小球系膜细胞,哑铃形圈套ODNs在体外能有效地抑制NF-κB与其顺式元件的结合;4、8mg/L剂量哑铃形圈套ODNs可明显抑制LPS诱导的大鼠肾小球系膜细胞TNF-α和IL-6转录与表达。结论:靶向N...     

经胸小切口在食管癌切除手术中的应用

目的探讨经胸小切口治疗食管癌手术的地位和可行性。方法对132例不同分期的食管癌行经胸小切口根治性手术,全部采用颈部吻合。结果切口平均长度13.0±2.0 cm,开关胸时间、开胸时出血量、术后伤口疼痛、呼吸功能受限及患肢活动等方面有显著差异,在手术时间、淋巴结清扫、术中出血及术后胸腔引流和常规手术无差异。结论经胸小切口食管癌根治手术安全、可行,并且有创伤小、恢复快等优点,便于推广应用。     

阴茎折断临床分析

目的 探讨阴茎折断伤的病因和诊治。方法 对2l例阴茎折断伤的临床资料进行回顾性分析。结果 致伤原因以粗暴性交13例，手淫5例，跌伤、撞击伤各l例，拒绝说明原因l例。B超确诊12例，阴茎海绵体造影确诊l例。12h内手术13例，超过12h手术3例，保守治疗5例。12h内手术组有2例发生阴茎白膜硬结，术后性功能正常；超过12h手术组和保守治疗组各有l例和2例并发阴茎硬结、阴茎成角畸形和勃起功能障碍。结论 阴茎折断致伤原因以粗暴性交和手淫为主；B超检查是诊断阴茎折断首选方法；早期手术能减少其并发症的发生；术中采用纵行小切口容易准确找到白膜破裂位置，且创伤小，适于临床应用。     

屈光度对SMILE术后眼压的预测和校正

目的 探究SMILE术后眼压的预测并校正。方法 回顾性研究+前瞻性验证。纳入2019-12/2021-12于中部战区总医院行SMILE的患者90例(180眼),随机抽取30眼为验证集,余150眼为训练集。前瞻性录入2022-01/2022-09SMILE的51例(102眼)为测试集。首先分析训练集手术前3d、术后1wk、1mo、3mo及6mo的眼压情况,确定眼压稳定期及于术前的眼压变化量(ΔIOP);再选取球柱镜代数和(SC)、球镜度(DS)、柱镜度(DC)及眼压(IOP)、中央角膜厚度(CCT)、角膜平均曲率(Km)、前房深度(ACD),眼压稳定时的变化量(ΔCCT、ΔKm、ΔK1、ΔK2、ΔACD)及个体因素,纳入与ΔIOP相关的因素拟合回归模型;最后建立适合临床SMILE术后眼压预测及校正的公式并作效能验证。结果 除术后1wk、3mo及6moIOP三者间无明显差异外,余时段IOP间差异均有统计学意义(P＜0.05);各因素与ΔIOP拟合最佳回归方程：ΔIOP=0.459IOP_术前-0.183SC-0.041Age+1.292ΔACD-1.270(调节R₂^=0.533,P＜0.001)。仅纳入术前IOP和SC,拟合简化方程：ΔIOP=0.496IOP_术前-0.194SC-2.952(调节R₂^=0.498,P＜0.001);预测和校正公式：IOP_术后预测=0.5IOP_术前+0.2SC+3,IOP_术后校正=IOP_术后+0.5IOP_术前–0.2SC–3。简化公式的效能验证显示良好。结论 SMILE术后3月IOP趋于稳定,且ΔIOP与屈光度相关。SMILE术后IOP可通过简化公式作快速临床预测和校正。     

Appearance of extrachromosomal circular DNAs during in vivo and in vitro ageing of mammalian cells

Appearance of extrachromosomal circular DNAs with in vivo and in vitro cellular ageing was examined by using a new technique of mica-press-adsorption for electron microscopy. The size distribution and the copy number of circular DNA complexes varied, depending on the cellular age. Extrachromosomal circular DNA complexes of variable length of more than 0.5 microns or 1.5 kilobase (kb) appeared during in vivo ageing of rat lymphocytes and in vitro ageing of cultured human lung fibroblasts. A restricted size class of circular forms of less than 0.5 microns in contour length was amplified in human skin fibroblasts from aged normal or Werner's syndrome subjects. These circular DNA molecules are suggested to be products of DNA rearrangements or gene amplification occurring in the chromosome.     

右腋下小切口在常见先天性心脏病中的应用

目的探讨右腋下小切口治疗常见先天性心脏病的方法和效果。方法应用右腋下施行心内直视手术22例，其中室间隔缺损（VSD）5例，房间隔缺损（ASD）14例，VSD＋ASD3例。结果全组无手术死亡。术后发生腩栓塞1例，右肺不张2例，术后随访21例，随访半个月～32个月，无残余漏发生，患者均恢复良好。结论应用右腋下小切口剖胸治疗常见先天性心脏病安全可靠，创伤小、恢复快、切口隐蔽、美学效果好。     

Inhibitory effects of opioids in a circular muscle-myenteric plexus preparation of guinea-pig ileum

Summary The actions of opioids were examined in a strip preparation of the external muscle and myenteric plexus of the guinea-pig ileum cut parallel to the circular muscle. Contractions of the circular muscle induced by electrical stimulation of myenteric neurons were depressed in a concentration-dependent manner by the mu agonists, morphine and DAGO, and by the kappa agonist, U-50,488H. The concentrations of morphine, DAGO and U-50,488H which depressed nerve-mediated contractions by 50% (IC₅₀) were 86 nM, 11 nM and 5.0 nM, respectively. The equilibrium dissociation constants (K _D) for naloxone as an antagonist of the inhibitory effects of DAGO and of U5-0,488H were 5.6 nM and 29.4 nM, respectively. In contrast to the potent inhibitory effects of mu and kappa agonists, the delta-selective agonist, d-Pen-l-Pen, produced only weak inhibition of nerve-mediated contractions. Even at a concentration of 3 M, there was less than 50% inhibition, which was not antagonised by the delta receptor antagonist, ICI 174864. The experiments indicate that both mu and kappa opioid receptors are present on the myenteric neurons supplying the circular muscle and that delta receptors are either absent or ineffectively activated. Send offprint requests to S. M. Johnson     

基于集中度和圆形分布法的上海市郊区某镇手足口病流行特征分析

目的分析上海市郊区某镇2012—2018年手足口病流行病学特征和季节性分布规律,为制定有效的防控策略提供科学依据。方法通过中国疾病预防控制信息系统,收集2012—2018年现住址为上海市郊区某镇的手足口病发病资料,采用描述性流行病学方法进行分析。结果上海市郊区某镇2012—2018年共报告手足口病病例538例,年平均报告发病率为186.27/10万,各年发病率差异有统计学意义(χ2=107.95,P<0.05);发病年龄以5岁以下儿童为主;发病高峰在5~9月份;职业以散居儿童为主;手足口病疫情主要发生在托幼机构和学校,占总疫情数的60.53%。结论2012—2018年上海市郊区某镇手足口病发病具有季节性,建议在高发期来临前针对重点人群、重点场所进行手足口病防控措施的落实,减少手足口病重症病例和疫情的发生。     

灌洗法一期叻除吻合术在左侧梗阻性结肠癌中的应用

目的：探讨左半结肠癌并梗阻一期切除吻合的可行性。方法：术中灌洗肠内容物,术后吻合口减压。结果：1995年至1999年所遇左侧梗阻性大肠癌中选择5例用此方法吻合成功。结论：左侧梗阻性大肠癌,只要掌握好手术指针。术中充分灌洗肠内容物,术后扩肛可一期切除吻合。     

介入联合手术治疗膀胱癌32例疗效分析

目的观察髂内动脉灌注化疗联合手术治疗膀胱癌的疗效。方法对32例中晚期膀胱癌先行介入治疗,再手术切除。结果32例膀胱癌完全缓解(CR)率为71．9％。结论介入治疗中晚期膀胱的手术提供了良好基础,对一部分原本行扩大切除术甚至全切的患实行单纯部分切除术,从而保留了膀胱生理功能,有助于提高患生活质量,延长生命。