腺病毒介导小鼠神经生长因子基因在骨髓间充质干细胞中的表达

目的构建具有生物学活性的小鼠神经生长因子(nerve growth factor,βNGF)基因重组腺病毒表达载体,并研究其在骨髓间充质干细胞中的表达特性。方法利用逆转录多聚酶链式反应(RT-PCR)从小鼠颌下腺总mRNA中扩增βNGF全长cDNA片断,定向克隆于携带巨细胞启动子(CMV)和标记蛋白-绿色荧光蛋白(GFP)的腺病毒穿梭质粒pAdtrack中;在细菌BJ5183中与缺陷型腺病毒基因组pAdeasy-1进行同源重组,构建pAdeasy-1/pAdtrack-CMV-GFP-mβNGF;在HEK293(人胚肾293细胞)细胞中包装成为有感染能力的、能表达βNGF和绿色荧光蛋白的重组腺病毒颗粒。用病毒感染原代培养的人骨髓间充质干细胞(marrow mesenchymal stem-cells,MSCs),荧光显微镜下观察病毒感染效率,免疫细胞化学法检测细胞中βNGF的蛋白表达,蛋白质免疫印迹法检测培养上清中NGF的分泌。结果成功获得小鼠βNGF的cDNA片断,经酶切鉴定证实重组腺病毒表达载体pAdeasy-1/pAdtrack-CMV-GFP-mβNGF构建成功。荧光显微镜下观测到感染病毒的细胞胞体发出明亮的绿色荧光,细胞中βNGF免疫染色阳性,培养上清中检测有NGF分泌。结论重组腺病毒表达载体能高效地将外源性目的基因βNGF导入骨髓间充质干细胞中,并能正确转录、翻译和分泌,为骨髓间充质干细胞在内耳基因干预的研究中奠定基础。     

快速康复外科在结直肠癌择期手术中的应用效果

Objective To investigate the clinical application of fast track surgery in patients undergoing elective colorectal carcinoma surgery. Methods Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: fast-track group (35 cases) and conventional care group (35 cases). Results Sixty-two patients finished the study, 32 cases in fast-track group and 30 cases in conventional care group. The median and average time to the first passage of flatus (2±1 vs. 4±2, P<0.01), the first passage of stool (3.8±1.6 vs. 6.4±2.5, P=0.0007), resumption of normal diet [(4±2) vs. (8.2±2.2), P<0.01] and the length of postoperative stay (6±1 days vs. 11.7±3.8 days, P<0.01) were much shorter in the fast-track group than in the conventional care group. The preoperative incidence of thirst (2/32 vs. 23/30, P<0.01), hunger (5/32 vs. 20/30, P<0.01) and postoperative infectious complications (2/32 vs. 8/30, P=0.04) were much lower in the fast-track group than in the conventional care group. Conclusion Fast track surgery in patients undergoing elective colorectal resection was safe and effective.     

美西律衍生物对α1肾上腺素受体的作用

为寻找新的α₁受体阻断剂,用[³H]-WB4101配体测定法测定了18种美西律衍生物。结果表明,其中6种化合物对大鼠脑皮层α₁受体有不同程度的亲和力。凡具有手性碳结构的化合物亲和力都较高。化合物M-85001的亲和力较妥拉唑林(tolazoline)高一个数量级并能抑制苯肾上腺素引起的大鼠肛尾肌收缩,其pA₂(6.86)与pK_i(6.51)相近。结果提示,美西律衍生物对α₁-受体的亲和力可能与手性碳结构有关,从美西律衍生物中研制新的α₁-受体阻断剂是有前途的。     

结直肠腺癌病理分型的临床意义及预后分析

目的 探讨结直肠黏液腺癌、印戒细胞癌与乳头状、管状腺癌临床病理的差异和预后.方法 收集1994年8月至2007年3月结直肠手术患者2089例,其中黏液腺癌144例,印戒细胞癌25例,乳头状腺癌和管状腺癌1837例,剔除其他类型肠道肿瘤83例.比较三组的临床病理特点.对影响结直肠预后的部分临床病理指标,如年龄、肿瘤部位、分期、腹膜、病理分型进行单因素和非条件Logistic回归分析.对三组进行总体生存分析.结果 黏液腺癌患者发病的中位年龄为(54.20±16.25)岁,印戒细胞癌患者为(40.43±12.88)岁,乳头状腺癌和管状腺癌患者为(58.73±13.62)岁,印戒细胞癌发病年龄最低(P<0.001).三组男女比例、肿瘤直径、肿瘤部位、TNM分期、腹膜转移、淋巴结转移和脏器侵犯差异均有统计学意义(P值均<0.05).经单因素和非条件Logistic回归分析发现,黏液癌和印戒细胞癌是预示结直肠癌预后的危险因素,而印戒细胞癌是预示结直肠癌预后的独立因素.三组总体生存时间和生存率间差异有统计学意义(P<0.001).结论 结直肠黏液腺癌和印戒细胞癌预后较乳头状、管状腺癌差.黏液癌和印戒细胞癌是预示结直肠癌预后的危险因素.     

结直肠黏液腺癌的临床特点

者黏液腺癌和非黏液腺癌中位生存时间分别为125.1和151.0个月,差异也有统计学意义(P＝0.020);两组Ⅰ、Ⅳ期患者总生存率差异无统计学意义(P＞0.05);而Ⅱ、Ⅲ期患者非黏液腺癌中位生存时间149.0个月,明显长于黏液腺癌的67.7个月(P＝0.033).结论 黏液腺癌可能是具有独特生物学行为的肿瘤,其预后差与其独特的病理类型有关.     

中国南方结直肠黏液腺癌和印戒细胞癌、非黏液腺癌的临床病理特征和预后

Background Previous studies have shown conflicting results on the relation between clinicopathologic features and prognosis of patients with colorectal mucinous, signet-ring cell, or non-mucinous adenocarcinoma; only few such studies have been performed in China. This retrospective study analyzed data from our department to investigate clinicopathologic characteristics, prognosis and possible correlations of three histologic types - colorectal mucinous, signet-ring cell, and non-mucinous adenocarcinoma, to clarify the bases for observed differences which may lead to development of targeted therapies Methods Of 2079 patients diagnosed with colorectal cancer between 1994 and 2007, 144 had mucinous, 25 had signet-ring cell, and 1837 had non-mucinous adenocarcinoma. Their clinicopathologic parameters and survival were analyzed using established statistical methodologies. Results Mucinous and signet-ring cell adenocarcinomas were common in younger patients （P 〈0.001）. Location, size and disease stage differed significantly among the three types. Signet-ring cell tumors were more commonly found in the rectum than mucinous and non-mucinous adenocarcinoma （P 〈0.001）. Mucinous and signet-ring cell tumors presented in a later stage in life more often than non-mucinous adenocarcinoma, with lymph node involvement, serosal infiltration, peritoneal dissemination, and adjacent organ invasion （P 〈0.01）. The rate of radical resection, hepatic metastasis and local recurrence did not differ among types （P 〉0.05）. Compared with patients with non-mucinous adenocarcinoma, patients with mucinous and signet-ring cell tumors who underwent potentially curative resections or stage Ⅱ/Ⅲ disease had poorer long-term overall survival. Survival did not differ by type for patients with either stage Ⅰ or Ⅳ disease （P 〉0.05）. Conclusions Mucinous and signet-ring cell adenocarcinoma have unique carcinogenesis and similar biologic behavior. Our study confirms that both histologic types, especially signet-ring cell tumors, are independent, negative prognostic factors for patients with colorectal cancer. Type does not appear to have a significant effect on survival when disease is either stage Ⅰ or Ⅳ at presentation.     

神经生长因子在新生大鼠耳蜗的定位及其意义

目的 观察神经生长因子在新生大鼠耳蜗中的定位,为进一步研究其在听觉通路中的作用机制提供依据.方法 出生后5～7 d健康SD大鼠20只,制备耳蜗石蜡切片,用兔抗小鼠神经生长因子(nerve growth factor,NGF)多克隆抗体行免疫组织化学染色(S-P法),检测NGF在耳蜗中的表达.结果 新生SD大鼠膜迷路呈类三角形结构,可清晰看见幼稚柯替器、螺旋神经节细胞、蜗轴中的细胞染色阳性,细胞核及细胞质内均有表达.结论 NGF对出生后5～7 d大鼠螺旋神经节细胞和毛细胞的存活、成熟密切相关.     

创伤结局的多因素分析

目的探讨影响创伤结局的各种因素,建立创伤结局预测模型,为提高创伤救治水平提供有用的信息。方法回顾性分析1131例创伤患者的资料,以创伤生存率为反应变量,对生理评分、SIRS评分和解剖损伤评分进行Logistic回归分析,并考虑年龄等因素,计算出各自的权重。结果 GCS、SIRS、年龄和收缩压进入Logistic回归方程,解剖损伤评分未进入回归方程。结论 GCS、SIRS、收缩压、年龄是影响创伤结局的重要因素。     

男性症状性良性前列腺增生症对其伴侣生活质量的影响

目的症状性良性前列腺增生(BPH)导致的一系列下尿路症状(LUTS)及其伴发的相关事件,不仅会影响男性患者,还会对患者配偶或女性伴侣产生重要影响,本研究旨在调查症状性良性前列腺增生对患者本人及其配偶生活的影响并进行对比,包括生活质量、日常生活习惯和家庭社交关系。方法选取255名50岁以上临床诊断BPH伴有LUTS患者及其配偶进行研究。男性患者填写国际前列腺症状评分(IPSS),并要求男性患者及其配偶对睡眠、夜间醒来、性生活、旅游、娱乐、家庭和社交关系的影响填写相关问卷,然后进行统计学分析。结果 BPH患者伴有的LUTS对其本人和配偶的生活均产生程度相近的不良影响。研究发现,绝大多数(88%)接受调查女性的生活因其配偶LUTS而受到了重要影响,包括日常生活、生活质量和家庭社交关系,其中夜间睡眠障碍是最主要的影响(48%),其他包括性生活问题(38%);无法共同长途旅行(19%);无法共同前往没有厕所的地方(13%);无法共同前往电影院或剧院(9%);家庭关系破坏(12%),交际关系破坏(18%)。男性有无LUTS对其配偶夜间起夜、性生活障碍以及无法长途旅行等方面的影响差异具有统计学意义(P0.05)。结论 BPH伴有的LUTS对男性患者及其配偶均产生了不良影响,在考虑治疗方案时应将女性作为整体的一部分纳入干预范畴。