谷氨酰胺对食管癌术后的营养支持作用

本研究旨在观察手术后早期应用谷氨酰胺营养支持方法对食管癌患者术后营养状态的影响,探讨食管癌患者术后合理的营养支持方案. 一、资料与方法 1.研究对象:选择我院2008年8月至2010年1月收治的32例食管癌患者,其中男21例,女11例,年龄46～72岁,平均56.5岁.术前随机分为2组:常规胃肠外营养组(TPN组,对照组)16例和TPN+Gla-Gln组(实验组)16例.     

Initial 12-h operative fluid volume is an independent risk factor for pleural effusion after hepatectomy

Pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital stays. Several studies have addressed the risk factors for postoperative pleural effusion. However, there are no researches concerning the role of the initial 12-h operative fluid volume. The aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after hepatectomy. In this study, we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December 2012. We prospectively collected and retrospectively analyzed baseline and clinical data, including preoperative, intraoperative, and postoperative variables. Univariate and multivariate analyses were carried out to identify whether the initial 12-h operative fluid volume was an independent risk factor for pleural effusion after hepatectomy. The multivariate analysis identified 2 independent risk factors for pleural effusion: operative time [odds ratio (OR)=10.2] and initial 12-h operative fluid volume (OR=1.0003). Threshold effect analyses revealed that the initial 12 h operative fluid volume was positively correlated with the incidence of pleural effusion when the initial 12-h operative fluid volume exceeded 4636 mL. We conclude that the initial 12-h operative fluid volume during liver resection and operative time are independent risk factors for pleural effusion after hepatectomy. Perioperative intravenous fluids should be restricted properly.     

纳米技术介导的光动力疗法治疗肝细胞癌的研究进展

肝脏恶性肿瘤包括原发性和转移性肿瘤,肝细胞癌又是肝脏恶性肿瘤中最常见的类型。然而,目前临床上常用的治疗手段在提高不宜手术的晚期肝细胞癌患者生存率方面取得的进展有限。因此,肝细胞癌的临床治疗除了手术、放化疗、经动脉化疗栓塞治疗、射频消融治疗、介入治疗、靶向治疗以及免疫治疗外,急需一种新的治疗方式。光动力疗法(PDT)是治疗晚期癌症的一种新策略,其为患者提供了一种微创、低毒副作用的潜在治疗方法,且在整个治疗过程是无痛、可重复的。因此,光动力疗法被认为是治疗晚期肝细胞癌的有效姑息疗法。纳米技术介导的光动力治疗可以有效的提高光敏剂在体内的靶向性,从而提高治疗效果。本文就纳米技术介导的光动力治疗在肝细胞癌中的应用作一综述。     

人arresten基因转染对自体移植静脉内膜增生的影响

目的:探讨体内转染arresten基因对自体移植静脉内膜增生的影响。方法:建立大鼠自体静脉移植模型。血管吻合术前，用脂质体介导重组质粒pSecTag2-AT（Ⅰ组），空载体pSecTag2转染（Ⅱ组）移植血管，等体积脂质体溶液处理移植血管(空白对照组，Ⅲ组）。各组动物均于4周后切取移植血管，RT-PCR检测移植血管中arresten mRNA的表达；常规HE，Verhoeff弹力纤维染色；计算机图象分析检测移植静脉血管内膜及中膜面积、厚度；免疫组化检测移植血管内膜α-SMA及PCNA的表达；Western blot检测TGF-β1蛋白的表达。结果:Ⅰ组转染的移植静脉中有目的基因mRNA的表达, 而Ⅱ、Ⅲ组无Ⅰ组内膜、中膜面积小均于Ⅱ组和Ⅲ组，差异有显著性（P<0.05）。而内膜面积/中膜面积3组间无统计学差异（P>0.05）；Ⅰ组内膜厚度小于Ⅱ组和Ⅲ组，组间比较有统计学差异（P<0.01）；α-SMA染色表明增生内膜中的细胞是血管平滑肌细胞；PCNA阳性细胞数及表达指数Ⅰ组均低于Ⅱ组和Ⅲ组（P<0.05）；Ⅰ组TGF-β1蛋白的表达明显低于Ⅱ组和Ⅲ组。结论:移植血管转染arresten基因，可有效抑制自体移植静脉内膜的增生，在防治血管移植术后再狭窄方面显示出良好的临床应用前景。     

谷氨酰胺对食管癌术后的营养支持作用

本研究旨在观察手术后早期应用谷氨酰胺营养支持方法对食管癌患者术后营养状态的影响,探讨食管癌患者术后合理的营养支持方案. 一、资料与方法 1.研究对象:选择我院2008年8月至2010年1月收治的32例食管癌患者,其中男21例,女11例,年龄46～72岁,平均56.5岁.术前随机分为2组:常规胃肠外营养组(TPN组,对照组)16例和TPN+Gla-Gln组(实验组)16例.     

尿激酶型纤溶酶原激活剂mRNA在胃癌组织中的表达及其意义

目的 研究尿激酶型纤溶酶原激活剂(uPA)mRNA在胃癌组织中的表达及其意义。方法 应用荧光定量RT-PCR方法，分别检测48例胃癌及其癌旁组织中uPA mRNA的表达，并结合其临床病理特征进行分析。结果 48例胃癌组织及癌旁组织中，uPA mRNA表达阳性率分别为83．3％和25.0％,胃癌伴有淋巴结转移和无淋巴结转移者中，uPA mRNA表达阳性率分别为93．8％和62．5％．且uPA mRNA表达与胃癌浸润程度呈正相关。结论 uPA mRNA表达可作为判断胃癌恶性程度及预后的指标之一。     

The Origin of Neointimal Smooth Muscle Cells in Transplant Arteriosclerosis from Recipient Bone-marrow Cells in Rat Aortic Allograft

In order to investigate the origin of neointimal smooth muscle cells in transplant arterio- sclerosis in rat aortic allograft, sex-mismatched bone marrow transplantation was performed from male Wistar rats to female Wistar rats. Four weeks after transplantation, the aortic transplant model was established by means of micro-surgery in rats. The recipients were divided into 4 groups: female Wistar-female Wistar aortic isografts, female SD-female Wistar aortic allografts, male SD-male Wis- tar aortic allografts, female SD-chimera Wistar aortic allografts. Eight weeks after transplantation, aortic grafts were removed at autopsy and processed for histological evaluation and immunohisto- chemistry. The results indicated that excessive accumulation of α-SMA-positive smooth muscle cells resulted in significant neointima formation and vascular lumen stricture in rat aortic allografts. Neointima assay revealed that the neointimal area and NIA/MA ratio of transplanted artery were sig- nificantly increased in all of aortic allograft groups as compared with those in aortic isograft group (P<0.01). Neointimal smooth muscle cells were harvested from cryostat sections of aortic allograft by microdissection method. The Sry gene-specific PCR was performed, and the result showed that a dis- tinct DNA band of 225 bp emerged in the male-male aortic allograft group and chimera aortic al- lograft group respectively, but not in the female-female aortic allograft group. It was suggested that recipient bone-marrow cells, as the origin of neointimal smooth muscle cells, contributed to the pathological neointimal hyperplasia of aortic allograft and transplant arteriosclerosis.     

mRNA差异显示法筛选和克隆胃癌相关基因

目的 :筛选和克隆胃印戒细胞癌与正常胃黏膜细胞差异表达基因片段。方法 :采用mRNA差异显示法 (mRNAdifferentialdisplayPCR ,DD PCR) ,对比胃印戒细胞癌组织与正常胃黏膜组织mRNA的表达差异 ,克隆胃印戒细胞癌差异片段 ,经过RNA的斑点杂交、测序以及序列分析和同源性比较。结果 :胃印戒细胞癌与正常胃黏膜中存在明显的基因表达差异 ,发现与胃癌相关的差异表达条带 16条 ,其中 7条为缺失表达条带 ,9条为过度表达条带。对其中 4条差异表达条带进行克隆、测序 ,经序列分析及同源性比较和RNA的斑点杂交 ,表明确认其中 1条为GenBank/BLAST中尚未收录的片段。结论 :胃印戒细胞癌的mRNA差异显示证明 ,该EST序列可能在胃癌的发生发展中具有一定作用     

瘤内注射pSTbAT-脂质体复合物对裸鼠移植瘤抑制效应的实验研究

目的:构建血管生成抑制因子arresten基 因的真核表达载体,并观察瘤内注射质粒DNA 脂质 体复合物对裸鼠移植瘤生长的影响。方法:利用 PCR方法,由重组质粒pGEM Arr中扩增出基因;将 该基因定向克隆于真核表达载体中。20只裸鼠皮 下注射HepG 2细胞,成瘤后以成功构建的质粒 DNA 脂质体复合物瘤内注射,治疗后采用免疫组化 方法检测肿瘤血管密度,并利用arresten基因瘤内注 射的方法对抑制肿瘤的效果进行分析。结果:我们 成功构建arresten基因真核表达载体(pSTbAT)。实 验组肿瘤生长速度较对照组慢(实验组平均15.3个 阳性血管/10个视野,对照组平均112.5个阳性血 管/10个视野)。结论:瘤内注射arresten基因质粒 DNA复合物能抑制裸鼠移植瘤的血管生成,并能抑 制移植瘤的生长。     

经门静脉途径输注骨髓细胞后大鼠小肠移植的排斥反应及细胞因子相关改变

目的 经受体大鼠门静脉途径输注供体大鼠的骨髓细胞,观察受体大鼠小肠移植排斥反应状况及生存时间,并分析其细胞因子的改变与病理学改变之间的关系.方法 取雄性BN大鼠30只为供体、雌性Lewis大鼠30只为受体建立异位节段小肠移植模型,随机分为3组:BN-Lewis组(对照组)、BN-Lewis+FK506组(FK506组)、BN-Lewis+BM(P.V.injection)+FK506组(PV组);对各组作生存时间分析,并于术后7、14、30、60和90 d制作移植小肠的病理切片评估排斥反应程度;分别于术后7、14、21、30 d留取受体血清,ELISA法测定血清中IL-2、IL-10水平.结果 与对照组、FK506组相比,PV组受体大鼠存活时间明显延长(P<0.01);对照组大鼠术后第14天即已出现严重的急性排斥反应,而FK506组急性排斥反应发生时间延迟至第30天;PV组在术后30 d之内均未见严重的急性排斥反应.各组移植后受体IL-2浓度均增加,但PV组的IL-2增高幅度明显低于对照组和FK506组(P<0.01);移植后受体大鼠血清IL-10浓度也均增加,但PV组IL-10升高幅度大于对照组和FK506组(P<0.01).结论 骨髓细胞经门静脉输注能明显延长小肠移植物的生存时间,外周血清IL-2、IL-10浓度变化与排斥反应相关.