丹参素对大鼠肝星状细胞氨基末端蛋白激酶信号转导的影响

Objective To investigate the inhibitory effect of danshensu on the activation of JNK signaling in rat hepatic stellate cells (HSCs) induced by IL-1 β. Methods The proliferation of primary rat HSCs treated with different concentration of Danshensu was checked by MTT colorimetric assay. The expres-sion and phosphorylation of JNK and P-JNK was detected by western blotting. Synthesis and secretion of collagen Ⅰ were detected by the quantitative immunocytochemical assay and ELISA. Results Danshensu inhibited the proliferation of HSCs in a dose-dependent manner. At the concentration of 0.0625 to 0.25 mmol/L, Danshensu significantly repressed the proliferation of HSC induced by IL-115 (P < 0.05). Synthesis and secretion of Type β collagen was significantly decreased 24 hours after 0.25 mmol/L Danshensu treatment (P < 0.01). The phosphorylation of JNK induced by IL-1 β was significantly inhibited by Danshensu treatment (P < 0.05), however, the expression of JNK was not regulated by Danshensu. Conelutions Danshensu represses the activation and proliferation of HSCs, and inhibits the synthesis and secretion of Type β collagen, possibly via the repression of the JNK signal transduction.     

胆道、十二指肠支架置入治疗胆道合并十二指肠恶性梗阻

目的探讨胆道支架、十二指肠支架置入治疗胆道合并十二指肠恶性梗阻的临床价值。方法2008年1月～2013年12月,对24例同时存在胆道和十二指肠恶性梗阻的患者完成胆道支架、十二指肠支架置入,其中介入中心10例患者行经皮肝穿刺造影完成胆道金属支架置入（percutaneoustranshepaticinsertionofbiliarystent,PTIBS）,14例消化内镜中心患者行逆行胰胆管造影放置胆道金属支架（endoscopicretrogradecholangiopancreatography—guidedbiliarystent,ERCP．BS）,其中1例失败后改行经皮肝穿刺胆管外引流术不纳入随访研究。胆管支架置入术后1周完成十二指肠支架置入。观察手术成功率、临床症状缓解率、并发症、支架通畅时间及患者生存期等指标。结果联合支架置入成功率95．8％（23／24）,梗阻症状消失率87．0％（20／23）;十二指肠支架置入术后1周胃出口梗阻评分（2分6例,3分17例）较术前（O分6例,1分17例）明显改善（Z=-4．796,P=0．000）。胆道支架通畅时间（73．9±5．3）d,生存时间（93．0±4．9）d。十二指肠支架再发梗阻率17．4％（4／23）。均未出现严重并发症。结论胆道、十二指肠支架联合置入治疗恶性胆道、十二指肠梗阻安全有效。     

L_1椎体压缩骨折与邻近椎小关节结构变化的相关性CT研究

目的:通过测量L1压缩椎体邻近椎小关节的角度、间隙,观察L1椎体压缩后邻近椎小关节的变化。探讨L1压缩椎体前后缘的比值与邻近椎小关节角度、间隙的关系。方法:应用64层螺旋CT对120例L1压缩椎体(压缩组)与有腰部疼痛但无L1椎体压缩的120例(对照组),进行邻近椎小关节结构及形态特点的对比分析。测量邻近椎小关节冠状位、矢状位、横断位的角度、间隙,将2组数据进行组间t检验分析。结果:以L1为中心,分为上下关节,以中轴线为中心,分为右、左关节。2组椎小关节的数据行统计学分析:冠状位角度差异无统计学意义(P值>0.05),矢状位、横断位角度差异均有统计学意义(P值<0.05);冠、矢、横断位椎小关节间隙的差异均无统计学意义(P值>0.05)。结论:L1椎体压缩骨折对邻近椎小关节间隙基本无影响;角度:冠状位基本无影响,横断位轻度变小,矢状位明显变小,但与椎体压缩程度不成比例。当矢状位上下椎弓根角(以L1为中心):上方<71.4°或下方<80.2°时,对胸腰段的生理曲度及脊柱的稳定性影响明显。     

胃低张碳酸饮料充气法MSCT扫描在胃癌诊断中的应用

目的:探讨胃低张碳酸饮料充气法MSCT扫描在胃癌诊断及术前分期中的应用价值。方法:选择经胃镜检查确诊、并于1周后接受手术治疗的胃癌患者80例,将其随机分为2组:常规检查组和低张可乐组,每组各40例,其中常规检查组患者在CT检查前饮用清水,而低张可乐组患者饮用碳酸饮料。结果:常规检查组患者胃壁浸润深度的T1～T4分期结果总准确率为80%,而低张可乐组为85%;常规检查组患者淋巴结N0～N2转移诊断总准确率75%,而低张可乐组为95%;常规检查组远处转移的M0和M1诊断的总准确率为82.5%,而低张可乐组为97.5%。两者与手术病理诊断的一致性应用Kappa检验比较,低张可乐组的一致性显著高于常规检查组。结论:胃低张碳酸饮料充气法MSCT扫描较常规充气法明显提高了胃癌的诊断率,而且判断胃癌术前TNM分期与术后病理有较好的相关性,可为临床提供丰富信息,指导手术方案的选择。     

肝脏淋巴瘤二例

例1，女，73岁，患者于4d前，无意中发现上腹部一拳头大小的包块，无明显压痛，高血压病史30年，糖尿病病史3年，1993年曾行子宫内膜癌根治术，1994年行双腹股沟囊肿穿刺术。实验室检查未见异常。     

丹参素对大鼠肝星状细胞氨基末端蛋白激酶信号转导的影响

目的 探讨丹参素抗肝纤维化作用的机制. 方法分离大鼠原代肝星状细胞(HSC),用0.0312、0.0625、0.1250、0.2500、0.5000、1.0000 mmol/I.不同浓度丹参素作用于HSC,四甲基偶氮唑黼法检测丹参素对HSC生长增殖的抑制作用;应用免疫细胞化学法观察Ⅰ型胶原合成,酶联免疫吸附法观察Ⅰ型胶原分泌.Western blot法观察丹参索对白细胞介素-1 β(IL-1 β)刺激的HSC内氨基末端蛋白激酶(JNK)蛋白及其磷酸化表达的影响.采用随机设计的方差分析,SNK-q进行统计学处理. 结果与0 mmol/L组比较,丹参素其他浓度组明显抑制了HSC增殖,并旱剂量依赖性.丹参素(0.0625～0.2500 mmol/L)对IL-1 β引起的HSC增殖具有明显的抑制作用,并呈剂量依赖性.0.25 mmol/L丹参素对正常培养的和经IL-1 β刺激的HSC作用24 h能下调Ⅰ型胶原的合成和分泌.IL-1 β能刺激ttSC中p-JNK的明显表达,丹参素能下凋亡IL-1 β诱导的ItSC中P-JNK的表达,但其对JNK表达水平没有明显影响. 结论丹参索可抑制正常传代培养的和经IL-1 β刺激的人鼠HSC增殖、Ⅰ型胶原合成与分泌,其机制可能与抑制JNK信号转导通路有关.     

中西医结合治疗脑梗死后迟发型癫痫的临床研究

目的:中药可减少丙戊酸钠的用量,减轻其毒副作用,延缓脑梗死后癫痫的病情进展,并可提高脑梗死的治疗效果。方法:采用随机双盲安慰剂对照试验设计方法,选择60例癫痫患者,中医辨证证型均为风痰闭窍,癖阻脑络者,分为西药对照组、西药+中药组,分别服用,疗程104周。观察:①中医证侯疗效;②对患者发作次数的影响;③对患者脑电图的影响;④对患者生活质量的影响;⑤对患者认知功能的影响。⑥安全性观察。结果:①患者发作次数减少,治疗组和对照组总有效率分别为85.9%和63.1%,两组比较有统计学意义(P<0.05)。②中医证候疗效,治疗组和对照组总有效率分别为82.8%(24/29)和71.4%(20/28),两组比较有统计学意义(P<0.05)。③脑电图改变明显好转两组脑电图比较,治疗组总有效率82.7%(24/29),对照组总有效率57.1%(16/28),差异有统计学意义(U=1.87,P<0.05)。④生活质量:治疗组改善生活质量优于对照组(P<0.05)。⑤认知功能评价:中药治疗组改善认知障碍优于西药对照组(P<0.05)。⑥安全性观察:治疗组和对照组无明显不良反应。结论:中药可以提高脑梗死后癫痫的治疗效果,具有明显疗效和良好的安全性。     

丹参素对大鼠肝星状细胞氨基末端蛋白激酶信号转导的影响

Objective To investigate the inhibitory effect of danshensu on the activation of JNK signaling in rat hepatic stellate cells (HSCs) induced by IL-1 β. Methods The proliferation of primary rat HSCs treated with different concentration of Danshensu was checked by MTT colorimetric assay. The expres-sion and phosphorylation of JNK and P-JNK was detected by western blotting. Synthesis and secretion of collagen Ⅰ were detected by the quantitative immunocytochemical assay and ELISA. Results Danshensu inhibited the proliferation of HSCs in a dose-dependent manner. At the concentration of 0.0625 to 0.25 mmol/L, Danshensu significantly repressed the proliferation of HSC induced by IL-115 (P < 0.05). Synthesis and secretion of Type β collagen was significantly decreased 24 hours after 0.25 mmol/L Danshensu treatment (P < 0.01). The phosphorylation of JNK induced by IL-1 β was significantly inhibited by Danshensu treatment (P < 0.05), however, the expression of JNK was not regulated by Danshensu. Conelutions Danshensu represses the activation and proliferation of HSCs, and inhibits the synthesis and secretion of Type β collagen, possibly via the repression of the JNK signal transduction.     

丹参素对大鼠肝星状细胞氨基末端蛋白激酶信号转导的影响

Objective To investigate the inhibitory effect of danshensu on the activation of JNK signaling in rat hepatic stellate cells (HSCs) induced by IL-1 β. Methods The proliferation of primary rat HSCs treated with different concentration of Danshensu was checked by MTT colorimetric assay. The expres-sion and phosphorylation of JNK and P-JNK was detected by western blotting. Synthesis and secretion of collagen Ⅰ were detected by the quantitative immunocytochemical assay and ELISA. Results Danshensu inhibited the proliferation of HSCs in a dose-dependent manner. At the concentration of 0.0625 to 0.25 mmol/L, Danshensu significantly repressed the proliferation of HSC induced by IL-115 (P < 0.05). Synthesis and secretion of Type β collagen was significantly decreased 24 hours after 0.25 mmol/L Danshensu treatment (P < 0.01). The phosphorylation of JNK induced by IL-1 β was significantly inhibited by Danshensu treatment (P < 0.05), however, the expression of JNK was not regulated by Danshensu. Conelutions Danshensu represses the activation and proliferation of HSCs, and inhibits the synthesis and secretion of Type β collagen, possibly via the repression of the JNK signal transduction.     

CK19、Vimentin和TLR4在肝胆管结石患者胆管上皮细胞中的表达及与上皮间质转换的相关性

目的 探究CK19、Vimentin、TLR4在肝胆管结石患者胆管上皮细胞中的表达及与上皮间质转换的相关性。方法 回顾性选取2015年1月至2018年12月盐城市第一人民医院收治的86例肝胆管结石患者作为观察组,同期40例因肝血管瘤行部分肝脏切除术患者作为正常对照组。采用免疫法检测CK19、Vimentin、TLR4在两组胆管细胞表达,并分析其与上皮间质转换关系。结果 86例肝胆管结石患者中,CK19阳性表达率75. 58%,Vimentin阳性表达率22. 09%,TLR4阳性表达率34. 88%,N-cadherin阳性表达率15. 12%,E-cadherin阳性表达率72. 09%。观察组CK19阳性细胞率明显低于对照组,而Vimentin、TLR4阳性细胞率高于对照组,差异具有统计学意义(P 0. 05)。CK19表达与Vimentin、N-cadherin表达呈负相关(r=-0. 332,r=-0. 426,P 0. 05)。TLR4表达与CK19、E-cadherin表达呈负相关(r=-0. 564,r=-0. 497,P 0. 05),TLR4表达与Vimentin、N-cadherin表达呈正相关(r=0. 738,r=0. 526,P 0. 05)。结论 肝胆管结石患者胆管上皮细胞中CK19低表达,Vimentin和TLR4高表达。胆管上皮细胞在肝胆管结石的病理改变过程中发生了EMT。TLR4可能参与了肝胆管结石胆管上皮细胞的上皮间质转换过程。