Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

功能性胰岛素瘤的外科临床诊疗分析

目的探讨功能性胰岛素瘤的外科诊疗方法。方法回顾性分析1990年1月至2006年12月有明显临床症状的,经手术治疗、病理证实的36例功能性胰岛素瘤患者的临床资料。结果在功能性胰岛素瘤患者中良性胰岛素瘤病例最多见,共27例,占全部病例的75%;恶性胰岛素瘤6例,胰岛细胞增殖症2例。在B超、CT、MRI、内镜超声等影像学检查中,术中B超阳性发现和定位准确率均为92.3%。所有病例均行手术治疗,7例行胰十二指肠切除术,17例行胰体尾切除术,12例行单纯瘤体摘除术,术后症状改善明显,复发率低。结论术中B超是诊断和定位胰岛素瘤最有效的诊断方法,手术规范切除是治疗功能性胰岛素瘤的有效方法,其预后良好。     

阿卡波糖治疗胃手术后迟发性倾倒综合征的疗效分析

迟发性倾倒综合征（late dumping syndrome）过去称为低血糖综合征（hypoglycenic syndrome），是胃手术后远期并发症中较严重的并发症之一。迟发性倾倒综合征可发生于任何类型的胃部手术之后，但以远端胃大部切除术后BillrothⅡ残胃空肠吻合术后较为多见，而食管手术引起迷走神经损伤也可产生倾倒症状。对于症状较轻的迟发性倾倒综合征患者，通过改善饮食习惯多可预防，但对于临床上反复发作症状明显者，一般的保守治疗效果均不满意。因此，我们尝试利用阿卡波糖治疗胃手术后迟发性倾倒综合征。     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

内皮祖细胞在创伤后多器官功能障碍中的变化及意义

Objective To investigate characteristics of changes in bone marrow endothelial progenitor cells (EPCs) and implications on multiple organ dysfunction syndrome (MODS) as a result of trauma.Methods Eighteen mini-pigs were randomized into two groups: MODS group (n=9) and control group (n=9).The animal models of MODS were reproduced by "two-hit" injury with hemorrhagic shock and lipopolysaccharide (LPS) injection.Bone marrow and peripheral blood of them were collected at five time points: normal condition (T1), before injection of LPS (T2), and 0 (T3), 24 (T4) and 48 hours (T5) after injection of LPS.Erythrocytic lysate was added to the samples, and the number of leucocytes in every sample was counted.The rate of EPCs in each sample was determined by flow cytometry.Number of EPCs in bone marrow and peripheral blood were calculated, and the results were analyzed statistically.Results The number of EPCs (×106/L) in bone marrow of control group at T1-5 was 7.64±0.68,7.32±0.55, 7.58±1.13, 7.77±0.70, and 7.88±0.84, respectively, and in peripheral blood control group was 3.54±0.26,4.06±0.64, 3.74±0.55, 3.61±0.37, and 3.98±0.63, respectively.The number of EPCs (×106/L) in bone marrow in the experimental group was 7.45 ± 1.55, 6.58 ± 0.80, 11.27 ± 1.20, 10.88±1.15, and 8.36 ± 2.88, respectively.The number of EPCa (× 106/L) in peripheral blood in the experimental group was 3.21±0.48, 8.71±2.04, 5.98±0.77, 1.27±0.91, and 2.14±0.96, respectively.The number of EPCs in bone marrow of experimental group was larger than that of control group at T3, T4, T5.The number of EPCs in the experimental group in peripheral blood was larger than that of control group at T2, T3, T4, T5.The number of EPCs in bone marrow was larger than that in peripheral blood at every time point (all P＜0.05).Conclusion The number of EPCs in peripheral blood elevates sharply in the earlier period, then plummetes quickly during MODS after a trauma.While the number of EPCs in bone marrow descends mildly at first, then rises obviously.Along with the aggravation of MODS, a declination of EPCs in bone marrow emerges.The change in bone marrow EPCs plays an important role in recovery of MODS.     

Endothelial progenitor cells modulated by IL-1β in multiple organ dysfunction syndrome in porcine

Objective To investigate the modulation of EPCs by interleukin 1β (IL-1β) and p38 mitogen activated protein kinase (p38MAPK) and the pathogenesis resulting from their dysdifferenfiation after trauma.Method Thirty pigs were divided into a control group (n = 15) and a multiple organ dysfimction syndrome (MODS) group (n = 15), the latter of which were subjected to a "two-hit" injury including hemon'hagic shock and endotoxemia. Phosphorylation of p38MAPK in peripheral blood mononuclear cells was monitored by western blotting. The concentration of IL-1β in peripheral blood plasma was determined by ELISA and the numbers of EPCs with FCM in peripheral blood plasma were monitored. The morbidity rates in the two groups were compared by chi square test. The levels of phosphorylation of p38MAPK in peripheral blood mononuclear cells, the concentmtions of IL-1β in peripheral blood plasma and the numbers of EPCs in the peripheral blood were compared between groups using with Student's t lest. Results The level of p38MAPK phosphorylation was more augmented and the concen-tration of IL-1β higher in peripheral blood mononuelear cells and plasma from MODS pigs compared with those from control pigs; nevertheless the mauler of EPC conspicuously decreased in the peripheral blood (P <0.01). The morbidity rate in the MODS group was much higher than that in the control group (P < 0.01). There were fewer EPCs in the peripheral blood of animals in group M than in the peripheral blood of animals in group C (P <0.01). Conclusions p38MAPK phosphorylation is important for the pathogenesis of MODS. p38MAPK phospho-rylation might cause the concentration of IL-1β in the peripheral blood plasma to rise and could cause a drop in the numbers of EPCs, thereby aggravating the inflanmmatory reaction in MODS.     

Clinical management of abdominal trauma

Objective： To improve the prognosis of patients with abdominal trauma.
Methods： Between January 1993 and December 2005, 415 patients were enrolled in this research. The patients consisted of 347 males and 68 females with mean age of 36 years （ranging from 3-82 years）. All abdominal traumas consisted of closed traumas （360 cases, 86.7%） and open traumas （55 cases, 13.3%）.Results： A total of 407 cases （98.1%） were fully recov- ered from trauma and the other 8 cases （1.9%） died of mul- tiple injuries. The mean injury severity score （ISS） of all patients was 22 while the mean ISS of the patients who died in hospital was 42. Postoperative complications were seen in 9 patients such as infection of incisional wounds （6 cases）, pancreatic fistula （2 cases） and intestinal fistula （1 case）. All these postoperative complications were cured by the conservative treatment. Conclusion： Careful case history inquisition and physical examination are the basic methods to diagnose abdominal trauma. Focused abdominal ultrasonography is always the initial imaging examination because it is non-invasive and can be performed repeatedly with high accuracy. The doctors should consider the severity of local injuries and the general status of patients during the assessment of abdominal trauma. The principle of treatment is to save lives at first, then to cure the injuries. Unnecessary laparotomy should be avoided to reduce additional surgical trauma.     

猪骨髓来源内皮祖细胞体外培养条件的优化

目的 优化选择猪骨髓来源内皮祖细胞(endothelial progenitor cell, EPC)体外培养条件,为后续研究奠定基础。方法 从猪髂骨抽取骨髓,利用密度梯度离心法分离得到单个核细胞(MNC),体外培养分化为EPC。在其他培养条件相同的前提下,分别比较不同的细胞接种密度(2×103/cm2、5×103/cm2、1×104/cm2、2×104/cm2),不同基础培养液(EGM、M199、DMEM),不同FBS浓度(5%、10%、20%、30%),以及血管内皮细胞生长因子(VEGF)与不同细胞因子\[碱性成纤维细胞生长因子(bFGF)、基质细胞衍生因子（SDF）、胰岛素样生长因子（IGF）和表皮生长因子（EGF）\]组合(VEGF+bFGF、VEGF+SDF、VEGF+bFGF+SDF、VEGF+bFGF+IGF+EGF、VEGF+bFGF+SDF+IGF)对EPC细胞增殖及迁徙功能的影响;采用细胞形态观察、双荧光染色法及免疫细胞化学染色方法对培养的EPC进行鉴定。结果 猪骨髓EPC以1×104/cm2密度接种在盛有M199,并添加10% FBS和VEGF+bFGF+SDF+IGF细胞因子的培养液时,细胞的增殖能力和迁徙率最高。每组细胞经结合Dil标记的乙酰化低密度脂蛋白(Dil-ac-LDL)和FITC标记的荆豆凝集素(FITC-UEA-1)双色荧光染色鉴定双阳性率>76%,免疫细胞化学检测CD133、CD34、KDR均为阳性。结论 通过优化猪骨髓来源EPC的体外培养条件,可使细胞数量增多及功能增强,为后续研究奠定了基础。     

主要组织相容性复合体Ⅱ类基因在多器官功能障碍综合征中的表达及意义

目的探讨主要组织相容性复合体(MHC)Ⅱ类基因在多器官功能障碍综合征(MODS)中的表达及意义。方法建立二次打击猪MODS模型。18只雄性家猪随机分为实验组(M组)和正常对照组(C组)每组9只。M组给予失血性休克、再灌注损伤、内毒素血症复合因素；C组仅进行麻醉和动静脉插管。观察7 d后处死动物,取脾组织用Trizol法提取总RNA。设计SLA- DQA(猪MHCⅡ类基因)引物序列,逆转录构建cDNA,用实时荧光定量PCR(Real Time FQ-PCR)检测SLA-DQA mRNA的表达量。UVP计算机图像分析系统绘出标准曲线。结果M组动物死亡率为7/9,有8例发生MODS,发生率为8/9。C组SLA-DQA mRNA拷贝数为(1．376±1．006)×10~3．M组拷贝数为(1．376±1．006)×10~3,两组差异有统计学意义(P＜0．01)。结论MODS模型复制满意。MHCⅡ类基因在MODS中表达下降,可能与逆转录因子(CIITA)的调控和TNF-α、IL-10等多种细胞因子的释放有关。     

消化道恶性肿瘤的周围神经浸润研究进展

消化道恶性肿瘤病人的生存时间决定于肿瘤的生物学特点及肿瘤的分期目前,临床普遍采用的肿瘤分期是TNM分期。而研究表明,除TNM分期外,还有一些独立的预后判断指标值得关注如周围神经浸润(perineural invasionPNI)等。肿瘤的周围神经浸润是指肿瘤细胞侵犯局部邻近的神经的神经束膜或神经肌束。在消化道恶性肿瘤中PNI多见于胰腺癌和胆道系统的恶性肿瘤,偶尔出现在直肠癌中,被认为是肿瘤的局部扩散方式之一,对判断预后也有重要作用[1]。PNI最早在前列腺癌的研究中被发现,是最常见也是最重要的前列腺癌局部生长的方式之一。因此,PNI不仅…