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.     

不同染色放大内镜方法在早期胃癌及癌前病变筛查中临床价值的前瞻性评估

目的前瞻性评价不同染色放大内镜方法在早期胃癌及癌前病变筛查中的临床价值。方法2010年3月至2011年10月期间．在复旦大学附属中山医院接受胃镜检查且年龄超过40岁的病例中,有699例发现胃黏膜可疑病灶。根据随机号将其分人肾上腺素染色放大组（240例）、靛胭脂染色放大组（246例）和靛胭脂冰醋酸混合液染色放大组（213例）。详细记录不同染色方法下病灶胃小区腺体开口形态和毛细血管网络情况等,作出镜下诊断。以病理诊断为金标准,采用Kappa一致性检验评价不同染色放大方法镜下诊断与病理诊断的一致性。采用MeNemar配对卡方检验,比较3种染色方法镜下诊断与普通白光、单独放大、窄带成像（NBI）放大镜下诊断的一致性。结果病理活检结果显示,699例病例中炎性病变415例,肠化生190例,低级别上皮内瘤变17例,高级别上皮内瘤变或早期胃癌77例。肾上腺素染色放大、靛胭脂染色放大和靛胭脂冰醋酸混合液染色放大镜下诊断与病理诊断一致的病例分别占77．1％（185／240）、80．5％（198／246）和81．2％（173／213）,Kappa值分别为0．579、0．502和0．667（均P〈0．01）。对于高级别上皮内瘤变或早期胃癌的筛查,3种染色方法镜下诊断的敏感度分别为84．0％、83.3％和92．9％,特异度分别为98．6％、97.3％和98．4％。3种染色方法均可显著提高普通白光对癌前病变镜下诊断的准确率（均P〈0．01）：靛胭脂染色和靛胭脂冰醋酸混合液染色还可显著提高单独放大对病变诊断的准确率（均P〈0．05）;但与NBI放大相比,3种染色方法镜下诊断的准确率均无明显优势（均P〉0．05）。结论NBI放大和3种染色放大方法均可显著提高早期胃癌及癌前病变镜下诊断的准确性。     

显微外科与腹腔镜两种手术治疗精索静脉曲张的疗效及并发症的对比观察

目的:比较显微外科与腹腔镜途径精索静脉结扎术治疗精索静脉曲张的疗效及并发症。方法:将72例精索静脉曲张患者随机分为显微外科精索静脉结扎术组(36例)和腹腔镜精索静脉结扎术组(36例),比较术前、术后3个月的精液质量、术后并发症,以及术后配偶妊娠率。结果:显微外科组手术时间明显长于腹腔镜组(P<0.05);术后住院天数显微外科组为(2.2±0.7)d,腹腔镜组为(2.8±0.8)d,两组无明显差别;两组术后精子浓度、存活率和(a+b)级精子百分率均较术前明显提高(P均<0.05),但两组间无统计学差异。配偶妊娠率显微外科组为65.2%,腹腔镜组57.1%。术后阴囊水肿发生率显微外科组为0,腹腔镜组为16%;复发率两组无明显差异(P>0.05)。结论:与腹腔镜精索静脉结扎术比,显微外科精索静脉结扎术创伤更小、恢复更快、麻醉经济、术后并发症少、复发率低,是更值得推广的安全有效的术式。     

食管胃交界部固有肌层来源黏膜下肿瘤内镜下切除方法的选择与评价

目的评价以内镜黏膜下剥离术（ESD）为基础的各种内镜切除技术在食管胃交界部（EGJ）固有肌层来源黏膜下肿瘤（SMT）治疗中的临床价值和适应证的选择。方法回顾性分析复旦大学附属中山医院内镜中心所有接受内镜下切除治疗的患者资料库．筛选出2007年3月至2011年6月间经内镜下超声或CT证实固有肌层来源的EGJ处SMT患者143例。详细记录患者的临床病理资料、内镜切除方法、完整切除率、并发症发生率及术后随访资料。结果143例患者中男74例,女69例,平均年龄49．1岁。135例（94-4％）病变成功完成内镜下整块切除,其中接受内镜黏膜下挖除术126例,无腹腔镜辅助的内镜全层切除术6例,内镜经黏膜下隧道肿瘤切除术3例：另外8例肿瘤于内镜下部分切除后,基底部尼龙绳套扎。肿瘤平均直径为17．6mm．平均手术时间45．1min．平均出血量50．0ml。术中穿孔6例,贲门黏膜撕裂1例。均通过内镜下处理及保守治疗好转。术后病理示,平滑肌瘤121例,胃肠间质瘤20例。颗粒细胞瘤1例．肌间脂肪瘤1例。术后经3。48个月的随访,未见局部复发和远处转移病例。结论在EGJ固有肌层来源SMT治疗中．各种内镜切除方法均安全有效．临床医师需根据肿瘤的临床特征具体选择．     

酶解法与LC-MS-MS相结合研究灯盏乙素在健康人体内的药代动力学

目的建立β-葡萄糖醛酸苷酶解法与LC-MS-MS法相结合测定人体血浆中灯盏乙素的苷元,研究健康男性单剂量口服灯盏花素分散片的药代动力学。方法血浆样品经β-葡萄糖醛酸苷酶水解,甲醇蛋白沉淀,色谱柱为Agilent ZORBAX SB C18(2.1 mm×150 mm,5μm),运用乙腈-甲醇-水洗脱,多反应监测(MRM)灯盏乙素苷元([M-H]-,m/z285.0/136.8)和内标槲皮素([M-H]-,m/z 301.1/120.8)。12名健康男性单剂量口服灯盏花素分散片120 mg后,采用该方法测定血浆中灯盏乙素苷元,使用DAS 1.0软件处理数据,计算药代动力学参数。结果灯盏乙素苷元在4.01~513.38μg·L-1范围内线性良好,日内日间精密度小于7.22%,提取回收率大于84.23%。12名健康男性单剂量口服灯盏花素分散片120 mg后,以灯盏乙素苷元为检测对象的主要药动学参数为:Cmax(μg·L-1):159.97±58.14;AUC(0-19)(μg·L-1·h):1151.37±279.80;AUC(0-∞)(μg·L-1·h):1194.13±264.51;Tmax(h):6.33±1.67;T1/2(h):2.83±0.60。结论建立的酶解与LC-MS-MS相结合分析方法准确灵敏,适用于灯盏乙素人体内的药代动力学研究。     

神经内镜经鼻视神经管减压术治疗外伤性视神经病变11例诊治体会

目的探讨经鼻神经内镜下视神经减压术治疗外伤性视神经病变的方法和效果。方法总结11例外伤性视神经病变的病例,伤后3 d内行神经内镜经鼻视神经管减压术。结果 2例视力由术前的手动分别恢复到术后的0.08和0.1,1例视力由术前的光感恢复到术后的0.05;1例视力由术前的眼前无光感恢复到术后的0.4,1例由术前无光感恢复到术后有光感。6例术后视力无恢复。结论神经内镜经鼻视神经管减压术是治疗外伤性视神经病变有效方法。     

青岛泊子盐场放线菌多样性及其功能酶的筛选--测试文章

采用平板涂布法利用3种培养基从青岛即墨市田横镇泊子盐场盐池底泥样中共分离纯化出15株放线菌,对分离菌株进行16S rRNA基因测序分析。发现这15株放线菌分属于链霉菌属(Streptomyces)、拟诺卡氏菌属(Nocardiopsis)和1个新属,其中Streptomyces属为优势菌属;菌株CXB832与Nocardiopsis arabia DSM 45083^T和Haloactinospora albus DSM 45015^T最接近,同源性分别为95.4%和94.9%,根据其表型和分子特征可以初步判定该菌株为放线菌新属。培养基及培养温度对盐池环境中放线菌的分离效果均有影响,利用淀粉酪素培养基在37℃分离的放线菌种类和数量较多。在15株放线菌中,分别有12株、3株、2株和1株放线菌产淀粉酶、酯酶、蛋白酶和纤维素酶。     

宫腔镜联合米非司酮治疗难治性宫内妊娠物残留的临床观察

目的:探讨宫腔镜联合米非司酮治疗难治性宫内妊娠物残留的临床疗效。方法:将难治性宫内妊娠物残留患者120例随机分成两组,观察组60例,对照组60例。观察组行宫腔镜联合米非司酮治疗,对照组行传统清宫术治疗,比较两组疗效。结果:术中子宫穿孔、术后阴道流血时间、月经复潮时间、需再次清宫、月经减少、宫腔粘连、血HCG恢复正常时间等情况,两组比较差异均有统计学意义(P<0.05)。结论:宫腔镜联合米非司酮治疗难治性宫内妊娠物残留具有微创、安全、有效等优点,优于传统的清宫术治疗。     

浅谈应用红外热成像技术早期诊断糖尿病足的策略

糖尿病足早期症状不明显,待明确诊断时病程多已步入中后期阶段,严重威胁民众健康。红外热成像技术作为一种医用功能性检测技术,能在人体组织发生结构性病变之前,敏感地发现其功能性改变导致的体表温度异常。基于中医学视角,借用计算机辅助诊断系统及属性篇序结构图,可以为糖尿病足红外热图的多角度、多维度解读提供全新思路,突破传统西医解剖学视角难以全面解读热图异常规律的瓶颈,也为红外热成像技术的应用拓宽视野。     

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??OBJECTIVE To study the changes of VEGF signaling pathway in colon cancer patients and the effect of schisandrin B on SW620 cells and to analyze its possible mechanism. METHODS The protein expression of VEGFA, VEGF-R2, PI3K, Akt and p-Akt in human cancerous colon samples and adjacent normal samples were detected by Western blotting. The proliferation of SW620 cells was detected by CCK-8 method. The mRNA expression of VEGFA, VEGF-R2, PI3K and Akt in SW620 cells were detected by real-time PCR. The protein expression of VEGFA, VEGF-R2, PI3K, Akt and p-Akt in SW620 cells were detected by Western blotting. RESULTS The protein expression of VEGF-R2, PI3K, Akt and p-Akt in human cancerous colon samples was significantly higher than that in the adjacent normal samples(P<0.05). Compared with the control group, schisandrin B could significantly inhibit the proliferation and migration of SW620 cells, the mRNA expression of VEGFA, VEGF-R2, PI3K and Akt(P<0.01) and the protein expression of VEGFA, VEGF-R2, PI3K, Akt and p-Akt(P<0.05) in SW620 cells also were significantly decreased by schisandrin B. CONCLUSION The VEGF/PI3K/Akt signaling pathway is activated in colon cancer patients. Schisandrin B could inhibit the activity and migration of SW620 cells and inhibit the VEGF/PI3K/Akt signaling pathway.