转基因小鼠中bcl-xl基因的过表达在小鼠大脑中动脉栓塞中的保护作用

目的观察bcl-xl基因的过表达对小鼠大脑中动脉栓塞的保护作用,探讨其作用机制。方法通过建立bclxl转基因小鼠,经传代及检测后证实,该转基因小鼠中存在着bclxl基因的过表达,然后将该模型小鼠与同种系野生型小鼠同时行线栓永久性阻塞大脑中动脉,在缺血24h时测其神经功能评分,观察转基因小鼠与野生型小鼠的差别。在缺血后不同时间点测其梗死体积,观察梗死体积的动态变化。用TUNEL法观察小鼠的脑组织缺血后不同时间点再灌注时凋亡细胞的数量和分布情况。用免疫组化方法观察梗死前后两种小鼠脑组织中bcl-xl的表达量的差异。结果缺血24h后转基因小鼠的神经功能评分低于野生型小鼠(P<0.05)。缺血后3、24、72h,转基因小鼠的梗死体积均明显低于野生型小鼠,差异有显著性意义。TUNEL显示在缺血再灌注后的不同时间点,转基因小鼠皮质缺血区内的凋亡细胞数明显少于野生型小鼠,差异有显著性意义。免疫组化结果显示,梗死前后转基因小鼠的皮质细胞bclxl的表达量均明显高于野生型小鼠(P<0.05),且梗死后两种小鼠体内的bclxl的表达量均较梗死前增加(P<0.05)。结论在规范化的标准条件下,转基因小鼠中bclxl基因的过表达能够降低脑梗死的体积并改善小鼠的神经功能;过表达bclxl基因的这种效应可能是通过抑制细胞凋亡而实现的。     

Upper Gastrointestinal Bleeding in Patients with CKD

Background and objectives

Patients with CKD receiving maintenance dialysis are at risk for upper gastrointestinal bleeding. However, the risk of upper gastrointestinal bleeding in patients with early CKD who are not receiving dialysis is unknown. The hypothesis was that their risk of upper gastrointestinal bleeding is negatively linked to renal function. To test this hypothesis, the association between eGFR and risk of upper gastrointestinal bleeding in patients with stages 3–5 CKD who were not receiving dialysis was analyzed.

Design, setting, participants, & measurements

Patients with stages 3–5 CKD in the CKD program from 2003 to 2009 were enrolled and prospectively followed until December of 2012 to monitor the development of upper gastrointestinal bleeding. The risk of upper gastrointestinal bleeding was analyzed using competing-risks regression with time-varying covariates.

Results

In total, 2968 patients with stages 3–5 CKD who were not receiving dialysis were followed for a median of 1.9 years. The incidence of upper gastrointestinal bleeding per 100 patient-years was 3.7 (95% confidence interval, 3.5 to 3.9) in patients with stage 3 CKD, 5.0 (95% confidence interval, 4.8 to 5.3) in patients with stage 4 CKD, and 13.9 (95% confidence interval, 13.1 to 14.8) in patients with stage 5 CKD. Higher eGFR was associated with a lower risk of upper gastrointestinal bleeding (P=0.03), with a subdistribution hazard ratio of 0.93 (95% confidence interval, 0.87 to 0.99) for every 5 ml/min per 1.73 m² higher eGFR. A history of upper gastrointestinal bleeding (P<0.001) and lower serum albumin (P=0.004) were independently associated with higher upper gastrointestinal bleeding risk.

Conclusions

In patients with CKD who are not receiving dialysis, lower renal function is associated with higher risk for upper gastrointestinal bleeding. The risk is higher in patients with previous upper gastrointestinal bleeding history and low serum albumin.     

Soluble vascular endothelial growth factor receptor-1 protects mice in sepsis

OBJECTIVE: To determine the putative role in the modulation of inflammation of a soluble form of Flt-1 (sFlt), a potent vascular endothelial growth factor antagonist, in experimental endotoxemia and sepsis. DESIGN: Randomized prospective experimental study. SETTING: University medical laboratory. SUBJECTS: Male C56BL/6 strain mice. INTERVENTIONS: We investigated the expression patterns and the effects of vascular endothelial growth factor and soluble Flt-1 in experimental endotoxic shock and sepsis. The possible anti-inflammatory mechanism of soluble Flt-1 was also evaluated. MEASUREMENTS AND MAIN RESULTS: Both vascular endothelial growth factor and sFlt-1 were rapidly released from macrophages activated in vitro by lipopolysaccharide and in the plasma of endotoxemic mice. Administration of vascular endothelial growth factor enhanced proinflammatory cytokine production and mediated a dramatic increase in mortality in endotoxemic mice. Treatment with sFlt-1 attenuated inflammatory responses, inhibited recruitment of inflammatory cells into the peritoneal cavity, and improved survival in a lethal endotoxemia and cecal ligation and puncture-induced sepsis model, even when administered as late as 24 hrs after the onset of sepsis. CONCLUSIONS: These findings support a critical protective role of sFlt-1 in endotoxic shock and sepsis. sFlt-1 may therefore have utility as an adjunctive agent for the treatment of sepsis syndrome.     

急性职业性手外伤的病例交叉研究

目的 用病例交叉研究方法探讨急性职业性手外伤的瞬时危险因素。方法 对166例急性职业性手外伤患者进行问卷调查，分别用配对间隔和日常频率2种方法计算各危险因素的危险度。结果 配对间隔研究无法计算OR值，但设备（工具）异常、非日常工作任务、操作方式改变和注意力不集中主要出现在伤害阶段。日常频率分析发现，设备（工具）异常和匆忙的RR值和95％可信区间下限均大于1；而加班和戴手套的RR值虽然大于1，但95％可信区间下限均小于1；非日常工作任务、操作方式改变、身体不适或生病、注意力不集中无法计算RR值。结论 设备（工具）异常和匆忙作业是导致手外伤发生的危险因素。手外伤的预防措施应着重于控制各种瞬时危险因素。     

多光子激光扫描成像技术对活细胞内淀粉样前体蛋白裂解和β-淀粉样蛋白生成的观察(英文)

目的在活细胞内探究淀粉样前体蛋白(amyloid precursor protein,APP)的裂解和p一淀粉样蛋白(amyloid beta,Aβ)的生成机制。方法利用PCR扩增CFP(编码蓝色荧光蛋白),YFP(编码黄色荧光蛋白)和C99(编码APP最后99个氨基酸)三片段。含有54个碱基(编码APP中间18个氨基酸)的片段54bp由生物公司合成。CFP,YFP,54bp和C99四个片段连入载体质粒pcDNA3.0得到重组质粒pcDNA3.0-CFP-54bp-YFP和pcDNA3.0-CFP-54bp-YFP- C99。将这两个重组质粒分别瞬时转染SH-SY5Y细胞。利用多光子激光扫描显微镜观察融合基因的表达,荧光共振能量转移(fluorescence resonance energy transfer,FRET)检测APP的β裂解。免疫细胞化学和多光了激光扫描显微镜观察Aβ的生成。MTT检测转染细胞活性。结果(1)限制性内切酶双酶切消化和测序分析鉴定重组质粒序列完全正确。(2)转染细胞内可以观察剑蓝色平和黄色荧光。(3)在pcDNA3.0-CFP-54bp-YFP转染细胞中存在FRET现象;在pcDNA3.0-CFP-54bp-YFP-C99转染细胞中观察不到FRET现象。(4)免疫细胞化学和多光子激光扫描显微镜观察到在pcDNA3.0-CFP-54bp-YFP-C99转染的细胞中有Aβ的牛成。(5)Aβ的沉积广泛分布于细胞内。(6)随着Aβ在细胞内的产生和聚集,细胞的活性逐步下降。结论C99对于APP的β裂解非常重要。早期Aβ首先在细胞内生成并在细胞内形成广泛沉秋。细咆内聚集的Aβ会影响细胞活性,带来不利结果。     

N-(α,β-双取代-4-氯桂皮酰基)另丁胺的合成及构效关系研究

本文合成了13个N-(α,β-双取代-4-氯桂皮酰基)另丁胺类化合物(4 Ea,4 Eb～e,4Zb～e,6 Ea～b,6 Za～b),通过NMR指定了其几何异构体的构型,其中4个化合物的构型已由X光衍射结果证实。报道了用量子化学(EHMO)方法计算18个化合物与其分子稳定构象相适应的扭角Q_1和Q_2的值,以及它们的抗惊活性。讨论了Q_1和Q_2与抗惊活性间的关系。提出了该类化合物与受体结合,产生抗惊厥作用的模型。     

Outcomes of Stage I and II Breast Cancer with Nodal Micrometastases Treated with Mastectomy without Axillary Therapy

Breast Cancer Research and Treatment - Studies that report equivalent oncologic outcomes of sentinel lymph node biopsy (SLNB) alone versus axillary lymph node dissection (ALND) for T1-2N1mi breast...