移植胰腺病理学诊断标准及其进展

胰腺移植和胰肾联合移植是治疗1型糖尿病和部分2型糖尿病及其并发症导致的肾衰竭的最佳治疗方法。胰腺移植的类型主要包括同期胰肾联合移植(SPK)、肾移植后胰腺移植(PAK)和单纯胰腺移植(PTA)。在所有的胰腺移植类型中,对移植胰腺的活组织检查(活检)仍然是明确诊断其排斥反应并与其他并发症进行鉴别的最佳方法。本文对移植胰腺活检的方法及其相关的研究进展、移植胰腺活检排斥反应诊断标准及其进展、移植胰腺主要的并发症及其病理学表现进行阐述,旨在为指导临床对上述并发症予以准确诊断,良好地保障移植胰腺和受者的长期存活提供参考。     

载脂蛋白A5与2型糖尿病并发冠心病相关性分析

目的:探讨APOA5在与血脂代谢及其糖尿病并发冠心病中的作用.对象:研究对象共90例,分为三组.2型糖尿病并发冠心病组30例,糖尿病组30例,对照组30例,为内分泌科门诊及健康体检者.方法:(1)标本的采取:所有研究对象均在清晨空腹自肘静脉采血5ml,留取血清.APOA5含量测定应用ELISA法.(2)结果以均数±标准差(x±s)表示,APOA5与各指标之间的关系用双变量相关分析.结果:(1)与对照组比较,2型糖尿病并发冠心痛和糖尿病组的APOA5水平明显降低,前者更明显(P＜0.05);CH、TG和低密度脂蛋白胆固醇(LDL-C)均明显升高,前者更明显(P ＜0.01或P＜0.05)结论:2型糖尿病并发冠心痛患者和糖尿病患者的APOA5水平明显低于健康对照者,血清CH、TG和LDL-C明显高于健康对照者,APOA5水平降低可能是冠心病和糖尿病的危险因素.     

心脏移植术后移植物血管病:阜外医院单中心长期随访结果总结

目的 总结心脏移植术后心脏移植物血管病变(CAV)的发生情况及其对患者长期存活的影响.方法 回顾性分析1006例心脏移植受者的临床资料,48例CAV患者中4例因缺失影像学证据未纳入分析.1002例受者中,根据CAV发生情况分为CAV组(44例)和无CAV组(958例).总结CAV的发生情况,比较两组患者的临床资料,分析...     

移植肺病理学诊断标准及其进展

近年来,随着肺移植外科技术和术后管理经验的积累,我国肺移植例数逐步增长。肺移植术后移植肺可出现多种并发症,主要包括由移植肺缺血-再灌注损伤(IRI)等所致的原发性移植肺无功能(PGD)、急性与慢性排斥反应以及移植术后应用免疫抑制剂所致机体免疫力下降出现的机会性感染或淋巴组织异常增生等。移植肺并发症的确诊主要依据移植肺活组织检查(活检)。本文对移植肺病理学研究的简史、移植肺活检的主要方法及其病理学处理技术、肺移植术后主要并发症及其活检病理学诊断标准进行阐述,旨在为指导临床对上述并发症采取针对性的治疗方案提供参考。     

Na-KATPase与高血压

Na KATPase(NKA)是肾脏Na 重吸收的能量来源 ,此酶的功能异常与多种疾病有关。本文重点阐述NKA的生理调控及其与高血压的关系     

间充质干细胞治疗缺血性胆道损伤的研究进展

目前,缺血性胆道损伤(ITBL)的临床治疗仍以外科手术、内镜治疗等方法为主,具有治疗策略单一、治疗方法难度大和医疗费用高的缺点,亟需寻找一种新的治疗策略。间充质干细胞(MSC)具有高度的自我更新能力、多向分化潜能、低免疫原性及免疫调节作用等特性,已然成为再生医学中组织和器官修复的潜在种子细胞。近年来众多研究发现,MSC移植到ITBL动物模型后,不但可归巢到损伤区域,而且可通过抗凋亡、促血管新生等作用促进损伤胆道组织的修复,这表明MSC移植有望成为治疗ITBL的新策略。本文对MSC的生物学特性、MSC移植治疗ITBL的机制及其临床应用做一综述。     

正常人颈段脊柱结构内CGRP和SP阳性神经纤维的分布

目的 为深入探讨颈肩痛的发病机理。方法 用免疫组织化学方法观察人颈段脊柱结构内CGRP和SP阳性神经末梢存在的情况。结果 人颈段脊柱结构的纤维层内均有CGRP和SP免疫反应阳性神经末梢存在，多数神经末梢独立行走，呈树枝状或念珠状，少量神经末梢交织网状。结论 CGRP和SP可能参与了人颈段脊柱结构的伤害性感觉信息的传递。当人颈段脊柱结构的神经末梢受刺激时，可能引起CGRP和SP的释放和传递，这可能是引起原发性颈肩痛的原因之一。     

前列腺癌患者癌组织中miR-647和HOXA9表达水平及其与预后的关系分析

目的 通过检测前列腺癌组织中微小RNA(microRNA,miR)-647、同源盒A9(HOXA9)表达水平，分析miR-647、HOXA9与前列腺癌患者预后的关系。方法 收集本院108例前列腺癌患者术中切除的癌组织及其对应的癌旁组织，使用qRT-PCR技术检测组织中miR-647和HOXA9 mRNA表达水平，免疫组化法检测HOXA9蛋白表达水平，并分析miR-647、HOXA9表达水平与患者临床病理特征及预后的关系；Pearson相关系数分析miR-647与HOXA9的相关性。结果 前列腺癌组织中miR-647表达水平(0.65±0.12)显著低于癌旁组织(1.01±0.09)(P<0.05),HOXA9 mRNA表达水平(1.86±0.37)明显高于癌旁组织(1.03±0.10)(P<0.05);癌组织中HOXA9蛋白阳性表达率显著高于癌旁组织(P<0.05);前列腺癌组织中miR-647与HOXA9呈负相关(r=-0.680,P=0.000);miR-647、HOXA9表达水平与患者T分期、淋巴结有无转移、Gleason评分以及前列腺特异抗原(PSA)水平有关...     

核糖核酸酶T2在人精液中的鉴定和定位

目的 检测核糖核酸酶T2(ribonuclease T2,RNaseT2)是否存在于人精子、精浆及其在精子中的定位.方法 克隆RNaseT2基因且在原核生物中表达蛋白,随后制备抗重组RNaseT2多克隆抗体,再运用免疫印迹检测其在精子和精浆中的存在,最终运用间接免疫荧光法检测其在精子中的定位及与精子中肌动蛋白(actin)的相关关系.结果 人精子和精浆中存在一定量的RNaseT2,主要定位于精子顶体区、颈部、尾部,并且与精子中肌动蛋白的定位有部分相似,尤其是在与精子动力相关的尾部.结论 RNaseT2在精子和精浆中的存在及其与肌动蛋白的定位关系提示其在精子成熟、获能、项体反应等过程中可能发挥着重要作用.     

内毒素诱导Kupffer细胞所致肝脏损害及S-腺苷蛋氨酸的保护机制

S-腺苷蛋氨酸(SAM)是一种存在于人体所有组织和体液中的生理活性分子,参与体内多种重要的生化反应,对调节肝细胞再生、分化以及肝细胞对各种损伤的敏感程度都是非常重要的.SAM对肝脏的这些作用是通过多种途径实现的,现已证实S-腺苷蛋氨酸及其代谢物methyhhioade-nosine(MTA)能阻断脂多糖(LPS)诱导的kupffer细胞中肿瘤坏死因子α(TNF-α)的表达从而对肝脏起到保护作用.S-腺苷蛋氨酸的这些作用可能有益于LPS诱导的肝损伤的临床治疗.     

Discrepancies in Serum Albumin Measurements Vary by Dialysis Modality

Background.?Serum albumin level is an important prognostic marker in patients with chronic renal failure. However there are discrepancies in the methods of estimation of serum albumin. The objective of this study is to evaluate the magnitude of the discrepancy in the serum albumin levels as measured by Bromcresol Green (BCG) and Bromcresol Purple (BCP) dye methods in patients on hemodialysis (HD) and peritoneal dialysis (PD) and to ascertain the clinical determinants of the discrepancy (ΔSA = BCG-BCP; g/dL) in each of the modalities. Method.?We measured serum and plasma albumin levels by BCG and BCP methods in 19 adult HD patients and 18 adult PD patients treated in the dialysis units of the University of Colorado Health Sciences Center. Similar measurements were performed in 10 normal adult subjects. In all groups, paired blood samples were taken to estimate the albumin in both serum and plasma. Nephelometry (NM) was subsequently performed on the serum of 13 of the HD patients, 14 of the PD patients, and each of the 10 normal subjects. Results.?We found that for both the dye methods serum and plasma albumin levels are almost identical in each of the three subject groups. In the normal subjects serum albumin estimated by BCP is in good agreement with NM values but BCG overestimates the albumin levels. In the PD group the discrepancy between the BCG and BCP (ΔSA) is statistically significant with the BCG averaging 0.59 ± 0.12 g/dL more than the BCP. The BCG values are closer to those obtained by the “gold standard”, NM. In the HD group the ΔSA is significantly (p<0.001) less than in the PD group (0.34 ± 0.11 g/dL). As for PD, BCG values are closer to NM values. Increasing age, female gender, and higher dialysis adequacy are associated with higher ΔSA in the HD but not in the PD group. Utilizing linear regression analysis we developed equations for each dialysis modality to convert albumin measurements from one method to the other. Conclusion.?We confirm that a discrepancy exists between the commonly used dye methods (BCG and BCP) for serum albumin estimation. This discrepancy is significantly lower in HD patients than in PD patients. Nephrologists should be aware of this discrepancy and appropriate corrections should be made during quality improvement analysis.     

Interlinked monitoring in support of the anesthesia service in a surgical unit

The interlinking of patient monitors, which allows observation of current measurement data from several patients in a treatment unit not only at the bedside, but also at more distant monitors attached to the unit, has become generally established in intensive care medicine. In several years of use in the anesthesia department of a surgical unit, such an interconnection of information has also proved to be useful.     

Detection of basic calcium phosphate crystals in osteoarthritis

Osteoarthritis (OA) is the most common human joint disorder. Its complex pathogenesis remains poorly understood but appears multifactorial. To date, no specific pharmacological agent has been identified to alter the disease course of OA. Calcification of articular cartilage is a hallmark of OA and evidence suggests it contributes directly to joint degeneration. Calcium crystals are frequently found in OA synovial fluid but their exact role in the disease process is unclear. Basic calcium phosphate (BCP) crystals are the predominant crystal type found in OA and recent data indicate a pathogenic role for these crystals in OA. However, information on the exact frequency and distribution of BCP crystals vary considerably, mainly due to the lack of simple and reliable methods of detection. The purpose of this review is to describe the current available methods for detecting BCP crystals and to highlight their obvious advantages and limitations. Recent developments in the field are also discussed with particular reference to their potential clinical applicability. Improved methods of detection for BCP crystals could potentially aid the diagnosis of OA and the development of novel therapies.     

个性化处理SMAS层的面部年轻化手术

目的:总结并探讨各种通过SMAS个性化处理达到面部年轻化的除皱手术方法.方法:回顾研究56例面部老化患者的治疗过程,根据患者自身老化程度,行相应区域的SMAS广泛剥离,并以不同方式个性化处理SMAS层,达到对面部软组织年轻化重塑的手术方法和术后效果.结果:术后随访6月～2年,面部软组织均获得显著的年轻化效果,术后56例患者均较满意.结论:根据患者自身的老化程度,以不同方式个性化处理 SMAS层的面部年轻化手术,是安全有效的软组织提升方法,可达到除皱术更为持久的年轻化效果.     

Clinical evaluation of model‐based radiostereometric analysis to measure femoral head penetration and cup migration in four different cup designs

In conventional Radiostereometric analysis (RSA) implants with attached tantalum markers are frequently used, which may be difficult to visualize. This problem can be avoided with model‐based RSA (MBRSA), but it is uncertain if this method has the same precision as marker‐based RSA. We evaluated the influence of cup design for the precision of MBRSA in four uncemented cups to study if the design had any influence on the precision. Stereo radiographs were analyzed postoperatively (double‐examinations) and after 2 years (single examinations). The difference between the double‐examinations was used to compute the precision for the methods and for each type of implant. Femoral head penetration and cup translation up to 2 years were compared using marker‐based RSA as reference. The precision of proximal penetration and migration measurements did not differ between the methods for Trilogy, TMT and ABG. For Ringloc design a poorer precision was observed using MBRSA. Comparison between the methods regarding proximal penetration and cup migration at 2 years did not differ for three of the designs (p = 0.12–0.91). However, for the group with porous plasma sprayed surface (Ringloc) a significant difference between the methods was observed (p _penetration <0.01 and p _migration <0.01). Poorer precision, different penetration and migration values at 2 years for one of the designs indicate that the resolution of MBRSA might vary depending on surface coating and implant geometry. Therefore, we conclude that the resolution of MBRSA has to be studied for each type of basic cup design. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:760–767, 2017.

     

Evaluation of lung and chest wall mechanics during anaesthesia using the PEEP-step method

Background

Postoperative pulmonary complications are common. Between patients there are differences in lung and chest wall mechanics. Individualised mechanical ventilation based on measurement of transpulmonary pressures would be a step forward. A previously described method evaluates lung and chest wall mechanics from a change of ΔPEEP and calculation of change in end-expiratory lung volume (ΔEELV). The aim of the present study was to validate this PEEP-step method (PSM) during general anaesthesia by comparing it with the conventional method using oesophageal pressure (PES) measurements.

Extended LMI representatives for stability and stabilization of discrete‐time Takagi‐Sugeno fuzzy systems

In this paper, we study the stability conditions and stabilization problem of Takagi‐Sugeno systems under the discrete‐time framework. By introducing slack matrices, we obtain extended stability condition in an LMI form. Both parallel distributed compensation (PDC) control law, and non‐PDC control law are studied. Finally, we give an example to compare our results with other methods. Copyright © 2013 John Wiley & Sons, Ltd.     

Prognostic Factors and Recurrence of Small Hepatocellular Carcinoma after Hepatic Resection or Microwave Ablation: A Retrospective Study

Purpose This study aims to analyze the long-term therapeutic results of small HCC less than 5 cm in diameter after microwave ablation (MA) or hepatic resection (HR) and choose factors that could predict metastasis and recurrence of small HCC. Materials and Methods The metastasis and recurrence of 194 patients with one HCC less than 5 cm in diameter who underwent curative HR or MA between January 1995 and December 2004 were reviewed retrospectively; immunohistochemistry was used to analyze the expressions of VEGF, bFGF, and c-Met in HCC tissues. Posttreatment prognostic factors were evaluated by multivariate analysis using Cox’s proportional hazards model. The variables included the expressions of these three proteins in HCC tissues, the clinical and pathologic characteristics of the patients. Results The retrospective study showed that 1-, 3-, and 5-year disease-free survival rates of patients with single HCC of diameter <5 cm were 71.3, 57.0 and 32.5%, respectively. Furthermore, 1-, 3-, and 5-year disease-free survival rates of the patients in MA group and resection group were 72.8, 54.0 and 33.0%; 68.5, 60.0, and 25.6%, respectively. There was no significant difference in disease-free survival rates between these two groups. The result of multivariate analysis showed that differentiation degree of HCC and the expressions of VEGF and c-Met in HCC tissues could be as the independent prognostic factors affecting metastasis and recurrence in patients with small HCC, whereas the methods of therapy had no impact on prognosis. Conclusions The metastasis and recurrence rate after MA is similar to that after HR, and the methods of therapy do not affect the prognosis of small HCC. The metastasis and recurrence of patients with small HCC will differ depending on tumor differentiation, expressions of VEGF and c-Met in HCC tissues.     

经乳晕切口取出聚丙烯酰胺水凝胶60例临床分析

目的探讨聚丙烯酰胺水凝胶注射隆乳后的手术取出方法。方法2005年1月至2008年6月,对60例患者分别采用乳晕下半缘切口进行聚丙烯酰胺取出治疗。结果60例患者中54例均感效果满意;6例术后乳房形态欠佳。结论对大多数聚丙烯酰胺水凝胶隆乳患者采用乳晕下半缘切口进行取出手术能得到满意效果,乳房瘢痕不明显．并发症少,外形较佳。