第三腰椎横突综合征致腹痛十三年1例报道

第三腰椎横突综合征致腹痛十三年１例报道刘登位患者女性，４９岁，干部，于９２年７月１６日入院，反复发作性右下腹痛１３年，伴腹胀，无腹泻，恶心呕吐，体温正常。到某院就诊，疑为“肾绞痛”、“阑尾炎”。查血尿常规正常，Ｂ超检查：肝、胆、脾胰正常，肾盂静脉造影...     

右上腹不适包块黄痘反复发作3年

1病历简介 孔凡民医师：病人女性，24岁。2005年3月5日入院。病人近3年无明显诱因出现右上腹不适和黄疸，呈间歇性反复发作。并发现右上腹包块。曾于当地医院就诊，诊断为先天性胆总管扩张症。病来无发热、寒战，无恶心、呕吐。发病时尿色深黄，大便颜色变浅，体重无减轻。     

肾结石术后对侧肾损伤坏死1例报告

患者，女，44岁。反复双肾区隐痛伴间歇性血尿1年余，无外伤史。体检：体型瘦小，腹软，无压痛及色块，双肾区轻叩痛，双下肢无水肿。实验室血常规检查：血红蛋白100g／L，白细胞10．8×109／L，中性79％，血小板计数261×109／L；尿常规检查：色黄清，蛋白阴性，红细胞＋；出、凝血时间正常，尿素氮3．44mmol／L。腹部平片示双肾多发性结石，右输尿管末段结石。静脉尿路造影示双肾、膀胱显影淡薄，双肾中度积液，右输尿管未显影。入院经抗感染治疗1周后行右肾盂切开取石加右输尿管末段切开取石术。取右剖腰切口及下腹斜切口。术后24h尿量…     

双侧自发性肾包膜下血肿一例报告

患者 ,女 ,2 9岁。右腰部持续性胀痛 2 0ｄ ,于 2 0 0 1年 2月 2 8日入院。疼痛不放射 ,无尿频、尿急、尿痛 ,无肉眼血尿 ,无发热及外伤史。 1年余前左腰部曾出现类似症状 ,Ｂ超诊断为左肾包膜下血肿。经保守治疗症状逐渐缓解。既往无血液系统病史。体检 :体温 37.2℃ ,皮肤、粘膜未见出血点及瘀斑 ,右肾区饱满 ,触痛。实验室检查 :尿常规正常 ,血小板 2 13× 10 9/Ｌ ,凝血酶原及凝血酶时间均正常。Ｂ超可见右肾周围一半月形液性回声区 ,宽约 2 7ｍｍ ,边界清晰 ,肾实质回声均匀 ,形态、大小正常。ＣＴ见右肾包膜下环形低密度影 ,ＣＴ值约 …     

腔静脉后输尿管3例

腔静脉后输尿管３例胡言雨，林少鹏腔静脉后输尿管临床上较少见。我科于１９９３～１９９４年收治３例，均经手术治疗。现报告如下。例１女，４０岁。因反复尿频、尿急、右腰部酸胀不适２年就诊。曾按“尿路感染”治疗，病情几经反复不愈。平素身体健康，无外伤史。体检除...     

输尿管硬镜钬激光碎石患者死亡一例

患者，女，22岁，因“右侧腰部反复胀痛1年，加重1周”入院，无尿频、尿急、尿痛和肉眼血尿。入院体查：BP120／70mmHg，心肺无异常，腹平软，右肋脊角压痛及叩击痛（＋）。KUB＋IVP提示右肾盂输尿管移行处有一约3．0cm×1．2cm大小结石（图1），右肾重度积水，左肾功能正常。超声提示右肾集合系统分离4em，右输尿管上段见一约3.0cm×1.3cm团状强回声，伴声影。尿常规：RBC（＋）、WBC（H）；心电图正常，胸片及血常规、凝血四项等其他各种生化检查均正常。入院诊断：“右输尿管上段结石并右肾重度积水”。     

双侧肾上腺浆细胞肉瘤1例报告

患者，女，64岁。因反复有腰部胀痛伴肩背部牵涉痛1个月，B超示右腹膜后肿瘤手1995年1月30日入院。无其他伴随症状。体检无异常。实验室检查：血糖8．7mmol／L，余正常。入院后B超示右肾上腺区有8．0cm×5．0cm低回声占位性病变，右肾实质上后部分缺损，左肾上腺区有5.0cm×3．0cm低回声占位性病变。肾图示双肾功能正常。MRI示右肾上腺区域有约8．0cm×7．0cm×5.0cm占位性病变并越过中线与左肾上腺肿块相连，后者约5．5cm×2.5cm×2．0cm大小；右侧肿块对下腔静脉压迫推移明显。临床诊断为双侧肾上腺肿瘤（无功能性）。于1995年2月23日…     

左肾子宫内膜异位症1例报告

子宫内膜异位症在临床上比较多见,但肾脏子宫内膜异位症实属罕见.我院于1995年5月收治1例,现报告如下.患者,27岁.主诉反复左腰痛伴尿频、尿痛,镜下血尿13年.该患者13年来在无诱因情况下反复出现左腰痛伴持续性隐痛,但不放射,且有尿频、尿痛及镜下血尿,但无发热、咳嗽、午后潮热、盗汗等.曾诊断为左肾结核,予抗结核治疗(不系统)无明显好转.近3年上述症状加重,拟“左肾结核”入院.患者月经正常,腰痛与月经无明显关系,婚后3年不孕.体检:无发热,一般情况好,心、肺听诊未见异常,双肾、输尿管及膀胱均末发现异常.子宫及附件无     

肱骨中段Brodie骨脓肿1例

病历摘要:患者,男,36岁,右上臂反复疼痛20余年,加重半年余。缘于1979年无任何诱因,始感右上臂不适呈酸胀感,偶感上臂疼痛,曾在当地医院按“风湿”治疗,局部外敷中药,疼痛加剧给予抗生素静滴,间断发作,时轻时重,每年2～3次,每次持续半个月,无发热,未行Ｘ线检查,1998年9月右上臂疼痛加重,尤以夜间为重,在当地医院行Ｘ线、ＣＴ检查,诊断不明确,怀疑骨肿瘤,1999年12月27日来我院诊治。查体:浅表淋巴结未触及,右上肢无畸形,肱骨中段皮肤无红肿,皮温正常,无破溃,无压痛,无叩击痛。右肩,肘关节运动正常。感觉、未梢血运正常。Ｘ线检查,右肱骨中上段…     

不典型肾结核的诊断

由于肾结核的表现不典型 ,容易误诊而延误治疗。我们于 2 0 0 1年 1月和 3月收治 2例不典型肾结核 ,报告如下。1　临床资料例 1　男 ,5 8岁。主要表现为右侧腰腹部胀痛不适 1年 ,无血尿、尿频、尿急和尿痛 ,无低热和消瘦。于 2 0 0 0年 1 2月 1 3日收入院。尿常规正常 ,尿PCR- TB( - ) ,X线胸片示心肺正常 ,B超示右肾积水伴右输尿管扩张。IVU示右肾积水 ,右输尿管扩张 ,右输尿管下段狭窄。CT示右肾盂、肾盏扩张 ,肾实质变薄 ,积水肾盏边缘不规则 ,右输尿管扩张 ,右输尿管开口附近膀胱壁增厚。膀胱镜检查示膀胱内粘膜正常 ,输尿管开口清…     

pcDNA3-hBMP2转染对成纤维细胞 生物学性状的影响

目的 探讨人BMP2基因转染对成纤维细胞NIH3T3生物学性状的影响。方法 构建重组真核表达载体pcDNA3-hBMP2,并在脂质体介导下,将其导入NIH3T3成纤维细胞,通过G418筛选获得阳性克隆,用细胞原位杂交和免疫组织化学方法检测hBMP2基因在NIH3T3成纤维细胞内的表达情况;MTT法和FCM检测pcDNA3-hBMP2转染pcDNA3-hBMP2后成纤维细胞超微结构的改变,碱性磷酸酶的检测观察转染pcDNA3-hBMP2后成纤维细胞向成骨细胞分化情况。结果 转染pcvDNA3-hBMP2后的NIH3T3细胞内有大量hBMP2mRNA的转录及其蛋白的表达;转染pcDNA3-hBMP2对成纤维细胞增殖和细胞周期无影响;转染pcDNA3-hBMP2后的成纤维细胞超微结构可见粗面内质网丰富,囊腔扩张明显其内充满中等电子密度的蛋白分泌物;碱性磷酸酶活性显著上升。结论 pcDNA3-hBMP2转染对成纤维细胞NIH3T3增殖和细胞周期无影响。转染后的成纤维细胞不仅可形成BMP2,而且具有向成骨细胞系分化的特性。     

Choledochal cysts: Part 3 of 3: Management

Much about the etiology, pathophysiology, natural course and optimal treatment of cystic disease of the biliary tree remains under debate. Gastroenterologists, surgeons and radiologists alike still strive to optimize their roles in the management of choledochal cysts. To that end, much has been written about this disease entity, and the purpose of this 3-part review is to organize the available literature and present the various theories currently argued by the experts. In part 3, we discuss the management of choledochal cysts, thus completing our comprehensive review.     

H3K4m3和H3K9m3修饰对胰岛组织特异性基因表达的影响

目的 通过比较不同细胞类型之间胰腺十二指肠同源盒1(Pdx-1)、配对盒基因4(Pax4)、MafA(mast cell function associated antigen)和Nkx6.1等胰岛组织特异性基因其转录起始区的H3K4m3和H3K9m3修饰的差异,探讨H3K4m3和H3K9m3修饰对胰岛组织特异性基因表达的作用.方法 采用染色质免疫共沉淀一实时定量聚合酶链反应(PCR)法检测小鼠胚胎干细胞(mES,1×10~7)、小鼠成纤维细胞株NIH3T3细胞(1×10~7)和小鼠β细胞株NIT-1细胞(1×10~7)三者中的胰岛组织特异性基因、Oct4基因和MLH1基因转录起始区H3K4m3和H3K9m3修饰的状况.同时采用实时定量逆转录(RT)-PCR检测上述3种细胞各基因mRNA表达水平.分析H3K4m3和H3K9m3修饰改变与基因表达之间的关系.结果 NIT-1细胞中Pdx-1、Pax4、MafA、Nkx6.1等胰岛组织特异性基因转录起始区的H3K4m的修饰水平分别为:(4.84±0.05)%、(9.91±1.33)%、(10.64±0.87)%、(0.23±0.03)%,与mES细胞比较明显增高(P<0.05),基因表达;NIH3T3细胞中Pdx-1、Pax4、MafA、Nkx6.1等胰岛组织特异性基因转录起始区的H3K9m3的修饰水平分别为:(0.64±0.21)%、(7.04±1.29)%、(0.39±0.10)%、(2.35±0.81)%,与mES细胞比较明显增高(P<0.05),基因不表达.结论 H3K4m3与H3K9m3修饰能相互协调,共同调控胰岛组织特异性基因的表达.     

Identification of the insulin-regulated interaction of phosphodiesterase 3B with 14-3-3 beta protein

Phosphodiesterase (PDE)-3B, a major PDE isoform in adipocytes, plays a pivotal role in the antilipolytic action of insulin. Insulin-induced phosphorylation and activation of PDE3B is phosphatidylinositol 3-kinase (PI3-K) and Akt dependent, but the precise mechanism of PDE3B activation is not fully understood. We have identified 14-3-3 beta, a critical scaffolding molecule in signal transduction, as a protein that interacts with PDE3B using the yeast two-hybrid system. The interaction between PDE3B and 14-3-3 beta was then confirmed in vitro. The glutathione S-transferase (GST)-tagged 14-3-3 beta interacts with endogenous PDE3B of rat adipocytes, and this interaction is enhanced when adipocytes are treated with insulin. Coimmunoprecipitation experiments reveal that endogenous PDE3B also associates with endogenous 14-3-3 beta in rat adipocytes, and this interaction is enhanced by insulin. Two different PI3-K inhibitors, wortmannin and Ly294002, block this induction, suggesting that PI3-K is required. Synthetic 15 amino acid peptides of rat PDE3B containing phosphorylated Ser-279 or -302 inhibit this interaction, indicating that the insulin-regulated phosphorylation of these serine residues is involved. Because insulin receptor substrate-1 also associates with 14-3-3, the dimeric 14-3-3 beta could function as a scaffolding protein in the activation of PDE3B by insulin.     

Overexpression of EIF3S3 promotes cancer cell growth

BACKGROUND: Amplification and overexpression of EIF3S3 gene has been demonstrated in breast and prostate cancer. Here, our goal was to study the effect of EIF3S3 on cell growth. METHODS: The effect of EIF3S3 on growth of NIH 3T3 murine fibroblasts as well as breast (SK-Br-3 and ZR-75-1) and prostate (PC-3 and LNCaP) cancer cell lines was examined by using transfection with inducible pTet-Off system and siRNAs. RESULTS: NIH 3T3 cells with overexpression of EIF3S3 grew significantly faster than cells transfected with empty vector and survived longer when grown in soft agar. The EIF3S3 overexpression was associated with increased fraction of cells in S-phase and with phosphorylation of retinoblastoma (Rb) protein. siRNA treatment inhibited significantly (P = 0.0022) the growth of all breast and prostate cancer cell lines studied. CONCLUSIONS: The results suggest that EIF3S3 regulates cell growth and viability, and that overexpression of the gene may provide growth advantage to the cancer cells.     

Effects of carboxy-terminal modifications of proteinase 3 (PR3) on the recognition by PR3-ANCA

BACKGROUND: Autoantibodies directed against neutrophil proteinase 3 (PR3-ANCA) from patients with Wegener's granulomatosis and microscopic polyangiitis recognize conformational epitopes of PR3. During maturation of neutrophils, PR3 undergoes amino-terminal and carboxy-terminal processing. In contrast to amino-terminal processing, the effects of carboxy-terminal processing on recognition of PR3 by PR3-ANCA remain unknown. Carboxy-terminally modified or tagged recombinant PR3 (rPR3) molecules may be useful for the refinement of diagnostic assays and for the study of biological processes. METHODS: This study was designed to determine whether 293 cells can be used to express specifically designed carboxy-terminal variants of rPR3, and to evaluate the effects of different carboxy-terminal modifications on the recognition by PR3-ANCA in the capture ELISA. RESULTS: The rPR3-variants secreted into the media supernatants of transfected 293 cells escaped proteolytic processing. Furthermore, in contrast to the effects of amino-terminal pro-peptide deletion on PR3-ANCA binding, carboxy-terminal modifications (deletion and additions) did not significantly affect recognition by PR3-ANCA. CONCLUSIONS: This expression system is ideally suited for the expression of custom-designed carboxy-terminal rPR3 variants, and major conformational effects of carboxy-terminal modifications seem unlikely.     

Expression of p63 and 14-3-3σ in normal and hyperdifferentiated mucosa of the upper aerodigestive tract

Objective: Our goal was to analyze p63 and 14-3-3σ expression in normal and hyperdifferentiated head and neck mucosa. Study Design: Compare the in vivo expression of p63 and 14-3-3σ by immunohistochemistry in normal mucosa and oral lichen planus, a benign mucosal lesion marked by hyperdifferentiation and apoptosis. Results and Conclusion: p63 is underexpressed and 14-3-3σ is overexpressed in lichen planus on immunohistochemical analysis. Significance: The findings support the hypothesis that p63 plays an antidifferentiation role, whereas 14-3-3σ plays a prodifferentiation role in the upper aerodigestive tract epithelium. Lichen planus is a valuable model for the study of p63, 14-3-3σ, and mucosal differentiation. p63 and 14-3-3σ may be molecular markers for oral lichen planus. (Otolaryngol Head Neck Surg 2002;126:598-601.)     

3H-thymidine, 3H-uridine and 3H-leucine uptake in erythroblasts of patients with chronic renal failure

The in vitro incorporation of 3H-thymidine, 3H-uridine and 3H-leucine, reflecting the synthetic capacity for DNA, RNA and protein, respectively, was detected by radioautography in the erythroid precursors of 10 patients with chronic renal failure. The results were compared with the uptake of the isotopes in the erythroid precursors of healthy subjects. The pattern of incorporation for all three isotopes in the patients' cells was similar to that of control cells, but significantly lower. The possible causes of this difference are discussed.