实验性不同类型大鼠臂丛根性损伤后脊髓运动神经元存活情况观察

目的 研究臂丛神经根性切断伤与根性撕脱伤后脊髓前角运动神经元的存活情况。方法 对76只健康成年SD大鼠,按手术先后顺序分成臂丛神经根性切断伤组和根性撕脱伤组,两组按术后9个不同的时间组取材,每组4只大鼠,共72只大鼠。另外4只为正常对照组。取了脊髓标本后,观察颈髓前角运动神经元数目的变化。结果 臂丛神经根性切断伤后,各时间组的脊髓前角运动神经元数目和术前无明显变化;而根性撕脱伤组于术后1周其神经元数目开始减少,术后2周时神经元数目比正常对照组减少30％,术后6周时减少70％。撕脱伤组与切断伤组相比,损伤1周后,各时间组的差异均有显著性意义（X^2＝3．922－17．21,P＜0．01）。结论 臂丛神经根性切断伤其脊髓运动神经元和术前比无明显变化,而臂丛神经性撕脱伤后其脊髓运动神经元有死亡,死亡速度快,死亡程度高。     

雪旺细胞源神经营养因子预防臂丛神经根性撕脱伤所致运动神经元死亡

目的　研究雪旺细胞源神经营养因子（ Ｓ Ｄ Ｎ Ｆ）对臂丛神经根性撕脱伤所致前角运动神经元死亡的保护作用。方法　选成年 Ｓ Ｄ 大鼠,制成颈６、７神经根性撕脱伤动物模型,损伤处定期应用 Ｓ Ｄ Ｎ Ｆ,３ 周后观察损伤侧脊髓前角运动神经元的成活率和形态学变化,以及一氧化氮合酶（ Ｎ Ｏ Ｓ）表达的情况。结果　对照组６８６％ 的脊髓前角运动神经元死亡,成活神经元胞体明显萎缩,同时表达 Ｎ Ｏ Ｓ神经元增多;实验组脊髓前角运动神经元的死亡率较对照组降低３５％ ,成活神经元胞体无萎缩,表达 Ｎ Ｏ Ｓ神经元未见增多。结论　 Ｓ Ｄ Ｎ Ｆ对臂丛神经根性撕脱伤所致运动神经元死亡有明显的保护作用,一氧化氮在臂丛神经根性撕脱伤所致运动神经元死亡中起一定作用。     

臂丛损伤神经干细胞脊髓前角移植后分化情况及对运动神经元的保护作用

目的观察臂丛根性撕脱伤后将脊髓源性神经干细胞(neuralstemcell,NSC)移植于脊髓前角后的存活、分化情况及对脊髓前角受损运动神经元的保护作用。方法取新生鼠脊髓,分离获得脊髓源性神经干细胞,体外培养、扩增、鉴定、5溴2-脱氧尿苷(BrdU)标记。取SD大鼠60只,随机分成实验组、对照组和单纯组。从后路制备C5~C7臂丛神经根性撕脱伤动物模型。实验组移植神经干细胞于C6脊髓前角,对照组移植灭活神经干细胞,单纯组不作移植。术后1、2、4、8、12周取脊髓标本进行组织学与免疫组化染色观察。结果神经干细胞移植入脊髓后能存活、分化;臂丛根性撕脱伤后脊髓前角运动神经元数目明显减少;实验组神经干细胞移植后2、4、8、12周各个时间点运动神经元的存活率均高于对照组和单纯组。结论臂丛根性撕脱伤脊髓前角神经干细胞移植后能存活并分化为神经元及星型胶质细胞,脊髓源性神经干细胞移植能明显减少前角运动神经元的继发性死亡,对脊髓前角受损运动神经元有保护作用。     

雪旺细胞源神经营养因子预防臂丛神经根性撕脱伤所致 …

目的 研究雪旺细胞源细胞神经营养因子（ＳＤＮＦ）对臂丛神经根性撕脱伤所致前角运动神经元死亡的保护作用。方法 选成年ＳＤ大鼠,制成颈６、７神经根性撕脱伤动物模型,损伤处定期应用ＳＤＮＦ,３周后观察损伤侧脊髓前角运动神经元的成活率和形态学变化,以及一氧化氮合酶（ＮＯＳ）表达的情况。结果 对照组６８．６％的脊髓前角运动神经元死亡,成活神经元胞体明显萎缩,同时表达ＮＯＳ神经元增多;实验组脊髓前角运动神经元     

臂丛根性损伤脊髓前角α运动神经无数目变化的实验研究

以Sprague-Dawly大鼠为研究对象，设计臂丛根性撕脱伤的实验模型，研究臂丛根性撕脱后脊髓前角α运动神经元数目变化。实验结果表明：臂丛根性撕脱伤后脊髓前角α运动神经元死亡23．7％。     

细胞外ATP对臂丛神经根性撕脱伤后脊髓运动神经元保护的实验研究

目的 观察细胞外ATP对臂丛神经根性撕脱伤所致脊髓前角运动神经元损伤的保护作用. 方法 Wistar大鼠36只,随机分为两组:单纯神经根撕脱组和神经根撕脱加ATP治疗组.行左侧臂丛神经根性撕脱术,术后实验组腹腔注射ATP(2 mg/kg)0.4 nd,对照组腹腔注射生理盐水0.4 ml,均为1次/日,连续应用ATP或生理盐水2周.术后2周、4周和6周后取材,处死动物后取C5～C8脊髓分别行一氧化氮合酶(NOS)、神经丝蛋白(NF-200)免疫组织化学染色. 结果 术后2、4和6周,实验组脊髓前角运动神经元存活率为80.48%、73.55%、53.43%,对照组为68.90%、63.58%、37.72%,实验组与对照组比较脊髓前角运动神经元死亡率分别降低了11.58%、9.87%和15.71%(P<0.01);实验组脊髓前角运动神经元中NOS阳性率为17.85%、40.20%、18.03%,对照组为25.53%、53.88%、25.58%,实验组与对照组比较.脊髓前角运动神经元中NOS阳性率分别下降了7.68%(P<0.01)、13.68%和7.55%(P<0.05);实验组脊髓前角运动神经元的NF-200阳性细胞数均高于对照组,两者比较差异有统计学意义. 结论 ATP对臂丛神经根性撕脱伤后脊髓前角运动神经元具有保护作用.     

大鼠臂丛神经根性回植后脊髓病理改变和轴突再生

目的 探讨臂丛神经根性撕脱后神经根再植入脊髓的可行性。方法 采用大鼠颈5-7，神经根性撕脱伤实验动物模型，伤后将C5-7，神经根即刻植入脊髓。分别于神经根植入后3周、3个月、6个月取材。应用组织病理活检、免疫组化技术及神经示踪技术，对神经中枢及吻合口下段神经干检查。观察脊髓前角运动神经元和神经元内尼氏体数目和形态的改变；周围神经纤维再生数目、距离，轴索和髓鞘发育情况。结果 臂丛神经根性撕脱伤对动物生长和存活有较大的影响。脊髓前角运动神经元数目在3个月内持续减少，3个月后趋于稳定，6个月时脊髓前角大型运动细胞坏死比率在40％左右，残存的神经元多为受损的神经元，尼氏体减少或消失。脊髓前角运动神经元再生轴突可重新生长入周围神经干，再生神经纤维轴索较细，大部分髓鞘发育不完全，轴突再生距离较短，肌皮神经6个月内无神经纤维再生。结论 臂丛神经根性撕脱伤，神经根回植入脊髓后，脊髓前角运动神经元坏死比率为40％左右，残存神经元多为受损神经元，再生神经纤维表现为动力不足和发育不全，对终末器官功能恢复没有意义。     

大鼠臂丛放射性损伤后脊髓前角运动神经元病理变化及c-fos基因表达

目的模拟乳癌放疗方案，观察实验大鼠臂丛神经受照射后相应脊髓前角运动神经元的病理改变及c—fos基因表达。方法采用剂量分割照射方案，建立大鼠臂丛神经放射性损伤动物模型。将加只SD大鼠随机分成臂丛神经损伤组（实验组）和正常对照组，实验组又根据损伤后取材时间的不同分成损伤后3、5、7和9周4个时间组，每个时间组和对照组各4只大鼠，每个时间组以左侧为照射侧，右侧为对照侧，采用日照射2Gy／次，每周5次深部X线照射，累计剂量达到30Gy后，分别于末次照射后3、5、7和9周取材。检测两侧脊髓前角运动神经元形态及数目变化并以免疫组织化学染色法检测c—fos在前角运动神经元中的表达。结果大鼠臂丛神经受照射后3周，实验组照射侧脊髓前角运动神经元存活数目随时间延长而明显减少，神经元内有明显的c—fos染色，c—fos阳性细胞数渐减。照射后9周，c-fos阳性细胞偶见。结论大鼠臂丛神经受大剂量X线照射后可使大鼠脊髓前角运动神经元存活数目明显减少；与脊髓神经元凋亡相关的c—fos基因呈阳性表达，表明原癌基因的表达在臂丛神经放射损伤的凋亡、损伤和修复过程中起重要作用。     

臂丛神经根性撕脱伤后神经营养因子在脊髓及肌肉中表达的变化

目的：通过观测臂丛神经根性撕脱伤后脊髓前角运动神经元及肌肉组织内神经营养因子表达的变化。探讨臂丛神经撕脱伤后中枢运动神经元,靶器官的功能改变可能对神经再生产生的影响。方法：清洁级Wistar大鼠48只,随机分成正常对照组和损伤术后1天,1,4,8和12周共六组,损伤组均从前路造成臂丛颈5,6,7神经根性撕脱伤,按各组所示时间取脊髓及肌肉分别检测碱性成纤维细胞生长因子（bFGF)蛋白及mRNA,神经生长因子（NGF）蛋白的表达,并采用计算机图像分析系统对组织切片中bFGF蛋白及mRNA,NGF蛋白进行半定量分析,比较,结果：臂丛神经根性撕脱伤后,肱二头肌内NGF蛋白表达增高,1天时达到高峰,随后下降,3个月时仍高于对照组,而脊髓前角运动神经元bFGF蛋白及mRNA的表达在伤后亦升高,1周时达到高峰,随后下降,3个月时下降到稍低于正常水平,结论：臂丛神经根性撕脱伤后神经营养因子在中枢神经元及靶器官内表达增高,可能起保护神经元,促进神经再生的作用。     

雪旺细胞源神经营养因子对脊神经根性撕脱所致运动神经元死亡的保护作用

目的研究雪旺细胞源神经营养因子（ＳＤＮＦ）对臂丛神经根性撕脱所致前角运动神经元死亡的保护作用。方法于颈神经根性撕脱处应用ＳＤＮＦ,３周后观察损伤侧脊髓前角运动神经元的存活率和形态学变化以及ＮＯＳ表达的情况。结果对照组６８．６％的神经元死亡,存活神经元胞体明显萎缩,同时表达ＮＯＳ神经元增多;实验组的死亡率较对照组降低３５％,存活神经元胞体无萎缩,表达ＮＯＳ神经元未见增多。结论ＳＤＮＦ对脊髓前角运动神经元死亡有明显的保护作用,ＮＯ在臂丛神经根性撕脱所致运动神经元死亡中起一定作用。     

2015年乳腺癌辅助化疗进展

【摘要】〓乳腺癌是危害我国女性健康的头号杀手,尽管近年来辅助化疗的研究进展突飞猛进,但临床中仍有不少问题未能明确,如辅助化疗的合适人群、化疗的开始时间、蒽环及紫杉类的地位和用法、强化维持治疗的作用、疗效及预后的生物标志物等。本文结合乳腺癌辅助化疗在临床上的常见问题和2015年各大乳腺癌会议阐述乳腺癌辅助化疗的最新进展。     

Alterations in T-Cell Subset Frequency in Peripheral Blood in Obesity

Background: Obesity affects the regulation of immune and inflammatory responses. This study characterizes differences in peripheral blood lymphocyte phenotype in obese humans. Methods: Frequencies of lymphocyte subsets among peripheral blood mononuclear cells were compared between 10 obese (BMI ≥35) and 10 lean subjects, as determined by antibodies directed against cluster differentiation (CD) markers. Results: Obese patients demonstrated an increased frequency of CD3+CD4+ T-cells (mean difference 12%, P=0.004), a decreased frequency of CD3+CD8+ T-cells (mean difference 9.4%, P=0.016) and an increased frequency of CD3+CD8+CD95+ T-cells (mean difference 13.3%, P=0.032). No other differences among T-cell or monocyte subsets were noted. Conclusions: Obesity is associated with alterations in frequencies of peripheral CD4+ and CD8+ T-cells and aberrations in the expression of CD95 among CD8+ T-cells. These data suggest both CD4+ and CD8+ T-cell compartments, as well as the regulation of CD95 expression on CD8+ T-cells, as targets for further study into obesity's effects on the immune system.     

西宁地区烧伤病人动脉血气分析观察

对高海拔地区的27例烧伤病人动脉血气变化进行了分析和观察。结果证明:无论是存活病人还是死亡病人伤后均存在有低氧血症问题。并且在死亡病人和烧伤合并吸入性损伤病人其低氧血症的发生早于单纯烧伤病人。提示:吸入性损伤病人应立即行气管切开术以保障氧气供给,单纯烧伤病人可常规吸氧以维持正常血 PaO_2,ARDS 均发生在合并吸入性损伤的病人,高频喷射通气技术对纠正低氧血症有一定效果。     

Controversies in Fistula in Ano

Managing a complex fistula in ano can be a daunting task for most surgeons; largely due to the two major dreaded complications—recurrence & fecal incontinence. It is important to understand the anatomy of the anal sphincters & the aetiopathological process of the disease to provide better patient care. There are quite a few controversies associated with fistula in ano & its management, which compound the difficulty in treating fistula in ano. This article attempts to clear some of those major controversies.     

β-半乳糖苷酶在体内外成骨细胞中的表达

目的 研究β—半乳糖苷酶(β—gal)在成骨细胞中的表达状况，为阐明MorquioB综合征的发病机制提供依据。方法 裸鼠各器官和骨组织标本行X-gal染色检测。抽取羊和人骨髓行骨髓基质细胞(BMSCs)培养，分为4组：I：Adv-hBMP-2转染组；Ⅱ：Adv—β—gal转染组；Ⅲ：未转染组；Ⅳ：地塞米松诱导组。分别行X-gal染色和RT-PCR检测β—gal的表达。结果 裸鼠骺板两侧、骨膜内面及松质骨的成骨细胞和破骨细胞可见多量β—gal的表达。未转染BMSCs组有少量β—gal的表达，其他3组细胞的β—gal表达增高。结论成骨细胞和破骨细胞可表达多量β—gal，该两种细胞的β—gal缺乏可能是MorquioB综合征骨骼异常的直接原因。     

Smoking-Attributable mortality in Spain in 2016

IntroductionSmoking-attributable mortality (SAM) is a valuable indicator that can be used to characterize the course and health burden of the smoking epidemic. The aim of this paper was to estimate SAM in Spain in 2016 in the population aged 35 and over, using the best available evidence.MethodsA smoking prevalence-dependent analysis based on the estimation of population-attributable fractions was performed. Smoking prevalence (never, former, and current smokers) was calculated from a combination of the Spanish Health Survey (2016) and the European Health Survey (2014); the relative risk of death among current and former smokers was taken from the follow-up of various cohorts; and mortality rates were obtained from National Center for Statistics data. SAM estimates are presented globally, and by sex, age groups, and major disease categories: cancer, cardiometabolic diseases and respiratory diseases.ResultsIn 2016, 56,124 deaths were attributed to tobacco consumption, 84% in men (47,000), and 50% in the population aged over 74 (27,795). Overall, 50% of SAM was due to cancer (28,281), 65% of which was lung cancer. One in 4 attributable deaths (13,849) occurred before the age of 65.ConclusionsOne in 7 deaths in Spain in 2016 were attributable to smoking. This estimation of SAM clearly highlights the great impact of smoking on mortality in Spain, mainly due to lung cancer and chronic obstructive pulmonary disease.     

MicroRNAs in hepatic pathophysiology in diabetes

MicroRNAs(miRNAs or miRs) are small approximately 22 nucleotide RNA species that are believed to regulate diverse metabolic and physiological processes.In the recent past,several reports have surfaced that demonstrate the role of miRNAs in various biological processes and numerous disease states.For a disease as complex as diabetes,the emergence of miRNAs as key regulators leading to the disease phenotype has added a novel dimension to the area of diabetes research.On the other hand,the liver,a metabolic hub,contributes in a major way towards maintaining normal glucose levels in the body as it can both stimulate and inhibit hepatic glucose output.This equilibrium is frequently disturbed in diabetes and hence,the liver assumes special significance considering the correlation between altered hepatic physiology and diabetes.While the understanding of the mechanisms behind this altered hepatic behavior is not yet completely understood,recent reports on the status and role of miRNAs in the diabetic liver have further added to the complexities of the knowledge of hepatic pathophysiology in diabetes.Here,we bring together the various miRNAs that play a role in the altered hepatic behavior during diabetes.     

Fluid-phase transcytosis in the primate epididymis in vitro and in vivo

Ligated tubules from the corpus epididymidis of men and monkeys were incubated in medium containing horseradish peroxidase (HRP) as a marker for fluid-phase endocytosis. HRP was localized by light and electron microscopy after 0, 15, 30 and 60 min of incubation. Movement between the cells was prevented by tight junctions, but bypass of this barrier was apparently achieved by an intracellular vesicular mechanism leading to a time-dependent appearance of HRP in the lumen. Uptake of HRP into basal cells and capture by the lysosomal apparatus of principal cells were also observed. HRP-filled vesicles also appeared in the basal, mid and apical cytoplasm of epithelial cells in the caput 1 h after injection of the tracer into the epididymal circulation of the monkey, suggesting that this pathway also operates in vivo.