皮下移植和皮下注射构建子宫内膜异位症皮下模型的比较研究

目的 比较皮下移植和皮下注射两种方法建立裸鼠人子宫内膜异位症模型的效果及血管新生相关因子表达的差异.方法 雌性BALB/c裸鼠41只,随机分为皮下移植组(A组,n=22)和皮下注射组(B组,n＝19),分别采用皮下移植人子宫内膜块和皮下注射人子宫内膜碎屑的方式建模.每组又分为2、4周两个亚组,即A1、A2组和B1、B2组.采用SP法检测异位病灶血管内皮生长因子(VEGF)表达和微血管密度(MVD),并比较组间的异位病灶的体积和重量.结果 在相同时间点(2周或4周),两组异位病灶体积差异无统计学意义(P>0.05),A组异位病灶重量较B组明显增加(P<0.05),而两组病灶腺体和间质中VEGF表达、MVD差异无统计学意义(P>0.05).两组在2周时病灶腺体中VEGF表达及MVD均明显高于4周时(P<0.05).结论 两种方法均可成功构建裸鼠人子宫内膜异位症模型,并可观察血管新生情况,以皮下移植造模效果较好.     

子宫内膜异位症裸鼠模型的建立及内皮抑素治疗的实验研究

目的 建立人子宫内膜异位症(EMS)裸鼠皮下种植及腹腔注射模型,探讨内皮抑素在EMS治疗中的作用.方法 将4例确诊为EMS并行子宫切除患者的子宫内膜标本植入30只BALB/c雌性裸鼠体内,建立EMS裸鼠模型.其中皮下种植组20只,腹腔注射组10只,2周后比较两组的成模成功率.将皮下种植组成模裸鼠按随机数字表分为对照组(7只)与实验组(8只).实验组以2mg/(1kg·d)的剂量局部注射内皮抑索,对照组局部注射同体积PBS.注射后14d处死,采用免疫组化法检测裸鼠异位内膜中血管内皮生长因子(VEGF)蛋白的表达水平.结果 腹腔注射组7只成模,皮下种植组15只成模,两组成模成功率分别为70%和75%(P>0.05).实验组异位病灶VEGF表达水平(0.73±0.13)较对照组(1.09±0.12)明显降低(P<0.05).结论 内皮抑素可通过抑制血管生成和降低VEGF的表达发挥治疗EMS的作用.     

PAMAM介导内皮抑素基因治疗对裸鼠人子宫内膜异位症的作用

目的 探讨聚酰胺-胺型树枝状高聚合物(PAMAM)介导内皮抑素(ES)基因抗血管生成对裸鼠人子宫内膜异位症(EMs)的治疗作用及时机.方法 120只BALB/c雌性裸鼠经皮下移植法建立人子宫内膜异位症模型后,分为以下4组:ES转染组(n=33),病灶局部注射20μg pcDNA3.1(+)-hES+65μg PAMAM混合液85μl,PAMAM组(n=30),病灶局部注射65μg PAMAM+无菌蒸馏水混合液85μl;生理盐水组(n=27),病灶局部注射生理盐水85μl;空白组(n=30),病灶局部未做任何处理.每组又分为建模后第1天和第14天给药两个亚组.给药1周后处死动物,对裸鼠卵巢、子宫及EMs病灶进行称重,并测量病灶大小,计数卵泡数目、微血管密度(MVD),免疫组化法检测各组病灶中ES、血管内皮细胞生长因子(VEGF)的表达水平.结果 在建模后第1天给药裸鼠中,ES转染组腺体中ES表达明显高于其余3组(P<0.05),但异位病灶重量和体积、VEGF表达水平及MVD与其余3组比较差异无统计学意义(P>0.05).在建模后第14天给药裸鼠中,与其余3组比较,ES转染组腺体中ES表达增高、VEGF表达降低,异位病灶体积缩小、重量减轻,MVD降低(P<0.05).在ES转染组中,与建模后第1天给药亚组比较,建模后第14天给药裸鼠VEGF表达水平及MVD明显降低(P<0.05).在建模后第1天和第14天给药裸鼠中,与其余3组比较,KS转染组心、肝、肾、卵巢及子宫未见明显组织形态学改变,且卵巢、子宫重量及卵巢卵泡计数差别无统计学意义(P>0.05).结论 建模后14d采用PAMAM介导20μg ES基因病灶局部注射对裸鼠人EMs模型具有治疗作用,且对心、肝、肾及内生殖器无明显不良反应.     

脂质体介导内皮抑素基因治疗对裸鼠人子宫内膜异位症的作用

目的 探讨脂质体介导内皮抑素(ES)基因治疗裸鼠人子宫内膜异位症(EMs)的疗效及不良反应.方法 BALB/c雌性裸鼠40只,建立皮下EMs模型后将动物随机均分为4组(n=10):A组,病灶局部注射脂质体介导的pcDNA3.1(+)-hES 20μg;B组,肌内注射脂质体介导的pcDNA3.1(+)-hES 20μg;C组,病灶局部注射脂质体介导的pcDNA3.1(+)空质粒20μg;D组,病灶局部注射等量培养液.观察治疗21d后裸鼠皮下异位病灶生长情况,检测病灶内微血管密度(MVD)、血管内皮细胞生长因子(VEGF)蛋白及治疗后第3、7天时VEGF mRNA的表达情况,并计算治疗21d后内生殖器(子宫、卵巢)重量及与体重的比值.结果 A、B、C、D组病灶生长倍增时间分别是7.49、7.02、6.67、6.15d;A、B组注射ES基因后病灶生长抑制率分别为90.51%、43.05%.治疗21d后,A组MVD值(32土10/mm~2)较B组(56±14/mm~2)、C组(82±19/mm~2)、D组(82士19/mm~2)明显减少(P<0.05),后三组间差异无统计学意义,四组间VEGF表达水平差异无统计学意义(P>O.05).与C、D组比较,A组在治疗第3天VFGF mRNA明显下降,第7天显著回升,而B组变化不明显.A、B组的内生殖器与体重比值(分别为0.008 6±0.002 5、0.008 O士0.003 4)较C、D组(分别为0.011 6士0.014 0、0.012 0士0.023 0)明显下降(P<0.05).结论 20μg脂质体介导pcDNA3.1(+)-hES治疗裸鼠人EMs有效,但须注意其对子宫、卵巢的影响.     

双自杀基因联合Survivin反义寡核苷酸对结肠癌裸鼠的体内抑瘤作用

目的 研究VEGF启动子驱动的双自杀基因(Ad-VEGFP-CDglyTK)联合Survivin反义寡核苷酸对裸小鼠体内结肠癌移植瘤的抑瘤作用.方法 建立裸小鼠人结肠癌模型,将24只成瘤后的裸小鼠随机分为4组(n=6):空白对照组,不施加任何处理;重组腺病毒组,注射重组腺病毒Ad-VEGFP-CDglyTK与前药氟胞嘧啶(5-DC)、更昔洛韦(GCV);Survivin反义寡核苷酸(SurvivinASODN)组,注射Survivin ASODN;基因联合治疗组,注射重组腺病毒Ad-VEGFP-CDglyTK与前药5-FC、GCV,同时注射SurvivinASODN.治疗后测定瘤重并计算肿瘤生长抑制率;将瘤组织进行HE染色;免疫组化检测微血管密度(MVD).结果 各组最终瘤重及肿瘤生长抑制率分别为:空白对照组516.58±10.58mg,0%;重组腺病毒组238.74±15.77mg,53.78%±3.12%;Survivin ASODN组225.61±13.47mg,56.23%±2.60%;基因联合治疗组63.70±3.41mg,87.66%±0.70%.空白对照组与其他3组有显著差异(P<0.05),基因联合治疗组与重组腺病毒组、SurvivinASODN组比较亦有显著性差异(P<0.05).常规病理检查可见肿瘤细胞生长受抑制,特别是基因联合治疗组抑瘤作用最明显,肿瘤组织切片中可见片状坏死区,而且这些区域可见大量炎性细胞浸润.空白对照组、重组腺病毒组、Survivin ASODN组和基因联合治疗组MVD分别为19.25±3.19、11.33±2.46、10.42±2.35、3.33±1.56,空白对照组MVD明显高于其他3组(P<0.05),重组腺病毒组及Survivin ASODN组MVD均显著高于基因联合治疗组(P<0.05).结论 VF/3F启动子驱动的双自杀基因和Survivin ASODN均具有一定的体内抑瘤作用,两者联合应用具有协同作用,对于肿瘤的抑制作用更加显著.     

HLA-G蛋白及基因在子宫内膜异位症在位和异位内膜中的表达

目的 探讨人类白细胞抗原G（HLA-G）基因及蛋白在子宫内膜异位症（EM）在位和异位内膜组织中的表达及其生物学意义。方法 应用免疫组化法和原位杂交法检测38例子宫腺肌症、30例卵巢子宫内膜异位症异位内膜及在位内膜、20例子宫肌瘤患者（对照组）在位子宫内膜中HLA-G蛋白和基因的表达。结果 HLA-G蛋白和基因在子宫内膜异位症患者异位和在位内膜组织中的表达均明显高于对照组（P〈0．01）,但在异位内膜和在位内膜的表达无明显差异（P〉0．05）。HLA-G蛋白在EM不同临床分期的表达无明显差异（P〉0．05）,在增生期和分泌期子宫内膜的表达无差异（P〉0．05）。结论 HLA-G的表达可能与子宫内膜异位症的发病有关。     

血管内皮生长因子和碱性成纤维生长因子在子宫内膜异位症中的表达及临床意义

 目的 探讨有关血管生长因子在血管生成及子宫内膜异位症发生发展中的作用。方法 应用免疫组织化学法分析血管内皮生长因子(Vascular endothelial growth factor,VEGF)、碱性成纤维生长因子(Basic fibroblast growth factor,bFGF)与子宫内膜组织中微血管密度及其阳性表达率的关系。结果 在异位内膜中VEGF、bFGF的阳性表达率分别为75％和63.89％,明显高于正常内膜组42.86％和39.29％(P<0.01,P<0.05)。VEGF、bFGF的阳性表达率在卵巢子宫内膜样囊肿组织、子宫肌腺症组织中无差异(P>0.05)。微血管密度在VEGF、bFGF的阳性组表达明显高于VEGF、bFGF的阴性表达组(P<0.01)。结论VEGF、bFGF与子宫内膜异位症的血管生成密度相关,VEGF、bFGF在子宫内膜异位症的发生发展中发挥作用。     

内皮抑素在兔VX2肝移植瘤介入治疗中的应用价值

目的 探讨内皮抑素在兔VX2肝移植瘤介入治疗中的应用价值.方法 建立兔肝移植瘤模型,随机分为对照组(NS,10只),TACE组(Lipiodol+ADM,10只)和内皮抑素组(Lipiodol+ADM+ES,10只),多排螺旋CT测量肿瘤大小,计算肿瘤增长率(GR);术后1周取出病理标本,利用免疫组化染色及半定量RT-PCR法分别检测残瘤组织微血管密度(MVD)和血管内皮生长因子(VEGF)表达.结果 3组肿瘤增长率分别为对照组(270.86±148.94)%,TACE组(-8.91±21.77)%,内皮抑素组(-20.40±36.07)%,3组间相互比较,对照组呈明显正增长,与其余2组比较差异均有统计学意义(P＜0.01),而TACE组与内皮抑素组之间差异无统计学意义(P＞0.05);各组的MVD值分别为80.00±17.14(对照组)、84.22±16.45(TACE组)和57.00±13.26(内皮抑素组),内皮抑素组MVD值最低,与另外2组比较差异均有统计学意义(P＜0.05),对照组和TACE组之间差异性不明显(P＞0.05);VEGF165 mRNA:对照组为(0.85±0.056),TACE组为(1.10±0.087),内皮抑素组为(0.72±0.065),TACE组表达水平最高,与其余2组比较差异有统计学意义(P＜0.01).结论 兔VX2肝移植瘤的介入治疗中应用内皮抑素后,肿瘤明显缩小,肿瘤组织VEGF的表达减低,MVD的分布减少,提高了肿瘤的治疗效果.     

子宫内膜异位症的MRI诊断

子宫内膜异位症(endometriosis,简称内异症)定义为在子宫腔以外存在有功能的子宫内膜腺体和基质,即相对于在位内膜(eutopic endometrium)存在的异位内膜(ectopic endometrium),子宫腺肌病特指异位内膜组织位于子宫肌层,而内异症一般指除子宫腺肌病以外的内异症.     

β-连接素和生存素在子宫内膜异位症患者异位内膜和在位内膜的表达及意义

目的探讨β-连接素(β-catenin)、生存素(survivin)两种蛋白在子宫内膜异位症(EMs)患者异位内膜和在位内膜的表达、分布及其在EMs发病中的作用与关系。方法应用免疫组织化学法检测31例子宫内膜异位症患者(EMs组)异位内膜和在位内膜及10例非子宫内膜异位症患者(正常对照组)在位内膜中β-连接素、生存素的表达,并检测两者的相关性。结果β-连接素在EMs组囊壁组织、在位内膜中表达的阳性率分别为87.1%(27/31)、83.9%(26/31);生存素在EMs组异位内膜、在位内膜中表达的阳性率分别为90.3%(28/31)、87.1%(27/31);β-连接素、生存素在正常对照组在位内膜表达的阳性率分别为40%(4/10)、30%(3/10)。EMs组异位内膜、在位内膜的β-连接素、生存素表达与正常对照组比较,差异有统计学意义(P<0.05)。EMs组异位内膜、在位内膜中β-连接素与生存素的表达有相关性(r分别为0.850,0.616,P<0.01)。结论子宫内膜β-连接素、生存素的高表达可能在子宫内膜异位症的发病过程中起重要作用。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.