三日龄大鼠缺氧缺血性脑损伤对大脑MRI影像和学习记忆能力的远期影响

Objective To investigate the activation of apoptotic genes of the brain with hypoxia- ischemia (HI) in newborn SD rats, and MRI changes and memory and learning ability in adulthood. Methods HI was induced by right carotid artery ligation followed by 2.5 h of hypoxia (6% O2) on 3-day-old SD rats (n=36). Control pups were sham-operated (n = 27). Right brain hemisphere was collected at 12 h and 7 d after HI and subjected to an apoptosis Oligo GEArrayR. MRI and Morris water maze test were performed on both groups at 42 and 44 days old, respectively. Results Comparing to 12 h after HI, up-regulated apoptotic genes included TNF, Caspase and pro-apoptotit genes of Bcl2 families, whereas the anti-apoptotic genes of Bcl2 family were down-regulated at 7 d after HI. The MRI assessment of the rats in HI group demonstrated that the area of the right cerebra l cortex was significantly smaller than the left side and control [periventricular layer: (23.5±3.6) mm2 vs (33.0±4.3) mm2, (34.5±3.9) mm2; hippocampus layer: (18.9±4.4) mm2 vs (29.1±5.0) mm2,(30.8±4.5) mm2, both P<0.01]. During the navigation trial, the HI rats demonstrated longer escape latency (4th day: (52.7±35.9) vs (17.8±8. 9) s, P<0.01). HI rats passed the platform less times than the control ones (T= 292.5, P<0.05) in space probe trial. Conclusions The activation of apoptotic genes induced by HI brain injury remains until 7 days later, involving intrinsic and extrinsic apoptotic pathway. The apoptosis of neural cells may lead to poor development of the cortex and impair the memory and learning ability in the adult rats after neonatal hypoxia- ischemia injury.     

抑郁症气虚证候模型小鼠的药物反证与分子信号研究

对Balb/c小鼠在单独抑郁症疾病造模条件下的气虚证候表现进行方药反证,并探究病证相关的分子生物学基础。方法 对Balb/c雌性小鼠进行慢性不可预知轻度应激（CUMS）造模,通过旷场、糖偏好、新奇环境摄食等评判其抑郁样疾病表现,通过负重游泳、掌纹血色度、抓力、皮毛评分等评判气虚样表现,给予补气经典方四君子汤进行方药反证并观测病证疗效,用Western blot法检测各组海马与肌肉组织中PKA、p-CREB的表达变化。结果 四君子汤改善模型小鼠抓力下降、负重游泳时间减少、皮毛评分增加的气虚样证候,也逆转了糖偏好下降等抑郁样表现,而且逆转模型动物海马和肌肉PKA、p-CREB表达的下调。结论 在CUMS下Balb/c小鼠产生抑郁症样行为及气虚样证候,均被补气方药四君子汤的疗效所反证,这可能是通过改善外周和脑PKA-CREB信号通路发挥作用。结果支持Balb/c小鼠的气虚证候易感的特性和辨证论治治疗疾病的有效性。     

Miles会阴切除术的技术改进

目的探讨肛管直肠癌会阴切除术(PR)的技术改进方法和临床应用价值。方法对126例按常规进行腹会阴联合根治术(APR,常规手术组)和153例按技术改进方法(技术改进组)进行手术的病例资料进行回顾性分析。结果常规手术组术中、术后大出血12例(9.5%),技术改进组3例(2.0%)。常规手术组术中切破肠壁27例(21.4%),切破肿瘤19例(15.1%),输尿管损伤4例(3.2%),前列腺损伤11例(8.7%),后尿道损伤5例(4.0%);技术改进组术中切破肠壁7例(4.6%),切破肿瘤5例(3.3%),无输尿管损伤,前列腺损伤4例(2.6%),无后尿道损伤。常规手术组死亡1例;技术改进组无死亡者。常规手术组会阴切口延迟愈合49例(38.9%),局部复发16例(12.7%);技术改进组会阴切口延迟愈合22例(14.4%),局部复发11例(7.2%)。两组术后并发症发生率比较差异有显著性意义(P<0.01)。结论PR技术改进可降低术后各种并发症的发生率。     

马凡综合征并巨大腹主动脉瘤的诊治--附1例报告

马凡综合征(Marian syndrome)是一种少见的常染色体显性遗传病，病变侵犯全身结缔组织，主要累及眼部、骨骼和心血管系统。其血管方面的病变多限于升主动脉到无名动脉近端，很少发生在腹主动脉。我院收治了1例马凡综合征合并巨大腹主动脉瘤患者，成功为其实施了人造血管植入术，现报告如下。     

门静脉血细胞角蛋白20 mRNA检测对结肠癌肝脏微转移的诊断意义

目的:研究结肠癌患者门静脉血细胞角蛋白20(CK20)mRNA对肝脏微转移的诊断价值。方法:采用RT-PCR技术对31例结肠癌患者的门静脉血进行检测。结果:结肠癌患者中CK20 mRNA阳性率为26%,本组随访时间6～32个月,平均(18.5±10.6)个月。术中1例患者出现肝转移并且门静脉血CK20为阳性,术时无肝脏转移而门静脉血CK20阳性的7例中3例出现肝转移,术时无肝转移和门静脉血CK20阴性的23例患者中2例(9%)出现肝转移。结论:结肠癌患者术中门静脉血CK20 mRNA的检测对于了解预后和指导治疗有着重要的参考价值。     

不同呼气末正压对手足口病并神经源性肺水肿机械通气患儿的效果及对中心静脉压的影响

目的探讨机械通气治疗手足口病并神经源性肺水肿患儿的效果,探讨呼气末正压的选择,以及其对循环的影响。方法回顾性分析了2011年3月至2011年12月我院PICU成功救治的32例手足口病并发神经源性肺水肿、肺出血患儿,经口气管插管,机械通气,选择压力控制通气模式,加用呼吸末正压。结果 32例患儿均抢救成功。机械通气时间3d 11h～18d 8h。结论机械通气治疗手足口病并神经源性肺水肿,能够迅速改善患儿症状和低氧血症,适当的呼吸末正压选择能显著降低死亡率,是一种必要、有效、安全的治疗方法,但对患儿循环有明显影响,尤其是对中心静脉压（CVP）影响较大。     

定量RT-PCR检测结肠癌患者门静脉血CK20 mRNA的表达

目的 检测结肠癌患者门静脉血中细胞角蛋白20（CK20）mRNA的表达水平,并探讨其临床价值。方法 采用实时荧光定量RT-PCR检测31例病理学确诊的结肠癌患者门静脉血和20例健康对照者外周血CK20mRNA的表达水平。结果 结肠癌患者中CK20mRNA阳性率为25.81%,而对照组阳性率为5%,两者相比差异有统计学意义（P〈0.025）。随着临床分期的具体化,患者门静脉血中CK20mRNA表达率随之提高,但各分期间阳性率相比无显著统计学意义（P〉0.05）。DukesLC期与D期患者中〉10拷贝/ml者高于A期与B期患者。结论 术中检测结肠癌患者门静脉血CK20mRNA表达水平,对判断肝脏微转移有一定的提示意义。     

三日龄大鼠缺氧缺血性脑损伤对大脑MRI影像和学习记忆能力的远期影响

Objective To investigate the activation of apoptotic genes of the brain with hypoxia- ischemia (HI) in newborn SD rats, and MRI changes and memory and learning ability in adulthood. Methods HI was induced by right carotid artery ligation followed by 2.5 h of hypoxia (6% O2) on 3-day-old SD rats (n=36). Control pups were sham-operated (n = 27). Right brain hemisphere was collected at 12 h and 7 d after HI and subjected to an apoptosis Oligo GEArrayR. MRI and Morris water maze test were performed on both groups at 42 and 44 days old, respectively. Results Comparing to 12 h after HI, up-regulated apoptotic genes included TNF, Caspase and pro-apoptotit genes of Bcl2 families, whereas the anti-apoptotic genes of Bcl2 family were down-regulated at 7 d after HI. The MRI assessment of the rats in HI group demonstrated that the area of the right cerebra l cortex was significantly smaller than the left side and control [periventricular layer: (23.5±3.6) mm2 vs (33.0±4.3) mm2, (34.5±3.9) mm2; hippocampus layer: (18.9±4.4) mm2 vs (29.1±5.0) mm2,(30.8±4.5) mm2, both P<0.01]. During the navigation trial, the HI rats demonstrated longer escape latency (4th day: (52.7±35.9) vs (17.8±8. 9) s, P<0.01). HI rats passed the platform less times than the control ones (T= 292.5, P<0.05) in space probe trial. Conclusions The activation of apoptotic genes induced by HI brain injury remains until 7 days later, involving intrinsic and extrinsic apoptotic pathway. The apoptosis of neural cells may lead to poor development of the cortex and impair the memory and learning ability in the adult rats after neonatal hypoxia- ischemia injury.     

外周血PIP mRNA与乳腺癌预后因素的相关性研究

目的探讨泌乳素诱导蛋白（PIP）mRNA对估计乳腺癌预后的临床价值。方法用逆转录-聚合酶链式反应（RT-PCR）法,检测121例乳腺癌患者外周血中PIP mRNA表达情况,另抽取30例乳腺良性疾病患者外周血标本作为对照组。结果 121例乳腺癌患者外周血中PIP mRNA有38例表达,阳性率为31.4%,对照组中PIP mRNA表达为阴性。两组比较差异有显著性（P〈0.05）。PIPmRNA阳性表达与患者的淋巴结转移状况、原发肿瘤大小、分期、病理分级显著相关（P〈0.05）;而与患者的年龄、病理类型、ER、PR等无显著相关（P〉0.05）。结论外周血PIP mRNA阳性表达与乳腺癌不良预后有关。