超声对创伤骨科下肢近端急性亚急性深静脉血栓的诊断价值

创伤骨科围手术期下肢深静脉血栓形成临床较常见,而下肢近端急性血栓多发生隐匿,诊断棘手,预后凶险。本组对深静脉血栓形成高危的创伤骨科患者进行围手术期彩色多普勒超声检仓,探讨其在下肢近端急性亚急性深静脉血栓中的诊断价值。     

Vimentin significantly promoted gallbladder carcinoma metastasis

Background  The precise molecular mechanisms underlying the gallbladder carcinoma (GBC) metastasis has not been fully elucidated.

Methods  In the present study, metastasis-associated proteins were identified by comparative proteomic analysis. The functional study of the candidate protein vimentin was further investigated. First, a pair of higher and lower metastatic sublines (termed GBC-SD/M3 and GBC-SD, respectively), originated from the same parental cell line, was screened by spontaneous tumorigenicity and metastasis in vivo in animal study and further characterized by metastatic phenotypes analysis in vitro. Subsequently, a proteomic approach comprised two-dimensional gel electrophoresis analysis and mass spectroscopy was used to identify and compare the protein expression patterns between higher metastatic GBC-SD/M3 and lower metastatic GBC-SD cell lines. Then twenty-six proteins were identified.

Results  Among the 26 proteins identified, fourteen proteins were up-regulated and 12 proteins were down-regulated in GBC-SD/M3. Vimentin was identified and found to be overexpressed in GBC-SD/M3 as compared with GBC-SD. This result was further confirmed by quantitative PCR and Western blotting analysis. Furthermore, the cell migration and invasion potency of GBC-SD/M3 in vitro was remarkably suppressed after small interference RNA-mediated knockdown of vimentin. Moreover, immunoblot and immunohistochemical analysis on 12 human GBC specimens showed consistently increased vimentin expression in metastases compared with primary tumors.

Conclusion  Tumor vimentin level may reflect the pathological progression in some GBC and may be a useful marker for predicting tumor metastasis and a therapeutic target for the treatment of GBC patients with metastases.

     

切除脾血管保留脾脏的胰体尾切除术后胃脾区血流情况的改变

目的 观察切除脾血管保留脾脏的胰体尾切除术后胃脾区血流情况的改变.方法 上海交通大学医学院附属新华医院于2005年7月-2010年3月间对11例患者行切除脾血管保留脾脏的胰体尾切除术,于术后第3、12个月进行上腹部CT血管造影(CTA)成像和纤维胃镜检查,观察脾脏大小、胃食管及周围静脉情况.结果　术后平均随访(37.4±17.7)个月.术后3个月时CTA检查示,脾脏肿大4例(4/11),胃周静脉曲张3例(3/11),胃黏膜下静脉曲张1例(1/11).术后12个月时复查CTA示,4例脾脏肿大患者中,1例缓解,3例基本保持稳定,无新发脾脏肿大;3例胃周静脉曲张患者的情况稳定无进展,无新发胃周静脉曲张;1例胃黏膜下静脉曲张患者的情况稳定无明显进展.术后3个月胃镜检查示胃壁静脉曲张1例,术后12个月复查胃镜示胃壁静脉曲张无进展.结论　切除脾血管保留脾脏的胰体尾切除术后脾胃区血流发生改变,但无证据证实上消化道出血是其远期并发症.     

乙肝疫苗母-婴阻断失败者病毒全基因变异分析

Objective To determine the factors responsible for failed postnatal immunoprophylaxis for hepatitis B virus(HBV) in Qidong, China. Methods Eleven children who developed into chronic HBV infection after receiving HBIG and HBV recombinant vaccines were recruited into the study. Eleven paired mothers with chronic hepatitis and other 6 mothers whose children successfully generated anti-HBs after im-munoprophylaxis were included as the control in the study. Full-length HBV DNA was amplified through ser-um sample by PCR method and underwent cloning and sequencing. HBV DNA level was quantified by real-time PCR. Results The mean levels of HBV DNA in mothers who had HBV DNA positive children and healthy children were ( 1.2 ×107± 3.1 × 106 ) copies/ml and ( 1.6× 107±8.8×106 ) copies/ml, respec-tively. There was no significant difference between the groups (P >0.05). Meanwhile, viral load in chil-dren was unrelated to that in their mothers (r2 =0.2429). In 11 HBV DNA positive children, 4(36.4% ) demonstrated amino acid substitutions in HBsAg "a" determinant region with 6 different types, I.e. T125A, I126T, Q129H, M133V, D144V and G145A. All of the mothers showed the wild-type sequence in "a" epitope, indicating surface escape mutants were not acquired from the initial infection, but developed under the immune pressure. The mutation rates after immunoprophylaxis for preS1, preS2, S, X, preC/C and P genes were 0.38%, 0. 22%, 0.27%, 0.17%, 0.11%, and 0.11%, respectively, nt2999-3157 in preS1, nt529-677 in S, nt1955-2016 in C, nt923-1001 and nt2489-2602 in P genes were among the hottest muta-tional spots throughout the HBV genome. Conclusion HBV mutation may occur in all the open readingframes after passive and active immunoprophylaxis. In addition to S gene, HBV preS and P genes could alsoassociate with the escape mutants.     

她为何不停上厕所

<正>女孩一天反复上厕所达20余次一个表情严肃的母亲带着一个21岁的女孩来到我的诊室。女孩的主要症状是不停地上厕所,自述白天总有尿意,可反复上厕所达20余次,严重影响其白天的学习。每天晚上睡觉前也如此,直到很晚才能睡着,不过,晚上她只起夜两次,睡眠质量还可以。女孩每月来两次月经。母亲已经带这女孩反复     

乙型肝炎表面抗原携带与肝癌关系的前瞻调查

关于自然人群中乙型肝炎表面抗原(HBsAg)携带者和非携带者的前瞻观察调查,国内尚未见报道。自1976年以来,我们对启东县某公社自然人群中的HBsAg携带者进行了前瞻(配对)调查,以验证“大部分肝癌的发生可能都经历     

肝癌高发区乙肝疫苗免疫失败儿童丁型肝炎血清学调查

启东是肝癌高发区,乙型肝炎的发病率也较高。自从1982年对启东地区新生儿进行乙肝疫苗预防接种工作以来,儿童的HHV感染率明显下降,但仍有少数由各种原因引起免疫失败而出现HBsAg阳性的儿童。为了解这些儿童丁型肝炎(HDV)的感染情况,采用酶标法对其进行血清HDAg和抗-HDV测定,并以同龄未接种乙肝疫苗的HBsAg阳性儿童作为对照。另对肝癌患者进行HDV调查,作为启东地区与国内其他地区丁型肝炎发病率的对照比较。     

启东市乙肝干预研究随访人群高血压发生率及与体重指数的关联研究

目的 了解启东市乙肝干预研究队列随访人群体重指数、血压水平的分布特征,探讨两者间的关联,为慢性病预防研究提供基础资料。方法 采用横断面调查方法,在2013年1~10月对启东市乙肝干预研究队列研究对象分层随机抽样,进行问卷调查（社会人口学特征、吸烟饮酒）和体格检查（测量身高、体重、血压）,收集健康体检数据,分析研究对象的性别、体重指数及烟酒嗜好与血压间的关联。结果 本次调查抽样人群8269人,超重率和肥胖率分别为17.90%和5.74%,高血压发生率为14.60%。男性高血压发生率高于女性,差异有统计学意义（P<0.05）。男女性高血压发生率随体重指数的增加而上升,趋势检验差异均有统计学意义（P均<0.05）。吸烟者与饮酒者高血压患病率分别高于不吸烟者和不饮酒者,差异有统计学意义（P<0.05）。结论 结合调查结果,应加强对启东市乙肝干预研究队列青年群体健康宣传教育,倡导健康生活习惯,积极控制超重与肥胖,减少高血压发病风险。     

我们内心的那些伤

三十岁的静文是一家公司的高级白领,在我的一个朋友圈中,她是很受欢迎的一个女性朋友,不仅因为她良好的工作背景和经济条件,而且她的气质和容貌都可以让她成为许多男士心中的理想女人。但是静文始终和朋友圈内的人保持着朋友的关系,从不让自己和其中的任何一位男士有什么感情上的发展,虽然她让许多单身男士爱慕不已。我是已婚人士,加上在朋友中的     

鞘内注射水溶性脂聚体运载NR2B siRNA减轻坐骨神经缩窄性损伤大鼠神经病理性疼痛

脊髓背角N-甲基-D-天冬氨酸受体2B亚基（NR2B）的过度表达在神经病理性疼痛的产生和维持方面起关键作用,利用siRNA抑制NR2B的表达有望成为神经病理性疼痛甚至神经损伤治疗的新途径,然而,目前仍然缺乏NR2B siRNA安全且高效的载体。本实验探讨了低分子量聚乙烯亚胺和胆固醇组成的水溶性脂聚体（WSLP）运载NR2B siRNA治疗大鼠神经病理性疼痛的可行性,以寻找神经病理性疼痛基因治疗的安全且高效的载体。结果发现：WSLP与NR2B siRNA复合物（WSLP/siRNA）鞘内注射后3d,坐骨神经缩窄性损伤导致的神经病理性疼痛大鼠脊髓背角NR2B的基因表达显著下降,转录水平及蛋白水平的表达分别下降59%及54%（P < 0.01）,WSLP/乱序siRNA(scRNA) 及低分子量聚乙烯亚胺/siRNA鞘内注射后NR2B的基因表达无明显变化。WSLP/siRNA鞘内注射后3,7,14及21d神经病理性痛大鼠患足的疼痛程度明显减轻,而注射低分子量聚乙烯亚胺/ siRNA及WSLP/scRNA却无此作用。由此表明,WSLP可有效运载siRNA抑制神经病理痛大鼠NR2B基因的过度表达,从而对神经病理性疼痛大鼠具有治疗作用。