兔膝关节内注射透明质酸钠后胶原纤维及关节外相关韧带组织的变化

目的:在兔固定的膝关节内定期注入透明质酸钠,观察关节内外组织的变化。方法:实验于2003-10/2004-04在大连医科大学完成。实验分组:新西兰兔24只,随机分为透明质酸钠组、生理盐水组、单纯对照组,每组8只。实验干预:用树脂绷带将兔右膝关节固定于伸直位,膝关节注射部位开窗,左膝自由活动(自身对照侧)。透明质酸钠组膝关节腔内注入透明质酸钠0.1mL,生理盐水组注射同等剂量的生理盐水,单纯对照组不向关节内注射任何药物,每周1次,共5次。实验评估:5周后麻醉下处死动物,去除外固定,采用改良Clarke-Weeknesser关节伸屈范围检查标准测量右膝关节的活动范围;采用改良的Rydell-Balazes肉眼粘连评分标准评估膝关节内纤维粘连情况;光镜下观察股间肌、股直肌、髌内外侧支持带的纤维变性情况。结果:动物饲养过程中死亡4只,进入结果分析透明质酸钠组7只,生理盐水组6只,单纯对照组7只。①右膝关节的活动范围:透明质酸钠组大于生理盐水组和单纯对照组[(37.86±2.94)°,(15.67±2.23)°,(14.29±1.96)°,P<0.01]。②膝关节内纤维粘连评分:透明质酸钠组小于生理盐水组和单纯对照组(1.44±0.49,3.33±0.44,3.44±0.57,P<0.01)。③光镜下透明质酸钠组股间肌、股直肌的纤维变性较生理盐水组和单纯对照组减轻,髌内外侧支持带胶原纤维成分的变化也减轻。结论:在固定的兔膝关节内注射透明质酸钠不但可以明显抑制关节内的纤维性粘连;还可以抑制关节外股间肌、股直肌、髌内外侧支持带的组织变性。     

苏皖地区汉族人群不稳定型心绞痛患者与血小板反应素4基因A387P多态性的关系

目的:观察血小板反应素4基因G29926C(A387P)多态性与中国苏皖地区汉族人群不稳定型心绞痛的可能关系。方法:选择2004-11/2006-05在南京医科大学第一附属医院和江苏大学附属武进医院住院不稳定型心绞痛患者110例,病例均符合2002年AHA/ACC关于不稳定型心绞痛诊断指南的诊断标准,同期选择337例非冠心病者为对照。酚-氯仿法提取白细胞DNA,应用聚合酶链反应-限制性片段长度多态性方法分析血小板反应素4A387P多态性,取部分PCR扩增产物进一步测序鉴定,比较两组间多态性频率分布差异,探讨血小板反应素4基因多态性与不稳定型心绞痛发病的可能关系。结果:447例均进入结果分析。GC基因型在不稳定型心绞痛组和对照组的分布无统计学差异(5.5%,7.1%,P=0.54),未检测到CC纯合子。C等位基因频率在不稳定型心绞痛组和对照组分别为2.7%,3.6%(P=0.55)。GC基因型与不稳定型心绞痛无显著性关联(OR=0.75,95%CI:0.30￣1.89,P=0.54)。结论:血小板反应素4基因387A→P不是中国苏皖地区汉族人群常见的多态位点,且与不稳定型心绞痛的发病无显著相关性。     

Inactivation by acivicin of carbamoyl-phosphate synthetase II of human colon carcinoma

The effect of the anti-tumor, anti-glutamine drug acivicin, L-(alpha S,5S)-alpha-amino-3-chloro-4,5-dihydro-5-isoxazoleacetic acid, was determined on the activity of the rate-limiting enzyme of de novo pyrimidine biosynthesis, carbamoyl-phosphate synthetase II (glutamine-hydrolyzing) (EC 6.3.5.5), in human colon carcinoma. The synthetase II activity in human colon carcinoma was elevated 2- to 3-fold over values of the normal colon mucosa, and the substrate kinetic constants were similar for the enzyme in normal and neoplastic colon. The Km for glutamine was 17 microM (colon carcinoma) and 23 microM (normal mucosa), whereas the Km for ATP was 2.1 and 1.7 mM in tumor and mucosa respectively. The synthetase II activity in colon carcinoma was inhibited to a similar extent by UMP, UDP and UTP (36-41%). The three uracil nucleotides were also equally effective in inhibiting the enzyme from normal mucosa (39-46%). Both enzymes were activated by PRPP (63 and 57%) in mucosa and carcinoma respectively. Acivicin in vitro selectively inactivated the glutamine-dependent synthetase II from human colon carcinoma, and it did not affect the ammonia-dependent activity. The acivicin inactivation constant (Kinact) was 100 microM, and the minimum inactivation half-time (T) was 0.7 min. Acivicin most likely exerts its effect against human colon synthetase II by acting as an active site directed affinity analogue of L-glutamine.     

Peritoneal cystic mesothelioma presenting as a cystic mass in the pelvis: a challenging differential diagnosis

Peritoneal cystic mesothelioma is a relatively rare neoplasm, characterized by cystic lesions of various sizes on both visceral and parietal peritoneal surfaces. When located in the pelvis, a wide spectrum of cystic or multicystic lesions should be included in the differential diagnosis. From an imaging point of view, no definite differential diagnostic suggestions can be made, because reports of peritoneal cystic mesothelioma are few and consist mostly of case reports. The rarity of this disease, as well as its malignant potential, include it among the challenging differential diagnoses of pelvic/peritoneal cystic masses, especially in the case of a paraovarian cyst with identification of ovaries with non-suspect morphology. In this case, repetition of transvaginal ultrasound examination after a few weeks seems to be appropriate. When the findings persist, cystic peritoneal mesothelioma must be included in the differential diagnosis. Nevertheless, it seems that the definitive diagnosis of peritoneal cystic mesothelioma can be made only after surgery. Imaging with ultrasonography and magnetic resonance could play an important role in disease follow-up.     

Haemoptysis in patients with a normal chest radiograph: Bronchoscopy–CT correlation

The exact role of fibre-optic bronchoscopy (FOB) and CT of the chest in the diagnosis of patients presenting with haemoptysis and a normal or non-localizing chest radiograph has not been clearly defined. A study was designed to evaluate 50 patients presenting with haemoptysis and a normal or non-localizing chest radiograph using FOB and high-resolution computed tomography (HRCT). A definitive diagnosis was established in 17 (34%) patients. The aetiologies included bronchiectasis (24%), bronchial adenoma (6%), tuberculosis (2%) and bronchitis (2%). The diagnosis was made by HRCT in 15 (30%) patients, while FOB was diagnostic in five (10%) patients. The diagnosis was made by HRCT and FOB in all patients with focal airway abnormalities. Therefore, HRCT effectively delineated abnormalities of both the central and peripheral airways. It is concluded that CT should be obtained prior to FOB in all patients presenting with haemoptysis and a normal or non-localizing chest radiograph.     

构建大鼠牙胚肾被膜下培养模型及其牙胚组织混合后的成牙能力

目的:通过取孕16d的大鼠牙胚,植入同种异体大鼠肾被膜下,建立牙胚发育、形成的研究模型,人为干预发育中的牙胚,对比、观察该干预对牙胚发育、成牙能力的影响。方法:实验2004-04/08在解放军第四军医大学口腔组织工程中心实验室进行。①牙胚的获取:取孕16d的SD胎鼠的下颌第一磨牙牙胚,随机取分离的磨牙胚4个样本,行常规组织学切片以确定牙胚发育期。其余牙胚分两组:正常组和混合组。混合组将组织剪成4小块,随意混合后组成一个混合牙胚,分别加入DMEM培养液置37℃孵箱中备用。②肾被膜下牙胚植入:取成年雄性SD大鼠10只,采用随机数字表法随机分为正常组和混合组,每组5只,于两组大鼠的肾被膜下分别植入上述两组牙胚。③8周时取植入物,常规进行大体及牙胚植入前、后组织学观察。结果:10只大鼠进入结果分析。①两组大鼠牙胚植入后大体观察:牙胚植入肾被膜下后可继续发育,8周时正常组形成类似于正常天然牙齿样的形态和组织结构,混合组则形成不完整的类牙样结构。②牙胚植入前及植入后组织学观察:植入前牙胚处于帽状发育期;植入后正常组形成类似于天然牙有序排列的组织结构;而混合组形成类牙样结构,与正常组有一定差别。结论:以肾被膜下为大鼠牙胚培养环境,成功建立了牙胚继续发育、牙齿形成的研究模型。该模型便于牙齿发育形成过程中人为干预的实施和观察。人为干扰后,牙胚能继续发育,形成类牙样结构。