c-Jun氨基末端激酶在烧伤后胰岛素抵抗中作用的实验研究

目的探讨c-Jun氨基末端激酶（c-JunNH（2）-terminal kinase,JNK）在烧伤后胰岛素抵抗中的作用及其机制。方法将24只SD大鼠随机分为对照组、烧伤组和烧伤＋anisomycin组。烧伤组和烧伤＋anisomycin组大鼠制成30％总体表面积（TBSA）三度烧伤模型。烧伤＋anisomycin组大鼠伤后第4天静脉注射anisomycin[5mg／kg,溶于250-二甲基亚砜（DMSO）],其余两组静脉注射250μl DMSO,2h后进行正常血糖高胰岛素钳夹技术实验,然后采集肌肉标本,采用免疫沉淀和免疫印迹观测肌肉组织胰岛素受体底物1丝氨酸307（IRS-1 Ser307）磷酸化和酪氨酸活性变化并观察肌肉组织磷酸化JNK的差异。结果正常血糖高胰岛素钳夹技术实验中对照组、烧伤组和烧伤＋anisomycin组10％葡萄糖输注率（mg·kg^-1·min^-1）分别为12．3±0．4,6．6±0．3,6．5±0．4。烧伤后肌肉组织IRS-1磷酸化丝氨酸307活性明显升高,而IRS-1磷酸化酪氨酸活性明显降低,磷酸化JNK活性升高。结论JNK通过增加烧伤大鼠IRS-1磷酸化丝氨酸307活性,至少部分参与了烧伤后胰岛素抵抗。     

98例成人原发性腹膜后恶性肿瘤的诊治分析

目的探讨成人原发性腹膜后恶性肿瘤（APRMT）的诊断方法和手术经验。方法对1990年1月至2003年4月经手术治疗的98例APRMT患者的临床资料进行分析。结果98例成人原发性腹膜后恶性肿瘤中,肿瘤完全切除79例（80．6％）,姑息性切除16例（16．3％）,肿瘤探查和单纯活检3例（3．1％）,合并脏器切除25例（25．5％）;复发再次手术者28例（28．6％）。肿瘤完全切除的79例患者的1、3、5年生存率分别为93．7％、73．4％和34．2％,姑息性切除的1、3、5年生存率分别为75．O％、6．3％和6．3％。结论联合应用合理的影像学检查对判断APRMT肿瘤周围器官是否受累和切除范围有重要意义,充分的术前准备和受累器官的联合切除可以提高APRMT切除率和预后,对于复发病例,应争取尽早再次手术治疗。     

TNF-α、IL-6与进展期结直肠癌低白蛋白血症的相关性研究

目的:探讨进展期结直肠癌患者血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)与并发低白蛋白血症的关系. 方法:根据血清白蛋白(albumin,Alb)值将59例进展期结直肠癌患者分两组:伴低白蛋白血症(Alb≤35 g/L)组35例和白蛋白正常组(Alb＞35 g/L)患者24例,并以15例健康体检者作为正常对照组,应用双抗体夹心酶联免疫吸附法(ELISA)定量测定各组血清TNF-α、IL-6水平.结果:①病例组患者血清TNF-α和IL-6水平明显高于正常对照组(P=0.001,P=0.034);②肿瘤病例中,低白蛋白血症组血清TNF-α、IL-6水平明显高于白蛋白正常组(P=0.000,P=0.002);③病例组血清Alb与TNF-α、IL-6浓度均呈显著负相关(Alb与TNF-α:r=-0.606,P=0.000;Alb与IL-6:r=-0.439,P=0.001).结论:进展期结直肠癌患者并发低白蛋白血症与血清TNF-α、IL-6浓度的升高相关.     

闪光视觉诱发电位监测甘露醇降颅压效果的临床研究

目的利用闪光视觉诱发电位监测颅内高压患者颅压水平,研究降颅压效果与甘露醇用量以及其他影响因素的关系。方法选择60例颅内高压患者,应用NIP-200型无创颅内压监测仪监测患者每日颅压,计算最高颅压与最低颅压间的差值(降颅压效果),采用多元逐步回归方法分析降颅压效果与性别,年龄,最高颅压时的心率、血压以及降至最低颅压时甘露醇总用量的关系。结果60例患者最低颅压平均值为(213·4±66·8)mmH2O(83·5~364·5mmH2O),患者的颅压水平从入院至最低值时甘露醇总用量的平均值为(1870·8±861·9)ml(375~4000ml)。降颅压效果与最高颅压时的血压(舒张压和收缩压)和心率无相关性(P>0·05),与性别、年龄显著相关(P<0·05),与甘露醇用量显著相关(P<0·01)。结论甘露醇有明显的降颅压作用,但是用到一定的剂量后,便不再有降颅压作用。女性患者比男性患者降颅压的效果好。患者年龄越小,降颅压效果越好。     

食管癌术后经鼻肠管注入中药促进胃肠功能恢复研究

目的 促进食管癌术后患者胃肠功能的恢复.方法 将60例食管癌术后患者随机分为观察组和对照组各30例,对照组经鼻肠管内注入肠内营养液后注入100 ml生理盐水;观察组经鼻肠管内注入肠内营养液后注入150 ml自制中药,1次/d,连续3 d后评价效果.结果 观察组术后首次肛门排气、排便及肠鸣音恢复时间显著早于对照组,血浆胃...     

Does antimicrobial lock solution reduce catheter-related infections in hemodialysis patients with central venous catheters? A Bayesian network meta-analysis

International Urology and Nephrology - The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial lock solutions (ALS) for...     

Fas Ligand gene transfer enhances the survival of tissue-engineered chondrocyte allografts in mini-pigs

BACKGROUND AND PURPOSE: Since the Fas/Fas Ligand (FasL) interaction has been recognized as an apoptotic pathway, it eliminates the activated T cells and promotes the survival of grafts. In this study, the effect of FasL transfection of pig chondrocytes on allogeneic transplantation was examined in vitro and in vivo. METHODS: Chondrocytes were isolated from articular and aural cartilages of anesthetized Guizhou Xiang (Gz) pig. The cells were transfected with G418 selected virus, packed from PA317 cells with a constructed plasmid using pig FasL (pGCEN-FasL). The apoptotic effect of FasL transfection was examined on Jurkat cells and activated recipient Gz T cells. The FasL expression was assessed by Western blot and flow cytometry. FasL+chondrocytes-Pluronic F-127 complex was injected into the right abdomen of recipient Gz pig. Histology and morphology of the engineered tissue were examined after 2 and 5 weeks of transplantation. RESULTS: The FasL expression was confirmed in pGCEN-FasL transfected chondrocytes. The expression of FasL of chondrocytes from Gz pig was analyzed by FACS. The apoptosis of Jurkat cells and activated recipient Gz T cells was increased by co-culture with FasL(+) chondrocytes (53.41% and 30.38% (E/T=10:1), in contrast of 32.27% and 13.16% with the control chondrocytes, respectively, P<0.01). FasL(+) chondrocytes-Pluronic F-127 implant expressed FasL and Type II collagen at the 5th week and survived until the 8th week. INTERPRETATION: The result indicates that the expression of FasL by chondrocytes is capable of inducing apoptosis of activated T cells. This suggests a potential role for allogeneic transplantation with chondrocytes.     

Inhibition of 11beta-hydroxysteroid dehydrogenase enzymatic activities by glycyrrhetinic acid in vivo supports direct glucocorticoid-mediated suppression of steroidogenesis in Leydig cells

Previous studies have suggested that glucocorticoid (GC) can directly affect testicular testosterone (T) biosynthesis by Leydig cells through a receptor-mediated mechanism. Interconversion of corticosterone (CORT), the active form in rodents, and 11-dehydroCORT, the biologically inert 11-keto form, is catalyzed by 11betaHSD1. This enzyme thus controls the intracellular concentration of active GC. We have postulated that elevated CORT levels resulting from stress exceed the Leydig cell's capacity for metabolic inactivation of CORT, resulting in suppressed T production. The present study tested whether inhibition of 11betaHSD1 in vivo, by the administration of glycyrrhetinic acid (GA), increases intracellular active GC concentration and thereby affects serum T concentration and Leydig cell T production. Adult Sprague-Dawley rats were treated with vehicle (corn oil), CORT, GA, or GA + CORT. Serum luteinizing hormone (LH), CORT, and T levels were measured, as were the steroidogenic capacities of purified Leydig cells. Twofold elevations of CORT were achieved by the administration of either CORT or GA alone, but in both cases there was no effect on serum T levels. However, when CORT and GA were administered in combination, serum CORT levels increased 3.5-fold (to 420 +/- 34 ng/mL) and serum T levels were reduced significantly (to 0.72 +/- 0.07 ng/mL; control, 2.12 +/- 0.23 ng/mL). Serum levels of LH were not affected by CORT, GA, or GA + CORT. Consistent with the reduced serum T levels following GA + CORT, steroidogenic enzyme expression and capacities were significantly reduced compared to control. These data support a role for 11betaHSD1 in modulating intracellular CORT concentrations and, in turn, for a direct effect of GC on Leydig cells in response to stress.     

微型钢板螺钉内固定治疗桡骨头粉碎性骨折

目的运用微型钢板螺钉治疗桡骨头粉碎性骨折以改善肘关节功能。方法21例闭合性桡骨头粉碎性骨折,按Morrey改良Mason分型,Ⅲ型骨折15例,Ⅳ型骨析6例,其中4例涉及桡骨颈,合并肱骨内髁骨折6例,尺骨喙突骨折3例,均采用AO微型钢板螺钉进行固定。术后1～3天开始功能锻炼。结果所有病例关节面均获得满意复位。随访9～45个月,平均18.3个月,根据Mackay和Carn疗效评定,优15例、良4例、差2例,优良率98.9%。结论微型钢板螺钉内固定治疗桡骨头粉碎性骨折是一种有效的方法。     

选择性胆道造影在腹腔镜胆囊切除术中的应用体会

目的 评价选择性术中胆道造影在腹腔镜胆囊切除术中的应用价值。方法 腹腔镜胆囊切除术中经胆囊管插管行胆道造影共88例。结果 造影均成功。术中造影发现胆总管结石5例,无胆管损伤。结论 选择性术中胆道造影,对降低胆总管结石残留,避免胆管损伤,提高腹腔镜胆囊切除术的疗效有重要价值。