Pretreatment with recombined human erythropoietin attenuates ischemia–reperfusion-induced lung injury in rats

Objective: Based on the findings that erythropoietin (EPO) has been proved to be a multiple functional cytokine to attenuate ischemia–reperfusion (I/R) injury in various organs such as brain, heart, and kidney in animals, this experiment was designed to evaluate the effect of pretreatment with recombined human erythropoietin (rhEPO) on I/R-induced lung injury. Methods: Left lungs of rats underwent 90 min of ischemia and then were reperfused for up to 2 h. Animals were randomly divided into three experimental groups as sham group, I/R group, and rhEPO + I/R group (a single dose of rhEPO was injected intraperitoneally 3000 U/kg 24 h prior to operation). Lung injury was evaluated according to semi-quantitive analysis of microscopic changes, tissue polymorphonuclear neutrophils (PMNs) accumulation (myeloperoxidase (MPO) activity), and pulmonary microvascular permeability (Evan's blue dying method). Peripheral arterial and venous blood samples were obtained for blood–gas analysis after 5 min occlusion of right lung hilus at the end of reperfusion. The serum concentration of tumor necrosis factor (TNF)- was also measured by the method of enzyme-linked immunosorbent assay. Results: Histological injury scoring revealed significantly lessened lung alveolus edema and neutrophils infiltration in the rhEPO pretreated group compared with I/R group (p < 0.05). The rhEPO pretreated animals exhibited markedly decreased lung microvascular permeability (p < 0.05) and myeloperoxidase activity (p < 0.05). Blood–gas analysis demonstrated that the pretreated animals had significantly ameliorated pulmonary oxygenation function (p < 0.05). The serum concentration of tumor necrosis factor- in rhEPO pretreated group was markedly decreased compared with that of I/R group (p < 0.05). Conclusions: Pretreatment with rhEPO appears to attenuate I/R-induced lung injury. This function is partly related with the capacity that rhEPO inhibits the accumulation of polymorphonuclear neutrophils in lung tissue and decreases the systematic expression of tumor necrosis factor-.     

原位心脏移植30例临床分析

目的对30例心脏移植进行分析总结。方法30例患者中,24例的原发病为扩张型心肌病,4例为终末期瓣膜性心肌病,1例为终末期缺血性心肌病,1例为病毒性心肌炎行双心室辅助术后1个月。均在体外循环下行原位心脏移植术,3例采用标准心脏移植术式,27例采用双腔静脉吻合心脏移植术式,体外循环时间(75±24)min,主动脉阻断时间(72±8)min。术后采用环孢素A、霉酚酸酯和泼尼松预防排斥反应,根据血环孢素A的浓度调整CsA的用量。术后早期,每天行心肌内心电图及超声心动多普勒监测,以便早期发现急性排斥反应,必要时行心内膜心肌活检。结果30例患者中,术后死亡5例,3例死于低心排,1例死于感染所致的多器官功能衰竭,1例死于出血。术后并发症有低心排、心律失常、三尖瓣返流、右心衰竭、细菌和真菌感染、肾功能异常及血糖升高,上述并发症除导致死亡者外,其余经治疗好转;4例发生急性排斥反应,给予甲泼尼龙冲击治疗,并调整免疫抑制剂的用量后排斥反应逆转。结论术后并发症的预防和及时正确的处理,是心脏移植成功的关键,尤其是对感染、急性排斥反应、右心功能不全及肾功能异常的预防和处理。     

Implantation of a colorectal stent as a therapeutic approach in the treatment of esophageal leakage

Background  

While the mortality of esophageal surgery has decreased due to technological advancements, there is still a complication rate of about 30%. One of the main complications is the anastomotic leakage associated with a significant rate of morbidity and mortality. To close the leakage the efficacy of self-expanding stents (SES) has been shown in different studies. However, the high rate of stent migration limits the use of commercial available stents. In our case we were faced with the problem that the diameter of all available stents was too small to attach tightly to the mucosal wall of the esophagogastric anastomosis.     

内脏高敏感与功能性胃肠病

功能性胃肠病(functional gastrointestinal disorders,FGIDs)是指一组以慢性或反复发作的消化道症状就诊,但无明确胃肠黏膜结构改变或生化异常可查的症候群。心理、社会因素可加重FGIDs患者症状,患者可同时伴有躯体症状[1]。其发病机制目前尚不明确,最初该类疾病被认为是胃肠神经官能症,大量的流行病学资料表明,尽管精神压力与患者症状发作有关,但主要还是决定于患者的就医行为。此后,FGIDs发病机制的研究又集中在胃肠动力改变方面,肠易激综合征患者(IBS)、功能性消化不良患者(FD)、非心源性胸痛患者(NCCP)均发现了各种胃肠动力异…     

早期乳腺癌保乳手术247例报告

目的：探讨早期乳腺癌保乳手术的技巧和近期疗效。方法：1995年-2004年收治女性乳腺癌2548例，选择临床0～Ⅱa期、非乳晕区单发肿瘤247例施行保乳手术。对肿瘤直径〈2cm者，行肿瘤局部扩大切除；对肿瘤直径2～3cm者则行象限切除，切缘行冰冻检查，常规腋淋巴结清扫。乳晕部残留腺体作阶梯状对缝。术后胸壁行50Gy放疗，瘤床追加10Gv放疗。腋窝淋巴结阳性及高危病人接受化疗；雌激素受体阳性者接受内分泌治疗。结果：247例手术全部成功，无并发症发生。总保乳率9．7％（247／2548），占同期乳腺癌保乳率22．6％，美容满意率达93．6％。平均随访69个月，随访率74．1％（183／247例）。局部复发率1．63％（3／183例），腋淋巴结复发率1．09％（2／183例），复发时间为术后3年2个月：远处转移率1．09％（2／183例），术后4年半1例肺转移，1例肝转移；随访期中，死亡3例，1例死因为心肌梗死，2例为肺、肝转移；5年无病生存率95．6％（175／183例），总生存率98．4％（180／183例）。结论：乳腺癌保乳手术近期总疗效属满意。     

Isolation and differentiation of embryonic stem cells from BALB/c mouse

Objective To invest the efficient method which can culture and induce embryonic stem cells to neurocyte in vitro. Methods Isolate the blastula of 3.5 d from BALB/c species mouse. Culture the cells from inner cell mass (inner cell mass, ICM) which were isolated by mechanical method on the mouse embryonic fibroblaste cell (MEF) feeder layer or 0.1% gelatin coated dishes. The stem cells were identified by characterized morphology, alkaline phosphatase stain, differential potency in vivo and immunochemistry stain. The isolated cells were differentiated by serial induction method that mimicking the intrinsic developmental process of the neural system. Results The isolated cells were positive for alkaline phosphatatse and SSEA-1 (stage specific embryonic antigen 1). Moreover they were identified pluripotent by differentiation in vivo. Therefore the isolated cells presented the characters of ESCs. Then the isolated cells were able to differentiate into neurocytes in vitro. Conclusion Mouse embryonic stem cells isolation, culture and differentiation system has been established.     

鸡胚第一对弓动脉的发生

用印地安墨汁注入活体鸡胚心脏，在体现显微镜下观察１１２例第１０～２０期鸡胚第一对弓动脉的发生。第一对弓动脉于第１０期出现，至第２０期退化消失。第一对弓动脉出现时尚无相应的第一咽弓，随着第一咽弓的出现，第一对弓动脉的起始端形成一个突入第一咽弓内的动脉瘤样隆起，此隆起随着第一咽弓的增大逐渐发育成一对贯穿第一咽弓的弓状血管。第一对弓动脉可以分为位于第一咽弓内的近侧段和位于此咽弓之外，与背主动脉相连的远侧段。     

医院感染流行病学监测分析

介绍了我院１９９３年７月１日～１９９３年１２月２０日出院的１０３１例病人医院感染病率的监测分析，半年中感染率为８．４％，妇产科疗区发病率高于外科疗区，感染部位以泌尿道、下呼吸道、手术伤口为最多，侵袭性操作及易感因素引起的感染在感染病例中分别占４０．２％和５９．８％。     

4-芳杂环胺甲基酚衍生物的体外抗血小板聚集活性

血小板体内聚集可使心肌微循环功能产生障碍,导致心律失常或心肌梗塞,血小板聚集在心脑血管疾病的发病机理中起着重要作用,因而对抗血小板聚集药物的研究日益引起人们