下颌骨滤泡树突细胞肉瘤1例报道并文献复习

目的:探讨下颌骨滤泡树突细胞肉瘤(FDCS)的诊断与治疗。方法:报道1例发生于下颌骨的FDCS患者,通过问诊及专科查体,结合放射线、CT检查及病理检查,分析该病例的诊断和治疗,并对相关文献进行回顾。结果:手术采取在肿瘤外1.5cm截骨,并配合放疗,该患者经5年复诊未见复发。结论:初步明确下颌骨FDCS的诊断方法,确诊必须依靠免疫组化,主要特征为CD21(+),CD35(+),治疗应采取手术为主的综合治疗。     

α-亚麻酸对高糖导致的人脐静脉内皮细胞损伤的影响

目的观察α-亚麻酸（ALA）对高糖导致的人脐静脉内皮细胞（HUVECs）损伤的影响,探讨ALA在糖尿病血管并发症防治中的作用。方法采用体外培养的第24代HUVECs,分为6组,即正常对照组、高糖组（HG组）及HG+ALA（ALA浓度分别为10、50、100和200μmol/L）组。各组细胞于不同培养环境中培养72h后收集标本,用MTT比色法测定细胞活力,通过测定细胞上清液中一氧化氮（NO）和丙二醛（MDA）含量评估内皮功能,末端脱氧核糖核酸酶介导的dUTP末端标记法（TUNEL法）和流式细胞仪法检测细胞凋亡情况。结果较低浓度（10、50、100μmol/L）的ALA组中,细胞存活率和合成NO浓度均显著高于高糖组（P<0.05）,MDA浓度和细胞凋亡率显著低于高糖组（P<0.05）;尤以50μmol/L时为著。当ALA浓度增至200μmol/L时,细胞存活率和合成NO浓度反而低于高糖组,MDA浓度和细胞凋亡率也较高糖组进一步增加。结论ALA对高糖环境下培养的内皮细胞有着双重效应,既有保护作用也有细胞毒效应,与其浓度有关。     

罗格列酮对大鼠颈动脉球囊损伤后平滑肌细胞增殖和调亡的影响

目的观察罗格列酮对大鼠颈动脉损伤后平滑肌细胞增殖和凋亡的影响。方法SD大鼠随机分为3组,即对照组、手术组、治疗组。手术组及治疗组均给予左侧颈总动脉球囊损伤,治疗组给予罗格列酮灌胃治疗。术后2周取损伤血管行HE染色及光镜观察,计算内膜面积（NIA）、内弹力板围绕面积（IELA）及管腔狭窄指数（SI）。免疫组化法检测平滑肌细胞增殖率,Tunnel法检测平滑肌细胞凋亡率。结果术后2周,手术组内膜面积、管腔狭窄指数显著高于对照组（P<0.01）;经治疗后,治疗组内膜面积、管腔狭窄指数显著低于手术组（P<0.01）。手术组细胞增殖率显著高于对照组（P<0.01）,而治疗组细胞增殖率显著低于手术组（P<0.01）。手术组细胞凋亡率显著低于对照组（P<0.01）,而治疗组细胞凋亡率显著高于手术组（P<0.01）。结论罗格列酮可以促进血管平滑肌细胞凋亡,抑制其增殖,从而减轻损伤血管的再狭窄。     

人工晶状体置换原因临床分析

目的分析人工晶状体(IOL)置换的原因及预防对策。设计回顾性病例系列。研究对象2012年4月至2013年5月在北京大学第三医院眼科因各种原因行IOL置换者28例(28眼)。方法对患者的既往病史、IOL置换原因、IOL及囊袋情况进行描述性归纳分析,计算IOL置换原因构成比。针对不同原因研究预防对策。主要指标患者的既往病史、IOL置换原因、IOL及囊袋情况。结果 IOL置换原因包括:前房型IOL致大泡性角膜病变10眼(35.70%)。IOL脱位14眼(50.00%),其中IOL脱位于玻璃体10眼(35.70%),高度近视囊袋半脱位2眼(7.14%),脱位于玻璃体伴有缺血性视神经病变2眼(7.14%)。屈光异常2眼(7.14%),包括儿童IOL植入术后高度近视1眼(3.57%),高度近视IOL测量错误1眼(3.57%)。激光导致IOL损伤2眼(7.14%)。预防措施包括提高手术技巧,减少术中瞬间高眼压,较少悬韧带损伤,减少后囊破裂几率,掌握后囊破裂后IOL植入指征,正确计算IOL度数,提高儿童白内障术后近视控制技术,避免植入房角固定型前房IOL等。结论 IOL置换原因以前房型IOL导致大泡性角膜病变和IOL脱位为多。提高手术技巧,避免植入房角固定型前房IOL等可有助于减少IOL置换的发生。     

慢性阻塞性肺疾病患者呼吸衰竭有创机械通气治疗研究

目的探讨慢性阻塞性肺疾病(COPD)患者呼吸衰竭有创机械通气治疗策略,提高抢救成功率。方法选择2010年1月-2014年2月机械通气治疗COPD发生呼吸衰竭患者110例,对其进行气管插管、有创机械通气等治疗,分析机械通气治疗结果,并及时判定COPD呼吸衰竭急性加重病因,预防医院感染,数据采用SPSS17.0统计软件处理。结果 110例患者中成功脱机、拔管、康复出院106例,治疗成功率为96.36%;上机时间为(7.2±2.2)d;脱机成功者机械通气前后72h血气有明显改善,差异有统计学意义(P<0.05);13例经序贯通气(有创通气转无创通气)达到康复,直接脱机93例与无创通气辅助13例脱机前各种临床指标:急性生理与慢性健康评分(APACHEⅡ)、N末端B型脑钠肽前体(NT-proBNP)、浅快呼吸指数(RSBI)比较差异有统计学意义(P<0.05);呼吸、心率、机械通气时间比较差异也有统计学意义(P<0.05)。结论对慢性阻塞性肺疾病(COPD)发生呼吸衰竭患者采取恰当机械通气策略,能提高临床抢救成功率。     

三维适形放射治疗挡铅射野质量保证的方法探讨

目的:探讨MatriXX 2D矩阵电离室和X线模拟定位机应用于挡铅射野质量保证的方法及可靠性.方法:用MatriXX 2D矩阵电离室测得挡铅射野的形状和大小,应用Matlab编程绘制出治疗计划系统(treatment plan system,TPS)中相对应的射野的形状和大小;利用X线模拟定位机拍摄出射野挡铅的验证片并通过计算机上的RT PACS获取保存,对尺寸较大的射野,使用Photoshop图像处理软件合成出包含挡铅射野全部信息的验证片;从TPS调出相对应的包含挡铅射野信息的数字重建影像(digital reconstruction radiography,DRR).分别比较2对图片包含的射野信息.结果:对60个所测挡铅射野和计划射野进行比较,发现2种射野的形状总体上相符,3种方式的误差分别为(1.71±0.84)、(2.32±0.31)和(2.89±0.47)mm.结论:利用MatriXX 2D矩阵电离室和X线模拟定位机进行挡铅射野质量保证,简单易行、快速有效,能够满足放疗质控中对射野挡铅的要求.     

Down-regulation of microRNA-30d-5p is associated with gestational diabetes mellitus by targeting RAB8A

Gestational Diabetes Mellitus (GDM) is a complicated clinical process, and metabolic disorders during pregnancy are closely related to the structure and function of the placenta. The aberrant expression of miRNAs in the placenta may play a role in the occurrence and development of GDM. Analysis of microRNA (miRNA) expression signature in placenta showed that the level of miR-30d-5p was significantly down-regulated in GDM patients. This study aims to explore the possible mechanism of GDM under the regulation of miR-30d-5p. In situ hybridization and qRT-PCR assay showed that miR-30d expression down-regulated in the placentas from GDM patients compared with normal control group. The trophoblast cells proliferation and glucose uptake capacity were increased, the ability of migration and invasion were also improved after inhibiting the function of endogenous mature miR-30d-5p. Bioinformatics analysis and luciferase reporter assays showed that miR-30d-5p binds to the 3′UTR of RAB8A mRNA, resulting in RAB8A suppression. Moreover, the down-regulation of RAB8A could attenuate the increase in trophoblast cell proliferation, migration, invasion and glucose uptake induced by miR-30d-5p functional inhibitor. These data imply that miR-30d-5p expression is down-regulated in placental tissue from GDM patients and affects trophoblast cell functions by targeting RAB8A, which may provide new insight into the pathogenesis of GDM.     

基于过敏性疾病和健康儿童的淋巴细胞精细分型病例对照研究

背景：过敏性疾病的诊断缺乏明确的检测标准,主要依赖于病史,在无过敏原刺激情况下则无临床症状,诊断更加困难,寻找辅助诊断过敏标志物显得非常重要。 目的：检测过敏儿童淋巴细胞精细分型特征,期望对过敏性疾病的诊断提供新的标志物。 设计：病例对照研究。 方法：选择食物和呼吸道过敏儿童作为过敏性疾病组,选择与过敏性疾病组同时期在医院健康体检正常、性别和年龄匹配的儿童为健康对照组。采用流式细胞术分析对其淋巴细胞精细分型进行检测。 主要结局指标：淋巴细胞精细分型。 结果：过敏性疾病组30例,平均年龄3.6（0.7~10.6）岁;健康对照组27名,平均年龄4.1 (0.8~11) 岁。两组年龄、性别差异无统计学意义（P分别为0.616和0.574）。T淋巴细胞精细分型：Th2细胞占效应辅助性T细胞比例和Th2/Th1比值过敏性疾病组高于健康对照组［（31.34±2.52）% vs (20.02±2.05)%,（6.86±1.51） vs (2.73±0.35)］,差异均有统计学意义。B淋巴细胞精细分型：成熟B细胞比例及绝对计数、浆母细胞绝对计数、IgE+浆母细胞比例、IgE+记忆B细胞比例,过敏性疾病组均高于健康对照组［(11.53±1.22) % vs (6.02±0.52）%,(1 068±107.3)个/μL vs (578.74±58.49）个/μL ,(40.71±6.44) 个/μL vs ( 17.08±2.93)个/μL ,(8.21±1.33) % vs (1.64±0.53）%,(4.48±0.81) % vs (0.47±0.18）%。 结论：过敏儿童Th2细胞、IgE+浆母细胞和记忆B细胞比例增高,有潜力作为辅助诊断过敏性疾病的标志物。     

Modulation of multidrug resistance by andrographolid in a HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line

OBJECTIVE To develop an HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line and to elucidate the effect of Andrographolid (AG), an extract from Andrographis paniculate, a medicinal herb on the HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line. METHODS An HCT‐8 colorectal cancer cell line was used and a high concentration of 5‐Fluorouracid (5‐FU) was introduced at the beginning to induce drug resistance, then the concentration of 5‐FU was increased in gradients. Approximately 7 months later, the cells grew stably in 2.0 µg/mL of 5‐FU, and the cell line was named HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line. The resistant index of HCT‐8/5‐FU cells to 5‐FU, adriamycin (ADM), cisplatin (DDP) was checked by MTT test, and a growth curve was drawn. The morphological changes were observed by both light and electron microscope. The function of P‐170 was detected by rhodamine staining. After the application of AG and co‐administration of 5‐FU, ADM and DDP, the growth curves and inhibition rate as well as apoptosis rate of HCT‐8/5‐FU at different concentrations of AG were evaluated by MTT and flow cytometry. Rhodamine staining was used to investigate the possible mechanism involved by AG. RESULTS The resistance index of HCT‐8/5‐FU to 5‐FU was 16.6, and a cross‐resistance to ADM and DDP was noticed. Compared with parental cells, HCT‐8/5‐FU cell's growth rate did not change significantly but the cell's morphology was remarkably changed as compared with parental cells. Overexpression of P‐170 by HCT‐8/5‐FU cell was indicated through rhodamine staining. AG at a low concentration showed weak inhibitory effect on HCT‐8/5‐FU. However, a remarkable inhibitory and apoptosis rate was shown when AG was co‐administered with 5‐FU, ADM and DDP, respectively. Interestingly AG alone could not induce apoptosis and change the cell cycles. AG might affect the expression of P‐170, which was indicated by rhodamine staining. CONCLUSIONS The HCT‐8/5‐FU multidrug‐resistant colorectal cancer cell line has been successfully developed and because it has cross‐resistance to 5‐FU, ADM and DDP, it might serve as an ideal multidrug resistance (MDR) model for colorectal cancer research. The mechanism of HCT‐8/5‐FU resistance to chemotherapeutic agents might be related to the overexpression of P‐170. Low concentrations of AG alone have no significant inhibition on HCT‐8/5‐FU and fail to induce apoptosis and to change cell cycles. AG might act as a chemosensitizer when co‐administered with 5‐FU, ADM and DDP, and the mechanism of reversal modulation of multidrug resistance by AG in the HCT‐8/5‐FU resistant cell line might be related to its downregulation of overexpression of P‐170.     

一氧化氮、醛固酮对高血压左室肥厚及左室舒张功能的影响

目的:探讨一氧化氮(NO)、醛固酮(ALD)在高血压左室肥厚(LVH)形成中的作用及对左室舒张功能的影响。方法:以超声心动图检查55例原发性高血压(EH)患者和30例正常人并计算左室重量指数(LVMI),测定左室舒张功能等指标,并测定空腹血清NO、ALD水平,进行组间比较。结果:EH组与正常人相比NO水平降低、ALD 水平升高,左室舒张功能降低(P均<0.01)。EH-LVH组与EH组相比NO水平降低、ALD水平升高更明显(P< 0.01)。NO、ALD与LVMI相关系数(r)分别为-0.46和0.50(P<0.05)。NO、ALD与左室舒张指标E/A和PFR/ PAFR的,r分别为0.37、0.43、-0.42、-0.37(P<0.05)。结论:原发性高血压患者NO、ALD水平与LVMI和左室舒张功能减退呈显著相关性。