脊柱椎弓根内固定系统治疗胸椎骨折脱位

目的探讨胸椎骨折脱位的临床特点及应用脊柱椎弓根内固定系统的治疗作用。方法11例胸椎骨折脱位患者,损伤部位为T3—T9;损伤类型为脱位5例,爆裂骨折3例,爆裂脱位2例．压缩骨折1例。在行椎弓根内固定撑开复位的同时,采取经后人路环行减压、植骨术。以达到彻底椎管减压及维持脊柱的稳定性。结果全部11例获得随访,时间4—29个月,平均蚧月,按Frankel分级,改善1级者4例,无恢复者7例。结论脊柱椎弓根内固定系统配合后路环行减压、植骨对胸椎骨折脱位具有较好的疗效。脊柱椎弓根内固定系统手术操作简单,固定可靠,可重建脊柱的稳定性,适用于胸椎骨折脱位的治疗。     

Expression of the GLUT1 glucose transporter and p53 in carcinomas of the pancreatobiliary tract

Only few studies have evaluated the usefulness of the GLUT1 and p53 status of pancreatobiliary tract carcinomas in revealing tumorigenesis. We studied GLUT1 and p53 immunoexpression in a total of 355 cases of the pancreatobiliary carcinoma to determine the biological significance of GLUT1 and p53 expression. Positive expression of GLUT1 was identified in 38 out of 67 (57.7%) ampulla of Vater (AV) carcinomas, in 27 out of 52 (51.8%) pancreatic (PA) carcinomas, in 38 out of 121 (31.4%) extrahepatic bile duct (EBD) carcinomas, and in 53 out of 115 (46.5%) gallbladder (GB) carcinomas. GLUT1 expression in pancreatobiliary carcinomas showed some positive correlation with histological grade, T stage, N stage, TNM stage, and lymphatic invasion. However, p53 expression showed no correlation with any prognostic factors. In the Kaplan–Meier test, positive GLUT1 expression was a poor prognostic factor in the pancreatobiliary tract cancers; however, only GB cancers were statistically significant (P=0.002). Our results suggest that GLUT1 expression in the AV, EBD, and GB carcinomas is associated with some prognostic factors, and GLUT1 expression is associated with a worse prognosis in the patients with GB carcinomas.     

Correction to: Effect of JAK inhibitors on high- and low-density lipoprotein in patients with rheumatoid arthritis: a systematic review and network meta-analysis

Clinical Rheumatology -     

Genetic modification of mesenchymal stem cells to express a single‐chain antibody against EGFRvIII on the cell surface

Human adult mesenchymal stem cells (hMSCs) are under active investigation as cellular carriers for gene therapy. hMSCs possess natural tropism toward tumours; however, the targeting of hMSCs to specific cell populations within tumours is unexplored. In the case of glioblastoma multiforme (GBM), at least half of the tumours express EGFRvIII on the cell surface, an ideal target for antibody‐mediated gene/drug delivery. In this study, we investigated the feasibility of genetically modifying hMSCs to express a single‐chain antibody (scFv) to EGFRvIII on their surfaces. Nucleofection was used to transfect hMSCs with cDNA encoding scFv EGFRvIII fused with PDGFR or human B7‐1 transmembrane domains. The expression of scFv EGFRvIII on the cell surface was assessed by FACS. A stable population of scFv EGFRvIII‐expressing hMSCs was selected, based on antibiotic resistance, and enriched using FACS. We found that nucleofection allows the efficient expression of scFv EGFRvIII on the cell surface of hMSCs. hMSCs transfected with the construct encoding scFv EGFRvIII as a fusion with PDGFRtm showed scFv EGFRvIII expression in up to 86% of cells. Most importantly, human MSCs expressing scFv against EGFRvIII demonstrated enhanced binding to U87‐EGFRvIII cells in vitro and significantly increased retention in human U87‐EGFRvIII‐expressing tumours in vivo. In summary, we provide the first conclusive evidence of genetic modification of hMSCs with a single‐chain antibody against an antigen expressed on the surface of tumour cells, thereby opening up a new venue for enhanced delivery of gene therapy applications in the context of malignant brain cancer. Copyright © 2009 John Wiley & Sons, Ltd.     

脾脏炎性假瘤9例临床与病理分析

目的探讨脾脏炎性假瘤的临床及病理学特征、诊断要点和鉴别诊断。方法对9例脾炎性假瘤进行临床及病理分析,并复习了有关文献。结果本组男6例,女3例。年龄43~74岁,平均58.9岁。主要症状为间断性发热,上腹疼痛。影像学检查提示脾脏有边界清楚的占位性病变。肿瘤最大者18 cm×16 cm×10 cm,最小者3.2 cm×3 cm×2.8 cm。1例呈多发性结节,8例呈局限性肿块。组织学分型:浆细胞肉芽肿型4例,纤维增生型2例,淋巴细胞增生型3例。结论脾炎性假瘤是一种比较少见的肿瘤,具有组织病理形态多样性表现特点,诊断须与脾脏其他恶性肿瘤进行鉴别。     

我院门诊抗抑郁药物的使用现状及趋势分析

目的了解门诊抗抑郁药物的使用现状及发展趋势。方法对2004～2006年中国人民解放军总医院门诊抗抑郁药物用药金额、用药频度（DDDs）及日均费用等进行统计，并对2006年6月份来门诊诊疗的抑郁症患者的处方进行整理并分析。结果2005年门诊抗抑郁药的销售金额与DDDs比2004年分别增长了148．8％和103、3％，2006年比2005年的均有所下降。连续两年增幅较大的是西酞普兰和舍曲林。结论门诊抗抑郁药的使用量呈逐年上升趋势，其中选择性5-羟色胺再摄取抑制剂氟西汀、帕罗西汀等在门诊治疗抑郁症中起着举足轻重的作用。     

老年抑郁症及其药物治疗进展

目的阐述老年抑郁症的发病机理及其目前的药物治疗进展。方法查阅分析和归纳近年来国内外相关文献。结果与结论老年抑郁症具有病因复杂、不易被察觉和并发症多等特点，可针对患者特点选取不同的药物治疗，要遵从从低剂量开始缓慢加至常规治疗量和长期治疗以预防复发的治疗原则。     

神经生长因子对失神经状态下大鼠骨折愈合的影响?

目的:探讨神经生长因子(NGF)对脊髓完全横断伴胫骨骨折大鼠骨折愈合的影响.方法:120只SD大鼠随机分成3组:胫骨骨折组(F组,n=40),T10 脊髓完全性损伤合并胫骨骨折组(FS组,n=40),T10 脊髓完全性损伤合并胫骨骨折应用神经生长因子治疗组(FSN组,n=40).FS组及FSN组大鼠建立T10脊髓完全横断伴胫骨骨折模型,F组制备单纯胫骨骨折,伤后第4周对3组大鼠骨折断端行断层CT扫描,测量骨折断端最大横截面并计算骨痂灰度值;行生物力学三点弯曲试验;行骨组织形态计量学检查;骨密度测定;骨痂组织形态学观察;免疫组化法测定骨痂组织中骨钙素(OCN)的表达;观察3组大鼠骨痂中成骨细胞的超微结构变化;Western印迹检测Ⅰ、Ⅱ型胶原的表达.结果:F组骨痂断面最大直径明显小于FS组(P＜0.01)和FSN组(P＜0.05),FSN组小于FS组(P＜0.05);骨痂灰度值结果类似.三点折弯试验、骨计量学观察均发现F组各项生物力学参数优于其他2组(P＜0.05);FSN组优于FS组(P＜0.05).F组大鼠胫骨骨痂中OCN及Ⅰ型胶原蛋白表达明显高于其他2组(P＜0.05),FSN组高于FS 组(P＜0.05);而F组骨痂Ⅱ型胶原蛋白的表达明显低于FS组及FSN(P＜0.05),FSN组亦高于FS组(P＜0.05).形态学及超微结构观察见F组骨折愈合最佳,FSN组优于FS组.结论:失神经营养会影响骨折断端的骨化;神经生长因子对失神经状态下骨折断端的骨化有促进作用.     

骨巨细胞瘤中骨桥蛋白的表达及临床意义

目的:观察骨桥蛋白(osteopontin,OPN)在骨巨细胞瘤肿瘤组织中的表达并探讨其可能的临床意义.方法:EnVisionTM二步法检测77例骨巨细胞瘤患者肿瘤组织中OPN的表达,比较不同临床、病理指标骨巨细胞瘤患者间OPN的表达差异,分析其可能的临床意义.结果:OPN在骨巨细胞瘤中表达的阳性率为76.6%,而在正常骨组织中呈弱阳性表达.侵袭性骨巨细胞瘤OPN阳性表达率明显高于非侵袭性骨巨细胞瘤,差别具有统计学意义(95.5% vs 69.1%, P=0.013).OPN在不同Campanacci分级的肿瘤组织中均有阳性表达,且随着分级的增加,阳性表达率增加,不同分级间阳性表达率差别有统计学意义(P=0.019).OPN阳性表达率与复发与否、性别、年龄、手术方式、病程长短、发病部位等临床特征无显著相关.结论:骨巨细胞瘤OPN高表达,且与肿瘤侵袭性及分级密切相关.     

Effect of behavior training on learning,memory and the expression of NR2B,GluR1 in hippocampus of rats offspring with fetal growth restriction

Objective:To study effects of behavior training on learning,memory and the expression of NR2B,GluR1 in hippocampus of rat's offspring with fetal growth restriction(FGR).Methods:The rat model of FGR was established by passive smoking method.The rats offspring were divided into the FGR group and the control group,then randomly divided into the trained and untrained group,respectively. Morris water maze test was proceeded on postnatal month(PM2/4)as a behavior training method,then the learning-memory of rats was detected through dark-avoidance and step-down tests.The expressions of NR2B and GluR1 subunits in hippocampal CA1 and CA3 areas were detected by immunohistochemical method.Results:In the dark-avoidance and step-down tests,the performance record of rats with FGR was worse than that of control rats,and the behavior-trained rats was better than the untrained rats,when the FGR model and training factors were analyzed singly.The model factor and training factor had significant interaction(P<0.05).The expressions of NR2B and GluR1 subunits in hippocampal CA1 and CA3 areas of rats with FGR reduced.In contrast,the expressions of GluR1 and NR2B subunits in CA1 area of behavior-trained rats increased,when the FGR model and training factors were analyzed singly. Conclusion:These findings suggested that the effect of behavior training on the expressions of NR2B and GluR1 subunits in CA1 area should be the mechanistic basis for the training-induced improvement in learning-memory abilities.