角膜基质细胞体外长期培养过程中生物学特性的改变

目的 研究兔角膜基质细胞在体外长期培养传代过程中,细胞增殖能力和胞外基质表达水平的改变。方法 取体外培养兔角膜基质细胞,由光镜对各代细胞的形态学变化进行观测。通过对各代细胞生长曲线的绘制,得出其各自的群体倍增时间;MTT法比较各代细胞增殖能力的改变。RT-PCR和Western杂交检测各代细胞中Ⅰ、Ⅲ型胶原表达水平的改变;爱茜蓝法检测糖胺聚糖(GAG)的含量。结果 体外培养兔角膜基质细胞随着传代的进程,逐渐显现衰老的形态特征。细胞群体倍增时间由第7代起显著延长(P<0.01);MTT比色法的结果亦显示,第7代细胞的增殖能力开始大幅下降(P<0.01)。第9-11代时,Ⅰ、Ⅲ型胶原在mRNA和蛋白水平的表达都有明显减少(P<0.01),降至第1代细胞的30％左右;GAG的含量也降至40％左右。结论 兔角膜基质细胞经历长期体外培养后,细胞增殖能力和胞外基质表达水平显著下降,逐渐丧失原有的功能。但作为构建组织工程化角膜的种子细胞,在它的生物学特性未发生改变之前,经3次传代培养,获取的细胞量达到组织块消化所得细胞的240倍左右,已足以用于构建之用。     

脂质体包裹反义核酸对调控效果和降解时间的影响

目的 观察脂质体Dotap包裹反义脱氧寡核苷酸对酪氨酸酶(TYR)的调控效果和降解时间的影响,寻找适合于临床应用的高效转染、低降解率的载体和应用方法。方法 应用DNA合成仪合成针对TYR的反义脱氧寡核苷酸,32P标记、脂质体包埋,加入黑色素细胞培养体系进行点杂交,行黑素含量、酪氨酸酶mRNA表达量检测以及降解时间的同位素液闪检测。结果 经脂质体包埋的反义脱氧寡核苷酸使细胞黑素含量由(64±2.3)pg/cell下降至(23±1.5)pg/cell,并可使基因表达水平由160%降低至82%;同位素液闪显示经脂质体包埋的反义脱氧寡核苷酸能使其半衰期由8 h延长至12 h。结论 脂质体可以明显增强反义核酸的调控效果,并可延长其作用半衰期。     

关于医学生外科临床实习质量的探讨

外科是一门实践性很强的学科，如何培养实用型医学人才是摆在我们面前的首要问题。本文分析了外科临床实习中存在的问题，并提出一些应对措施。     

人源性多肽pCM-19抗菌机制的初步研究

目的：初步分析人源性多肽pCM-19的抗菌作用机制。方法：利用荧光素掺入破损细胞膜的原理，采用流式荧光激活细胞分析（FACScan）和扫描电子显微镜分析pCM-19对靶菌膜的作用机制。结果：FACS分析法结果显示pCM-19处理后的大肠杆菌PI着染细菌比例明显高于未处理组，并且随作用时间的延长，PI着染BL-21菌比例增大，20min时达最高水平，20min以后反而降低；扫描电子显微镜观察到pCM-19处理后的大肠杆菌有明显的表面形态学的改变，如细菌体积缩小、细菌表面出现皱缩、凹陷似有孔洞形成。结论：人源性多肽pCM-19可能作用于细菌细胞壁和（或）细胞膜，通过改变其通透性而发挥杀菌作用。     

环戊硫酮治疗干眼的临床疗效评价

Objective To investigate anethol trithione therapic efficiency on dry eye. Methods It was a prospective random double-blind controlled study. Eighty cases diagnosed dry eye in Ocular Surface Out-patient Clinic of Xiamen University Affiliated Xiamen Eye Center from 2006 to 2008 were divided into two groups: anethol trithione group and control group, 40 cases in each group. Every group was then divided into two subgroups: weak dry eye subgroup, middle and severe dry eye subgroup. All groups had been added with 0.05% refresh drops. All patients had been detected and evaluated by subjective symptoms of dry eye, visual acuity,corneal fluorescent staining(F1), break-up time(BUT) and Schirmer Ⅰ test (SⅠT) at pre-therapy and 3,7,28 d of post-therapy. All groups had been compared and analyzed by F test and sample mean difference (SMD) or median difference (MD) comparison between pre-therapy and post-therapy. Results Except of tear and red eye, the other subjective symptoms of dry eye, F1, BUT and SⅠT of weak dry eye subgroup of both groups had been improved at 7 d after therapy. Only those of middle and severe dry eye subgroup of anethol trithione group had been improved at 7 d after therapy compared with those of pre-therapy: SMD=0.96 (visual tiredness), 1.26 (dry and unsmooth sensation), 0.82 (foreign body sensation), 1.28 (burning sensation), 1.05 (photophobia), 1.48 ( pain ) ; MD=0.30 (visual acuity), 4.00 (F1) ,5.00 (BUT), 5.00 (SⅠT) [F=15.30 (visual tiredness), 15.68 (dry and unsmooth sensation ), 13.56 (foreign body sensation), 20. 91 ( burning sensation ), 18.90 (photophobia), 27.22 ( pain ), 10.54 (visual acuity), 188.21 (F1) ,261.76 (BUT) ,269.05 (SⅠT) ;P<0. 05]. Those of middle and severe dry eye subgroup of control group hadn't significantly been improved at 28 d after therapy: SMD=0.10 (visual tiredness) ,0.16 (dry and unsmooth sensation) ,0.09 (foreign body sensation) ,0.38 ( burning sensation ), 0.24(photophobia) ,0.36 (pain) ,0.23 (red eye) ; MD=0.10 (visual acuity) ,0.50(F1) ,0.50(BUT), 0.50(SⅠT) [F=1.76 (visual tiredness), 1.61 (dry and unsmooth sensation), 1.02 (foreign body sensation),2.39 (burning sensation), 2.42 (photophobia), 2.73 ( pain ), 2.55 ( red eye ), 1.46 ( visual acuity) ,2.35 (F1) ,2.90 (BUT) ,2.76 (SⅠT) ; P>0.05]. SⅠT of anethol trithione group had been improved more significantly after therapy (F=13.77, P<0.05). Conclusion Anethol trithione could significantly improve middle and severe dry eye patients' symptoms and signs whose lacrimal gland function survival and it has clinical application value.     

湖北地区汉族变应性哮喘患儿Tim-3启动子区基因多态性研究

目的 探讨湖北地区汉族儿童T细胞免疫球蛋白黏蛋白域蛋白．3（Tim-3）启动子区1541位C〉T和574位G〉T单核苷酸变异及其与变应性哮喘易感性之间的关系。方法 分别采用聚合酶链反应．限制性片段长度多态性（PCR-RFLP）和引物特异PCR-核酸序列测定技术检测湖北143例哮喘患儿和72名健康儿童Tim-3启动子区1541位C〉T和574位G〉T单核苷酸变异，讣算基因型和等位基因频率。结果 湖北地区健康儿童Tim-3启动子区1541位C／C、C／T和T／T基因型频率分别是0．961、0．039和0，而哮喘患儿频率分别为0．935、0．065、0，其基因型频率与对照组差异无统计学意义（r=0．3825，P=0．5362）；湖北健康儿童中Tim-3启动子区574位G／G、G／T和T／T基因型频率分别为0．992、0．008和0，而哮喘患儿频率分别为0．941、0．059、0，两组基因型频率差异有统计学意义（χ^2=4．134，P=0．042）。结论 湖北汉族儿童Tim-3启动子区存在多态性变异，其中574位G〉T多态性可能与湖北汉族儿童变应性哮喘易感性有关。     

肝胆管结石合并胆管癌的诊治

目的 :讨论肝胆管结石合并胆管癌的临床特点和诊治方法。方法 :对 11例肝胆管结石合并胆管癌的临床资料进行回顾性研究。结果 :本组肝胆管结石合并胆管癌的术前确诊率为 18.2 % (2 /11) ;术中冰冻病理检查确诊 2例 ;术后病理证实 7例。肝门胆管癌 72 .7% (8/11) ,中段胆管癌 9.1% (1/11) ,下段胆管癌 18.2 % (2 /11)。肿瘤根治切除率 36 .4 % (4/11) ,姑息性手术 6 3.6 % (7/11)。结论 :提高对本病的认识及详细的术中探查是及早发现胆管癌的重要途径。胆管癌根治性切除明显优于姑息性手术。     

鼻骨外伤X线摄影技术探讨

本文通过分析鼻骨外伤X线成像特点,重点探讨了常规X线与DR检查在鼻骨外伤中的应用价值,旨在提高对鼻骨骨折诊断的准确率。结果表明DR摄影是鼻骨常规检查的理想手段。     

结节性甲状腺肿合并其他甲状腺疾病临床分析

目的探讨结节性甲状腺肿合并其他甲状腺疾病的临床特点。方法回顾性分析我院手术治疗的4622例结节性甲状腺肿中并存其他甲状腺疾病的临床资料。结果4622例结节性甲状腺肿中700例合并其他甲状腺疾病，1418例存在不同的诊断失误。结论在诊断结节性甲状腺肿的同时应注意其合并的其他甲状腺疾病。     

Reversal of vascular 18F-FDG uptake with plasma high-density lipoprotein elevation by atherogenic risk reduction

Vascular 18F-FDG uptake marker represents inflammation in atherosclerotic lesions, but whether inflammation can be reversed by risk-modifying interventions has not, to our knowledge, been demonstrated. In this study, we evaluated the change of vascular 18F-FDG uptake in response to lifestyle intervention on serial PET/CT scans and further assessed how the findings relate to atherogenic risk reduction. METHODS: A total of 60 healthy adults underwent 18F-FDG PET/CT scans and atherogenic risk-factor assessment at baseline and again after 17.1 +/- 8.3 mo of practicing lifestyle modification. The PET/CT images were evaluated for the presence of vascular 18F-FDG lesions, and vessel-to-blood-pool 18F-FDG ratios were measured. Indices from summed ratios of positive lesions were compared and correlated to atherogenic risk factors. RESULTS: At follow-up, significant reductions in diastolic blood pressure (P < 0.05), total cholesterol (P < 0.05), and low-density lipoprotein level (P < 0.05) and an increase in high-density lipoprotein (HDL) level (P < 0.0001) were demonstrated. On the initial PET/CT scan, 50 of 60 subjects showed 1 or more 18F-FDG-positive lesions (5.9 +/- 5.0/subject), leading to a total of 352 vascular sites. On follow-up, 18F-FDG-positive lesions were significantly reduced to 2.1 +/- 2.2 sites per subject (P < 0.0001) and a total of 124 sites (64.8% reduction). Follow-up 18F-FDG-positive rates were significantly reduced for the aorta and iliac arteries. In addition, significant reductions in the whole-body 18F-FDG index from 1.39 +/- 1.23 to 0.53 +/- 0.59 (P < 0.0001) and carotid 18F-FDG index from 0.08 +/- 0.16 to 0.03 +/- 0.06 (P = 0.01) were shown. The whole-body 18F-FDG index correlated with total cholesterol (P < 0.05) and HDL level (P < 0.05), and the magnitude of reduction in the 18F-FDG index closely correlated to the amount of increase in plasma HDL level (P = 0.005). CONCLUSION: Our study demonstrated that vascular 18F-FDG uptake is reversed in response to atherogenic risk reduction by lifestyle intervention and that the magnitude of improvement correlates to increases in plasma HDL levels. Thus, serial 18F-FDG PET/CT may be useful for monitoring improvements in the inflammatory component of atherosclerotic lesions in response to risk modification.