Lung Transplant Metalloproteinase Levels Are Elevated Prior to Bronchiolitis Obliterans Syndrome

Parenchymal disease in the allograft lung is associated with interstitial remodeling believed to be mediated by matrix metalloproteinases (MMPs). Recent studies suggest high levels of MMP-9 are associated with bronchiolitis obliterans syndrome (BOS) in lung transplant recipients. Since BOS occurs late in the posttransplant period and may be preceded by episodes of acute rejection or infection, which are associated with interstitial remodeling, we examined MMP profiles in allograft bronchoalveolar lavage (BAL) fluid in the early posttransplant period (preceding BOS). Gelatin zymography, protein array analysis and specific ELISA on BAL fluids from transplanted lungs indicated that MMP-8, MMP-9 and TIMP-1 were strongly expressed in allograft BAL fluid from stable patients, or those with infection or rejection compared to BAL fluid from normal volunteers. Elevated expression of MMP-8, MMP-9 and TIMP-1 occurred early, and was sustained for the 3.2 years covered in this study. Elevations of MMP-8, MMP-9 and TIMP-1 in the first 2 years posttransplant appear to be associated with lung transplantation itself, and not infection or rejection. These data suggest that ongoing and clinically silent MMP activity could perpetuate progressive disease in the allograft lung.     

Inhibition of bone healing by pamidronate in calvarial bony defects.

OBJECTIVE: Pamidronate has been studied as a therapeutic drug for various osteopenic diseases. However, avascular osteonecrosis in the jawbone has been recently reported in patients receiving pamidronate. The objective of this study was to examine the effect of pamidronate on bone regeneration in a controlled animal model. MATERIALS AND METHODS: To determine the effect of parmidronate on bone healing in a local bony defect area, a rabbit calvarial bony defect model was used and poly L-lactide-co-glycolide (PLGA) used as a drug carrier material. Four defect groups were made in each rabbit calvaria and the defects were treated as follows: untreated bony defect (group 1), PLGA only (group 2), 2 mg of pamidronate with PLGA (group 3), and 3 mg of pamidronate with PLGA (group 4). Bone healing was evaluated by radiography and histology at 1, 2, 4, 6, and 8 weeks after surgery. RESULTS: In radiographic analysis, radiopacity was lower in pamidronate groups than non-operated rabbit calvarial bone at all observation points (P < .05). In histological analysis, the initial bone formation at 1 week was not different among groups, but it was much lower in the pamidronate groups than in the control or PLGA group after 2 weeks. Newly formed bone at 1 week underwent avascular necrosis after 2 weeks in both pamidronate groups. Avascular necrosis was not observed until 8 weeks in both topically applied pamidronate groups. CONCLUSION: Collectively, pamidronate inhibits bone healing in rabbit calvarial bony defect and it may explain the avascular necrosis of the jaws in patients receiving pamidronate.     

医学研究生临床技能培训与和谐医患关系构建的协调发展

临床技能培训与和谐医患关系构建是临床医学教育中两个不可分割的重要组成部分.促进临床技能培训与和谐医患关系的协调发展,达到完美和谐的统一,以提高医学研究生的培养质量.武汉大学人民医院采用具有特色的新型培养方式,加强研究生法律意识、医德教育,注重换位思考,提高专业技能,保持心理健康,改进医患沟通技巧,在研究生教育工作中取得了良好的效果.     

α-平滑肌肌动蛋白和β-肌动蛋白在瘢痕组织中的表达

目的 探讨α-平滑肌肌动蛋白(α-SMA)和β-肌动蛋白(β-actin)对增生性瘢痕形成的可能作用。方法 采用荧光定量PCR法检测10例增生性瘢痕和10例正常皮肤组织中α-SMA和β-actin的表达水平。结果 增生性瘢痕组织中α-SMA和β-actin表达水平均高于正常皮肤组织,差异有统计学意义(P<0.01)。结论 α-SMA和β-actin在瘢痕增生中起重要作用;由于β-actin在瘢痕组织和正常皮肤中的不恒定性,建议在瘢痕的mRNA定量研究中不作为内参照物。     

颈性眩晕的分型治疗及疗效分析

目的 将颈性眩晕分为上、下颈性眩晕，采取不同治疗方法并与常规治疗方法的疗效比较，以寻求更好的治疗方法。方法 将135例颈性眩晕随机分为试验组和对照组，对其治愈率及治疗时间进行统计学分析。结果 试验组的治愈率高于对照组，而试验组的治疗时间短于对照组，均有统计学意义。结论 对颈性眩晕进行分型并采用不同的治疗方法能提高治愈率，缩短治疗时间。     

瘢痕成纤维细胞中TGF-β受体与整合素相互作用的实验研究

目的:了解TGF-β受体和整合素在瘢痕增生和挛缩过程中的作用.方法:通过荧光定量PCR法(FQ-PCR)测定经TGF-β受体、整合素和粘着斑激酶(FAK)抗体阻断后培养的瘢痕成纤维细胞TGF-β受体以及整合素表达量的变化.结果:经不同抗体阻断后培养的瘢痕成纤维细胞其TGF-β RI和整合素β 1的基因拷贝数均较阴性对照组有不同程度的下降(P＜0.05).结论:TGF-β受体和整合素介导的信号传导途径间可能存在着正反馈的效应,共同促进瘢痕的增生和挛缩.FAK是两条信号传导途径的交汇点和作用的中心环节.     

泰素蒂加顺铂治疗进展期NSCLC的临床研究

目的观察泰素蒂加顺铂方案治疗进展期非小细胞肺癌的临床疗效、毒副作用。方法收集可评价疗效的进展期非小细胞肺癌50例,以泰素蒂加顺铂方案进行化疗,泰素蒂75 mg/m2静脉滴注,第1天;顺铂25 mg/m2～30 mg/m2静脉滴注,第2天～第5天,每3周为一个周期,2～3周期后评价疗效和毒副反应并随访。结果50例患者中,总有效率为50.0 %,其中初治病例为53.1 %,复治病例为44.4 %,初复治病例间差异无显著性(P >0.05)。中位缓解期为5个月。中位生存期为9.5个月,1年生存率为61.0 %。毒副反应主要为骨髓抑制,白细胞下降达Ⅲ度、Ⅳ度者52.0 %,血小板下降达Ⅲ度、Ⅳ度者为14.0 %。血红蛋白下降不严重。其他毒副反应还有脱发、过敏反应、水钠潴留、静脉炎、末梢神经炎、口腔炎、腹泻等,但发生率均较低。结论泰素蒂加顺铂方案治疗进展期非小细胞肺癌,特别是复发病例,临床疗效比较满意,毒副反应能够耐受。辅以G蛳CSF可防治重度的骨髓抑制,有较好的临床应用价值。     

Foot Polydactyly and Polysyndactyly: Genetic Implications in Two Families

The purpose of this study was to determine the genetic characteristics of foot polydactyly and identify its inheritance pattern by analyzing familial pedigree. Five cases from 2 Korean families were studied: 1 is a family whose members have been affected for 4 generations and the other for 2 generations. Using peripheral blood samples, we performed chromosomal analysis using the banding technique with Giemsa stain and karyotyping. We investigated the shape and structure of 46 chromosomes, looking for translation, deletion, inversion, ring chromosome, and isochromosome abnormalities. All peripheral blood samples demonstrated no chromosomal abnormalities, though the genetic nature of foot polydactyly and a new genetic locus was identified recently by other studies. Familial pedigree analysis suggested that polydactyly was inherited as an autosomal dominant trait in the first family. The mode of inheritance for the second family could not be determined due to an insufficient number of family members. The result of this study brought us to the conclusion that, while genetic factors play a major role in polydactyly, other factors may contribute to its occurrence.