单纯性胰腺创伤后大鼠胰腺细胞增殖状况的实验研究

目的：构建大鼠单纯性胰腺创伤模型观察胰腺细胞增殖变化特点并探讨胰腺细胞增殖与组织损伤的关系。方法将60只Wistar大鼠分为2组：撞击组（采用BIM‐Ⅲ生物撞击机构建胰腺创伤大鼠模型,40只）和对照组（假手术组,20只）,每组大鼠于建模后6、24、72 h ,7 d处死,采用分光光度法检测各组大鼠血清淀粉酶（AMS）、脂肪酶（LPS）活性,通过TUNEL染色和流式细胞技术测定胰腺组织细胞死亡并分析细胞周期分布特点,Western blot测定胰腺组织Bcl‐2、Bax蛋白的表达。结果撞击组大鼠LPS活性升高时相点晚于AMS且持续时间较长,TUNEL染色、流式细胞检测、Western blot结果揭示胰腺创伤可诱导胰腺组织细胞凋亡和代偿性增生。胰腺细胞增殖变化特点表明胰腺创伤后的最佳治疗时间是发病24 h内。结论同时检测AMS和L PS有助于判定胰腺的外分泌功能受损情况。     

黄芩苷对脂多糖诱导牙周膜成纤维细胞表达炎症因子的影响

【】目的：探讨黄芩苷对脂多糖促人牙周膜成纤维细胞炎症因子表达的影响。方法：将培养后的人牙周膜成纤维细胞用不同浓度的黄芩苷处理,CCK8实验观察不同浓度黄芩苷对人牙周膜成纤维细胞的细胞毒性。将培养后的人牙周膜成纤维细胞分为空白对照组、LPS组、黄芩苷组和LPS+黄芩苷组。空白对照组仅加入2%胎牛血清的培养液;LPS组加入加入100μg/mLLPS ;黄芩苷组分别加入黄芩苷200、500ng/mL ;LPS+黄芩苷组加入100μg/mL LPS,同时分别加入黄芩苷 200ng/mL 、500ng/mL。24h收集细胞, 检测各组IL-6、IL-8、IL-1βmRNA表达的变化。结果： 500ng/mL浓度以下黄芩苷添加至细胞没有明显的细胞增殖毒性。单独加入黄芩苷200ng/mL和500ng/mL的黄芩苷组和空白对照组比较,IL-6、IL-8、IL-1β均无明显变化(P＞0.05)。 和空白对照组比较,LPS组IL-6、IL-8、IL-1β明显上升,差异有统计学意义 (P<0.05),同时加入LPS和200ng/ml黄芩苷,相比单独加入LPS组,IL-6、IL-8、IL-1β明显下降,差异有统计学意义(P<0.05)。而同时加入LPS和500ng/mL黄芩苷,相比单独加入LPS组,IL-6、IL-8、IL-1β明显上升,差异有统计学意义 (P<0.05) 结论：黄芩苷在低浓度时显示有抑炎作用,而在浓度增加达到500ng/mL时显示有促炎作用。     

呼吸内科不同区域下呼吸道感染耐药菌分布及耐药特征比较分析

目的：探索昆明医科大学第一附属医院呼吸内科不同区域[门诊、病房,呼吸重症监护病房（RIC U ）]下呼吸道感染耐药菌株的分布构成及耐药特征,为临床抗菌药物的合理应用提供依据。方法采用K‐B纸片扩散法和仪器法（VITEK‐TWO）,按照美国临床与实验室标准化研究所（CLSI）2010年版标准判读结果,对昆明医科大学第一附属医院呼吸科门诊、病房、RICU患者送检的痰液、肺泡灌洗液标本通过细菌培养鉴定及药敏试验分离出的480株耐药菌株,用WHONET5．6软件对检测数据进行分析。结果该医院呼吸门诊、病房、RICU下呼吸道感染耐药菌分布构成前4位均以革兰阴性菌为主。肺炎克雷伯菌对多数抗菌药物的耐药率大于30％,对庆大霉素、左氧氟沙星、氨苄青霉素的耐药率大于50％,RIC U与呼吸科门诊和病房相比差异有统计学意义（ P＜0．05）。亚胺培南、哌拉西林／他唑巴坦、头孢哌酮／舒巴坦、阿米卡星抗菌活性较强,其耐药率小于20％。大肠埃希菌对11种常用抗菌药物在呼吸科门诊、病房与RICU的耐药率相似。产超广谱β‐内酰胺酶（ESBLs）菌株的多重耐药率明显高于非产ESBLs菌株（P＜0．05）,产ESBLs菌株对亚胺培南耐药率小于10％。铜绿假单胞菌对头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、头孢吡肟、喹诺酮类、氨基糖甙类在呼吸科门诊和病房仍保持较高的抗菌活性,但RIIU的耐药率大于54％（ P＜0．05）。鲍曼不动杆菌对亚胺培南的耐药率在RIC U和病房明显高于呼吸科门诊,分别为70．4％、64．6％和46．2％。RIC U检出的耐甲氧西林金黄色葡萄球菌（MRSA）对利福平耐药率明显高于呼吸科门诊和病房（P＜0．05）。结论呼吸科门诊、病房和RICU的耐药菌分布构成及耐药率均有明显差异,临床医师除了熟悉本地区耐药菌分布及耐药率监测情况外,还应掌握本单位各科室不同区域耐药菌的耐药率情况,才能正确有效合理应用抗菌药物。     

糖尿病急性并发症应用微量泵输注胰岛素效果观察

目的 探讨糖尿病急性并发症应用微量泵输注胰岛素的效果。方法 将58例糖尿病急性并发症病人随机分为两组，观察组（27例）采用微量泵输注小剂量胰岛素，对照组（31例）采用静脉滴注小剂量胰岛素，观察两组用药后的效果。结果 观察组控制血糖所需胰岛素用量明显少于对照组；血酮体消失时间明显短于对照组（t=4.16、3．39，均P＜0．05）；用药后低血糖、低血钾等并发症减少。结论 微量泵输注小剂量胰岛素可保持恒定的输入速度达到恒定的血药浓度，降低并发症，是值得推广的改良方法。     

Gastrin-releasing peptide is a growth factor for human neuroblastomas

OBJECTIVE: To evaluate whether gastrin-releasing peptide (GRP) and GRP receptor (GRP-R) expression correlate with tumor behavior and to examine the mitogenic actions of GRP on neuroblastomas. SUMMARY BACKGROUND DATA: Neuroblastoma is the most common solid tumor of infants and children. Despite recent advances in multimodality treatment regimens, the survival for advanced-stage tumors remains dismal. Neuroblastomas are known to produce GRP; however, the proliferative effects of GRP on neuroblastomas have not been elucidated. METHODS: Sections of paraffin-embedded neuroblastomas from 33 patients were analyzed for GRP and GRP-R protein expression by immunohistochemistry. Functional binding of GRP-R to the Ca2+ signaling pathway was examined. In addition, the proliferative effect of GRP on neuroblastoma cells (SK-N-SH, IMR-32, SH-SY5Y, LAN-1) was determined. RESULTS: Immunohistochemical analysis showed GRP and GRP-R protein expression in neuroblastomas; an increased expression of GRP-R was noted in a higher percentage of undifferentiated tumors compared with tumors that were benign. GRP-R mRNA was confirmed in neuroblastoma cell lines. GRP treatment resulted in intracellular calcium [Ca2+]i mobilization in two cell lines (SK-N-SH, LAN-1). GRP treatment stimulated growth of all four neuroblastoma cell lines; this effect was inhibited in SK-N-SH cells by pretreatment with GRP antibody. CONCLUSIONS: These findings show increased GRP-R expression in the more aggressive and undifferentiated neuroblastomas. The synchronous expression of GRP and its receptor, GRP-R, suggests a role for these proteins in tumor growth. Moreover, these findings show enhanced proliferation of neuroblastoma cells in vitro after GRP treatment, suggesting that GRP may act as an autocrine and/or paracrine growth factor for neuroblastomas. Treatment with specific GRP-R antagonists may provide novel adjuvant therapy for neuroblastomas in children.     

32 P局部照射对移植静脉内膜平滑肌细胞增殖与凋亡的影响

目的 研究β射线局部照射对自体移植静脉内膜平滑肌细胞（VSMC）增生与凋亡的影响及可能机制。方法 建立80只大鼠自体静脉移植模型,随机分成^32P局部照射组、对照组,每组按3、7、14、28d随机分成4个亚组、每亚组10只。取材固定,弹力纤维染色,增殖细胞核抗原、p53、bcl-2、bax免疫组化测定,TUNEL法检测静脉平滑肌细胞的凋亡,计算机图象分析仪测量移植血管内膜厚度,计算细胞增殖及凋亡百分化。结果 术后2组移植静脉段的内膜平均厚度：7、14、28d,照射组明显 于对照组（t＝15．694,P＜0．05）;7、14d照射组VSMC增殖较对照组受到明显抑制（t＝60．157,P＜0．01）。凋亡指数14d照射组高于对照组（t＝56．176,P＜0．01）。p53的表达,2组间差异无显著性意义（t＝0．473,P＞0．05）,bax与bcl－2的表达,14d照射组高于对照组（t＝9．783,P＜0．05）。结论 ^32P局部照射可以抑制自体移植静脉的内膜增生及VSMC的增殖,促进VSMC的凋亡,可能是通过bax、bcl－2基因的表达实现的。     

Effects of human midkine on spontaneous resorption of herniated intervertebral discs

This study was performed in 36 rabbits to investigate the role of midkine (MK) in the resorption of herniated intervertebral discs. The L_1-2 disc was excised and immersed in one of three kinds of solution for two hours before relocation into the L4 epidural space. In the MK-treated group, the weight of relocated intervertebral discs decreased more over time than in the control group. Newly formed vessels and inflammatory cells were more frequently observed in the MK-treated group than in the control group two weeks after surgery. The degradation of matrix was more significant in the MK-treated group than in the control group four weeks after surgery. Larger areas were replaced by fibrous tissues in the MK-treated group eight weeks after surgery. Thus, MK can accelerate the resorption of the intervertebral disc relocation to the epidural space. Epidural injection of MK may contribute to the therapy of lumber disc herniation.     

Host affinity and phylogenetic position of a new anamorphic fungus Beltraniella botryospora from living and fallen leaves of evergreen oaks

A new anamorphic fungus, Beltraniella botryospora, is described and illustrated with line drawings and photographs. This fungus was isolated frequently from living and fallen leaves of Quercus acuta, but rarely or never from other evergreen oaks and Castanopsis sieboldii grown at the same investigation site, suggesting that this new fungus might have strong host affinity to Quercus acuta. The phylogenetic relationships of Beltraniella botryospora and allied beltranioid fungi, such as Beltrania rhombica, Beltraniella sp. and Beltraniopsis sp., were estimated by molecular phylogenetic analysis using 28S rDNA D1/D2 region sequences. The constructed phylogenetic tree suggests that beltranioid fungi, including Beltraniella botryospora, an ascomycete Pseudomassaria carolinensis, which has a Beltraniella anamorphic stage, and a hyphomycete Subramaniomyces fusisaprophyticus, make a monophyletic group. This clade is located in the Xylariales lineage and is closely related to Amphisphaeriaceae. The phylogenetic relationships of the new anamorphic species and allied fungi are briefly discussed and a polyphyly of the anamorphic genus Beltraniella is suggested.     

胰腺癌患者外周血促血管生成因子浓度与疾病进展的关系

目的探讨胰腺癌患者外周血促血管生成因子中血管内皮细胞生长因子（VEGF）、碱性成纤维细胞生长因子（bFGF）及类胰岛素生长因子（IGF-1）浓度与临床病理学特点之间的关系。方法酶联免疫吸附试验测定32例胰腺癌可切除患者,24例胰腺癌不可切除患者和20例健康人外周血的VEGF、bFGF及IGF-1浓度,分析其与胰腺癌患者性别、年龄、病理分级、肿瘤大小、有无淋巴结及远处转移、是否侵犯血管及临床分期的关系。结果胰腺癌患者VEGF及bFGF浓度显著高于健康人（P〈0．01）,IGF-1浓度差异无统计学意义（P〉0．05）;胰腺癌不可切除组较可切除组VEGF显著升高（P〈0．05）,bFGF及IGF浓度差异无统计学意义（P〉0．05）;VEGF与胰腺癌分化、淋巴结转移、血管侵袭、远处转移及临床分期相关;bFGF与肿瘤大小及肿瘤分化相关;IGF-1与血管侵袭相关。结论胰腺癌进展过程中特有的生物学特性与胰腺癌不同时期的血管形成调控密切相关,促血管生成因子对于胰腺癌的进展发挥至关重要的作用,检测外周血促血管生成因子的表达对于胰腺癌临床筛查、诊断及治疗可能具有重要意义。     

应用前列腺素E1注射治疗勃起功能障碍8年经验

目的观察前列腺素E1(PGE1)注射治疗勃起功能障碍(ED)的长期疗效、副作用及预后。方法使用PGE1行阴茎海绵体注射,阴茎硬度检查仪(Rigiscan)连续记录1h,并根据观察结果,调查PGE1注射剂量,确定每例患者合适的注射量,掌握注射方法后回家自行注射。共筛选出ED患者410例,随访患者阴茎勃起情况、药量调整和副作用。结果410例ED患者中,心理性139例,静脉性83例,动脉性36例,神经性78例,混合性74例。对治疗满意的患者有256例(62.44%),其中21例(5.1%)在使用PGE15次后停用,并能达到满意的性生活而治愈。293例(71.46%)患者自述注射时有胀痛感。171例(43.17%)因疼痛(105例)、操作不便(25例)、副作用顾虑(37例)和其他原因(4例)而于6个月后放弃治疗。204例(49.76%)患者使用时间已超过1年,24例(5.85%)患者使用时间已超过5年,7例(1.7%)使用已有8年。未发现阴茎异常勃起和阴茎海绵体纤维化。注射损伤阴茎表面血管致瘀斑者有20例。有27例患者失访。结论PGE1是治疗ED的一种安全有效的药物,可以长期使用。其最常见的副作用是阴茎疼痛。Rigiscan能帮助确定PGE1的注射剂量。