促性腺激素治疗对多种垂体激素缺乏症男性患者睾丸形态和功能影响的时效性

目的研究人绒毛膜促性腺激素(hCG)和人绝经期促性腺激素(hMG)起始治疗年龄对多种垂体激素缺乏症男性患者的睾丸形态和功能改善情况的影响。方法以多种垂体激素缺乏症男性患者为研究对象,给予hCG和hMG治疗,同时维持其他激素正常,观察睾丸、阴茎形态,促性激素水平,身高,骨龄等变化值与开始治疗年龄的相关性。结果入组的54例患者经hCG和hMG治疗6个月后,阴茎长度由治疗前的(2.58±0.69)cm增长至(4.19±0.77)cm,阴茎周长由治疗前的(3.71±1.36)cm增长至(5.95±1.26)cm,睾丸容积从治疗前的(1.76±1.49)ml增加至(5.20±2.30)ml,身高从治疗前的(147.01±12.29)cm增加至(151.98±11.52)cm,骨龄从治疗前的(11.22±2.71)岁增长至(11.64±2.72)岁,差异均有统计学意义(P0.01)。睾丸容积及睾酮水平在治疗前、后的增长值随年龄增长均呈降低趋势,在各年龄组间的差异均有统计学意义(P均0.05)。用药前后睾丸容积增长值、血清促卵泡激素(FSH)和黄体生成素(LH)水平增加值以及用药前后身高增长值均与开始治疗年龄呈负相关(r=-0.517~-0.334,P0.05)。结论在正常青春期时期适当早期给予多种垂体激素缺乏症男性患者hCG和hMG治疗可更好改善其第二性征和睾丸功能。     

Angiopoietin-1 gene-modified human mesenchymal stem cells promote angiogenesis and reduce acute pancreatitis in rats

Mesenchymal stem cells (MSCs) can serve as a vehicle for gene therapy. Angiopoietin-1 (ANGPT1) plays an important role in the regulation of endothelial cell survival, vascular stabilization, and angiogenesis. We hypothesized that ANGPT1 gene-modified MSCs might be a potential therapeutic approach for severe acute pancreatitis (SAP) in rats. Human umbilical cord-derived MSCs with or without transfection with lentiviral vectors containing the ANGPT1 gene were delivered through the tail vein of rats 12 h after induction of SAP. Administration of MSCs alone significantly reduced pancreatic injury and inflammation, as reflected by reductions in pancreatitis severity scores and serum amylase and lipase levels as well as reducing the serum levels of proinflammatory cytokines (TNF-α, IFN-γ, IL-1β, and IL-6). Furthermore, administration of ANGPT1-transfected MSCs resulted in not only further reductions in pancreatic injury and serum levels of proinflammatory cytokines, but also promotion of pancreatic angiogenesis. These results suggest that MSCs and ANGPT1 have a synergistic role in the treatment of SAP. ANGPT1 gene-modified MSCs may be developed as a potential novel therapy strategy for the treatment of SAP.     

Role of biphasic changes in splenic dendritic cell activity in a mouse model of multiple organ dysfunction syndrome

To analyze the changes in splenic dendritic cell (DC) activity and serum cytokine levels during the progression of multiple organ dysfunction syndrome (MODS). A C57BL/6 mouse model of MODS was established by intraperitoneal injection of zymosan. Immunohistochemistry and flow cytometry were used to detect expression of I-A^b (MHC-II molecules of mice) as well as co-stimulatory and co-inhibitory molecules in spleen and DC surface. The levels of various cytokines in serum and spleen tissue were analyzed 6 h, 12 h, 24 h, 48 h, 5 d and 12 d after injury. Death occurred at 24-48 h and 10-12 d after injury. The expression of I-A^b and CD86 in spleen tissue and on DCs increased 6-12 h after injury, followed by gradual reduction and at 12 d. The inhibitory molecule, PD-L1, was expressed on normal DCs, but expression of PD-1 was undetectable. PD-L1 and PD-1 expression increased and remained high at 5 d and 12 d after injury. In addition, TNF and IL-1 levels increased 6-12 h after injury; HMGB1 and IL-10 levels increased 24 h and 5 d after injury, respectively. In contrast, IL-2 and IL-12 decreased with disease progression. At 12 d after injury, proinflammatory and anti-inflammatory cytokine levels remained high, while IL-2 and IL-12 were significantly reduced. IL-10 and IL-12 changes in spleen were consistent with those in serum. MODS progression was characterized by changes in splenic DC activity as well as altered serum pro-inflammatory and anti-inflammatory cytokine levels, suggesting early immune activation and predominant immune tolerance at the late stage.     

Increased expression of miR-24 is associated with acute myeloid leukemia with t(8;21)

This study was designed to learn the expression status of miR-24 and its clinical relevance in patients with acute myeloid leukemia (AML). We detected the miR-24 expression levels using real-time quantitative PCR in 84 AML patients and investigated the clinical significance of miR-24 expression in AML. There was no difference in clinical parameters between cases with miR-24 high expression and with miR-24 low expression. The frequency of miR-24 high expression was higher in patients with t(8;21) than in others (82% (9/11) versus 44% (32/72), P=0.026). The levels of miR-24 expression had no correlation with the mutations of nine genes (FLT3-ITD, NPM1, C-KIT, IDH1/IDH2, DNMT3A, N/K-RAS and C/EBPA). Meanwhile, among the group who obtained CR, the cases with miR-24 high expression had no difference in overall survival (OS) and relapse-free survival (RFS) than those with miR-24 low expression (P=0.612 and 0.665, respectively). These findings implicated that miR-24 high regulation is a common event in AML with t(8;21), and it might serve as a novel and selective therapeutic target for the treatment of AML with t(8;21).     

放射性颌骨坏死的术式选择及疗效评价

目的：探讨经济有效的治疗放射性颌骨坏死（RONJ）的手术方式。方法77例RONJ根据颌骨坏死的范围、软组织条件选择不同治疗方式。方案1：骨坏死范围局限,牙龈及周围软组织无明显炎症的采用局部刮治或方块切除术;方案2：骨坏死范围较大、周围软组织炎症明显和（或）伴有明显纤维化的病例在控制炎症后,扩大切除同时行血管化游离复合组织瓣修复。结果21例采用方案1,其中15例一期愈合、6例行二次刮治或方块切除;56例采用方案2,其中软组织条件较好的30例,22例一期愈合,5例延期愈合,3例发生骨组织瓣血管危象,经探查和再吻合后1例正常愈合,2例仍发生组织瓣坏死;软组织炎症明显或伴有局部组织明显纤维化26例中,7例出现骨组织瓣血管危象,探查和再吻合后5例正常,2例出现骨坏死,9例一期愈合,15例局部出现不同程度软组织感染坏死,延期愈合。结论局限性放射性颌骨坏死可采用刮治或方块切除;骨坏死范围较大、软组织条件较好的采用血管化游离组织瓣进行修复;软组织纤维化明显的失败率较高,临床使用时应综合多方因素考虑。