细胞凋亡与增殖在先天性胆总管囊肿发病中的作用

目的　研究不同类型 (囊状、梭状型 )先天性胆总管囊肿壁细胞凋亡与增殖的关系 ,了解细胞凋亡 /增殖在胆总管囊肿中的作用。方法　以胆总管囊状扩张组 32例、梭状扩张组 35例及胆总管结石致胆管扩张组 (对照组 ) 2 5例为研究对象。术中取部分胆总管壁送检 ,观察胆总管壁损伤情况。用免疫组织化学法检测细胞凋亡的相关指标bcl 2、bax及细胞增殖指标PCNA的表达 ;用TUNEL法检测细胞凋亡情况。结果　囊状扩张组胆总管壁粘膜上皮细胞破坏严重 ,梭状扩张组镜下所见与囊状扩张组相似 ,但程度较轻。对照组胆总管粘膜上皮细胞破坏最轻 ,其凋亡细胞呈散在分布 ,上皮细胞和成纤维细胞凋亡阳性率较低 ,分别为 (2 .74± 1 .0 0 ) %和 (2 .95± 0 .87) % ;bcl 2、bax表达率较低 ,水平相似 (P>0 .0 5) ;PCNA表达率较高 ,分别为 (3 .74± 1 .0 0 ) %和 (3 .71± 1 .77) %。囊状扩张组与梭状扩张组囊壁残留上皮中的bcl 2和PCNA表达率低 ,分别为 (0 .99± 0 .51 ) %和 (0 .90± 0 .38) % ;bax呈高表达 ,bcl 2呈低表达 ,凋亡细胞阳性率较高 ,分别为 (1 3 .94± 4 .77) %和 (7.51± 3 .46) % ;成纤维细胞中的PCNA表达率较高 ,分别为 (9.91± 2 .91 ) %和(9.70± 3 .1 8) % ,bax呈低表达 ,bcl 2呈高表达 ,凋亡细胞阳性率较低     

手部热压伤的早期修复(附43例报告)

目的 探讨早期清创、组织修复在热压伤治疗中的临床疗效。方法 分析43例不同程度手部热压伤患的病损特点并行临床分度，以便准确诊治、判断预后；全部病例采用早期手术治疗，轻度热压伤(即浅Ⅲ度烧伤)早期行切痂全厚或中厚皮片修复，中度和重度热压伤早期彻底清创保留间生态组织，应用血循环丰富的组织瓣修复创面。结果 42例创面一期修复，手功能和外形恢复满意：1例创面二期修复，手功能恢复差。结论 手部热压伤应早期手术清创，据病损程度选择良好的方法及时修复组织缺损，可最大限度地恢复手功能和外形，减少致残率，缩短疗程，获得较好的临床疗效。     

瘢痕Bcl-2基因与细胞增殖和凋亡的关系

目的:探讨增生性瘢痕成纤维细胞Bcl-2基因表达水平与细胞增殖活性及凋亡程度的关系。方法:用原位杂交、免疫组化染色ABC法,对79例增生性瘢痕组织分别检测Bcl-2mRNA、Bcl-2蛋白和增殖细胞核抗原的表达,并用TUNEL法作原位细胞凋亡检测。结果:75例（94.9％）表达Bcl-2mRNA,70例（88.6％）表达Bcl-2蛋白,两者表达水平呈正相关（rs=0.989,P<0.01）;随成纤维细胞Bcl-2蛋白表达水平升高其增殖活性相应增加,而凋亡相应减少,Bcl-2蛋白+++组与++组（P<0.05）及前两组分别与-组和+组间（P<0.01）两项指标差异均有显著性。结论:增生性瘢痕中成纤维细胞Bcl-2基因高表达可抑制其凋亡,可能由此引起的细胞凋亡减少与其他基因异常所致的细胞过度增殖共同导致瘢痕的形成。     

肠瘘患者腔静脉导管感染的回顾性分析

目的了解肠瘘患者腔静脉导管感染的发生率、细菌菌谱及药敏情况。方法对1998年1月至2001年4月收治的使用腔静脉导管进行全肠外营养(TPN)的肠瘘患者进行回顾性分析。结果216例肠瘘患者,共进行了358次腔静脉置管,腔静脉导管尖端培养阳性的有88次(24.6%),腔静脉导管平均使用时间为(16.9±13.0)d。88次腔静脉导管感染的尖端共培养出95株细菌,其中革兰阴性菌54株,占56.8%;其次为革兰阳性菌35株,占36.8%;真菌6株,占6.4%。根据药物敏感试验结果及临床表现,有16例患者更换了抗生素,4例改用抗真菌药物,所有患者均治愈。结论对于肠瘘患者,腔静脉感染仍是实施静脉营养的主要并发症之一,革兰阴性细菌感染最常见。     

Effects of Volatile Anesthetics on Glutamate Transporter, Excitatory Amino Acid Transporter Type 3: The Role of Protein Kinase C

Background: Glutamate transporters play an important role in maintaining extracellular glutamate homeostasis. The authors studied the effects of volatile anesthetics on one type of glutamate transporters, excitatory amino acid transporter type 3 (EAAT3), and the role of protein kinase C in mediating these effects.

Methods: Excitatory amino acid transporter type 3 was expressed in Xenopus oocytes by injection of EAAT3 mRNA. Using two-electrode voltage clamp, membrane currents were recorded before, during, and after application of l-glutamate. Responses were quantified by integrating the current trace and are reported as microcoulombs. Data are mean +/- SEM.

Results: l-Glutamate-induced responses were increased gradually with the increased concentrations of isoflurane, a volatile anesthetic. At 0.52 and 0.70 mm isoflurane, the inward current was significantly increased compared with control. Isoflurane (0.70 mm) significantly increased Vmax (maximum velocity) (3.6 +/- 0.4 to 5.1 +/- 0.4 [mu]C;P < 0.05) but not Km (Michoelis-Menten Constant) (55.4 +/- 17.0 vs. 61.7 +/- 13.6 [mu]m;P > 0.05) of EAAT3 for glutamate compared with control. Treatment of the oocytes with phorbol-12-myrisate-13-acetate, a protein kinase C activator, caused a significant increase in transporter current (1.7 +/- 0.2 to 2.5 +/- 0.2 [mu]C;P < 0.05). Responses in the presence of the combination of phorbol-12-myrisate-13-acetate and volatile anesthetics (isoflurane, halothane, or sevoflurane) were not greater than those when volatile anesthetic was present alone. Oocytes pretreated with any of the three protein kinase C inhibitors alone (chelerythrine, staurosporine, or calphostin C) did not affect basal transporter current. Although chelerythrine did not change the anesthetic effects on the activity of EAAT3, staurosporine or calphostin C abolished the anesthetic-induced increase of EAAT3 activity.     

Treatment of renal artery fibromuscular dysplasia with balloon angioplasty: a prospective follow-up study.

OBJECTIVES: to assess restenosis rates and blood pressure response after percutaneous transluminal renal angioplasty (PTRA) in patients treated for fibromuscular dysplastic renal artery stenosis. METHODS: a prospective 12-month follow-up study of 27 patients with 31 treated renal artery stenosis. Follow-up assessment included colour-coded duplex sonography (CCD) of renal arteries, monitoring of blood pressure, antihypertensive medication, and creatinine measurements before discharge and at 3, 6, and 12 months. Primary end point was defined as a haemodynamically significant restenosis >60% assessed by CCD. RESULTS: there was a cumulative 23% restenosis rate at 12 months. Arterial hypertension was cured or improved in 93% of patients immediately after the intervention and remained cured/improved in 74% of patients at 12 months of follow-up. Renal failure present in five patients before PTRA stabilised or improved in all patients. CONCLUSION: although restenosis rate after PTRA in fibromuscular dysplasia is as high as in non-ostial atherosclerotic lesions, there remains a considerable higher therapeutic effect. Profound pressure response and recurrent arterial hypertension with restenosis support the high probability of a renovascular origin of arterial hypertension in this young and otherwise healthy population compared to patients with atherosclerotic renal artery lesions.     

Increased Intratumoral Lymphatic Vessel Density Correlates with Lymph Node Metastasis in Early Gastric Carcinoma

Background  

Prediction of lymph node metastasis in early gastric carcinoma (EGC) is important for management and follow-up of EGC patients. Increased lymphangiogenesis has been suggested to correlate with lymphatic invasion and lymph node metastasis in various tumors.     

Extraskeletal soft tissue chondroma of the cheek

Extraskeletal soft tissue chondroma is a rare, benign, slow-growing cartilaginous tumor. Its pathological diagnosis is based on radiological and histopathological examination. There are a few reports of soft tissue chondroma in this region. We present a 57-year-old man with a painless mass measuring $ {6}.{7} \times {6}.0 \times {4}.0{\hbox{cm}} $ in the left cheek.     

Plating after lengthening (PAL): technical notes and preliminary clinical experiences

Introduction Shortening the period of time for the external fixator after limb lengthening decreases the complication rate and increases the patient satisfaction. Material and method We describe the plating after lengthening (PAL) as a new technique on five patients with limb length discrepancy (1 femoral, 4 tibial) who had lengthening procedure with Ilizarov technique. The mean amount of lengthening was 50 mm. The mean lengthening period was 100 days (5–135 days). When the lengthening period ended, the locking compression plate was applied percutaneously by using the technique of minimal invasive plate osteosynthesis, and the Ilizarov external fixator was removed. Results The fixator-free period was achieved at the beginning of the consolidation phase, except in two patients, which were delayed for plating because of pin-tract infection. No complication was encountered except in one patient who had limited flexion of knee joint. There was no need for blood transfusion. Discussion The PAL, which shortened the period of time for the external fixator, was an easy and safe method for the fixation of the bone after limb lengthening.