人骨肉瘤中S100A6蛋白的表达及其意义

目的观察人骨肉瘤中S100A6蛋白的表达,探讨其与肿瘤转移的关系以及对预后的影响。方法采用免疫组织化学技术对30例骨软骨瘤和60例骨肉瘤石蜡包埋标本进行检测,对9例骨软骨瘤和7例骨肉瘤泳冻标本进行Western-blot检测,分析其表达与转移和预后的关系。结果与骨软骨瘤（10％）相比,S100A6蛋白显著表达于人骨肉瘤（85％）中（P〈0．01）,其表达与性别、肿瘤的分期、分型无关（P〉0.05）,而与肿瘤的转移（P〈0．05）和术后生存时间（P〈0．01）密切相关。结论S100A6蛋白选择表达于骨肉瘤中,可作为肿瘤的早期诊断标志之一,也是判断骨肉瘤转移和预后的重要指标。     

舒芬太尼对0.75%罗哌卡因蛛网膜下腔阻滞效应的影响

目的:观察舒芬太尼对0.75%罗哌卡因蛛网膜下腔阻滞效应的影响。方法:40例择期行下腹部以下手术患者(ASAⅠ～Ⅱ级)随机分成两组:Ⅰ组(n=20)的蛛网膜下腔用药为罗哌卡因22.5mg,Ⅱ组(n=20)为罗哌卡因22.5mg+舒芬太尼5μg。分别观察两组的蛛网膜下腔阻滞效应及相关的副反应。结果:两组之间的血流动力学指标及相关副反应均无统计学差异(P>0.05)。运动阻滞起效时间、达最大运动阻滞时间、最大Bromage分级、运动阻滞持续时间、感觉阻滞起效时间、镇痛向尾延伸时间、痛觉减退平面和痛觉消失平面均无明显差异(P>0.05)。而镇痛向头延伸时间、镇痛减退至T12时间、镇痛持续时间Ⅱ组均长于Ⅰ组(P<0.01)。结论:小剂量舒芬太尼可明显延长0.75%罗哌卡因蛛网膜下腔阻滞的感觉阻滞时间,且无明显副反应,适合于时间较长的下腹部及下肢手术的麻醉。     

Origin of Heat-Induced Accelerated Junctional Rhythm

Accelerated Junctional Rhythm. Introduction : The application of high-frequency current to the AV junctional area results in a temperature rise in the myocardium and may cause accelerated junctional rhythm (AJR). The aim of the study was to characterize heat-induced AJR in an in vitro animal model.
Methods and Results : Studies were performed in isolated perfused pig and rabbit hearts. Using a small heating probe, we could induce AJR from a discrete area located in the middle of the triangle of Koch, which was smaller than the area from which RF energy application could elicit AJR. Histology showed that the heat-sensitive area was located over, or close to, the compact AV node. It did not correspond with the areas where double potentials were found or with the site(s) of earliest atrial activation during VA conduction. Microelectrode recordings revealed that AJR arose in nodal-type cells. Heat increased the slope of the phase 4 depolarization and shortened the action potential duration. Two types of AJR were observed: the first one was regular and the second one showed irregularity in the intervals. Interaction of multiple foci and the presence of conduction block between the foci and the His bundle caused the irregularity of the His-His intervals during the second type of AJR.
Conclusion: AJR observed during heat and RF application in the AV nodal area results from the effect of heat on AV nodal cells with underlying pacemaker activity. The heat-sensitive area is located over, or very close to, the compact AV node.     

慢性HBV感染患者血清CP，HNF1α与肝组织病理分级及分期的相关性研究

目的　分析慢性乙型肝炎病毒（ hepatitis B virus,HBV）感染者血清铜蓝蛋白（ ceruloplasmin,CP）、肝细胞核因子 1α（hepatocyte nuclear factor 1α,HNF 1α）与肝组织病理分级及分期的相关性。方法　选取 2018年 2月～ 2020年 12月于甘孜藏族自治州人民医院就诊并接受肝脏活组织检查的慢性 HBV感染者 158例,并选取同期医院内体检正常者 50例为对照组,检测血清 CP,HNF 1α,丙氨酸氨基转移酶（ alanine transferase,ALT）和天门冬氨酸氨基转移酶（aspartate amino transferase ,AST）,并对慢性 HBV感染患者进行肝穿刺病理检查,评估组织炎症分级（ G0～ G3）和纤维化分期（ F0～ F4）,分析患者血清 CP,HNF 1α水平与肝组织病理分级及分期的相关性。结果　感染组 CP（205.63±18.74 mg/L）和 HNF 1α（3.25±0.91 ng/ml）水平低于对照组（ 283.59±22.35 mg/L,6.38±0.83 ng/ml）, ALT（149.67±23.91 U/L）和 AST（109.84±19.23 U/L.）水平高于对照组（ 25.13±5.62 U/L,19.93±4.37 U/L）,差异具有统计学意义（ t=21.634～ 36.457,均 P＜ 0.05）。＜ G2级患者 CP（211.37±20.54 mg/L）和 HNF 1α（3.42±1.05 ng/ml）水平高于 ≥ G2级者（ 186.86±15.32 mg/L,2.69±0.83 ng/ml）; ALT（134.56±17.68 U/L）和 AST（92.53±17.93 U/L）水平低于≥ G2级者（ 199.08±22.34 U/L,166.45±20.58 U/L）,差异具有统计学意义（ t=3.872～ 21.183,均 P＜ 0.05）。＜ F2期患者 CP（215.69±21.37 mg/L）和 HNF 1α（3.58±1.12 ng/ml）水平高于 ≥ F2期者（ 171.54±16.64 mg/L,2.13±0.55 ng/ml）;ALT（130.25±16.52 U/L）和 AST（84.53±18.23 U/L）水平低于≥ F2期者（215.48±21.69 U/L,195.61±21.37 U/L）,差异均具有统计学意义（ t=7.431～ 30.857,均 P＜ 0.05）。血清 CP和 HNF 1α升高分别是肝组织炎症（ OR=0.776,0.832）或纤维化显著（ OR=0.753,0.848）的独立保护因素（均 P＜ 0.05）;CP,HNF 1α分别与 ALT和 AST呈负相关性（r=-0.452,-0.429;-0.521,-0.483,均 P＜ 0.05）。结论　血清 CP和 HNF 1α水平与慢性 HBV感染患者病情严重程度密切相关,可反映肝组织炎症及纤维化进程。     

CD14对胃癌SGC-7901细胞TNF-α、IL-1β、IL-6和IL-12表达的影响

目的 研究胃癌细胞中CD14的过表达对TNF-α、IL-1β、IL-6、IL-12的影响,探讨CD14在胃癌发生发展中的作用.方法 在本实验室前期建立的胃癌SGC-7901 CD14稳定转染细胞系的基础上,利用CD14蛋白受体胞壁酰二肽（MDP）刺激细胞,RT-PCR检测各细胞因子mRNA的表达,Western blot检测各细胞因子蛋白的表达,以空质粒转染的胃癌SGC-7901细胞为对照,探讨CD14强制表达对TNF-α、IL-1β、IL-6、IL-12表达的影响.结果 转染并稳定表达CD14的细胞中TNF-α、IL-13、IL-6、IL-12在mRNA及蛋白表达水平上都有不同程度的升高,与空质粒转染的细胞相比,差异均有统计学意义（P均＜0.05）.结论 CD14对TNF-α、IL-1β、IL-6、IL-12的表达具有一定的促进作用.