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。     

缓释rhVEGF的PDLLA/nHA复合多孔支架制备及血管诱导活性研究

目的研究制备消旋聚乳酸/纳米羟基磷灰石(PDLLA/nHA)多孔支架复合并缓释重组人血管内皮细胞生长因子(rhVEGF165),并观察其诱导血管形成的生物特性,为进一步实验提供理论依据。方法将rhVEGF165与PDLLA溶液物理混匀,用冷冻相诱导分离法制备PDLLA/nHA复合多孔支架,制成直径3 mm、高8～10 mm圆柱状支架。电镜观察其结构特点,检测在缓释rhVEGF的PDLLA/nHA支架降解过程中rhVEGF释放量,绘制释放曲线。分离培养兔骨髓间充质干细胞(BMSC),接种于复合和未复合rhVEGF的PDLLA/nHA支架。将细胞支架复合物植入兔大腿肌袋中,4周后取出材料行vWF免疫组化染色,观察新生血管形成情况。结果每个缓释rhVEGF的PDLLA/nHA支架含rhVEGF 4μg,材料孔径为20～100μm,孔隙率约90%,孔径联通性好。免疫组化及新生血管密度检测显示缓释rhVEGF支架+BMSC(rhVEGF-PDLLA/nHA+BMSC,VPB组)新生血管密度较空白支架(PDLLA/nHA,P组)之差异非常显著(P0.001),较空白支架+BMSC(PDLLA/nHA+BMSC,PB组)之差异显著(P0.05)。结论缓释rhVEGF的PDLLA/nHA多孔支架的结构特点适合细胞生长,有较强的血管诱导活性,是血管化组织工程的理想材料。     

The Health Status Questionnaire: achieving concordance with published disability criteria

AIM: To compare the Health Status Questionnaire with established methods of assessing disability in preterm and very low birthweight infants. METHOD: All survivors of gestational age <31 weeks or birth weight <1500 g, born in 1994 to women resident in Wales were identified. Assessments were by a single observer at a median corrected age of 28.3 months and included the Health Status Questionnaire and a Griffiths developmental test. Outcome was also described according to criteria for disability used in three published studies. RESULTS: There were 297 survivors of which 279 (94%) were assessed. Using the Health Status Questionnaire, severe disability was found in 12.9% of cases compared to 8.2%, 2.9%, and 3.6% using the Northern, Victorian, and Mersey outcome criteria respectively. Following the simple modifications of removing the growth criteria from the Health Status Questionnaire and reclassifying the severe disability group in the Victorian and Mersey criteria, comparable severe disability rates ranging from 7.9% to 9.3% were found. CONCLUSION: The Health Status Questionnaire requires no formal training, is rapid to perform, and with simple modifications provides comparable results to established methods of assessing disability. Its use in the follow up of preterm and very low birthweight infants should be encouraged.     

西藏0~5岁儿童母乳喂养时间与生长迟缓的关联研究

目的 探讨西藏自治区0~5岁儿童母乳喂养时间与生长迟缓的关联。 方法 采取分层、多阶段、与规模成比例的PPS方法和整群抽样方法抽取3136名0~5岁儿童进行问卷调查和体格检查。采用多因素logistic模型分析母乳喂养时间对儿童生长迟缓的影响。 结果 2020年西藏0~5岁儿童生长迟缓率为15.37%,6个月、12个月和24个月持续母乳喂养率分别为63.10%、28.70%和6.92%。多因素logistic回归模型显示,调整个体特征、家庭因素和社会环境因素后,与母乳喂养时间＜6个月的儿童相比,母乳喂养时间为12~＜24个月和≥24个月的儿童生长迟缓的OR值（95%CI）分别为1.91（1.43~2.53）和1.75（1.15~2.66）。 结论 西藏0~5岁儿童母乳喂养时间≥12个月与生长迟缓患病风险相关,在倡导延长母乳喂养时间的同时,应加强对科学喂养知识和技能的健康教育。     

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。     

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.     

Local Electrogram-Based Criteria of Cavotricuspid Isthmus Block

INTRODUCTION: The efficacy and outcome of cavotricuspid isthmus ablation guided by local electrogram-based criteria of linear block were prospectively assessed. METHODS AND RESULTS: In 40-consecutive patients (age 65+/-11 years) with typical right atrial (RA) flutter (cycle length = 255+/-31 msec), radiofrequency (RF) energy was delivered at electrograms in the isthmus coinciding with the center of the ECG plateau until termination of flutter, followed by local assessment of isthmus conduction during slow rate low-lateral RA pacing. 'Gaps' in the ablation line were located in the form of single or fractionated potentials centered on the isoelectric intervals of adjacent double potentials and ablated. Complete linear isthmus block was defined by the achievement of a complete corridor of parallel double potentials from the right ventricle to the inferior vena cava edge. Applications of 11+/-7 RF applications were required in all patients to achieve a complete line of double potentials separated by an isoelectric interval of 120+/-26 msec (range 60 to 190). After 6+/-3 RF applications, 6 (15%) patients had evidence of isthmus block using indirect RA activation sequence mapping without a complete line of double potentials. 5+/-5 further RF applications of eliminated local conduction and achieved complete linear block without altering descending septal RA activation. Conduction recovery occurred in 20 (50%) patients--1.85 times per patient-indicated by reversed changes in local electrograms eliminated by further ablation of the recovered gaps. After discharge, two recurrences (5%) occurred during a follow-up of 16+/-2 months. CONCLUSION: Double potential mapping is an effective assessment modality for local isthmus conduction. Slow conduction limited to the ablation line is observed during ablation in 15% of patients.     

升陷乌梅汤对激素干预哮喘大鼠TGF-β1/Smad信号通路及气道重塑的影响

目的观察升陷乌梅汤对激素干预哮喘大鼠TGF-β1/Smad信号通路和气道重塑的影响。方法将50只健康雄性SD大鼠随机分为正常组、哮喘组、激素组、布地奈德组、升陷乌梅汤组。除正常组外,其余各组采用卵蛋白致敏、雾化激发建立哮喘大鼠模型,并予各给药组大鼠腹腔注射糖皮质激素干预,在此基础上予升陷乌梅汤组大鼠灌胃、布地奈德组大鼠雾化吸入。观察各组大鼠肺功能及支气管病理改变,并采用Western blot及RT-qPCR法检测TGF-β1/Smad信号通路相关因子蛋白及mRNA表达的变化。结果①与正常组比较,哮喘组大鼠肺组织中胶原蛋白表达、WAi/Pbm、WAm/Pbm及WAe/Pbm升高(P0.05),信号通路因子TGF-β1、Smad2、Smad3的蛋白和mRNA表达及p-Smad2、p-Smad3的蛋白表达均升高(P0.05),而肺功能中FEV0.1、FEV0.1/FVC、FEF50%及FEF75%均降低(P0.05),肺组织中Ai/Pbm以及通路因子Smad6、Smad7的蛋白和mRNA表达均降低(P0.05)。②与哮喘组比较,各给药组均可减少肺组织中WAi/Pbm、WAm/Pbm和WAe/Pbm(P0.05),降低TGF-β1、Smad2、Smad3的mRNA表达及TGF-β1、Smad2、p-Smad2、p-Smad3的蛋白表达(P0.05),并升高FEV0.1、FEV0.1/FVC、FEF50%和FEF75%(P0.05),增加Smad6、Smad7的mRNA表达(P0.05);且升陷乌梅汤组较激素组可进一步减少WAi/Pbm、WAm/Pbm、WAe/Pbm,降低TGF-β1、Smad2、Smad3的蛋白和mRNA表达及p-Smad2、p-Smad3的蛋白表达(P0.05),并升高FEV0.1、FEV0.1/FVC、FEF75%,增加Smad6的蛋白和mRNA表达以及Smad7的mRNA表达(P0.05)。结论升陷乌梅汤可在激素干预基础上进一步阻止TGF-β1/Smad信号通路的异常激活,抑制气道重塑发展,延缓肺功能下降。