输尿管镜下早期尿道会师术治疗外伤性尿道断裂的体会（附13例报告）

2008～2012年，输尿管镜治疗外伤性尿道断裂13例。受伤时间1～8h，平均3．2h。术中见部分断裂5例，完全断裂8例，行输尿管镜探查，放置超滑黑泥鳅导丝进入膀胱，引导F33三腔尿管入膀胱，完成会师术。术后患者均恢复正常排尿，手术时间30～55min，平均40min。随访12～24个月，平均13．8月。12例最大尿流率18～24ml／s，1例12ml／s。     

Extended Synchronous Variational Integrators for Wave Propagations on Non-Uniform Meshes

This paper is concerned with the classical problem of wave propagation in discrete models of nonuniform resolution. We extend the traditional asynchronous variational integrators (AVIs) method to higher order and couple different spatial elements to adapt to nonuniform meshes. We show that the extension of AVIs method is stable, convergent and may reduce the spurious inter-grid reflection across meshes with different sizes. Numerical experiments are provided to verify the stability and convergence of the extended AVIs. The total energy is numerically conserved in our experiments.     

In utero origin of t(8;21) AML1-ETO translocations in childhood acute myeloid leukemia

Recent reports have established the prenatal origin of leukemia translocations and resultant fusion genes in some patients, including MLL-AF4 translocations in infants and TEL-AML1 translocations in children. We now report evidence for the prenatal origin of a translocation in childhood acute myeloid leukemia (AML). The t(8;21) AML1-ETO translocations were sequenced at the genomic level in 10 diagnostic leukemia samples from children with available neonatal Guthrie blood spots. Clonotypic genomic AML1-ETO sequences were detected in the Guthrie spots for 5 individuals, providing unambiguous evidence of prenatal origin in these cases. Two of these patients were older than 10 years of age at diagnosis, indicative of a protracted postnatal latency. Three of the patients were assessed for the persistence of genomic fusion sequences in complete clinical remission samples and were found to be positive. These data indicate that t(8;21) in childhood AML can arise in utero, possibly as an initiating event in childhood AML, and may establish a long-lived or stable parental clone that requires additional secondary genetic alterations to cause leukemia.     

胃黏膜相关组织淋巴瘤组织中miR-142-5p及miR-155表达及其临床意义

目的筛选胃黏膜相关组织(MALT)淋巴瘤的micro RNAs(mi RNAs)谱,并探讨mi RNAs表达与胃MALT淋巴瘤临床病理生物学行为的关系。方法收集台州市第一人民医院和温州医科大学附属第一医院2003年1月~2013年6月间手术治疗胃MALT淋巴瘤47例,检测手术切除标本的石蜡mi RNAs水平,并比较mi RNAs谱中mi R-142-5p及mi R-155的表达及其临床意义。结果胃MALT淋巴瘤组织中有38条mi RNA上调,包括差异17倍mi R-142-5p和4.5倍mi R-155;另外,有28条下调包括mi R-34a表达差异为4.9倍。本研究结果发现胃MALT淋巴瘤组织mi R-142-5p及mi R-155表达显著高于相应正常胃黏膜(P<0.01),且Hp感染阳性胃MALT淋巴瘤病例mi R-142-5p相对表达量显著低于Hp感染阴性病例(0.65比1.29,P=0.022),且较大肿瘤(≥5 cm)病例的mi R-142-5p相对表达量显著高于小肿瘤(<5 cm)病例(1.63比1.36,P=0.038),肿瘤浸润深度超过肌层及全层病例的mi R-142-5p表达显著高于肿瘤浸润局限于黏膜及黏膜下层病例(1.19比0.67,P=0.041),且Ⅱ+Ⅲ+Ⅳ期组mi R-142-5p相对表达量显著高于Ⅰ期病例(1.36比0.67,P=0.034)。另外,本资料表明Hp感染阳性胃MALT淋巴瘤病例mi R-155相对表达量显著低于Hp感染阴性病例(1.34比11.46,P=0.010),且较大肿瘤(≥5 cm)病例的mi R-155相对表达量显著低于小肿瘤(<5 cm)病例(1.34比4.36)(P=0.048),肿瘤浸润深度超过肌层及全层病例的mi R-155表达显著高于肿瘤浸润局限于黏膜及黏膜下层病例(1.86比1.37,P=0.048),且Ⅱ+Ⅲ+Ⅳ期组mi R-155相对表达量显著高于Ⅰ期病例(13.90比1.81,P=0.009)。结论胃MALT淋巴瘤组织与正常胃组织之间mi RNAs表达差异显著,尤其是mi R-142-5p及mi R-155基因,且这两种基因表达与肿瘤大小、核分裂像及恶性程度等密切相关,提示mi RNA在胃恶性淋巴瘤的发生发展过程中发挥重要作用。     

微循环阻力指数的研究进展

尽管经皮冠状动脉介入治疗使其心外膜动脉血流正常,但仍有相当一部分患者存在微循环血管功能障碍影响患者预后。因此,微循环的评估成为关键问题。近年来,微循环阻力指数(IMR)被证实是一种可靠的定量评估微循环功能的方法。多项研究显示IMR在ST段抬高型心肌梗死患者具有预后价值,同时为心血管疾病生理机制提供更多参考依据,并有望成为心血管疾病治疗靶目标。本文就IMR的测量及目前临床应用研究进展做一综述。     

地衣芽孢杆菌活菌颗粒杂菌检查方法验证

目的 建立地衣芽孢杆菌活菌颗粒杂菌检查方法。方法 控制菌检查采用平皿涂布法;非致病性杂菌检查以杂菌率不得过0.1%为限度指标,采用营养琼脂平皿涂布法37 ℃培养;真菌计数采用玫瑰红钠琼脂平皿涂布法25 ℃培养。结果 控制菌检查、非致病性杂菌检查和真菌计数方法均满足中国药典2010年版验证试验的基本要求。结论 该方法可作为地衣芽孢杆菌活菌颗粒杂菌检查方法。     

Distinct microRNA expression profiles in acute myeloid leukemia with common translocations

MicroRNAs (miRNAs) are postulated to be important regulators in cancers. Here, we report a genome-wide miRNA expression analysis in 52 acute myeloid leukemia (AML) samples with common translocations, including t(8;21)/AML1(RUNX1)-ETO(RUNX1T1), inv(16)/CBFB-MYH11, t(15;17)/PML-RARA, and MLL rearrangements. Distinct miRNA expression patterns were observed for t(15;17), MLL rearrangements, and core-binding factor (CBF) AMLs including both t(8;21) and inv(16) samples. Expression signatures of a minimum of two (i.e., miR-126/126*), three (i.e., miR-224, miR-368, and miR-382), and seven (miR-17-5p and miR-20a, plus the aforementioned five) miRNAs could accurately discriminate CBF, t(15;17), and MLL-rearrangement AMLs, respectively, from each other. We further showed that the elevated expression of miR-126/126* in CBF AMLs was associated with promoter demethylation but not with amplification or mutation of the genomic locus. Our gain- and loss-of-function experiments showed that miR-126/126* inhibited apoptosis and increased the viability of AML cells and enhanced the colony-forming ability of mouse normal bone marrow progenitor cells alone and particularly, in cooperation with AML1-ETO, likely through targeting Polo-like kinase 2 (PLK2), a tumor suppressor. Our results demonstrate that specific alterations in miRNA expression distinguish AMLs with common translocations and imply that the deregulation of specific miRNAs may play a role in the development of leukemia with these associated genetic rearrangements.     

外周血白细胞计数与冠状动脉狭窄的相关性

目的观察外周血白细胞计数与冠状动脉狭窄的关系,探寻冠心病的发病原因。方法对220例冠心病患者行冠状动脉造影及外周血白细胞的测定,采用Gensini评分系统衡量冠状动脉造影结果。按照Gensini积分的三分位间距将观察对象分为三组,Gensini积分0～3.00分(CHD1)组74例,Gensini积分3.01～32.67分(CHD2)组73例,Gensini积分32.68～180.00分(CHD3)组73例。应用方差分析研究白细胞计数在三组中的分布情况,应用多因素回归分析研究Gensini评分与白细胞计数的关系。结果单因素方差分析显示,外周血中性粒细胞、单核细胞及白细胞计数与Gensin评分有统计学相关;多因素逐步线性回归分析显示,外周血中性粒细胞总数与冠状动脉狭窄程度的积分独立相关,其偏相关系数为0.223,P=0.001。结论外周血中性粒细胞总数与冠状动脉狭窄独立相关。