硫化氢对大鼠肝缺血再灌注损伤的影响

目的 评价硫化氢对大鼠肝缺血再灌注损伤的影响.方法 健康雄性SD大鼠30只,体重220～250 g,采用随机数字表法,将其随机分为假手术组(S组)、缺血再灌注组(IR组)和不同剂量硫化氢组(H2S1～3组),每组6只.S组仅暴露肝门,不夹闭动、静脉;IR组采用夹闭左、中叶肝蒂、门静脉和肝动脉支1h恢复灌注的方法制备大鼠肝缺血再灌注模型;H2S1～3组于再灌注前5min分别腹腔注射14、28、56 μmol/kg硫化氢钠.于再灌注6h时抽取下腔静脉血样并取肝组织,采用全自动生化分析仪测定血清谷丙转氨酶(ALT)和谷草转氨酶(AST)活性,采用二硫代二硝基苯甲酸法测定肝组织谷胱甘肽(GSH)含量,光镜下观察肝组织病理学结果.结果 与S组相比,IR组血清ALT和AST活性升高,肝组织GSH含量下降(P＜0.05);与IR组相比,H2S1～3组ALT和AST活性降低,肝组织GSH含量升高(P＜0.05);H2S1～3组肝病理学损伤较IR组明显减轻.结论 H2S可减轻大鼠肝缺血再灌注损伤.     

神经调节蛋白对小鼠睾丸精原细胞增殖作用的研究

目的:研究神经调节蛋白(NRG)对小鼠睾丸精原细胞增殖的影响。方法:将纯化的NRG1β或NRG3的类EGF区域的重组蛋白分别添加到DMEM培养液中,终浓度分别为50、100、200 ng/m l,进行小鼠睾丸断片的器官培养,随后进行B rdU免疫组化染色,检测精原细胞的增殖效应。结果:添加NRG后可以促进精原细胞的增殖活性,与对照组相比具有显著性差异(P<0.05)。按NRG1β50、100、200 ng/m l、NRG3 50、100、200 ng/m l的顺序,精原细胞的增殖活性分别是对照组的1.69、1.55、1.86、1.35、1.54、2.11倍。结论:NRG1β、NRG3能促进小鼠精原细胞的增殖。可以期待NRG应用在男性不育症的治疗上。     

Protective effects of deferoxamine mesylate preconditioning on pancreatic tissue in orthotopic liver autotransplantation in rats

Background

Deferoxamine mesylate is known to ameliorate tissue ischemia-reperfusion injury. This study was designed to explore the impact of deferoxamine mesylate preconditioning (DMP) on pancreatic tissue and its possible effects during orthotopic liver autotransplantation.

Methods

A modified orthotopic liver autotransplantation model was used to simulate pancreatic ischemia-reperfusion injury. Sprague-Dawley rats (0.25-0.30 kg) were randomly divided into normal control, autotransplantation (AT), systemic deferoxamine mesylate preconditioning (SDMP), and partial deferoxamine mesylate conditioning (PDMC) groups. The SDMP group was injected with deferoxamine mesylate (75-90 mg; 300 mg/kg), via the celiac artery at 24 and 48 hours before surgery. During surgery, the PDMC group underwent liver perfusion by means of deferoxamine mesylate solution (20 ml; 0.6 mmol/L) rather than Ringer's lactate solution, with no prior preconditioning. At 6, 24, and 48 hours after surgery, the rats were sacrificed to sample their pancreatic tissues for the expression of hypoxia-inducible factor-1α (HIF-1α) and malondialdehyde (MDA) content. The samples were subjected to blood chemistry analyses, light and transmission electron microscopic morphological studies, and quantitative measurement of HIF-1α expression.

Results

The serum levels of amylase, lipase, and MDA in SDMP and PDMC groups were significantly lower than those in the AT group at 6, 24, and 48 hours after orthotopic liver autotransplantation (P < .05). Light and electron microscopic analyses showed much more severe pancreatic injury in the autotransplantation than in the SDMP and PDMC groups. The HIF-1α expression was increased in the SDMP and PDMC groups more than in the autotransplantation group (P < .05).

Conclusions

Deferoxamine mesylate preconditioning protected pancreatic tissue in orthotopic liver autotransplantation in rats. Inhibition of oxidative toxic reactions and up-regulated expression of HIF-1α protein are possible mechanisms.     

Popliteal vein aneurysm as a source of pulmonary embolism: report of a case and review of the world literature

Although popliteal vein aneurysms are uncommon, they are potentially fatal because they can cause a pulmonary embolism. One-third of patients have further embolic events despite therapeutic anticoagulation. We report the case of a 67-year-old man who presented with dyspnea, rapid respirations, and dull, left pleuritic chest pain of 3-day duration. Computed tomography scanning of chest confirmed the diagnosis of multiple bilateral pulmonary emboli. Color duplex scanning followed by ascending venography confirmed a 3 × 4 cm(2) right saccular aneurysm of above-knee popliteal vein--containing thrombus. Aneurysm was treated with open tangential aneurysmectomy and lateral venorrhaphy.     

TKA胫骨平台冠状位倾斜度与临床结果

目的研究TKA患者膝关节胫骨平台冠状位倾斜度与临床结果之间的关系。方法回顾性分析我科自2004年1月至2005年2月期间TKA的骨关节炎病例261例。按术后胫骨平台假体内外翻情况分为3组：A组（外翻组）、B组（中立组）和C组（内翻组）。结果 A、B、C三组间在患者性别比例、年龄、体重指数、止血带时间、术后引流量、术后住院时间方面无显著差异。术前膝关节畸形情况各组间无显著差异。各组间术前ROM及HSS评分无显著差异。在术后2周时的膝关节活动度方面,A组与B、C两组间均存在显著差异（P〈0.01）,B组与C组间存在显著差异（P〈0.05）。术后2周时HSS评分,A组与B、C两组间均存在显著差异（P〈0.05）,但B组与C组间无显著差异。术后2年HSS评分A、B、C三组间无显著差异。A组中有1例、B组中有2例,C组中有2例伤口脂肪液化;B组中有3例、C组中有1例术后出现患肢小腿肌间静脉血栓。结论 TKA术后冠状位倾斜度与术前因素、手术因素及手术并发症之间无显著相关性。TKA术后力线对近期临床结果可能有显著影响。通过进一步康复锻炼可弥补力线对长期临床结果的影响。     

Post-traumatic extra-articular osteoid osteoma of the calcaneus following military training

Osteoid osteoma is a benign bone tumor that causes localized pain that typically increases during the night and is relieved by NSAIDs [1]. It most commonly occurs in the femur and tibia. Only 8% of osteoid osteoma is found in the foot [2]. For that reason, if osteoid osteoma develops in the foot, there may be a delay in diagnosis as it often mimics other, more frequent pathologies. Moreover, if the patient has a history of injury, the initial diagnosis of osteoid ostoema is even more difficult to make [3] as it is natural for the physician to attribute the symptoms to the trauma.     

肠三叶因子和黏蛋白对烧伤血清所致肠上皮细胞免疫功能变化的影响

目的 观察肠三叶因子(ITF)和黏蛋白对烧伤血清所致肠上皮细胞免疫功能变化的影响.方法 (1)体外培养大鼠小肠上皮细胞株IEC-6,根据培养液添加物质不同,按照随机数字表法将细胞分为5组:①正常对照组,培养液中含10％(指体积分数,下同)小牛血清;②烧伤对照组,培养液含10％烧伤血清;③ITF+烧伤血清组,培养液含10％烧伤血清及终浓度25μg/mL ITF;④黏蛋白+烧伤血清组,培养液含10％烧伤血清及终浓度250 μg/mL黏蛋白;⑤ITF+黏蛋白+烧伤血清组,培养液含10％烧伤血清及终浓度25 μg/mL ITF、250 μg/mL黏蛋白.向各组细胞加入上述培养液的同时,加入大肠杆菌菌液(1×108 CFU/mL,200 μL).继续培养15 min、30 min、1h、2h、3h后,行瑞氏-吉姆萨染色,于显微镜下观察并统计黏附在细胞上的细菌数;采用锥虫蓝染色法观察并统计细胞存活率.每组每时相点样本数均为20.(2)将IEC-6细胞按照随机数字表法分为4组:烧伤对照组、ITF+烧伤血清组、黏蛋白+烧伤血清组、ITF+黏蛋白+烧伤血清组,分别同前加入相应的培养液(不加菌液)培养3、6、12、24、48 h.采用放射免疫分析法测定各时相点培养上清液中TNF-α、IL-6和IL-8 含量,每组每时相点样本数均为6.对实验数据行t检验.结果 (1)烧伤对照组细胞各时相点细菌黏附数量较正常对照组明显增多(t值为2.947 ～8.149,P值均小于0.01).与烧伤对照组比较,其余3个烧伤血清组在加菌后多数时相点细菌黏附的数量明显偏少(t值为-4.733～-2.180,P＜0 05或P ＜0.01).烧伤对照组细胞各时相点存活率与正常对照组比较均明显降低(t值为-4.126～-2 363,P值均小于0 05).ITF+烧伤血清组、黏蛋白+烧伤血清组细胞存活率在部分时相点明显高于烧伤对照组(t值为2.120～3.423,P＜0.05或P＜0.01).ITF+黏蛋白+烧伤血清组细胞存活率加菌后15 min为(96.7±2 4)％,明显高于ITF+烧伤血清组[(94 5±3 1)％,t=2.507,P＜0.05];在3h时为(84.0±6 7)％,明显高于黏蛋白+烧伤血清组[(77 1±8 2)％,t=2.934,P＜0.01].(2)ITF+黏蛋白+烧伤血清组培养6、12、24、48 h,TNF-α含量均低于其余3组(t值为-6.914 ～ -2.889,P＜0.05或P＜0.0i).ITF+黏蛋白+烧伤血清组IL-6含量在部分时相点明显低于其余3组(t值为-7.657～-2.580,P＜0.05或P＜0.01).ITF+黏蛋白+烧伤血清组在培养6、12、24、48 h IL-8含量明显低于烧伤对照组和黏蛋白+烧伤血清组(t值为-8.802 ～ -3.640,P值均小于0.01);在培养12、24 h明显低于ITF+烧伤血清组(t值分别为-2.786、-2.740,P值均小于0.05).结论 ITF能维护肠上皮细胞功能,抵御细菌黏附,降低细胞死亡率,同时能维护细胞免疫稳态,减少炎症介质释放;ITF与黏蛋白联用效果更明显.     

Conventional laparoscopic adrenalectomy versus laparoscopic adrenalectomy through mono port

A standard procedure for single-port laparoscopic adrenal surgery has not been established. We retrospectively investigated intraoperative and postoperative outcomes after laparoscopic adrenalectomy through mono port (LAMP) and conventional laparoscopic adrenalectomy to assess the feasibility of LAMP. Between March 2008 and December 2009, 22 patients underwent adrenalectomy at the Department of Surgery, Kangbuk Samsung Hospital. Twelve patients underwent conventional laparoscopic adrenalectomy and 10 patients underwent LAMP. The same surgeon performed all the surgeries. The 2 procedures were compared in terms of tumor size, operating time, time to resumption of a soft diet, length of hospital day, and postoperative complications. The 2 groups were similar in terms of tumor size (30.08 vs. 32.50 mm, P=0.796), mean operating time (112.9 vs. 127 min, P=0.316), time to resumption of a soft diet (1.25 vs. 1.30 d, P=0.805), and length of hospital day (4.08 vs. 4.50 d, P=0.447). Despite 1 patient in the LAMP group experiencing ipsilateral pleural effusion as a postoperative complication, this parameter was similar for the 2 groups (P=0.195). Perioperative mortality, blood transfusion, and conversion to open surgery did not occur. Perioperative outcomes for LAMP were similar to those for conventional laparoscopic adrenalectomy. LAMP appears to be a feasible option for adrenalectomy.     

Endoscopic removal of impacted magnetic foreign bodies in the gastroesophageal junction

Ingestion of foreign bodies is common in gastroenterology practice. Most of them are spontaneously passed through gastrointestinal tract. However, ingestion of multiple magnets can cause serious complications, because magnets attract each other and they hold the gastrointestinal wall. Here, we describe a patient who ingested multiple magnets that attracted each other between distal esophagus, and a part of them was impacted into the esophageal wall. In general, impacted magnetic foreign bodies should be removed by surgical intervention because of a high perforation risk. But, in this case, we used an insulated-tip knife for endoscopic submucosal dissection technique to make an incision to expose the impacted magnetic foreign bodies, and removed them successfully without surgery. With this report, we hope to encourage gastroenterologists to consider this new technique as one of procedures for difficult cases, including impacted foreign bodies.