体外培养版纳微型猪近交系骨髓基质干细胞的生物学特性

目的　分离培养成年版纳微型猪近交系骨髓基质干细胞并探讨其体外生物学特性。方法　成年版纳微型猪骨髓基质干细胞通过密度梯度离心法分离获得 ,用含 15 %小牛血清的 DMEM在 37℃ ,5 % CO2 条件下培养 ;通过克隆生长特性、特异抗原表达和成骨分化能力鉴定其干细胞特性。结果　版纳微型猪近交系骨髓分离获得的基质干细胞具有多种形状 ,但主要为梭形。其具有很强的增殖能力 ,在体外培养条件下可以观察到明显的克隆样生长 ;表达 SH2、SH3、SH4、SB10和 SB2 1等骨髓基质干细胞的特异标记 ;经成骨添加剂诱导培养之后能分化为成骨细胞 ,碱性磷酸酶活性增强并具有细胞外基质矿化能力。结论　成年版纳微型猪近交系骨髓来源的基质干细胞具有干细胞的一般生物学特性     

足底内侧逆行岛状皮瓣修复前足底顽固性溃疡

目的　为临床前足底顽固性溃疡的修复提供一种方法。　方法　自 1 998年起 ,应用以足底内侧血管束远端为蒂的足底内侧逆行岛状皮瓣修复前足底顽固性溃疡 5例 ,同期矫正局部畸形 ,皮瓣切取范围 3.5～ 5.0 cm×4.0～ 5.5 cm,术后注意皮瓣区近期不负重 ,保持清洁干燥。　结果　皮瓣全部成活 ,随访 6～ 1 4个月 ,皮瓣质地好 ,可见较厚角化层 ,但皮瓣痛觉迟钝 ,患足可负重行走 ,溃疡无复发。　结论　以足底内侧动静脉为蒂的逆行岛状皮瓣血运好 ,适用于修复前足底顽固性溃疡     

食管胃黏膜延长分层吻合的实验研究

目的　探讨食管胃吻合抗胃食管反流、预防吻合口瘘及狭窄的术式。　方法　选杂种犬 5 8条 ,随机分为实验组和对照组。实验组 :31条犬 ,自贲门横断 ,食管黏膜延长 1.5～ 2 cm;切除部分胃小弯 ,剥除大弯侧保留部分浆肌层 ,成形为宽 3～ 3.5 cm、长 4～ 5 cm黏膜管 ,行食管胃黏膜、肌层分层吻合。对照组 :2 7条犬 ,用“深套叠”术式。于术后 3～ 180天检测对比分析。　结果　两组突入胃内结构长度、肌层吻合口直径差别无显著性意义 (P>0 .0 5 ) ,黏膜游离缘直径差别有显著性意义 (P<0 .0 1) ;实验组能耐受较高胃内压 ,胃与食管压力差两组差别有显著性意义 (P<0 .0 1) ;突向胃腔内结构厚度两组相差 1倍以上 ;实验组成形黏膜血供良好 ,吻合口愈合及缝线脱落早于对照组。　结论　适当剥除肌层不引起黏膜缺血坏死 ;成形黏膜瓣薄软 ,具有良好的抗反流效果 ;黏膜层密缝对合严密、愈合快 ,能有效预防吻合口瘘的发生 ,不同平面吻合狭窄发生率低。     

腹膜透析生存率及其预后分析

目的 :调查腹膜透析病人的生存率及其独立的预后因素 ,识别病人死亡的高危人群 ,以指导临床治疗。方法 :随诊腹膜透析病人 2 6 8例 ,采用Kaplan -Meirie法分析生存率 ,采用COX模型多变量分析透析前各临床指标对预后的影响。结果 :2 6 8例病人中位数随访时间为 2 6个月 ;1年、2年、3年及 4年总体生存率分别为 85 .6 %、6 7.1%、5 6 .9%及 44 .4% ;经时序检验 ,透析前病人年龄、体重、经济状况、残余尿量、原发病、合并疾病、血红蛋白、血清白蛋白、血清尿素氮、肌酐及血磷浓度对生存率均有影响 (P值均 <0 .0 5 ) ;经COX回归分析 ,透析前病人年龄、血清白蛋白及合并疾病成为独立的预后因素。结论 :我国腹膜透析远期生存率稍低于西方发达国家。根据透析前年龄、血清白蛋白及有无合并疾病 ,可对腹透病人的预后进行初步判断     

中西医结合治疗原发性肾病综合征疗效及激素副作用观察

目的 :探讨中西医结合方法治疗原发性肾病综合征的疗效及观察激素的副作用。方法 :将 6 9例首发住院患者随机分成两组 ,其中中西医结合治疗组 (中西组 ) 35例 ,西医治疗组 (西医组 ) 34例 ,分别观察其疗效、激素副作用及 2年内复发率。结果 :中西医组治疗有效率 91.4% ,西医组治疗有效率 76 .5 % (P <0 .0 5 )副作用中西医组 2 2 .9% ,西医组 5 0 .0 % (P <0 .0 5 ) ,完全缓解者 2年内复发率中西组 19.2 % ,西医组 45 .0 % (P <0 .0 5 )。结论 :中西结合治疗原发性肾病综合征疗效明显优于单纯西医治疗 ,且副作用少 ,复发率低     

内皮素-1及受体基因在良性前列腺增生组织中的表达及意义

目的　探讨内皮素 1(ET 1)及受体A、B(ETAR、ETBR)在良性前列腺增生 (BPH)组织中的表达及意义。　方法　应用免疫组化和RT PCR方法检测前列腺组织ET 1及ETAR、ETBRmRNA的表达 ,并与患者临床参数行相关分析。　结果　ET 1、ETARmRNA和ETBRmRNA在BPH组织中的表达 (吸光度A值分别为 0 .94± 0 .0 8、0 .6 4± 0 .0 8、0 .97± 0 .0 8)与正常前列腺组织(0 .5 7± 0 .0 6、0 .37± 0 .0 5、0 .5 1± 0 .0 4 )相比 ,差别均有显著性意义 ,P均 <0 .0 5 ,其中ET 1、ETARmRNA与IPSS、前列腺体积、前列腺尿道长度、前列腺尿道压、最大尿道压呈正相关 ,与最大尿流率、平均尿流率呈负相关。　结论　ET 1和ETAR在BPH中的表达量与膀胱出口梗阻严重程度密切相关。     

添加特需营养素的营养支持对手术创伤后肠黏膜形态和屏障功能的影响

目的 探讨补充益生菌等特需营养素对手术应激后机体肠道屏障功能、上皮紧密连接及微生态的影响.方法 SD大鼠70只随机分成对照组、全肠外营养组(TPN组)、普通肠内营养组(EN组)和生态免疫肠内营养组(EEN组).建立创伤应激模型,接受等氮、等能量营养支持后光镜和电镜下观察肠黏膜形态和紧密连接,比较肠道细菌脏器易位率、肠道菌群数量及肠黏膜occludin蛋白免疫组织化学表达.结果 (1)电镜下观察,TPN组肠上皮损伤程度较严重,而EN组和EEN损伤程度较轻,肠上皮紧密连接、微绒毛较完整;光镜下chiu分级,TPN组和EN及EEN组比较差异有统计学意义(P<0.05).(2)EEN组和EN组肠道跨膜结合蛋白表达明显优于TPN组,且EEN和EN组间差异也有统计学意义(P<0.05).(3)EEN组和EN组肝、肺和肠系膜淋巴结的肠道细菌易位率低于TPN组,差异有统计学意义(P<0.05).(4)EEN组和EN组肠道内乳酸杆菌和双歧杆菌数量均高于TPN组,差异有统计学意义(P<0.05).结论 联合益生菌、肠道黏膜营养素、免疫营养素的营养支持能明显改善肠道微生态环境,维持肠道黏膜屏障和紧密连接,从而防止肠道菌群易位.     

多房性囊性肾癌一例报告及文献复习

Objective To discuss the diagnosis and outcome of multilocular cystic renal cell car-cinoma. Methods The clinic data of 1 case of multilocular cystic renal cell carcinoma were reviewed with its clinical manifestation, imaging, pathology and therapy in our hospital. The male patient aged 49 was incidentally found to have a right renal tumor. The CT scan showed a multiloeular cystic tumor in the low pole of the right kidney with a clear outline. The thin septa were found in the tumor, which were enhanced in the enhancement CT scan. The enhancement MRI showed the cystic wall was en-hanced. Results The patient received a partial nephrectomy as his treatment. The pathological char-acteristics were as following: the multilocular cystic tumor was about 3 cm×2 cm×2 cm with clear serosity in it. The cystic wall was smooth with the width of 0.1-0.2 cm. Most of the cystic cavities were covered by monostratified or stratified cubic clear cells, and some were covered by squamous epi-thelium or no epithelium at all. The septum was composed of collagen fiber, and clear cells were found in it. The clear cells form small collections but do not form expansile nodules. The final pathological diagnosis was multilocular cystic renal cell carcinoma. The follow-up was 20 months, without local re-currence or distant metastasis was found. Conclusions Multilocular cystic renal cell carcinoma (MCRCC) is a rare variant of renal cell carcinoma with a good prognosis. MCRCC is an uncommon tumor of the kidney composed of multiple cysts with clear cells in the septa indistinguishable from grade I renal cell carcinoma. Most patients are asymptomatie and the tumors are discovered inciden-tally. The preoperative diagnosis of MCRCC immediately depends on imaging studies. Pathology is the key to diagnosis.     

雌、孕激素受体和Her-2阴性乳腺癌的临床病理特征

Objective To study the clinicopathologic characteristics of triple-negative breast cancer (TNBC) and its value in the prediction of prognosis. Method In this study,500 cases of female breast cancers were examined immunohistochcmically for the TNBC. The clinicopathologic characteristics of the 243 TNBC cases were inspected. Results TNBC accounted for 17.6% (88/500) of the 500 breast cancers. The histological types of the TNBC included mainly infihrative ductal carcinoma, metaplastic carcinoma and medullar carcinoma. Among those, histological grade Ⅲ accounted for 72.7% (64/88) of all the TNBC and was more common than that in hormone receptor positive breast cancers (HR+ group ) and Her-2 overexpression breast cancers (Her-2 group)(P=0.000). The positive rates of CK5/6 and EGFR in the TNBC were 30.7% (27/88) and 34.1% (30/88), respectively. The positive rates of ERCC1 and KIT in the TNBC were 28.4% (25/88) and 34.1% (30/88), respectively, Both of which were higher than those in the HR + group and Her-2 group, respectively (P=0.032 and P=0.026). 3-year survival rate of the TNBC was 71.5% and it was lower than that of HR group (P=0.021) and not significantly different from that of Her-2 group (P=0.474). Conclusions TNBC is the breast cancer with high aggressive pathologic futures and poor prognosis. EGFR and ERCC1 expression were positive in a portion of TNBC cases.     

胆汁外引流对重症急性胰腺炎大鼠肺部炎症和水肿的疗效及机制研究

目的 探讨胆汁外引流对重症急性胰腺炎大鼠肺部炎症和水肿的疗效与机制。方法 24只雄性Sprague-Dawley（SD）大鼠随机分为4组（n=6）：假手术组（SS组）、重症急性胰腺炎组（SAP组）、SAP+胆汁外引流组（SAP+BTED组）、SAP+BTED+锌原卟啉组（SAP+BTED+ZnPP组）。ZnPP是血红蛋白氧合酶1（HO-1）的特异性阻断剂,抑制HO-1的表达。造模24 h后取肺组织和血液备用。采用Schmidt评分标准对肺组织进行病理评分。采用Western印迹法检测肺组织中HO-1蛋白质水平表达。采用荧光定量RT-PCR法检测肺组织中HO-1、肿瘤坏死因子α（TNF-α）和白细胞介素6（IL-6）mRNA 基因水平的表达。采用ELISA法检测肺组织中髓过氧化物酶（MPO）的含量。计算肺组织干湿比。结果 SAP+BTED组大鼠肺组织Schmidt评分显著低于SAP组大鼠（P<0.05）。BTED使肺组织中TNF-α和IL-6 mRNA 基因表达水平、MPO含量显著低于SAP组大鼠（P<0.05）。SAP+BTED组大鼠干湿比和HO-1表达水平显著高于SAP组大鼠（P<0.05）。当应用ZnPP时,BTED引起大鼠的这些效应则消失。结论 BTED通过HO-1通路减轻SAP大鼠肺部的炎症和水肿。