动脉粥样硬化的分子成像:血管细胞黏附分子-1为靶向的磁性微泡和对比增强超声诊断效能

目的评价经血管细胞黏附分子-1(VCAM-1)(CD106)靶向的微泡,在磁性导引系统帮助下,能否提高对比增强分子超声(US)对主动脉粥样硬化的检出效能。材料与方     

巨大肝癌并肝硬化患者的围手术期处理

74例巨大肝癌合并肝硬化患者实施半肝或肝左三叶切除,围手术期处理包括①纠正贫血和低蛋白血症及低氧血症,纠正水与电解质平衡失调;②手术前后肠外营养支持;③术前按结肠手术的要求准备肠道;④术中不阻断肝门血流;⑤术后适当限制水盐摄入量及利尿治疗。结果:71例半肝切除患者中,术前肝功A级58例,B级13例,术后1～2周评定肝功A级22例,B级30例,C级12例(其中1例于术后17天死于消化道出血);术后3～4周评定肝功A级43例,B级23例,C级4例,3例肝左三叶切除的术前肝功均为A级,但3例均于术后1个月内死于肝衰竭。表明在充分的围手术期处理下,绝大多数肝功能处于代偿期的肝癌合并肝硬化患者可以安全耐受半肝切除术,但不能耐受肝三叶切除手术。     

基于转化医学理念临床医学研究生的科研能力培养

【摘要】 我国现行临床医学研究生培养体系中存在临床实践与基础研究严重脱节现象,将“转化医学”理念导入我国的临床医学研究生教育,将有利于产生新的培养模式。转化医学是基础研究与临床实践之间双向转化的培养体系,在此探索通过优化教学体系、临床技能培养、基础科研训练、凝炼临床课题、参与并申报课题与人文素质培养的方式培养临床医学研究生的“转化”能力,最终造福患者。     

Neutrophil extracellular trap fragments stimulate innate immune responses that prevent lung transplant tolerance

Neutrophil extracellular traps (NETs) have been shown to worsen acute pulmonary injury including after lung transplantation. The breakdown of NETs by DNAse‐1 can help restore lung function, but whether there is an impact on allograft tolerance remains less clear. Using intravital 2‐photon microscopy, we analyzed the effects of DNAse‐1 on NETs in mouse orthotopic lung allografts damaged by ischemia‐reperfusion injury. Although DNAse‐1 treatment rapidly degrades intragraft NETs, the consequential release of NET fragments induces prolonged interactions between infiltrating CD4⁺ T cells and donor‐derived antigen presenting cells. DNAse‐1 generated NET fragments also promote human alveolar macrophage inflammatory cytokine production and prime dendritic cells for alloantigen‐specific CD4⁺ T cell proliferation through activating toll‐like receptor (TLR) — Myeloid Differentiation Primary Response 88 (MyD88) signaling pathways. Furthermore, and in contrast to allograft recipients with a deficiency in NET generation due to a neutrophil‐specific ablation of Protein Arginine Deiminase 4 (PAD4), DNAse‐1 administration to wild‐type recipients promotes the recognition of allo‐ and self‐antigens and prevents immunosuppression‐mediated lung allograft acceptance through a MyD88‐dependent pathway. Taken together, these data show that the rapid catalytic release of NET fragments promotes innate immune responses that prevent lung transplant tolerance.     

23例冠状动脉搭桥术同时行心脏瓣膜置换术的麻醉处理

本文总结23例冠状动脉搭桥术同时行心脏瓣膜置换术的麻醉。20例术前有ST-T改变。选用对循环影响轻的麻醉方式。用大剂量芬太尼麻醉，复合异丙酚，氨氟醚维持，效果良好。术中应用硝酸甘油，硝普钠降低前后负荷。体外循环后7例低心排病人用多巴肢和10例心动过缓病人用异丙肾上腺素治疗，效果显著。     

非持续性室性心动过速患者心率变异的研究

对非持续性室性心动过速（ＮＳＶＴ）患者进行心率变异（ＨＲＶ）分析。记录２４ｈ动态心电图分析６个ＨＲＶ时域指标，并对照分析ＮＳＶＴ发作前、后的窦性Ｒ－Ｒ间期标准差（ＳＤ）。结果：ＮＳＶＴ患者（ｎ＝３５）之ＨＲＶ时域指标中２４ｈ平均Ｒ－Ｒ间期（ＭＲＲＩ）、ＳＤ、５ｍｉｎ节段Ｒ－Ｒ间期均值的标准差（ＳＤＡ）、５ｍｉｎ节段Ｒ－Ｒ间期标准差的均值（ＭＳＤ）较正常对照组（ｎ＝１０５）明显下降（其中ＳＤ为９０．８８±３７．７７ｍｓｖｓ１４３．１８±３１．００ｍｓ，Ｐ＜０．０１），与病例对照组（ｎ＝４４）比较无显著性差异（Ｐ＞０．０５）。ＮＳＶＴ发作前、后５ｍｉｎ和１ｈ的ＳＤ（５ｍｉｎＲ－Ｒ节段）无显著性差异。结论：ＮＳＶＴ患者ＨＲＶ较正常对照组下降，但ＨＲＶ下降与ＮＳＶＴ无明显关系。     

The bone marrow--cardiac axis of myocardial regeneration

Congestive heart failure remains the leading cause of morbidity and mortality in the developed world. Current therapies do not address the underlying pathophysiology of this disease, namely, the progressive loss of functional cardiomyocytes. The notion of repairing or regenerating lost myocardium via cell-based therapies remains highly appealing. The recent identification of adult stem cells, including both cardiac stem/progenitor cells and bone marrow stem cells, has triggered an explosive interest in using these cells for physiologically relevant cardiomyogenesis. Enthusiasm for cardiac regeneration via cell therapy has further been fueled by the many encouraging reports in both animals and human studies. Further intensive research in basic science and clinical arenas are needed to make this next great frontier in cardiovascular regenerative medicine a reality. In this review, we focus on the role of bone marrow-derived stem cells and cardiac stem/progenitor cells in cardiomyocyte homeostasis and myocardial repair and regeneration, as well as provide a brief overview of current clinical trials using cell-based therapeutic approaches in patients with heart disease.     

Cross-host evolution of severe acute respiratory syndrome coronavirus in palm civet and human

The genomic sequences of severe acute respiratory syndrome coronaviruses from human and palm civet of the 2003/2004 outbreak in the city of Guangzhou, China, were nearly identical. Phylogenetic analysis suggested an independent viral invasion from animal to human in this new episode. Combining all existing data but excluding singletons, we identified 202 single-nucleotide variations. Among them, 17 are polymorphic in palm civets only. The ratio of nonsynonymous/synonymous nucleotide substitution in palm civets collected 1 yr apart from different geographic locations is very high, suggesting a rapid evolving process of viral proteins in civet as well, much like their adaptation in the human host in the early 2002–2003 epidemic. Major genetic variations in some critical genes, particularly the Spike gene, seemed essential for the transition from animal-to-human transmission to human-to-human transmission, which eventually caused the first severe acute respiratory syndrome outbreak of 2002/2003.     

人参皂甙与己烯雌酚联用对去卵巢大鼠骨丢失作用的观察

目的　探讨人参皂甙单用或与己烯雌酚合用对去卵巢大鼠骨丢失的预防作用。方法　 4.5月龄 SD雌性大鼠 ,按体重随机分为正常对照组、去卵巢组、己烯雌酚组、人参皂甙组和人参皂甙与己烯雌酚联用组。采用双侧卵巢摘除术 ,体内双荧光标记法 ,胫骨上段硬组织包埋切片 ,全自动图像分析及松质骨形态计量学软件处理 ,观察药物对骨形态计量参数的影响。结果　去卵巢 1 0 w后骨量丢失和破骨细胞活性、骨形成率及骨转换率增加 ,子宫重量减轻 ,子宫内膜厚度变薄 ,存在显著性差异 (P<0 .0 1或 P<0 .0 5)。人参皂甙与己烯雌酚合用能使骨量增加 ,骨形成增多 ,骨吸收和骨转换率下降并有显著性差异 (P<0 .0 1或 P<0 .0 5) ,子宫重量和子宫内膜厚度均下降。结论　去卵巢大鼠骨量丢失 ,骨转换率增高 ,出现明显的骨质疏松 ;己烯雌酚 (1 0μg· kg- 1· d- 1 )能抑制骨吸收 ,也抑制骨形成。与 1 0 0 mg/ kg人参皂甙合用 ,能增加骨量 ,增加骨形成 ,并减轻己烯雌酚导致的子宫重量增加和内膜增厚的危险性 ,能完全预防去卵巢大鼠的骨丢失     

In-vitro endothelialization of patches of bovine jugular vein stabilized by dye-mediated photooxidation

BACKGROUND AND AIM OF THE STUDY: The study aim was to evaluate the cytotoxicity of photooxidatively stabilized bovine jugular vein and the in-vitro endothelialization properties of such material. METHODS: Bovine jugular veins were cross-linked by dye-mediated photooxidation and cut into 4 cm2 pieces. Ovine jugular vein endothelial cells were isolated, cultured, and then seeded onto the inner surface of bovine jugular vein patches at a density of 1.5 x 10(5) per cm2. Specimens were cultured for five days and then examined using scanning electron microscopy (SEM) and immunohistochemical staining for von Willebrand factor. RESULTS: SEM showed confluent lining of cultured ovine jugular vein endothelial cells similar to native endothelium. Von Willebrand factor staining for cells on the surface of patches was positive. CONCLUSION: The photooxidatively stabilized bovine jugular vein patches were not cytotoxic, and their in-vitro endothelialization was possible.