乙型肝炎病毒对肝内TGF-β1/Smads信号通路的作用

 目的：探讨乙型肝炎病毒（HBV）对肝内TGF-β1蛋白表达及Smads信号通路的作用,为制定慢性乙肝肝纤维化临床治疗策略提供理论依据。方法：(1)运用免疫组化PV-6000法检测对照组和慢性乙肝组肝组织中TGF-β1、HBsAg和HBcAg的表达,并采用荧光定量PCR法测定慢性乙肝患者血清HBV DNA含量。(2)应用体外细胞培养技术培养HBV刺激的人肝星状细胞系LX-2细胞,Western blotting方法测定其细胞内TGF-β1、Smad3和Smad7的蛋白表达。结果：(1)慢性乙肝组肝组织内TGF-β1的表达高于对照组（P＜0.01）;肝内TGF-β1表达水平与血清HBV DNA含量呈正相关（P＜0.01）,且HBcAg阳性肝组织水平较高（P＜0.01）。(2)体外细胞学实验中,HBV刺激组LX-2细胞内TGF-β1和Smad3蛋白含量高于对照组和HBV+抗-TGF-β1组（P＜0.01）;Smad7蛋白表达差异无统计学意义（P>0.05）。结论：(1)TGF-β1在慢性乙肝患者肝组织中的表达与血清HBV DNA含量及肝内HBcAg的表达有关。(2)在TGF-β1/Smads信号通路中,HBV致纤维化作用机制以Smad3的正性调控为主,Smad7的作用不明显。     

Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of solid pancreatic masses: the impact on patient-management strategy

Background  Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a safe and accurate technique for diagnosing pancreatic cancer. However, its impact for management of these patients is poorly investigated.
Aims  To investigate the diagnostic yield and the therapeutic impact of EUS-FNA in the management of solid pancreatic masses.
Methods  One hundred consecutive patients who underwent EUS-FNA for a solid pancreatic mass were included. Aspirates were placed onto glass slides for cytological examination and microbiopsies were fixed in formaldehyde for histology. The impact on clinical management was analysed retrospectively according to different endpoints, such as its impact on indications for chemotherapy, surgery or appropriate follow-up modality.
Results  Eight procedures were considered failures and two patients were lost to follow-up. A final diagnosis was obtained in 90 patients. The sensitivity, specificity and accuracy of combined cytology and histology for the diagnosis of malignant or potentially-malignant tumours were 78%, 75%, and 78% respectively. The sensitivity and accuracy of cytology alone were significantly higher than those of histology alone ( P  = 0.0003). By intention-to-diagnose analysis, EUS-FNA directly influenced the management strategy in 62 of 100 patients.
Conclusions  In patients with pancreatic mass and suspected malignancy, EUS-FNA provides an accurate diagnosis in approximately 80% of cases. EUS-FNA directly influences the management in two-thirds of patients.     

上海市闵行区居民小区自动售水机的卫生现状

由于目前饮用水地表水水源污染较严重,自来水厂传统水处理工艺又不能彻底去除有机污染物、藻毒素和环境激素,管网污染、陈旧老化、渗漏率高,导致出厂水一用户自来水龙头,水质不合格率增加20％左右。另外,高层水箱、蓄水池清洗消毒不规范,二次供水污染,水质安全得不到保证,     

融合性网状乳头瘤病21例临床分析

报告21例融合性网状乳头瘤病,其中男13例,女8例.发病年龄9～27岁(平均17.7岁),病程1个月～7年.临床上皮损以躯干中部为著,为密集分布的灰褐色丘疹或斑片,相互间融合呈网纹状.真菌检查均为阴性.组织病理学表现为表皮呈城垛样平顶或呈锥状.治疗给予米诺环素50 mg每日2次口服,0.1%维A酸乳膏外涂.4周后皮损开始好转,8周后皮损明显缓解.     

个青皮总糖及总黄酮含量测定

目的对个青皮多糖及总黄酮含量进行测定。方法多糖采用水提醇沉法提取,硫酸-苯酚法显色,分光光度法进行含量测定;总黄酮采用回流提取法进行提取,分光光度法测定含量。结果个青皮多糖含量为4.99%,总黄酮含量为14.57%。结论本法简便、重现性好,可用于个青皮的质量控制。     

HIV-Ⅰ CN54株gagprotease基因嵌合脊髓灰质炎病毒cDNA质粒的构建和表达研究

目的 构建HIV-1 CN54株gagprotease基因嵌合脊髓灰质炎病毒cDNA的表达质粒，并鉴定、检测基因及其表达。方法 用PCR技术获得人免疫缺陷病毒CN54株的gagprotease基因，并使其两端带上合适的酶切住点，将其定向插入到包含脊髓灰质炎病毒cDNA的表达质粒pSVA14中，替代其部分结构基因，构建HIV基因嵌合缺陷性脊髓灰质炎病毒基因组的表达质粒。经筛选、鉴定后用脂质体转染技术将新构建的质粒转入Hela细胞内，用Western Blot方法检测目的基因在Hela细胞内的表达。结果 PCR技术扩增所得的人免疫缺陷病毒CN54株gagprotease基因经琼脂糖凝胶电泳、DNA测序证实成功获得，未引入突变碱基，筛选、鉴定证明gagprotease基因被正确定向插入到脊髓灰质炎病毒的cDNA序列之中，Western Blot检测到gagpro-tcase基因正确表达了相关蛋白。结论 成功构建了表达人免疫缺陷病毒CN54株gagprotease基因的缺陷性脊髓灰质炎病毒基因组嵌合质粒，为利用脊髓灰质炎病毒作人免疫缺陷病毒基因的表达载体奠定了基础，此研究对开发以脊髓灰质炎病毒为艾滋病的疫苗载体有重要意义。     

羟基磷灰石/聚合物复合材料的研究进展

该文对羟基磷灰石与天然生物材料、人工合成的医用可生物降解高分子材料以及医用非降解高分子材料的研究应用与进展进行了总结.并对羟基磷灰石/聚合物复合材料的发展趋势进行了探讨.     

Doppler evaluation of intrathyroid arterial resistances during preoperative treatment with Lugol's iodide solution in patients with diffuse toxic goiter

Background: The aim of this study was to ascertain the utility of echo-Doppler in the analysis of the low resistance thyroid vascularization in diffuse toxic goiter (DTG), and the effectiveness of Lugol’s solution (iodine-iodide solution) in patients undergoing thyroidectomy.

Study Design: Twenty-five patients with diffuse toxic goiter were evaluated and compared with 19 normal subjects. Patients were treated with increasing doses of Lugol’s solution 2% for 7 days until a total dose of 75 mg of iodine was given. Echo-Doppler was performed on the last day of treatment, 12 hours before operation.

Results: Mean basal Doppler Resistance Index (RI) of intrathyroid arterial flow was significantly lower in patients with DTG compared with normal controls (0.4718 ± 0.0625 versus 0.55 ± 0.05, range: 0.472 to 0.643; P = 0.008). Moreover, the RI was significantly increased in patients with DTG after Lugol’s solution (+16.46 ± 10.22%, range: −2.59 to +39.97; p < 0.0005).

Conclusions: Echo-Doppler RI allowed documenting lower arterial resistances within the thyroid gland in patients with DTG. The use of preoperative Lugol’s solution therapy induces normalization of those changes for safer thyroidectomy.     

Intragastric balloon for morbid obesity causing chronic gastric dilatation

We describe the radiographic findings observed in a morbidly obese and diabetic patient with an intragastric air-filled balloon introduced as a therapeutic measure to reduce food intake. The balloon was associated with chronic gastric dilatation and had to be removed 3 months after insertion. However, together with diet and behavioural therapy, it proved effective in reducing body weight and ameliorating glycaemic control. Although rarely used, intragastric balloons for the treatment of morbid obesity are still encountered in radiological practice. Radiologists must be able to recognize them and to understand their complications. Received: 26 April 2000 Accepted: 13 July 2000