Wnt/β-catenin信号通路与大肠癌的始发和防治策略

大肠癌的发生是一个多因素、多阶段、多基因改变渐进性累积的复杂过程．Wnt/β-catenin 信号通路中关键成分的异常改变,导致该通路的高度激活,在细胞水平上表现为过度增殖．在组织水平上表现为肠黏膜上皮转变为腺瘤性息肉．这是大肠癌形成的重要起始环节之一．对Wmt/β-catenin通路中关键成分异常改变的检测是实现大肠癌早期诊断的基础．在治疗干预方面,一些非甾体抗炎药、COX-2抑制剂、酪氨酸激酶抑制剂和血管生成抑制剂等能抑制Wnt/β-catenin通路过度激活,而有望在大肠癌的治疗中发挥作用;而以该通路中关键成分为靶点设计的生物制剂、小分子化合物,已显示出良好的体外抗癌作用．     

体温对内毒素致急性肺损伤大鼠肺微血管通透性的影响

目的探讨亚低温和高温对内毒素致急性肺损伤(ALI)大鼠肺微血管通透性的影响。方法健康雄性SD大鼠48只,体重300～350 g,随机分为4组(n=12),常温对照组(A组)静脉注射37℃生理盐水;常温内毒素组(B组)静脉注射脂多糖(LPS)5 mg·kg-1;亚低温 内毒素组(C组)静脉注射LPS 5 mg·kg-1,维持直肠温31.5～32℃;高温 内毒素组(D组)静脉注射LPS 5 mg·kg-1,维持直肠温39.5～40℃。动脉血氧合指数(PaO2/FiO2)≤300 mm Hg即ALI模型制备成功。于ALI 6 h后处死大鼠,取肺组织,清洗固定后测定肺微血管通透性指标:肺湿/干重量比(W/D)、肺泡灌洗液(BALF)蛋白(BALFpro)、肺通透性指数(PPI)、肺微血管通透性指数(PMPI)及肺组织硝基酪氨酸(NT)、髓过氧化物酶(MPO)、丙二醛(MDA)含量,观察肺组织病理学改变。结果与A组比较,B组、C组、D组PPI、W/D、BALFpro、PMPI和肺组织MPO、MDA、NT均升高(P<0.05);与B组比较,C组上述指标降低,D组上述指标升高(P<0.05);与C组比较,D组PPI、W/D、BALFpro、PMPI和肺组织MPO、MDA、NT升高(P <0.05)。结论高温加重内毒素血症大鼠ALI程度,亚低温通过抑制ONOO-生成,抑制了肺微血管通透性的升高,可减轻大鼠内毒素致ALI。     

异丙酚靶控输注技术在妇科腹腔镜手术中的应用

0引言 异丙酚靶控输注(target controlled infusion, TCI)是以血浆药物浓度为目标的靶控输注技术,具有给药迅速、精确和方便的特点,能使药物浓度和临床效应个体化,血药浓度可随时调整,提高了静脉麻醉的可控性和安全性,目前已在临床逐步推广应用. 妇科腹腔镜手术因操作简便、创伤小、需时短、周转快,要求麻醉能够诱导快、维持期平稳、术毕苏醒迅速. 因此,我们将异丙酚靶控输注用于妇科腹腔镜手术,其体会如下.     

Urologic complications following renal transplantation: role of interventional radiologic procedures

Seventy renal transplant recipients with suspected urologic problems underwent interventional radiologic procedures for further diagnosis and treatment. We found that 28 patients did not have urologic complications. The other 42 patients demonstrated a total of 62 complications, including 40 cases of obstruction, 12 cases of extravasation, and ten collections of pararenal fluid. Ultrasound and nuclear renal scans with both technetium-99m DTPA and iodine-131 hippuran were found to be sensitive screening techniques for the detection of these complications. Fifty of the 51 abnormalities were detected using a combination of these techniques. Percutaneous methods alone were successful in treating 15 urinary obstructions, eight pararenal fluid collections, and five urinary extravasations. We encountered six procedure-related complications, and there were three delayed infectious complications that were related to indwelling nephrostomy tubes. One of these three complications resulted in death. The results of our study suggest that invasive radiologic procedures can be safely used to diagnose and treat urologic complications in renal transplant recipients.     

Crossover use of donated blood for autologous transfusion: report of the Council on Scientific Affairs, American Medical Association

BACKGROUND: Controversy exists concerning whether the costs and potential risks outweigh the potential benefits of "crossover" use in the general blood supply of unutilized blood that was donated for autologous transfusion. STUDY DESIGN AND METHODS: Published articles and reports were identified through systematic search of MEDLINE and review of references cited in previously identified articles, textbooks, and reports. Consultation was made with experts in blood donation and transfusion. Additional peer review was received from the American Medical Association (AMA) Council on Scientific Affairs RESULTS: Concern over infectious disease transmission has led to increased interest in and support for autologous transfusion for individuals having planned surgeries. Different requirements exist for collection, labeling, and screening of blood to be used for autologous versus allogeneic transfusions; therefore, procedures for diverting autologous blood donations to the general blood supply involve considerable expense. Several cost-effectiveness studies of autologous blood donation and transfusion conclude that currently this "crossover" appears to be an expensive procedure yielding little increased benefit from a societal perspective. CONCLUSIONS: The recommendations in this report were adopted as AMA Policy at the AMA Annual Meeting in June 1997. The AMA does not encourage blood collection programs to "cross over" units donated for autologous use to the allogeneic blood supply. Practice guidelines are needed, and should be utilized to ensure parsimony in the use of autologous blood donations and transfusions.     

Pattern reversal visual evoked potentials in children with migraine or tension-type headache

Pattern reversal visual evoked potentials were recorded in 71 children with different types of migraine (e.g. migraine with aura, migraine without aura) or tension-type headache and in 19 controls (mean age of both groups 9 years). P100 latencies were comparable in all three groups.