肝细胞生长因子基因转染骨髓间充质干细胞对脂肪颗粒移植存活率的影响

目的研究携带人肝细胞生长因子基因的重组腺病毒（Ad—HGF）修饰骨髓间充质干细胞（MSCs）对大鼠脂肪颗粒移植存活率的影响。方法用携带绿色荧光蛋白的重组腺病毒（Ad-GFP）、Ad—HGF转染雄性Wistar大鼠MSCs,测定转染效率与感染上清中肝细胞生长因子（HGF）的表达。用雌性Wistar大鼠150只,随机分为5组：空白对照组（A组）、Ad—HGF组（B组）、MSCs组（C组）、Ad—GFP感染MSCs组（D组）和Ad—HGF感染MSCs组（E组）,每组30只。各组均匀振动5分钟,将颗粒脂肪移植于自体背部皮下;移植后3、5、7、14、28、60d,每组各取5只大鼠脱颈处死,取出移植物;测体积、HE、Masson染色观察病理改变,免疫组织化学法测定组织中HGF表达和血管生成。结果积分吸光度＝100时,Ad—GFP转染MSCs效率可达89．6％;移植后3、5、7、14d,E组移植物中HGF的表达高于其他各组（P〈0．05）;移植后5、7、14、28、60d,E组血管数量也多于其他各组（P〈0．05）;28d和60d时,E组脂肪颗粒体积保持率明显好于其他4组（P〈0．05）。结论携带HGF基因的MSCs在移植物中能够持续表达HGF,有效地减少脂肪颗粒移植后的吸收,从而提高移植颗粒脂肪的存活率。     

平原人进驻高原后红细胞生成素的变化

目的　探讨红细胞生成素在高原低氧适应机制中的作用。方法　对平原进驻海拔 3 70 0m和气 5 3 80m第 7天及半年的健康青年进行血液促红细胞生成素 (EPO)、血红蛋白 (Hb)及血氧饱和度 (SaO2 )检测 ,并与平原健康青年作对照。结果　进驻高原低氧环境EPO、Hb较平原增高显著 (P <0 .0 5或 0 .0 1 ) ,SaO2 降低非常显著 (P <0 .0 1 )。进驻高原第 7天和半年 ,3 70 0m较 5 3 80mEPO ,Hb降低非常显著 ,SaO2 增高非常显著 (P <0 .0 1 )。进驻 3 70 0m ,第 7天较半年EPO无统计学意义 (P >0 .0 5 ) ,Hb ,SaO2 差异显著 (P <0 .0 5或 0 .0 1 ) ;进驻 5 3 80m ,第 7天较半年EPO ,Hb,SaO2 均有显著性差异 (P <0 .0 5或P <0 .0 1 )。结论　在高原缺氧环境下 ,红细胞生成素调节机制紊乱 ,是导致继发性红细胞增多的一个重要环节。     

多层螺旋CT双期增强扫描结合仿真内镜成像在膀胱癌术前分期中的诊断价值

目的 探讨多层螺旋CT双期增强扫描结合仿真内镜成像在膀胱癌术前分期中的诊断价值.方法 经纤维膀胱镜或手术病理证实为膀胱癌患者75例.对患者术前螺旋CT双期增强扫描图像和仿真内镜图像进行分析,比较多层螺旋CT分期与病理分期的准确率.结果 75例患者共发现病灶94个.螺旋CT分期:T1 26例、T2a 27例、T2b 13例、T3 12例、T4 16例;病理分期:pT1 28例、pT2a 24例、pT2b 14例、pT3 12例、pT4 16例.螺旋CT双期增强扫描诊断膀胱癌准确率为89.4%(84/94);腔内息肉样病变,仿真内镜诊断敏感性96.6%(84/87);膀胱壁无蒂隆起性病变诊断敏感性为90.9%(10/11).螺旋CT双期增强扫描结合仿真内镜诊断膀胱癌分期准确率为94.5%(91/94),当肿瘤局限于膀胱壁内(≤T2b)时,诊断准确率为91.2%(51/56);肿瘤侵犯膀胱壁外结构时(≥T3),诊断准确率达100.0%(28/28).结论 多层螺旋CT双期增强扫描结合仿真内镜成像对膀胱癌术前临床分期具有重要价值.     

Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass?

Although iron, vltamm B₁₂, and folate deficiency have been well documented after gastric bypass operations performed for morbid obesity, there is surprisingly little information on either the natural course or the treatment of these deficiencies in Roux-en-Y gastric bypass (RYGB) patients Durmg a l0-year period, a complete blood count and serum levels of iron, total iron-binding capacity, vltamin B₁₂, and folate were obtained in 348 patients preoperatively and postoperatively at 6-month intervals for the first 2 years, then annually thereafter The principal objectives of this study were to determine how readily patients who developed metabolic deficiencies after Roux-en-Y gastric bypass responded to postoperative supplements of the deficient micronutrient and to learn whether the risk of developmg these deficiencies decreases over time Hemoglobin and hematocrit levels were slgnificantly decreased at all postoperative intervals in comparison to preoperative values Moreover, at each successive interval through 5 years, hemoglobin and hematocrit were decreased signifiantly compared to the preceding interval Folate levels were significantly increased compared to preoperative levels at all time intervals Iron and vltamin B₁₂ levels were lower than preoperative measurements and remained relatively stable postoperatively Half of the low hemoglobin levels were not associated with iron deficiency Taking multivltamin supplements resulted in a lower incidence of folate deficiency but did not prevent iron or vitamin B₁₂ deficiency Oral supplementation of iron and vitamin B₁₂ corrected defiaencies in 43% and 81% of cases, respectively Folate deficiency was almost always corrected with multivitamins alone No patient had symptoms that could be attributed to either vitamin B₁₂ or folate deficiency Conversely, many patients had symptoms of iron deficiency and anenua Lack of symptoms of vitamin B₁₂ and folate deficiency suggests that these deficiencies are not clinically important after RYGB Conversely, iron deficiency and anemia are potentially serious problems after RYGB, particularly in younger women Hence we recommend prophylactic oral iron supplements to premenopausal women who undergo RYGB     

中药强骨丹对去卵巢骨质疏松大鼠骨密度和骨生物力学的影响

[目的]观察中药强骨丹对去卵巢骨质疏松大鼠骨密度和骨生物力学的影响,探讨其治疗绝经后骨质疏松症的作用。[方法]运用切除大鼠卵巢方法建立去卵巢骨质疏松症模型,随机分为假手术组、模型组、强骨丹高、低剂量组和西药组5组,每组10只。摘除卵巢后第4天分别给予生理盐水、强骨丹高、低剂量和二膦酸盐,各组均在服药14周后处死动物,进行血清雌二醇、骨密度、骨矿含量和骨生物力学测定。[结果]强骨丹能够明显升高去卵巢骨质疏松大鼠血清雌二醇水平,使骨密度和骨矿含量增加,胫骨最大载荷显著提高。[结论]强骨丹可通过提高机体雌激素水平,降低骨的转换率,增加骨密度,有效维持骨生物力学性能,对绝经后骨质疏松症有防治作用。     

Association between palmoplantar pustulosis and cigarette smoking in Brazil: a case–control study

Background  Palmoplantar pustulosis (PPP) discloses some differences compared to vulgar psoriasis (PV) in terms of age of onset, female predominance and low occurrence of psoriasis lesions elsewhere. Cigarette smoking has been associated to PPP in international studies; nevertheless, these studies were never performed among Brazilian.
Objectives  To compare prevalence of smoking among PPP, PV and other dermatologic patients (NPD).
Methods  Case–control study involving 25 PPP patients from a reference psoriasis centre. Two control groups were matched according to gender and age: 50 patients with PV and 50 NPD. Confounders were adjusted by conditional multiple logistic regression.
Results  Among cases, 84.0% were female and PPP age of disease onset (41.4 years) was greater than PV (34.5 years). Prevalence of ever smoking was higher among cases (92.0%) than PV (52.0%) and NPD (30.0%). Adjusted odds ratio of PPP ever smoking compared to PV and NPD was 9.5 and 36.2, respectively. All smokers reported the onset of their habit before the development of PPP.
Conclusions  There was significant association between PPP and smoking. However, the impact of giving it up in the clinical course of the disease remains to be established.     

MR运动成像对CSM诊断的临床研究

目的探讨MR运动成像对脊髓型颈椎病（cervical spordylogic myelopathy,CSM）的诊断价值。方法比较52例患者常规（静态）MR成像和MR运动成像检查结果,观察分析CSM患者脊髓受压的因素和特征,并与正常组MR表现进行对照分析。常规MR成像采用SE、FSE矢状位及横断位T1WI、T2WI或STIR等序列。MR运动成像采用FSE矢状位T2WI序列观察分析颈椎过屈、自然和过伸位MR征象特点。结果52例患者中,常规MR成像发现脊髓压迫46例,其中1级9例,2级26例,3级11例。MR运动成像全组病例均见脊髓压迫,其中1级10例,2级29例,3级13例。结论MR运动成像可动态观察CSM患者脊髓受压的因素及特征,并且能早期发现椎体不稳,为临床制定合适治疗方案及早期干预提供较可靠依据。     

顺铂为基础的联合化疗对非小细胞肺癌患者血糖影响的临床观察

目的:探讨顺铂(DDP)为基础的联合化疗在非小细胞性肺癌(NSCLC)治疗中对血糖变化的影响.方法:以顺铂为基础的联合化疗患者150例,回顾性分析化疗前后的血糖变化情况及相关临床资料.结果:150例患者中,化疗期间6例(4.00%)确诊为糖尿病(DM),6例(4.00%)出现糖耐量减低(IGT),10例(6.67%)出现空腹血糖受损(IFG),8例(5.33%)一过性血糖升高,继发DM患者化疗前后的平均血糖值分别为(5.08±0.18)和(10.79±2.80)mmol/L,化疗前后空腹血糖水平差异有统计学意义,t=5.200,P=0.003.继发DM多发生在化疗的第3.5个周期,DDP的累积量约280 mg/m2.结论:常规剂量顺铂化疗能引起DM、IGT、IFG及一过性血糖升高,化疗期间应密切监测血糖.     

Growth, puberty and obesity after treatment for leukaemia

Final height, body proportions, pubertal growth and body mass index were studied retrospectively in 142 survivors of acute lymphoblastic leukaemia (ALL). Treatment consisted of combination chemotherapy and cranial irradiation (18 or 24 Gy). Significant standing height loss and disproportion, with a relatively short back, was seen in both radiation dose groups. Girls were more severely affected than boys. Pubertal growth was adversely affected, with a reduction in peak height velocity in both sexes. Puberty occurred early in girls but at the normal time in boys. Nearly half the group were obese at final height, with no significant difference in incidence between the sexes. The relative roles of cranial irradiation and chemotherapy in the disturbance of growth, puberty and body composition observed in survivors of childhood ALL remain unclear. The aetiology is almost certainly multifactorial, with radiation-induced growth hormone insufficiency, early puberty, steroids and chemotherapy all having a role.