体外膜肺氧合在危重心肺疾患的临床应用体会

目的总结危重心肺疾病患者实施体外膜肺氧合支持方法和效果。方法对5例患者实施体外膜肺氧合支持,年龄27-82岁（平均年龄47岁）,体质量53～87kg（平均体质量69．6kg）。5例患者病因不同,分别为：例1,男性,29岁,爆炸伤,心肺功能衰竭：例2,男性,82岁,急性心肺功能衰竭;例3,女性,34岁,急性心源性休克复苏后支持;例4,男性,27岁,心脏外伤,心脏手术后低心排血量;例5,女性,63岁,联合瓣膜置换术后低心排血量。采用静脉-动脉转流,辅助流量40～70ml／（kg·min）;间断检测激活凝血时间（ACT）160～200s。结果体外膜肺氧合支持时间22～61h（平均39．4h）。1例未能脱机而死亡,4例成功脱机,3例康复出院。结论体外膜肺氧合支持是抢救危重心肺功能衰竭及心脏手术心功能支持有效方法。     

Inhibitory effects of erythromycin on wear debris-induced VEGF/Flt-1 gene production and osteolysis

Objectives  A highly vascularized and inflammatory periprosthetic tissue augments the progress of aseptic loosening, a major clinical problem after total joint replacement. The purpose of this study is to investigate the effect of erythromycin (EM) on ultra high molecular weight polyethylene (UHMWPE) particle-induced VEGF/VEGF receptor 1 (Flt-1) gene production and inflammatory osteolysis in a mouse model. Methods  UHMWPE particles were introduced into established air pouches on BALB/c mice, followed by implantation of calvaria bone from syngeneic littermates. EM treatment started 2 weeks after bone implantation (5 mg/kg day, i.p. injection). Mice without drug treatment as well as mice injected with saline alone were included. Pouch tissues were harvested 2 weeks after bone implantation. Expression of VEGF, Flt-1, RANKL, IL-1, TNF and CD68 was measured by immunostain and RT-PCR, and implanted bone resorption was analyzed by micro-CT (μCT). Results  Exposure to UHMWPE induced pouch tissue inflammation, increase of VEGF/Flt-1 proteins, and increased bone resorption. EM treatment significantly improved UHMWPE particle-induced tissue inflammation, reduced VEGF/Flt-1 protein expression, and diminished the number of TRAP⁺ cells, as well as the implanted bone resorption. Conclusion  This study demonstrated that EM inhibited VEGF and Flt-1 gene expression. The molecular mechanism of EM action on VEGF/Flt-1 signaling-mediated osteoclastogenesis warrants further investigation.     

Effectiveness of Chinese herbal medicine in treating liver fibrosis: a systematic review and meta-analysis of randomized controlled trials

Background

The studies on the effectiveness of Chinese herbal medicines (CHM) in treating liver fibrosis (LF) were not consistent. This study aims to systematically review the effectiveness of CHM on treating LF patients.

Methods

Databases including MEDLINE, AMED, EMBASE, The Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, TCMOnline, Chinese Biomedical Literature Database, and Chinese Medical Current Contents were searched up to March 2011. Randomized controlled trials (RCTs) involving LF patients receiving CHM, Western medicine, combined CHM and Western medicine compared with placebo, Western medicine or no intervention were included. LF markers including serum hyaluronic acid (HA), laminin (LN), procollagen type III (PC-III), type IV collagen (IV-C), matrix metalloproteinase (MMP), and tissue inhibitors of metalloproteinase (TIMP) were measured as primary outcomes. Liver biochemistry, including alanine aminotransferase (ALT) and aspartarte aminotransferase (AST), and improvement of related clinical symptoms were measured as secondary outcomes. Risk of bias of allocation sequence, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases were assessed.

Results

Twenty-three RCTs with 2123 participants were analyzed in subgroups of types of comparison and study quality. Fifteen studies were graded as good quality. CHM alone and combined with Western medicine showed significant improvements in HA, LN, PC-III and IV-C compared with Western medicine alone. However, there were no significant differences observed between CHM and placebo treatments.

Conclusion

The current inconclusive results in determining the effectiveness of CHM treatment on LF, due to the poor methodological quality and high heterogeneity of the studies, suggests that large RCTs using standardized Chinese medicine syndrome diagnosis and CHM formulae with longer follow-up are required for further evaluation.     

伊文思蓝检测急性高眼压后大鼠血-视网膜屏障的变化

目的:检测急性高眼压后大鼠血-视网膜屏障(BRB)的改变.方法:大鼠随机分为正常对照组、实验对照组和实验组（急性高眼压模型）.动物分别存活3h、12 h、1d、3d、7d,处死前注射伊文思蓝(EB),共聚焦显微镜检测视网膜铺片和切片中EB的分布;用分光光度计定量视网膜EB的含量.结果:在急性高眼压后视网膜中可见,EB红...     

12例多种羧化酶缺乏症的基因突变分析

目的 旨在从基因水平证实多种羧化酶缺乏症(multiple carboxylase deficiency,MCD)的诊断,探讨我国MCD患儿的基因突变情况.方法 12例MCD患儿接受基因诊断.采用PCR及直接测序法分别对4例生物素酶(biotinidase,BT)缺乏症和8例全羧化酶合成酶(holocarboxylase synthetas,HLCS)缺乏症进行BT基因和HLCS基因突变分析,对基因新突变通过限制性片段长度多态性分析及患儿父母和50名正常对照者基因检测以证实.结果 12例患儿基因突变检出率100%.4例BT缺乏症中发现BT基因突变6种:c.98-104del7ins3,c.1369G>A(V457M),c.1157G>A(W386X),c.1284C>A(Y428X),c.1384delA,c.1493_1494insT,后4种为新突变.8例HLCS缺乏症中发现HLCS基因突变4种:c.126G>T(E42D),c.1994G>C(R665P),c.1088T>A(V363D),c.1522C>T(R508W),后两种为热点突变[75%(12/16)],c.1994G>C为新突变.结论 本研究从基因水平上证实了12例MCD的诊断.共发现了6种BT基因突变,4种HLCS基因突变,其中5种为新突变;得出2种HLCS基因的热点突变.     

Effects of lead exposure on hippocampal metabotropic glutamate receptor subtype 3 and 7 in developmental rats

Background  

A complete explanation of the mechanisms by which Pb²⁺ exerts toxic effects on developmental central nervous system remains unknown. Glutamate is critical to the developing brain through various subtypes of ionotropic or metabotropic glutamate receptors (mGluRs). Ionotropic N-methyl-D-aspartate receptors have been considered as a principal target in lead-induced neurotoxicity. The relationship between mGluR3/mGluR7 and synaptic plasticity had been verified by many recent studies. The present study aimed to examine the role of mGluR3/mGluR7 in lead-induced neurotoxicity.     

Abnormal Development at Early Postimplantation Stage in Mouse Embryos After Preimplantation Genetic Diagnosis

Preimplantation genetic diagnosis (PGD) is an established procedure for the genetic analysis of embryos. To assess the effect of the procedure on early embryonic development, we generated a murine experimental system, including mice implanted with biopsied in vitro cultured embryos, control mice implanted with in vitro cultured embryos without biopsy, and mice with naturally conceived embryos. Embryos at the 7.5‐dpc stage were isolated from all three groups and the embryo implantation rate, the survival rate of implanted embryos, and the developmental stage of surviving embryos were carefully assessed and compared among all three groups. We found the implantation rate was similar between biopsied and control group embryos (67.92% vs. 66.67%). However, the survival rate of implanted embryos in the biopsied group (49.31%) was significantly lower than that of the control (60.91%) and normal groups (96.24%) at 7.5 dpc. In addition, the survival rate of control group embryos was significant lower than that of normal group embryos. Classification of the precise developmental stages of randomly selected live implanted embryos at 7.5 dpc revealed no differences among the three groups. Our results indicate that blastomere biopsy does not adversely affect embryo implantation. The PGD procedure, in particular blastomere biopsy, increases the rate of embryo death at 4.5–7.5 dpc, but does not affect the development of surviving 7.5 dpc embryos. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.     

肝癌组织差异表达基因cDNA序列的筛选与鉴定

目的：筛选并鉴定肝癌组织特异表达基因。方法：通过菌落原位杂交技术筛选用抑制消减杂交法构建肝癌与癌旁肝组织差异表达基因消减cDNA文库，用PCR方法进一步筛选出有插入片段的阳性克隆，将阳性克隆进行DNA测序和同源性比较分析，用Northern印迹方法对新的cDNA序列进行初步鉴定。结果：从消减文库中随机挑取的100个白色克隆中筛选出13个阳性克隆，DNA测序获得11个不同的cDNA序列；同源性比较分析表明，6个cDNA片段与在基因高度同源，5个cDNA片段为新的序列。其长度大于300bp的3个新序列，Norther印迹证实它都来源于肝癌组织。结论：用抑制消减杂交方法构建的肝癌差异表达基因消减cDNA文库富含肝癌特异表达基因，经验证的3个新的cDNA序列可能为肝癌特异的基因序列。     

不同表面处理方法对纯钛表面形貌及成分的影响

分别用HNO3、热H2SO4/H2O2、热H2SO4/HC l处理纯钛片30 m in。采用扫描电子显微镜、X射线光电子能谱对试样的表面形貌及成分进行分析。扫描电镜结果显示,HNO3组表面形貌光滑,平整;而H2SO4/HC l、H2SO4/H2O2处理方法可获得粗糙的表面,其中H2SO4/HC l处理后的表面孔隙更大。X射线光电子能谱分析表明:三组钛片表面的主要成分均为钛、氧和碳,H2SO4/H2O2组的碳含量最低,而H2SO4/HC l组碳含量最高。HNO3组和H2SO4/H2O2组表面除了T iO2还存在T i2O3、T iO、金属T i等多种物质,而H2SO4/HC l组表面只存在T iO2。     

喘可治注射液抑制小鼠变应性接触性皮炎的实验研究

目的：探讨中药喘可治注射液抑制小鼠变应性接触性皮炎（Ⅳ型变态反应）的效果。 方法： 将小鼠按给药不同分为喘可治注射液高、中，低剂量组，地塞米松(DEX)组，苯海拉明及生理盐水组，利用2，4-二硝基氟苯诱发的小鼠左耳变应性接触性皮炎的动物模型，各组于第0 d、1 d致敏前2 h，第2 d和第5 d诱发前2 h及诱发后6 h腹腔注射给药，通过测量左耳厚度差、左耳重量差，体重差及观察左耳病理改变，比较不同剂量喘可治注射液之间以及与对照组之间的疗效。 结果： 喘可治注射液高、中、低剂量和DEX组小鼠左耳厚度及重量的增加，浸润的单核细胞和中性粒细胞的数量均明显低于生理盐水组(P<0.01)；DEX组小鼠左耳红肿的程度虽稍低于喘可治组，但小鼠体重差与其它组比较均有显著差异（P<0.01）；苯海拉明组小鼠变应性接触性皮炎的程度与生理盐水组差异无显著。 结论： 喘可治注射液具有明显抑制小鼠变应性接触性皮炎的作用。