Double-bundle technique: Endoscopic posterior cruciate ligament reconstruction using tibialis posterior allograft

Recently, attention has been given to the double-bundle technique for treating the posterior cruciate ligament (PCL)-deficient knee. We present an arthroscopic PCL reconstruction using a double-bundle technique with 3-stranded tibialis posterior (TP) allograft that has not been described before. The anterolateral bundle of the PCL is reconstructed using 2-stranded TP allograft and the posteromedial bundle using 1-stranded TP allograft. Three-stranded TP allograft will be an alternative graft choice for PCL reconstruction.     

常规医疗设备招标存在问题的思考和对策--决策学多属性效用理论的实践探索

通过对常规医疗设备招标存在问题的思考,采用决策学多属性效用理论作为一种对策方法,并在实际操作中进行了尝试探索,以取得更好的效果.     

莱菔硫烷对人膀胱癌细胞周期的影响及机制研究

背景与目的:探讨莱菔硫烷对人膀胱癌细胞(T24)细胞周期的影响及作用机制。材料与方法:采用噻唑蓝(MTT)法研究不同浓度的莱菔硫烷对T24细胞生长的抑制作用并测定其半数抑制浓度(IC50);采用流式细胞仪检测莱菔硫烷对T24细胞周期的影响;采用westernblot研究莱菔硫烷对T24细胞中细胞周期蛋白依赖激酶抑制剂P16和P27的表达情况。结果:在较低剂量范围内(≤40μmol/L),随着作用剂量的增加,莱菔硫烷对T24细胞的生长的抑制作用也明显增强。10、20、40μmol/L莱菔硫烷的抑制率分别为(12.5±3.95)%,(25.0±2.50)%、(50.0±5.33)%;在较高剂量(60μmol/L~160μmol/L)时,这种抑制作用不再呈剂量依赖性;莱菔硫烷作用72h后的IC50值为(51.12±7.10)μmol/L;莱菔硫烷能使T24细胞周期阻滞于G0/G1期,20μmol/L莱菔硫烷作用48h后,在G0/G1峰之前出现凋亡峰;20μmol/L莱菔硫烷作用于T24细胞8、12、24h后能明显诱导P27蛋白的表达,作用早期(8h)时能诱导P16蛋白的表达。结论:莱菔硫烷能抑制T24细胞生长并使该细胞周期阻断在G0/G1期,其作用机制主要是通过诱导P27蛋白及早期诱导P16蛋白来实现的。     

磁共振成像在乳腺癌中的应用：究竟是进了一步还是退了两步？

目前，人们正对乳腺磁共振成像（magnetic resonance imaging，MRI）的应用进行研究，表现在两个不同方面：一是将MRI列为乳腺癌高危妇女（例如BRCA1和BRCA2基因发生突变者）的筛查方法；二是对乳腺癌确诊或可疑患者行乳腺X线的同时辅以MRI以决定是否选用局部疗法。这两种用途的依据迥然不同。有预置性突变（predisposition mutations）的妇女乳腺癌发病年龄通常较低，此时由于乳腺组织较为致密，因而乳腺X线筛查的敏感性有所减低。     

维生素E琥珀酸酯诱导人胃腺癌细胞凋亡途径

目的　探讨维生素E琥珀酸酯 (VES)诱导人胃腺癌SGC -790 1细胞凋亡的死亡受体 (Fas)信号转导途径。方法　人胃腺癌SGC -790 1细胞经不同剂量VES(5,10 ,2 0 μg/ml)处理 ,同时做琥珀酸、维生素E和空白对照 ,采用DAPI(4,6-贰脒基 -2 -苯基吲哚 )荧光染色法观察细胞凋亡情况 ,用WesternBlot法检测Fas、带有死亡结构域的Fas相关蛋白 (FADD)和天冬氨酸特异性半胱氨酸蛋白酶 (caspase -8)蛋白表达情况 ,Fas和FADD反义寡聚核苷分别转染SGC -790 1细胞后 ,用荧光法检测caspase -8活性。 结果　经VES处理后的细胞DAPI染色可见凋亡的形态学改变 ,2 0 μg/mlVES处理 48h后的细胞凋亡率为 89.6% ;VES处理 48h后Fas、FADD和caspase -8蛋白表达明显增加 ,且呈剂量 -效应关系 ;阻断Fas可明显抑制FADD蛋白表达 ,Fas和FADD反义寡聚核苷转染细胞后caspase -8活性明显降低 (P <0 .0 1) ,其中阻断Fas的效果高于阻断FADD。结论　维生素E琥珀酸酯诱导人胃腺癌SGC -790 1细胞凋亡过程中启动了Fas信号转导途径 ,VES启动Fas后 ,FADD将Fas和caspase -8联接起来 ,活化caspases级联反应 ,从而构成Fas/FADD/caspase -8的凋亡信号途径     

A case of Non-Hodgkin's lymphoma in a patient with Crohn's disease]

Although adenocarcinoma is a well known complication of chronic inflammatory bowel disease, primary gastrointestinal lymphoma occurring in Crohn's disease is rare. A 40-year-old man with 10 year-history of Crohn's disease had multiple longitudinal ulcerative lesions on descending colon in follow-up colonoscopic examination. Microscopic examination of proximal descending colon revealed peripheral T cell lymphoma and other site of the descending colon was consistent with Crohn's disease. The patient reached complete remission of malignant lymphoma after three cycles of combined chemotherapy. He has been well for 10 months with sulfasalazine maintenance therapy but was admitted to the hospital due to spontaneous bowel perforation of ascending colon. Right hemicolectomy was done, but the patient died of post-surgical recurrent mesenteric abscess and sepsis. To the best of our knowledge, this is the first case of Non-Hodgkin's lymphoma complicating Crohn's disease in Korea which was confirmed by immunohistochemical studies.     

The immunomodulatory effects of 3-monochloro-1,2-propanediol on murine splenocyte and peritoneal macrophage function in vitro.

3-Monochloro-1,2-propanediol (MCPD) is a well-known by-product of acid-hydrolyzed soy sauce during its manufacturing process. MCPD has been reported genotoxic in vitro, and reproductive toxicity and carcinogenicity in rats. To evaluate the immunomodulatory effect of MCPD on murine splenocyte and macrophage in vitro, we investigated splenocyte blastogenesis by concanavalin A (Con A), anti-CD3, and lipopolyssacharide (LPS), the production of cytokines from splenocyte, and the activity of mouse peritoneal macrophages. There was a significant decrease in lymphocyte blastogenesis to Con A or anti-CD3 at subtoxic dose of MCPD. A significant decrease in splenocyte blastogenesis to LPS was also observed. The production level of interferon (IFN)-gamma on splenocyte culture with Con A was significantly reduced at the higher concentration than 1.0mM of MCPD. The levels of interleukin (IL)-4 and IL-10 were also decreased at high concentrations of MCPD. There was a significant decrease in production of nitric oxide (NO) by peritoneal macrophages treated with MCPD. MCPD also inhibits tumor necrosis factor (TNF)-alpha production of stimulated macrophages. These results indicate that MCPD might be able to reduce the functionality of lymphocytes and peritoneal macrophages in vitro.     

海风藤酚、甲基海风藤酚、海风藤醇A和海风藤醇B对兔血小板聚集的影响

海风藤酚、甲基海风藤酚、海风藤醇Ａ和海风藤醇Ｂ均有抑制血小板激活因子（ＰＡＦ）诱导的兔血小板聚集作用，ＩＣ_（５０）分别为１７．９、９．２、１４２．０、１４．０μｍｏｌ·Ｌ~（－１）。经阿司匹林（ＡＳＡ）、磷酸肌酸／磷酸肌酸激酶（ＣＰ／ＣＰＫ）预处理的兔洗涤血小板，甲基海风藤酚和海风藤醇Ｂ仍能抑制ＰＡＦ诱导的兔血小板聚集，ＩＣ_（５０）为９．０、１６．５μｍｏｌ·Ｌ~（－１）。同时，４种成分对于二磷酸腺苷（ＡＤＰ），花生四烯酸（ＡＡ）诱导的血小板聚集抑制作用较弱，海风藤Ｂ能使ＰＡＦ诱导血小板聚集量－效曲线平行右移，ＥＣ_（５０）由１．５９ｎｍｏｌ·Ｌ~（－１）升为２０．６ｎｍｏｌ·Ｌ~（－１）。结果表明：４种成分能选择性拮抗ＰＡＦ对兔血小板的聚集作用。     

Enhanced expression of adenovirus-mediated sodium iodide symporter gene in MCF-7 breast cancer cells with retinoic acid treatment.

Increased expression of the sodium iodide symporter (NIS) is required for effective radioiodine treatment and reporter gene imaging of breast cancer. We investigated the effect of retinoic acid on adenovirus-mediated expression of the human NIS gene in the MCF-7 breast cancer cell line. METHODS: The MCF-7 cell line was infected with recombinant adenovirus carrying the human NIS gene (Rad-NIS). Levels of NIS messenger RNA (mRNA) and protein expression and radioiodine ((125)I) uptake were measured to evaluate adenovirus-mediated NIS gene expression in wild-type and Rad-NIS-infected MCF-7 cells after treatment with all-trans-retinoic acid (ATRA; 10(-8)-10(-6) mol/L). RESULTS: The transduction efficiency of adenovirus in MCF-7 cells at a multiplicity of infection (MOI) of 50 was >60%. After incubation with 10(-6) mol/L ATRA, the mRNA level in Rad-NIS-infected MCF-7 cells increased to 118.5 times that of wild-type MCF-7 cells, whereas the mRNA level in wild-type MCF-7 cells showed only a 2.1-fold increase. Western blot, immunocytochemical staining, and flow cytometry analyses showed that NIS protein expression in MCF-7 cells infected with Rad-NIS increased after ATRA treatment. With ATRA treatment, the amount of (125)I uptake increased in a dose-dependent manner (P < 0.001). The (125)I uptake in wild-type MCF-7 cells increased 3.1-, 5.5-, and 7.6-fold with treatment with 10(-8), 10(-7), and 10(-6) mol/L ATRA, respectively. Rad-NIS-infected cells showed a 4.0-fold increase in (125)I uptake. Treatment of Rad-NIS-infected cells with 10(-8), 10(-7), and 10(-6) mol/L ATRA increased (125)I uptake by 4.9-, 8.2-, and 27.6-fold, respectively, compared with wild-type MCF-7 cells. The level of NIS expression in Rad-NIS-infected MCF-7 cells treated with 10(-6) mol/L ATRA (245.0 +/- 13.7 pmol/10(6) cells) was much greater than the sum of the expression levels seen in ATRA-treated wild-type cells and Rad-NIS-infected wild-type cells. CONCLUSION: Retinoic acid increases adenovirus-mediated NIS expression in MCF-7 cells. Our results indicate that improved efficiency of NIS gene therapy or reporter imaging in breast cancer may be possible with retinoic acid treatment.     

体外循环浅低温心脏不停跳心内直视手术的临床研究

目的:探讨体外循环浅低温心脏不停跳心内直视手术的方法、疗效评价及其对心肌保护作用。方法:总结2004年3月～2008年12月间12例施行浅低温心脏不停跳心内直视手术病例,并行循环不阻断主动脉,鼻咽温维持在32～35℃,阻断上、下腔静脉,完成心内直视手术。结果:全组无围手术期死亡,心脏手术结束能顺利停机,术后血流动力学平稳,无严重心律失常,血尿发生率0%,无1例发生空气栓塞。1例心房切口缝合针眼渗血,行再次开胸止血,1例术后第32h发生急性肺梗塞,均经治疗痊愈。结论:浅低温心脏不停跳心内直视手术技术安全可行,是一种接近生理状态的心肌保护方法,可避免再灌注损伤,有较理想的心肌保护效果。