采用组织芯片技术分析胃癌组织中胃泌素和胃泌素释放肽的表达

目的研究胃癌组织中胃泌素(GAS)、胃泌素释放肽(GRP)的表达及其临床意义。方法采用组织芯片技术制作60例胃癌组织芯片,同时用生物素-链霉菌卵白素检测系统(SP)免疫组织化学方法检测胃癌组织芯片中GAS、GRP的表达。结果60例胃癌中GAS阳性率为30.0%;GRP阳性率为11.7%。中、低分化胃癌GAS、GRP阳性率高于高分化胃癌(P<0.05);印戒细胞癌GAS、GRP阳性率显著高于其他组织学类型胃癌(P<0.05);胃癌GAS、GRP阳性表达与淋巴结转移相关(P<0.05)。结论应用组织芯片大规模高效检测临床组织样本是可行的,具有快速、方便、经济、准确的特点。     

A new technique of transferring island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of recurrent ischial pressure sores.

We describe island pedicled anterolateral thigh and vastus lateralis myocutaneous flaps for reconstruction of the difficult, recurrent ischial pressure sore. Rather than transfer through a subcutaneous tunnel, the flap is transferred directly through the upper thigh to the ischial defect. A total of 15 patients with 16 recurrent ischial pressure sores were treated between May 2003 and April 2005. Eleven sores were treated with pedicled island anterolateral thigh flaps and five sores with vastus lateralis myocutaneous flaps. There was no difficulty in transferring the flap to reach the ischial defect in any patient. The length of the pedicle ranged from 8.5 to 14 cm. All donor sites were closed primarily. Fifteen of the 16 flaps survived completely. Total necrosis occurred in one vastus lateralis myocutaneous flap, which was located at the distal third of the thigh. We conclude this flap can be added to the repertoire for the treatment of recurrent, difficult ischial pressure sores.     

爆炸伤创面IL-1、IL-6、TNF-α、CRP的测定

[目的]检测兔肢体爆炸伤创面组织IL-1、IL-6、TNF-α和CRP含量。[方法]新西兰大白兔24只,随机分为炸伤后即刻取材组（A组,n=12）和炸后1h取材组（B组,n=12）;0.9g铜壳单质猛黑索金炸药（RDX）以海绵间隔5cm,绑于左下肢股部中段前外侧,电引爆,分别取爆炸中心区（Ⅰ区）、爆炸边缘区（Ⅱ区）、爆震区（Ⅲ区）的肌肉组织,测IL-1、IL-6、TNF-α、CRP的含量并取对侧肢体肌肉组织做对照研究。[结果]炸伤后两组各区标本IL-1、IL-6、TNF-α、CRP含量均比正常组织高,差异显著（P〈0.05）,且从Ⅰ区、Ⅱ区到Ⅲ区,含量依次降低,差异显著（P〈0.05）：A组：Ⅱ区与Ⅲ区的IL-1含量差别有显著意义（P〈0.05）。Ⅰ区与Ⅲ区、Ⅱ区与Ⅲ区的IL-6含量差别有极显著意义（P〈0.01）。Ⅰ区与Ⅲ区的TNF-α、CRP含量差别有极显著意义（P〈0.01）,Ⅰ区与Ⅱ区、Ⅱ区与Ⅲ区的含量差别有显著意义（P〈0.05）。其余各区的含量无统计学差异（P〉0.05）;B组：Ⅱ区与Ⅲ区的Ⅱ-1、IL-6、TNF-α含量差别有显著意义（P〈0.05）。Ⅰ区与Ⅲ区、Ⅰ区与Ⅱ区、Ⅱ区与Ⅲ区的CRP含量差别有显著意义（P〈0.05）。其余各区的含量无统计学差异（P〉0.05）。A、B两组比较,炸后组织中上述因子表达虽有增强,但差异无显著意义（P〉0.05）。[结论]肢体爆炸伤1h内,创面组织中IL-1、IL-6、TNF-α、CRP表达增强,不同区域间表达有差异。     

Ⅳ型胶原在贲门癌自体荧光诊断中的意义初步探讨

目的通过比较胃底贲门正常组织和癌组织中Ⅲ、Ⅳ型胶原蛋白分布差异，分析胃底贲门组织癌变后Ⅲ、Ⅳ型胶原蛋白分布的改变对组织的自体荧光产生的影响。方法采用免疫组化技术，半定量计分分析Ⅲ、Ⅳ型胶原在16例责门癌病人正常组织和癌组织中的分布差异。结果正常组织的基底膜呈现很强的Ⅳ型胶原抗体阳性反应，在基底膜形成较粗的环形染色带；Ⅲ型胶原抗体阳性反应在细胞外间质呈连续的细丝纤维样。癌组织Ⅳ型胶原抗体反应在癌巢周边为阴性，或仅在残存的基底膜有片断的阳性反应；而Ⅲ型胶原在癌间质中的抗体阳性反应较正常组织变化不明显，或还稍有增强；Ⅲ型和Ⅳ型在正常组织和癌组织中的分布差异有极其显著性（P〈0．001）。结论胃底贲门组织癌变后，细胞外基质内Ⅳ型胶原显著减少，而Ⅲ型胶原减少不明显；Ⅳ型胶原是胃底贲门黏膜细胞外基质自体荧光的主要来源；组织发生癌变后，细胞外基质中Ⅳ型胶原的降解是癌组织自体荧光减弱的主要原因之一。     

Transmural and endocardial Purkinje activation in pigs before local myocardial activation after defibrillation shocks.

BACKGROUND: Earliest recorded postshock myocardial activations in pigs originate in the subepicardium of the apex and lateral free wall of the left ventricle (LV) 30-90 ms after the shock. OBJECTIVE: The purpose of this study was to determine whether the Purkinje system is a candidate for the source of postshock activations by performing endocardial and transmural postshock activation mapping. METHODS: In five pigs, 32 plunge needles with 12 electrodes (1-mm spacing) were inserted into the LV apex and lateral free wall. Up to 70 plunge needles with six electrodes (2-mm spacing) were spread throughout the remainder of the LV, while 9-12 plunge needles with four electrodes (2-mm spacing) were inserted into the right ventricle. A basket catheter with 32 bipolar recording sites was inserted into the LV. Defibrillation-threshold (DFT)-level shocks were delivered during 10 episodes of electrically induced ventricular fibrillation. Electrograms of postshock activation cycles were analyzed for Purkinje and myocardial activations. RESULTS: Purkinje activations were recorded before local myocardial activation in 9% of basket electrograms and in 15% of plunge needles during the first postshock activation cycle. Purkinje activations were identified during the first and subsequent several postshock activation cycles in at least one basket and one needle electrogram in 96% and 98% of defibrillation episodes, respectively. CONCLUSIONS: The Purkinje system is active during the early postshock activation cycles after DFT-level shocks. Further studies are required to determine whether activation initiates in the Purkinje system or whether it is activated by the myocardium or by Purkinje-myocardial junctional cells.     

对称性颅脑损伤的临床诊断与治疗(附123例报告)

目的提高治疗对称性颅脑损伤临床疗效。方法总结123例对称性颅脑损伤患者的临床资料,对其临床特点和治疗情况进行回顾性分析。结果预后良好64例(52.0%),中残25例(20.3%),重残8例(6.5%),植物生存4例(3.3%),死亡22例(17.9%)。结论对称性颅脑损伤是一种较为危重的特殊损伤类型,重视其临床特点,严密观察病情变化,正确把握治疗适应证,方可提高疗效。     

Post-injury regeneration in rat sciatic nerve facilitated by neurotrophic factors secreted by amniotic fluid mesenchymal stem cells.

Amniotic fluid mesenchymal stem cells have the ability to secrete neurotrophic factors that are able to promote neuron survival in vitro. The purpose of this study was to evaluate the effects of neurotrophic factors secreted by rat amniotic fluid mesenchymal stem cells on regeneration of sciatic nerve after crush injury. Fifty Sprague-Dawley rats weighing 250-300 g were used. The left sciatic nerve was crushed with a vessel clamp. Rat amniotic fluid mesenchymal stem cells embedded in fibrin glue were delivered to the injured nerve. Enzyme-linked immunosorbent assay (ELISA) and immunocytochemistry were used to detect neurotrophic factors secreted by the amniotic fluid mesenchymal stem cells. Nerve regeneration was assessed by motor function, electrophysiology, histology, and immunocytochemistry studies. Positive CD29/44, and negative CD11b/45, as well as high levels of expression of brain-derived neurotrophic factor, glia cell line-derived neurotrophic factor, ciliary neurotrophic factor (CNTF), nerve growth factor, and neurotrophin-3 (NT-3) were demonstrated in amniotic fluid mesenchymal stem cells. Motor function recovery, the compound muscle action potential, and nerve conduction latency showed significant improvement in rats treated with amniotic fluid mesenchymal stem cells. ELISA measurement in retrieved nerves displayed statistically significant elevation of CNTF and NT-3. The immunocytochemical studies demonstrated positive staining for NT-3 and CNTF in transplanted cells. The histology and immunocytochemistry studies revealed less fibrosis and a high level of expression of S-100 and glial fibrillary acid protein at the crush site. Rat amniotic fluid mesenchymal stem cells may facilitate regeneration in the sciatic nerve after crush injury. The increased nerve regeneration found in this study may be due to the neurotrophic factors secreted by amniotic fluid mesenchymal stem cells.     

新基因Tctex5在雄鼠生殖细胞中的表达

目的探讨雄鼠生殖细胞中是否有Tctex5基因的表达。方法从三株体外培养的雄鼠生殖细胞CRL-1715、CRL-2053和CRL-2196细胞株中提取总RNA和蛋白，采用RT-PCR和Western blot分别从mRNA和蛋白质水平分析基因产物的表达。结果Tctex5基因在CRL-1715、CRL-2053、CRL-2196三株细胞中都有高表达。结论Tctex5基因作为一个未知功能的基因，在雄鼠生殖细胞中有丰富的表达，可能参与了精子发生的功能调节，作为男性正常生育的。个新的标志物，它可能在精子发生中扮演了一个重要的角色，该基因在雄性生殖细胞中的发现可能会对男性不育的诊断与治疗提供新的途径。     

改良"箭头"皮瓣法乳头乳晕再造术

目的 介绍改良"箭头"皮瓣法乳头乳晕再造术的应用经验.方法 将"箭头"皮瓣法乳头乳晕再造术的设计经过凋整改进,为曾使用自体组织行乳房再造的患者再造乳头乳晕12例,其中2例采用改良"箭头"皮瓣法+薄中厚皮片移植乳头乳晕再造,4例采用改良"箭头"皮瓣法+自体肋软骨埋置+乳晕文身的乳头乳晕再造,6例采用"箭头"皮瓣法+乳晕文身的乳头乳晕再造.结果 再造乳头全部成活,其中2例术后1个月时再造乳头回缩完全变平,其余10例术后3个月时再造乳头回缩率约50%,跟踪随访6个月至1年,再造乳头大小稳定,与对侧基本对称.结论 本手术方法设计合理、操作简单,且无需另选供区,远期乳头突度维持也良好.