介入技术在血液透析患者中心静脉导管相关问题中的应用

目的总结介入技术在血液透析患者中心静脉导管相关性问题诊断及治疗中的应用。方法回顾性分析我院肾内科82例中心静脉导管相关性介入诊断、治疗患者的临床资料,包括导管置入、导管位置调整及单纯诊断性造影,总结导管纤维鞘的诊断和介入处理方法。结果本组中伴有糖尿病者33例（40.2%）,既往平均置管次数（3.2±1.7）次;介入下置管共55例次,导管位置调整24例次。置管的患者中,造影提示38例患者存在中心静脉狭窄或闭塞;导管调整的患者均为颈内静脉置管,13例为左侧颈内静脉置管,导管调整的原因多为导管末端不能达到适当的位置;经造影诊断纤维鞘13例次。结论 X线介入下中心静脉导管相关操作可实时明确中心静脉情况,确保导管置入适当位置,并可对病变的中心静脉治疗后置入导管,也是导管纤维鞘的诊断和处理的有效方法之一。     

MicroRNA基因递送系统抗激素非依赖型前列腺癌增殖作用研究

目的：采用分枝状聚乙烯亚胺（BPEI）、线型的聚乙烯亚胺（LPEI）和树枝状聚合物聚酰胺-胺（PAMAM）与具有抑制激素非依赖型前列腺癌细胞PC3增殖的miRNA-15a和miRNA-16-1质粒结合,构建了MicroRNA基因递送系统。考察形成的三种纳米复合物的粒径、zeta电位、细胞内摄取,以及对PC3细胞的抑制作用。方法：利用粒径分析仪测定形成的三种纳米复合物的粒径和电位,凝胶电泳实验测定三种材料对miRNA的结合能力; 利用FAM标记的NC-miRNA考察PC3细胞对三种复合的摄取情况;通过CCK8 法测定三种材料与miRNA-15a和miRNA-16-1形成的复合物对PC3细胞的抑制作用;PCR法测定三种材料与miRNA-15a和miRNA-16-1结合后对PC3细胞中Bcl-2,Cylin D1和Wnt3a表达的阻滞作用。结果：BPEI,LPEI和PAMAM三种材料与miRNA可结合形成稳定的纳米级复合物,在N/P=5时,PC3细胞对BPEI/miRNA-FAM的摄取高于LPEI/miRNA-FAM和PAMAM/miRNA-FAM,具有统计学意义（P<0.01）。BPEI、LPEI和PAMAM都可以携带miRNA-15a和miRNA-16-1进入PC3细胞,并且阻滞PC3细胞中Bcl-2,Cylin D1和Wnt3a蛋白的表达。结论：BPEI,LPEI和PAMAM三种材料包裹miRNA-15a和miRNA-16-1可对激素非依赖型前列腺癌细胞PC3细胞产生抑制作用。并可以有效阻滞PC3细胞中Bcl-2,Cylin D1和Wnt3a蛋白的表达。     

非病毒类载体靶向治疗前列腺癌研究进展

在治疗前列腺癌的各种传统方法中,普遍存在着杀伤癌细胞的同时对正常组织器官造成损伤的现象。近年来兴起的靶向治疗在一定程度上能很好地解决这一问题。但作为靶向治疗的载体,病毒类载体存在免疫原性大、毒性大等缺点,而非病毒类载体靶向治疗前列腺癌往往能克服这些缺点。本文综述了以阳离子聚合物、脂质体和壳聚糖聚合物为主的非病毒类载体包裹基因药物靶向治疗前列腺癌的研究进展。     

Short-term Safety and Efficiency of Cryoablation for Renal Sympathetic Denervation in a Swine Model

Background:

Renal sympathetic nerves are involved in the reflective activation of the sympathetic nervous system in circulatory control. Catheter-based renal denervation (RDN) ameliorated treatment-resistant hypertension safely, but 10%–20% of treated patients are nonresponders to radiofrequency denervation. The purpose of this study was to investigate the safety and efficiency of cryoablation for sympathetic denervation in a swine model and to explore a new way of RDN.

Methods:

Seven swines randomly assigned to two groups: Renal cryoablation (CR) group and control group. The control group underwent renal angiogram only. The CR group underwent renal angiogram plus bilateral renal cryoablation. Renal angiograms via femoral were performed before denervation, after denervation and prior to the sacrifice to access the diameter of renal arterial and the pressure of aorta abdominalis. Euthanasia of the swine was performed on 28-day to access norepinephrine (NE) changes of the renal cortex and the changes of renal nerves.

Results:

Cryoablation did not induce severe complications at any time point. There was no significant change in diameter of renal artery. CR reduced systolic blood pressure (BP) from 145.50 ± 9.95 mmHg at baseline to 119.00 ± 14.09 mmHg. There was a slight but insignificant decrease in diastolic BP. The main nerve changes at 28-day consisted of necrosis with perineurial fibrosis at the site of CR exposure in conjunction with the nerve vacuolation. Compared with the control group, renal tissue NE of CR group decreased by 89.85%.

Conclusions:

Percutaneous catheter-based cryoablation of the renal artery is safe. CR could effectively reduce NE storing in the renal cortex, and the efficiency could be maintained 28-day at least.     

遵义地区初复治肺结核患者耐药情况的调查分析

目的 比较遵义地区初、复治肺结核患者耐药的差异,并分析产生差异的可能原因.方法 采用比例法对194株痰阳标本进行分离培养、菌种鉴定、耐药性检测;194例涂阳肺结核患者按初、复治分组进行回顾性分析.结果 初治组总耐药率为66.4％、耐多药率2.6％、广泛耐药率1.7％,复治组总耐药率79.5％,耐多药和广泛耐药率分别为37.2％、6.4％,复治组耐药率均明显高于初治组,差异具有统计学意义(P＜0.05);复治患者对一线抗结核药任何耐利福平、异烟肼、链霉素、乙胺丁醇分别为46.2％、56.4％、42.3％、25.6％均明显高于初治患者(5.2％、35.3％、18.1％、4.3％),差异具有统计学意义(P＜0.05);复治患者对二线抗结核药任何耐左氧氟沙星为25.6％明显高于初治患者(6.9％),差异具有统计学意义(P＜0.05).结论 该地区结核病患者耐药率高,尤其是复治患者,可能与治疗不规范、管理不彻底有关;此外,高耐喹诺酮类可能会加重耐药结核病的治疗难度,须给予高度重视.     

日本血吸虫(中国大陆株)22.6kDa重组抗原对小鼠免疫保护性的初步研究

目的：为研究日本血吸虫（中国大陆株）22．6kDa抗原的免疫保护性。方法：将其编码cDNA经PCR扩增后亚克隆入载体质粒PGEX—1λt进行表达，并用重组抗原免疫了一批昆明鼠。结果：与对照组相比，重组抗原免疫小鼠获得了38．93％的减虫率。结论：证明重组的日本血吸虫22．6kDa抗原可诱导宿主抗血吸虫感染的部分保护力。     

Use of intrinsic modes in biology: Examples of indicial response of pulmonary blood pressure to ± step hypoxia

Recently, a new method to analyze biological nonstationary stochastic variables has been presented. The method is especially suitable to analyze the variation of one biological variable with respect to changes of another variable. Here, it is illustrated by the change of the pulmonary blood pressure in response to a step change of oxygen concentration in the gas that an animal breathes. The pressure signal is resolved into the sum of a set of oscillatory intrinsic mode functions, which have zero “local mean,” and a final nonoscillatory mode. With this device, we obtain a set of “mean trends,” each of which represents a “mean” in a definitive sense, and together they represent the mean trend systematically with different degrees of oscillatory content. Correspondingly, the oscillatory content of the signal about any mean trend can be represented by a set of partial sums of intrinsic mode functions. When the concept of “indicial response function” is used to describe the change of one variable in response to a step change of another variable, we now have a set of indicial response functions of the mean trends and another set of indicial response functions to describe the energy or intensity of oscillations about each mean trend. Each of these can be represented by an analytic function whose coefficients can be determined by a least-squares curve-fitting procedure. In this way, experimental results are stated sharply by analytic functions.     

Histological precursors of oesophageal squamous cell carcinoma: results from a 13 year prospective follow up study in a high risk population

BACKGROUND: Oesophageal squamous cell carcinoma (OSCC) has a very poor prognosis, which is largely due to late diagnosis. Successful early detection strategies will require identification of clinically relevant precursor lesions that can be targets for screening and treatment. AIMS: To identify the clinically relevant histological precursors of OSCC. SUBJECTS: A cohort of 682 endoscoped patients from a high risk rural population in Linxian, China. METHODS: Subjects were endoscoped and biopsied at baseline and followed for 13.5 years. We estimated the relative risk of developing OSCC for each of the initial histological diagnoses using Cox proportional hazards regression models. RESULTS: A total of 114 (16.7%) patients developed OSCC during the follow up period. After adjusting for potential confounding factors, relative risks (95% confidence intervals) for incidence of this tumour, by initial histological diagnosis, were: normal 1.0 (reference), oesophagitis 0.8 (0.2-3.2), basal cell hyperplasia 1.9 (0.8-4.5), mild dysplasia 2.9 (1.6-5.2), moderate dysplasia 9.8 (5.3-18.3), severe dysplasia 28.3 (15.3-52.3), and carcinoma in situ 34.4 (16.6-71.4). CONCLUSIONS: In this study, squamous dysplasia and carcinoma in situ were the only histological lesions associated with a significantly increased risk of developing OSCC within 13.5 years after endoscopy. There was no evidence that oesophagitis predisposed to this tumour. Increasing grades of dysplasia were strongly associated with increasing risk, indicating that the histological grading was clinically meaningful. The follow up experience of severe dysplasia and carcinoma in situ was equivalent, suggesting that this distinction is not clinically relevant. Documenting these precursor lesions of OSCC should assist in the development of effective prevention, early detection, and treatment strategies for this disease.     

胃癌腹腔化疗毒副反应的观察和处理

目的 评价胃癌腹腔化疗的毒副反应，并探讨其处理方法。方法 将156例胃癌病人进行随机分组。分为术中即时低渗温热腹腔化疗联合术后早期腹腔化疗组（治疗组），单纯术中即时低渗温热腹腔化疗组（对照组1），未行腹腔化疗组（对照组2），共三组，观察化疗的安全性和毒副反应。结果 治疗组化学性腹膜炎、消化道反应、骨髓抑制和肝功能异常的发生率明显高于两个对照组。结论 应用术中即时，低渗温热腹腔化疗联合术后早期腹腔化疗时化学性腹膜炎的防治不容忽视。