腹腔镜辅助远端胃癌根治术的临床应用

目的：探讨腹腔镜辅助远端胃癌根治术的可行性、安全性。方法：回顾性分析12例腹腔镜辅助远端胃癌根治术的临床资料。结果：12例均顺利完成手术,无中转开腹。平均手术时间240min,术中平均出血100ml,无手术并发症发生,术后病理检查淋巴结平均23.5枚,两切端无癌细胞残留。结论：腹腔镜辅助远端胃癌根治术安全、可行,近期效果满意。     

终末期肾病并存冠心病患者行冠状动脉介入治疗的护理

73例上消化道肿瘤患者应用金蒸气激光仪作为治疗光源，通过内镜活检孔导入柱状光导纤维，对准病变部位连续3d行3次光照射。结果73例全部完成治疗，总有效率67．12％（49例）。并发症中发热27例（36．99％），消化道出血26例（35．62％），局部水肿19例（26．03％），疼痛18例（24．66％），皮肤光敏反应4例（5．48％），气管食管瘘1例（1．37％），均经对症治疗和护理及时缓解。提出金蒸气激光治疗上消化道肿瘤时，早期预防和护理有利于增加治疗的顺应性和有效性，有利于并发症的早期发现和及时处理。     

Abnormal Nuclear Factor (NF)-κB Signal Pathway and Aspirin Inhibits Tumor Necrosis Factor α–Induced NF-κB Activation in Keloid Fibroblasts

BACKGROUND: Keloid is characterized with disproportionate extracellular matrix accumulation and fibroblast proliferation. Rel/nuclear factor-kappaB (NF-kappaB) signal transduction pathway may play an important role in keloid pathogenesis. OBJECTIVE: To examine the effect of aspirin on the tumor necrosis factor (TNF)-alpha-induced NF-kappaB activation in keloid fibroblasts. METHODS: Primary cultured fibroblasts were pretreated with aspirin and then stimulated with TNF-alpha. Proliferation and apoptosis were measured by MTT reduction and flow cytometry. Expression of DNA-binding activity of NF-kappaB p65 and cytoplasmic IkappaBalpha/p- IkappaBalpha protein levels were determined by Trans AM NF-kappaB/p65 kit and Western blot, respectively. Subcellular localization of NF-kappaB p65 and IkappaBalpha were observed with immunofluorescence assay. RESULTS: In this study, we demonstrate that TNF-alpha induced NF-kappaB activation in keloid fibroblasts, which show more sensitively than the normal skin fibroblasts. Aspirin pretreatment can inhibit TNF-alpha-induced activation of NF-kappaB in a dose-dependent manner by preventing the phosphorylation and degradation of IkappaBalpha and nuclear translocation of NF-kappaB. Moreover, aspirin may inhibit keloid fibroblasts proliferation and sensitize keloid fibroblasts to apoptosis. CONCLUSION: These results suggest that aspirin could help in developing therapeutic interventions for the treatment of keloid scarring.     

microRNA-139-5p及其靶基因Notch1在结直肠癌中的作用

目的：探讨microRNA-139-5p（miR-139-5p）在结直肠癌中的表达及其对结直肠癌细胞转移和侵袭的影响。 方法：用荧光定量PCR方法检测miR-139-5p在结直肠癌组织与不同结直肠癌细胞株中的表达变化;用Boyden小室分析和伤口愈合实验检测miR-139-5p转染及miR-139-5p抑制对结直肠癌细胞转移和侵袭能力的影响;生物信息学方法预测miR-139-5p的靶基因,并采用荧光素酶报告基因实验验证,Western blot方法检测miR-139-5p转染对靶基因表达的影响。 结果：与各自的正常对照组比较,结直肠癌组织与结直肠癌细胞系中miR-139-5p表达均明显降低（P<0.05）。结直肠癌DLD1细胞和HCT116细胞转染miR-139-5p后,转移与侵袭能力均明显降低（均P<0.05）,而miR-139-5p抑制剂处理后,两种细胞的的侵袭能力均明显增强（均P<0.05）。生物信息学预测显示,Notch1是miR-139-5p的靶基因,且得到荧光素报告实验结果证实。Western blot结果显示,转染miR-139-5p后,结直肠癌DLD1细胞和HCT116细胞中Notch1蛋白表达均明显下调（均P<0.05）。 结论：miR-139-5p可能通过调节Notch1的表达而抑制肿瘤细胞的转移和侵袭,而下调的miR-139-5p可能在结直肠癌的发生发展中起了重要作用。     

侧后方入路手术治疗高位腰椎间盘突出症

目的探讨侧后方入路治疗高位腰椎间盘突出症(ULDH)的临床疗效。方法对20例ULDH患者行侧后方入路治疗。术前、术后2周及末次随访时进行腰痛视觉模拟评分法(VAS)及JOA评分。结果 20例全部获得随访,时间12~24(18.8±2.3)个月。VAS评分:术前为7.8分±1.3分,术后2周为1.3分±1.2分,末次随访时为1.4分±1.1分,术后2周及末次随访时与术前比较差异均有统计学意义(P0.05);JOA评分:术前为12.12分±2.12分,术后2周为20.60分±3.12分,末次随访时为21.88分±3.05分,术后2周及末次随访时与术前比较差异均有统计学意义(P0.05)。疗效按Otani et al分级方法评定:优15例,良1例,可3例,差1例,优良率为16/20。结论侧后方入路治疗ULDH疗效明确。术中应仔细操作,以避免医源性损伤。     

激光光动力学疗法治疗恶性黑色素瘤6例

目的 探讨激光光动力学疗法治疗恶性黑色素瘤的临床疗效.方法 恶性黑色素瘤患者6例,静脉滴注血卟啉衍生物(HpD)5 me/kg后6～72 h内以金蒸气激光或半导体激光照光,功率密度120～150 mW/cm2,能量密度120～200 J/cm2.治疗前后观察病灶情况,1个月后评价疗效.结果 6例患者中,完全效应4例,部分效应2例,总有效率达100%.1例患者随访6年未见复发.所有病例均未出现严重毒副反应.结论 光动力学疗法是治疗恶性黑色素瘤的有效方法,值得进一步深入研究.     

大豆异黄酮在不同的雌激素环境下对MMTV-erbB-2转基因小鼠的作用

目的 观察大豆异黄酮在不同的雌激素环境下,对MMTV-erbB-2转基因小鼠的乳腺肿瘤发生及发展的影响.方法 选取鼠龄5周的健康MMTV-erbB-2转基因雌性小鼠150只,分为对照组、低雌激素组1、低雌激素组2、高雌激素组1和高雌激素组2五组,观察各组小鼠乳腺癌的发病率和潜伏期,并采用免疫组织化学染色SP法检测各组小鼠乳腺组织中雌激素受体(ER)、孕激素受体(PR)、增殖细胞核抗原(PCNA)的表达.结果 对照组、低雌激素组1、低雌激素组2、高雌激素组1和高雌激素组2的乳腺癌发病率分别为73.3%、96.7%、30.3%、40.0%和83.3%,对照组与高雌激素组2、低雌激素组1与高雌激素组2发病率比较差异无统计学意义(P＞0.05),其他各组间比较差异有统计学意义(P＜0.05).各组小鼠乳腺癌平均潜伏期比较差异无统计学意义(P＞0.05).低雌激素组1的TEB数量与其他各组比较差异有统计学意义(P＜0.05).erbB-2表达在各组之间表达差异无统计学意义(P＞0.05).低雌激素组1、低雌激素组2、高雌激素组1和高雌激素组2与对照组乳腺ER和PR的表达比较差异无统计学意义(P＞0.05).低雌激素组1实验小鼠发生肿瘤的乳腺组织内PCNA的表达明显高于其他各组(P＜0.05).对照组与高雌激素组2,低雌激素组1与高雌激素组2比较差异有统计学意义(P＜0.05),其他各组间比较差异有统计学意义(P＜0.05).结论 大豆异黄酮在不同的雌激素环境下,对MMTV-erbB-2转基因小鼠乳腺肿瘤的发生及发展起不同的作用.低雌激素环境下大豆异黄酮可促进乳腺肿瘤的发生及发展,高雌激素环境下大豆异黄酮可抑制乳腺肿瘤的发生及发展.

Abstract：

Objective To investigate the effect of the soybean isoflavones at different estrogen environments on the pathogenesis of breast cancer in MMTV-erbB-2 transgenic mice. Methods 150 fiveweek-old MMTV-erbB-2 transgenic female mice were phosen and divided into five groups; control group,low estrogen group 1, low estrogen group 2, high estrogen group 1 and high estrogen group 2. The incidence and latent period of breast cancer were observed, and the expression of estrogen receptor (ER) ,progesterone receptor (PR), and proliferating cell nuclear antigen (PCNA) proteins was detected by using immunohistochemistry SP method. Results The incidence of breast cancer in control group, low estrogen group 1, low estrogen group 2, high estrogen group 1 and high estrogen group 2 was 73. 3% , 96. 7% ,30. 3% , 40. 0% and 83. 3% , respectively, with the difference being not significant between control group and high estrogen group 2, and between low estrogen group 1 and high estrogen group 2 (P ＞ 0. 05 ) , but with the difference being significant among the other groups (P ＜ 0. 05 ). There was significant difference in the average latent period of breast cancer among all groups (P ＞ 0. 05 ). There was significant difference in the number of TEB between low-estrogen group 1 and other groups (P ＜ 0.05). There was significant difference in the erbB-2 expression among the groups ( P ＞ 0. 05 ). There was no significant difference in the expression of breast ER and PR between control group and other groups ( P ＞ 0. 05 ). The PCNA expression in breast tumor tissue in low-estrogen group 1 was significantly higher than other groups (P ＜0. 05) , and there was significant difference in the PCNA expression between control group and high estrogen group 2, between low estrogen group 1 and high estrogen group 2 (P ＜ 0. 05). Conclusion The soybean isoflavones at different estrogen environments play different roles in the occurrence and development of MMTV-erbb-2 transgenic mouse mammary tumor. In the context of low estrogen, soybean isoflavones could even promote breast cancer formation and development. In the context of high estrogen, soybean isoflavones could inhibit breast cancer and development.     

新生大鼠胰腺nestin阳性细胞的体外分离、培养和分化的研究

目的探索新生大鼠胰腺nestin阳性细胞体外分离、培养并使之形成类胰岛样细胞团的方法。方法应用胶原酶消化新生大鼠胰腺,将消化的组织碎片培养形成类胰岛样细胞团后传代。免疫荧光细胞化学法检测贴壁细胞胰岛素、胰高血糖素及nestin的表达。RT-PCR检测培养1周的贴壁细胞nestin及细胞角蛋白(CK19)的表达。结果在pH 7．6条件下培养24-36 h有部分细胞贴壁生长,改用pH 7．4无血清RPMI 1640培养液培养18-24 d可形成类胰岛样细胞团,传代后可有单层细胞生长。培养24～36 h的贴壁细胞nestin呈阳性,但胰岛素、胰高血糖素阴性,形成的类胰岛样细胞团传代后24 h胰岛素、胰高血糖素呈阳性。培养1周的单层细胞经RT-PCR扩增获得nestin 片段,但未获得CK19相应的片段。结论类胰岛样细胞团传代培养后可表达胰岛素、胰高血糖素; 胰腺nestin阳性细胞具有胰岛干细胞的特点。     

常态化疫情防控背景下广州市某三甲医院护理人员灾害脆弱性分析与防控策略

目的 对广州市某三甲医院的护理人员进行灾害脆弱性分析,明确应急管理方向.方法 以基于Kaiser模型的灾害脆弱性分析作为指导,在常态化疫情防控的背景下,结合本地区常见的灾害性事件,制定护理管理风险事件指标评估体系,于常态化疫情防控期间现场发放问卷进行调查,并对指标风险值及矩阵分布进行分析.结果 通过Kaiser模型分析...     

隐匿性肝癌自发破裂出血的螺旋CT诊断

目的探讨隐匿性肝癌自发破裂出血的螺旋CT诊断价值。方法对6例经手术病理证实的隐匿性肝癌破裂出血病人的CT资料进行回顾性分析。结果平扫肝内呈混杂密度影,边界欠清晰,5例肝、脾周见液体密度影;增强扫描动脉期边缘可见不均匀强化,1例肿瘤可见包膜及裂口,5例密度不均匀,内可见多条裂隙;静脉期2例可见门静脉癌栓;造影剂渗漏均不明显。结论CT诊断隐匿性肝癌自发破裂出血有较高的价值,可作为首选检查方法;三期增强扫描十分必要,对于肝癌破裂的诊断具有较高的临床应用价值。