黄芪当归合剂及他汀类药物对缺氧复氧人肾小管上皮细胞的保护作用

目的研究黄芪当归合剂及阿托伐他汀对缺氧／复氧人肾小管上皮细胞损伤的影响。方法选用人肾小管上皮细胞建立缺氧／复氧损伤模型,设正常对照组、单纯缺氧复氧组、黄芪当归合剂组、阿托伐他汀组、黄芪当归合剂和阿托伐他汀联合用药组。检测活性氧的产生量。酶联免疫吸附法检测细胞间黏附分子-1、单核细胞趋化蛋白-1的表达,逆转录聚合酶链式反应检测细胞间黏附分子-1mRNA、单核细胞趋化蛋白-1mRNA表达,免疫印迹法检测核因子-kB。结果缺氧复氧组活性氧高于对照组,细胞间黏附分子-1、单核细胞趋化蛋白-1及各自mRNA表达上调,黄芪当归合剂组、阿托伐他汀组均降低细胞内活性氧水平,抑制炎性因子表达,黄芪当归合剂和阿托伐他汀联合用药组效果更加明显。结论黄芪当归合剂、阿托伐他汀对肾小管上皮细胞缺氧复氧性损伤有保护作用,联合用药效果显著,可能与通过抑制核因子-kB炎症通路减少细胞间黏附分子-1、单核细胞趋化蛋白-1表达从而降低氧化应激水平有关。     

胃癌与上皮内瘤变差异基因表达谱的研究

目的 观察胃癌与上皮内瘤变(GIN)的差异基因表达.方法 利用基因芯片技术,筛选12例胃癌与12例GIN胃镜病理标本的差异表达基因.结果 通过t检验和SAM检验筛选差异基因185个,它们与细胞黏附、血管生成、细胞增殖与凋亡等有关,与Wnt信号通路,血管内皮生长因子(VEGF)信号通路,酪氨酸蛋白激酶/信号转导及转录激活因子(JAK/STAT)信号通路,p53信号通路等细胞通路密切相关,而这些细胞通路可能与胃癌的发生有关.结论 胃癌与GIN差异基因的筛选为后续胃癌分子机制的研究提供前期试验基础.     

烧伤重症监护病房细菌学调查及其药物敏感性分析

目的调查笔者单位烧伤重症监护病房(ICU)6年来细菌感染及其药物敏感性动态变化。方法对1998—2003年笔者单位烧伤ICU209例患者的细菌培养及药物敏感试验结果进行回顾性分析。结果209例患者标本检出感染菌株845株,其中革兰阴性(G-)菌486株占57.51%,革兰阳性(G )菌339株占40.12%。G-菌中铜绿假单胞菌占66.26%,位居第一;G 菌中粪肠球菌占34.51%、金黄色葡萄球菌占31.27%,耐甲氧西林金黄色葡萄球菌(MRSA)在金黄色葡萄球菌中的分离率为72.64%。药物敏感试验结果显示各检出菌具有多重耐药性。结论笔者单位烧伤ICU细菌感染以G-菌为主,G 菌次之;这些细菌对临床常用抗生素具有多重耐药性。临床应重视细菌的药物敏感性,合理使用抗生素。     

胰体尾部肿瘤的手术切除

摘要：目的 探讨胰体尾部肿瘤的外科治疗方法。方法 近18年来，采用手术治疗胰体尾部肿瘤45例，其中恶性肿瘤33例，良性肿瘤12例；行远端胰腺切除17例，联合脏器切除24例，肿瘤局部切除4例。结果 病理类型：胰体尾癌33例，胰岛细胞瘤8例，囊腺瘤2例，上皮样纤维瘤1例，囊性畸胎瘤1例。切除肿瘤最大径：胰体尾癌平均为（8.0±2.6）cm；胰岛细胞瘤平均为（6.5±2.4）cm。无手术死亡病例。术后并发症：胰瘘2例，膈下脓肿2例，胰腺假性囊肿1例，上消化道出血 1例，切口感染或愈合不良3例，均经非手术疗法治愈。结论 远端胰腺切除术是治疗胰体尾部肿瘤的有效方法；术前需常规做好联合脏器切除的准备；胰腺残端的处理选用主胰管结扎加褥式缝合法可有效避免胰瘘的发生。     

单核细胞趋化因子-1在间质性膀胱炎中表达的研究

目的 探讨单核细胞趋化因子-1(MCP-1)在间质性膀胱炎(IC)患者膀胱组织和尿液中的表达水平及其意义. 方法根据美国国立糖尿病、消化、肾病协会IC诊断标准确诊女性IC患者35例,感染性膀胱炎(UI)患者20例,肾囊肿患者25例作为正常对照组.IC患者平均年龄47(31～65)岁.主诉下腹酸胀/疼痛和夜尿次数多,伴有尿频尿急;已生育30例.均行24 h排尿卡记录、IC症状及问题评分表(O'Leary-Sant评分表)、钾离子敏感试验(PST)和麻醉状态下水扩张后膀胱镜检查.膀胱镜检查获取3组患者膀胱组织和尿液样本,免疫组化染色方法观察MCP-1在IC组织中的表达分布.RT-PCR技术测定3组膀胱组织中MCP-1 mRNA表达水平,酶联免疫吸附试验测定3组尿液标本中MCP-1水平. 结果 IC、UI、对照组尿液标本中MCP-1浓度分别为(74.1±36.9)、(280.6±68.9)、(10.8±6.9)pg/ml;膀胱组织中MCP-1相对定量值分别为76.2±24.0、99.5±30.1、36.1±14.1.lC组和UI组中组织/尿液中MCP-1表达水平均高于正常对照组,差异有统计学意义(P＜0.01).IC组临床症状评分为(14.9±1.8)分,与MCP-1升高水平呈正相关(r=0.686). 结论 IC患者膀胱组织和尿液中MCP-1表达升高,可能成为IC诊断的非特异性免疫指标之一.     

含胆酸的肠内营养在肝硬化大鼠肝切除术后的应用

目的探讨含胆酸的肠内营养在肝硬化大鼠肝切除术后的应用。方法24只肝硬化大鼠随机分为术前组、肝切除术后1d组、肝切除术后行不含胆酸的肠内营养5d组、肝切除术后行含胆酸的肠内营养5d组,各6只。并选择6只正常大鼠作为正常对照组,测大鼠肝功能、炎症反应、脂质过氧化、肝组织白蛋白（ALB）mRNA的表达和肝组织Ki67蛋白的表达。结果与不含胆酸的肠内营养5d组比较,含胆酸的肠内营养5d组血清AST、ALT、ALP显著下降（P〈0.05）,血清ALB、IGF-1显著升高（P〈0.05）,血清IFN-γ、TNF-α、MDA显著下降（P〈0.05）,血清SOD活性显著升高（P〈0.05）,肝组织ALBmRNA表达显著升高（P〈0.05）,肝组织Ki67蛋白表达显著升高（P〈0.05）。结论含胆酸的肠内营养可以加快肝硬化大鼠肝切除术后肝功能的恢复,减轻炎症反应和脂质过氧化损伤,促进肝脏蛋白合成和残肝再生。     

18F-FDG PET/CT与3.0T MRI联合显像在乳腺癌原发病灶诊断中的价值

目的 探讨18F-FDG PET/CT与3.0T MRI联合显像在乳腺癌原发病灶诊断中的价值。 方法 对38例临床怀疑为乳腺癌的女性患者于一周内分别行18F-FDG PET/CT、3.0T MRI和病理学检查。 结果 组织病理学检查结果证实,全部患者中,24例为乳腺癌患者,14例为乳腺良性肿瘤患者。3.0T MRI诊断乳腺癌的灵敏度、特异度、准确率分别为91.7%、78.6%、86.8%;PET/CT诊断乳腺癌的灵敏度、特异度、准确率分别为87.5%、92.9%、89.5%;PET/CT和3.0T MR联合显像诊断乳腺癌的灵敏度、特异度、准确率分别为100.0%、92.9%、97.4%;3种显像方法间灵敏度、特异度、准确率差异无统计学意义（χ2=2.987、1.612和2.955,P均＞0.05）。 结论 18F-FDG PET/CT和3.0T MRI联合显像在乳腺癌原发病灶诊断中具有重要价值;但与单独18F-FDG PET/CT和3.0T MRI显像比较,3种显像方法在乳腺癌原发病灶的诊断效能上差异无统计学意义。     

肝尾状叶原发性肝细胞肝癌的外科治疗

目的 探讨尾状叶原发性肝癌手术切除的方式及其影响。方法 自1995年至2003年,对39例尾状叶原发性肝癌进行了手术切除,其中单独尾状叶切除19例,联合切除20例。并对两组病例中可能影响术后肝功能的指标进行了比较。结果 39例患者均被成功切除肿瘤,1例于术后30d因肾功能衰竭死亡,3例并发胸腔积液,4例并发腹水,1例并发胆漏,其余病例均顺利恢复。术后30例获得随访,1年、3年、5年生存率分别为53％、50％、39％。结论 尾状叶切除是治疗原发于尾状叶肝癌的有效手段,若肿瘤原发于肝尾状叶而又无其他肝叶侵犯时,单独尾状叶切除该是外科治疗的最佳选择。     

不同浓度5-溴脱氧尿嘧啶核苷标记山羊骨髓基质干细胞的体外研究

Objective To explore the feasibility of labeling and tracing in vitro goat bone marrow mesenchymal stem cells (BMSCs) by bromodeoxyuridine (BrdU) on the basis of investigation of its optimal concentration, incubating time and cytotoxicity. Methods A healthy goat, aged 10 months old, male, weighing 32 kg, was used in this study. Bone marrow was aspirated. BMSCs were isolated and cultured using the adherence method in vitro. The fourth passage of BMSCs (P4) were incubated with BrdU at 5, 10, 15, 20 μmol/L as 5, 10, 15, 20 μmol/L BMSC groups. Cells were not labeled by BrdU as negative control. The following parameters were measured: induction, differentiation and determination of goat BMSCs; the optimal mass concentration and incubation time of 5-BrdU labeling; cell positive rate at 12, 24, 48 and 72 hours in each group using immunofluoreseenee; the cell survival rate after various concentrations of BrdU ladling by trypan-blue exclusion. Results The morphology of the primary and passage goat BMSCs was fusiform in shape. Goat BMSCs could differentiate into osteoblasts and chondrocytes following induction. BMSC nucleus showed green fluorescence under fluorescence microscope after being labeled by BrdU. The mean labeling rate increased with the increase in the concentration and incubation time of BrdU, and reached to (93.32± 3.25)% after incubation in 15 μmol/L, BrdU for 48 hours. There were no significant differences between 15 μmol/L BrdU for 72 hours, 20 μmol/L BrdU for 48 hours and 72 hours (P > 0.05), or between the other groups or time points (P < 0.05). The labeling rate of the blank control group was 0. The cell survival rate was all above 90% (P > 0.05). Conclusions BrdU can be used as a labeling marker for goat BMSCs. When the concentration is 15 μmol/L and the incubation time is 48 hours, the optimal labeling effect can be achieved. Goat BMSCs labeled with BrdU is of high efficiency and safety.     

绿脓杆菌制剂对人肝癌MHCC97L细胞增殖和侵袭能力的影响

Objective To investigate the effects of Pseudomonas aeruginosa vaccine (PA) on proliferation and invasiveness of the hepatocellular carcinoma cell line MHCC97L with metastatic potential. Methods Proliferation, growth curve, plate efficiency, flow cytometry, transwell invasion assay, cell motility assay, scarification test, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP2) protein activity were evaluated after cells were treated with PA at various concentrations. Results PA can inhibit the proliferation and plate efficiency of MHCC97L cell markedly in a dose-dependent manner. The IC50 of cells treated with PA for 48 h and 72 h was 3.1 ×108/ml and 1.9 × 108/ml, respectively. The doubling time increased and plate efficiency decreased gradually when cells treated with 0.5 × 108/ml, 1 × 108/ml and 2 × 108/ml PA (P＜0.01). PA could induce cell cycle arrest at the G1 phase in a dose-dependent manner by flow cytometric analysis. The average amount of invading cell per field in cell invasion assay and motility assay were 4. 8 ± 1.3 and 8. 8±2.2 when cells treated with 1× 108/ml PA, which was significantly lower than that of control group (8. 6±2. 1 and 15. 6±1.2 ) (P＜0.01) Scarification test showed that the metastatic ability of cells treated with 1 × 108/ml PA significantly lower than that in the control group. Comparison between cells treated with 1 × 108/ml PA and control group, no remarkable difference was found regarding expression of VEGF and MMP2 in supernatant of cell culture. Conclusion PA can inhibit proliferation and plate efficiency of HCC cell line MHCC97L, which is in part mediated by the cell cycle arrest at the G1 phase. PA could inhibit invasiveness of HCC cell line MHCC97L, which is unrelated to the VEGF and MMP2 protein activity.