High-risk stress fractures

High-risk stress fractures require precise assessment and treatment because of their propensity for delayed union, nonunion, or complete fracture and their resulting disabling complications. Proper diagnosis necessitates a thorough clinical evaluation, centering on the patient's diet and history, particularly the training regimen. For a definitive diagnosis, plain radiography, ultrasound, bone scintigraphy, magnetic resonance imagery (MRI), and computed tomography (CT) are helpful, and each plays a specific role. High-risk stress fractures typically require aggressive treatment such as nonweight-bearing immobilization coupled with therapy and often surgery.     

Fibroblast activation protein: a serine protease expressed at the remodeling interface in idiopathic pulmonary fibrosis

Fibroblast activation protein (FAPalpha) is a member of the cell surface dipeptidyl peptidase (DPP) family of serine proteases. In its dimer form, FAPalpha exhibits gelatinase, collagenase, and DPP activity in vitro. Reactive fibroblasts in healing wounds and stromal fibroblasts associated with epithelial tumors express FAPalpha. Idiopathic pulmonary fibrosis (IPF) is a disease of the lung characterized by progressive fibrosis with no clear etiology or molecular marker for disease activity. Recently, it has been shown that fibroblast FAPalpha expression is induced in liver cirrhosis, with an expression pattern distinct from alpha-smooth muscle actin (alpha-SMA). In this study, we determine whether FAPalpha expression is selectively induced in areas of ongoing tissue remodeling characterized by fibroblast foci in IPF. Human lung tissue was obtained from patients with IPF, centrilobular emphysema, and normal lung. Immunohistochemical studies were performed using anti-FAPalpha antibody and antibodies against alpha-SMA and CD26 (DPPIV), another member of the DPP family. We found that FAPalpha was not expressed in normal human lung tissue or tissue with evidence of centriacinar emphysema, but was induced in all patients with IPF and With a pattern distinct from that of CD26 found primarily on hyperplastic alveolar epithelium. Specifically, FAPalpha was detected in fibroblast foci and in fibrotic interstitium and not in the interstitium of adjacent architecturally normal lung. Alveolar/airway epithelium and vascular smooth muscle did not express FAPalpha. This is the first report of FAPalpha expression in IPF and our results suggest that FAPalpha is selectively induced in fibrotic foci, but not in normal or emphysematous lung. Future studies will address whether FAPalpha may be used as a marker for disease activity in IPF.     

多聚赖氨酸表面改性后同种异体骨的骨传导能力研究

目的:探讨多聚赖氨酸表面改性兔同种异体骨后骨传导能力的变化。方法:采用冻干法,将多聚赖氨酸覆盖在实验组兔同种异体骨的微孔表面,对其进行表面改性,并将未经表面改性的同种异体骨设为对照组。兔骨髓基质干细胞（BMSCs）种植于2组的微孔表面,进行培养,并向成骨方向诱导。采用扫描电镜观察、MTT法检测BMSCs在同种异体骨微孔表面黏附、增殖情况,检测2组细胞表达的碱性磷酸酶的活性;将2组复合自体BMSCs的同种异体骨回植入兔双侧桡骨缺损处,1、2、3和4个月后分别对标本进行螺旋CT三维重建,观察新骨生成情况。结果:实验组中BMSCs在同种异体骨微孔表面黏附、增殖以及表达碱性磷酸酶的情况明显优于对照组（P<0.01）,实验组兔桡骨缺损处的修复情况优于对照组（P<0.01）。结论:同种异体骨经多聚赖氨酸表面改性后,其在体内和体外的骨传导能力得到了显著的增强。     

序列接近性配型方法预测异基因造血干细胞移植后GVHD的发生

本研究探讨序列接近性配型（sequence similar matching,SSM）方法对HLA不相合异基因造血干细胞移植后GVHD的预测作用;利用2005—2009年我科进行的23例HLA不相合移植资料,通过SSM软件进行分析比较和数值计算。结果表明：总分值小于55分的异基因造血干细胞移植患者的急性GVHD和重度GVHD的发生率小。结论：SSM软件在HLA不相合造血干细胞移植中对GVHD有一定的预测作用。     

健康人外周血KIR表达规律分析

本研究旨在分析杀伤细胞免疫球蛋白样受体(KIR)在健康人的基因型及表达谱,探索KIR受体在健康人的表达调控规律。采用PCR及RT-PCR技术检测健康人NK-92MI及Molt4细胞系中KIR2DL1、2DL2、2DL3、2DL4、2DL5、2DS1、2DS2、2DS3、2DS4、2DS5、3DL1、3DL2、3DL3、3DS1、2DP1、3DP1的基因型及KIR2DL1、KIR2DL2、KIR2DL3、KIR3DL1、KIR2DS1、KIR2DS3及KIR2DS2/4受体mRNA的表达。结果表明,KIR2DL1、KIR2DL3、KIR2DL4、KIR3DL2、KIR3DL3和KIR3DP1在所有受试者、NK-92MI及Molt4细胞中均能检测到基因型。NK-92MI表达KIR2DL1、KIR2DL3及KIR2DS2/4,Molt4不表达KIR。比对健康人的基因型及mRNA表现型发现,若健康人能检测到KIR2DL1、2DL2、2DL3、2DS1、2DS2、2DS3和2DS4的基因型,其外周血几乎均有相应的KIR的mRNA表达,但KIR各基因的表达强度不同。结论:KIR各基因在健康人的表达水平不同,同一个体中各基因的表达量不一致,同一KIR基因在不同个体内的表达水平也不一致。     

Kennedy病的临床特点及诊断

目的通过1例经基因检测明确诊断的Kennedy病患者,探讨Kennedy病的临床特点及诊断。方法根据临床症状、神经系统体征、肌电图和神经传导速度、家族史等特点对临床疑诊Kennedy病患者,检测其雄激素受体基因第1个外显子的CAG重复片断。结果本病病程进展缓慢,肌酶和血睾酮增高,肌电图示神经源性损害,雄激素受体基因第1个外显子的CAG重复数为51。结论Kennedy病有相对独特的临床特点,确诊有赖于雄激素受体基因第1个外显子的CAG重复片段数的检测。     

全人护理在甲型H1N1流感医学观察中的应用

目的探讨全人护理知识在甲型H1N1流感医学观察中的应用。方法对226例处于甲型H1N1流感检疫期接受医学观察的人员进行全面照护。结果所有接受医学观察人员平稳渡过观察期,无相关不良事件发生。结论综合运用全人护理知识实施甲型H1N1流感医学观察护理,有助于提高护士应对重大突发公共卫生事件的能力。     

ICAM-1-GFP的构建及其与Molt-4细胞的结合

本研究构建人细胞间黏附分子1（ICAM-1）全长基因的真核表达载体pEGFP—CI—ICAM—1,转染中国仓鼠卵巢细胞（CHO—K1）细胞株,并检测其在cH0细胞中的表达及与Molt-4细胞的结合。采用RT—PCR法从健康人外周血中分离单个核细胞,钓取ICAM-1全长基因（1622bp）,与pMD18-T载体连接做全自动序列测定。将测序正确的克隆质粒pMD18-T—ICAM-1和表达载体pEGFP—C1分别用HindⅢ和Ⅰ进行双酶切,应用基因重组技术构建ICAM-1全长基因真核表达载体pEGFP—C1-ICAM-1,质粒经Hindm和SacⅡ双酶切和PCR电泳鉴定后,采用脂质体转染法转染CHO细胞,并进行G418筛选。用RT—PCR、流式细胞术和荧光显微术检测ICAM-1-GFP的表达及亚细胞的定位,用检测ICAM-1-GFP／CHO细胞与Molt-4细胞的结合能力评价ICAM．1-GFP融合蛋白的功能。结果表明：重组质粒经限制性酶切鉴定得到与ICAM—1全长基因长度-致（1622bp）的酶切产物;测序分析证实,PCR产物与GenBank上登录的ICAM-1基因（NM-000201）序列完全-致,表明成功地完成了ICAM-1的扩增和表达载体的构建;荧光显微镜下可见转染的CHO细胞有绿色荧光蛋白的表达,表达的融合蛋白较均匀地分布于整个细胞：FACS检测ICAM．1-GFP的荧光转染率为（13±5．5）％,表明ICAM—1—GFP基因进入到CHO细胞并获得了有效表达,成功构建了ICAM-1-GFP／CHO细胞,并且ICAM-1-GFP／CHO细胞能够结合PMA处理的Molt-4细胞。结论：成功构建了ICAM-1-GFP真核表达载体,构建的ICAM—1—GFP真核表达载体在CHO细胞内稳定表达,／CAM—1—GFP／CHO细胞能与M0lt-4细胞结合,这为进-步研究ICAM-1分子的功能打下基础。     

双色双融合荧光原位杂交探针检测慢性髓系白血病Bcr／Ab1基因重排的研究

本研究探讨双色双融合荧光原位杂交技术（DC-DF-FISH）在慢性髓系白血病（CML）中的应用价值,应用常规R-显带技术、DC-DF-FISH、RT—PCR技术检测41例CML患者的染色体核型及bcr／abl融合基因。结果表明,对于初诊CML的18例患者,R-显带显示Ph染色体阳性检出率为94．4％（17／18）,DC—DF—FISH阳性检出率也为94．4％（17／18）,对于治疗后CML的18例患者,R-显带显示14例有可分析分裂相,其中有ll例存在Ph染色体,阳性检出率为78．6％（11／14）;而用DC—DF—FISH检测治疗后患者的阳性率为94．4％（17／18）;移植后的5例患者R-显带均未检出Ph染色体,而FISH检测出1例bcr／abl基因阳性,RT-PCR证实了FISH的检测结论,但在移植患者中,RT-PCR无阳性发现。结论：双色双融合荧光原位杂交技术具有高度的准确性、可靠性,是检测CML患者bcr／abl基因重排的可靠方法,适用于CML的诊断、疗效判定及微小残留病灶的检测。