带线锚钉及锁骨钩钢板固定治疗胸锁关节脱位的疗效比较

目的比较利用带线锚钉及锁骨钩钢板两种不同内固定方式手术治疗胸锁关节脱位的疗效。方法回顾性分析2005年1月~2013年1月在我科住院治疗胸锁关节脱位患者30例的手术资料,分别采用切开复位带线锚钉固定(A组)及锁骨钩钢板内固定(B组)治疗。比较两组的手术时间、切口长度、术中出血量、临床愈合时间、术后并发症、术后功能恢复程度等方面指标和疗效。结果 30例患者切口均愈合良好,影像学检查提示所有患者复位满意及内固定位置良好。所有患者获得完整的随访,随访时间6~18个月,平均14个月。依据Rockwood评分法进行术后胸锁关节功能评定,所有患者外观及功能均获得良好的恢复。未出现再脱位及其它副损伤,术后均恢复正常的解剖形态。结论对胸锁关节脱位采用锚钉固定能达到锁骨钩钢板固定效果,而且锚钉固定系统具有切口小、手术时间短、固定可靠、避免再次手术取出内固定等特点。     

Juniper哮喘生命质量问卷在中国哮喘患者中的初步应用

目的通过分析我国哮喘患者Juniper哮喘生命质量问卷(AQLQ)资料,总结Juniper AQLQ应用于我国哮喘患者的初步经验。方法慢性哮喘患者96例,66例用AQLQ中文自我测试版本的普通版,30例用AQLQ标准版,共210例次生命质量评估数据,分析受哮喘限制的活动选择频度、AQLQ总分及4个能区(症状、活动受限、情感功能及环境刺激)与第1秒钟用力呼气容积(FEV1)占预计值的百分比的相关性,不同程度肺功能的患者间AQLQ总分及4个能区是否有差别?观察前后生命质量发生变化时FEV1占预计值的百分比及呼气峰流速(PEF)是否发生了相应的变化?结果AQLQ总分及4个能区除环境刺激外均与FEV1占预计值的百分比呈弱相关(相关系数：0．201～0．284)。不同程度的FEV1占预计值的百分比的AQLQ总分及各能区评分可以很好地反映肺功能的差异。观察前后比较,AQLQ的变化与相应的FEV1占预计值的百分比的变化之间无相关性。AQLQ症状的变化与晨间或晚间PEF的变化相关(相关系数0．301～0．353);情感功能变化与晚间PEF的变化相关;而AQLQ总分与PEF的变化无相关性。结论Juniper AQLQ评分与肺功能相关,在反映病情变化方面可能比肺功能更敏感和更全面。Juniper AQLQ同样也适用于我国的哮喘患者。     

Antiproliferative effect of octreotide on gastric cancer cells mediated by inhibition of Akt／PKB and telomerase

AIM: To investigate the antiproliferative effect of octreotide,a long-acting analogue of somatostatin, on gastric cancer cell line SGC7901 and its possible molecular mechanisms.METHODS: Gastric cancer cell line SGC7901 employed in the study was treated with 0.008, 0.04, 0.2, 1, 5 and 25μg@ml-1 of octreotide respectively for 24 h to evaluate the antiproliferative effect of somatostatin analog on the tumor cells by MTT assay method. To elucidate the underlying mechanism, the cells were exposed to 1 μg@ml-1 of octreotide for 0, 12, 24 and 48 h, when their Akt/PKB and telomerase activities were respectively determined using PCR-ELSIA and nonradioactive protein kinase assay protocols. The same experimental procedures were also performed in the control cells that were treated with corresponding vehicles instead of somatostatin analog.RESULTS: After exposed to octreotide for 24 h at the concentrations of more than 1 μg@ml-1 SGC7901 cells exhibited a dose-dependent inhibition of growth with the inhibiting rate to be as high as 34.66 % when 25 μg@ml-1 of octreotide was applied. The Akt/PKB and telomerase activity of SGC7901 cells was significantly inhibited when the cells were exposed to 1 μg@ml-1 of octreotide for 12, 24 and 48 h compared with that of their control counterparts (P＜0.01),both of which exhibited in a time-dependent manner.CONCLUSION: The antiproliferative effect of octreotide on SGC7901 cells might be mediated by the inhibition of Akt/PKB and telomerase.     

Relationship between the expression of MDR1 in hepatocellular cancer and its biological behaviors

Objective: By the detection of HBV infection, AFP and AST, the targets of biological behavior and the gene expression of multi-drug resistance gene 1 (MDR1) in hepatocellular carcinoma (HCC), we investigate characteristics of the expression of MDR1 in HCC and its relationship with HCC biological behavior. Methods: Using real-time fluorescence quantitative PCR (FQ-PCR) to detect the expressions of MDR1 in 102 samples of HCC tissue and 20 samples of non-cancerous tissue, we analyze the relationship between expressions of MDR1 and biological characteristics of HCC. Results: The expression of MDR1 in HCC is 0.55±0.27, and in normal liver tissues is 0.23±0.10, respectively. The expression in HCC is higher than it in normal liver tissue, the difference is statistically significant (P<0.05) and the difference between the expression and the HCC envelopes is statistically significant, and the expression increases along with the increase of Edmondson classification (P<0.05). HBV infection, AFP positive, the rise of AST, all these factors have positive correlations with the expression (r=0.463, 0.473, 0.299). In MDR1 expressions of HCC patients, the survival curve of the negative is higher than that of the positive, but the difference is not statistically significant. Conclusion: There are drug resistance phenomena in HCC, MDR1 expression may play an important role in primary HCC drug resistance. HBV infection can be detected as a reference indicator of HCC chemotherapy resistance, plasma levels of AFP, AST can be used as a reference index change dynamic monitoring of MDR1 expression.     

Increased expression of HMGB3: a novel independent prognostic marker of worse outcome in patients with esophageal squamous cell carcinoma

HMGB3, an X-linked member of the high-mobility group (HMG) superfamily of HMG proteins, has been shown to affect numerous tumorigenic progression. However, the expression and the prognostic role of HMGB3 in esophageal squamous cell carcinoma (ESCC) remained unknown. In this study, we examined the HMGB3 expression in ESCC tissues and adjacent nontumorous tissues by qRT-PCR and immuohistochemistry. Statistical analyses were applied to test for prognostic and diagnostic associations. The mRNA levels of HMGB3 were found to be significantly higher in tumorous tissues than in the adjacent normal tissues. We found that the HMGB3 expression was higher in tumorous tissues than in the adjacent non-tumorous tissues by immunohistochemical analysis of paired tissue specimens (P < 0.001). Moreover, there was a significant correlation between HMGB3 expression and gender (P = 0.037), clinical stage (P = 0.038), T classification (P = 0.013) and N classification (P = 0.017). Patients with higher HMGB3 expression had shorter overall survival than those with lower HMGB3 expression. Multivariate Cox analysis indicated that HMGB3 expression is an independent prognostic factor for overall survival (HR = 0.591, 95% CI = 0.379-0.793, P = 0.039). In summary, these findings demonstrate that HMBG3 may be a potential molecular marker for predicting the prognosis of ESCC patients.     

Impact of chemokine receptor CXCR3 on tumor-infiltrating lymphocyte recruitment associated with favorable prognosis in advanced gastric cancer

Chemokine receptor CXCR3 has been proved to play an important role in tumorigenesis and tumor progression in many malignancies, but its precise efficacy on gastric cancer (GC) has not been evaluated yet. The present study was aimed to explore the correlation of chemokine receptor CXCR3 with tumor-infiltrating lymphocytes (TILs) and prognosis in advanced gastric cancer (GC). Expression of CXCR3 and CD4+, CD8+ TILs was conducted in 192 advanced GC specimens and 48 corresponding paracancerous tissues by immunohistochemical (IHC) analysis. CXCR3 expression in GC tissues was significantly higher than that in paracancerous tissues (P<0.001) and CD8+, CD4+ TILs infiltration increased with high CXCR3 expression (P=0.032 and P<0.001, respectively). Our study showed significantly lower CXCR3 expression in patients with greater tumor invasion depth and lymph node metastasis compared with patients with lesser tumor invasion depth and without lymph node metastasis (P=0.002 and P=0.001, respectively). Univariate analysis indicated that patients with high CXCR3 expression and high CD8+ TILs infiltration had longer overall survival (OS) (log-rank test, P<0.001 and P=0.002, respectively). Univariate and multivariate analyses indicated that CXCR3 expression was an independent prognostic factor for OS (P=0.002). The present study suggested that CXCR3 expression was upregulated in advanced GC and was associated with increased CD4+, CD8+ TILs infiltration and improved OS. Therefore, CXCR3 overexpression is implicated as a favorable prognostic biomarker in human advanced GC.     

Role of transcriptional factor Nrf2 in the acute lung injury of mice

Objective: This study aimed to investigate the expression and role of Nrf2 in the acute lung injury (ALI) of mice. Methods: A total of 60 BABL/c mice were randomly divided into 2 groups: ALI group and control group. In ALI group, ALI was introduced by injection of LPS. Immunohistochemistry was performed to detect Nrf2 expression in the lung; Western blot assay was employed to detect the expression of Nrf2 in the lung homogenate; ELISA was conducted to detect the expression of Nrf2 in the lung homogenate and BALF. Results: As compared to control group, ALI mice had a high Nrf2 expression in the lung as shown in immunohistochemistry, and the Nrf2 expression in the lung homogenate and BALF also increased markedly (P<0.05). Conclusion: The Nrf2 expression increases in the lung and BALF of ALI mice, suggesting that Nrf2 is involved in the inflammation during ALI and may serve as a new target in the therapy of ALI.     

口腔黏膜鳞状细胞癌、上皮异常增生及正常黏膜组织拉曼光谱研究

目的 研究口腔黏膜鳞状细胞癌、上皮重度异常增生及正常黏膜组织的拉曼光谱特征,以期为拉曼光谱诊断口腔黏膜癌变提供依据.方法 收集手术切除的新鲜口腔黏膜鳞状细胞癌组织56例,重度上皮异常增生组织50例及正常黏膜组织32例,采用配备光纤探头的便携式拉曼光谱仪获取拉曼光谱.应用主成分分析法(principle component analysis,PCA)结合判别函数分析(discriminant function analysis,DFA)对不同组织的光谱数据进行分析,建立诊断模型对口腔鳞状细胞癌、上皮重度异常增生及正常黏膜的光谱数据进行鉴别,应用交互验证方法对诊断模型进行验证.结果 口腔鳞状细胞癌、上皮重度异常增生及正常黏膜组织间的拉曼光谱存在差异,主要表现为口腔鳞状细胞癌和上皮重度异常增生组织光谱中对应核酸、蛋白质及脂类物质的谱峰明显高于正常黏膜上皮组织;鉴别诊断建模的总体分类准确率达96.4％(133/138),交互验证的分类准确率达92.8％(128/138).结论 口腔鳞状细胞癌和上皮重度异常增生组织中细胞增殖代谢明显高于正常黏膜组织;应用PCA-DFA建立的分类诊断模型可以很好地区分3种不同组织的光谱数据.     

ε-聚赖氨酸与灭菌注射用水湿化效果二阶段交叉试验分析

目的采用二阶段交叉试验分析ε-聚赖氨酸与灭菌注射用水的湿化效果。方法选择我院神经内科94例长期氧疗患者行分组研究。按患者入院顺序将其编号,再按随机数字表法将其分为A组(n=47)及B组(n=47)。A组第一阶段湿化液为灭菌注射用水,第二阶段湿化液为ε-聚赖氨酸;B组第一阶段湿化液为ε-聚赖氨酸,第二阶段湿化液为灭菌注射用水。对比两组采样菌落数、合格率及氧疗舒适度。结果通过二阶段交叉试验发现:A组及B组在应用ε-聚赖氨酸作为湿化液期间菌落数更少(P0.01)。湿化液灭菌注射用水的合格率为82.98%,明显低于ε-聚赖氨酸的合格率100.00%(P0.01)。与灭菌注射用水相比,应用ε-聚赖氨酸作为湿化液具有更温暖、更湿润、舒适度更高、异味及噪声更少等优点(P0.01)。结论应用ε-聚赖氨酸作为氧疗湿化液可有效减少湿化液污染,增进患者氧疗舒适度,值得临床推广应用。