低位直肠癌经肛提肌外腹会阴联合切除术的研究进展

目的 肛提肌外腹会阴联合切除术(exralevator abdominoperineal excision,ELAPE)的提出旨在改善低位直肠癌的手术安全性和肿瘤预后,但其应用仍存在争议.本研究总结ELAPE治疗低位直肠癌的最新研究进展.方法 应用PubMed及CNKI期刊全文数据库检索系统,以"肛提肌外、腹会阴联合切除术和低位直肠癌"为关键词,检索2006-01-2015-12的相关文献.纳入标准:(1)ELAPE的疗效分析;(2)ELAPE术后并发症的处理;(3)ELAPE的适用范围;(4)ELAPE体位的选择.排除标准:(1)综述和会议汇编等相关文献;(2)实验设计不严谨.根据纳入和排除标准,符合分析53篇,其中英文文献45篇,中文文献8篇.结果手术是低位直肠癌的首选治疗方案,ELAPE作为治疗低位直肠癌新的术式,目前其手术体位,术后盆底重建,手术疗效及适用范围等方面存在诸多争议,仍需要进一步探讨,尤其是手术疗效及患者术后生活质量亟需进一步的前瞻性研究来验证.结论ELAPE尚不能取代传统腹会阴联合切除术(abdominoperinealexcision,APE)而成为治疗低位直肠癌的标准术式,ELAPE术式可能还需要进一步优化和改进.     

细胞生长因子微环境与早期胚胎发育

BACKGROUND: Early mammalian embryonic development and implantation is a very complex process, which is regulated by a variety of cytokines. Moreover, epidermal growth factor, transforming growth factor, leukemia inhibitory factor, insulin-like growth factor and vascular endothelial growth factor play an important role in this regulation process. OBJECTIVE: To introduce cytokines related to early embryonic development, including types, structural features and molecular mechanisms, and meanwhile to review the effects of epidermal growth factor, transforming growth factor, leukemia inhibitory factor, insulin-like growth factor and vascular endothelial growth factor in the early embryonic development. METHODS: A literature retrieval was performed to search relevant articles published from 1989 to 2015 using the keywords of “embryos development, epidermal growth factor, transforming growth factor, leukemia inhibitory factor, insulin-like growth factor, vascular endothelial growth factor”. Active effects of these five kinds of cytokines in overcoming the mammalian embryonic development block were reviewed and summarized to provide theoretical and experimental basis for further optimization of the embryonic culture system in vitro. RESULTS AND CONCLUSION: Cell growth factors involved in embryonic development is the focus of the study. Insulin-like growth factor is capable of promoting the embryonic growth; epidermal growth factor exhibits multiform functions in the embryonic development; leukemia inhibitory factor directly affects oocyte cell development, and progesterone increases the expression of leukemia inhibitory factor to provide a good cytokine microenvironment for embryonic development; vascular endothelial growth factor promotes in vitro oocyte maturation, and plays a very important role in various stages of embryonic development. To clarify these regulatory patterns of cytokines cannot only contribute to in vitro embryonic culture, but also reduce embryonic apoptosis, which is of great significance for promoting embryonic development.       

自制胶体金试剂盒对布鲁氏菌病的诊断效果评价

目的 评价自制的免疫胶体金诊断试剂盒对人间布鲁氏菌病(布病)的诊断价值。方法 选取乌兰察布市地方病防治中心布病门诊的就诊者,确诊为布病患者做为病例组(34例),排除布病的非患者做为对照组(34例)。分别进行虎红平板凝集试验（RBPT）、试管凝集试验（SAT)、酶联免疫吸附试验（ELISA）以及自制免疫胶体金诊断试剂盒的检测,并对以上检测结果进行联合实验分析。结果 自制免疫胶体金诊断试剂盒的检测结果与临床诊断结果差异无统计学意义（P＞0.05）。该试剂盒的灵敏度为94.12%;漏诊率为5.88%;特异度为79.41%;误诊率为20.59%,正确指数为0.74;与临床诊断方法的符合率为86.76%,该试剂盒与虎红平板凝集试验串联使用,即两种试验结果均为阳性才诊断为布鲁氏菌阳性,灵敏度为94.12%,特异度为97.06%,正确指数为0.91,均高于其他几种方法的联合试验结果。结论 自制免疫胶体金诊断试剂盒与虎红平板凝集试验的串联,方法简便、成本较低,对实验室仪器设备要求不高,容易操作,耗时较短,可应用于人间布病大面积的普查。     

表面活性剂与氟化钠涂料对牙骨质表面显微硬度的体外研究

目的观察表面活性剂与氟化钠涂料防治根面龋与单独用氟化钠涂料或洗必泰涂料防龋效果的比较.方法测定离体牙釉-牙骨质界下4×4 mm开窗区分别经洗必泰与氟化钠涂料(简称氟泰涂料)、洗必泰涂料、氟化钠涂料等处理,观察进行矿化试验和抗龋试验后牙骨质表面的显微硬度.结果试验前后牙骨质表面硬度相比,氟泰涂料组、氟化钠涂料组均有显著差异,且氟泰组比氟化钠组硬度值显著增加.抗龋试验前后牙骨质表面显微硬度值相比,氟泰组、氟化钠组无显著差异.洗必泰组及对照组均有显著差异.结论用氟泰涂料可增强牙骨质表面硬度,与氟化钠组效果相同,但优于氟化钠组.     

上中切牙不同排列位置对骨组织及基托影响的力学分析

目的分析上颌全口义齿及承托区组织受力情况。方法运用三维有限元应力分析方法，对上颌全口义齿中切牙不同排列位置的六种工况，进行了应力和位移的计算和分析。结果在中切牙切缘施载的情况下，各种工况牙槽嵴顶区的压应力均由中线向远中越来越小，随着人工牙位置的唇侧移位，牙槽嵴唇侧压应力值渐趋增大；此时，牙槽嵴舌侧基托有离开组织面向下翘曲的较大的位移发生，这也是牙槽峭舌侧吸收小于唇侧的原因之一。结论承托区组织的受力情况主要与加力点有关，而与人工牙的倾斜角度关系不大。     

中药白及的化学成分研究

采用硅胶、ODS、Sephadex LH-20、RP-HPLC等色谱分离方法,对白及的90%乙醇提取物的乙酸乙酯萃取部位进行化学成分研究,根据化合物的波谱数据进行结构鉴定。从该植物中分离得到18个化合物,分别为5-羟基-2-(对羟基苄基)-3-甲氧基联苄(1)、shancigusin B(2)、shanciguol(3)、arundinan(4)、3',5-二羟基-2,4-二(对-羟基苄基)-3-甲氧基联苄(5)、arundin(6)、3,3'-二羟基-2-(4-羟基苄基)-5-甲氧基联苄(7)、3,3'-二羟基-2',6'-二(对羟苄基)-5-甲氧基联苄(8)、7-羟基-2,4-二甲氧基菲(9)、bleformin B(10)、nudol(11)、3,7-二羟基-2,4-二甲氧基菲(12)、2,7-二羟基-4-甲氧基-9,10-二氢菲(13)、bleformin D(14)、4,4'-二甲氧基-9,10-二氢-[6,1'-联菲]-2,2',7,7'-四醇(15)、gymconopin C(16)、(2,3-反式)-2-(4-羟基-3-甲氧基苯基)3-羟甲基-10-甲氧基-2,3,4,5-四氢菲[2,1-b]呋喃-7-醇(17)、shanciol(18)。其中化合物1为新的联苄类化合物,化合物2~6,9,15~18为首次该属植物中分离得到。     

腺样囊性癌细胞系中肿瘤干细胞的生物学特性初探

目的：对腺样囊性癌细胞系ACC-2中不同表型的肿瘤细胞生物学特性进行分析和研究,为肿瘤干细胞学说提供实验依据。方法：采用单细胞体外培养法,了解腺样囊性癌细胞(ACC-2)的分裂、增殖特点；采用免疫组化方法,检测ACC-2细胞表面CD44和CD24表达的差异性；应用免疫磁珠技术,分离不同表型的ACC-2细胞后,以裸鼠成瘤试验了解不同表型ACC-2细胞的成瘤能力。采用SPSS10．0统计软件包对所得数据进行X~2检验。结果：体外单细胞培养的ACC-2,仅有4．5%可持续分裂、增殖。CD44-和CD44 /CD24 细胞在体外培养条件下均无长期存活能力。不同表型的ACC-2动物成瘤试验结果显示,CD44 /CD24-亚群的ACC-2细胞最低成瘤接种细胞数显著低于常规ACC-2细胞,CD44-和CD44 /CD24 细胞则均无成瘤能力。免疫组化染色证实,CD44 /CD24-肿瘤细胞具有分化为其他表型肿瘤细胞的能力。结论：细胞表面抗原为CD44 CD24-的肿瘤细胞仅占ACC-2肿瘤细胞的极少部分,这些细胞具有极强的增殖能力和分化为其他表型肿瘤细胞的能力。ACC-2肿瘤细胞的增殖和成瘤能力源于CD44 / CD24-细胞亚群。未分离的ACC-2细胞与CD44 /CD24-ACC-2细胞在与细胞分化、凋亡、黏连、信号传导等有关的基因上存在差异。提示ACC-2中存在肿瘤干细胞,而CD44 /CD24-是ACC-2肿瘤干细胞必须兼备的表面标志。     

Rapid Release of GABA Inhibiting Epilepsy in Vivo

Objective：Epilepsy is a multi-etiological brain dysfunction syndrome characterized by synchronously repeated spontaneous discharges from neuronal cells. Itspathogenesis involves excitatory / inhibitory imbalance,ion channel abnormalities and may be related to the abnormal structure and function of neurotransmitter receptors. The research was to observe the effects of rapid increase inhbitory neurotransmitter GABA on the excitatory /inhibitory imbalance,ion channel abnormalities and abnormal neurotransmitter receptors in living epileptic mice from the level of free moving animal,cell,sub-cell and receptor. Methods： The techniques of fiber photometry and laser uncage of Rub-GABA for epileptic free moving mice induced by administration of Kainic acid （KA） or 4-AP,local field potentials （LFP）,multicell bolus lording of calcium （OGB-1AM）,virus transfection of calcium-sensitive protein GCaMP6f, transfection of fluorescent labeled AMPA receptors in cortical neurons by in utero electroporation,two-photon uncage of Rubi-GABA,two-photon imaging,two-photon calcium imaging,twophoton cell attach,two-photon targeted patch clamp and two-photon shadow patch clamp in living epileptic mice induced by 4-AP were used. Results： Laser photolysis of Rubi-GABA in hippocampal CA1 could immediately alleviate KA induced acute epileptic seizures in living mice. In cellular level,two-photon uncage Rub-GABA or rapid release of GABA significantly decreased the number of neurons releasing the calcium signals by multicell bolus lording of calcium,inhibited spikes recording by LFP and immediately inhibited both calcium signals and spikes using two-photon cell attaching technique in the living epileptic mice induced by 4-AP. Two-photon uncage Rub-GABA significantly decreased spikes induced by 4-AP recording with two-photon shadow patch clamp in vivo. In sub-cellular level,two-photon Rubi-GABA uncage of dendritic spines of cortical neurons transfected with GCaMP6f obviously decreased the frequency and amplitude of calcium signal on those dendritic spines in 4-AP induced epileptic living mice. Two-photon targeted patch clamp and shadow patch clamp were performed separately to both the cortical neurons transfected fluorescent labeled AMPA receptors in the mice by in utero electroporation and the cortical neurons with no fluorescent labeled AMPA receptors in control mice. The results showed that there was no difference in the electrophysiological indices between the two kinds of cortical neurons,meaning that there was no obvious change of electrophysiological characteristics in the cortical neurons transfected fluorescent labeled AMPA receptors. Further study showed that rapid disappearance of the AMPA receptors was found before disappearance of dendritic spines in epileptic living mice induced by high concentration of 4-AP,and the disappearance of the AMPA receptors was significantly delayed or the AMPA receptors even reappeared after rapid release of GABA with the different concentration of 4-AP in the living mice. Conlusion： Rapid release of GABA can rectify the excitatory / inhibitory imbalance and ion channel abnormalities of epilepsy,and rapidly inhibits epilepsy in free moving mice,and from cellular and sub-cellular level in vivo. It also protects the structure and function of
neurotransmitter receptors during epilepsy in vivo.     

Core needle biopsy can minimise the non-diagnostic results and need for diagnostic surgery in patients with calcified thyroid nodules

Purpose

To evaluate the role of core needle biopsy (CNB) for calcified thyroid nodules.

Methods

Between October 2008 and July 2011, 264 patients underwent ultrasound-guided CNB for 272 calcified thyroid nodules at our institution. We retrospectively evaluated the incidence of technical failure, non-diagnostic readings, and the diagnostic performance of CNB, and analysed the relationship between the types of calcification and the CNB results. Finally, the incidence of diagnostic surgery was calculated.

Results

The incidence of technical failure was 1.1 % (3/275) and that of non-diagnostic results was 0.7 % (2/272). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CNB were 94.7 %, 89.5 %, 100 %, 100 %, and 90.2 %, respectively. There were no significant differences according to the calcification subtype for either the non-diagnostic results or the incidence of technical failure (P?>?0.99 and P?>?0.99). CNB could prevent diagnostic surgery for 92.9 % (13/14) of the patients who showed more than two non-diagnostic results in previous FNA.

Conclusions

CNB can minimise the non-diagnostic results as well as diagnostic surgery in patients with calcified thyroid nodules. Therefore, CNB may be used as a first-line diagnostic tool for calcified thyroid nodules rather than FNA.

Key points

? CNB results show the low incidence of technical failure (1.1 %, 3/275). ? CNB results show the low non-diagnostic rate (0.7 %, 2/272). ? There were no significant differences according to the calcification subtype. ? CNB can prevent unnecessary diagnostic surgery in 92.9 % (13/14).     

Development of a guinea pig model of perinatal cytomegalovirus-induced hepatobiliary injury

To explore the possible link between perinatal cytomegalovirus infection and onset of biliary atresia, we build up a perinatal cytomeglovirus induced hepatobiliary system injury model in guinea pigs, verified the biliary tropism of gpCMV and the related inflammatory injury. It suggested host immune status, local response to inflammation, and activation of Th1-cell-mediated antiviral immune responses contributed to newborn geinea pigs' hepatobiliary damage. The model was helpful in study the CMV infection and biliary injury.