Biosynthetic response and mechanical properties of articular cartilage after injurious compression.

Traumatic joint injury is known to produce osteoarthritic degeneration of articular cartilage. To study the effects of injurious compression on the degradation and repair of cartilage in vitro, we developed a model that allows strain and strain rate-controlled loading of cartilage explants. The influence of strain rate on both cartilage matrix biosynthesis and mechanical properties was assessed after single injurious compressions. Loading with a strain rate of 0.01 s(-1) to a final strain of 50% resulted in no measured effect on the cells or on the extracellular matrix, although peak stresses reached levels of about 12 MPa. However, compression with strain rates of 0.1 and 1 s(-1) caused peak stresses of approximately 18 and 24 MPa, respectively, and resulted in significant decreases in both proteoglycan and total protein biosynthesis. The mechanical properties of the explants (compressive and shear stiffness) were also reduced with increasing strain rate. Additionally, cell viability decreased with increasing strain rate, and the remaining viable cells lost their ability to exhibit an increase in biosynthesis in response to low-amplitude dynamic mechanical stimulation. This latter decrease in reparative response was most dramatic in the tissue compressed at the highest strain rates. We conclude that strain rate (like peak stress or strain) is an important parameter in defining mechanical injury, and that cartilage injuriously compressed at high strain rates can lose its characteristic anabolic response to low-amplitude cyclic mechanical loading.     

Analysis of Hurthle cell neoplasms of the thyroid by interphase fluorescence in situ hybridization.

Recent studies have indicated that numerical chromosomal abnormalities including changes in p53 and cyclin D1 may be involved in Hurthle cell tumorigenesis. We analyzed a series of Hurthle cell neoplasms of the thyroid to evaluate the diagnostic and prognostic utility of numerical anomalies by DNA fluorescent probes for cyclin D1 and p53 gene loci and chromosomes 5, 7, 11, 12, 17, and 22. Interphase fluorescence in situ hybridization (FISH) analysis was performed on paraffin-embedded tissue sections from 10 Hurthle cell adenomas, 19 Hurthle cell carcinomas, and 7 normal thyroid tissues used as controls. Directly labeled fluorescent DNA probes for the centromere region of chromosomes 7, 11, 12, and 17 and locus-specific probes for chromosomes 5 and 22, cyclin D1, and p53 were utilized for dual-probe hybridizations. Sixty percent (6 of 10) Hurthle cell adenomas and 63% (12 of 19) Hurthle cell carcinomas showed chromosome gains. Twenty percent (2 of 10) Hurthle cell adenomas and 26% (5 of 19) Hurthle cell carcinomas showed chromosome losses. Normal thyroid tissues used as controls showed no chromosomal abnormalities. Among Hurthle cell tumors with chromosomal abnormalities, adenomas averaged 2.7 gains and 0.3 losses per case, and carcinomas averaged 3.3 gains and 0.6 losses per case. The two adenomas with chromosome losses each showed loss of one chromosome, whereas the five carcinomas with losses averaged 1.8 losses per case. Chromosome 22 was the most common loss identified, occurring in three of the 11 patients who died of disease. These results indicate that chromosomal imbalances as gains are common in both benign and malignant Hurthle cell neoplasms, but Hurthle cell carcinomas tend to have more chromosome losses than adenomas. Among Hurthle cell carcinomas in this study, chromosome losses were identified only from patients who died of disease. The loss of chromosome 22 may have prognostic value in Hurthle cell carcinoma of the thyroid.     

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目的 总结膈肌破裂和创伤性膈疝的诊治方法。方法 回顾性分析16例创伤性膈肌破裂和膈疝病例,其中穿透伤6例,闭合伤10例,16例进行X线检查。9例有阳性发现,8例进行CT检查。均为阳性,结果 术前确诊12例（75.0%),治愈14例,死亡2例（12.5%)。结论 CT和X线检查是诊断膈肌破裂和创伤性膈疝的主要诊断依据。早期诊断,及时手术是提高治愈率,降低病死率的关键。     

肠康复治疗用于小肠移植的免疫安全性研究

目的 :观察肠康复治疗对大鼠小肠移植急性排斥反应的影响 ,评价其应用的安全性。方法 :48只异基因异位小肠移植受体大鼠 (SD→Wistar)根据肠康复治疗及环孢素A应用与否随机分为 4组 ,观察至术后 14天各时相点移植小肠病理改变、固有层淋巴细胞IL 2受体表达、血浆IL 2水平以及受体大鼠脾淋巴细胞转化试验和IL 2分泌能力。结果 :肠康复治疗能够增强小肠移植受体大鼠的细胞免疫功能 ,加重急性排斥反应。应用环孢素A(10mg·kg-1·d-1)能阻断这种免疫增强作用 ,在这种情况下 ,肠康复治疗不能诱发或加重急性排斥反应。结论 :肠康复治疗能够加重小肠移植的排斥反应 ,但在应用环孢素A的情况下 ,免疫增强作用受抑制 ,不会诱发或加重急性排斥反应。     

Fas/FasL在乳头状甲状腺癌组织中的表达

目的：探讨凋亡相关基因Fas/FasL在甲状腺癌组织中的表达与细胞凋亡的关系。方法：采用流式细胞技术检测43例乳头状甲状腺癌癌细胞凋亡及相关基因Fas及FasL表达。同时检测Fas及FasL在甲状腺癌组织肿瘤浸润淋巴细胞（TIL）中的表达。结果：43例乳头状甲状腺癌细胞中Fas低表达者19例,细胞凋亡率为3．71％,高表达者24例,细胞凋亡率为7．26％,高表达组癌细胞凋亡率明显高于低表达组（P＜0．05）,癌细胞中FasL表达明显高于甲状腺腺瘤组织（P＜0．01）,乳头状甲状腺癌组织TLL表达Fas及FasL的水平明显高于甲状腺腺瘤组织（P＜0．01）。结论：Fas系统参与乳头状甲状腺癌细胞中细胞凋亡的调节,Fas/FasL表达异常使甲状腺癌癌细胞逃避免疫监视,诱导Fas敏感的TIL凋亡,有助于癌细胞发生浸润及转移。     

黄芪对人肾小球系膜细胞CD44mRNA表达的影响

目的：了解黄芪（AM）对小肾小球系膜细胞（HMCs)分泌基质和表达CD44mRNA的影响。方法：应用不同浓度AM或AM血清处理经PDGF-BB刺激的HMCs,分别采用MTT法和ELISA方法检测HMCs增殖和Ⅳ型胶原（Col-Ⅳ）分泌,用RT-PCR法检测AM对HMCs表面CD44mRNA表达的影响。结果：经AM或AM血清处理后,由PDGF-BB诱导的HMCs增殖与未处理对照组相比呈显抑制,并呈剂量依赖效应;HMCs分泌Col-Ⅳ和CD44mRNA表达水平较未处理对照组相比也有显下降,并与剂量呈一定相关。结论 ：AM可抑制HMCs增殖和Ⅳ型胶原蛋白的过度生长成,并且这种作用可能部分是通过降低HMCs表面CD44mRNA的过表面而介导的,本研究结果提示,AM对延缓慢性肾脏疾病向肾硬化进展可能有益。     

糖尿病早期肾损害的彩色多普勒超声研究

目的：探讨彩色多普勒超声肾血流测定对诊断糖尿病早期肾损害的价值。方法：以尿白蛋白排泄率（UAER）作为早期肾损害指标,对60例糖尿病患在26例正常人行彩色多普勒超声肾血流检查,结果：小叶间动脉收缩期峰值流速（Vs),弓状动脉及小叶间动脉舒张末期流速（Vd)的减慢是糖尿病患最早出现的肾内血流动力学改变;有肾脏早期损害的糖尿病患肾血流频谱参数特点是肾内弓状动脉,小叶间动脉的Vs和肾内各分支动脉的Vd明显减低,肾内各分支动脉的阻力指数（RI）明显增高,RI与糖尿病患肾功能损害程度相关。结论：彩色多普勒超声肾血流检测是早期诊断糖悄病肾损害的简便,可靠的方法。     

中心静脉插管与直接动脉穿刺血透治疗比较

目的：观察中心静脉插管（CVC）和直接动脉穿刺（AP）的透析效率,可维持透析时间及并发症并进行比较。方法：50例血透病人,22例行CVC（双腔静脉导管）单针单泵透析;28例行AP透析,于透析前,透析后不同时间采血查肾功,电解质,HCO3^-浓度。结果：CVC及AP对BUN,血Ca^2 ,P^3-浓度的影响相似（P＞0．05）,而首次透析2h后血K^ ,HCK3^-浓度的变化似与其相应透析前浓度测定值的水平有关,Scr浓度变化（降低）,AP组大于CVC组（P＜0．05）,可能由于存在通路再循环的影响,CVC常见并发症为感染,细菌为表皮葡萄球菌,AP常见并发症仍为血肿或动脉瘤,结论：CVC与AP作为临时性血管通路的短期透析效率相似,但CVC有减少穿刺,保护血管的优点。     

病毒感染与新生儿肾损害的临床研究

目的：研究新生儿巨细胞病毒（CMV）,单纯疱疹病毒（HSV）,柯萨奇病毒（COXV）对肾脏影响。方法：用荧光定量聚合酶链反应（FQ－PCR）检测CMV,HSV,COXV,用尿N－乙酰β-D－氨基葡萄糖苷酶（NAG）,尿补体C3,α2巨球蛋白（α2－M）,尿分析,血尿素氨（BUN）,肌酐（Cr)指标检测肾功能,对76例病毒感染（感染组）,20例非病毒感染（对照组）进行比较分析。结果：感染组尿NAG酶显高于对照组（P＜0．01）,尿NAG酶变化与血基因拷贝数呈正相关（P＜0．01）,19例尿FQ－CMV－PCR阳性血基因拷贝数显高于阴性（P＜0．01）,前尿NAG酶显高于后（P＜0．01）,尿C3,α2－M,尿分析,血BUN,Cr两组对比无显差异（P＞0．05）,结论：新生儿病毒感染可引起肾损害,早期以肾小管功能损害为主,临床上应予重视。     

抗纤灵冲剂对成纤维细胞增殖及其分泌EMC与TNF—α的影响

目的：探讨抗纤灵冲剂对成纤维细胞增殖及其分泌细胞外基质（ECM）,细胞因子：肿瘤坏死因子－α（TNF－α）的影响。方法：采用血清药理学方法,提取慢性肾衰竭大鼠的含药血清作用于体外培养的鼠成纤维细胞体系,观察具有活血化瘀、扶正降浊作用的中药抗纤灵冲剂对成纤维细胞增殖及其分泌形成ECM中主要成份的纤维边结蛋白（FN）,Ⅳ型胶原（C－Ⅳ）、以及TNF－α的影响。结果：抗纤灵冲剂具有抑制成纤维细胞增殖及其分泌FN、C－Ⅳ、细胞因子TNF－α的作用,该抑制作用具有一定的量效关系。结论：成纤维细胞是抗纤灵冲剂发挥治疗作用的重要靶细胞,这可能是该方防治慢性肾衰竭的机制之一。