矽肺患者肺阻抗图及其一阶微分图的临床观察

肺阻折图及其一阶微分图已广泛应用于临床，协助肺心病诊断和评价肺循环功能。本文检测２１０例矽肺患者肺阻抗图，发现阻抗容积图彼型多为单峰波，并出现多峰被，与健康组比较，有极显著性差异。矽肺组波幅值均随病变发展而逐渐降低，舒张指数（ｈＤ／ｈｓ）、ＲＶＥＴ亦随之下降，而ＰＥＰ及ＰＥＦ／ＲＶＥＴ则逐渐延长。因此，对评价矽肺病人肺血循环功能有一定参考价值。     

三维超声成像对妇科肿瘤的探讨

本文报告７７例妇科肿瘤的三维超声成像。子宫肌瘤２３例、卵巢癌３２例、卵巢囊肿２２例。三维超声成像显示肿块占据空间位置优于二维超声显像的，占７０％（５４／７７）；三维超声成像显示肿块内部结构优于二维超声显像的，占６５％（５０／７７）；三维超声成像显示肿块边界和边缘状况优于二维超声显像的，占６２％（４８／７７）。说明三维超声成像对盆腔占位病变能较准确地提示肿瘤所占据的空间位置及内部结构和边缘病变形态，为临床提供有意义的影像诊断学依据。     

主要抗结核药物肝脏毒性的动物实验研究

目的探讨肝脏脂质过氧化反应和肝药酶活性改变与抗结核药物肝毒性的关系.方法健康成年SD大鼠56只,随机分为7组：INH（isoniazid,H）组、RFP（rifampicin,R）组、PZA（pyrazinamide,Z）组、HR组、RZ组、HRZ组和生理盐水对照组.分别灌药10 d后处死大鼠,取肝脏切片,电子显微镜下观察肝脏病理变化,制备肝匀浆测定MDA（Maleic Dialdehyde）、SOD（Superoxide Dismutase）、GSH（reduced glutathione）和P450含量.结果各实验组MDA和P450均有不同程度升高,SOD和GSH有不同程度降低,肝脏病理变化与脂质过氧化反应、肝药酶有相关性.结论异烟肼、利福平、吡嗪酰胺均可引起大鼠的脂质过氧化指标的改变及肝脏细胞的病理损害,多种药物联用比单用改变明显;抗结核药物肝脏毒性与脂质过氧化反应程度关系密切,吡嗪酰胺组比其他单用药组肝脏毒性大.利福平有明显肝药酶诱导活性.     

Role of Extracellular Signal-Regulated Kinase, p38 Kinase, and Activator Protein-1 in Transforming Growth Factor-β1–Induced Alpha Smooth Muscle Actin Expression in Human Fetal Lung Fibroblasts In Vitro

Myofibroblasts characterized by alpha smooth muscle actin(α-SMA) expression play a key role in pulmonary fibrosis. Transforming growth factor-beta1 (TGF-β1) is likely to be involved in the emergence of myofibroblasts, but the intracellular signal pathways for this process have not been well determined. The aim of the present study was to investigate the role of mitogen-activated protein kinase (MAPK)/activator protein-1 (AP-1) signaling pathways in TGF-β1–induced α-SMA expression in human fetal lung fibroblasts (HLF-02). We found that TGF-β1 treatment activated p38 kinase and extracellular signal-regulated kinase (Erk) in HLF-02 cells. The induction of α-SMA by TGF-β1 was suppressed by p38 kinase inhibitor (SB203580) and Erk inhibitor (PD98059). AP-1 inhibitor curcumin also inhibited TGF-β1–induced α-SMA expression. In addition, dominant negative mutant c-Jun (TAM67) downregulated TGF-β1–induced AP-1 transactivation and α-SMA expression. In additional, PD98059 but not SB203580 inhibited the AP-1 DNA binding activity induced by TGF-β1. Based on these findings, we conclude that p38 kinase, Erk, and AP-1 are responsible for the α-SMA expression induced by TGF-β1 in human fetal lung fibroblasts. Erk is involved in inducing α-SMA expression via AP-1 activation.     

Analysis of the clinical features of recurrent acute pancreatitis in China

Background Since few systematic studies have focused on recurrent acute pancreatitis in China, we sought to investigate its clinical features, including etiological factors and relative frequency. Methods Patients were selected from a total 1471 patients with acute pancreatitis in ten cities of China. All had been admitted to a hospital with an attack of acute pancreatitis between January 1992 and December 2002. Data for each patient was recorded on a standardized form. Results Of the 1471 patients with acute pancreatitis, 157 (10.7%) had recurrent acute pancreatitis. The majority (63%) were male, with a mean age of 41 years (range, 13–82 years). Regarding the etiology, alcohol (20.4%) and cholelithiasis (20.4%) were the most frequent causes, followed by diet (13.4%), hypertriglyceridemia (8.3%), biliary tract infection (5.7%), other (5.1%), and idiopathic factors (26.8%). Alcohol was most frequent in male patients (30.3%), whereas cholelithiasis was most frequent (34.5%) in female patients. The majority of patients (79.6%) presented with their second attack of pancreatitis. Complications of recurrent acute pancreatitis in order of frequency were pancreatic pseudocyst, multiple organ failure, diabetes mellitus type 2, and shock. Conclusions Recurrent acute pancreatitis remains a frequent disease, with cholelithiasis and alcohol being the most usual etiological factors. Alcohol is the primary etiological factor in male patients. In about 26.8% of cases, the etiology remains unknown.     

A series of 64 cases of pancreatic cystic neoplasia from an institutional study of China

INTRODUCTION Cystic neoplasia of the pancreas accounts for about 10%-15% of all cystic pancreatic lesions[1]. The majority of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasia of the pancreas is rare, it encompasses a spectrum of b…     

Role of duodenogastroesophageal reflux in the pathogenesis of esophageal mucosal injury and gastroesophageal reflux symptoms.

BACKGROUND AND AIM: Patients with gastroesophageal reflux disease (GERD) usually suffer from acid reflux and duodenogastroesophageal reflux (DGER) simultaneously. The question of whether DGER has an important effect on the development of GERD remains controversial. The aim of the present study was to investigate the role of DGER in the pathogenesis of GERD and its value for the diagnosis of nonerosive reflux disease (NERD). METHODS: GERD was initially diagnosed using the reflux disease questionnaire. For further diagnosis, results of the upper gastrointestinal endoscopy (excluding a diagnosis of Barrett's esophagus) were considered in conjunction with simultaneous 24 h esophageal pH and bilirubin monitoring. RESULTS: According to endoscopic findings, 95 patients (43 men, 50+/-10 years of age) were divided into two groups: the reflux esophagitis (RE) group (n=51) and the NERD group (n=44). Three DGER parameters, the percentage of time with absorbance greater than 0.14, the total number of reflux episodes and the number of bile reflux episodes lasting longer than 5 min, were evaluated in the study. For the RE group, the values of the DGER parameters (19.05%+/-23.44%, 30.56+/-34.04 and 5.90+/-6.37, respectively) were significantly higher than those of the NERD group (7.26%+/-11.08%, 15.68+/-20.92 and 2.59+/-3.57, respectively, P<0.05 for all) but no significant difference was found in acid reflux. Of NERD patients, 18.5% were diagnosed with simple DGER. The positive diagnosis rate of NERD could be significantly elevated from 65.9% to 84.1% (P<0.05), if bilirubin monitoring was employed in diagnosis. CONCLUSIONS: DGER may occur independently but plays an important role in the development of RE and GERD symptoms. Simultaneous 24 h esophageal pH and bilirubin monitoring is superior to simple pH monitoring in helping identify patients at risk for NERD.     

Blockade of the receptor for advanced glycation end products attenuates acetaminophen-induced hepatotoxicity in mice

BACKGROUND AND AIM: Severe injury to the liver, such as that induced by toxic doses of acetaminophen, triggers a cascade of events leading to hepatocyte death. It is hypothesized that activation of the receptor for advanced glycation end products (RAGE) might contribute to acetaminophen-induced liver toxicity by virtue of its ability to generate reactive oxygen species, at least in part via nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, and thereby activate downstream signaling pathways leading to cellular injury. METHODS: A model was employed in which toxic doses of acetaminophen (1125 mg/kg) were administered to C57BL/6 mice. To block RAGE, mice received murine soluble (s) RAGE, the extracellular ligand binding domain of the receptor that acts as a decoy to interrupt ligand-RAGE signaling. RESULTS: Animals treated with sRAGE displayed increased survival compared with vehicle treatment, and markedly decreased hepatic necrosis. Consistent with an important role for RAGE-triggered oxidant stress in acetaminophen-induced injury, a significant reduction of nitrotyrosine protein adducts was observed in hepatic tissue in sRAGE-treated versus vehicle-treated mice receiving acetaminophen, in parallel with significantly increased levels of glutathione. In addition, pro-regenerative cytokines tumor necrosis factor-alpha and interleukin-6 were increased in sRAGE-treated versus vehicle-treated mice. CONCLUSION: These findings implicate RAGE-dependent mechanisms in acetaminophen-induced liver damage and suggest that blockade of this pathway may impart beneficial effects in toxin-induced liver injury.     

Assessment of hemodynamics properties of a new-type artificial heart valve prosthesis using catheterization and echocardiography

OBJECTIVE: The objectives of this study were to assess the hemodynamic properties of the newly developed artificial heart valve prosthesis experimentally in laboratory simulation, in an animal model, and clinically in a human model and to compare the results measured by catheterization and echocardiography. METHODS: (1) Laboratory simulation. The prosthesis was tested using a pulsatile flow simulator in the aortic position. Hydrodynamics parameters were automatically analyzed through a custom-designed data processing program. (2) Animal experiment. Six sheep subjected to mitral replacement with 21-mm-valve prosthesis were measured by open cardiac catheterization intraoperatively. Doppler echocardiography and open cardiac catheterization under dobutamine stress were performed in two sheep subjected to implantation 2.5 years ago. (3) Clinical patient observation. Observations were carried out on 14 patients with aortas replacement and 10 patients with bicuspid replacement using both doppler echocardiography and open cardiac catheterization. RESULTS: (1) Laboratory simulation. The results showed that the value of the transvalvular gradient (DeltaP) decreased with the increase of heart rate, and the values were not greater that 10 mm Hg at any given tissue annulus diameter. (2) Animal experiment. The mean DeltaP value of the six sheep was 5.2 +/- 1.7 mm Hg intraoperatively, while the corresponding DeltaP value of the two sheep 2.5 years after implantation was 6.1 +/- 0.3 mm Hg measured by open cardiac catheterization. (3) Clinical patient observation. The mean DeltaP values in the aortic position measured by catheterization and echocardiography were 6.26 approximately 4.10 and 9.42 approximately 7.48 mm Hg, respectively. The gradients in the mitral position were 2.10 approximately 1.9 and 5.28 approximately 4.10 mm Hg, respectively. CONCLUSIONS: The results demonstrate that the new-type bileaflet heart valve prosthesis only generates a relatively low transvalvar gradient and thus has good hemodynamic properties.     

人骨形态发生蛋白2基因重组腺病毒的构建与鉴定

背景:骨形态发生蛋白2是诱导成骨关键物质,参与调节从细胞增殖、决定种系分化方向到细胞死亡等一系列的生物过程。目的:利用AdMax系统构建人骨形态发生蛋白2基因的重组腺病毒载体并鉴定。方法:以人cDNA为模板PCR扩增人骨形态发生蛋白2基因,转化E.coli感受态细胞,经菌落PCR鉴定阳性转化子、阳性克隆测序无误后,扩增、抽提。将带有目的基因的腺病毒表达载体和携带有腺病毒大部分基因的辅助包装质粒共转染293细胞进行病毒包装扩增,PCR检测目的基因、Western Blot检测目的蛋白及终点稀释法检测病毒滴度。结果与结论:PCR获得长度为1223bp的人骨形态发生蛋白2目的基因片段,同源重组表达载体经阳性克隆PCR及测序鉴定,结果正确。293细胞内包装、扩增,经Westernblot及PCR鉴定无误后,获得病毒滴度为5×1013pfu/L的重组腺病毒。实验成功构建携带有人骨形态发生蛋白2基因的重组腺病毒载体。