带蒂组织瓣转位修复手部创伤组织缺损

目的探讨手部创伤组织缺损显微外科修复方法及其效果。方法采用食指背侧岛状皮瓣、缝接指神经的背侧支指动脉逆行岛状皮瓣、邻指皮瓣、掌背动脉逆行岛状皮瓣和前臂骨间后动脉逆行皮瓣、髂腹股沟皮瓣、髂骨皮瓣及胸脐皮瓣转位修复手部创伤组织缺损197例。结果组织瓣全部成活，随访3个月至1年，指腹、指端感觉S2-pd：5～7mm，能最大限度保留和恢复手功能与外形。结论带蒂组织瓣转位修复手部创伤组织缺损，效果满意。     

Clinical Application of Layered Anastomosis During Esophagogastrostomy

The aim of this study was to compare the operative results in regard to reducing anastomotic leakage and stricture formation using a newly designed layered manual esophagogastric anastomosis versus a stapler esophagogastrostomy versus the conventional hand-sewn whole-layer anastomosis after resection for esophageal or gastric cardiac carcinoma. From January 2004 to September 2006, a total of 1024 patients with esophageal or gastric cardia carcinoma underwent a layered esophagogastric anastomosis with the assistance of a three-leaf clipper in a single university medical center. The mucosal layers of the esophagus and stomach were sutured continuously with 4/0 Vicryl plus antibacterial suture (polyglyconate). From May 2002 to December 2003, there were also 170 patients and 69 patients who underwent stapler and conventional whole-layer anastomosis, respectively; they served as control groups. The results were analyzed retrospectively. The operative mortality rate was 0.7% in the layered group compared to 5.9% and 7.2% for the stapler group and the whole-layer group (p < 0.01), The anastomotic leakage rates were 0%, 3.5%, and 5.8% for the layered group, stapler group, and whole-layer group, respectively (p < 0.01). All patients were followed postoperatively. Six patients in the layered group (0.6%) developed mild stricture formation compared to 16 patients in stapled group (9.9%) and 5 patients in the conventional whole-layer group (7.8%) (p < 0.01). The application of layered esophagogastric anastomosis could reduce the incidence of anastomotic leakage and stricture after esophagectomy compared with the stapler and whole-layer manual anastomoses. It is easy to apply and could be used as an alternative for esophagogastric anastomosis after resection for esophageal or cardiac carcinoma. This abstract was accepted as a free paper and oral presentation at International Surgical Week 2007, Abstract 320, Montreal, Canada, August 2007     

Continuous PGE2 leads to net bone loss while intermittent PGE2 leads to net bone gain in lumbar vertebral bodies of adult female rats

The present study examined the effects of continuous and intermittent PGE₂ administration on the cancellous and cortical bone of lumbar vertebral bodies (LVB) in female rats. Six-month-old Sprague–Dawley female rats were divided into 6 groups with 2 control groups and 1 or 3 mg PGE₂/kg given either continuously or intermittently for 21 days. Histomorphometric analyses were performed on the cancellous and cortical bone of the fourth and fifth LVBs. Continuous PGE₂ exposure led to bone catabolism while intermittent administration led to bone anabolism. Both routes of administration stimulated bone remodeling, but the continuous PGE₂ stimulated more than the intermittent route to expose more basic multicellular units (BMUs) to the negative bone balance. The continuous PGE₂ caused cancellous bone loss by stimulating bone resorption greater than formation (i.e., negative bone balance) and shortening the formation period. It caused more cortical bone loss than gain, the magnitude of the negative endocortical bone balance and increased intracortical porosity bone loss was greater than for periosteal bone gain. The anabolic effects of intermittent PGE₂ resulted from cancellous bone gain by positive bone balance from stimulated bone formation and shortened resorption period; while cortical bone gain occurred from endocortical bone gain exceeding the decrease in periosteal bone and increased intracortical bone loss. Lastly, a scheme to take advantage of the marked PGE₂ stimulation of lumbar periosteal apposition in strengthening bone by converting it to an anabolic agent was proposed.     

慢性胰腺炎大鼠肝组织NF—κB的表达及中药的干预作用

目的:研究实验性慢性胰腺炎大鼠肝组织核转录因子(NF-κB)的表达以及药物的干预作用。方法:建立慢性胰腺炎大鼠模型,Western印迹法检测各组大鼠肝组织NF-κB蛋白的表达,应用放免法检测血清IL-6、TNF-α的水平。结果:慢性胰腺炎模型组大鼠肝组织NF-κB蛋白的表达较对照组明显升高(P<0.05),且血清细胞因子IL-6、TNF-α含量增加。大承气颗粒治疗组及丹参治疗组NF-κB的表达较模型组明显降低(P<0.05)。结论:慢性胰腺炎导致大鼠肝组织NF-κB蛋白的表达升高,大承气颗粒及丹参对NF-κB蛋白的表达有明显的抑制作用。     

沉默PRL-3基因表达抑制胃癌生长研究

目的 探究miRNA干扰沉默PRL-4基因表达对胃癌生长的作用.方法 构建表达人工PRL-3 miRNA的慢病毒载体,转染SGC7901细胞并沉默其PRL-3表达;噻唑蓝(MTT)试验评价PRL-3在SGC7901细胞增殖中的作用;移植瘤生长试验评估其在胃癌生长中的作用.结果 与转染空载体组比较,转染PRL-3 miRNA的慢病毒载体可抑制SGC7901细胞的增殖.荷瘤动物实验表明,转染PRL-3组肿瘤大小为(1.92±0.18)cm3,转染空载体组为(4.74±0.39)cm3,两组差异有统计学意义(P＜0.05).结论 沉默PRL-3表达可抑制胃癌SGC7901细胞的增殖,并抑制移植瘤的生长,可作为一种有潜力的抗肿瘤靶点.     

高强度聚焦超声系统治疗局限性前列腺癌（附26例报告）

目的探讨高强度聚焦超声系统(HIFU)治疗局限性前列腺癌的有效性及安全性。方法使用Sonablate-500聚焦超声系统对26例局限性前列腺癌患者进行治疗,观察术后3、6、12个月时的血清前列腺特异性抗原(PSA)、直肠指诊及经直肠B超情况。结果平均手术操作时间48min(28～86min),平均术后住院时间3.2d(2～9d)。治疗后3、6、12个月PSA与治疗前相比有显著降低(P<0.05),直肠指诊发现结节消失或减小的占73.3%(11/15),B超提示:低回声结节消失或缩小的占76.9%(20/26)。治疗后3、6、12个月各项检查结果经统计学检验无显著性差异。结论HIFU可以安全、有效杀死前列腺癌细胞,在治疗局限性前列腺癌方面具有美好的应用前景。     

Improved effects of a double suicide gene system on prostate cancer cells by targeted regulation of prostate-specific membrane antigen promoter and enhancer

Objective:   To explore the specific killing effect on prostate cancer cells of a dual cytosine deaminase (CD) and uracil phosphoribosyltransferase (UPRT) expression plasmid system controlled by the prostate-specific membrane antigen (PSMA) promoter and enhancer.
Methods:   The CD gene was used to construct the recombinant plasmid prostate-specific membrane antigen_{promoter/enhancer}-CD (pPSMA_E/P-CD). The specific regulatory function of the pPSMA_E/P promoter was demonstrated by detection of enhanced green fluorescent protein (EGFP) expression in the LNCaP cell line. Survival of cells transfected with different plasmids and treated with 5-fluorocytosine (5-FC) was measured by microculture tetrazolium assay. Cell cycle changes were measured by flow cytometry.
Results:   Target-specific expression of PSMA_E/P was observed in the prostate cancer cell line. Cytotoxicity of 5-FC was greater against LNCaP cells transfected with pPSMA_E/P-CD and UPRT and pPSMA_E/P-CD than control groups. Percentages of cells in S phase were 37.5% (LNCaP) and 30.6% (5-FC treatment) in the un-transfected groups, whereas they were 23.9% and 12.4% in the double and single suicide gene groups, respectively.
Conclusions:   Our findings confirm the cytotoxic efficacy of the pPSMA_E/P-CD + 5-FC and pPSMA_E/P-CD and UPRT + 5-FC suicide gene systems. The CD and UPRT gene system quickly and directly converted 5-FC into 5-FU, and then into toxic metabolites. The CD and UPRT double suicide gene system was more effective in inducing tumor cell apoptosis with 5-FC than the single suicide gene system. Thus, this construct can specifically target prostate cancer cells and might have a role in gene therapy against prostate cancer.     

胃癌患者及其手术前后红细胞免疫功能与淋巴细胞功能之间的相关性研究

目的探讨胃癌患者及其手术前后红细胞免疫功能的变化及与淋巴细胞免疫功能之间的相关性.方法72例胃癌患者,20例正常人为对照,检测血红细胞C3b受体花环(RBC-C3bRR)和免疫复合物花环(RBC-ICR),T淋巴细胞亚群、B细胞含量;NK细胞活性、血清循环免疫复合物(CIC)、血清免疫球蛋白和补体.结果(1)胃癌患者RBC-C3bRR显著降低,RBC-ICR显著升高(P＜0.01).(2)术后组RBC-C3bRR显著升高,RBC-ICR显著降低(P＜0.01).(3)胃癌患者CD3+、CD4+、CD4+/CD8+,NK细胞活性,B细胞,IgG、IgA均显著降低,CIC显著升高(P＜0.05或P＜0.01);手术后CD3+、CD4+、CD4+/CD8+、NK细胞活性,免疫球蛋白IgA均有显著提高(P＜0.01);胃癌患者术前组及手术前后RBC-C3bRR变化组与CD3+、CD4+、NK细胞组均呈显著正相关(P＜0.01).结论(1)胃癌患者红细胞免疫粘附功能、淋巴细胞免疫功能低下.(2)手术可使胃癌患者红细胞免疫、淋巴细胞免疫功能明显改善.(3)红细胞免疫粘附功能与T淋巴细胞、NK细胞活性之间关系密切.     

二孔技术腹腔镜下阑尾切除术的评价

目的评价二孔技术腹腔镜阑尾切除术(LaparascopicAppendetectomy,LA).方法比较二孔、三孔/四孔LA、开腹阑尾切除术各组的手术时间及术后恢复各项指标及并发症.结果手术时间,二孔LA组(15±3)min较三孔/四孔LA组(27±5)min明显缩短,(P＜0.05),腹壁穿刺孔少,损伤小.二孔LA组与开腹组比较手术时间(15±3VS47±11)min(P＜0.01),术后镇痛剂应用(0/132VS18/100)(P＜0.01),自主下床活动时间(6±2VS48±6)h(P＜0.01),开始进食(8±2VS52±7)h(P＜0.01),住院时间(48±11VS192±17)h(P＜0.01),切口感染率(0/132VS13/100)(P＜0.01),肠梗阻发生率(0/132VS6/100)(P＜0.01).结论二孔技术LA较传统开腹阑尾切除术及三孔/四孔LA有明显优越性.     

Amplatz血栓消融术治疗大块肺栓塞——附2例报告

目的 探讨Amplatz血栓消融器治疗大块肺栓塞(PE)的可行性。方法 对2例年轻男性经溶栓无效或贻误有效溶栓时机的大块PE患者行Amplatz血栓消融术。结果 术后肺血流灌注亚急性PE患者明显改善,慢性PE再发患者略有改善。前者PaQ2由术前53．8mmHg升至67．3mmHg,2个月后升至80．0mmHg。7个月后核素肺灌注显像大致正常。后者术中症状明显减轻,术后PaO2由66．4mmHg升至83．6mmHg。3个月后,肺动脉压由53．5mmHg降至24mmHg。仅1例术中轻微左侧胸痛。结论 对大块亚急性PE患者实施Amplatz血栓消融术技术上可行,但需进一步评价。