双气囊内镜在中消化道疾病诊断中的应用价值研究

目的 探讨双气囊内镜(DBE)在中消化道疾病诊断中的应用价值.方法 对53例行DBE检查的疑似中消化道疾病患者的临床资料进行回顾性分析,总结病变检出情况以及并发症、不良反应发生情况.结果 53例均顺利完成DBE检查,其中单纯经口进镜者26例、单纯经肛进镜者9例、经口+经肛进镜者18例,共46例(86.79％)发现病变,包括上消化道病变3例(5.66％)、中消化道病变41例(77.36％)和下消化道病变2例(3.77％).53例患者均能耐受麻醉及内镜检查,无一例发生消化道出血、穿孔、肠道扭转、肠系膜撕裂、胰腺炎等严重并发症,亦未出现麻醉相关的并发症及意外.部分患者术中出现腹部胀气、一过性腹痛;经口进镜者术中出现不同程度的咽喉部不适或少量鼻腔出血;1例术中因外套管根部硅胶管与气管插管摩擦松脱形成嵌顿,放气并拔出气管插管后松解;术后1d有2例出现轻微腹泻伴低热,于48 h内自然缓解.结论 DBE在中消化道疾病的诊断中具有较好的临床价值,安全性较高.     

3种用药方案治疗HIV/TB患者抗结核药物性肝损伤126例临床疗效分析

目的探讨3种不同治疗方案用于治疗HIV/TB患者抗结核药物性肝损伤的有效性及安全性。方法将126例患者随机分成3组,A组(还原型谷胱甘肽口服)、B组(复方甘草酸苷口服),C组(还原型谷胱甘肽+复方甘草酸苷静滴),观察比较疗效。结果 3种药物治疗方案有效率分别为92.9%、90.5%、97.6%(P>0.05),治愈率分别为52.4%、45.2%、71.4%(P<0.05),发生不良反应率分别为31%23.8%47.7%(P>0.05);三种方案治疗HIV/TB患者抗结核药物性肝损伤在有效率和不良反应发生率方面无显著差异,但在治愈率上三组有显著差异。结论 C组临床疗效最好。     

雌二醇对豚鼠离体心脏功能的作用研究

目的研究雌二醇（E2，10-6）急性给药对缺血再灌注心脏功能的作用及可能机制。方法制备豚鼠离体工作心脏模型，记录使用马时正常灌注和缺血再灌注心功能的变化，测定心肌组织内丙二醛（MDA）浓度和超氧化物歧化酶（SOD）活力。结果E2抑制正常灌注心脏的舒缩功能，减少心肌内MDA含量；促进缺血再灌注心脏的舒缩功能和SOD活力恢复，减少其心肌内MDA含量。结论E2对缺血再灌注心脏的心功能具有一定的保护作用。     

miR-21 induces cell cycle at S phase and modulates cell proliferation by down-regulating hMSH2 in lung cancer

Purpose

MicroRNAs regulate critical genes associated with lung cancer. Human mutS homolog 2 (hMSH2), one of the core mismatch repair genes, is affected in lung cancer development. The aim of this study is to investigate the role of miR-21 in hMSH2 gene expression and the effect of miR-21 on cell proliferation and cell cycle in lung cancer.

Methods

The targets of miR-21 were predicted by a bioinformatics tool, and hMSH2 was validated as a direct target of miR-21 by luciferase activity assay. MiRNA mimics or inhibitors were used to stimulate or attenuate the effect of endogenous miR-21 on hMSH2 expression. MiR-21 and hMSH2 expressions were assessed with real-time RT-PCR and Western blotting. Cell cycle was determined by flow cytometry, and cell growth was analyzed by MTT assay and real-time cell analysis system.

Results

MiR-21 expression was inversely correlated with hMSH2 expression in human lung cancer cell lines. Further validation showed hMSH2 was directly regulated by miR-21. The up-regulation of miR-21 significantly promoted cell proliferation and revealed a higher proportion of cells at S phase. However, knockdown of miR-21 expression resulted in cell cycle arrest at G2/M phase and inhibited cell proliferation.

Conclusions

These data suggest miR-21 is a key regulator of hMSH2 and modulates cell cycle and proliferation by targeting hMSH2 in human lung cancer.     

Reduction of serum matrix metalloproteinase 1 and matrix metalloproteinase 3 in rheumatoid arthritis patients following anti- tumour necrosis factor-alpha (cA2) therapy

Matrix metalloproteinase (MMP)-1 and MMP-3 levels were measured in serum samples from rheumatoid arthritis (RA) patients undergoing a double-blinded placebo-controlled trial with the chimaeric anti-tumour necrosis factor (TNF)-alpha antibody cA2. Both MMP-1 (P < 0.015), but to a larger extent MMP-3 (P < 0.001) levels were elevated in all RA patients prior to the commencement of the trial compared with normal control sera. Following cA2 therapy, MMP-1 and MMP-3 levels were assessed in the placebo, and 1 and 10 mg/kg cA2-treated groups at 7, 14, 21 and 28 days. In both the 1 and the 10 mg/kg cA2-treated groups, a significant decrease in serum MMP-3 levels at all time points was observed, reducing maximally to 41% of pre-infusion values at day 7. MMP-1 levels were also reduced, but less dramatically than MMP-3, to 85% of pre-infusion values after 14 days in the 10 mg/kg cA2 treated group. In a separate non-placebo-controlled study, we also evaluated the tissue inhibitor of metalloproteinase (TIMP)-1 levels in plasma following cA2 infusion. Pre-infusion TIMP-1 levels were above the normal control range, but were significantly reduced (P < 0.035) 14 days after infusion to 72% of pre-infusion values. This study confirms previous reports that MMP-3 levels are elevated and correlate with measures of inflammation in RA, and furthermore demonstrate that serum MMP-3 and MMP-1 levels are downmodulated following anti-TNF-alpha antibody therapy. Whilst serum MMP-3 levels correlated with C-reactive protein (CRP) both prior to and following anti-TNF-alpha antibody therapy, it remains to be demonstrated that serum MMP-3 and/or MMP-1 levels reflect the cartilage and bone resorptive processes which are evident in this disease.      

A selective role of calcineurin aalpha in synaptic depotentiation in hippocampus

Pharmacological studies have suggested that long-term potentiation (LTP) and long-term depression (LTD) and depotentiation, three forms of synaptic plasticity in the hippocampus, require the activity of the phosphatase calcineurin. At least two different isoforms of calcineurin are found in the central nervous system. To investigate whether all of these forms of synaptic plasticity require the same isoforms of calcineurin, we have examined LTD, depotentiation, and LTP in mice lacking the predominant calcineurin isoform in the central nervous system, Aalpha-/- mice. Depotentiation was abolished completely whereas neither LTD nor LTP were affected. These studies provide genetic evidence that the Aalpha isoform of calcineurin is important for the reversal of LTP in the hippocampus and indicate that depotentiation and LTD operate through somewhat different molecular mechanisms.     

食管固有肌层平滑肌瘤黏膜下隧道法内镜剥离切除治疗探讨

目的 探讨黏膜下隧道法内镜切除治疗食管固有肌层平滑肌瘤的临床效果.方法 2011年1月至11月间胃镜及超声内镜榆查确诊食管固有肌层肿物的患者,按照知情同意的原则选择性参加本组研究.16例患者入组并完成了研究计划.入组病例采用内镜经食管黏膜下隧道切除病变,并且术后行病理检查和跟踪随访观察.结果 食管固有肌层肿物完整切除率100％,术后均病理学检查证明为平滑肌瘤,病理免疫组化提示增生活跃9例.术中并发纵隔、皮下、腹膜后气肿1例,1周后自行恢复,无其他并发症及相应病例,无死亡病例.平均随访观察半年,无复发病例.结论 黏膜下隧道法内镜切除治疗食管固有肌层平滑肌瘤是微创、安全有效的治疗方法.     

联合门诊模式对老年糖尿病病人治疗效果分析

目的：探讨和分析联合门诊模式对老年糖尿病治疗效果。方法：选择120例2型糖尿病病人,随机分为联合门诊治疗组（62例,在常规门诊指导的基础上实施联合门诊治疗的形式）和常规门诊治疗组（58例,常规治疗模式门诊治疗）,比较1、2、4、8、12、16、20和24个月后空腹血糖（FBG）、餐后2h血糖（2hBG）、病人生活质量和低血糖发生率。结果：治疗24个月后,与常规门诊治疗组比较,联合门诊治疗组FBG[（9.2±1.2）mmol/L比（6.8±0.5）mmol/L]、2hBG[（11.2±0.6）mmol/L比（8.4±0.4）mmol/L]、糖化血红蛋白[（8.35±1.47）%比（7.27±1.14）%]水平均明显降低（P均〈0.05）,且控制更好、更稳定,轻度和重度低血糖发生率更低（29.31%比19.35%,10.34%比1.61%）,病人生活质量满意度得分更高[（2.57±0.15）分比（2.78±0.23）分],P均〈0.05。结论：联合门诊治疗模式有助于老年糖尿病病人实现良好的血糖控制,使低血糖发生率更低,有助于提高病人生活质量,是一个值得推广的糖尿病门诊模式。     

辽宁省普马拉病毒检测及基因特征分析

目的研究辽宁省境内棕背鼠平体内普马拉病毒(PUUV)的基因特征及分布情况。方法收集辽宁省抚顺和本溪地区棕背鼠平的肺组织标本,采用间接免疫荧光法(IFA)检测PUUV抗原,RT-PCR方法扩增标本中PUUV S基因片段,并测序,进行同源性比对和系统发生分析。结果共采集38份棕背鼠平肺组织标本,IFA检测PUUV抗原阳性2份,RT-PCR扩增PUUV S基因阳性4份,测序表明均为PUUV特异性序列。系统进化分析显示,本次检出的抚顺和本溪病毒株与吉林省的抚松株属于同一亚型,核苷酸同源性为95.2%～96.9%,在进化树上形成一个新的分支,在亲缘关系上与日本PUUV株较近。结论辽宁省可能存在PUUV的一个新亚型。