Cucurbitane-type triterpenoids from Momordica charantia

Five new cucurbitane-type triterpenes, (23E)-25-methoxycucurbit-23-ene-3beta,7beta-diol (1), (23E)-cucurbita-5,23,25-triene-3beta,7beta-diol (2), (23E)-25-hydroxycucurbita-5,23-diene-3,7-dione (3), (23E)-cucurbita-5,23,25-triene-3,7-dione (4), and (23E)-5beta,19-epoxycucurbita-6,23-diene-3beta,25-diol (5), together with one known triterpene, (23E)-5beta,19-epoxy-25-methoxycucurbita-6,23-dien-3beta-ol (6), have been isolated from the methanol extract of the stems of Momordica charantia. The structures of the new compounds were elucidated by spectroscopic methods.     

改良Ⅱ期法耳廓再造术

目的 探讨改良Ⅱ期法耳廓再造的方法并总结6年来的临床应用经验。方法 对146例（155耳）小耳畸形患者行耳廓再造术,手术分Ⅱ期进行。Ⅰ期：采用“U”形切口,切除残耳,在耳后分离合适的腔隙,置入肋软骨耳支架,耳垂向后转位衔接于再造的耳廓下方。6个月后行Ⅱ期手术：掀起耳廓,耳后置入软骨块,颞浅筋膜瓣转移覆盖后行中厚皮片移植术。结果 146例患者中141例（150耳）Ⅰ期术后恢复顺利,伤口愈合良好;5例（5耳）Ⅰ期术后4～6d出现皮瓣尖端坏死,范围约1.0 cm×1.5 cm,经换药后痊愈,未出现软骨外露、感染等;139例（147耳）Ⅱ期术后耳后移植皮片成活良好,7例（8耳）Ⅱ期术后出现耳后移植皮片部分成活不良,换药1周后愈合。146例患者随访94例（97耳）,失访52例（58耳）,随访时间为术后6个月至2年,随访病例均无感染、软骨吸收等并发症,再造耳廓结构清晰,耳颅角稳定。结论 改良Ⅱ期法耳廓再造手术操作相对简单,易于掌握,是耳廓再造的较为理想的方法之一。     

鼻NK/T细胞淋巴瘤的临床及病理学特征分析

目的探讨鼻NK/T细胞淋巴瘤的临床及组织病理学特征。方法对经治的21例鼻腔NK/T细胞淋巴瘤患者临床资料进行回顾性分析，总结其临床特点及组织病理学特征。结果患者主要临床症状表现为单侧鼻塞及脓血涕；经鼻内镜检查，证实肿瘤位于鼻腔外侧壁者17例，位于鼻中隔者4例；肿瘤形状类似于息肉样病变者9例，肿瘤表面糜烂且质脆者12例；CT显示肿瘤居于鼻腔前部者17例，发于鼻中隔者4例；病变累及上颌窦者12例，累及筛窦3例，同时累及上颌窦与筛窦者6例。病理学检查显示鼻型NK/T细胞淋巴瘤15例，外周T细胞淋巴瘤6例。结论本病临床表现缺乏特异性，CT检查有利于确定病变范围及临床分期，多部位活检及免疫组织化学检查是确诊鼻NK/T细胞淋巴瘤的主要依据。     

Café-au-lait macules and pediatric malignancy caused by biallelic mutations in the DNA mismatch repair (MMR) gene PMS2

A 14-year-old male presented with a T4 sigmoid adenocarcinoma, <10 colonic adenomas and multiple café-au-lait macules. Family history was not suggestive of a dominant hereditary form of colorectal cancer. Evaluation of the tumor revealed abnormal immunohistochemical staining of the PMS2 protein and high frequency microsatellite instability. Germline analysis identified biallelic PMS2 missense mutations. A new cancer syndrome caused by biallelic mutations in the mismatch repair genes, including PMS2, is now emerging and is characterized by café-au-lait macules, colonic polyps and a distinctive tumor spectrum.     

吗啡戒断时M2毒蕈碱受体介导大鼠蓝斑核中nNOS表达增强

目的:观察脊髓不同M受体亚型对纳络酮催促吗啡戒断大鼠戒断症状评分以及蓝斑核nNOS表达变化的影响.方法:采用nNOS免疫组织化学、鞘内注射和反义寡核苷酸技术.结果:鞘内注射M_2-AS可显著减少吗啡戒断症状评分,M_1-AS虽可部分减轻戒断症状,但总的作用弱于 M_2-AS;吗啡依赖大鼠蓝斑核nNOS表达增加,用纳络酮催促戒断后nNOS表达进一步增加,鞘内注射M_2-AS可抑制在吗啡戒断时蓝斑核nNOS的表达增强,而M_1-AS对其无影响.结论:脊髓M_2受体介导吗啡戒断大鼠蓝斑核nNOS的表达增加.     

错配修复系统MLH1基因rs1800734多态性与肝细胞癌的关联研究

目的研究错配修复系统MLH1基因rs1800734多态性与肝细胞癌遗传易感性的关系。方法采用以医院为基础的病例对照研究方法,运用荧光定量聚合酶链反应(polymerase chain reaction,PCR)和非条件Logistic回归分析MLH1基因型在两组中分布频率的差异,以及基因多态性和环境因素的交互作用。结果病例组MLH1基因位点AA、AG和GG各基因型频率分别为37.09%、48.57%和14.35%,对照组中基因型频率分别为32.89%、47.46%和19.65%,差异无统计学意义(P=0.085)。多因素Logistic回归分析表明,与AA基因型相比,AG或者GG基因型的个体罹患HCC的风险OR值分别为1.102和1.544。病例组等位基因(A)频率(61.37%)较对照组(56.62%)增高(2=4.22,P=0.040),A等位基因携带者患肝细胞癌的危险性是G等位基因携带者的1.217倍。交互作用分析结果表明MLH1基因多态性与肿瘤家族史、乙型肝炎病毒表面抗原(epatitis B surface antigen,HBsAg)阳性之间均存在交互作用(P<0....     

叉形头转录因子O亚型相关基因位点多态性与肝细胞癌关系

目的探讨叉形头转录因子O亚家族（forkhead box-containing protein O subfamily,FOXO）基因多态性与肝细胞癌（hepatocellular carcinoma,HCC）遗传易感性的关系。方法采用以医院为基础的病例对照研究方法,选取1 049例HCC患者作为病例组,1 052例无肿瘤患者作为对照组,对照组按年龄、性别、民族与病例组频数匹配。采用高通量TaqMan MGB实时荧光定量聚合酶链式反应（real-time fluorescent guantitative polymerase chain reaction,RT-PCR）技术对FOXO1的rs17592236位点、FOXO3的rs4946936位点和FOXO4的rs4503258位点进行基因分型。应用Logistic回归模型分析上述位点单核苷酸多态性（single nucleotide polymorphism,SNP）与HCC发病风险的关系,并研究基因多态性与环境因素的交互作用。结果 rs17592236、rs4946936和rs4503258位点基因型在病例组和对照组中分布差异均无统...     

Motor control assessment for rhizotomy in cerebral palsy

OBJECTIVE: To apply motor control assessment for selection of appropriate spastic cerebral palsy children to receive selective posterior rhizotomy (SPR). DESIGN: Forty children with spastic cerebral palsy (3-16 yr) were divided into three groups: "independent ambulator," "dependent ambulator," and "nonambulator." Another 18 healthy children were selected as the control group. Both motor control (tested by using polyelectromyography (PEMG)) and clinical ambulatory capability were assessed within 1 mo before SPR and 12 mo after. PEMG patterns were classified into seven patterns according to electromyographic activities during hip/knee flexion and extension. Gait patterns, which were analyzed by computer DynoGraphy, were classified into four patterns for children with ambulatory capability. RESULTS: PEMG and gait patterns were correlated with ambulatory ability. PEMG patterns 2-3 could predict independent ambulatory ability, whereas patterns 6-7 will interfere with ambulatory ability. PEMG patterns showed significant improvement after SPR in the ambulatory groups (P < 0.05), whereas they did not improve in the nonambulator group. Children with cerebral palsy with co-contraction of proximal/distal muscles had better results after SPR, whereas those with diffuse co-contraction or reduced electromyography activities had poor results. CONCLUSIONS: PEMG patterns may allow the physician to select the appropriate children with spastic cerebral palsy to receive SPR with good results.