山东省医学影像研究所所长——连世海

山东省医学影像研究所所长连世海副研究员是解放后我国自己培养的一代科学家之一,1945年参加革命,1953年毕业于山东医学院,1958年任山东省立医院放射科主任,副主任医师。     

焦虑症共病抑郁症状在门诊患者中的调查研究

目的调查门诊患者中焦虑症的患病率以及共病抑郁症状的发生率。方法在我院精神科门诊、心理咨询门诊以及社区卫生服务中心内科门诊就诊的1106例患者作为研究对象，并做SAS、SDS、HAMA量表评定。结果1106例患者中，符合焦虑症诊断，且HAMA≥14分者共93例，患病率为8.41%。SDS标准分≥50共病抑郁症状的共43例，占46.23%。HAMA分值、SAS分值与SDS分值有显著性正相关。结论门诊中罹患焦虑症的患者焦虑程度越高，共病抑郁的可能性就越大。     

Synergistic effects of Nell-1 and BMP-2 on the osteogenic differentiation of myoblasts.

Osteogenesis is synergistically enhanced by the combined effect of complimentary factors. This study showed that Nell-1 and BMP-2 synergistically enhanced osteogenic differentiation of myoblasts and phosphorylated the JNK MAPK pathway. The findings are important because of the osteochondral specificity of Nell-1 signaling and the potential therapeutic effects of coordinated BMP-2 and Nell-1 delivery. INTRODUCTION: BMPs play an important role in the migration and proliferation of mesenchymal cells and have a unique ability to alter the differentiation of mesenchymal cells toward chondrogenic and osteogenic lineages. Signaling upstream of Cbfa1/Runx2, BMPs effects are not limited to cells of the osteoblast lineage. Thus, additional osteoblast-specific factors that could synergize with BMP-2 would be advantageous for bone regeneration procedures. NELL-1 (NEL-like molecule-1; NEL [a protein strongly expressed in neural tissue encoding epidermal growth factor like domain]) is a novel growth factor believed to preferentially target cells committed to the osteochondral lineage. MATERIALS AND METHODS: C2C12 myoblasts were transduced with AdLacZ, AdNell-1, AdBMP-2, or AdNell-1+AdBMP-2 overexpression viruses. Effects were studied by cell morphology, alkaline phosphatase activity, osteopontin production, and MAPK signaling. Additionally, in a nude mouse model, viruses were injected into leg muscles, and new bone formation was examined after 2 and 8 wk. RESULTS: C2C12 myoblasts co-transduced with AdNell-1+AdBMP-2 showed a synergistic effect on osteogenic differentiation as detected by alkaline phosphatase activity and osteopontin production. Nell-1 stimulation on AdNell-1 + AdBMP-2 preconditioned C2C12 cells revealed significant activation of the non-BMP-2 associated c-Jun N-terminal kinase (JNK) MAPK signaling pathway, but not the p38 or extracellular signal-regulated kinase (ERK1/2) MAPK pathways. Importantly Nell-1 alone did not induce osteogenic differentiation of myoblasts. In a nude mouse model, injection of AdNell-1 alone stimulated no bone formation within muscle; however, injection of AdNell-1+AdBMP-2 stimulated a synergistic increase in bone formation compared with AdBMP-2 alone. CONCLUSIONS: These findings are important because of the confirmed osteochondral specificity of Nell-1 signaling and the potential therapeutic effects of enhanced BMP-2 action with coordinated Nell-1 delivery.     

BKV in Simultaneous Pancreas-Kidney Transplant Recipients: A Leading Cause of Renal Graft Loss in First 2 Years Post-Transplant

With the introduction of more potent immunosuppressive agents, rejection has decreased in simultaneous pancreas/kidney transplant (SPK) recipients. However, as a consequence, opportunistic infections have increased. The purpose of this report is to outline the course of SPK patients who developed polyomavirus-associated nephropathy (PVAN). A retrospective review of 146 consecutive SPK recipients from January 1, 1996 to December 31, 2002 was performed. Immunosuppression, rejection and development of PVAN were reviewed. Nine patients were identified. All received induction with either OKT3 or thymoglobulin. Immunosuppression included tacrolimus/cyclosporine, MMF/azathioprine and sirolimus/prednisone. Two patients were treated for kidney rejection prior to the diagnosis of PVAN. Time to diagnosis was an average of 359.3 days post-transplantation. Immunosuppression was decreased but five ultimately lost function. However, none developed pancreatic abnormalities as demonstrated by normal glucose and amylase. Two underwent renal retransplantation after PVAN diagnosis and both have normal kidney function. PVAN was the leading cause of renal loss in SPK patients in the first 2 years after transplantation and is a serious concern for SPK recipients. The pancreas, however, is spared from evidence of infection, and no pancreatic rejection occurred when immunosuppression was decreased.     

Intra-lesional injections of collagenase are ineffective in the treatment of keloid and hypertrophic scars.

The treatment of keloid and hypertrophic scars remains difficult. Enzymatic digestion of keloid scars has been previously proposed as an effective treatment strategy for reducing the volume of keloid scars. To test this, we administered intra-lesional injections of pure collagenase (between 600 and 4500 units for each scar) into the keloid and hypertrophic scars of seven human volunteers (five keloid and two hypertrophic scars). Five patients (three keloid and two hypertrophic) received more than one injection of collagenase. The treatment resulted in a temporary reduction in scar volume for three of the patients with keloid scars. However, scar volumes for these three patients returned to the same (or greater) levels after 6 months of follow-up. Treatment with collagenase produced no change in scar volume for the two patients with hypertrophic scar. Side effects were numerous and severe including; pain, swelling, blistering, ulceration and ecchymosis at the site of injection. One patient required admission to hospital for 48 h after the first injection. Maximum length of follow-up was 6 months. None of the seven patients completed the study and returned for final follow-up at 2 years. This pilot study suggests that treatment of keloid and hypertrophic scars with intra-lesional injections of collagenase is ineffective.     

13例肝结核临床分析

我院于1998年1月-2005年5月共收治13例肝结核病患者，现分析如下。     

烧伤后早期应用中/长链甘油三酯对患者免疫功能的影响

目的　探讨烧伤后早期肠内喂养中链甘油三酯 (MCT) /长链甘油三酯 (LCT)对机体免疫功能的影响及其可能机制。　方法　选取 30例烧伤面积 >30 %TBSA的患者 ,随机分为两组 (每组 15例 )。F组 ,饲以含MCT/LCT的肠内营养制剂Fresubin 75 0MCT ;N组 ,饲以只含LCT的肠内营养制剂Nutrison。于伤后 2 4h内进行完全肠内营养支持 ,共持续 10d。于伤后 1、4、7、10d检测两组患者血浆白细胞介素 (IL) 2、IL 4、前列腺素 (PG)E2 及外周血T淋巴细胞转化率的改变。　结果　伤后各时相点F组患者血浆IL 2水平与N组相比 ,无明显差异 (P >0 .0 5 ) ;伤后 4dF组PGE2 水平较N组明显降低 (P <0 .0 1) ;伤后 4、7、10dF组IL 4水平及外周血T淋巴细胞转化率均明显高于N组 (P <0 .0 5～ 0 .0 1)。　结论　在改善烧伤后机体的免疫功能方面 ,含MCT/LCT的肠内营养制剂较单纯LCT制剂更具优势。