乳腺囊性增生病癌变过程中部分因素变化的意义

检测乳腺囊性增生病（ＦＣＤ）经不典型增生到癌变部分因素的变化。结果提示：从因明显ＦＣＤ症状活检至癌变为２～１０年；从Ⅱ级以上不典型增生到临床癌变需２～７年；癌变率为３．１％。ＦＣＤ患者存在性激素分泌调控失常，血浆雌激素和催乳素含量增加，导致上皮细胞增生。乳腺一般性增生细胞的ＤＮＡ含量和超微结构与正常乳腺上皮细胞相似；无肿瘤相关抗原及异常基因产物表达。而发生在一般性增生基础上的不典型增生则呈现细胞基因物质ＤＮＡ含量增加，部分为超４Ｃ的多倍体细胞；同时出现细胞膜和细胞核超微结构异常；雌激素受体含量增加，对性激素的依赖性和敏感性增强；部分不典型增生细胞出现胚胎性肿瘤相关抗原和异常基因产物表达。随不典型增生程度加重至乳腺癌，上述诸因素的变化趋势具有明显规律性。提示ＦＣＤ上皮细胞从一般性增生经不典型增生至乳腺癌为细胞生物学连续逐渐变化的过程。部分不典型增生细胞中具有癌倾向的细胞生物学行为异常和表型变化与乳腺癌发生密切相关。细胞核ＤＮＡ含量等异常变化及程度可作为乳腺癌前病变发展程度的客观标志     

Evaluation of peripheral blood involvement of mantle cell lymphoma by fluorescence in situ hybridization in comparison with immunophenotypic and morphologic findings.

Mantle cell lymphoma is non-Hodgkin's B-cell lymphoma characterized by the t(11;14)(q13;q32) translocation. Peripheral blood involvement of mantle cell lymphoma is usually associated with a poor prognosis and therefore, its identification is clinically important. In this study, we performed cyclin D1/IgH-probe fusion fluorescence in situ hybridization analysis on 223 peripheral blood samples: 185 from 125 mantle cell lymphoma patients, and 38 normal controls. The cutoff values for the test were established using normal controls. Flow cytometry on peripheral blood and corresponding bone marrow samples was used to evaluate this test. In all, 26% of the 185 peripheral blood samples and 27% of the 161 corresponding bone marrow samples were flow cytometry positive for mantle cell lymphoma. The mean numbers of single and- double-fusion signals and the mean number of CD5/CD19-positive cells, absolute blood lymphocyte count, and white blood cell count were significantly higher in peripheral blood and corresponding bone marrow samples with mantle cell lymphoma-positive flow cytometry. Double-fusion signals were more specific than single-fusion ones. Fluorescence in situ hybridization was far more likely to be positive for mantle cell lymphoma when the peripheral blood and the corresponding bone marrow samples had positive flow cytometry results or morphology (P<0.01). Our study indicates that cyclin D1/IgH-fusion fluorescence in situ hybridization analysis could be used to determine the presence and character of circulating mantle cell lymphoma cells in peripheral blood, thus enhancing our ability to evaluate leukemic mantle cell lymphoma and minimum residual disease.     

抗氧化性维生素与男性生殖

生殖系统内过多的活性氧 (ROS)产生可导致精子膜脂质过氧化损伤 ,而抗氧化性维生素对于清除ROS 避免精子脂质过氧化损伤具有一定保护作用。本文就抗氧化性维生素在男性生殖中的作用及其在男性不育治疗等方面进行了综述     

超顺磁性氧化铁Resovist标记神经干细胞的实验研究

目的研究超顺磁性氧化铁（superparamgnetic iron oxides，SPIOs）标记神经干细胞及其生物学特性．方法：神经干细胞培养、传代和诱导分化；Resovist（一种SPIOs）标记神经干细胞。制备磁标记神经干细胞；利用免疫细胞化学、透射电镜和Prussian blue染色等方法对磁标记神经干细胞生物学特性进行研究。结果：在原代及传代细胞中有Nestin阳性细胞即神经干细胞．血清诱导下，神经干细胞可分化为GFAP、NF200阳性细胞．Resovist与神经干细胞共同孵育后，透射电镜及Prussian blue染色显示胞浆中含有铁颗粒，Resovist也可以随细胞的分裂增殖而传到子代细胞中。随Resovist浓度的增高（5．6μg／ml-11．2μg/ml），Resovist对神经干细胞存活、分化能力的影响无显著性差异（P〉0．05）．当Resovist的浓度大于22．4μg／ml时。Resovist影响其存活和分化（P〈0．05）。结论：本实验利用Resovist作为磁标记探针，对神经干细胞进行成功磁标记，为进一步利用核磁共振（MRI）对神经干细胞活体追踪奠定实验基础。     

无张力性吊带术治疗女性压力性尿失禁

目的探讨无张力阴道吊带术(tension-free vaginal tape，TVT)治疗女性压力性尿失禁的疗效。方法13例经尿动力学检查证实为压力性尿失禁在连续硬膜外麻醉下经阴道前壁行无张力阴道吊带术，低平截石位，经阴道前壁向上穿刺尿道两侧间隙，从耻骨上腹壁引出TVT吊带，调整张力，关闭切口。结果手术时间15～45min，平均35min。13例随访6～24个月，平均13个月，12例治愈，1例改善，无尿失禁复发或排尿困难。结论TVT操作简单，创伤小，手术时间短，术后恢复快，治疗压力性尿失禁疗效好。     

原发性单纯性脑干出血52例临床研究

目的研究原发性单纯性脑干出血的病因、诊断、治疗、预后及预防。方法对52例原发性单纯性脑干出血的临床资料进行回顾性分析。结果预后良好25例，优良率为48．1％；死亡21例，死亡率40．4％；出血量≤5．0ml死亡率21．9％（7／32），出血量≥5．1ml死亡率70．0％（14／20），出血量〉10.0ml 10例全部死亡。结论原发性单纯性脑干出血发病急，病情重，死亡率高，预后差；高血压为本病的主要发病原因；CT是原发性单纯性脑干出血的安全、可靠诊断方法；适时进行气管切开及亚低温治疗能有效提高疗效及降低死残率；严格控制血压是预防原发性单纯性脑干出血的重要措施。     

S-F内固定器治疗胸腰椎爆裂型骨折

目的　探讨使用S -F脊柱内固定器治疗胸腰椎爆裂型骨折的效果。方法　回顾分析从 2 0 0 0年 1月～ 2 0 0 2年 4月使用S-F脊柱内固定器治疗的胸腰椎爆裂型骨折 4 4例 ,比较手术前后的椎体前后缘高度 ,椎管狭窄程度 ,Cobb角及症状恢复情况。结果　经平均 2年左右的随访 ,术后椎体前缘平均高度达正常的 93 8%± 6 2 7% ,较术前增加了 4 2 5 3%。椎体后缘平均高度达到正常的 97 5 9%± 0 0 3% ,较术前增加了 1 6 5 2 %。脊柱后凸Cobb为 4 98°± 3 32°。较术前矫正了 1 4 6 8°。CT片显示椎体后突骨块占椎管前后径的比例为 9 5 9%± 7 2 1 % ,较术前减少 2 7 71 %。统计学分析差异有显著性 (P <0 0 5 )。有神经功能损伤者 ,术后平均改进一级以上。在术后二周与术后一年以上的X线片相比较其椎体前缘的高度平均仅丢失 1 0 % ,椎体后缘的高度平均丢失 0 8% ,Cobb角平均丢失 0 1°。结论　使用S -F脊柱内固定器治疗胸腰椎爆裂型骨折具有操作简单、复位完美、固定牢靠、疗效优良的优点。术中注意不宜过度撑开及双侧不对称 ,对椎板减压者宜作“H”型椎板后路植骨 ,横突间、关节突间植骨融合将提高疗效、减少并发症     

3423份病案质量调查分析

随机抽查某医院2001年9月-2002年6月出院病案3423份,占同期出院病案的26.9％。按有关标准对其质量进行了 审查,并针对存在的质量问题,提出了对策性意见。     

Effect of curcumin on nitric oxide synthase expression in Iipopolysaccharide-activated microglia cells and the anti-oxidative effect of curcumin

BACKGROUND: It has been demonstrated that curcumin can increase the activities of various anti-oxidase in blood and tissue, effectively eliminate various free radicals, reduce the production of peroxisome, and alleviate oxidative stress reaction. Whether it has the same effect on microglia? OBJECTIVE: To observe the effects of curcumin on the expressions of inducible nitric oxide synthase (iNOS), nuclear factor-κB (NF-κB), and superoxide dismutase (SOD) in microglial cell line BV stimulated by lipopolysaccharide (LPS). DESIGN: An observational comparative study. SETTING: Research Room of Biochemistry, Medical College of Nantong University. MATERIALS: Mice microglia cell line BV, iNOS and NF-κB reporter gene plasmids were presented by Dr. Bhat.NR. from the Medical University of South Carolina (USA). Curcumin was produced by the Xi'an Branch of China Chengdu Scholar Bio-Tech. Co.,Ltd.; LPS (E.Coli O26:B6), anti-mice iNOS monoclonal antibody, horseradish peroxidase labeled goat-anti-mice IgG were the products of Sigma Company (USA). METHODS: The experiments were carried out in the Research Room of Biochemistry, Medical College of Nantong University from May 2006 to April 2007. ① Detection of iNOS: The cells were seeded onto 24-well plate at the density of 1×105, After the cells had adhered to the cover glasses, the cells were grouped as negative control group (the primary antibody was replaced by phosphate buffered solution PBS); normal control group (the cells were normally cultured); LPS-treated group (the cells were treated with LPS for 24 hours); curcumin+LPS group (the cells were treated with curcumin for 1 hour and LPS for 24 hours). The expressions of iNOS protein were detected with immunocytochemical staining. ② Determination of iNOS and NF-κB gene activities: According to the introduction of the kit for transfection, iNOS or NF-κB report gene plasmids were transiently transfected with LipofectamineTM2000 liposomes into the cells in the 24-well plate for 24 hours. The cells were divided into normal control group (the cells were normally cultured after transfected with report gene plasmids); blank plasmid group (the cells were normally cultured after transfected with blank plasmids); LPS-treated group (the cells were treated with LPS for 4 hours after transfected with report gene plasmids); curcumin+LPS group (the cells were treated with curcumin for 1 hour and LPS for 24 hours after transfected with report gene plasmids). The content of luciferase in the cell lysis buffer was determined after cell lysis. ③ Determination of SOD activity: The cells were seeded into culture bottle at the density of 1×106, and the divided into four groups, including normal control group (the cells were normally cultured); LPS-treated group (the cells were treated with LPS for 24 hours); curcumin+LPS group (the cells were treated with curcumin for 1 hour and LPS for 24 hours); vitamin C+LPS group (the cells were treated with vitamin C for 1 hour and LPS for 24 hours). The SOD activity was determined with xanthine oxidase and quantitative colorimetric assay. MAIN OUTCOME MEASURES: The expressions of iNOS protein, iNOS and NF-κB, and the activity of SOD were observed. RESULTS: ① Expression of iNOS protein in microglia: The expression of iNOS protein in the LPS-treated group was obviously higher than that in the negative control group (P < 0.01); Those in the curcumin+LPS group were significantly decreased as compared with that in the LPS-treated group (P < 0.01). ② Expressions of iNOS and NF-κB genes: The expressions of iNOS and NF-κB genes in the LPS-treated group were significantly higher than those in the normal control group (P < 0.01); Those in the curcumin+LPS group were significantly lower than those in the LPS-treated group (P < 0.01). ③ SOD activity: The activity of SOD in the LPS-treated group was significantly lower than those in the normal control group (P < 0.01). It in the curcumin+LPS group and vitamin C +LPS group was significantly higher than that in the LPS-treated group (P < 0.01). CONCLUSION: Curcumin could inhibit the expression of iNOS in the activated microglia, and it also has the abilities in eliminating free radicals and antagonizing lipid peroxidation.