Bim蛋白在骨肉瘤细胞株中的表达及其意义

目的 检测Bim蛋白在3种骨肉瘤细胞中和1种正常成骨细胞中的表达.方法 提取成骨肉瘤细胞Saos-2和成骨细胞hFOB 1.19中总RNA,通过全基因组表达谱芯片比较Bim基因在Saos-2和hFOB 1.19中表达;对骨肉瘤细胞MG-63、U2-OS、Saos-2及成骨细胞hFOB 1.19细胞进行细胞爬片免疫荧光、提取4种细胞中的总蛋白进行Western blot、提取4种细胞中的总RNA进行荧光定量聚合酶链反应(PCR),检测4种细胞内Bim的表达,观察骨肉瘤细胞与成骨细胞中Bim的差异,并通过查阅文献分析全基因组表达谱芯片中筛查出与Bim蛋白表达有关的基因.结果 全基因组表达谱芯片结果为Saos-2/hFOB 1.19=0.32,Saos-2中Bim基因表达比hFOB 1.19下调2倍以上;免疫荧光显示Bim在3种骨肉瘤细胞中的表达显著低于hFOB 1.19;Western blot条带结果表明Bim蛋白在hFOB1.19里面表达最多,定量分析条带灰度显示MG-63、U2-os、Saos-2及hFOB1.19细胞里面的表达值为0.04±0.02、0.15±0.01、0.12±0.02、0.39±0.02,3种骨肉瘤细胞Bim蛋白水平明显低于成骨细胞(P＜0.05);荧光定量PCR检测得出骨肉瘤细胞MG-63、U2-os、Saos-2及hFOB1.19里Bim mRNA的2-△△CT为:1.00±0.03、1.96±0.21、1.20±0.14、0.64±0.07,3种骨肉瘤细胞Bim mRNA明显低于成骨细胞,差异有统计学意义(P＜0.05);通过文献报道+基因芯片筛查出了10种可能跟Bim蛋白表达及生物学作用相关联的基因.结论 Bim在mRNA和蛋白水平下,骨肉瘤细胞中表达量明显少于成骨细胞.

Abstract：

Objective To examine the expression of Bim protein in three osteosarcoma cell lines and the osteoblasts. Methods Comparison of whole genome expression profiling chip in osteosarcoma cell Saos-2 expression and osteoblast hFOB 1. 19 expression; and then the Bim expression were detected and authenticated by immunofluorescence, Western blotting, quantitative polymerase chain reaction (PCR) on the MG-63, U2-OS, Saos-2 osteosarcoma cells and hFOB 1. 19 osteoblast to investigate the differences, and through literature review of whole-genome microarray screening for Bim expression of related genes. Results The gene expression microarray results of Saos-2/hFOB 1. 19 =0. 32,the Bim gene expression in Saos-2 is lower down than hFOB 1. 19 around 2 times; fluorescence signal of Bim in 3 osteosarcoma cells was significantly lower than hFOB 1. 19; Western blotting results show that Bim expression in hFOBl. 19 which is the most,quantitative analysis of band intensity showed MG-63, U2-os, Saos-2 and hFOBl. 19 expression is 0.04 ± 0. 02,0. 15 ± 0. 01,0. 12 ± 0. 02,0. 39 ± 0.02, Bim protein levels in osteosarcoma cells was significantly lower than osteoblast (P＜0. 05) ;fluorescence quantitative PCR detection of MG-63 ,U2-os,Saos-2 and hFOBl. 19 in Bim mRNA expression of 2-△△CT was:1. 00 ±0. 03,1. 96 ±0. 21,1. 20 ±0. 14,0. 64 ±0. 07, osteosarcoma cells Bim mRNA expression were significantly lower than that of osteoblast, the difference was significance (P＜0. 05) ;reviewed and gene chip screening came out of the 10 possible with Bim protein expression and biological function associated genes. Conclusion Bim mRNA and protein level expression in osteosarcoma cells were significantly lower than the osteoblast.     

CD4+CD25+调节性T细胞对小鼠肝脏移植自发性免疫耐受的影响

目的 研究CD4+CD25+调节性T细胞在诱导自发性肝脏免疫耐受中的作用.方法 向受体和供体注射抗CD25抗体(PC61)后进行小鼠原位肝脏移植,观测其生存时间.术后20～30 d切取移植肝脏行HE染色,同时观察CD4+CD25+T细胞对CD4+T细胞和CD8+T细胞功能的影响.结果 去除受体而不是供体小鼠的CD4+CD25+T细胞可以导致肝移植排斥反应.而且,去除CD4+CD25+T细胞使移植物的白细胞浸润明显增多,组织损伤加重.同时,去除CD4+CD25+T细胞导致CD4+T细胞的增殖活性和CD8+T细胞的细胞毒活性明显增强.结论 受体来源的CD4+CD25+调节性T细胞在小鼠肝脏移植免疫耐受诱导中起重要作用.

Abstract：

Objective To examine the contribution of CD4+ CD25+ regulatory T cells to liver transplant tolerance. Methods After injection of anti-CD25 monoclonal antibody (mAb, PC61), mouse orthotopic liver transplantation was performed and survivals were determined. The paraffin-embedded sections of hepatic allografts were cut and stained with hematoxylin and eosin (HE). Furthermore, the effect of CD4+ CD25+ regulatory T cells on proliferative response of CD4+ T cells and cytotoxicity of CD8+ T cells was examined by depleting these regulatory T cells. Results Depletion of these cells in the recipients but not in the donors before liver transplantation caused rejection. Histological analyses of hepatic allografts with PC61 treatment showed extensive leukocyte infiltration and tissue destruction, whereas those in the control group showed minimal changes. Moreover, elimination of CD4+CD25+ T cells resulted in the enhancement of both proliferative response of CD4+ T cells and cytotoxicity of CD8+ T cells against donor-type alloantigen. Conclusions These results suggest that CD4+CD25+ regulatory T cells were important for tolerance induction to hepatic allografts.     

升主动脉替换联合三分支支架血管术中置入治疗急性A型主动脉夹层

目的 总结升主动脉人工血管替换联合三分支支架血管术中置入治疗急性Stanford A型主动脉夹层的初步经验.方法 2008年6月至2009年9月20例急性A型主动脉夹层病人接受了升主动脉人工血管替换和三分支支架血管置入术.体外循环鼻咽温度降至20℃时,停止下半身灌注,经无名动脉近端升主动脉横断切口,将三分支支架血管置入主动脉弓和近端胸降主动脉真腔内,并将其分支支架血管依次置入左锁骨下动脉、左颈总动脉和无名动脉.将主干支架血管的近端与无名动脉近端的升主动脉切口重建后与替换近端升主动脉的人工血管端端吻合.结果 所有病人术中均顺利地置入三分支支架血管,平均体外循环(163.2±19.2)min,主动脉阻断(89.4±10.0)min,低流量选择性脑灌注和下半身缺血(32.7±6.6)min.术后出现短暂性神智障碍1例,急性肾功能衰竭1例.20例均治愈出院.术后3个月电子束CT检查结果示,主干支架血管及分支支架血管通畅、无扭曲;支架血管置入部位夹层假腔闭合;16例远端胸降主动脉夹层假腔闭合.结论 三分支支架血管术中置入是简化急性主动脉夹层者主动脉弓重建、提高手术安全性的一种有效方法.主要适应证为弓内内膜无破口而需主动脉弓重建的急性A型主动脉夹层病人.支架血管大小、分支支架血管间的距离选择和放置过程中避免内膜损伤是术中三分支支架血管成功放置的关键.

Abstract：

Objective To report the primary experience of open placement of triple-branched stent graft for acute Stanford type A aortic dissection. Methods Between June 2008 and September 2009, 20 well-selected patients with acute Stanford type A aortic dissection underwent open placement of triple-branched stent graft for total arch reconstruction. When core cooling to a 20℃ nasophageal temperature, perfusion to the lower body was discontinued and the ascending aorta was transected at the base of the innominate artery. Through a transverse incision, the triple-branched stent graft was inserted into the true lumen of the arch and descending aorta, and each side arm of the stent graft was positioned one by one into the arch branches.The transected stump of the ascending aorta was reconstructed by inner proximal stent-free dacron tube of the main graft and outer teflon felt, and subsequently continuous anastomosis to the 1-branched dacron tube graft was made. Results Open placement of triple-branched stent graft was technically successful in all patients. The mean cardiopulmonary bypass time, aortic cross-clamp time and lower body arrest time were (163.2 ±19.2) min, (89.4 ±10.0) min and (32. 7 ±6. 6)min, respectively. Transient postoperative neurological dysfunction was observed in 1 patient and acute renal failure in 1 patient. All patients were discharged from the hospital. Their computed tomographic scans at 3 months postoperatively showed that all stent grafts were fully opened without distortion. In the vascular stent implantation site the dissected false lumen was eliminated. The false lumen of the descending aorta distal to the stent graft was closed with thrombus in 16 cases. Conclusion Open placement of triple-branched stent graft is a new effective technique for total arch reconstruction in acute type A aortic dissection. Patients have the indications of the extensive primary repair of the thoracic aorta without primary intimal tears in the arch may be the best candidates for this new technique. The size of the stent graft, the distances between two neighboring side arm grafts and the prevention of the intimal trauma during the placement are crucial for successful open placement of triple-branched stent graft.     

Does the complication rate and treatment effect of balloon kyphoplasty and vertebroplasty differ in countries or specialties of operators?

Purpose

Vertebral compression fracture results in back pain, kyphotic deformity, loss of vertebral height, and restriction in daily activity. Conservative treatment, including analgesics, bed rest, and bracing, did not show up for good clinical control. Recently, minimally invasive surgical techniques, such as kyphoplasty and vertebroplasty, could become popular because of quick relief of pain. The goal of this review is to find out whether the complication rates and treatment effects differ in countries or specialties of operators.

Materials and Methods

Detailed searches of electronic databases (i.e. Pubmed, Cochrane library) were performed from 1987 to April 2007. Outcome measures of efficacy included visual analog scale decrease, change in kyphotic angle, restoration of vertebral height, and improvement of functional capacity. Outcome measures of safety were cement leakage, new vertebral compression fracture, and complications.

Results

There is a trend of increasing publications regarding these two procedures, especially in vertebroplasty. We found a higher level of cement leakage rate in vertebroplasty than in kyphoplasty. We also found that reduction in kyphotic angle was better in kyphoplasty than in vertebroplasty. These results were compatible with other literatures. Cement leakage rates were lower in neurosurgery department (20.6%) and orthopedic department (24.7%) than radiology department (52.9%).

Conclusions

The procedure operated by orthopedic surgeons and neurosurgeons tend to have lower cement leakage rate. One possible reason was that the neurosurgeons and the orthopedic surgeons are more familiar with the anatomical information needed for the procedure. Another possible explanation was that the radiologists might have more sufficient data to report the complications than the clinicians.     

嗓音病患者激光术后的嗓音康复训练

目的探讨发声训练在嗓音病患者显微激光手术后嗓音康复中的作用。方法将60例嗓音病行显微激光手术后患者随机分为训练组和常规组各30例,两组患者均按嗓音外科显微激光术后常规治疗与护理;训练组另予发声训练,包括放松训练、呼吸训练、基础发声训练、咀嚼发声训练和变调发声训练,并注意训练步骤。结果两组术后3个月主观评估和客观评估指标比较,差异有统计学意义(均P<0.01)。结论发声训练能显著改善嗓音病患者术后嗓音质量,促进康复。     

教学医院实习护生信息平台的构建及应用

目的对实习护生进行科学管理,提高带教质量和实习护生的综合素质。方法将2009年的实习护生设为对照组(121人),采用传统方法带教;2010年的实习护生设为实验组(121人),在传统带教基础上,构建实习护生信息平台用于临床教学管理。结果实验组护生理论、操作技能、综合能力考试成绩显著高于对照组(均P<0.01)。结论构建实习护生信息平台有利于医院对实习护生进行科学的管理,提高带教质量和实习护生的综合素质。     

等待肺移植患者生存质量及其影响因素研究

目的了解等待肺移植患者的生存质量及其影响因素。方法采用简明健康问卷(SF-36)、焦虑自评量表(SAS)、抑郁自评量表(SDS)和领悟社会支持量表(PSSS)对55例等待肺移植患者进行调查。结果等待肺移植患者SF-36各维度得分23.18~74.57,显著低于常模(均P<0.01);SAS、SDS得分分别为48.09±9.06、52.18±9.98,显著高于常模(均P<0.01);PSSS社会总支持因子得分为5.56±1.04,其中家庭内支持因子得分显著高于家庭外支持因子(P<0.05)。多因素分析结果显示生存质量的影响因素为呼吸困难和抑郁(P<0.05,P<0.01)。结论等待肺移植患者的生存质量较低,其生存质量受呼吸困难和抑郁的影响。医务人员应从患者生理及心理方面进行有效干预,以提高其生存质量。     

Percutaneous nephrolithotomy in semisupine position: a modified approach for renal calculus

Conventional percutaneous nephrolithotomy (PCNL) is usually performed in a prone position, which compresses the thorax and results in difficulty in rescue during operation. When PCNL is performed in a supine position, the flank renal puncture area is limited, so it is difficult to treat disseminated and complex renal calculi. Herein, we introduce a modified semisupine position for performing PCNL, which has numerous benefits as well as safe and effective. Between May 2002 and May 2009, a total of 452 patients with renal calculi were treated with semisupine PCNL. The patient was placed in 45° semisupine position during the procedure, with the affected flank arched as much as possible. In this series, no one converted to open surgery. The average operating time was (115.2 ± 44.5) min. Single tract PCNL was performed for 80.97% of the cases, two tracts 13.94%, three tracts 4.65%, and four tracts 0.44%. The upper, middle, and lower calix tracts accounted for 12.1, 63.0, and 24.9%, of procedures, respectively. Stone-free rate was 85.7% overall, 92.2% for single calculus (83/90), and 72.9% for staghorn calculi (78/107). Major postoperative complications occurred in 3.3% of the cases. This study demonstrated PCNL in a semisupine position is an effective alternative for treating renal calculi, which combines the advantages of PCNL in a prone position, and PCNL in a supine position. The semisupine position allows easier irrigation of stone fragments, is more comfortable for the patient, and facilitates monitoring of anesthesia.     

PLK1在原发性肝癌组织中的表达

目的 探讨极样激酶1（Polo-like kinase 1,PLK1）在原发性肝癌细胞中的表达情况,并且探索其与肝癌病人临床病理特点及预后的关系。方法 采用免疫组化技术研究PLK1在40例原发性肝癌组织石蜡切片中的表达情况。数据分析采用SPSS13.0统计软件处理,P<0.05表示差异有统计学意义。结果 癌栓、包膜侵犯、肿瘤直径大小、BCLC分期等因素和PLK1的阳性表达呈明显相关性（P<0.05）; PLK1阳性组和阴性组之间在术前AFP数值上存在着明显的统计学差异（P=0.029）;通过生存分析,发现PLK1的表达情况和患者的生存时间没有明显关联;Kaplan-Meier法分析原发性肝癌的预后的单因素相关因子显示与包膜侵犯、TNM分期、癌栓及转移与生存期有相关性（P<0.05）。与性别、乙肝、肝硬化、肿瘤数目BCLC分期及临床分期无关。结论 PLK1的表达在肝癌的发展及其生物学行为方面有着较为密切的关系,是重要的分子标记物,PLK1可能在肝癌早期的诊断中有重要作用。