人羊膜上皮细胞对大鼠坐骨神经再生影响的实验研究

目的 通过实验研究了解人羊膜上皮细胞(human amniotic epithelial cells,HAECs)对大鼠坐骨神经再生的促进作用.方法 取60只SD大鼠随机分为两组,羊膜细胞组和对照组,各组再分为2周和4周组,每组15只.制作大鼠周围神经损伤再生室模型,HAECs组局部应用培养的HAECs,对照组局部使用等量的生理盐水.术后分别于2周、4周检测神经传导功能和HE染色观察神经纤维形态学变化.结果 术后2周两组的神经电生理及组织学检测比较差异无统计学意义;4周HAECs组的大鼠坐骨神经传导功能明显恢复,HE染色显示术后坐骨神经手术部位出现大量炎性肉芽组织,呈现纤维性修复,吻合口以远HAECs组神经纤维形态结构较对照组完整,神经纤维与髓鞘直径均较对照组大.结论 HAECs移植可加速大鼠坐骨神经损伤后神经传导功能恢复,有助于有髓神经纤维损伤后的轴突与髓鞘的再生修复.     

乳腺癌干细胞放疗反应性和耐受机制的研究

Objective To discuss the response of breast cancer stem cells to radiation and its resistant mechanism. Methods Single breast cancer stem cells were isolated from the human breast adenocarcinoma cell line, MCF-7, and suspension-cultured into mammary cell microspheres in vitro. The radiosensitivity of these breast cancer stem cells were evaluated using a colony formation assay. Real-time polymerase chain reaction (PCR) was used to detect the expression levels of the following genes before and after radiation in the breast cancer stem cells, along with non-stem cells of the breast cancer cell line: ATM, p53, Her-2, Ku70/Ku80 and Survivin. Results The average survival fraction (SF2) of the suspensioncultured MCF-7 cells after 2 Gy of radiation was 0. 49, while the average SF2 of MCF-7 cells cultured as a monolayer was 0. 27 (P<0.01). Compared to the MCF-7 cells grown in a monolayer, the suspension-cultured MCF-7 cells had higher expression levels of ATM, p53, Her-2, Ku70/Ku80 and Survivin; The expression of ATM, p53, Her-2, Ku70/Ku80 and Survivin was 5. 29±1. 36,1. 37±0. 73,2.10±0. 57,4. 69±1. 45,and 1. 80±1.29 fold, respectively. Conclusion Breast cancer stem cells have stronger anti-radiation capabilities than breast cancer non-stem cells. The stronger DNA repair capacity is an important resistant mechanism about radiotherapy of breast cancer stem cells.     

酸性微环境下大蒜素增强大鼠自然杀伤细胞的功能活性

Objective To investigate the role of allicin on rat nature killer (NK) cell activity in vitro under acidic microenvironment, and its possible mechanism. Methods CD3- NKR-P1+ NK cells isolated from the rat spleen were cultured in the complete RPMI 1640 medium ( pH 5. 6, pH 6. 5, or pH 7. 2 respectively), and treated with allicin at final concentration of 30 mg/L. Enzyme linked immunosorbent assay (ELISA) was used to determine supernatant interferon (IFN)-γ levels. The percentage of NK cells proliferation and apopotosis was analyzed by flow cytometry. NK cell cytotoxicity toward YAC-1 tumor cells was detected by LDH release assay. Results Proliferation and cytotoxicity of NK cells were significantly suppressed by acidic microenvironment in vitro. Under the cultured condition of acidic pH below 7. 2, allicin seemed to promote NK cells proliferation, which reached to highest level of 33% at pH 5. 6 cultured for 16 h. Correspondingly, at pH of 5. 6, allicin induced a marked increase of IFN-γ concentration in the supernatant from (50. 07 ± 0. 38) (cultured for 4 h) to (64. 59 ± 0. 09) ng/L ( cultured for 16 h). The cytotoxicity of NK cells toward YAC-1 tumor cells was also found strongest under the condition of pH 5. 6 cultured for 16 h. Conclusion Allicin favored to enhance the cytotoxicity of NK cells under the acidic cultured condition, which might be related to the increase of IFN-γ production.     

肾移植受者BK病毒的感染特点

Objective To investigate the characteristics of BK virus (BKV) infection in renal transplant recipients. Methods A total of 243 renal recipients from our clinic within 48 months after transplantation were enrolled as the trial group and 82 healthy people as the control group. Urine and peripheral blood samples of these two groups were harvested for urinary sediment BKV cytology by Decoy cell counting and BKV DNA by real-time PCR. Results The positive rates of urinary Decoy cell, BKV viruria and viremia were 35.4%, 36.6% and 16.9% in trial group, and 4.9%, 20.7% and 2.9% in control group, respectively. In trial group, the medians of urinary Decoy cell, urinary BKV and peripheral blood BKV were 6/10 HPF, 1.00×104 copy/ml and 6.87×103 copy/ml respectively, while in control group, they were 2/10 HPF, 1.10×104 copy/ml and 2.24×1(3 copy/ml. Compared with the healthy people, the positive rates and the levels of BKV DNA in urine and peripheral blood of recipients were significantly higher. The amount of urinary Decoy cells was positively correlated to urinary BKV load (r=0.636, P＜0.01). Conclusions BKV replication is easier to happen in renal recipients as compared to healthy people. Counting of urinary Decoy cells is convenient, useful and sensitive to evaluate BK viruria and viremia in renaltransplant recipients. BKV DNA detection in urine and peripheral blood can be used to screen the evidence of BK reaction in order to prevent irreversible graft damage by BKV.[ Key words ] Kidney transplantation; BK virus; Kidney diseases; Decoy cells     

新疆地区维吾尔族35岁以上人群肾功能与动脉僵硬度的相关性

目的 研究新疆地区维吾尔族人群的肾功能与动脉僵硬程度的相关性.方法 应用四阶段分层整群随机抽样方法,于2007年10月至2010年3月,在乌鲁木齐市、克拉玛依市、阜康市、吐鲁番地区、和田地区、伊犁哈萨克自治州、阿勒泰地区抽取了35岁以上,资料完整的维吾尔族城乡居民4312人,进行研究分析.用简化MDRD公式计算估计肾小球滤过率(eGFR).测量双侧臂-踝脉搏波速度(b-aPWV),取双侧的平均值与eGFR做线性相关性分析,并对b-aPWV的影响因素进行校正.结果 eGFR与平均b-aPWV值呈负相关(R=0.174,P＜0.01).运用Stepwise多重线性回归校正年龄、性别、体质量指数、收缩压、舒张压、腰围、臀围、尿酸、空腹血糖、总胆同醇、三酰甘油、低密度脂蛋白后,eGFR仍与b-aPWV呈负相关(P=0.012).结论 新疆地区35岁以上维吾尔族人群的肾功能与动脉僵硬度存在负相关.     

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

The objectives of the study were to evaluate the association between lumbar paraspinal muscle density, evaluated on computed tomography (CT) and age, sex and BMI; and to evaluate the association of those changes with low back pain (LBP) and spinal degeneration features in a community-based sample. This study was an ancillary project to the Framingham Study. A sample of 3,529 participants aged 40–80 years had a CT scan performed to assess aortic calcification. 187 individuals were randomly enrolled in this study. LBP in the last 12 months was evaluated using self-report questionnaire. Density (in Hounsfield units) of multifidus and erector spinae was evaluated on CT. The prevalence of intervertebral disc narrowing, facet joint osteoarthritis (FJOA), spondylolysis, spondylolisthesis and spinal stenosis were also evaluated. We used linear regression models to examine the association of paraspinal muscles density with age, sex, BMI, LBP, and spinal degeneration features. The results show that in our study, men have higher density of paraspinal muscles than women, younger individuals have higher density than older ones and individuals with lower weight have higher muscle density than overweight. No differences between individuals with and without LBP were found. Significant association was found between L4 multifidus/erector spinae density and FJOA at L4–L5; between multifidus at L4 and spondylolisthesis at L4–5; and between erector spinae at L4 and L5 with disc narrowing at L4–5 and L5–S1, respectively. We conclude that the paraspinal muscle density decreases with age, and increases BMI. It is associated with at some levels FJOA, spondylolisthesis and disc narrowing at the same level, but not associated with occurrence of LBP.     

胃肠道腺癌并发阻塞性肺疾病的围手术期处理60例分析

目的探讨防治胃肠道恶性肿瘤合并阻塞性肺疾病(COPD)患者术后并发症的有效方法。方法回顾性分析60例胃肠道恶性肿瘤合并COPD患者的围手术期处理措施及其效果。结果术后11例患者出现并发症(18.3%),其中肺炎5例(8.3%),肺不张1例(1.7%),切口感染2例(3.3%),吻合口漏1例(1.7%),泌尿系感染1例(1.7%),肠梗阻1例(1.7%)。除1例肺炎发展为MODS死亡外,其余经非手术治疗后痊愈。结论围手术期采取综合措施可有效降低胃肠道恶性肿瘤合并COPD患者术后并发症的发生。     

完全腹腔镜肝切除治疗肝脏恶性肿瘤的临床研究

目的近年来,随着技术的不断成熟和设备的不断改进,腹腔镜肝切除(laparoscopic hepatectomy,LH)在国内外已得到一定的推广应用,但LH治疗肝脏恶性肿瘤的报道仍然较少。本研究通过回顾性分析探讨腹腔镜肝切除LH治疗肝脏恶性肿瘤的技术要点及安全性。方法 2002年6月至2008年12月由同一手术组施行的腹腔镜肝切除手术116例,其中肝细胞癌95例,肝门部胆管癌3例,肝内胆管细胞癌5例(包括肝内胆管结石癌变1例),肝脏转移癌12例,肝囊腺癌1例,其中男77例,女39例,平均年龄48.7(28～71)岁。结果手术方式包括解剖性肝55例,非解剖性切除61例。手术时间75～310min,平均(216±87)min。出血量50～1500ml,中位数250ml。116例病人中23例输血,输血量400～800ml。5例中转开腹,其中1例死亡。中转开腹5例,其中1例术中死亡。8例术后出现少量胆漏,经引流后愈合;11例出现少量腹水(均为肝功能ChildB级),经对症治疗消失。术后住院时间3～18d,平均(6.1±1.9)d。术后随访6～83个月,平均(28.1±10.5)个月,复发12例,未发现腹腔及穿刺孔转移。结论 LH是一种治疗肝脏恶性肿瘤安全有效的方法,值得在临床中进一步推广。     

皮肤老化及细胞生长因子在美肤方面的应用

皮肤老化受到多种因素的影响,是当前医学美容研究的热点之一。细胞生长因子是一类刺激细胞分裂的生物活性多肽,在创伤修复过程中具有多种重要作用：促进细胞增殖、促进创面的血管化、调节细胞外基质的产生和降解、诱导邻近细胞合成细胞因子等。本文介绍了皮肤衰老的机理、细胞生长因子的特点及其在美容方面的应用。     

固定平台后稳定型假体与旋转高屈曲型假体治疗膝骨性关节炎的早期疗效比较

目的评价人工全膝关节置换(total knee replacement,TKR)中使用固定平台后稳定型假体与旋转高屈曲型假体治疗骨性关节炎的早期临床疗效。方法对我院2007年1月—2009年12月收治的68例骨关节炎患者施行TKR手术,其中应用固定平台后稳定型假体32例38膝,旋转高屈曲型假体36例44膝,通过测量手术前及末次随访时的膝关节活动度和美国特种外科医院膝关节评分(hospital for special knee surgery score,HSS)对两种假体置换方式的临床疗效进行比较。结果 68例患者获随访3～26个月,平均19个月。根据HSS评分标准,末次随访时优47例(69.1%),良17例(25.0%),可4例(5.9%),总优良率94.1%。两组之间术前活动度以及术前、末次随访时HSS的差异无统计学意义(P0.05),而旋转高屈曲型假体组在末次随访活动度方面较固定平台后稳定型假体组为高(P0.05)。结论高屈曲度人工膝关节假体在运动学上有潜在的优势,有助于改善关节功能,减轻接触应力和假体磨损;固定平台后稳定型假体手术方式简单、疗效肯定、术后并发症少,对不需要从事高屈曲活动、经济较为困难以及高龄患者是一种可供选择的假体。