胎羊单侧输尿管不完全性梗阻解除前后肾脏组织足细胞表型转化及PAX2、VEGF的表达

目的 从超微结构和分子学方面探讨胎儿期单侧输尿管不完全性梗阻解除后肾脏恢复之机制.方法 26只孕75～85 d的胎羊分3组:梗阻组,对12只胎羊实行宫内手术造成单侧输尿管不完全性梗阻;梗阻解除组,对10只胎羊以同样的手术方法造成单侧输尿管不完全性梗阻,3周后,再次宫内手术解除梗阻;对照组,对4只胎羊实行宫内手术但不结扎输尿管.待胎羊出生后,取其肾脏标本检测病理改变,足细胞表型转化以及PAX2和VEGF的表达变化.结果 梗阻组12只胎羊,其中9只顺利出生;梗阻解除组10只胎羊,其中8只顺利出生;对照组4只胎羊,均顺利生产.与对照组羔羊肾脏相比,梗阻组羔羊梗阻侧肾脏,表现为皮质囊性改变,间质纤维化,肾小球数目显著减少;足细胞足突广泛融合[(4.20±1.08)%比(86.79±1.66)%];PAX2表达显著升高(1.43±0.09比2.44±0.09);而VEGF表达明显减少(0.80±0.15比0.33±0.14).解除梗阻后,肾脏的囊性改变大大改善,肾小球数目增加,但细胞外基质沉着仍明显;足细胞足突融合减轻[(41.18±3.13)%比(86.79±1.66)%];VEGF的表达显著升高(2.08±0.21比0.33±0.14);PAX2的表达也有一定程度的恢复(2.05±0.14比2.44±0.09).结论 通过对胎羊单侧输尿管不完全性梗阻解除前后肾脏组织病理改变、足细胞表型转化以及PAX2和VEGF表达变化的观察,说明宫内干预能减缓甚至逆转输尿管不完全性梗阻所致的肾脏损伤性改变.

Abstract：

Objective To investigate ultrastructure and molecular change of kidneys after correction of partial unilateral ureteral obstruction. Methods The 26 fetal lambs at 75-85 days of gestation were divided into 3 groups. Obstructed group: partial unilateral ureteral obstruction was achieved with intrauterine surgery in 12 fetal lambs. Decompressed group: partial unilateral ureteral obstruction in 10 fetal lambs first was released 3 weeks later by intrauterine surgery. Control group: a sham operation was performed. The kidneys of the lambs were removed after birth to study the transformation of podocytes as well as expression of paired-box 2 (PAX2) and vascular endothelial growth factor (VEGF). Results Overall, 21 fetal lambs survived: 9 from the obstructed group, 8 from the decompressed group, and 4 from the control group. Compared with the control kidneys, the obstructed kidneys showed cysts of various sizes in the cortex, fibrosis of the interstitial tissue, significantly decreased number of glomeruli, severer podocyte foot process fusion (4. 20 ± 1. 08% vs 86.79 ± 1. 66%) , markedly increased PAX2 (1. 43 ± 0. 09 vs 2. 44 ± 0. 09) and decreased VEGF expressions (0. 80 ± 0. 15 vs 0. 33 ± 0. 14). However, in the decompressed kidneys, the cystic changes decreased, number of glomeruli increased, but extracellular matrix (ECM) deposition was still obvious, fusion of the podocyte foot processes was reduced (41. 18±3. 13% vs 86. 79± 1. 66%), VEGF expression was significantly increased (2. 08 ± 0. 21 vs 0. 33 ± 0. 14) , and expression of PAX2 was restored to some extent (2. 05 ± 0. 14 vs 2. 44 ± 0. 09) in decompressed kidneys. Conclusions Relief of obstruction in utero can reverse the development of nephropathy, evidenced by the phenotype transformation of podocytes, expression of PAX2 and VEGF.     

小青龙汤抗实验性咳痰作用有效部位筛选

目的:小青龙汤水煎液经大孔树脂用不同浓度乙醇洗脱,对所得的3个部位进行止咳化痰作用研究,进行有效部位的筛选。方法:小青龙汤经水煎煮后,上AB8型大孔树脂,用不同浓度乙醇洗脱,分离得到3个部位,以空白组和小青龙汤原煎液组为对照,筛选该复方的有效部位及观察该有效部位的止咳化痰作用。结果:50%乙醇洗脱部分高剂量有良好的止咳作用,可以明显减少氨水所致咳嗽模型小鼠的咳嗽次数;同时具有良好的祛痰作用,能显著促进酚红的排出;水部分高剂量组也可明显延长氨水所致咳嗽模型小鼠的咳嗽潜伏期。结论:50%乙醇洗脱部分高剂量其止咳化痰药效与原煎液相似,可以将该部分进行进一步开发利用。     

生病不要盲目去医院输液

有些病人认为口服药不如输液见效快,作用强,只要感到酸痛不舒服就会去医院输液。这些都是对输液疗法的片面认识,盲目的输液会导致非常严重的后果,甚至会危及生命。     

消化道重复畸形12例

目的探讨消化道重复畸形的临床和病理特点。方法回顾性分析消化道重复畸形共12例。男8例,女4例。收集临床资料,对患儿进行随访,复习病理切片并结合临床分析。结果本组12例均经手术及病理检查证实诊断,重复畸形解剖部位分布:回盲部4例,食管、结肠各2例,胃、空肠、直肠、肛管各1例。术后均恢复正常。10例重复畸形黏膜性质与主肠管相似,2例临床表现为便血、贫血者在病理上均为异位胃黏膜组织。结论手术切除是治疗消化道重复畸形的最好选择。     

乳腺癌的影像学诊断现状与进展

近年来由于生活习惯、环境的变化及其他因素的影响,乳腺癌发病率迅速增高,尤其是大城市较明显,其发病率正逐年升高已居女性恶性肿瘤的首位,且趋于年轻化。由于多数乳腺癌患者早期无任何临床症状,若只是进行临床体格检查,不进行常规的影像学筛查,待发现时多已属中晚期,此时治疗效果并不理想。