姜黄素通过NLRP3/Caspase-1/IL-1β轴对低氧性肺动脉高压的干预作用

目的：探讨姜黄素对低氧性肺动脉高压（HPH）的作用及其机制。方法：同时研究肺动脉平滑肌细胞（PASMCs）和SD大鼠肺组织,PASMCs和SD大鼠都设置为常氧组（N）、低氧组（H）、低氧+姜黄素组（HC）3组。CCK-8法测3组PASMCs细胞活力,Western blot法检测3组PASMCs和肺匀浆中NLRP3、Caspase-1及IL-1β蛋白表达差异。血流动力学检测3组大鼠的平均肺动脉压（mPAP）及右心肥大程度,HE染色观察3组大鼠肺血管重塑程度。结果：与N组比,H组PASMCs的数量有明显增加（P＜0.05）,H组PASMCs和肺匀浆中NLRP3、Caspase-1、IL-1β蛋白表达均上升（均P＜0.05）,H组大鼠的mPAP及右心肥大指数明显升高（均P＜0.05）,发生明显肺血管重塑;与H组比,HC组PASMCs的数量明显降低（P＜0.05）,PASMCs和肺匀浆中NLRP3、Cas-pase-1、IL-1β蛋白表达均下降（均P＜0.05）,HC组大鼠的mPAP及右心肥大指数明显降低（均P＜0.05）,肺血管重塑改善。结论：姜黄素可能通过抑制NLRP3/Caspase-1/IL-1β轴,改善低氧PASMCs异常增殖、HPH大鼠肺血管重塑和右心肥大,降低肺动脉压力。     

急性细胞性排斥伴补体裂解片断C4d沉积对移植肾预后的影响

探讨急性细胞性排斥伴肾小管周围毛细血管补体裂解片断(C4d)沉积对移植肾预后的影响.方法 经病理证实的急性细胞性排斥肾移植患者 145 例,根据病理表现有否肾小管周围毛细血管C4d沉积,将其分为细胞性排斥+C4d阳性组(C4d阳性组)64例,单纯细胞性排斥组(C4d阴性组)81例.比较两组术前一般情况、排斥反应发病情况、抗排斥治疗、移植肾失功率及移植肾存活率.结果两组的术前一般情况比较差异无统计学意义(P>0.05).C4d阳性组的急性细胞性排斥反应发生时间明显早于C4d阴性组,比较差异有统计学意义(P<0.05).两组Banff 分型Ⅰ型与Ⅱ型比例差异有统计学意义(P<0.01).随访期间C4d阳性组有22例(34%)移植肾失功,明显高于C4d阴性组的11例(14%),比较差异有统计学意义(P<0.01).Kaplan-Meier法分析发现C4d阳性组的移植肾存活率明显低于C4d阴性组(P<0.01),移植肾的5年生存率分别为51%、79%.结论 急性细胞性排斥反应伴肾小管周围毛细血管C4d沉积的肾移植患者,术后较早发生排斥反应,抗排斥治疗效果较差,移植肾存活率低.     

New β Ti alloy mini-prosthesis with low elastic modulus resurfacing articular surface defect in dogs

Objective To assess the effect of a new β Ti alloy mini-prosthesis with low elastic modulus on resurfacing the full-thickness Surface defect of the knee joint in dogs.Methods A full-thickness osteochondral defect of 7 mm in diameter was created at the medial femoral condyle of both hind limbs in 8 healthy adult dogs.The titanium alloy mini-prostheses with high-modulus of elasticity were implanted on the right side(control group)and those with low-modulus of elasticity on the left side(experiment group)to repair the cartilage defects.After 3 months,all the 8 dogs were sacrificed to harvest the specimens.Radiographic,histologic and micro-CT examinations were conducted to observe stability of the mini-prostheses and growth of the bone and cartilage surrounding the implants. Results Radiographic evaluation revealed no indications of device disassembly or subsidence.Bone trabeculae surrounding anchoring screws in the experiment group was visibly more and denser compared with the control group.Micro-CT data revealed that the bone volume fraction,trabecular thickness,trabecular number and tissue mineral density were 0.389%±0.025%,0.049±0.002 μm,8.9±0.4 mm-1 and 652.7 ±12.6 mg/mm3 respectively in the experiment group,compare with 0.253%±0.024%,0.038±0.002 μm,5.9±0.4 mm-1 and 595.2±7.6 mg/mm3 in the control group,with statistically significant differences between the 2 groups(P<0.05).Cartilage around the cap grew well and the surface remained smooth.Periphery of the resurfacing implant was covered by an extension of the superficial cartilage emanating from the defect margins. Conclusions The new β Ti alloy mini-prosthesis with low elastic modulus is favorable toward resurfacing the articular surface defect.The low-modulus of elasticity can improve new bone formation on the implant-bone interface.     

内观疗法治疗边缘型人格障碍1例

内观治疗(Naikan Therapy)是一种源于日本的东方心理治疗方法,是由日本的吉本伊信(1916～1988)开创的,也被称为自我观察法。这是一种通过对自己人生经历中的基本人际关系进行验证,从而彻底洞察自己的人际关系,改变自我中心意识的心理疗法。常言道：“江山易改,本性难移”。由此可见,对于人格障碍的治疗是一项长期而且艰巨的工作。本文通过一例边缘型人格障碍治疗有效的案例,来探讨内观治疗对边缘型人格     

空心加压螺钉治疗股骨颈骨折疗效分析

目的：探讨空心加压螺钉内固定术治疗股骨颈骨折的疗效及术后致股骨头缺血性坏死的相关影响因素。方法：对2003年1月至2009年6月应用空心加压螺钉治疗的96例股骨颈骨折进行回顾性分析,男44例,女52例;年龄21～88岁,平均56.3岁。将患者年龄、性别、骨折类型、骨折复位情况、外伤至手术复位时间与术后骨折不愈合及股骨头缺血性坏死之间的关系进行统计学分析。结果：84例获得随访,时间9～60个月,平均25.4个月。术后出现下肢深静脉血栓2例,骨折不愈合8例,股骨头缺血性坏死11例。术后Harris评分为（86.20±11.00）分,优40例,良32例,可7例,差5例。未移位骨折组和移位骨折组股骨头坏死发生率分别为3.22%和18.87%,两者差异有统计学意义（P=0.037）;解剖复位组和非解剖复位组的股骨头坏死发生率分别为5.00%和20.45%,两者差异有统计学意义（P=0.036）;而不同年龄、性别、手术时间对继发股骨头坏死无明显差异。结论：空心加压螺钉内固定术治疗无移位股骨颈骨折疗效良好,骨折类型及骨折复位情况是影响术后股骨头缺血性坏死的主要因素。对年轻移位的股骨颈骨折患者,应尽可能解剖复位、牢靠内固定,以减少术后股骨头缺血性坏死的发生;对于骨折移位严重的高龄患者,建议行人工关节置换术。     

壳聚糖微球转染人IL-1Ra与TGF-β1基因治疗兔骨关节炎

目的 探讨壳聚糖微球转染人IL-1Ra与TGF-β1基因治疗兔膝关节早期骨关节炎的方法与效果.方法 制备分别包裹IL-1Ra质粒DNA和TGF-β1质粒DNA的壳聚糖微球缓释系统,分组向兔膝关节早期骨关节炎模型关节腔注射含IL-1Ra基因和(或)TGF-β1基因的壳聚糖微球、不含上述基因的壳聚糖溶液,定期处死,使用ELISA检测关节腔灌洗液的IL-1Ra、TGF-β1浓度,取关节标本Mankin评分、苏木精-伊红(HE)染色、番红O染色及免疫组化检测.结果 经过60 d观察,壳聚糖微球转染基因组的IL-1Ra与TGF-β1的基因可持续表达,双基因组的软骨标本从外观、染色观察,损伤程度轻于单基因组.双基因组的Mankin评分明显低于单基因组(P＜0.05),单基因组的Mankin评分明显低于空白组(P＜0.05).结论 关节腔注射壳聚糖微球转染IL-1Ra与TGF-β1基因能抑制软骨的退变和促进软骨的修复.

Abstract：

Objective To explore the method and effect of transinfection of rabbit early knee osteoarthritis models via chitosan microsphere with gene of recombined human IL-1Ra gene and TGF-β1 gene. Methods Chitosan microspheres with plasmids of IL-1Ra gene and TGF-β1 gene, and rabbit early knee osteoarthritis models were prepared. Rabbits in different groups had intra-articular injections of chitosan microsphere containing IL-1Ra gene and / or TGF-β1 gene, and chitosan solution as control group before being executed regularly and randomly. The joint specimens were evaluated by HE staining, lycopene red O staining and immunohistochemical analysis and Mankin's score. ELISA was used for detection of IL-IRa and TGF-β1 concentration of articular cavity fluid in each group. Results The control group was consistent with the pathological changes of early OA. In co-transinfection group, judging from the appearance and staining of cartilage,the OA damage of the specimens was less serious than other groups'. Its Mankin's score was significantly lower than single-gene transinfection group (P ＜ 0.05), and the latters Mankin's score were significantly lower than control group (P ＜ 0.05). Conclusion Intra-articular injection of chitosan microspheres containing both IL-1Ra gene and TGF-β1 gene could inhibit the degeneration of cartilage and promote cartilage repair.     

离心机训练矫治+Gz耐力不良的高性能战斗机飞行员

目的 矫治两名＋Ｇｚ耐力不良的高性能战斗机飞行员。方法在离心机上高＋ＧＺ负荷下训练抗荷动作（ＡＧＳＭ）和加压呼吸（ＰＢＧ）动作。结果 ＡＧＳＭ的抗荷效果提高３．０－３．２５Ｇ,加压呼吸了系统的抗荷效果提高２．７５－３．０Ｇ,综合耐力比基础耐力高４．２５－４．５Ｇ,两人均顺利通过８Ｇ１０Ｓ的ＳＡＣＭ＋ＧＺ曲线,达到训练标准。     

指静脉的位置对血管1∶1型再植手指成活的影响

临床中我们发现吻合一条指动脉的断指再植手术中 ,只吻合一条指静脉建立血液回流通路时 ,静脉与动脉的相对位置关系对再植指成活质量有直接的影响。为此 ,我们通过解剖实验并结合临床病例进行分析 ,报道如下。1　临床资料选取 2例行断指再植手术 (2～ 5指近侧指间关节与远侧指间关节之间离断 )中仅吻合一条指动脉和一条指静脉者。其中指静脉与指动脉的相对位置关系及再植结果 :吻合指背静脉 11指 ,成活 10指 ;吻合对侧指腹静脉 4指 ,成活 3指 ;吻合同侧指腹静脉 6指 ,完全成活 1指 ,纵向部分成活 3指 ,坏死 2指 ,纵向部分成活的 3指因指骨外…     

JWA调控能量代谢重编程抑制胰腺癌细胞迁移

目的：探讨JWA通过调节细胞能量代谢,抑制胰腺癌细胞迁移的作用及其分子机制。方法：通过基因转染和JWA小分子激动剂JAC4处理人胰腺癌细胞Panc1和Bxpc3,采用划痕实验、穿孔实验、Seahorse XF能量代谢分析仪分别检测细胞迁移能力以及能量代谢水平的改变。用小鼠被动转移模型检测JAC4抑制胰腺癌转移的作用。蛋白免疫印迹法检测相关分子蛋白质表达水平。结果：JWA基因在胰腺癌肿瘤组织与胰腺癌细胞中表达水平显著低于正常;JAC4处理可显著增加JWA表达并抑制胰腺癌细胞迁移,并且抑制小鼠胰腺癌转移并降低血清中乳酸脱氢酶（LDH）水平;JAC4增强肿瘤细胞线粒体有氧呼吸,同时抑制糖酵解;JAC4通过AMPK信号通路正调控FOXO3a,激活线粒体复合物Ⅲ（UQCRC2）的表达,同时下调FAK。结论：JWA通过AMPK/FOXO3a/UQCRC2/FAK信号通路调节细胞能量重编程,进而抑制胰腺癌细胞的迁移。