完全性肺静脉异位引流术后肺静脉狭窄手术干预9例近中期结果北大核心CSCD

目的总结阜外医院过去10年完全性肺静脉异位引流(TAPVC)术后肺静脉狭窄(PVS)患者行再次手术干预的近中期结果。方法纳入2009~2019年于阜外医院完成手术治疗的9例TAPVC术后PVS患者,其中男4例、女5例,手术时年龄(5.10±5.00)岁。根据肺静脉成形手术方式将患者分为2组:无缝线缝合(sutureless)组(n=3)和非无缝线缝合(non-sutureless)组(n=6)。分析患者的临床资料。结果本组患者原发TAPVC类型包括:心上型4例,心内型2例,心下型1例,混合型2例。全组患者中位体外循环时间95(63,208)min,中位主动脉阻断时间58(30,110)min,术后中位ICU滞留时间24(24,2 136)h。早期院内死亡1例(11.1%)。1例(11.1%)合并单心室患者发生住院并发症,术后行血液滤过治疗。随访时间11.9(2.2,18.0)个月,随访期间死亡2例,死因分别为肺静脉再狭窄及脑卒中。Sutureless组与non-sutureless组术后结果及随访结果差异无统计学意义(P>0.05)。结论外科手术是TAPVC术后出现PVS的有效治疗手段,但仍存在较高的并发症发生率及死亡率,sutureless缝合技术在此类患者中应用的优势仍有待验证。     

新鲜自体心包片在婴幼儿主动脉弓补片成形术的经验探讨

目的探讨新鲜自体心包片在婴幼儿主动脉弓补片成形术的外科治疗经验,为临床治疗提供更合理的手术方法。方法回顾性分析2018年6月至2019年10月12例应用新鲜自体心包片进行主动脉弓成形的患儿资料,分析比较患儿术前、术后及近中期随访的结果。结果12例患儿均在体外循环下完成主动脉弓补片成形术,9例为主动脉缩窄合并弓发育不良,3例为主动脉弓中断,平均体外循环时间为(125.1±38.5)min,平均下半身停循环时间为(33.5±6.1)min,术后早期无患儿死亡,9例主动脉缩窄合并弓发育不良患儿术后早期超声估测主动脉弓降部处平均峰值压差为(14.3±4.9)mmHg,较术前[(46.3±15.2)mmHg]显著降低(P<0.05);3例主动脉弓中断患儿术后早期超声提示主动脉弓降部血流通畅。12例患儿均完成随访,平均随访时间为(8±4.3)个月,随访期间无患儿死亡,无主动脉瘤样扩张、左主支气管压迫、膈肌麻痹及神经系统等并发症;12例患儿随访期间超声提示主动脉弓降部血流通畅,平均峰值压差为(10.3±3.6)mmHg。结论新鲜自体心包片是主动脉弓补片成形术比较理想的材料,术后近中期结果满意,但是远期结果有待进一步随访观察。     

急性早幼粒细胞白血病中t(15;17)染色体易位的分子生物学研究

急性早幼粒细胞白血病（以下简称APL），是人类白血病和癌症研究中具有代表性的模式之一。APL存在特异性的染色体易位t（15；17）。1986年以来，上海血液学研究所率先以分出诱导剂全反式维甲酸（ATRA）治疗APL获得成功，开辟了肿瘤分化诱导治疗的崭新途径。因此，阐明ATRA诱导A     

hSav1蛋白高表达对Mst1介导的细胞凋亡的影响

Objective To elucidate the effect of hSavl expression on Mstl-mediated apoptosis in HeLa cells. Methods Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and cotransfected into HeLa cells. Triple immunofluorescent labeling of hSav1, Mst1 and nucleus was performed to determine their subcellular localization. Plasmids pCMV-HA-hSav1 and/or pcDNA/4TO-Flag-Mst1 were transfected into HeLa cells, and 36 hours later cisplatin (50 μmol/L) as a pro-apoptotic agent was added for 14 hours. Cell apoptosis was analyzed by annexin V/PI assay. Results Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and the authenticity of constructs was verified by sequencing. The binding in vitro showed that hSavl could be detect from the anti-Mstl immunoprecipitation complex. The immunofluorescent labeling showed that hSavl and Mstl had the same localization in cells. Overexpressed protein hSavl did not induce a significant cell apoptosis. However, co-expression of hSavl with Mstl resulted in a significant increase of apoptosis above the level seen with Mstl alone (24. 5% ± 2.4% vs. 39.3% ± 4.0%, P < 0. 05). Conclusion Our findings indicate that hSavl is a newly identified protein that interacts with Mst1 and a, augments Mst1-mediated apoptosis.     

hSav1蛋白高表达对Mst1介导的细胞凋亡的影响

Objective To elucidate the effect of hSavl expression on Mstl-mediated apoptosis in HeLa cells. Methods Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and cotransfected into HeLa cells. Triple immunofluorescent labeling of hSav1, Mst1 and nucleus was performed to determine their subcellular localization. Plasmids pCMV-HA-hSav1 and/or pcDNA/4TO-Flag-Mst1 were transfected into HeLa cells, and 36 hours later cisplatin (50 μmol/L) as a pro-apoptotic agent was added for 14 hours. Cell apoptosis was analyzed by annexin V/PI assay. Results Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and the authenticity of constructs was verified by sequencing. The binding in vitro showed that hSavl could be detect from the anti-Mstl immunoprecipitation complex. The immunofluorescent labeling showed that hSavl and Mstl had the same localization in cells. Overexpressed protein hSavl did not induce a significant cell apoptosis. However, co-expression of hSavl with Mstl resulted in a significant increase of apoptosis above the level seen with Mstl alone (24. 5% ± 2.4% vs. 39.3% ± 4.0%, P < 0. 05). Conclusion Our findings indicate that hSavl is a newly identified protein that interacts with Mst1 and a, augments Mst1-mediated apoptosis.     

hSav1蛋白高表达对Mst1介导的细胞凋亡的影响

Objective To elucidate the effect of hSavl expression on Mstl-mediated apoptosis in HeLa cells. Methods Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and cotransfected into HeLa cells. Triple immunofluorescent labeling of hSav1, Mst1 and nucleus was performed to determine their subcellular localization. Plasmids pCMV-HA-hSav1 and/or pcDNA/4TO-Flag-Mst1 were transfected into HeLa cells, and 36 hours later cisplatin (50 μmol/L) as a pro-apoptotic agent was added for 14 hours. Cell apoptosis was analyzed by annexin V/PI assay. Results Plasmids pCMV-HA-hSav1 and pcDNA/4TO-Flag-Mst1 were constructed and the authenticity of constructs was verified by sequencing. The binding in vitro showed that hSavl could be detect from the anti-Mstl immunoprecipitation complex. The immunofluorescent labeling showed that hSavl and Mstl had the same localization in cells. Overexpressed protein hSavl did not induce a significant cell apoptosis. However, co-expression of hSavl with Mstl resulted in a significant increase of apoptosis above the level seen with Mstl alone (24. 5% ± 2.4% vs. 39.3% ± 4.0%, P < 0. 05). Conclusion Our findings indicate that hSavl is a newly identified protein that interacts with Mst1 and a, augments Mst1-mediated apoptosis.     

急性早幼粒细胞白血病的分子生物学研究进展

非随机染色体异常在人类白血病的发生中起着重要作用。九十年代以来,用分子生物学方法已发现急性早幼粒细胞白血病(APL)中的特征性染色体易位t(15;17)导致17号染色体上的维甲酸受体α(RARα)基因和15号染色体上的早幼粒细胞白血病(PML)基因发生融合,形成PML-RARα基因,该基因可能在APL 的发生机制中起着重要作用,也可能与维甲酸对APL 的特异治疗作用有关。     

一种活动形状模型中的二维灰度模型

活动形状模型(active shape models,ASM)是一种较为流行的用于目标对象定位的统计学形状模型.该模型结合了一个点分布模型(point distribution model,PDM)和每个标志点周围的局部灰度模型,从而能够获取可靠精确的图像解释结果.对于二维图像,一维曲线的灰度模型会丟失其它方向上的信息.本文对于每个标志点周围的正方形邻域的灰度信息建立了模型,希望能够使活动形状模型方法考虑到更多的信息.     

胰岛素基因突变所致糖尿病——用PCR检出国内第一例B链25位亮氨酸患者

本文应用聚合酶链反应(PGR)扩增了1例糖尿病伴有高胰岛素血症患者以及正常对照的胰岛素基因片段,随后用合成的顺序特异性寡核苷酸探针对上述患者及正常对照的胰岛素基因片段进行点杂交(dot-blot)分析。结果发现该患者是1例胰岛素基因B链25位突变患者(芝加哥胰岛素型),基因突变为B_(25)(TTC-TTG),蛋白质水平为亮氨酸在B_(25)位上替代苯丙氨酸,从而在中国糖尿病患者中首次发现了此类突变病例。     

成人再次二尖瓣成形术的临床特征分析

目的分析二尖瓣成形术后复发性病变的病因,总结再次二尖瓣成形术的手术技术和效果。方法回顾分析2012年1月至2019年10月阜外医院19例行再次二尖瓣成形术的成人患者的临床资料,男12例,女7例,首次手术年龄4~66岁,平均(34.9±22.6)岁。先天性二尖瓣关闭不全7例,退行性二尖瓣关闭不全12例。再次手术时年龄18~81岁,平均(43.5±19.1)岁。两次手术间隔2~430个月,平均(118±116)个月。再次手术同期进行三尖瓣成形术5例,冠状动脉搭桥手术2例,左房血栓清除1例。术前心胸比0.56±0.07,左房内径(LA)为(49.4±8.5)mm,左室舒张末径(LV)为(56.6±5.9)mm,左室射血分数(LVEF)62.6%±7.8%。结果手术失败组包括瓣叶缝线撕脱5例,瓣叶裂未完全缝合2例、人工瓣环瓣周漏2例、人工腱索撕脱1例。病变进展或新发病变组包括新发瓣叶脱垂4例,瓣环明显扩张2例,自体腱索断裂1例,感染性心内膜炎1例,二尖瓣相对性狭窄1例。本组患者体外循环时间(109±53)min,阻断时间(70±29)min,术后呼吸机使用时间(16±5.8)h。围术期无死亡。出院时有2例二尖瓣少中量反流,LA为(42.9±6.1)mm,LV为(53.4±6.3)mm,LVEF为59.3%±3.8%。术后随访(21.0±14.9)个月。1例术后2个月出现感染性心内膜炎,二尖瓣中量反流。另有1例术后10个月发生脑梗死。无死亡、再次手术患者,心功能均为Ⅰ级或Ⅱ级。结论二尖瓣成形术后出现复发性二尖瓣病变患者,在瓣叶条件良好,反流原因明确情况下,行再次二尖瓣成形手术可以获得满意的围术期结果,近中期疗效良好。