热休克蛋白72肽结合区对肾小管上皮间质转分化的影响

目的 探讨热休克蛋白72肽结合区在肾小管上皮间质转分化(EMT)过程中的作用和可能机制.方法 应用质粒转染方法分别诱导热休克蛋白72(HSP72)野生型、肽结合区缺失型(HSP72-△PBD)和肽结合区(PBD)的表达.用转化生长因子β1(TGF-β1)刺激大鼠肾小管上皮细胞(NRK-52E)48 h,Western印迹和免疫荧光染色检测细胞E-钙黏蛋白(cadherin),α-平滑肌肌动蛋白(SMA),HSP72和Smad3/磷酸化(p)-Smad3蛋白表达.结果 TGF-β1(10 μg/L)刺激NRK-52E细胞48 h后上调α-SMA和下调E-cadherin蛋白表达水平.Western印迹及细胞免疫荧光显示,过表达HSP72和PBD能明显减轻TGF-β1诱导的NRK-52E细胞E-cadherin蛋白表达下调和α-SMA蛋白表达上调,而过表达HSP72-△PBD不能改变上述蛋白的表达.此外,过表达HSP72和PBD显著抑制Smad3的磷酸化.结论 HSP72抑制Smad3活化和EMT的发生可能与PBD的功能有关.     

腹部及盆腔急性出血的介入治疗

目的探讨腹部急性出血选择性血管造影诊断及介入治疗价值。方法回顾性分析80例行选择性动脉血管造影及血管内介入治疗的腹部及盆腔急性出血患者的临床资料。结果80例均采用Seldinger技术,经股动脉插管后作选择性血管造影,用碘化油、明胶海绵或弹簧圈栓塞治疗,80例中完全止血68例、再出血9例、无效3例。结论介入方法不仅可确定出血部位,而且可达到止血目的,效果确切。     

高气压暴露对大鼠血浆内皮素-1含量、血清一氧化氮含量、一氧化氮合酶活性的影响

目的 探讨高气压暴露对大鼠血浆内皮素-1(endothelin-1,ET-1)含量、血清一氧化氮(nitric oxide,NO)含量、一氧化氮合酶(nitric oxide synthase,NOS)活性的影响.方法 40只SD大鼠随机分为5组.A组为对照组,B组0.7 MPa空气暴露后缓慢减压,C组0.7 MPa空气暴露后快速减压,D组0.147 MPa纯氧暴露后减压,E组0.250 MPa纯氧暴露后减压.各组暴露时间均为60 min.采用放射免疫方法测定血浆ET-1含量,硝酸还原酶法测定血清NO含量,比色法测定血清NOS活性.结果 与对照组相比,安全减压组和高压氧组的血浆ET-1含量明显升高(P<0.05),原因可能与高分压氧有关(PO2=0.147 MPa/0.250 MPa);快速减压组血清NO含量、NOS活性明显升高(P<0.05),与血浆ET-1含量升高的3个组相比,血清NO、NOS升高得更为显著(P<0.01).结论 NO与ET-1在机体对高气压暴露的反应中呈拮抗关系.高气压与高压氧暴露导致血浆ET-1的释放增加,但快速减压刺激血管内皮细胞产生更多的NO,这种机制可能是通过提高血浆中的NOS活性实现的,这个现象可能是血管内皮系统对血管内气泡产生的应激性反应之一.     

Ventral hernia repair: a study of current practice

Ventral wall hernias are common; despite this, there are no guidelines on the best surgical management. The aim of this study was to examine the types of repair in use for abdominal wall hernias in the West of Scotland over a 3-month period. Data were gathered on 120 patients. There were 60 incisional, 32 umbilical, and 28 epigastric hernias. The main indication for repair was pain (78%), while 12 patients (10%), presented acutely with incarceration or strangulation. The most common method of repair was sutured (55%), followed by mesh (29%) and Mayo repair (16%). There was no correlation between use of mesh and hernia size or whether repair was for a recurrent hernia. Surgical practice varies widely in the repair of ventral wall hernias. Clinical trials are required to establish the best method of repair for this common condition. Electronic Publication     

腹腔镜外科和妇科联合手术的临床应用

目的：探讨腹腔镜技术在外科和妇科疾病治疗中联合应用的临床价值。　
方法：总结近7年来施行腹腔镜联合手术治疗妇、外科疾病229例的临床资料,其中腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合输卵管造口术5例,LC联合卵巢囊肿剥除术28例,LC联合子宫肌瘤剔除术25例,LC联合子宫次全切除术39例,LC联合子宫全切除术26例,LC联合子宫内膜异位症手术6例;腹腔镜阑尾切除术(laparoscopicappendectomy,LA)联合输卵管手术38例,LA联合卵巢囊肿切除术32例,LA联合子宫全切除术或子宫次全切除术24例,腹腔镜肝囊肿开窗引流术联合卵巢囊肿切除术6例。
结果：229例妇、外科联合腹腔镜手术均获成功,无中转开腹手术。手术时间40~220 min,平均120 min;住院1~6 d,平均3.4 d。仅1例术后10 d阴道残端出血非手术疗法治愈。175例随访3~24个(平均19.5)月,1例术后2个月发现阴道残端息肉,经手术切除治愈。　
结论：严格掌握联合手术指征,充分术前准备,多科室良好配合,腹腔镜联合手术能够有效地同时处理外科和妇科并存疾病,在基层医院具有良好的应用前景。     

hTEFT重组绿色荧光表达载体的构建与表达

目的构建人端粒酶逆转录酶(hTERT)片段的真核表达质粒。方法用RT-PCR方法从肝癌组织中提取总RNA扩增出hTERT基因片段,将其连接pGEM-TEasy质粒上,将重组质粒pGEM-T-hTERT和pEGFP-C3真核绿色荧光蛋白表达载体同时用HindⅢ和BamHⅠ双酶切后进行连接,再将重组的pEGFP-C3-hTERT基因片段转染NIH3T3细胞,经G418筛选获得稳定转染的细胞系,荧光倒置显微镜观察并检测转染细胞的hTERTmRNA表达水平。结果DNA序列分析证实了重组载体pGEM-T-hTERT和pEGFP-C3-hTERT内插入片段的碱基组成与公开发表的hTERT序列一致。转染pEGFP-C3-hTERT的NIH3T3细胞可见绿色荧光,并检出高水平表达的hTERT。结论成功构建高效表达hTERT的真核表达载体,为以hTERT为靶点的肿瘤治疗打下实验基础。     

细化药品采购环节，全方位保障药品供应

通过探讨细化药品采购环节：包括建立和完善采购制度，优选药品配送企业，制定合理的采购时间、合理采购价格和合理的库存结构及库存水平。以便及时、准确地为临床用药提供安全、有效、经济的药品以及全方位保障药品供应。     

Biologic basis for interleukin-1 in disease

To understand the role of the proinflammatory cytokine interleukin-1 (IL-1) in disease, investigators have studied how production of the different members of the IL-1 family is controlled, the various biologic activities of IL-1, the distinct and various functions of the IL-1 receptor (IL-1R) family, and the complexity of intracellular signaling. Mice deficient in IL-1Beta, IL-1Beta converting enzyme, and IL-1R type I have also been studied. Humans have been injected with IL- 1 (either IL-1alpha or IL-1beta) for enhancing bone marrow recovery and for cancer treatment. The IL-1-specific receptor antagonist (IL-1Ra) has also been tested in clinical trials. The topics discussed in this review include production and activities of IL-1 and IL-1Ra molecules, the effects of IL-1 on gene expression, functions of cell-bound and soluble IL-1 receptors, the importance of the IL-1R accessory protein, newly discovered signal transduction pathways, naturally occurring cytokines limiting IL-1 production or activity, the effects of blocking cyclooxygenase and nitric oxide, and the outcomes of IL-1 and IL-1 Ra in human trials. Special attention is paid to IL-1beta converting enzyme and programmed cell death. The roles of IL-1 in hematopoiesis, leukemia, atherosclerosis, and growth of solid tumors are also discussed. This is a lengthy review, with 586 citations chosen to illustrate specific areas of interest rather than a compendium of references. At the end of each section, a short commentary summarizes what the author considers established or controversial topics linking the biology of IL-1 to mechanisms of disease.