咪达唑仑在清醒镇静胃镜检查中的应用研究

目的:研究咪达唑仑在清醒镇静胃镜下的效果、安全性,并与异丙酚联合芬太尼的镇静效果作出对比。方法:对本院消化内科门诊接受清醒镇静胃镜检查患者249名,随机分为两组,咪达唑仑组(A组)及异丙酚联合芬太尼组(B组),以检查期间MAP、HR、SpO2、苏醒时间及检查后患者满意情况进行评价,分析应用效果、患者满意度及费用对比。结果:A、B两组检查中MAP、HR、SpO2均有下降,但B组下降更为明显(P<0.01);A、B组患者中分别有71.8%及81.6%患者表示有意接受再次检查;A组患者较B组苏醒时间长,组间比较有差异;A组检查费用明显低于B组。结论:清醒镇静内镜检查对医患双方均有益处,咪达唑仑在清醒镇静胃镜中安全易操作,且费用低廉。     

成年斑马鱼牙齿发育的形态学观察

目的:观察成年斑马鱼牙齿的生长部位和形态.方法:以成年斑马鱼(鱼龄>3个月)为研究对象,在体视显微镜下,解剖成年斑马鱼腮弓,对其牙齿进行活体观察,并做石蜡切片和HE染色观察.结果:成年斑马鱼牙齿位于第五腮弓上,每条腮弓上牙齿数量不等.牙齿外形呈三角形,为端生牙,无牙根.三角形牙齿的底部附着于腮弓上,三角形牙齿的尖即为牙尖,朝向内侧咽部,左右牙尖相对.HE染色显示成年斑马鱼的牙齿为钙化结节样物质,类似人牙齿的牙本质结构.结论:对斑马鱼牙齿组织形态和发育过程的进一步研究将有利于寻找到一种良好的研究牙齿组织发育的模式动物.     

科莫非对维持性血液透析患者肾性贫血的疗效观察

目的 探讨科莫非治疗维持性血液透析患者肾性贫血的疗效.方法 治疗组30例采用科莫非100mg加生理盐水100ml于血液透析结束后静脉滴注,每周2次,共6周.对照组30例,口服力蜚能150mg,1次/d,疗效观察6用.所有患者均给予适量促红细胞生成素(EPO)等常规治疗.记录两组每位患者治疗前后的血红蛋白(Hb)、红细胞教(RBC)、血细胞比容(HCT)、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT).结果 口服力蜚能组患者SF、TSAT治疗前后有统计学意义(P＜0.05),但不如治疗组显著,血红蛋白的增长也不理想.而科莫非组SF、TSAT均显著提高(P＜0.01),明显优于口服力蜚能组.结论 科莫非能迅速有效地纠正接受EPO治疗的维持性血液透析患者的肾性贫血.     

Modulation of TLR9 on anti-tumor immune responses of peripheral blood mononuclear cells from patients with non-small-cell lung cancer

OBJECTIVE: To assess the modulation of TLR9 on anti-tumor immune responses in peripheral blood mononuclear cells (PBMC) from patients with non-small-cell lung cancer (NSCLC). METHODS: PBMCs were isolated from 36 NSCLC patients. Lung cancer cells were isolated from these patients and further enriched. PBMCs were cultured in RPMI-1640 medium (blank control group), and medium with cytosine guanine oligodeoxynucleotide (CpG ODN, an TLR9 agonist) or control ODN for 72 h; and then flow cytometry was used to examine the expression of CD69 antigen on the surface of CD3 cells, [3H]-thymidine incorporation method was used to examine the cell proliferation, and the IFN-alpha level in the supernatant was measured. Another PBMCs were cultured in medium with interleukin (IL)-1 and then CpG ODN, control ODN, and CpG ODN + chloroquine or inhibitory ODN were added respectively for 24-48 h. Then the IFN-alpha in the supernatant was measured. Subsets were assessed by flow cytometry and the expression of TLR9-mRNA in freshly isolated PBMC was detected by RT-PCR. The production of interferon (IFN)-alpha in the PBMCs was measured by ELISA. The proliferation of the PBMCs was determined by [3H]-thymidine incorporation. The PBMCs co-cultured with CpG ODN and autologous lung tumor cells treated with mitomycin C were used as effector cells, and K562 cells and autologous tumor cells were used as target cells flow cytometry was used to detect the capacity of PBMCs to kill autologous lung tumor cells and K562 cells. Meanwhile we investigated the intracellular expression of IFN-gamma and IL-4 in CD8+ T. RESULTS: The expression level of TLR9 of the PBMCs from patients was not significantly different from that of the PBMCs from the healthy donors. The proportion of CD69 antigen expressing CD3+ T cells of the CpG ODN group was (39.5 +/- 8.9)%, significantly higher than those of the blank control group [(8.8 +/- 1.2)%, t = 40.30, P = 0.00] ands control ODN group [(10.6 +/- 1.0)%, t = 41.85, P = 0.00]. Examination with beta liquid scintillation counter showed that the cpm value of the CpG ODN group was (1.61 +/- 0.20) x 10(4), significantly higher than those of the blank control group [(0.27 +/- 0.14) x 10(4), t = 20.43, P = 0.00] and control ODN group [(0.34 +/- 0.13) x 10(4), t =20.20, P = 0.00]. Chloroquine and inhibitory ODN dose-dependently inhibited the IFN-alpha levels in the supernatant. The CD4 + T/CD8 + T of the CpG ODN group was (3.44 +/- 0.20), significantly higher than those of the control ODN group (1.73 +/- 0.27, t = 19.85, P = 0.00) and blank control group (1.69 +/- 0.13, t = 29.32, P = 0.00). The IFN-gamma positive CD8 + T cells of the CpG ODN group was (18.5 +/- 4.2)%, significantly higher than those of the control ODN group [(4.2 +/- 1.0)%, t = 24.12, P = 0.00] and blank control group [(3.1 +/- 1.2)%, t = 25.1, P = 0.00]. There was no significant differences in the proportion of IL-4 positive CD8 + T cells among different groups. When the E/T was 40:1 the killing capacity of PBMCs against the K562 cells was (19.5 +/- 1.0), significantly higher than those of the control ODN group (7.9 +/- 1.1, t = 19.9, P = 0.00) and blank control group (5.1 +/- 1.6, t = 21.9, P = 0.00), and the killing capacity of PBMCs against the autologous lung tumor cells was (29.8 +/- 2.1), significantly higher than those of the control ODN group (8.1 +/- 0.9, t = 36.9, P = 0.00) and blank control group (5.7 +/- 1.6, t = 35.7, P = 0.00). CONCLUSION: TLR9 signal takes part in the immunomodulation of PBMCs. The activation of TLR9 results in enhanced anti-tumor response in the PBMCs against autologous lung cancer cells and K562 cells.     

MR DIFFUSION WEIGHTED IMAGING FOR EVALUATION OF RADIOTHERAPEUTIC EFFECTS ON RABBIT VX2 TUMOR MODEL

Objective To investigate the feasibility of magnetic resonance （MR） diffusion weighted imaging （DWI） for evaluation of radiotherapeutic effects on rabbit VX2 tumor model.
Methods Sixteen New Zealand white rabbits received a subcutaneous implantation of VX2 tumor cell suspension 0.5 mL （4× 10^7 ceUs/mL） in their right thighs to set up tumor model. And 2 weeks later they were randomly divided into therapy group （Group T, n = 10） and control group （Group C, n = 6）. Group T received radiotherapy at a single dose of 10 Gy. MR imaging （MRI） scan including short TI inversion recovery echo-planar imaging DWI, T1-weighted imaging （T1WI） and T2-weighted imaging （T2WI） sequences were performed 1 day prior to as well as 1 day, 2 days, 3 days and 7 days after radiotherapy. Group C received only MRI scan at the same time points without any treatment. MRI appearance on T2WI, TlWI, and DWI images was compared and tumor volume was calculated. Apparent diffusion coefficient （ADC） values of the tumor were evaluated in all cases. HE staining was used for pathological study.
Results Necrosis （n = 8） and hemorrhage （n = 2） were seen gradually on T2WI and T1WI images of Group T after time point of day 2 after irradiation. In Group C, no obvious necrosis was found until day 7. There was no significant difference in tumor volume between the two groups before radiotherapy. After radiotherapy, tumors in Group T showed a gradual growth but not as obvious as Group C. There was a significant difference in tumor volume between the two groups from day 2 on （P 〈 0.05）. ADC value changed dramatically fight from the 1st day after radiotherapy in Group T [（0.99 ± 0.15） ×10^-3 mm^2/s for 1 day before radiotherapy, （1.23 ± 0.08） ×10^-3 , （1.45 ± 0.07） ×10^-3 , （1.63 ± 0.06） ×10^-3 , and （2.02 ± 0.18） ×10^-3 mm^2 for day 1, 2, 3, and 7]; and ADC value had no significant changes after radiotherapy in Group C except day 7 [（1.07±0.08） ×10^-3 mm^2 for 1 day befor     

硫化氢在大鼠肝星状细胞氧应激中的作用

目的利用铁超载的方法在体外复制肝纤维化的氧应激模型，给予H2S供体硫氢化钠（NaHS）和内源性H2S作用的KATP通道阻滞剂格列苯脲（GLBN），论证氧应激下硫化氢对HSC细胞具有保护作用的假说。方法将HSC—T6分为8组：空白组、对照组、NaHS组（分为3个浓度组）、格列苯脲组（分为3个浓度组）。用CCK-8试剂盒测定HSC细胞增殖情况；用MDA试剂盒测定上清液MDA（丙二醛）含量；用SOD（超氧化物歧化酶）试剂盒测定上清液和裂解液中SOD活力；用RT—PCR试剂盒检测p38基因表达水平。结果1．Fe—NTA能够促进HSC的增殖，使p38基因表达水平降低、SOD活性降低、MDA浓度提高。对照组和空白组有明显差异（P〈0．05）；2．给予NaHS处理后，细胞增殖减慢，上清液中MDA含量下降，上清液、裂解液中SOD活性提高，p38基因表达水平增高（P〈0．05）；3．给予GLBN处理后，各项指标结果与给予NaHS处理后结果相对应，各组与对照组比较均有明显差异（P〈0．05）。结论氧应激下硫化氢对HSC细胞具有保护作用，可抑制肝纤维化的发生发展。     

新生儿窒息后选择性头部降温的实施和安全性研究

目的:评估选择性头部降温治疗围产期窒息后新生儿缺氧缺血性脑损伤的实施及其安全性。方法:选取符合以下条件的新生儿:①孕周≥37周。②出生后首次动脉血气分析BD>15mEq/L,或生后5minApgar评分<6分。③出生后6h内出现临床神经系统症状和体征,随机分为亚低温组(n=40)和对照组(n=38)。亚低温组采用选择性头部降温方法,维持直肠温度于34～35℃,持续72h;6h内常规应用苯巴比妥负荷量20～30mg·kg-1,再用维持量5mg·kg-1·d-1对症止痉治疗,予多巴胺5μg·kg-1·min-1,维持3d。对照组维持正常体温,其他治疗相同。动态监测血压、心率、血气分析、血糖、电解质、心、肝、肾等功能。结果:两组各有40例和38例完成治疗;亚低温组直肠温度降至目标温度35℃所需时间为(55±20)min,治疗过程中心率平均下降至(105±6)次/min,对照组(140±11)次/min,两组差异有显著性(P<0.01);但两组平均动脉压保持在正常范围(45±5)mmHg;两组血肌钙蛋白-I、肝功能、肌酐、尿素氮虽有升高,两组比较差异无显著性(P>0.05)。结论:对围产期窒息后新生儿实施选择性头部降温维持直肠温度于34～35℃是安全的,可应用于具有重症监护条件的新生儿病房。     

Rho激酶和转化生长因子β通路在醛固酮/盐诱导的单肾切除SD大鼠肾脏损伤中的作用

目的观察Rho激酶和转化生长因子β(transforming growth factor-β,TGF-β)通路是否参与醛固酮/氯化钠诱导的单肾切除SD大鼠肾脏损伤的发病及可能的机制。方法健康雄性5周龄SD大鼠在实验初始行右肾切除,手术后2周给予1%氯化钠饮水。随机将大鼠分3组:对照组(2%酒精皮下泵入,n=9);醛固酮组(2%酒精+醛固酮0.75μg/H皮下泵入,n=9);醛固酮+fasudil组[2%酒精+醛固酮0.75μg/H皮下泵入+fasudil 10mg/(kg·day)皮下注射,n=8]。共治疗5周。观察收缩压、尿蛋白、肾功能、肾组织学改变,并用western blot法和real-time PCR法观察肾皮质磷酸化MYPT1(代表Rho激酶活性)和Smad2/3蛋白表达和TGF-β1、结缔组织生长因子(connective tissue growth factor,CTGF) mRNA表达。结果醛固酮/盐长期灌注引起渐进性高血压同时伴有以大量蛋白尿,肌酐清除率下降,严重的肾小球增生和硬化、间质纤维化为特征的肾脏损伤,同时伴有肾皮质磷酸化MYPT1和Smad2/3表达增加,TGF-β1、CTGF ...     

失血性休克复苏大鼠心脏P-选择素表达与心脏功能的关系

目的 观察失血性休克复苏大鼠左心室功能与心肌组织中P-选择素表达的关系以及左旋精氨酸(L-Arg)对其影响,探讨失血性休克复苏大鼠心脏的损伤及保护机制.方法 健康SD大鼠30只,随机均分成正常对照组(NC组)、失血性休克复苏组(HS组)和左旋精氨酸治疗组(L-Arg组),通过生理记录仪观察左心功能的变化,采用酶联免疫吸附试验测定血清、心肌组织P-选择素含量,免疫组化方法检测心肌P-选择素蛋白表达.结果 休克大鼠复苏后3 h,HS组和L-Arg组血浆、心肌的P-选择素含量明显高于NC组;左心室内压最大变化速率、左心室内收缩压明显低于NC组,左心室舒张末期压明显高于NC组.但L-Arg组血浆、心肌组织中的P-选择素含量低于HS组,上述心功能指标的异常变化明显减轻.结论 大鼠失血性休克复苏后,P-选择素参与心脏损伤过程,L-Arg对P-选择素表达有抑制作用,对心脏功能具有保护作用.     

血浆甘露糖凝集素和C反应蛋白与缺血性脑血管病的相关性

目的检测缺血性脑血管病(ICVD)患者甘露糖凝集素(MBL)基因外显子I区54位密码子(ExonI54)点突变情况,分析血浆MBL及C反应蛋白(CRP)含量与ICVD的相关性。方法ICVD组患者100例,健康对照组60例,用聚合酶链反应—扩增产物的限制性片段长度多态性分析(PCR-RFLP)法测试MBLExonI54点突变,用酶联免疫吸附试验(ELISA)测定MBL水平,用免疫比浊法测定CRP水平。结果ICVD组血浆MBL基因点突变频率分别为GGC84.0%、GAC16.0%,MBL平均含量为(3372±661)μg/L,CRP平均含量为(7.5±4.9)mg/L,健康对照组MBL基因点突变频率分别为GGC84.2%,GAC15.8%,MBL平均含量为(2065±196)μg/L,CRP平均含量为(2.2±1.3)mg/L。ICVD组与对照组基因点突变频率的比较差异无统计学意义(P>0.05)。ICVD组MBL水平、CRP含量均高于对照组(均P<0.01),CRP与MBL水平成正相关(γ=0.5,P<0.01),结论ICVD患者MBL点基因突变频率与健康者无显著差异。MBL和CRP可能参与ICVD的发生、发展。