晚发型脊柱骨骺发育不良伴进行性骨关节病患者的成骨细胞增殖分化及基因表达谱改变

目的探讨晚发型脊柱骨骺发育不良伴进行性骨关节病(SEDT PA)患者WISP3基因突变所造成的软骨及周围骨组织病变和可能的发病机制。方法从SEDT PA患者及正常同龄个体的股骨头松质骨分离成骨细胞进行体外培养,对培养的成骨细胞进行细胞增殖、骨特异性碱性磷酸酶(BAP)、骨钙素、护骨素测定,利用cDNA表达芯片进行基因表达谱分析,并用免疫组织化学方法对基因芯片进行验证。比较SEDT PA患者及正常对照的成骨细胞在细胞增殖、分化及基因表达谱等方面的改变。同时采用Northern杂交检测成骨细胞的WISP3表达情况。结果与正常人成骨细胞相比,SEDT PA患者成骨细胞的增殖能力较强(0.86±0.04vs0.71±0.10),氚胸腺嘧啶(3H TDR)的掺入量明显较高(1363cpm±350cpmvs867cpm±128cpm)。SEDT PA患者的成骨细胞骨钙素的表达水平明显低于正常同龄人(3.62ng/μg蛋白±0.3ng/μg蛋白vs0.85ng/μg蛋白±0.06ng/μg蛋白),护骨素的表达明显低于正常同龄人(9.43pg/μg蛋白±0.41pg/μg蛋白vs1.98pg/μg蛋白±0.03pg/μg蛋白),而BAP的表达未发生明显改变;WISP3基因的表达极低。cDNA表达芯片分析结果发现,与正常对照比较,SEDT PA患者的成骨细胞有22个基因表达明显上调,16个基因表达明显下调,这些基因包括有成骨细胞的标记分子、细胞外基     

敏咳清颗粒对人胚肺成纤维细胞增殖、凋亡的影响

目的:通过观察敏咳清颗粒对体外培养的肺成纤维细胞(lung fibroblast,LFB)增殖、凋亡的影响,探讨敏咳清颗粒治疗咳嗽变异性哮喘的作用机制.方法:将常规培养LFB分为空白组、模型组、对照组、敏咳清高浓度组、敏咳清低浓度组、养阴清肺糖浆高浓度组、养阴清肺糖浆低浓组、地塞米松组,加入肝素刺激后分别加入对应的含药血清,采用MTT法检测LFB增殖,TUNEL法检测LFB凋亡.结果:①各组含药血清均可以不同程度地抑制肝素刺激下LIB的增殖,以敏咳清颗粒高剂量组抑制LFB增殖的作用最强,48 h的抑制作用强于24 h,呈剂量依赖性;②各组均出现不同程度细胞凋亡的形态改变,以敏咳清高剂量组诱导LFB凋亡细胞最多.结论:敏咳清颗粒能显著抑制LFB增殖,诱导LFB凋亡.     

严肃游戏在《中国医学史》学习中的应用

传统中医知识学习通常采用“机械记忆”的方式,学生在学习中感到十分抽象,学习效果不尽人意。《岐黄之途》游戏采用Unity 3D为开发平台,融合中国医学史知识要点,将中医理论知识学习与严肃游戏相结合,采用寓教于乐的方式,激发学生学习热情,并提高其学习效率。     

大鼠肝纤维化模型中基质金属蛋白酶-2及其抑制物的表达

目的了解基质金属蛋白酶－２（ＭＭＰ－２）及其组织型抑制剂（ＴＩＭＰ－２）在纤维化过程中的变化,分析它们在始动阶段的作用。方法用免疫组化和酶图法,在异种血清诱导的大鼠肝纤维化模型不同阶段,作肝细胞内ＭＭＰ－２、ＴＩＭＰ－２、酶降解底物Ⅳ型胶原（ＣｏｌⅣ）以及结蛋白（Ｄｍ）定位和半定量研究。结果实验鼠于４周末形成细胞间隔,８周末发展为肝纤维化,含细胞－纤维间隔或纤维间隔,１２、１６周仍为纤维间隔。酶图法表明４周末ＭＭＰ－２活性升高２．５倍左右,８周末仍高于对照鼠。免疫组化显示４周末ＭＭＰ－２阳性细胞数最多,连续切片观察ＭＭＰ－２与Ｄｍ阳性细胞（活化的肝星状细胞）几乎重叠。８周末阳性细胞数有所减少,１２周末明显减少。半定量变化趋势与酶图法一致。ＴＩＭＰ－２于８周末表达开始升高,１２周末达最高。２周末ＣｏｌⅣ表达开始上升,４周末达高峰,以后缓慢下降。结论肝纤维化早期ＭＭＰ－２活性增高,继而ＴＩＭＰ－２分泌过多,ＭＭＰ－２活性受抑,ＥＣＭ降解受阻,纤维化进一步发展。     

Pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy: a meta-analysis of randomized controlled trials

Background

The best reconstruction method for the pancreatic remnant after pancreaticoduodenectomy remains debatable. We aimed to investigate the perioperative outcomes of 2 popular reconstruction methods: pancreaticogastrostomy and pancreaticojejunostomy.

Data Sources

Randomized controlled trials comparing pancreaticogastrostomy versus pancreaticojejunostomy were identified from literature databases (MEDLINE/PubMed, EMBASE, Web of Science, Cochrane Library).The meta-analysis included 8 studies: 607 patients who underwent pancreaticogastrostomy and 604 who underwent pancreaticojejunostomy. Postoperative pancreatic fistula and intra-abdominal fluid collection rates were significantly lower after pancreaticogastrostomy compared with pancreaticojejunostomy. No statistically significant differences were found in the incidence of delayed gastric emptying, biliary fistula, hemorrhage, reoperation, wound infection, overall morbidity, mortality, and length of hospital stay.

Conclusions

Our meta-analysis suggests that pancreaticogastrostomy not only reduces the rate of postoperative pancreatic fistula but also decreases its severity. Pancreaticogastrostomy is associated with a lower rate of intra-abdominal fluid collection. Our results suggest that pancreaticogastrostomy should be the preferred reconstruction method.     

子宫体、乳腺双原发癌的临床病理特征

目的 探讨子宫体、乳腺双原发癌的临床病理特征。方法 回顾性分析首都医科大学附属北京朝阳医院2004年1月至2015年1月收治子宫体、乳腺双原发癌患者（双癌组）29例和子宫体恶性肿瘤患者（单癌组）319例的临床病理资料。结果 双癌组合并糖尿病（χ²=8.02,P=0.007）、肿瘤家族史（χ²=31.76,P<0.001）及其他部位恶性肿瘤（χ²=31.76,P<0.001）的比例显著高于单癌组,双癌组Ⅱ型子宫体恶性肿瘤（χ²=5.52,P=0.030）及低分化癌（χ²=8.39,P=0.020）的构成比明显高于单癌组。单癌组的总生存率（overall survival,OS）明显优于双癌组（Log-rank=6.75,P=0.011）。分层分析显示,在双癌组中,首发子宫体癌的双癌患者Ⅱ型子宫内膜癌的构成比明显高于首发乳腺癌组（58.33%vs 11.76%,χ²=6.882,P=0.014）。首发子宫体癌与首发乳腺癌的两癌发病间隔时间显著不同,前者的间隔时间明显缩短（t=2.23,P=0.028）。两组双原发癌间隔时间的分布差异有统计学意义（χ²=9.60,P=0.010）。结论 合并乳腺癌的子宫体恶性肿瘤与子宫体恶性肿瘤的临床、病理特征不同。乳腺癌后子宫体恶性肿瘤与子宫体恶性肿瘤术后发生乳腺癌的临床、病理特征不同。     

闭合性胃损伤50例临床分析

回顾性分析50例闭合性腹部创伤中胃损伤患者的临床资料,其中胃穿孔20例,胃撕裂伤30例,胃穿孔患者受伤时均为饱食胃状态,胃撕裂伤患者正相反;49例存在合并伤,肝胰损伤是胃撕裂伤患者的常见合并症(15/30与10/30),而脾损伤是胃穿孔患者的常见合并症(11/20).均行手术治疗,手术方式为胃修补术.治愈48例,病死2例,病死率4%.外科手术是主要治疗方式,以修补术为主,手术中应注意处理合并伤及合并症.     

肝力注射液逆转人肝癌细胞获得性多药耐药的体外研究

目的研究肝力注射液体外逆转人肝癌细胞5-Fu获得性多药耐药的作用。方法MTT法检测肝力注射液对人肝癌BEL-7402/5-Fu耐药细胞株的增殖抑制率及对5-Fu获得性多药耐药的逆转指数,倒置显微镜及Wright-Giemsa染色观察细胞形态学改变,流式细胞术检测细胞内阿霉素荧光强度。结果人肝癌BEL-7402/5-Fu细胞株对临床常用化疗药物显示出不同程度的交叉抗药性,肝力注射液(以苦参碱计)在0.230、0.115、0.058mg/mL3个质量浓度对人肝癌BEL-7402耐药细胞株72h的增殖抑制率分别为(9.25±2.38)%、(8.46±1.90)%、(4.23±2.05)%,对5-Fu的逆转指数分别为5.50、3.83、2.25,肝力注射液在0.230mg/mL质量浓度预处理细胞2h能提高细胞内阿霉素的量约38.61%。结论肝力注射液在体外具有逆转人肝癌细胞5-Fu获得性多药耐药的作用。     

Genetic damage induced by organic extract of coke oven emissions on human bronchial epithelial cells

Coke oven emissions are known as human carcinogen, which is a complex mixture of polycyclic aromatic hydrocarbon. In this study, we aimed to clarify the mechanism of action of coke oven emissions induced carcinogenesis and to identify biomarkers of early biological effects in a human bronchial epithelial cell line with CYP1A1 activity (HBE-CYP1A1). Particulate matter was collected in the oven area on glass filter, extracted and analyzed by GC/MS. DNA breaks and oxidative damage were evaluated by alkaline and endonucleases (FPG, hOGG1 and ENDO III)-modified comet assays. Cytotoxicity and chromosomal damage were assessed by the cytokinesis-block micronucleus cytome (CBMN-Cyt) assay. The cells were treated with organic extract of coke oven emissions (OE-COE) representing 5, 10, 20, 40 μg/mL extract for 24 h. We found that there was a dose–effect relationship between the OE-COE and the direct DNA damage presented by tail length, tail intensity and Olive tail moment in the comet assay. The presence of lesion-specific endonucleases in the assays increased DNA migration after OE-COE treatment when compared to those without enzymes, which indicated that OE-COE produced oxidative damage at the level of pyrimidine and purine bases. The dose-dependent increase of micronuclei, nucleoplasmic bridges and nuclear buds in exposed cells was significant, indicating chromosomal and genomic damage induced by OE-COE. Based on the cytotoxic biomarkers in CBMN-Cyt assay, OE-COE may inhibit nuclear division, interfere with apoptosis, or induce cell necrosis. This study indicates that OE-COE exposure can induce DNA breaks/oxidative damage and genomic instability in HBE-CYP1A1 cells. The FPG-comet assay appears more specific for detecting oxidative DNA damage induced by complex mixtures of genotoxic substances.     

高频焊接仪闭合动脉血管的安全性与可靠性研究

目的:探讨高频焊接仪(HFWD)闭合动脉血管的安全性与可靠性。方法:将6头西藏小型猪均随机分为HFWD组与超声刀组(HS组),全麻后分离裸化颈、股动脉,分别采用HFWD与HS闭合离断血管。比较两组血管闭合后的爆破压、闭合时间、闭合过程中的最高温度及闭合处病理热损伤。结果:不区分血管管径大小时,HFWD组平均爆破压高于HS组(489.64 mm Hg vs.439.88 mm Hg,P0.05),当血管直径≤3 mm时,HFWD组与HS组爆破压无明显差异(593.40 mm Hg vs.572.48 mm Hg,P0.05),对于直径3~5 mm、5~7 mm的血管,HFWD组爆破压均大于HS组(457.02 mm Hg vs.404.32 mm Hg;418.51 mm Hg vs.342.84 mm Hg,均P0.05);无论血管直径大小,HFWD组闭合血管所需时间均少于超声刀(均P0.05)。HFWD组闭合处的平均最高温度低于HS组(65.91℃vs.105.25℃,P0.05);HFWD组闭合处血管壁胶原变性及血管平滑肌损伤程度轻于HS组。结论:HFWD闭合动脉血管是安全可靠的。