大鼠急性肺栓塞后cytokeratin-19表达下降

目的研究急性肺血栓栓塞大鼠的肺组织中细胞角蛋白19(cytokeratin-19,CK-19)及其分解产物CYFRA21-1的表达变化。方法建立大鼠急性肺血栓栓塞模型并做肺泡灌洗。用半定量RT-PCR法和Western blot法检测CK-19的mRNA和蛋白表达;免疫组化方法检测CK-19在肺组织内的分布;放免法检测血清和肺泡灌洗液中CYFRA21-1的水平;检测动脉血氧饱和度。结果急性肺栓塞后CK-19mRNA和蛋白质水平均逐渐降低;肺泡上皮细胞CK-19的表达明显下降;血清和肺泡灌洗液中CYFRA21-1水平升高;动脉血氧饱和度呈明显下降趋势。结论急性肺栓塞不仅导致CK-19表达降低,而且分解代谢增强,因此CYFRA21-1的检测对于判断急性肺栓塞的严重程度及预后具有重要意义。     

大鼠急性肺栓塞后hnRNP-E1的表达及胶原代谢的变化

目的 研究大鼠急性肺栓塞模型肺组织中异源性核糖核蛋白E1(heterogeneous nuclear ribonucleoprote E1, hnRNP-E1)的表达变化及其对胶原代谢的影响.方法 建立大鼠急性肺栓塞模型,分别在急性肺栓塞后1、2、7和21 d开胸取出肺组织,然后提取肺组织的总RNA和总蛋白,以正常大鼠为对照组,采取半定量RT-PCR的方法研究hnRNP-E1在mRNA水平表达的变化;采用Western blot方法进一步验证hnRNP-E1在蛋白水平表达的变化.采用Northern blot法分析大鼠肺组织中Collagen α1(Ⅰ)(COL1A1)和Collagen α1(Ⅲ)(COL3A1)在肺栓塞后mRNA水平的表达变化;采用羟脯氨酸(HYP)和Masson染色观察急性肺栓塞3周后肺组织内的胶原沉积状况.结果 在大鼠急性肺栓塞后的不同时间点,hnRNP-E1的mRNA水平和蛋白水平的表达均有显著升高.大鼠急性肺栓塞后肺组织中COL1A1的mRNA表达水平有明显升高,但是COL3A1的mRNA表达水平无显著变化.HYP分析和Masson染色均显示急性肺栓塞3周后肺组织内的胶原沉积明显增加.结论 大鼠急性肺栓塞后肺组织内hnRNP-E1的表达升高,可能促进了COL1A1的蛋白表达和胶原在肺部的沉积.     

Effects of Bone Marrow-derived Mesenchymal Stem Cells on TGF-β and MCP-1 in Injured Lung of Rats

The primary objective of the present study is to investigate the therapeutic effect of bone marrow-derived mesenchymal stem cells （MSCs） on bleomycin （BLM）-induced lung injury of rats and the effect on transforming growth factor-β （TGF-β） and monocyte chemoattractant protein-1 （MCP-1）. MSCs were isolated from SD rats. The recipients rats were divided randomly into four groups： lung injury group, MSC treatment group, MSC control group and normal control group. Rats of lung injury group and MSC treatment group were perfused with BLM of 5mg/kg （0.2-0.3ml） intratracheally, others were perfused with normal saline. After twelve hours, rats of MSC treatment group and MSC control group were injected MSCs of 0.5×10^6per rat into tail vein. Haematoxylin-eosin staining was used to observe the morphology in lung tissue. ELISA was used to detect the contents of TGF-β and MCP-1 in serum and bronchoalveolar lavage fluid （BALF）. Collagen content of the lung tissue was assessed by hydroxyproline （HYP） concentration. It was found that the thickness of alveolar wall and lung interstitium were significantly reduced in the rats of MSC treatment group compared with the lung injury group. HYP content in lung interstitium, TGF-β and MCP-1 in serum and BALF were increased significantly in rats of lung injury group two weeks after BLM perfusion, but they were reduced significantly in the rats of MSC treatment group compared with the injured rats. These observations provide evidence that MSCs engraftment could alleviate bleomycin-induced lung injury and fibrosis in rats and the therapeutic effects might relate with the decrease of TGF-β and MCP-1.     

非程控降温,—80℃冻存自体外周血干细胞的研究

目的：观察非程控降温、－80℃冻存的方法对自体外周血十细胞（APBSC）的保存效果。方法：以6％羟乙基淀粉（HES）、5％二甲基亚砜（DMSO）及4％人血白蛋白（ALB）的混合物为冷冻防护剂，将APBSC直接置于－80℃下保存，冻存前反复苏后测定APBSC的CFU－GM、BFU－E；观察移植后造血功能重建情况。结果：13例患者白细胞在十3～＋7天下降至（0．0～0．1）×10／L，白细胞（0．0～0．2）×109／L持续时间3～6天，于＋9～＋11天恢复至1．0X109／L以上．中性粒细胞绝对值（ANC）于＋9～＋11天达到0．5X109／L。血小板在＋3～＋7天下降至（2．0～21）×109／L，于＋8～＋15天恢复至20×109／L以上。CFU－GM、BFU－E回大率分别为76．5％、78．4％。结论：非程控降温、－80℃冻存是一简便、经济、有效的自体外周血于细胞保存方法。     

Kallikrein 4 is a predominantly nuclear protein and is overexpressed in prostate cancer

Kallikreins (KLKs) are highly conserved serine proteases that play key roles in a variety of physiological and pathological processes. KLKs are secreted proteins that have extracellular substrates and function. For example, prostate-specific antigen (or KLK3) is a secreted protein that is widely used as a diagnostic marker for prostate cancer. KLK4 is a recently identified member of the kallikrein family that is regulated by androgens and is highly specific to prostate for expression. Here, we show that the gene product of KLK4, hK4, is the first member of the KLK family that is intracellularly localized. We provide strong evidence that the previously assigned first exon that was predicted to code for a signal peptide that would target hK4 for secretion is not part of the physiologically relevant form of KLK4 mRNA. In addition to detailed mapping of the KLK4 mRNA 5' end by RT-PCR, this conclusion is supported by predominantly nuclear localization of the hK4 protein in the cell, documented by both immunofluorescence and cell fractionation experiments. Furthermore, in addition to androgens, hK4 expression is regulated by estrogen and progesterone in prostate cancer cells. Finally, in situ hybridization on normal and hyperplastic prostate samples in tissue microarrays indicate that KLK4 is predominantly expressed in the basal cells of the normal prostate gland and overexpressed in prostate cancer. These data suggest that KLK4 has a unique structure and function compared with other members of the KLK family and may have a role in the biology and characterization of prostate cancer.     

肝胆外科临床见习教学探讨

为适应培养现代高素质医学人才的需要,从加强理论联系实践、培养学员自主学习和解决问题的能力、全面提高学员综合素质等方面进行了积极的探索,并总结了改善肝胆外科见习教学质量和临床实践能力的具体做法。     

肺、结肠和直肠癌患者血清瘦素的表达及意义

目的研究肺癌、结肠癌和直肠癌患者血清瘦素（Leptin）的表达变化,探讨其与患者预后的关系。方法采集肺癌、结肠癌、直肠癌患者及正常对照者的血清样品,采用相应试剂盒检测血清Leptin、癌胚抗原的水平,采用全自动生化分析仪检测反映脏器功能、代谢功能的相关生化指标变化。结果与正常对照者相比,三种肿瘤患者血清Leptin显著升高,癌胚抗原、脏器功能指标和代谢指标均有不同程度变化。结论Leptin可能作为评价恶性肿瘤患者状况的新指标。     

联合疗法治疗女性外阴上皮内非瘤样病变临床观察

目的探讨高强度聚焦超声（HIFU）配合专用药物治疗女性外阴上皮内非瘤样病变的效果。方法将2006年1月～2011年1月在济南军区总医院妇产科就诊的女性外阴上皮内非瘤样病变376例分为两组,HIFU组75例,单独应用HIFU治疗,联合疗法组301例,采用HIFU联合局部专用药物治疗。以同期56例单纯应用传统药物治疗的同类疾病患者为对照组。设立＂外阴瘙痒评分法＂、＂外阴白色病变面积计算法＂、＂四象限比较法＂和＂四度皮肤弹性评估法＂判定疗效。结果①HIFU组与联合疗法组对控制各类外阴上皮内非瘤样病变瘙痒症状的疗效显著优于对照组（P〈0.05）,联合疗法组疗效更佳（P〈0.05）。②HIFU组与联合疗法组控制白色病变的总有效率均高于对照组（P〈0.05）。HIFU组、联合疗法组治疗后白色病变面积与本组治疗前比较显著减小（P〈0.01）。③HIFU组、联合疗法组符合外阴皮肤弹性不良标准的患者治疗后外阴局部皮肤弹性评分与治疗前比较差异均有统计学意义（P〈0.05,P〈0.01）,HIFU组、联合疗法组外阴局部皮肤弹性改善总有效率均显著高于对照组（P〈0.05）,联合疗法组疗效更佳（P〈0.05）。结论 HIFU联合局部专用药物治疗女性外阴上皮内非瘤样病变,对瘙痒症状、外阴局部皮肤弹性的改善及减小白色病变面积效果满意,并具有治疗方便、安全无创的优势。     

环氧合酶-2抑制剂对白血病细胞HL-60的化疗增敏作用及机制

 目的　观察环氧合酶-2（COX-2）抑制剂塞来昔布对白血病细胞株HL-60的化疗增敏作用,并对其机制进行初步探讨。方法　MTT法评估塞来昔布、多柔比星及二者联合对HL-60细胞的生长抑制效应;流式细胞术（FCM）检测细胞的凋亡;反转录聚合酶链反应（RT-PCR）检测Survivin基因的表达;Western blotting检测Survivin蛋白的表达。结果　多柔比星联合塞来昔布5和10 μmol／L对HL-60细胞的半数抑制浓度（IC50）分别为0.25及0.16 μg／ml,明显低于多柔比星单用的IC50（0.48 μg／ml）;多柔比星0.10 μg／ml联合10 μmol／L塞来昔布下调Survivin基因mRNA及蛋白的表达;联合塞来昔布5和10 μmol／L的凋亡率[分别为（13.07±1.66）%及（22.36±1.84）%]较多柔比星0.10 μg／ml单用[（5.72±1.25）%]明显增加（P＜0.01）。结论　COX-2抑制剂塞来昔布对白血病细胞株HL-60具有明显的化疗增敏作用,其初步机制涉及下调Survivin的表达,增加细胞凋亡。     

胰管空肠连续吻合联合肠腔外引流预防胰十二指肠切除术后胰瘘

目的 对胰十二指肠切除术的胰肠吻合缝合技术和置管引流方法进行改进,以防止胰瘘的发生.方法 对2004年6月至2007年9月138例胰十二指肠切除术患者的胰肠吻合采用降落伞式胰管空肠连续吻合和吻合口下方肠腔减压外引流的临床资料进行回顾性分析.结果 降落伞式胰管空肠连续吻合时间平均11min,手术时间明显缩短,全部病例均未出现胰肠吻合口漏,术中出血平均353±61ml,平均住院日19.2d.6例患者出现肺部感染,3例上消化道出血考虑为应激性溃疡,2例患者出现胃排空障碍,均保守治疗痊愈,无手术死亡.结论 降落伞式胰管空肠连续吻合和吻合口局部肠腔减压外引流,操作简便、省时、并发症少,是胰肠吻合术的一种有效改进.