多药耐药相关基因及其蛋白在介导胰腺癌细胞原发性耐药中的作用及调控

目的 检测多药耐药相关基因（MDR1）及其蛋白（P-gP）在胰腺癌细胞株的表达,初步探讨胰腺癌发生先天性耐药的机理。方法 选择8株人胰腺癌细胞株,采用RT-PCR方法检测MDR1mRNA在胰腺癌细胞中的表达;通过免疫细胞化学方法检测P-gP的表达;以流式细胞仪检测胰腺癌细胞对罗丹明的外排情况,评价P-gP泵功能;最后通过P-gP抑制物维拉帕米与化疗药物联合应用,检测其对胰腺癌细胞的杀伤作用。结果 MDR1mRNA在胰腺癌细胞株SW1990中的表达最高,除PCT-2未检测到MDR1的表达外,其余6株细胞均有MDR1的微弱表达;免疫细胞化学染色结果证实P-gP在SW1990中的表达明显高于其他细胞株。57．9％±5．4％的SW1990细胞内有罗丹明蓄积,而在P-gP阴性对照细胞中,99．5％±3．3％的细胞内存在罗丹明的积聚,两者差异有统计学意义（P〈0．05）。P-gP抑制物维拉帕米与阿霉素或表阿霉素联合应用时可以部分逆转肿瘤细胞对化疗药物的耐药性。结论 MDR1及P-gP在人胰腺癌细胞中存在一定量的表达;维拉帕米联合阿霉素可以明显抑制P-gP阳性细胞的生长。     

儿童隐匿性阴茎的手术治疗

目的:探讨隐匿性阴茎的发病因素和手术治疗方式。方法:总结5年来32例隐匿性阴茎患者的临床资料,对其病理类型及手术治疗方式及效果进行回顾性分析。结果:26例患者都有不同程度的阴茎浅筋膜发育异常,22例患者行阴茎海绵体松解牵拉术,10例行Maizels术。术后随访4个月～5年,3例术后出现龟头及包皮缘水肿,经温盐水坐浴及理疗于手术后1月内消退渐恢复正常。1例术后海绵体部分回缩。31例患者手术后龟头显露良好,阴茎较术前平均延长2.2c(m勃起状态)。结论:隐匿性阴茎的形成与先天性阴茎浅筋膜发育异常有关,彻底解除皮肤浅筋膜纤维索带,将阴茎根部白膜牢靠固定是手术成功的关键。     

踝关节色素沉着绒毛结节性滑膜炎误诊1例报告

患者,女性,53岁,发现左外踝无痛性肿物2年余,无外伤史。发病1个月后曾在外院诊断为“血管瘤”,建议观察随诊。近期肿物逐渐增大,查体发现肿物位于外踝尖的前后侧分为两部分,轻度压痛,有揉面感,踝关节活动无受限。超声示外踝附近两个不规则低回声影,边界清,内部回声不均匀,内可见血流信号,为实性肿物。踝关节X线片未见明显骨质破坏,关节面光滑,关节间隙较对侧稍增宽。病理报告见图1。图1滑膜上皮呈乳头状增生,间质大量纤维组织细胞增生,淋巴细胞、多核巨细胞浸润,并伴大量含铁血黄素沉积(HE染色,×20)2005年1月12日行肿瘤切除术,由外踝沿肿…     

咪唑立宾对大鼠肾小球系膜细胞增殖的抑制作用

目的探讨咪唑立宾（MZ）对肾小球系膜细胞增殖的抑制作用及其对细胞周期蛋白依赖性蛋白激酶抑制物p27^kip1表达的影响。方法大鼠系膜细胞同步后分为无血清组、20％FCS刺激组、20％FCS＋MZ组。四甲基偶氮唑盐（MTT）法检测细胞数。BrdU标记法检测S期细胞。流式细胞仪检测细胞周期。Western印迹检测p27^kip1蛋白的表达。结果MZ可抑制20％FCS刺激所致的系膜细胞增殖，呈剂量依赖性。与20％FCS刺激组比较，20％FCS＋MZ组S期细胞的百分比显著降低[（10．28±1．26）％比（21．04±5．38）％，P〈0．05]。MZ可改善由20％FCS刺激诱导的GO／G1期细胞减少[（83．53±2．50）％比（71．15±1．25）％]和S期细胞增加[（12．22±1．22）％比（23．19±0．38）％，P〈0．051。20％FCS刺激后p27^kip1蛋白表达显著下降，MZ上调p27^kip1蛋白表达。结论MZ能够有效抑制系膜细胞增殖，作用时相在G1／S期转化，其抑制系膜细胞增殖的作用部分是通过上调p27^kip1蛋白表达实现的。     

主动脉扩张病腔内微创治疗新进展

1991年Parodi首次报道腹主动脉瘤腔内隔绝术,1994年Dake首次报道胸主动脉瘤腔内隔绝术.国内腔内隔绝术首次应用于腹主动脉瘤(1996)和胸主动脉夹层动脉瘤(1998)治疗,也已经有十年左右的时间.在这短短十年里,主动脉扩张性疾病的腔内微创治疗如雨后春笋般蓬勃发展,开展单位越来越多、病例数越来越多、病例难度越来越大、技术越来越成熟、相关认识系统化深入.     

MRI of combination treatment of embolic stroke in rat with rtPA and atorvastatin

To test the hypothesis that combination treatment of embolic stroke with rtPA and statins improves the efficacy of thrombolytic therapy in rats. Rats subjected to embolic MCA occlusion (MCAo) were randomized into control (n = 10) and treatment (n = 9) groups. Four hours after MCAo, a combination of rtPA and atorvastatin (treatment) or saline (control) was administered. MRI measurements were performed on all animals at 2 h, 24 h and 48 h after MCAo. The patency of cerebral microvessels was examined using fluorescent microscopy. MRI images showed complete blockage of the right MCA and a reduction of CBF in the territory supplied by the MCA 2 h after MCAo for all animals. By 48 h after stroke, MRI showed that the decreased lesion size, elevated CBF and increased incidence of recanalization were found in treated rats compared with the control rats. The combination treatment significantly increased microvascular patency (16.3 +/- 5.5% vs. 12.4 +/- 3.5%, of field-of-view) and reduced the infarct volume (23.1 +/- 9.6% vs. 38.8 +/- 13.3%, of hemisphere). These data demonstrate that the co-administration of rtPA and atorvastatin 4 h after ischemia is efficacious and is reflected by the MRI indices of recanalization of the MCA, reduction of secondary microvascular perfusion deficits and reduction of the ischemic lesion.     

脑fMRI观察电针神门及三阴交穴治疗失眠机制

目的利用fMRI技术探讨电针神门、三阴交穴治疗失眠的机制。方法对7名失眠患者（失眠组）及6名健康志愿者（正常对照组）分别在无任何刺激状态下行静息扫描、电针刺激双侧神门和三阴交穴下行BOLD-fMRI扫描,观察两组受试者的激活脑功能区。采用SPM基本模式中的单样本t检验进行统计分析。结果两组受试者均可见脑岛（BA13）明显激活。但在失眠组,右侧丘脑腹前核、右侧壳核、左内侧苍白球、左侧中央前回（BA9）、双侧尾状核头部被特异性地激活。结论电针神门、三阴交穴治疗失眠的机制可能是电针刺激激活了丘脑腹前核、尾状核、壳核、内侧苍白球、丘脑网状核以及其他睡眠中枢,整合传入和传出的信息,调节睡眠;并可通过不同的通路调畅情志,舒缓压力,达到助眠作用。     

Diagnosis and surgical treatment of solid pseudopapillary neoplasm of the pancreas: analysis of 24 cases

Background

Our aim was to summarize our experience with the diagnosis and surgical treatment of solid pseudopapillary neoplasm (SPN) of the pancreas to provide a reference for the management of this rare condition.

Methods

We collected and analyzed retrospective data on the clinical presentation, laboratory investigations, radiologic imaging, pathology and operative details of patients with SPN of the pancreas diagnosed between February 2001 and December 2009.

Results

In all, 23 of 24 patients were women, and the mean age of all patients was 31 years. The most common clinical presentation was vague abdominal pain. Abdominal imaging showed solid or solid cystic masses in the pancreas, mostly in the tail or head of the gland. All patients were treated surgically. There were no postoperative deaths. After follow-up ranging from 4 to 109 months (median 68 mo), 20 of 22 patients who underwent curative resection were alive with no evidence of disease recurrence. Of the 2 patients with R1 resections, 1 died 42 months after surgery, whereas the other underwent a second operation and was alive after 36 months’ follow-up.

Conclusion

Solid pseudopapillary neoplasm of the pancreas is a relatively indolent tumour. The initial diagnosis of SPN of the pancreas is suggested by radiologic imaging findings but should be considered in the context of clinical and histopathologic characteristics. We advocate for complete surgical resection once SPN is diagnosed.