先天性无肛直肠舟状窝瘘手术186例

1临床资料1988-06/2003-12我院共186例,均为女性,无肛门,其中0～6月龄21例,0.5～1岁96例,1～3岁53例,3～8岁15例,13岁1例.以大便从会阴部舟状窝瘘口处排出而就诊,患儿有不同程度的排便困难,严重时伴腹胀呕吐,多数患儿有营养不良性贫血.瘘口直径0.3～0.6 cm,直肠盲端到肛穴皮肤之间的距离1.0～2.5 cm,属于中、低位肛门直肠畸形.本组有3例合并先天性心脏病-室间隔缺损,2例合并骶前囊肿,1例合并脐疝.     

吗啡增强谷氨酸单钠神经毒性及其作用机制

用皮层神经细胞体外培养、形态学观察、单个神经细胞内游离钙检测及乳酸脱氢酶(LDH)测定等方法,观察了吗啡对谷氨酸单钠(MSG)神经毒性增强作用以及纳洛酮对吗啡作用的逆转,分析了其可能的作用机制。结果表明:吗啡能显著增强的MSG的细胞毒作用.纳络酮可逆转这种增强作用,细胞内Ca²⁺超载可能是兴奋性神经毒素引起神经元死亡的共同病理学机制。     

骨髓间充质干细胞基因工程改造方法的比较

目的:对脂质体介导、反转录病毒载体介导、腺相关病毒载体介导这3种常用的基因转染方法进行比较,寻找一种适合于骨髓间充质干细胞的基因转移方法。方法:实验于2004-10/2005-06在首都医科大学北京神经科学研究所完成。①在脂质体介导下,将增强的绿色荧光蛋白基因导入骨髓间充质干细胞,然后通过G418抗性筛选,观察转染效率。②反转录病毒介导的基因转染,首先利用LipofectAMINETM 2000转染包装细胞系PT67,获得重组反转录病毒上清,然后用病毒上清直接感染骨髓间充质干细胞。转染后的细胞同样用G418筛选,得到阳性克隆后进行定点消化、扩增。③在腺相关病毒介导的基因转染过程中,首先通过磷酸钙沉淀法转染包装细胞系HEK293,得到重组AAV-LacZ病毒颗粒直接感染骨髓间充质干细胞,1周后进行β-gal染色,计算转染效率。结果:①脂质体介导的基因转染24h后在荧光显微镜下观察,可见少量细胞呈现绿色荧光蛋白阳性,阳性率大约为5%。抗生素筛选3周后细胞全部死亡,经过多次试验均未得到阳性细胞克隆。②反转录病毒感染后,在荧光显微镜下观察可见少量骨髓间充质干细胞表达增强的绿色荧光蛋白。当加入G418筛选后,大量细胞死亡,1周后仅有极少数细胞存活。继续培养3～4周后,细胞形成克隆,定点消化细胞克隆,扩增后95%的细胞表达绿色荧光蛋白。③腺相关病毒上清感染骨髓基质细胞1周后,用β-gal染色估计骨髓间充质干细胞转染效率大约为75%。但传代后阳性细胞所占比例明显下降,大约2%。结论:骨髓间充质干细胞易于接受外援基因。3种基因转移方法相比:脂质体转染法转染效率最低,不适合骨髓间充质干细胞;反转录病毒载体法感染效率最高,最适用于骨髓间充质干细胞;而腺相关病毒载体法感染效率较高,但该载体系统没有抗生素筛选,所以无法使阳性细胞得到纯化和扩增,其可能更适合于体内基因直接感染。     

pcDNA3．1-VEGF165质粒转染骨髓基质干细胞后血管内皮生长因子的表达

目的:检测pcDNA3.1-VEGF165载体转染对兔骨髓基质干细胞血管内皮生长因子表达的影响。方法:实验于2005-07/2006-01在山东省青岛市市立医院中心试验室完成。①pcDNA3.1-VEGF165质粒由华中科技大学同济医学院附属协和医院骨科杨述华教授惠赠。②选取1月龄新西兰大白兔1只,无菌条件下取胫骨和股骨,进行骨髓基质干细胞的分离与培养。③转染前24h计数细胞,每孔5×105细胞接种于6孔板,待骨髓基质干细胞达到80%～90%融合时准备转染,设立未转染组、空载体组和载体组。未转染组无特殊处理,空载体组转染pcDNA3.1载体,载体组转染pcDNA3.1-VEGF165。④转染后72h,反转录聚合酶链反应检测各组骨髓基质干细胞中血管内皮生长因子165mRNA的表达;酶联免疫吸附法检测各组骨髓基质干细胞中血管内皮生长因子165蛋白的含量。结果:①骨髓基质细胞分离培养形态观察:初始分离的骨髓细胞呈圆形,大小不一;24h后有少量细胞贴壁;48h后贴壁细胞部分为成纤维样细胞;72h贴壁的成纤维样细胞数不断增加;96h后贴壁生长的细胞主要为梭形的成纤维样细胞;分瓶后细胞形成克隆;传代后细胞贴壁生长,分裂相增多,并不断增殖分化形成均一的梭形细胞。②转染72h后各组细胞血管内皮生长因子165mRNA的表达情况:反转录聚合酶链反应检测到载体组在576bp处有明显条带,空载体组和未转染组均未见血管内皮生长因子165表达。③转染72h后各组细胞血管内皮生长因子165蛋白含量检测结果:酶联免疫吸附结果显示,载体组转染pcDNA3.1-VEGF165载体的骨髓基质细胞培养上清液中血管内皮生长因子165蛋白浓度为(170.1±14.3)ng/L,而空载体组与未转染组均未检测到血管内皮生长因子165蛋白表达,差异有显著性意义(t均=42.206,P=0.000)。结论:应用pcDNA3.1-VEGF165载体转染,可使兔骨髓基质干细胞获得外源性血管内皮生长因子165基因和蛋白的表达。     

慢性自身免疫性胰腺炎误诊1例

总结1例AIP患者的临床表现及影像和病理特点,探讨慢性自身免疫性胰腺炎(AIP)的临床表现与特点．本例42岁发病,以持续性腹痛1 mo伴进行性黄疸2 wk多处就医,均误诊为胰腺癌,经术中快速病检证实为AIP.通过本病例,可以看出AIP临床表现缺乏特异性,临床医师时刻保持警惕及活组织病检是诊断AIP的重要手段．     

Impact of social media on the health of children and young people

This paper reviews the literature on the impact of social media on the health of children and young people. Relevant papers were identified from Medline, Embase and PsycINFO databases. The studies identified that the health impact of social media on children and young people was greatest on mental health and specifically in the areas of self‐esteem and well‐being, with related issues around cyberbullying and ‘Facebook Depression’, with an association between the use of social media and self‐esteem and body image. However, it is difficult to determine the cause and effect, which is likely to be related to the nature of the young person. There is little work on the impact of social media on younger children. More research is needed to identify those most at risk of harm from social media and risk mitigation strategies to assist health‐care professionals to provide essential education for parents and young people.     

Amyloid β 1-42 induces hypometabolism in human stem cell-derived neuron and astrocyte networks

Alzheimer''s disease (AD) is the most common form of dementia, affecting more than 35 million people worldwide. Brain hypometabolism is a major feature of AD, appearing decades before cognitive decline and pathologic lesions. To date, the majority of studies on hypometabolism in AD have used transgenic animal models or imaging studies of the human brain. As it is almost impossible to validate these findings using human tissue, alternative models are required. In this study, we show that human stem cell-derived neuron and astrocyte cultures treated with oligomers of amyloid beta 1-42 (Aβ1-42) also display a clear hypometabolism, particularly with regard to utilization of substrates such as glucose, pyruvate, lactate, and glutamate. In addition, a significant increase in the glycogen content of cells was also observed. These changes were accompanied by changes in NAD⁺/NADH, ATP, and glutathione levels, suggesting a disruption in the energy-redox axis within these cultures. The high energy demands associated with neuronal functions such as memory formation and protection from oxidative stress put these cells at particular risk from Aβ-induced hypometabolism. Further research using this model may elucidate the mechanisms associated with Aβ-induced hypometabolism.