不同镇痛方式在开胸术后的镇痛效果及对肺功能影响

目的观察不同镇痛方式在开胸手术后的镇痛效果及其对肺功能的影响。方法39例ASAⅠ~Ⅱ级,在硬膜外复合全身麻醉下行侧开胸手术的病人,术后随机接受罗哌卡因(罗哌组,n=10)、甲磺酸罗哌卡因(甲罗组,n=10)和布比卡因(布比组,n=10)硬膜外镇痛(patient controlled epidural analgesia,PCEA)及吗啡(吗啡组,n=9)静脉镇痛(patient controlled intravenous analgesia,PCIA)。结果术后1、2、5d静息时的疼痛评分罗哌组和甲罗组均明显低于布比组,但与吗啡组相比无明显差异;术后1d静息时疼痛评分吗啡组也明显低于布比组,但术后2、5d两组间无明显差异。术后1、2、5d咳嗽时疼痛评分罗哌组均明显低于布比组和吗啡组;各时间咳嗽时疼痛评分布比组和吗啡组之间无明显差异。术后1、2dPaCO2罗哌组均明显低于布比组,术后1dPaCO2罗哌组也明显低于布比组;术后1、2dPaCO2罗哌组均明显高于吗啡组,但与布比组之间无明显差异。术后1、2、5d用力肺活量和呼吸峰流速四组间无明显差异。结论罗哌卡因和甲磺酸罗哌卡因加舒芬太尼可安全用于开胸手术后硬膜外镇痛,其镇痛效果优于布比卡因加芬太尼硬膜外镇痛和吗啡静脉镇痛,并使术后病人维持更好的呼吸功能,且不增加副作用的发生率。     

成年大鼠胰岛的体外基因转染

目的 探讨携带外源基因的慢病毒在体外有效感染胰岛及外源基因在胰岛中的表达，为通过移植前向胰岛细胞转入特定的免疫调节分子基因诱导胰岛移植物耐受奠定基础。方法 将目的基因CTLA4Ig导入慢病毒载体pWPTS，构建成pWPTS-CTLA4Ig载体。用磷酸钙沉淀法将pWPTS-EGFP、pWPTS-CTLA4Ig分别和其辅助载体pMD2．G、pCMVΔ8．92共转染293T细胞，收获病毒上清液，测定病毒滴度后感染新分离的胰岛。通过Western Blot测定胰岛培养上清液中CTLA4Ig蛋白的表达。结果 ①成功构建了携带CTLA4Ig基因的慢病毒载体pWPTS-CTLA4Ig；②包装产生的慢病毒Lenti-EGFP、Lenti-CTLA4Ig在体外可以感染胰岛，其中在Lenti-EGFP慢病毒感染的胰岛观察到了绿色荧光，及在Lenti-CTLA4Ig慢病毒感染的胰岛培养上清液中检测到了CTLA4Ig蛋白的表达。结论 慢病毒在体外可以有效感染大鼠胰岛，且携带的外源基因可以在胰岛细胞中稳定表达，其中Lenti-CTLA4Ig慢病毒感染的胰岛为进行胰岛移植并诱导体内特异的胰岛移植物耐受奠定了基础。     

保持形状特征的自适应轮廓点采样算法

在三角形贴面表面重建中，选择轮廓线上哪些点作为重建点，一方面决定重建的质量，另一方面决定重建的速度。本文提出了一种保持形状特征的变分辨率轮廓点采样算法。首先，建立了本算法的数学模型，我们认为离弧对应的弦距离最大的点可作为一个形状特征点。其次，利用二叉树数据结构递归实现了该算法。本算法具有保持轮廓形状特征、根据形状复杂度自适应决定采样频率、编程简单等优点。     

miR-29b介导的TGF-β/Smad信号通路对大鼠肝纤维化进程的影响

目的:初步研究微小RNA-29b(mi R-29b)介导的TGF-β/Smad信号通路在肝星状细胞(HSC)活化中的作用及其对大鼠肝纤维化进程的影响。方法:构建肝纤维化大鼠模型并分离其HSC,同时通过体外获取并鉴定正常大鼠HSC。运用RT-qPCR和Western blot检测以上获取细胞中mi R-29b、TGF-β/Smad信号通路相关蛋白和肝纤维化标志蛋白的变化水平,并通过双萤光素酶报告基因检测系统鉴定mi R-29b对TGF-β1的直接靶向结合情况。结果:随着HSC活化加深,mi R-29b的表达量逐渐减少(P 0. 01),而HSC活性标志物I型胶原蛋白和α-平滑肌肌动蛋白的表达量逐渐增加(P 0. 01)。在TGF-β/Smad信号通路中,Smad2/3/4的表达显著增加,而Smad7的表达明显下降(P 0. 01)。双萤光素酶报告基因检测结果显示,mi R-29b可直接结合于TGF-β1 3’UTR的"UCUCUCCGU"序列,表明TGF-β1为mi R-29b的一个下游靶基因。结论:mi R-29b可参与抑制HSC的活化和迁移,进而抑制肝纤维化进程,而其生物学功能可能是通过直接靶向抑制TGF-β1进而调控TGF-β/Smad信号通路实现的。     

Mutation spectrum and genotype-phenotype analyses in Cowden disease and Bannayan-Zonana syndrome, two hamartoma syndromes with germline PTEN mutation

The tumour suppressor gene PTEN , which maps to 10q23.3 and encodes a 403 amino acid dual specificity phosphatase (protein tyrosine phosphatase; PTPase), was shown recently to play a broad role in human malignancy. Somatic PTEN deletions and mutations were observed in sporadic breast, brain, prostate and kidney cancer cell lines and in several primary tumours such as endometrial carcinomas, malignant melanoma and thyroid tumours. In addition, PTEN was identified as the susceptibility gene for two hamartoma syndromes: Cowden disease (CD; MIM 158350) and Bannayan-Zonana (BZS) or Ruvalcaba-Riley-Smith syndrome (MIM 153480). Constitutive DNA from 37 CD families and seven BZS families was screened for germline PTEN mutations. PTEN mutations were identified in 30 of 37 (81%) CD families, including missense and nonsense point mutations, deletions, insertions, a deletion/insertion and splice site mutations. These mutations were scattered over the entire length of PTEN , with the exception of the first, fourth and last exons. A 'hot spot' for PTEN mutation in CD was identified in exon 5 that contains the PTPase core motif, with 13 of 30 (43%) CD mutations identified in this exon. Seven of 30 (23%) were within the core motif, the majority (five of seven) of which were missense mutations, possibly pointing to the functional significance of this region. Germline PTEN mutations were identified in four of seven (57%) BZS families studied. Interestingly, none of these mutations was observed in the PTPase core motif. It is also worthy of note that a single nonsense point mutation, R233X, was observed in the germline DNA from two unrelated CD families and one BZS family. Genotype-phenotype studies were not performed on this small group of BZS families. However, genotype-phenotype analysis inthe group of CD families revealed two possible associations worthy of follow-up in independent analyses. The first was an association noted in the group of CD families with breast disease. A correlation was observed between the presence/absence of a PTEN mutation and the type of breast involvement (unaffected versus benign versus malignant). Specifically and more directly, an association was also observed between the presence of a PTEN mutation and malignant breast disease. Secondly, there appeared to be an interdependent association between mutations upstream and within the PTPase core motif, the core motif containing the majority of missense mutations, and the involvement of all major organ systems (central nervous system, thyroid, breast, skin and gastrointestinal tract). However, these observations would need to be confirmed by studying a larger number of CD families.      

H1N2新亚型流感病毒神经氨酸酶基因来源的进一步研究

对流感病毒Ｈ１Ｎ２亚型重组株Ａ／哈防／１／８８、Ａ／哈防／１２／９２以及Ｈ３Ｎ２亚型病毒株Ａ／雅防／２／８７、Ａ／京防／５７／８９８和Ａ／粤防／１／９２神经氨酸酶（ＮＡ）基因核苷酸全序列的测定，进一步弄清了Ａ／哈防／１／８８病毒株的ＮＡ基因确来自当时人群中流行的Ｈ３Ｎ２亚型病毒株，很可能是来自Ａ／雅防／２／８７类病毒株；而Ａ／哈防／１２／９２病毒株的ＮＡ基因可能是与Ａ／哈防／１／８８病毒株的ＮＡ基     

内皮型、诱导型一氧化氮合酶在乳腺癌中的表达

目的 :研究内皮型一氧化氮合酶 (eNOS)、诱导型一氧化氮合酶 (iNOS)在乳癌中表达及与淋巴结转移的关系。方法 :采用免疫组化S P法检测 60例乳癌中eNOS和iNOS的表达。结果 :eNOS和iNOS阳性在乳癌中表达率分别为 75 0 %和71 7%。在淋巴结转移组和无淋巴结转移组中eNOS阳性表达率分别为 66 7%和 83 3 % ,两组间差异无统计学意义 (χ2 =2 2 2 ,P >0 0 5) ,而iNOS在淋巴结转移和无转移组中阳性表达率分别为 53 3 %和 90 0 % ,两组间差异有统计学意义 (χ2 =9 93 ,P <0 0 1 )。结论 :内皮型、诱导型一氧化氮合酶在乳腺癌中高表达 ;iNOS的表达与乳腺癌的淋巴转移相关     

靶向血管内皮生长因子C短发夹式RNA对人乳腺癌MCF-7细胞生物学特性的影响

目的 研究重组质粒表达载体介导的短发夹式RNA(shRNA)对乳腺癌MCF-7细胞株中血管内皮生长因子C(VEGF-C)的表达及乳腺癌细胞增殖、侵袭能力的影响.方法 脂质体介导重组质粒pSIREN-VEGF-C转染乳腺癌MCF-7细胞株,嘌呤酶素筛选阳性克隆;荧光定量PCR及Western blot检测转染前后乳腺癌MCF-7细胞中VEGF-C基因的表达;MTT法及Transwell体外侵袭实验检测转染前后乳腺癌MCF-7细胞的增殖及侵袭能力.结果 转染重组质粒后乳腺癌MCF-7细胞中VEGF-C mRNA及蛋白表达均明显下调,抑制率分别为95%及100%(P<0.05);MTT法和 Transwell体外侵袭实验显示,与阴性质粒组和空白对照组比较,转染重组质粒后各时间段乳腺癌MCF-7细胞增殖均明显受抑制(P<0.05),同时穿膜的肿瘤细胞数也明显减少[(29.0±1.9)个与(59.0±2.1)个和(61.0±2.2)个相比,P<0.05].结论 表达VEGF-C shRNA的重组质粒载体pSIREN-VEGF-C在乳腺癌MCF-7细胞中能高效、特异地发挥靶基因沉默作用,并对乳腺癌细胞的增殖及侵袭能力有显著抑制作用.     

综合性医院老年病人抑郁症状的调查分析

目的 :分析综合性医院老年病人的抑郁症状特征及影响因素。方法 :应用中文版流调用抑郁量表 (CES -D) ,调查同济医院住院和门诊的 3 15例老年患者 (年龄≥ 60岁 )。结果 :①在 3 15例老人患者中 ,共有 70例老年患者 (占 2 2 2 % )肯定有抑郁症状 ,5 3例 (16 8% )可能存在抑郁症状 ;②CES -D总分女性组明显高于男性组 (t=2 0 3 2 ,P <0 0 1) ,且教育程度越低抑郁症状越明显 (F =3 75 6,P <0 0 1) ;③CES -D总分的多元逐步回归分析提示所有被调查老人及内科组老人的CES -D总分明显受其教育程度的影响。结论 :在综合性医院对老年病人进行抑郁症状的常规筛查是必要的