通心络对动脉粥样硬化模型兔内皮功能、CD40及CD40L表达的影响

目的 观察通心络对动脉粥样硬化家免模型的预防治疗作用,并探讨其对内皮功能、CD40及CD40L mRNA表达的影响.方法 选取60只雄性健康家兔,随机分为对照组、模型组、通心络组三组,每组20只,后两组家兔分别通过高脂饮食制备动脉粥样硬化模型.给药处理前及12周后分别测定以下指标：血浆总胆固醇（TC）、甘油三酯（TG）和高密度酯蛋白胆固醇（HDL-C）的浓度;主动脉内膜/中膜厚度比值及粥样斑块面积;测定血清内皮素（ET）水平和血清一氧化氮（NO）水平;运用定量逆转尿PCR技术（RT-PCR）测定外周血单核细胞中CD40及CD40L mRNA的表达水平.结果 模型组和通心络组家免的TC水平均显著高于对照组（P〈0.01）,通心络组又低于模型组（P〈0.05）;通心络组血清ET水平和ET/NO显著降低（P〈0.05,P〈0.01）,血清NO水平显著升高（P〈0.01）;通心络组中,家兔的主动脉内膜/中膜厚度比值及斑块面积占血管总面积百分率均明显低于模型组[（0.56±0.07）与（1.16±0.08）,P〈0.01;（36.88±2.38）%与（76.58±2.86）%,P〈0.01];与模型组（0.798±0.115）、（0.592±0.132）比较,通心络组家兔外周血单-核细胞中的CD40及CD40L mRNA表达量明显降低[（0.686±0.132）、（0.498±0.108）]（P〈0.01）.结论 通心络可抑制动脉粥样硬化斑块的形成,其机制可能下调CD40及CD40L表达及有效地改善内皮功能有关.     

颏下岛状肌皮瓣修复口腔鳞癌术后颊黏膜缺损效果观察

目的 评价颏下岛状肌皮瓣修复口腔鳞癌术后颊黏膜缺损的疗效.方法 对9例口腔癌患者行口腔鳞癌扩大切除术,对颊黏膜缺损采用颏下岛状肌皮瓣修复.制备岛状肌皮瓣最小为4 cm × 6 cm,最大为5cm×10cm.结果 9例皮瓣均完全成活,1例术后发生暂时性面神经下颌缘支麻痹,3个月后恢复,2例发生颌下区积液,经拆除切口缝线2针、引流后痊愈.随访时间6 ～ 12个月,9例颊部两侧基本对称,吞咽及咀嚼功能恢复满意,开口度达2.5指2例,达3指7例.供区瘢痕隐蔽,仰头无明显受限,未发现肿瘤局部及颈部复发.结论 采用颏下岛状肌皮瓣修复口腔鳞癌术后黏膜缺损具有血供可靠、邻近受区、制备方便、皮瓣成活率高的特点,效果较好.     

保妇康栓联合宫颈环形电切除术治疗宫颈上皮内瘤样病变预防术后宫颈柱状上皮外翻的临床分析

目的探讨保妇康栓联合宫颈环形电切除术（LEEP）治疗宫颈上皮内瘤样病变（CIN）,在预防术后宫颈柱状上皮外翻上的作用。方法对160例CIN行LEEP治疗的患者按随机数字表法分组行随机对照研究,其中对照组80例术前未使用任何药物;研究组80例术前配合保妇康栓治疗2周,观察比较术后第1个月和第3个月宫颈柱状上皮外翻的发生率。结果研究组术后1个月、3个月宫颈柱状上皮外翻发生率分别为2．5％（2／80）、1．2％（1／80）,均低于对照组的12．5％（10／80）、11．2％（9／80）（x2=7．9073、6．8267,均P〈0．05）。结论LEEP治疗CIN前联合应用保妇康栓可有效预防宫颈柱状上皮外翻的发生。     

The RNA m6A methyltransferase METTL3 promotes pancreatic cancer cell proliferation and invasion

Epigenetic modifications are involved in carcinogenesis and METTL3 is involved in RNA methylation. This study aimed to explore the role of the RNA m6A methyltransferase METTL3 in pancreatic cancer cells. The m6A modification was analyzed in human pancreatic cancer and paracancerous specimens, as well as in the normal HPDE6-C7 pancreatic cell line and the MIA-PaCa-2 and BxPC-3 pancreatic cancer cell lines. Immunohistochemistry (IHC), western blotting, and RT-qPCR were used to detect the expression of METTL3. Cell lines were transfected with siRNAs against METLL3. Proliferation, invasion, and migration were examined. The functions of METTL3 were predicted by bioinformatics analysis. In the 40 patients included, high METTL3 expression was associated with high pathological stage (P = 0.02) and high N stage (P = 0.02). Survival was better in patients with low METTL3 expression compared with those with high MTTL3 expression (P < 0.01). METTL3 and CIITA expression levels were inversely correlated (r = ?0.71, P < 0.01). RNA m6A content in tumor specimens was significantly higher than that in paracancerous specimens. METTL3 protein and mRNA levels were significantly higher in tumor specimens compared with paracancerous specimens, as well as in cancerous cell lines vs. normal cells. METTL3 knockdown in MIA PaCa-2 and BxPC-3 cells decreased RNA m6A modifications. Cell proliferation, invasion, and migration were decreased by METTL3 knockdown in cancerous cell lines. A total of 673 differentially expressed genes were identified by bioinformatics: 659 were upregulated and 14 were downregulated. In conclusion, METTL3 is probably involved in pancreatic carcinogenesis. It could eventually be a prognostic marker or a treatment target.     

乳腺癌组织中Bmi-1和CARD9表达及其与淋巴结转移和预后的关联

目的 探究乳腺癌组织中Bmi-1、胱天蛋白酶募集域蛋白9（CARD9）表达及其与淋巴结转移、预后的关联性。方法 以我院2017年1月~2018年11月96例乳腺癌患者为研究对象,检测其乳腺癌组织及癌旁组织中Bmi-1、CARD9表达情况;分析乳腺癌组织中Bmi-1、CARD9表达情况与临床病理及预后的关系。结果 乳腺癌组织中Bmi-1、CARD9阳性表达率均高于癌旁组织（P＜0.05）;Bmi-1阳性表达组在TNM分期为Ⅲ、Ⅳ期、组织学分级为Ⅲ级、肿瘤长径≥2 cm、存在淋巴结转移、ER+方面的人数比例高于Bmi-1阴性表达组,CARD9阳性表达组在TNM分期为Ⅲ、Ⅳ期、肿瘤长径≥2 cm、存在淋巴结转移方面的人数比例高于CARD9阴性表达（P＜0.05）;TNM分期为Ⅲ、Ⅳ期、肿瘤长径≥2 cm、存在淋巴结转移是影响Bmi-1表达的危险因素,TNM分期为Ⅲ、Ⅳ期、存在淋巴结转移是影响CARD9表达的危险因素（P＜0.05）;Bmi-1、CARD9不同表达情况的1年生存率对比无明显差异（P＞0.05）;乳腺癌组织中Bmi-1、CARD9表达情况预测患者术后1年生存情况的AUC分别为0.561、0.628。结论 乳腺癌组织中Bmi-1、〖JP2〗CARD9阳性表达率较高,且其阳性表达与淋巴结转移、TNM分期相关,但Bmi-1、CARD9表达情况与术后1年生存情况无明显关联。     

Messenger RNA Expression for Growth Factors in Glomeruli from Focal Glomerular Sclerosis

Focal glomerular sclerosis was induced in rats by chronic injections of puromycin aminonucleoside (PAN) on Days 0, 27, 34, and 41 and by unilateral nephrectomy on Day 22. Rats were sacrificed on Days 0, 8, and 20 (acute phase) and on Days 48, 60, and 80 (sclerotic phase). The percentage of sclerosing glomeruli was 16.6% on Day 48 and increased significantly to 72.8% on Day 80. We examined glomerular mRNA levels for proliferating cell nuclear antigen (PCNA), platelet-derived growth factor (PDGF)-A and B chains, transforming growth factor (TGF)-β, epidermal growth factor (EGF), insulin-like growth factor (IGF)-I, and basic fibroblast growth factor (bFGF) on Days 0, 8, 20, 48, 60, and 80. Although these growth factor mRNA levels showed little change in glomeruli until Day 20, all growth factor mRNA levels increased in glomeruli during the sclerotic phase of PAN nephrosis as glomerular sclerosis progressed. On Day 80, mRNA levels for PCNA, PDGF-A and B chains, TGF-β, EGF, IGF-I, and bFGF increased 12-, 10-, 12-, 15-, 2-, 2-, and 8-fold, respectively, in the glomeruli of PAN-treated rats with marked glomerular sclerosis when compared with control rats. Unilateral nephrectomy without PAN administration did not cause glomerular sclerosis up to Day 80 and mRNA levels for PCNA, PDGF-A and -B chains, TGF-β, EGF, IGF-I, and bFGF in this group were almost the same as those in the normal sham-operated group. These data suggest that changes in growth factor mRNA levels in glomeruli may contribute to the development of PAN-induced glomerular sclerosis.     

应用数字化钛网塑形修补颅骨缺损

背景:颅骨修补的材料种类繁多,而修补效果也不尽相同,采用何种修补材料、如何将颅骨缺损修复的更加完美是当前国内外学者研究的热点.目的:针对数字化三维塑形钛网在颅骨缺损修补中的临床应用进行探索.方法:以"tissue engineering,craniocerebral trauma,CAD/CAM和titanium armor plate"为检索词,检索Medline数据库(2000/2011-06),"头颅骨损伤,数字化三维成形,钛网"为检索词,检索CNKI数据库.将近年发表的针对性强的文章纳入研究范围,同一领域的文献则选择近期发表或权威杂志的文章.排除与传统材料或方法修复头颅骨损伤和陈旧的文献.对查阅到的最新研究及临床应用有实用价值的文献详细分析并加以总结概括.结果与结论:初次检索到236篇文献,最终纳入27篇文献进行分析.传统方法修复颅骨损伤已暴露很多问题,而钛网作为近几年临床应用广泛的颅骨修补材料显示了很多优点,尤其是随着数字化技术的广泛应用,头颅CT扫描数据、三维重建模拟缺损颅骨形状和曲度、个性化设计缺损颅骨的钛网补片,制造出了与缺损处吻合良好的修补物,使患者颅骨缺损修补后头颅形状恢复解剖原貌,无论是整形外观还是相容性方面均可取得满意效果.     

淮安市市区成人体脂百分比与BMI关系初探

目的调查淮安市区部分成人体脂成分现状,了解体重指数(BMI)与体脂百分比(F%)之间的关系。方法对1700名成人进行体格测量,应用生物电阻抗技术对体重、腰臀比、F%、BMI、内脏脂肪面积分布进行描述,部分指标与上海、太原和日本东京成人指标进行比较,重新确定研究对象的肥胖诊断切点。结果随年龄增长,BMI和F%均呈现逐年增长的趋势,但两者之间存在不均衡性;淮安市成人与上海、太原、日本东京的BMI、F%分布相近,但20～30岁男性在BMI,50～60岁女性在F%均与其他地区存在统计学差异;研究对象中男性、女性内脏脂肪分布呈逐年增长趋势,而男性达到50%内脏型肥胖的情况比女性提前10年左右;重新确定肥胖的切点显示男性BMI为24.625kg/m2,女性为22.505kg/m2;对研究对象F%的预测:F%(男性)=腰臀比×233.241-BMI×0.673-年龄×0.297-156.3;R2=0.881;F%(女性)=腰臀比×43.388+BMI×0.928-年龄×0.083-25.43;R2=0.616。结论 BMI与F%对肥胖的判定存在不均衡性,BMI的肥胖诊断切点可随慢性病预防的需要适当调整。     

激活Notch信号的骨髓间充质干细胞心肌移植促血管新生的研究

目的:探讨干预Notch信号的骨髓间充质干细胞(BMSCs)移植对心肌梗死（MI）大鼠心肌中治疗性血管新生的作用及其机制。方法: 60只 Wistar大鼠通过结扎冠状动脉前降支(LAD)建立MI模型。建模后2周,进行相应处理后,随机分为激活Noth信号的BMSCs移植实验组（D组）、BMSCs移植对照组（E组）、培养液移植对照组（C组）及MI模型对照组（B组）,每组15只大鼠。另选取10只大鼠为假手术对照组（A组）。4周后,观察细胞生长及增殖情况,运用ELISA法血浆中VEGF浓度,免疫组织化学法及Western blot法测定缺血心肌中血管内皮细胞生长因子（VEGF）蛋白的表达及缺血区心肌中毛细血管密度的改变。结果: BMSCs在梗死区中可增殖分化为内皮细胞,与B组、C组及A组相比,D组、E组缺血心肌中VEGF蛋白的表达增多及毛细血管密度均明显增加(P<0.01),D组较E组更明显(P<0.05)。结论: Notch信号可促进心肌梗死区BMSCs向内皮细胞分化, 并通过自分泌和旁分泌的方式增加缺血心肌中VEGF的表达,从而促进缺血心肌中毛细血管新生。     

培美曲塞或多西他赛联合顺铂治疗晚期NSCLC临床对照研究

目的:对比培美曲塞与多西他赛联合顺铂治疗晚期非小细胞肺癌(NSCLC)的近期疗效和毒副作用.方法:将48例NSCLC患者随机分为观察组(n=25)和对照组(n=23).观察组给予培美曲塞联合顺铂治疗,对照组给予多西他赛联合顺铂治疗,21 d为1个周期,2个周期后评价疗效,每个周期进行1次毒副作用评价.结果:观察组与对照组客观有效率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)分别为36.0％ (9/25)和30.4％(7/23)、84.0％ (21/25)和84.0％(18/23)、9.3和8.9个月,两组比较差异无统计学意义,x2值分别为0.167、0.159和1.576,P值分别为0.683、0.611和0.209.但观察组中性粒细胞减少及脱发的发生率显著低于对照组,分别为28.0％和56.5％、28.0％和60.9％,差异有统计学意义,x2值分别为4.009和5.259,P值分别为0.045和0.022.结论:培美曲塞联合顺铂与多西他赛联合顺铂的近期疗效相当,但前者毒副作用较后者轻,提高了化疗耐受性,适合临床进一步推广应用.