Treatment of severe subglottic laryngotracheal stenosis using hyoid graft with sternohyoid muscle flap]

OBJECTIVE: To evaluate the possibility and reliability of the hyoid-sternohyoid graft transfer in the correction of server subglottic laryngotracheal stenosis, and delineate the operation skills and clinical results. METHODS: Seven patients with severe subglottic stenosis underwent laryngotracheal reconstruction using the hyoid grafts with sternohyoid muscle flaps (HG-SHMF). Five of these patients had traumatic subglottic stenosis, one with scar tissue of unknown etiology arising in the subglottic region, another with tracheal narrowing caused by inhalation of hydrochloric acid. RESULTS: All seven patients were successfully decannulated with moderate good voice. The average time from reconstruction to decannulation was 15.4 months. The stent was endoscopically removed with a range of 3 to 22 months; the mean time required for stenting was 9.6 months. Two patients who received additional salvage reconstruction procedures because of graft or stent displacement were extubated with improved voices and satisfactory airway. CONCLUSIONS: The HG-SHMF transfer was a single-stage reconstruction, relatively simple procedure that can restore an adequate airway and a good voice. Patients undergoing laryngotracheal reconstruction with HG-SHMF must have regular, long-term follow-up since graft displacement and recurrent granulation tissue or scar reformation can cause restenosis after an initially successful surgery. This procedure should be used in a large number of patients to further test its reliability.     

北方汉族人群维生素D受体基因Bsm I位点多态性与前列腺癌易感性的相关性分析

目的 :研究低发病的中国汉族人群维生素D受体基因 (VDRG)BsmⅠ 位点单核苷酸多态性 (SNP)与前列腺癌的关系 ,探讨不同种族前列腺癌发病的基因差异。　方法 :收集中国北方地区汉族人群 10 3例前列腺癌病人及10 6例健康对照者外周血标本 ,应用变性高效液相色谱 (DHPLC)检测VDRG第 8内含子BsmⅠ多态位点 ,并对该位点SNP分布进行分析。　结果 :BsmⅠ 多态位点bb、Bb、BB基因型和等位基因在北方地区汉族前列腺癌病人及对照者中的分布频率差异无显著性 (P >0 .0 5 ) ,基因型分布频率分别为 92 .2 3%、7.77%、0和 94.34 %、5 .6 6 %、0 ;等位基因B、b分别为 3.88%、96 .12 %和 2 .91%、97.0 9%,而与高发病人群的分布相比有显著不同。　结论 :VDRGBsmⅠ多态性在低发病的中国汉族人群与前列腺癌无相关 ,其分布与高发病人群有明显差异 ,提示VDRGBsmⅠ多态性可能是前列腺癌发病种族差异的原因之一。     

嘌呤霉素肾病大鼠肾小球中nephrin、Podocin和α-actinin与蛋白尿的关系

目的动态观察肾小球足细胞及裂孔隔膜分子nephrin,podocin和α-actinin在嘌呤霉素(puromycinaminonucleoside,PAN)大鼠肾病模型肾组织中表达的时相变化,探讨这些分子间及这些分子与蛋白尿发生的关系。方法用间接免疫荧光染色及实时定量PCR方法,检测PAN注射后12h、1d、36h、2d、5d、10d、15d及20d大鼠肾小球中nephrin,podocin和α-actinin分子分布和表达。结果(1)PAN注射后1d、2d及5d时,尿蛋白量无明显改变;10d时尿蛋白量明显增加(P=0.02);20d时恢复至对照组水平。(2)对照组大鼠肾小球中nephrin和podocin沿肾小球毛细血管袢呈连续线状分布,α-actinin沿肾小球毛细血管袢呈点线状分布。PAN注射1d后,nephrin和podocin的分布即发生改变,表现为断续、非线性分布。nephrin和podocin的分布改变随着尿蛋白的增多而加重,尿蛋白恢复时也逐渐恢复。20d时,α-actinin沿肾小球毛细血管袢呈连续线性分布。(3)免疫荧光定量分析结果表明,在PAN注射后36h(P=0.04)、2d(P=0.03)及5d(P=0.04)时,肾小球中podocin的免疫荧光染色强度明显下降,于第10d降至最低(P=0.006);自15d时逐渐恢复(P=0.007),20d后podocin的免疫荧光强度恢复至对照组水平。nephrin的免疫荧光染色强度在PAN注射第5天后出现下降(P=0.002),持续下降至第10天(P=     

大肠癌Lovo细胞E-Cadherin,N-Cadherin的表达及化学治疗药物对其表达的影响

目的：研究大肠癌Lovo细胞上皮钙粘附素(E-Cadherin)，神经钙粘附素(N-Cadherin)的表达及常用化学治疗药物对其表达的影响。方法：应用逆转录聚合酶链反应(RT-PCR)法检测大肠癌Lovo细胞E-Cad-herin，N-Cadherin的表达，并通过几种不同的化疗药物(顺铂、吡柔比星、丝裂霉素、5-FU)不同浓度和时间作用后，对E-Cadherin，N-Cadherin表达的影响。结果：不同化疗药物对大肠癌Lovo细胞N=Cadherin表达无影响，高浓度顺铂和高浓度吡柔比星二组出现-Cadherin表达，其它各组未见表达。结论：大肠癌常用的化疗药物无论低浓度持续用药，还是高浓度短时间用药，对大肠癌Lovo细胞N-Cadherin的表达无抑制作用，说明上述药物不能通过抑制N—Cadherin的表达，而起到抗癌作用。高浓度顺铂和吡柔比星二组显示E-Cadherin的表达，表现出抑癌的作用，从而提示在大肠癌化疗时，顺铂和吡柔比星更适合于高浓度短时间应用。     

Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

CACNA1H基因G773D突变对钙通道功能的影响

目的研究儿童失神癫痫（childhood absence epilepsy，CAE）患儿CACNA1H基因G773D突变对钙通道功能的影响。方法用定点突变重叠延伸聚合酶链反应（polymerase chain reaction，PCR）方法构建G773D突变体，脂质体法将突变体和野生型人Cav3．2a cDNA分别转染HEK-293细胞，获得稳定表达细胞株，全细胞膜片钳法研究其电生理变化。结果突变体和野生型细胞钙通道激活和失活动力学差异无统计学意义，但突变体G773D钙电流密度明显高于野生型。结论CACNA1H基因G773D突变可使其编码通道电流增加，并可能引起神经元兴奋性增加。     

Animal models of asthma: Innovative methods of lung research and new pharmacological targets

Allergic diseases like bronchial asthma are increasing in societies with western lifestyle. In the last years substantial progress was made in the understanding of the underlying mechanisms and explanations like the hygiene hypothesis were developed. However the exact mechanisms of the physiological and immunological events in the lung leading to bronchial asthma are still not fully understood. Therefore, animal models of asthma have been established and improved to study the complex cellular interactions in vivo. Since mice became the most frequently used animal species the methods for detecting lung physiology, e.g. lung function measurements were adapted to the small size of the murine lung. Laser-dissection and precision cut lung slices have become common techniques to get a view into distinct lung compartments and cells. In addition genomic and proteomic approaches are now used widely. On the other hand a major conclusion of the workshop stated that more than one species is necessary in research and for pharmacological screening in asthma and COPD. The resulting new understanding in the mechanisms of asthma pathogenesis has lead to a rapid identification of novel pharmaceutical targets for treatment of the disease.     

Connexin26 gene ( GJB2): prevalence of mutations in the Chinese population

The connexin26 gene ( GJB2) has been shown to be responsible for DFNB1 and DFNA3 (Autosomal Recessive Hereditary Nonsyndromic Deafness Locus 1 and Autosomal Dominant Hereditary Nonsyndromic Deafness Locus 3). Two hundred ten independently ascertained Chinese probands with nonsyndromic hearing loss (NSHL) were evaluated for mutations in GJB2, including 43 probands from families with more than one sib with NSHL, likely indicating dominant inheritance, and sporadic cases of NSHL, compatible with recessive inheritance. Of the 210 probands, 43 (20%) were homozygous or heterozygous for mutations in GJB2. Four different mutations were identified: 35delG, 109G-A, 235delC, and 299-300delAT. It was confirmed that GJB2 mutations are an important cause of hearing loss in this population. Of these four mutations, 235delC was the most prevalent at 93%; yet the 35delG mutation, which is the most common GJB2 mutation in Caucasian subjects (Europeans and Americans), was found in low frequency in the present study. It appears from our limited data and reports from other East Asians that 235delC is the most prevalent GJB2 mutation in these populations. GJB2 mutations are consistent with ethnic predilections.     

Distribution of genotypes and antibiotic resistance genes among invasive Streptococcus agalactiae (group B streptococcus) isolates from Australasian patients belonging to different age groups.

Serotype distribution and antibiotic resistance (AR) among group B streptococci (GBS) affect GBS disease prevention strategies, but vary among patient groups. A multiplex PCR-based reverse line blot (mPCR/RLB) hybridisation assay was used to compare the distributions of GBS serotypes, serotype III subtypes and AR-associated genes among 666 invasive isolates from 663 patients, divided into five age groups: infants, early-onset (EO; 0-6 days) and late-onset (LO; 7-90 days); children (aged 3 months to 14 years); women of childbearing age (WCBA; aged 15-45 years); and other adults (males aged >15 years; females aged >45 years). Serotypes Ia and V and serosubtype III-1 accounted for 60% of infections. Serosubtype III-2, which corresponds to a virulent clone belonging to sequence type (ST)17, was relatively uncommon overall (7%), but was associated strongly with LO infant infections, in which it was significantly more common than in adult infections (25/104 (24%) vs. 9/392 (2%), p <0.0001) or in EO infections (25/104 (24%) vs. 14/155 (9%), p <0.005). Erythromycin resistance genes were found in 8% of all isolates (ermB 3%, ermA 2.5% and mefA/E 2%), in 11-15% of isolates of serotypes II and V and subtype III-1, but in none of the isolates of serosubtype III-2 (III-2, 0/49 vs. all others, 54/618 (9%), p <0.04). In summary, the virulent serosubtype III-2 was associated strongly with LO infant GBS infection, but was less likely than other serotypes or serosubtype III-1 to carry AR genes.     

金属硫蛋白抑制同型半胱氨酸诱导的大鼠血管平滑肌细胞增殖

目的:研究金属硫蛋白(MT)对同型半胱氨酸(Hcy)诱导大鼠血管平滑肌细胞(vascularsmoothmusclecells,VSMCs)增殖的影响及其作用机制。方法:以[³H]-TdR掺入法测定VSMCs增殖程度,免疫沉淀法测定VSMCs内丝裂素活化蛋白激酶(MAPK)活性,[¹⁰⁹Cd]-血红蛋白饱和法测定MT含量,硫代巴比妥酸法测定丙二醛(MDA)含量,NADH氧化法测定乳酸脱氢酶(LDH)漏出量。结果:Hcy(10^-6-10^-4mmol/L)呈浓度依赖性的刺激培养大鼠VSMCs[³H]-TdR掺入,0.1mmol/LHcy刺激[³H]-TdR掺入比对照组高4.2倍(P＜0.01)。Hcy亦呈浓度依赖性地激活VSMCsMAPK活性、增加细胞MDA的生成和LDH的漏出(P均<0.01)。单独MT孵育,对VSMCs的上述指标均无明显影响(P＞0.05)。但MT(10^-6-10^-4mol/L)呈浓度依赖性抑制100μmol/LHcy的促增殖效应(r=0.98,P＜0.01)。MT显著抑制Hcy对VSMCs的MAPK活性、MDA生成和LDH漏出的激活作用(均P＜0.01)。以0.5mmol/LZnCl₂预孵育6h后,VSMCsMT含量比非诱导细胞高5.7倍(P＜0.01),这种内源性MT高表达的细胞,显著抵抗Hcy刺激的-TdR掺入和MAPK激活;抑制Hcy的促细胞MDA生成与LDH漏出效应(均P＜0.01)。结论:MT能有效抑制Hcy促大鼠VMSCs增殖作用,其机制可能与MT拮抗Hcy对MAPK的激活和其抗氧化作用有关。