脂肪间充质干细胞外泌体改善骨质疏松症的研究进展

骨质疏松症是由于骨吸收和骨形成之间的动态平衡被打破,从而导致骨质流失,骨密度降低以及骨骼微细结构遭到破坏所形成的一种慢性骨代谢疾病。近年来,越来越多的研究证明,外泌体疗法将成为骨质疏松治疗的一个重要方向。外泌体是参与细胞间通信的脂质双分子层细胞外囊泡,可通过传递脂质、蛋白质、核酸的方式调节受体细胞的生物活性。其来源十分广泛,可存在于各种生物体液中,也由多种动物细胞分泌,如间充质干细胞等。脂肪来源的间充质干细胞作为细胞治疗领域最具前途的多功能工具之一,不仅具有分离的简便性和微创性,还可通过分化成不同的细胞谱系参与骨质修复、血管生成以及神经再生等生物环节,并利用旁分泌信号传导释放外泌体,调控相关骨细胞的分化、增殖和凋亡,影响骨组织微环境,从而预防和改善骨质疏松。该文将从脂肪间充质干细胞衍生外泌体在骨质疏松方面的应用及其作用机制进行综述,为未来脂肪间充质干细胞外泌体应用于骨质疏松的临床治疗提供理论依据。     

Neutralizing antibodies to gB based CMV vaccine requires full length antigen but reduced virus neutralization on non-fibroblast cells limits vaccine efficacy in the guinea pig model

Cytomegalovirus is a leading cause of congenital disease and a vaccine is a high priority. The viral gB glycoprotein is essential for infection on all cell types. The guinea pig is the only small animal model for congenital CMV (cCMV), but requires guinea pig cytomegalovirus (GPCMV). Various GPCMV gB vaccine strategies have been investigated but not with a full length protein. Previous GPCMV gB vaccines have failed to fully protect against cCMV, with approximately 50% efficacy. In an effort to define the basis of GPCMV gB based vaccine failure, we evaluated recombinant defective Ad vectors encoding GPCMV gB full length (gBwt), or truncated protein lacking transmembrane domain (gBTMD). Both candidate vaccines evoked high anti-gB titers and neutralized virus infection on fibroblast cells but had varying weaker results on non-fibroblasts (renal epithelial and placental trophoblasts). Non-fibroblast cells are dependent upon the viral pentamer complex (PC) for endocytic pathway cell entry. In contrast, fibroblasts cells that express the viral receptor platelet derived growth factor receptor alpha (PDGFRA) to enable entry by direct cell fusion independent of the PC. Anti-gBwt sera was approximately 2-fold (renal epithelial) to 3-fold (fibroblasts) more effective at neutralizing virus compared to anti-gBTMD sera. Both gB vaccines were weakest against virus neutralization on trophoblasts. Knockout of PDGFRA cell receptor on fibroblast cells (GPKO) rendered virus dependent upon the PC pathway for cell entry and anti-gB GPCMV NA₅₀ was more similar to epithelial cells. In a gBwt vaccine protection study, vaccination of animals significantly reduced, but did not prevent dissemination of wild type GPCMV challenge virus to target organs. Depletion of complement in vivo had limited impact on vaccine efficacy. Overall, a full length gB antigen has the potential to improve neutralizing antibody titer but fails to fully prevent virus dissemination and likely congenital infection.     

宫颈小细胞神经内分泌癌伴多发转移18F-FDG PET/CT显像一例

笔者报道了一例以头痛7 d伴右颅顶部质硬包块为首发表现的宫颈小细胞癌病例。颅脑CT平扫示右顶叶高密度结节伴周围低密度水肿带、邻近颅骨骨质破坏,考虑颅内肿瘤性病变。颅脑MRI示右顶叶稍长T1、T2信号结节伴水肿带,增强扫描后病灶明显强化。18F-FDG PET/CT全身显像示宫颈软组织团块伴高代谢、双侧盆腔淋巴结高代谢、全身多处骨骼包括右颅顶部病灶骨质破坏伴高代谢。宫颈活检病理结果确诊为小细胞癌。文献复习加深了对宫颈小细胞癌的认识,其发病率极低,临床表现缺乏特异性,早期不易被发现,该病侵袭性强,易发生淋巴结和血行转移,预后较差。18F-FDG PET/CT对宫颈小细胞癌的原发灶、淋巴结转移、骨转移及其他较隐匿部位转移病灶的探测灵敏度较高,在该病的临床管理中具有较好的应用价值。     

Frey综合征防治研究现状的文献计量学分析

 目的 分析Frey综合征防治研究的现状。方法 采用文献计量学分析的方法。检索Web of Science数据库中自建库至2017年9月8日收录的有关Frey综合征防治研究的文献,进行文献筛选后采用Prism Graphpad 5.0软件和VOSviewer1.6.4软件分析相关研究的发表年份、机构、文献类型、期刊、引用情况及合作网络等。结果 共纳入文献602篇。Frey综合征相关研究的发文量近年来呈逐年上升的趋势,其文献类型以论著为主(75.25%)。美国在该领域发表的文献最多(18.60%),在该领域发文量靠前的机构多数为西方国家,中国的四川大学在该领域发表的文献也较多(1.16%)。Frey综合征高引用文献多与腮腺手术和药物及手术治疗Frey综合征相关。Frey综合征相关研究的相关作者中存在一定的合著关系,但不是很密切。结论 本文提示Frey综合征防治领域是有价值的研究方向,仍需要在其病因、防治方面开展高质量的研究,特别是基于我国人群的研究。     

Identification of functional domains required for HearNPV P10 filament formation

Baculovirus encoded P10 form fibrillar structures in infected cells. We have tried to identify the functional domains for the P10 filament formation by green fluorescence protein (GFP) tag. The p10 gene of Helicoverpa armigera single nucleocapsid nucleopolyhedrovirus (HearNPV) was the subject of these studies. Different lengths of HearNPV p10 gene were constructed with GFP fused in frame to the C-terminus. The constructs were transfected into insect and mammalian cells and observed by confocal microscopy. The results indicated that the first N-terminal 66 amino acids, which form the complete coiled-coil domain, were necessary for the aggregation and formation of filament structures of HearNPV P10. The proline-rich region and the C-terminal positively charged amino acids were not necessary for the formation of fibrillar structure but had some impact on the shape of the fibrillar structures. No other baculoviral proteins were needed for the formation of P10 filament structures in transfected cells.     

以膝下外血管为蒂的成人腓骨上段移植术

在24侧灌注红色乳胶的成人下肢标本和2侧新鲜截肢标本上,对腓骨上段的血供来源进行了应用解剖学研究.我们设计了以膝下外血管为蒂的成人腓骨上段移植术,已成功应用于临床.本文详细介绍了手术操作方法及其注意事项.     

Inhibition of viral suppressor of RNAi proteins by designer peptides protects from enteroviral infection in vivo

1. Download : Download high-res image (157KB)
2. Download : Download full-size image

     

重度烧伤患者并发ARDS的临床分析

目的分析重度烧伤患者并发ARDS的病因，治疗及预后。方法总结2006年3月至2008年3月武汉市第三医院烧伤重症监护室（BICU）收治的201例重度烧伤患者中19例并发ARDS的临床资料，包括致伤因素，入院前后的治疗措施及预后。所有病例入院后均采取补液抗休克、抗感染及维护重要脏器功能及营养支持治疗，同时监测中心静脉压、呼吸频率、SpO2、PaO2／FiO2、血气分析和X线胸片，一经ARDS诊断成立及早应用呼吸机治疗，我们采用保护性肺通气策略，呼吸模式采用SIMV＋PEEP模式。结果重度烧伤患者201例中并发ARDS的病例19例，11例存活，死亡8例。其发病率为9．5％，病死率却高达54％。结论重度烧伤患者并发ARDS预后差，为重度烧伤患者的主要死因，应该早预防早治疗。     

腓血管为蒂的胫腓骨远段后面骨膜瓣移位术

目的：为胫骨中、下段骨不连合并胫前区软组织条件极差者提供一种新的疗法。方法：应用经小腿后路以腓血管为蒂的胫腓骨远段后面骨膜瓣移位予以修复。结果：临床应用６例，效果满意。结论：本骨膜瓣移位术具有操作简便、手术安全、疗效可靠和易于推广等优点     

原发性高血压合并脑梗塞患者血管紧张素Ⅱ-1型受体基因多态性的研究

目的 探讨血管紧张素Ⅱ－1型受体（angiotensin Ⅱ type 1 receptor,AT1R)基因A1166／C多态性与原发性高血压及合并脑梗塞的关系。方法 应用聚合酶链反应－限制性片段长度多态性方法检测70名健康人、72例原发性高血压无合并症患者及70例原发性高血压合并脑梗塞患者的AT1R基因型；生化技术测定血脂水平。结果 原发性高血压无合并症组及合并脑梗塞组的C等位基因频率分别为11．1％和10．7％，均显著高于正常对照组的3．6％（P＜0．05）；而两者之间的C等位基因频率差异无显著性（P＞0．05）；牟发性高血压患者血浆脂蛋白a水平与AT1R基因正相关。结论 提示AT1R基因可能是原发性高血压的重要遗传因素，但与高血压病患者是否易患脑梗塞无关。