不同剂量寻骨风致大鼠慢性肾间质纤维化初探

目的:观察马兜铃科中药寻骨风水煎剂引起大鼠慢性肾间质纤维化与剂量的关系并探讨其发病机制。方法:将雌性Wister大鼠随机分5组:(1)正常对照组(NC组,n=8):给予蒸馏水2 ml/d灌胃;(2)马兜铃酸对照组(AA组,n=16):给予马兜铃酸制剂5 mg.kg-1.d-1腹腔注射;(3)寻骨风高剂量组(XGFH组,n=16):给予寻骨风水煎液27 g.kg-1.d-1灌胃;(4)寻骨风中剂量组(XGFM组,n=16):给予寻骨风水煎液13.5 g.kg-1.d-1灌胃;(5)寻骨风低剂量组(XGFL组,n=16):给予寻骨风水煎液2.7 g.kg-1.d-1灌胃。各组在45 d、90 d时分别处死8只大鼠,处死前测体重、采血、留尿,做肾功能,尿潜血、MA/Cr、TF/Cr及尿NAG/Cr检查,处死后测肾重,留取肾组织行HE、PAS染色,做LN、FN、TGF-β1、MMP-2、TIMP-2免疫组化检查。结果:90 d后AA组、XGFH组、XGFM组大鼠体重和肾重较NC组均有下降(P<0.01或P<0.05),AA组、XGFH组、XGFM组MA/Cr、TF/Cr、NAG/Cr、Scr和BUN明显高于NC组(P<0.05或P<0.01)。光镜检查XGFH组用药45 d后,出现肾小管上皮细胞肿胀,管腔缩小,小管间质增生;AA组、XGFM组肾小管上皮细胞发生空泡变性;XGFH组用药90 d后,肾小管上皮细胞坏死,肾小管萎缩,肾间质出现灶性纤维化。AA组、XGFM组肾脏近曲小管上皮细胞明显肿胀,管腔变小,小管间质增生,部分发生纤维化;XGFL组肾组织未见明显损害。免疫组化显示AA组、XGFH组、XGFM组肾小管和间质上MMP-2的表达下调,而TGF-β1、TIMP-2、LN、FN的阳性表达较NC组明显上调(P<0.05)。结论:XGFH组、XGFM组和AA组均导致了实验大鼠肾小管间质的损害,而且病变的程度与用药剂量相关,XGFH组肾小管间质损害程度最严重,90 d内造成了大鼠肾间质纤维化,同时我们证实了慢性马兜铃酸肾病大鼠肾间质纤维化的发生同致纤维化因子TGF-β1和抑制细胞外基质降解因子TIMP-2的过度表达导致FN、LN胶原纤维在肾间质的过度增殖有关。     

乳腺癌化疗后中性粒细胞减少性发热的临床观察

目的 探讨乳腺癌化疗后中性粒细胞减少性发热(febrile neutropenia,FN)的发生率及影响因素.方法 回顾性分析2012年9月至2014年3月191例接受新辅助、辅助及姑息治疗的乳腺癌患者的临床资料,分析FN的发生率,采用logistic回归分析发生FN的危险因素.结果 191患者共有52例发生FN,发生率为27.22％.TA方案发生率最高,为46.80％ (22/47),其次为AC方案,为21.78％(22/101).Logistic回归分析显示化疗方案(OR=0.768,95％CI:0.608～0.974,P=0.029)及Hb(OR=0.962,95％CI:0.933～0.993,P=0.014)与FN的发生有关.结论 化疗方案是及化疗前Hb水平是FN的影响因素,TA及AC方案是高度危险引起FN方案.     

碱性成纤维细胞生长因子对受损面神经元凋亡及Bcl-2、Bax、Caspase-3蛋白表达影响研究

目的: 探讨碱性成纤维细胞生长因子对面神经切断端端吻合后面神经元凋亡及Bcl-2、Bax、Caspase-3蛋白表达的影响.方法 应用SD大鼠面神经切断端端吻合伤模型,正常侧做自身对照,实验组腹腔注射给予碱性成纤维细胞生长因子,单纯生理盐水组给予生理盐水.分别在术后1、7、15、30d,免疫组化染色检测面神经元Bcl-2、Bax、Caspase-3蛋白表达;原位末端标记(TUNEL)法检测神经元胞体的凋亡;取术侧新生面神经行透射电镜观察;应用随机对照t检验分析数据.结果 (1)面神经元凋亡:实验组面神经元凋亡的发生比单纯生理盐水组少,二者差异有统计学意义(P＜0.01).(2)Bcl-2蛋白表达的改变:实验组Bcl-2蛋白表达逐渐上升,单纯生理盐水组Bcl-2蛋白表达逐渐下降,两组间差异有统计学意义(P＜0.01).(3)Bax蛋白表达的改变:Bax蛋白表达在单纯生理盐水组中随时间的增长而增加,在15d达到高峰然后下降.实验组随着时间增加,Bax蛋白的表达快速下降,在损伤后15d达到最低点,以后表达有所增加,但在损伤后30d表达仍未恢复正常水平.实验组和单纯生理盐水组各时段表达差异有统计学意义(P＜0.05).(4)Caspase-3蛋白表达的改变:实验组Caspase-3蛋白表达逐渐下降,而单纯生理盐水组Caspase-3蛋白表达逐渐上升,二者差异有统计学意义(P＜0.01). (5)面神经透射电镜观察:实验组再生神经纤维数目、髓鞘厚度明显优于单纯生理盐水组.结论 碱性成纤维细胞生长因子可以使面神经损伤后的神经元Bcl-2蛋白表达增多,Bax 、Caspase-3蛋白表达减少,使面神经元凋亡发生减少,这可能是碱性成纤维细胞生长因子对面神经元保护作用的机制之一.     

降钙素原在乳腺癌化疗中的诊断价值分析及乳腺癌的感染特点探讨

目的分析乳腺癌化疗后粒细胞减少伴发热(FN)合并感染的临床特点及降钙素原在FN合并感染患者中的诊断价值。方法选取2015年10月~2017年8月乳腺癌化疗后粒细胞减少伴发热(FN)合并感染的患者20例为观察组,另外选择非感染患者20例为对照组,分析乳腺癌化疗后粒细胞减少伴发热(FN)合并感染的临床特点,分别测定两组降钙素原的水平并进行比较。结果分析乳腺癌化疗后粒细胞减少伴发热(FN)合并感染的部位包括呼吸道、泌尿道和消化道,导致感染的病原菌包括大肠埃希菌、金黄色葡萄球菌和肺炎克雷伯杆菌。观察组的降钙素原水平明显高于对照组,差异有统计学的意义(P0.05)。结论乳腺癌化疗后粒细胞减少伴发热(FN)合并感染影响化疗的效果,需要进行预防管理,降钙素原可用于乳腺癌化疗后粒细胞减少伴发热(FN)合并感染的诊断。     

螺旋藻对阿霉素肾硬化大鼠肾脏的保护作用

目的研究螺旋藻对阿霉素肾硬化大鼠肾脏的保护作用及相关机制。方法将32只SD大鼠随机分为4组：假手术组（S组）,阿霉素肾硬化对照组（M组）,螺旋藻组（SP组）,贝那普利治疗组（B组）。8周后观察各组大鼠24 h尿蛋白定量、血尿素氮（BUN）、肌酐（Scr）及肾脏病理改变,免疫组化观察肾脏组织纤连蛋白（FN）、IV型胶原（Col IV）、转化生长因子β1（TGF-β1）的表达。RT-PCR测定肾皮质TGF-β1mRNA的表达。结果螺旋藻能减少尿蛋白、降低BUN和Scr,减轻基质增生和肾小球硬化,且能减少FN、Col IV、TGF-β1的表达。下调肾皮质TGF-β1mRNA的表达。结论螺旋藻能减轻阿霉素肾硬化大鼠肾脏损害,对肾脏有保护作用。     

NSF干预5／6肾切除大鼠模型肾纤维化的实验研究

目的：研究NSF对5／6肾切除大鼠模型肾纤维化干预作用及机制。方法：取SD大鼠72只,随机分为假手术组、模型组、阳性对照组、NSF组,通过对大鼠实施5／6肾切除手术建立大鼠慢性肾功衰模型;治疗组自二次术后第31d起给药,连续30d。检测大鼠血清生化指标Urea、Crea,残余肾组织病理情况及纤维化相关指标：残余肾组织中纤维连结蛋白（FN）、转化生长因子Bl（TGF-β）,血清肿瘤坏死因子α（TNF-α）的变化。结果：NSF组与模型组比较：Urea、Crea明显降低（P〈0．05）,肾脏病理改变较轻,肾组织FN和TGF-β的表达明显降低（P〈0．05）,血清TNF-α表达也明显降低（P〈0．05）。结论：NSF可能通过下调TNF-α的表达,降低肾脏中纤维化调节因子TGF-β含量,从而抑制FN增生,控制或延缓肾纤维化进展,发挥对慢性肾功能衰竭的治疗作用。     

Use of Magnetic Resonance Imaging for N-Staging in Patients with Non-Small Cell Lung Cancer. A Systematic Review

Introduction

The aim of this study is to assess the diagnostic value of the magnetic resonance imaging (MRI) in differentiating metastasic from non-metastatic lymph nodes in NSCLC patients compared with computed tomography (CT) and fluorodeoxyglucose (FDG) - positron emission tomography (PET) or both combined.

猪血纤维连接蛋白促进小鼠Ⅲ度烧伤愈合

目的 研究相同浓度下不同纯度纤维连接蛋白对小鼠Ⅲ度烧伤创面愈合的效果及差异.方法 制备小鼠背部Ⅲ度烧伤模型,模型小鼠随机分5组:纤维连接蛋白高纯度组(85％)、中纯度组(75％)、低纯度组(65％)、贝复济阳性对照组以及空白对照组,观察各组创面愈合时间,脱痂时间及病理学变化.结果 不同纯度的纤维连接蛋白与空白对照组比较均能缩短小鼠皮肤创面愈合的时间及脱痂时间,并能显著改善创面皮肤的病理形态.结论 纤维连接蛋白对小鼠Ⅲ度烧伤愈合有显著促进作用,中纯度组可能具有潜在应用价值.     

A molecular study of synovial chondromatosis

Synovial chondromatosis (SC) is a rare benign cartilaginous neoplasm in which recurrent fibronectin 1 (FN1) and activin receptor 2A (ACVR2A) gene rearrangements have been recently reported. Triggered by a case of malignant transformation in SC (synovial chondrosarcoma) showing a novel KMT2A‐BCOR gene fusion by targeted RNA sequencing, we sought to evaluate the molecular abnormalities in a cohort of 27 SC cases using a combined methodology of fluorescence in situ hybridization (FISH) and/or targeted RNA sequencing. Results showed that FN1 and /or ACVR2A gene rearrangements were noted in 18 cases (67%), with an FN1‐ACVR2A fusion being confirmed in 15 (56%) cases. Two cases showed only FN1 gene rearrangement, without other abnormalities. A novel FN1‐NFATc2 gene fusion was noted in one case by RNA sequencing. The remaining nine cases showed no abnormalities in FN1 and ACVR2A genes. No additional cases showed BCOR gene alterations. In conclusion, this study confirms that FN1‐ACVR2A fusion is the leading pathogenetic event in SC, at even higher frequency than previously reported. FISH methodology emerges as an appropriate tool in the identification of FN1 and ACVR2A gene abnormalities, which can be used in challenging cases. Further studies are needed to determine the recurrent potential of BCOR abnormalities in this disease.     

Universal neonatal hearing screening: the Siena (Italy) experience on 19,700 newborns

BACKGROUND: Hearing loss (HL) is likely to be the most common congenital abnormality in humans, with a reported prevalence of 1 to 3 per 1000 live births. Early detection and intervention is critical to prevent the adverse consequences of a delayed diagnosis on speech, language and cognitive development. As 33-50% of all congenital HLs cannot be detected in a selective hearing risk, use of universal neonatal hearing screening (UNHS) programs is expanding. AIMS: We tested the value of a UNHS protocol, based on a two-stage strategy of Transient Evoked Otoacoustic Emissions (TEOAEs) in all infants, followed by diagnostic auditory brainstem response (ABR) testing in those infants who did not meet TEOAE pass criteria and those infants at high risk for hearing loss. METHODS: TEOAES (292 DP Echoport OAE Analyzer) served as the initial screen, followed by diagnostic ABR (Amplaid MK12) in newborns that did not meet pass criteria for TEOAEs. Additionally, all infants at high audiologic risk according to the Joint Committee on Infant Hearing received a diagnostic ABR evaluation. Of 21,125 total live births, 19,700 were tested (April 1, 1998-July 31, 2006). Accuracy of the UNHS strategy in predicting congenital HL was evaluated by calculating sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: Prevalence for all HLs in the neonatal period was 1.78/1000 l.b. (35/19,700), with bilateral HL in 1.42/1000 l.b. (28/19,700) [low risk rate: 0.43/1000 l.b. (8/18,356); high risk infants rate: 14.88/1000 l.b. (20/1344)]. All the HL infants were diagnosed <3 and received intervention <6 months age. ROC curves results showed 100% sensitivity (95% C.I.: 89.0-100) and 99.3% specificity (95% C.I.: 99.2-99.4) of the two-stage strategy in detecting congenital HLs [area under the ROC curve: 0.997 (95% C.I.: 0.995-0.997)]. CONCLUSIONS: (1) The epidemiology of congenital HLs widely justifies UNHS; (2) a two-stage TEOAE and diagnostic ABR screening for congenital HL is feasible, minimally invasive and accurate in the early detection of congenital HL; and (3) a congenital HL screening strategy based exclusively on the use of TEOAEs should always consider the possibility of false negative cases.