胆红素对新生儿脐血单核细胞髓样分化蛋白-2、肿瘤坏死因子受体相关因子6mRNA表达的影响

目的观察脐血单核细胞(CBMC)经不同水平胆红素孵育后髓样分化蛋白2(MD-2)、TNF受体相关因子6(TRAF6)mRNA表达的变化。方法采集10例健康足月新生儿的脐血,经纤维蛋白结合法分离得CBMC,将其加入含不同水平胆红素(0μmol.L-1、17.1μmol.L-1、42.8μmol.L-1、102.6μmol.L-1、153.9μmol.L-1、220.6μmol.L-1和307.8μmol.L-1)的牛血清清蛋白溶液中孵育1 h,再加入脂多糖(LPS)刺激30 min。收集CBMC,采用反转录-PCR方法测定其MD-2、TRAF6 mRNA的表达水平。结果 1.LPS单独作用对CMBC MD-2 mRNA和TRAF6 mRNA表达水平无明显影响,低水平胆红素(17.1μmol.L-1、42.8μmol.L-1)单独作用对CBMC MD-2 mRNA和TRAF6 mRNA表达水平无明显影响。2.先经不同水平胆红素孵育,再接受LPS刺激,胆红素有抑制细胞MD-2 mRNA表达的趋势,随着胆红素水平的升高,抑制趋势越明显;先经不同水平胆红素孵育,再接受LPS刺激,低水平胆红素促进细胞TRAF6 mRNA的表达,当胆红素≥102.6μmol.L-1时,抑制TRAF6 mRNA表达,胆红素水平越高,抑制作用越明显。在相同胆红素水平作用下,随着MD-2 mRNA表达水平的降低,TRAF6 mRNA表达水平随之降低。结论低水平胆红素对CBMC MD-2 mRNA的表达无明显影响,对TRAF6 mRNA的表达有促进作用。高水平胆红素对二者的表达均有抑制作用,随着胆红素水平升高,抑制作用越来越明显。高胆红素血症患儿免疫功能低下可能与高浓度胆红素对免疫细胞的抑制作用有关。     

磁共振成像(T2*)检测重型β-地中海贫血患儿心脏、肝脏铁负荷及左心室射血分数的研究

目的观察我院重型β-地中海贫血(β-TM)患儿血清铁蛋白(SF)和体内铁沉积状况及对心脏功能的影响。方法检测我院28例重型β-TM患儿SF水平,并由我院放射科运用磁共振成像T2*(MRI T2*)技术检测心脏及肝脏铁沉积状况及左室射血分数(LVEF)。结果本组28例患儿中男16例,女12例,中位年龄11.2岁(7岁1个月~16岁11个月)。28例患儿中SF轻度升高者4例(14.3%),中度升高者8例(28.6%),高度升高者16例(57.1%)。肝脏MRI T2*检测结果 :肝铁轻度沉积2例(7.1%),中度沉积8例(28.6%),重度沉积18例(54.8%);心脏MRI T2*检测结果 :心铁正常16例(57.1%),轻度铁沉积4例(14.3%),中度铁沉积4例(14.3%),重度铁沉积4例(14.3%);LVEF降低者19例(67.9%),4例心脏重度铁沉积患儿中有3例(75%)LVEF明显降低(≤55%)。本组患儿SF水平与肝脏T2*值(r=-0.467,P=0.036)、心脏T2*值(r=-0.486,P=0.01)呈明显负相关;SF与输血量呈正相关(r=0.634,P=0.043;r=0.067,P=0.124)而与去铁治疗呈负相关(r=-0.526,P=0.043),SF和心脏T2*值与LVEF均无相关性(r=-0.154,P=0.306;r=0.067,P=0.124)。结论重型β-TM患儿SF增高及肝脏重度铁沉积发生率高,虽然心脏重度铁沉积患儿发生率不高,但心脏重度铁沉积患儿多有LVEF明显降低。     

No reduction of high density lipoprotein2 during weight reduction in obese children and adolescents

The effects of a 3 week weight reduction regimen on lipids and lipoproteins, in particular high density lipoprotein (HDL)-subfractions in 61 grossly obese children and adolescents (37 females and 26 males) aged 11–15 years were studied. Dietary treatment resulted in a significant weight reduction of initial body weight of 9.6±2.1%, a highly significant decrease in cholesterol, low density lipoprotein cholesterol (LDL-C) and HDL-C (P<0.001), as well as a significant reduction in triglycerides, HDL₃ and Apolipoprotein B concentrations (P<0.01). HDL₂ concentrations remained almost constant. It is concluded that HDL reduction during a weight reducing regimen in adolescents does not result in a decrease of the antiatherogenic HDL₂ subfraction.     

新型医用黏合剂治疗角膜穿通伤对眼前节的影响

目的探讨医用组织黏合剂治疗角膜穿通伤对眼前节的刺激反应,及对角膜内皮细胞和血-房水屏障功能的影响。方法 20只日本大耳白兔建立角膜穿通伤模型,右眼采用医用胶黏合、左眼采用缝线缝合术,术后大体观察兔眼前节情况;角膜共聚焦显微镜观察角膜内皮细胞形态和密度变化,抽兔眼房水行房水蛋白含量测定,透射电镜观察内皮细胞超微组织结构变化。结果术中和术后各时间点医用胶组和缝线组角膜伤口均密闭。两组术后不同时间点角膜共聚焦显微镜观察角膜穿通伤口周边内皮细胞形态和密度无明显差异。房水蛋白含量在术后7d均为最高,医用胶组和缝线组分别为(0.561±0.284)g·L-1、(0.523±0.303)g·L-1,随伤口愈合术后90d恢复正常,各观察时间点两组间差异均无统计学意义(均为P>0.05)。透射电镜观察角膜内皮细胞示:术后14d细胞超微结构基本正常,两组均可见细胞内少量粗面内质网扩张,空泡稍增多,线粒体肿胀;术后30d均恢复正常。结论医用组织黏合剂治疗角膜穿通伤口组织相容性好,对眼前节无明显刺激反应和异物反应。     

Early pregnancy losses in in vitro fertilization and oocyte donation

Objective: To evaluate prospectively the incidence of early pregnancy losses (before menstruation occurs) in IVF and ovum donation cycles.

Design: Prospective case-control study.

Setting: Tertiary care, university-associated center.

Patient(s): One hundred forty-five patients undergoing IVF and 92 undergoing oocyte donation were recruited. The control group for IVF consisted of 15 ovum donors who had no ET and were instructed to avoid intercourse. The control group for oocyte donation included 10 women undergoing a mock cycle of steroid replacement.

Intervention(s): Starting on day 6 after ET, the women were instructed to collect the first urine sample of the day every 2 days. Each patient collected six different specimens of urine (days 6, 8, 10, 12, 14, and 16 after ET for cases or the same days without ET for controls.

Main Outcome Measure(s): β-HCG was measured with a standardized microparticle enzyme immunoassay, and IVF reproductive outcome was assessed.

Result(s): For IVF, positive implantation was registered in 88 of 145 cycles of embryo replacement (60.7%). Only 30 (20.7%) resulted in viable pregnancies, whereas the remaining 58 miscarried. Forty-two of these miscarriages (72.4%) were early pregnancy losses and 13 (22.4%) were classified as clinical abortions. In ovum donation, positive implantation was recorded in 64 of 92 cycles of ET (69.6%). A total of 30 (32.6%) ended in viable pregnancies, whereas the remaining 34 (37.0%) were miscarriages. Early pregnancy loss accounted for 70.6% of pregnancy losses, whereas biochemical pregnancies and clinical abortions accounted for 11.8% and 17.6%, respectively.

Conclusion(s): Our results demonstrate that patients undergoing assisted reproductive technology have an increased rate of early pregnancy loss compared with fertile patients. In addition, these data indicate that implantation is more frequently impaired in IVF than in oocyte donation cycles, resulting in a high incidence of early pregnancy loss. This suggests that implantation may be subjected to abnormal conditions in assisted reproduction.     

选择性环氧合酶抑制剂NS398对子宫内膜癌细胞株的影响

目的探讨环氧合酶抑制剂NS398对子宫内膜癌细胞株的生物学行为的影响。方法2005年9月至2006年11月于华中科技大学同济医学院附属同济医院妇产科实验室用MTT、DNA梯度降解试验及流式细胞仪等方法,研究NS398体外对子宫内膜癌细胞系Ishikawa的抑制增殖、促进凋亡作用。结果NS398对Ishikawa细胞产生明显的生长抑制作用,且表现为剂量依赖性(F=36.598,P<0.01);DNA梯度降解试验、流式细胞仪分析NS398浓度依赖性地诱导了Ishikawa细胞凋亡(F=11.342,P<0.01),且凋亡与细胞周期受阻有关(F=22.445,P<0.01)、主要阻止在G1/S期即DNA合成期。结论NS398对Ishikawa细胞具有显著浓度依赖性的体外生长抑制、诱导凋亡、阻滞DNA合成作用。     

酸性成纤维细胞生长因子在宫颈癌中的表达及其信号传导途径

目的探讨酸性成纤维细胞生长因子(aFGF)在宫颈癌发生发展中的作用及其信号传导机制.方法应用逆转录-聚合酶链反应技术(RT-PCR)对36例宫颈癌组织aFGF 及其受体FGFR1的表达进行了分析;并以不同浓度的aFGF 和酪氨酸蛋白激酶(TPK)抑制剂genistein诱导宫颈癌细胞株HeLa细胞,[γ-32P]ATP掺入外源性底物的方法,液体闪烁测定蛋白激酶C(PKC)及细胞外信号调节激酶(ERK)的活性.结果 aFGF mRNA 和FGFR1 mRNA在宫颈癌组织中的半定量检测结果分别为(1.233±0.064)和(1.168±0.103),与正常宫颈组织相比,差异有显著性(P<0.05),且在Ⅲ～Ⅳ期宫颈癌中的表达水平明显高于Ⅰ～Ⅱ期(P<0.05);随着aFGF浓度的增加,HeLa细胞PKC及ERK 活性随之升高,与aFGF浓度呈剂量依赖效应;genistein抑制细胞内PKC及ERK 活性,与genistein 浓度亦呈剂量依赖效应.结论提示aFGF 与宫颈癌的发生、发展、浸润呈正相关,其受体具有TPK活性,TPK激活后可进一步激活PKC和ERK,进一步证明PKC及ERK确是TPK的下游信号分子.     

Expression of cyclooxygenase-2 in association with clinicopathological prognostic factors and molecular markers in epithelial ovarian cancer

OBJECTIVES: This study examines whether expression of COX-2 is associated with clinicopathological features and other molecular markers of ovarian cancer. METHODS: Sixty-four paraffin-embedded tissue specimens were obtained from patients with ovarian cancer who received cytoreductive surgery and combination chemotherapy. Tissue specimens were subjected to immunohistochemical analysis using antibodies to COX-2, p53, and VEGF. RESULTS: Increased COX-2 expression significantly correlated with histologic type (mucinous 5.6% vs. non-mucinous 65.2%, P<0.001). COX-2 expression was also significantly associated with stage, tumor grade, residual disease status, and presence of ascites. COX-2 expression correlated positively with expression of p53 (P=0.006) and VEGF (P=0.025). Although survival was lower in patients with high COX-2 expression than in those without high COX-2 expression (P<0.001), only tumor grade and stage were independent prognostic indicators. In patients with non-mucinous cancer, COX-2 expression correlated with stage (P<0.001) and presence of ascites (P=0.033). CONCLUSIONS: Our results suggest that expression of COX-2 in ovarian cancers is specific to histologic type of tumor and is associated with poor clinicopathologic prognostic factors. Expression of COX-2 also correlates well with expression of p53 and VEGF.