TGF-β1/Smad3信号转导通路与创伤后瘢痕形成

目的对近年TGF-β1/Smad3信号转导通路与创伤后瘢痕形成的相关研究作一综述。方法广泛查阅国内外近年有关TGF-β1/Smad3信号转导通路及与创伤后瘢痕形成的文献,并进行综述。结果 TGF-β1是纤维化疾病的重要影响因子,通过TGF-β1/Smad3信号通路转导产生其生物学效应。该途径受多种因子调控并在细胞及分子水平与其他信号通路串话。该途径参与创伤后早期炎性反应、创面愈合及后期病理性瘢痕的形成。在分子水平干预转导途径的各个环节,可以影响纤维化及细胞外基质沉着的进程。结论 TGF-β1/Smad3信号转导途径是影响创伤后瘢痕形成及细胞外基质沉着的重要途径。对该途径进行深入研究,可为临床促进创面的愈合及病理性瘢痕的防治奠定理论基础。     

Incidence and predictors of post-reperfusion syndrome in living donor liver transplantation

A characteristic pattern of hemodynamic changes that may occur in reperfusion phase of liver transplantation (LT) is known as post-reperfusion syndrome (PRS). In this study, we determined the frequency of PRS and evaluated possible predictors of PRS. The medical records of 152 patients who underwent living donor LT were reviewed. PRS was defined as a decrease in mean arterial pressure of more than 30% from the baseline value for more than one min during the first five min after reperfusion. The frequency of PRS was determined, and patients were divided into two groups: PRS group and non-PRS group. Donor factors, preoperative and intraoperative recipient factors, and postoperative outcomes were compared between the two groups. PRS occurred in 58 recipients (34.2%). Preoperative model for end-stage liver disease scores of recipients and percentage of graft steatotic changes were higher in PRS group. PRS group showed higher heart rates and lower hemoglobin values preoperatively. Before reperfusion, PRS group received more transfusion and their urine output was less than that of non-PRS group. Postoperatively, peak bilirubin during the first five d after LT was higher in PRS group. In conclusion, both severity of liver disease and graft steatosis may increase risk for PRS in LT. Further prospective studies of PRS in its relationship to outcome are indicated.     

骨髓间质干细胞培养上清液调控肝细胞的体外研究

目的探讨骨髓间质干细胞(bone marrow mesenchymal stem cells,BMSC)培养上清液对肝细胞增殖、凋亡的影响,初步探讨BMSC治疗肝纤维化的旁分泌机制。方法采用密度梯度离心及贴壁细胞分离相结合提取BMSC。培养48h的BMSC细胞培养上清液按BMSC不同处理(培养)时间和含量两种方法建组。不同处理时间建组:取培养48hBMSC上清液处理肝细胞(完全培养),分为处理24h、48h、72h组,对照组为1640培养基处理24h的肝细胞。不同含量BMSC建组:实验1组为完全BMSC培养上清液(含肝细胞的6孔板中每孔加入BMSC上清液2ml)处理肝细胞;实验2组为部分BMSC培养上清液(每孔加BMSC上清液1ml+1640培养基1ml)处理肝细胞;对照组为完全细胞培养基(每孔加1640培养基2ml)处理肝细胞。用酶联免疫吸附试验(ELISA)试剂盒检测BMSC旁分泌肝细胞生长因子(hepatocyte growth factor,HGF)情况及培养时间对其的影响;用流式细胞仪观察肝细胞细胞分期和检测凋亡细胞数;用蛋白免疫印迹法(Western-blot)检测样本上清液中白蛋白的表达。结果 BMSC分泌HGF,其含量变化具有时间依赖性。加入BMSC培养上清液后,与对照组相比,实验1组中的培养上清液可以明显促进肝细胞增殖、抑制其凋亡,并随着处理时间的延长而增加(处理72h>处理48h>处理24h,均为P<0.05);实验组(1组、2组)的白蛋白分泌较对照组上调,且随着处理时间的延长白蛋白含量增加。结论 BMSC有可能通过分泌HGF促进肝细胞增殖、抑制凋亡,促进白蛋白分泌,从而抑制肝脏纤维化。     

老年高血压患者便秘风险评估与预防护理

目的 探讨老年高血压患者便秘风险因素及预防护理的效果.方法 采用自制评估表对65例住院老年高血压患者进行便秘风险评估,对中、高风险患者采取针对性预防护理干预.结果 65例患者入组均未发生便秘,便秘中、高风险49例,低风险16例;干预1个月后,发生便秘6例,发生率为9.2％.结论 对老年高血压患者进行便秘风险因素评估,根据风险级别采取针对性预防护理措施,可有效预防和缓解其便秘发生,提高生活质量.     

转化生长因子β1诱导永生化人前软骨干细胞向髓核样细胞分化的实验研究

  目的 研究转化生长因子β1 (TGF-β1) 诱导永生化人前软骨干细胞 (IPSCs) 向髓核样细胞分化的可行性。方法 将体外培养的IPSCs 接种于温敏型壳聚糖水凝胶 (C/GP) 三维支架上,加入含TGF-β1的诱导培养基,低氧条件下进行诱导培养,观察三维支架上IPSCs的生长及分化情况。7 d后行Alcian Blue染色,分析细胞外基质糖胺聚糖（GAG）合成情况,并收集细胞,提取RNA。RT-PCR检测诱导前后髓核样细胞标志基因Ⅱ型胶原（Collagen Ⅱ）和蛋白聚糖（Aggrecan）的表达情况,Western Blot 检测诱导前后细胞内β-catenin蛋白表达水平的变化。结果 IPSCs在三维支架上生长状态良好,诱导7 d 后,Alcian Blue染色表明,细胞外基质GAG的合成明显增多,实验组（诱导培养基）明显多于对照组（普通培养基）。RT-PCR证实Ⅱ型胶原和Aggrecan的基因表达水平明显增高,实验组明显高于对照组;Western Blot证实细胞内β-catenin蛋白表达水平明显上调,实验组明显高于对照组。结论 IPSCs经TGF-β1诱导可在体外定向分化为髓核样细胞,诱导分化后的细胞具有良好的分泌功能,能够有效地分泌细胞外基质成分。TGF-β1可能通过上调细胞内β-catenin的表达诱导IPSCs向髓核样细胞分化。     

干细胞表面标志物CD90、 IGF1R及hTERT在原发性肝癌中的表达及临床意义

目的探讨CD90、IGF1R及hTERT蛋白在原发性肝癌的发生和发展过程中的表达特点及相互关系。方法应用免疫组化S-P法检测36例原发性肝癌中CD90、IGF1R和hTERT蛋白的表达,并以同期20例正常肝组织作对照,比较其表达与肝癌患者预后及术后生存率的关系。结果肝癌组织中CD90、IGF1R和hTERT蛋白表达阳性率显著高于其相应良性对照组(P<0.05),分别为63.9%比0、52.8%比5.0%和47.2%比0;CD90、IGF1R和hTERT蛋白表达在UICC临床分期Ⅲ～Ⅳ期患者中明显高于Ⅰ～Ⅱ期的患者(P<0.05),分别为79.2%比33.3%、70.8%比16.7%和62.5%比16.7%;CD90与IGF1R蛋白表达呈正相关(Kendall相关系数tau-b=0.563 1,P<0.05);CD90与hTERT蛋白表达呈正相关(Kendall相关系数tau-b=0.363 6,P<0.05);CD90、IGF1R和hTERT蛋白表达阳性患者的生存率明显低于CD90、IGF1R和hTERT蛋白表达阴性患者,分别为21.7%比50.0%、17.6%比43.8%和20.0%比38.9%,Log-rank检验显示其生存率差异均有统计学意义(P<0.05)。结论 CD90、IGF1R和hTERT可能与肝癌的发生与发展相关,其有望成为判断患者预后的指标之一。     

survivin在结直肠癌组织中的表达及其临床意义

目的探讨survivin在结直肠癌组织中的表达及其与肿瘤生物学特性及临床特性之间的相关性。方法应用RT-PCR方法检测60份结直肠癌组织及40例癌旁正常组织标本中survivin的表达,并分析其与肿瘤临床特性及生物学特性之间的相关性。结果 survivin在结直肠癌中的表达较癌旁正常组织明显升高(P<0.05)。在癌组织中,survivin的表达与患者的性别、肿瘤大小、部位及组织分化程度无明显相关性,但与Dukes分期及有无淋巴结转移密切相关。结论 survivin在结直肠癌组织中高表达,并与肿瘤Dukes分期及淋巴转移相关,提示检测survivin可以反应肿瘤的侵袭性,为评估肿瘤的预后提供参考。     

预处理对病理状态下心脏缺血/再灌注损伤的影响

背景 缺血性心脏病被认为是世界范围内人类发病和死亡的主要原因;预处理,包括缺血预处理(ischemic preconditioning,IP)和药物预处理在正常心肌中的保护作用已得到证实.目的 了解合并心血管相关危险因素等病理条件下预处理对心脏缺血/再灌注(ischemia/reperfusion,I/R)的影响.内容 就近年来在某些病理状态下(如高血脂、糖尿病、高血压、老龄化及肥胖等)预处理对心脏缺血/再灌注损伤(ischemia/reperfusion injury,I/RI)的作用及可能机制的研究简要作一综述.趋向 为进一步研究相关的心脏保护策略提供思路.     

Recombinant human granulocyte-macrophage colony-stimulating factor hydrogel promotes healing of deep partial thickness burn wounds

Objective

To assess the effects of recombinant human granulocyte/macrophage colony-stimulating factor (rhGM-CSF) hydrogel on the healing of deep partial thickness burn wounds.

Methods

Ninety three wounds of 65 burn patients who suffered from a deep partial thickness burn of <5% TBSA and could not heal over 3 weeks were included in this study. The patients were randomly assigned to use rhGM-CSF hydrogel (GC group, n = 32) or hydrogel without rhGM-CSF (control group, n = 33). rhGM-CSF hydrogel or hydrogel without rhGM-CSF was topically applied to the wounds, the dressing was changed once a day. Wound healing time and percentage, wound discharge, periwound inflammation, the positive wound swabs culture count, and adverse drug reactions were observed and compared between two groups.

Results

Healing time was 12.2 ± 5.0 days after the application of rhGM-CSF hydrogel. This was significantly shorter than that of control wounds (15.5 ± 4.7 days). Healing percentage at 14 days in the rhGM-CSF-treated wounds was 97.5 ± 7.7%, which was markedly higher than the control (85.9 ± 6.8%). At 3, 6, 12, 14 day, the GC group was significantly superior to the control group with respect to the score of periwound inflammation, wound purulence and discharge. The positive wound swabs culture count of the GC group on the 7th and 14th day post-treatment was 14 and 4, respectively, which was significantly lower than the control.

Conclusion

rhGM-CSF hydrogel promotes the healing process of deep partial thickness burns effectively. No adverse reaction of the drug was observed during the study.