IVF—ET中未受精卵母细胞行早期（5hrs）补救ICSI授精后胚胎发育潜能

在常规应用卵胞浆内单精子注射（ICSI）之前,常规体外受精（IVF）受精率低下很常见,大约有20％～35％的IVF患者会发生受精率很低（〈35％的卵子受精）甚至受精完全失败（所有卵子都不受精）。卫生部辅助生殖技术管理条例规定,在应用辅助生殖技术助孕的治疗中,对以女方输卵管堵塞、排卵障碍、子宫内膜异位症或不明原因等不孕因素为主的患者,     

Model Studies for the Direct Effect of High-energy Irradiation on DNA. Mechanism of Strand Break Formation Induced by Laser Photoionization of Poly U in Aqueous Solution

Summary

Laser flash photolysis of polyuridylic acid (poly U) in anoxic aqueous solutions leads to biphotonic photoionization of the uracil moiety followed by the formation of single strand breaks (ssb). The rate constant for ssb formation (1·0 s^?1, obtained from the slow component of conductivity increase at 23°C and pH 6·8) increases with decreasing pH to 235 s^?1 at pH 3·5. The activation energy (pre-exponential factor) was measured to be 66 kJ mol^?1 (5 × 10¹¹ s^?1) at pH 6·8. Addition of dithiothreitol (DTT) or glutathione (GSH) prevents ssb formation by reacting with a poly U intermediate (rate constant = 1·2 × 10⁶ and 0·16 × 10⁶ dm³ mol^?1 s^?1, respectively). Since with OH radicals as initiators very similar data have been obtained for the kinetics of ssb formation and for the reaction with DTT, we conclude that photoionization of the uracil moiety in poly U leads eventually to the same chemical pathway for ssb formation as that induced by OH radicals. Furthermore, we propose that protection by DTT and GSH occurs via H donation to the C-4′ radicals of the sugar moiety of DNA and to the C-4′ and the C-2′ radicals of poly U.     

Changes in bone turnover markers during 14-day 6° head-down bed rest

Osteoporosis caused by exposure to microgravity represents a serious clinical concern, but the mechanisms have yet to be fully elucidated. The present research aimed to elucidate the effects of microgravity environments on bone turnover, with a specific focus on changes in bone resorption markers such as type I collagen cross-linked N-telopeptides (NTx) and deoxypyridinoline (Dpyr), for which scant data are available regarding detailed time course. Methods using 6° head-down bed rest were utilized to simulate a microgravity environment. Eleven adult male volunteers underwent 6° head-down bed rest for 14 days; measurements were made of serum and urine Ca concentrations, in addition to osteocalcin (OC), bone alkaline phosphatase (ALP), NTx, and Dpyr as bone turnover markers. By the end of bed rest, concentrations of bone ALP had significantly increased, but OC displayed a tendency toward decrease. Concentrations of Dpyr significantly increased from day 6, remaining elevated until the end of bed rest. Concentrations of NTx significantly increased on day 13 and at the end of bed rest. Serum and urinary concentrations of Ca increased significantly at the end of bed rest. Bone ALP represents a relatively early marker of osteoblast differentiation at the matrix maturation phase and OC is a late marker in osteoblast differentiation at the calcification phase. The present results therefore suggest an absolute increase in bone resorption and normal or reduced bone formation, together causing prominent uncoupling and rapid bone loss after simulated microgravity. Moreover, the present results suggest that bone resorption is enhanced at an early stage of exposure to microgravity environments.     

Diagnostic limitations of 10 mm thickness single-slice computed tomography for patients with suspected appendicitis

Purpose The aim of this retrospective analysis was to evaluate the accuracy of 10 mm thickness single helical computed tomography (CT) examination for confirming the diagnosis of appendicitis or providing a diagnosis other than appendicitis, including underlying periappendical neoplasms. Materials and methods From April 1, 2001 to March 30, 2005, a total of 272 patients with suspected appendicitis underwent CT examinations. Of the 272 patients, 106 (39%) underwent surgery. Seven CT examinations for seven patients were excluded because of inconsistency of the CT protocol. We therefore reviewed 99 CT images (99 patients) with correlation to surgical-pathological findings to clarify the diagnostic accuracy of CT examinations. We compared the postoperative diagnosis with the preoperative CT report. The final diagnoses were confirmed by macroscopic findings at surgery and pathological evaluations if necessary. Results Of the 99 patients, 87 had acute appendicitis at surgery. The sensitivity, specificity, and accuracy of CT were 98.9%, 75.0%, and 96.0%, respectively. The positive predictive value and negative predictive value were 96.6% and 90.0%, respectively. Among nine patients in the true-negative category, five had colon cancers; and among three patients in the false-positive category, two had cancer of the cecal-appendiceal region as the underlying disease. Conclusion CT examination is useful for patients with suspected appendicitis, but radiologists should be aware of the limitation of thick-sliced single helical CT. They should also be aware of the possibility of other diseases, including coincident abdominal neoplasms and underlying cecal-appendiceal cancer.     

Eph and Ephrin Signaling in Mammary Gland Morphogenesis and Cancer

The Eph family of receptor tyrosine kinases and their membrane-bound ligands, the ephrins, play a central role in pattern formation during embryonic development and there is growing evidence that they are also instrumental in the control of tissue dynamics in the adult. The mammary gland is a paradigm for morphogenic processes occurring in the adult, since the gland develops predominantly postnatally and is subjected to continuous cyclic remodeling according to functional demands. Thus, pattern formation and the establishment of a functional organ structure are permanent themes in the mammary gland life cycle. In this paper we summarize the experimental evidence and discuss possible mechanisms by which Ephs and ephrins are modulating mammary epithelial cell adhesion, communication, and migration. Furthermore, we speculate on the different aspects of their influence on normal mammary gland development, function, and carcinogenesis.     

骨碎补总黄酮对Masquelet技术诱导膜内血管形成的影响

【目的】探讨骨碎补总黄酮对Masquelet技术诱导膜内血管形成的影响。【方法】将72只SD大鼠随机分成4组,分别为模型组,药物高、中、低剂量组,每组18只。复制SD大鼠股骨中段临界骨缺损模型,并在骨缺损区行聚甲基丙烯酸甲酯(PMMA)骨水泥旷置诱导生物膜形成。从术后第1天开始,各药物组大鼠分别给予骨碎补总黄酮高、中、低剂量(0.44、0.22、0.11 g·kg~(-1)·d~(-1))灌胃治疗,模型组予等量生理盐水灌胃。给药6周后取材,采用苏木素—伊红(HE)染色法观察诱导膜组织病理变化,分别采用酶联免疫吸附(ELISA)法和实时荧光定量逆转录—聚合酶链反应(RT-qPCR)法检测诱导膜中转化生长因子-β1(TGF-β1)、血管内皮生长因子(VEGF)的蛋白及其mRNA表达。【结果】骨碎补总黄酮高剂量组诱导膜组织形成的新生血管多于其余各组。药物高、中、低剂量组诱导膜组织中TGF-β1、VEGF的蛋白及其mRNA表达水平均明显高于模型组(P0.05),除VEGF mRNA指标外,其余指标的表达均具有剂量依赖性。【结论】骨碎补总黄酮在诱导膜形成期可促进TGF-β1及VEGF的表达,加速血管化进程,促进后期骨缺损重建。     

SNOMED CT概念关系表达与语义检索

详细阐述SNOMED CT基于概念的组织框架、表示模式、关系模型、表达规则等,初步探索SNOMED CT在医疗数据表达、语义检索方面的应用,为研究制定我国临床诊疗术语标准提供参考借鉴,进一步推动临床医疗数据的处理、挖掘与分析研究。     

三种颗粒细胞剥除方式对卵母细胞受精率及胚胎发育的影响

目的对三种颗粒细胞剥除方式在常规体外受精(IVF)中对卵母细胞受精率及胚胎发育影响进行前瞻性研究。方法2004年1～12月,因输卵管因素不育在我院生殖中心行常规体外受精-胚胎移植(IVF-ET)的患者54例,患者年龄均小于35岁。采用随机表法随机分为三组,每组18例,共818个卵母细胞。对三组卵母细胞在IVF后采取不同的颗粒细胞剥除方式:第一组在受精后4h完全剥除颗粒细胞;第二组在受精后4h部分剥除颗粒细胞,受精后16～18h再将颗粒细胞完全剥除;第三组在受精后16～18h完全剥除颗粒细胞(即传统的过夜培养方式)。对三组的受精率、优质胚胎率、囊胚形成率进行比较。结果第一组及第二组的优质胚胎率高于第三组,差异有统计学意义(P<0.05)。三组在受精率及囊胚形成率方面没有显著差别。结论第一组的颗粒细胞剥除方式最好,即缩短精-卵共培养时间可以提高胚胎质量,长时间的精-卵共培养对优质胚胎的形成有不利影响。较短时间(12～14h)的颗粒细胞与卵细胞的共培养可能对胚胎发育的质量无显著影响。     

维拉帕米对胶原基因表达及大鼠腹膜粘连形成的影响

目的探讨维拉帕米(Verapamil)在胶原基因表达及大鼠腹膜粘连形成中的作用.方法通过造成腹壁和盲肠浆膜的均一缺损制成大鼠粘连模型;关腹前注入1ml生理盐水或维拉帕米(0.002 kg/L);术后7 d进行粘连评分;采用逆转录-聚合酶链反应(RT-PCR)方法测定各组织标本Ⅰ(α2)、Ⅲ(α1)型胶原基因mRNA的表达.结果与正常腹膜相比,模型组和生理盐水组粘连组织Ⅰ(α2)、Ⅲ(α1)型胶原基因mRNA表达显著增强(0.64±0.17至4.37±0.83、3.56±0.57,P＜0.01;0.06±0.02至0.39±0.12、0.47±0.21,P＜0.01);与模型组或生理盐水组相比,维拉帕米组大鼠粘连显著减轻,同时Ⅰ(α2)、Ⅲ(α1)型胶原基因mRNA表达显著减弱(0.77±0.21,0.09±0.03,P＜0.01).结论粘连形成过程中胶原基因表达增强,抑制胶原基因表达能减轻粘连程度.     

Complications and Functional Results after Ileoanal Pouch Formation in Obese Patients

Objective Ileoanal pouch formation (IPAA) can be technically challenging in obese patients, and there is little data evaluating results after the procedure in these patients. We compare outcomes for patients with a body mass index (BMI) ≥30 undergoing IPAA when compared with those for patients with BMI <30. Methods Retrospective analysis of prospectively accrued data for patients with BMI ≥30 undergoing IPAA. Patient and disease-related characteristics, complications, long-term function, and quality of life (QOL) using the Cleveland Global Quality of Life scale (CGQL) were determined for this group of patients (group B) and compared with those for patients with BMI <30 (group A). Kruskal–Wallis and Wilcoxon rank sum tests were used to compare quantitative or ordinal data and chi-square or Fisher’s exact tests for categorical variables. Long-term mortality and complication rates were estimated using the Kaplan–Meier method with group comparisons performed using log rank tests. Results There were 345 patients (median BMI 32.7) in group B and 1,671 patients in group A. When the cumulative risk of complications over 15 years was compared, group B patients had a significantly higher chance of getting a complication (94.9% vs 88%, p = 0.006). The rates of pelvic sepsis (6.7% vs 5.3%, p = 0.3), pouchitis (58.1 vs 54.4%, p = 0.9), pouch failure (6% vs 4.5%, p = 0.9), and hemorrhage (5.6% vs 4.8%, p = 0.7) were similar for group B and group A. Group B patients, however, had a significantly higher risk of the development of wound infection (18.8% vs 8.1%, p < 0.001) and anastomotic separation (10.4% vs 5.4%, p < 0.001), whereas group A patients had a higher rate of development of obstruction over time (26.7% vs 22.3%, p = 0.02). Long-term outcome including QOL and function after 15 years was comparable between groups. Conclusions Although technically demanding, IPAA can be undertaken in obese patients with acceptable morbidity. Good long-term functional results and QOL that is comparable to nonobese patients may be anticipated.