实验性腹主动脉瘤瘤体外径与iNOS相关性分析及分期研究

Objective To construct new model of experimental abdominal aortic aneurysm (AAA) and detect the AAA outer diameter and the change of induce nitric oxide synthase(iNOS) in the abdominal aor-tic aneurysm in different period,and analysis the correlation between experimental AAA and iNOS.Methods During the operation of the experiment group,the vascular prosthesis of PTFE was implanted to the rabbit abdominal aorta to form an aneurysm,while sham operation was done in the control group.The tissue of ab-dominal aortic aneurysm was harvested in 1 d,7d,14d,and 28d after operation,respectively.The tissue bo-mogenate concentration of iNOS in the abdominal aortic aneurysm were detected by enzyme linked immu-nosorbent assay (ELISA).Results In experimental group,mean concentration of the tissue bomogenate concentration of iNOS in the abdominal aortic aneurysm in 1 d,7 d,14 d,28 d were (22.129 ±2.518)μ/mL,(27.337±5.321) μ/mL,(36.047±4.584)μ/mL,(44.756±1.799)μ/mL,respectively;In control group,that was (12.499±1.807)μ/mL.The concentration of iNOS in experimental group was significantly higher than that of control group (P < 0.01).The difference during the experimental group all had statisti-cal significance (P < 0.05).Conclusion It is possible that iNOS has some biological function during the formation and progression of the abdominal aortic aneurysm.     

实验性肌炎动物模型制作的研究

目的建立实验性肌炎动物模型，研究特发性炎性肌病的发病机制。方法将50只健康的雄性SD大鼠随机分成两组：模型组40只，对照组10只。兔骨骼肌制备肌匀浆。模型组用肌匀浆与弗氏完全佐剂完全乳化后皮下免疫注射1ml．对照组用生理盐水替代肌匀浆，每周免疫1次，连续免疫5次。前2周同时腹腔注射百日咳毒素1ml。分别于免疫注射后各周取大鼠的骨骼肌组织，观察其肌活检病理、免疫组织化学的改变，同时检测血清肌酶水平，并与人类炎性肌病比较。结果模型组肌酶升高与对照组间有显著差别。病理改变以骨骼肌多发性炎症为特点：横纹肌呈灶性分布的肌纤维变性、坏死，横纹消失；周围炎性细胞浸润；肌纤维粗细不等、染色不一。病理分级以2a级为主。单个核细胞浸润以CD8^＋T细胞为主．主要定位于肌内膜。骨骼肌细胞膜上主要组织相容性复合体（MHC）-Ⅰ类分子表达增加。结论用异种动物骨骼肌匀浆免疫大鼠可诱导出炎性肌病动物模型，与人类炎性肌病在临床表现、组织病理和免疫组织化学方面有相似之处。     

脑动静脉畸形实验动物模型的建立

脑动静脉畸形(AVM)实验性动物模型建立是研究AVM必不可少的。建立脑AVM实验性动物模型最常用的动物是猪，目前主要有如下几种猪的脑AVM模型建立的方式：利用猪的自然奇网模式，颈动脉一颈内静脉瘘模式，奇网一海绵窦交通模式，利用导管形成AVM模型以及颈总动脉与颈外静脉端一端吻合模式。随着此项工作的不断完善，对脑AVM的病理生理、血流动力学的认识定会进一步提高，这将会更有力地有助于AVM的治疗。     

Assessing the Stiffness of Spinal Fusion in Animal Models

The clinical goal of spinal fusion is to reduce motion and the associated pain. Therefore, measuring motion under loading is critical. The purpose of this study was to validate four-point bending as a means to mechanically evaluate simulated fusions in dog and rabbit spines. We hypothesized that this method would be more sensitive than manual palpation and would be able to distinguish unilateral vs bilateral fusion. Spines from four mixed breed dogs and four New Zealand white rabbits were used to simulate posterolateral fusion with polymethyl methacrylate as the fusion mass. We performed manual palpation and nondestructive mechanical testing in four-point bending in four planes of motion: flexion, extension, and right and left bending. This testing protocol was used for each specimen in three fusion modes: intact, unilateral, and bilateral fusion. Under manual palpation, all intact spines were rated as not fused, and all unilateral and bilateral simulated fusions were rated as fused. In four-point bending, dog spines were significantly stiffer after unilateral fusion compared with intact in all directions. Additionally, rabbit spines were stiffer in flexion and left bending after unilateral fusion. All specimens exhibited significant differences between intact and bilateral fusion except the rabbit in extension. For unilateral vs bilateral fusion, significant differences were present for right bending in the dog model and for flexion in the rabbit. Unilateral fusion can provide enough stability to constitute a fused grade by manual palpation but may not provide structural stiffness comparable to bilateral fusion.     

Liver regeneration in acute severe liver impairment: a clinicopathological correlation study.

BACKGROUND: Although normally quiescent, the adult mammalian liver possesses a great capacity to regenerate after different types of injury. Major players in the regeneration process are mature residual cells, including hepatocytes, cholangiocytes and stromal cells. However, if the regenerative capacity of mature cells is impaired, hepatic progenitor cells (HPCs) are activated and expand into the liver parenchyma. Upon transit amplification, the progenitor cells generate new hepatocytes and biliary cells to restore liver homeostasis. AIMS/METHODS: To study the relationship between different histopathological parameters as well as their correlations with clinical parameters and outcome, we examined liver specimens from 74 patients with acute or subacute severe liver impairment by immunohistochemistry for CK7/CK19 (evaluation of HPCs activation/differentiation), Mib1(Ki 67)/P21 (evaluation of proliferative activity/proliferation arrest of hepatocytes) and hematoxylin and eosin (evaluation of hepatocyte loss). RESULTS: Of the 74 patients, 32% survived without transplantation, 14% died without transplantation and 54% were transplanted. Our results show that a threshold of 50% loss of hepatocytes, associated with significant decrease in the proliferative activity of remaining mature hepatocytes, is needed for extensive hepatic progenitor cell activation. Such activation is a sign of disease severity and occurs early (within 1 week) in the disease course. However, development of intermediate hepatocytes, suggesting HPCs differentiation towards mature hepatocytes, takes at least 1 week's time. We found a positive correlation between histopathological parameters (percentage hepatocyte loss, number of proliferating hepatocytes and number of HPCs) and clinical parameters of liver impairment such as model for end stage liver diseases (MELD). Surviving patients compared with those who either died or were transplanted had significantly less hepatocyte loss, less HPCs activation and more mature hepatocyte proliferative activity. Hepatocyte proliferative activity and degree of hepatocyte loss were the most important independent histopathological parameters in predicting outcome. CONCLUSION: Liver biopsy can provide important additional information in a patient with severe acute liver impairment.     

Safety of, and biological and functional response to, a novel metallic implant for the management of focal full-thickness cartilage defects: Preliminary assessment in an animal model out to 1 year.

Focal full-thickness cartilage lesions of the human medial femoral condyle (MFC) can cause pain and functional impairment. Affected middle-aged patients respond unpredictably to existing treatments and knee arthroplasty may be required, prompting risk of revision. This study assesses the safety of, and biological and functional response to, a metallic resurfacing implant which may delay or obviate the need for traditional arthroplasty. The anatomic contour of the surgically exposed MFC of six adult goats was digitally mapped and an 11 mm diameter full-thickness osteochondral defect was created. An anchor-based Co-Cr resurfacing implant, matching the mapped articular contour, was implanted. Each goat's contralateral unoperated femorotibial joint was used as a control. Postoperative outcome was assessed by lameness examination, radiography, arthroscopy, synoviocentesis, necropsy, and histology up to 26 (n = 3) or 52 (n = 3) weeks. By postoperative week (POW) 4, goats demonstrated normal range of motion, no joint effusion, and only mild lameness in the operated limb. By POW 26 the animals were sound with only occasional very mild lameness. Arthroscopy at POW 14 revealed moderate synovial inflammation and a chondral membrane extending centrally across the implant surface. Radiographs at POWs 14 to 52 implied implant stability in the operated joints, as well as subchondral bone remodeling and mild exostosis formation in the operated and contralateral unoperated joints of some goats. By POW 26, histology revealed new trabecular bone abutting the implant. At POWs 26 and 52 MFC cartilage was metachromatic and intact in the operated and unoperated femorotibial joints. Proximal tibiae of some operated and unoperated limbs demonstrated limited subchondral bone remodeling and foci of articular cartilage fibrillation and thinning. The chondral membrane crossing the prosthesis possessed a metachromatic matrix containing singular and clustered chondrocytes. Our data imply the safety, biocompatibility, and functionality of the implant. Focal articular damage was documented in the operated joints at POWs 26 and 52, but lesions were much reduced over those previously reported in untreated defects. Expanded animal or preclinical human studies are justified.     

线栓法制作大鼠局灶性脑缺血再灌注损伤模型的改进

目的 研究一种稳定、简便的大鼠局灶性脑缺血再灌注损伤模型制作方法。方法 采用健康SD雄性大鼠，线栓法制作局灶性脑缺血再灌注损伤模型．结扎颈总动脉（CCA）及颈外动脉（ECA），不结扎翼腭动脉，用5．0头皮针于CCA结扎的远端刺一小口插入栓塞线造成缺血，拔出线栓形成再灌注。通过神经功能缺损评分、红四氮唑（TTC）染色和病理学检查等方法评价该模型的可靠性。结果动物麻醉后一般只需15min左右即可完成手术，术后大鼠神经功能缺损明显，TTC染色示脑梗塞区苍白，病理学检查显示典型病理表现。结论该方法缺血效果明确可靠，术式简便，手术时间短，不需具备显微手术操作技巧，是一种理想的制作局灶性脑缺血再灌注损伤模型的方法。     

低压状态下猪鼾症模型的建立及其CT研究

目的探讨低压环境对动物上气道软组织形态学的影响。方法将试验猪置于一个低压环境饲养6个月建立猪的鼾症模型,当出现类似鼾症临床症状和鼾症相似的咽腔压力波形时,再进行CT扫描影像学检查。并与正常状态饲养的对照组进行对比。结果模型猪咽后壁及软腭明显增厚,分别为(0.94±0.16)cm和(1.06±0.23)cm;对照组分别为(0.60±0.11)cm和(0.59±0.13)cm。模型猪的气管截面积在在前、中、后部分别为(1.49±0.12)cm2、(1.37±0.32)cm2和(1.00±0.21)cm2,其中以悬雍垂水平(后部)最为狭窄;对照组前、中、后部分别为(1.30±0.14)cm2、(1.57±0.32)cm2和(2.48±0.42)cm2。结论低压状态是鼾症的重要的致病因素之一,低压状态可建立鼾症的动物模型。     

Attempts to make models for Alzheimer''s disease

Profound reductions in cortical acetylcholine levels together with degeneration of cholinergic neurons in the basal forebrain have been reported in patients with Alzheimer's disease. A similar loss of the cholinergic neurons of the basal forebrain and impairment of learning and memory occur in animals injected with a nerve growth factor-diphtheria toxin conjugate, suggesting that this animal model is suitable to analyze cholinergic roles on learning and memory processes, and also the pathogenesis of Alzheimer's disease. In addition, animal models constructed by electrolytic or neurotoxic lesioning of the basal magnocellular nucleus, and models made by transgenetic technology were described.     

网络模式下临床医师绩效评价指标体系研究

为了充分利用医院信息网络信息，更为全面、客观地对医生进行评价，阐述建立网络模式下临床医师绩效评价指标体系的原则、方法，并对的建立指标体系的可信度及合理性进行了分析。