Occult celiac disease prevents penetrance of hemochromatosis

AIM:To report a patient with C282Y homozygocity,depleted body iron and intestinal atrophy caused by celiac disease (CD) who experienced resolution of the enteropathy with subsequent normalization of iron metabolism upon gluten free diet. METHODS:To obtain information on the tissue distribution and quantitative expression of proteins involved in duodenal iron trafficking,we determined the expression of divalent-metal transporter 1 (DMT1),ferroportin 1 (FP1) and transferrin receptor (TfR1) by means of immunohist-ochemistry and real-time PCR in duodenal biopsies of this patient. RESULTS:Whereas in hereditary hemochromatosis patients without CD, DMT1 expression was up-regulated leading to excessive uptake of iron, we identified a significant reduction in protein ana mRNA expression of DMT1 as a compensatory mechanism in this patient with HH and CD. CONCLUSION:Occult CD may compensate for increased DMT1 expression in a specific subset of individuals with homozygous C282Y mutations in the hemochromatosis (HFE) gene,thus contributing to the low penetrance of HH.     

Localization and radiofrequency ablation of slow conducting pathway in left free wall

Objectives To study the Electrophysiologic characteristics and method of radiofrequency ablation in patients with slow conduction in left free wall. Methods When 5 cases induced tachycardia, using VS2 program stimulation terminated the tachycardia to establish that ventricle is the part of reentry circle. Results No retrograde A waves in 4 cases but only 1 case present A wave in terminating tachycardia. The accessory pathways have decreasing conduction in One case. Successful ablation were located in ventricle sides. Conclusions Ventricular sense and S2 program stimulation to terminate tachycardia is a reliable method to different atrial tachycardia . A wave of successful targets ahead of A wave of any coronary sinus leads is 8 -22 ms.     

误诊为结核性腹膜炎的腹腔间皮肉瘤一例

患者男 ,4 7岁 ,盗汗 3个月、腹胀消瘦 1个月。体检 :消瘦 ,腹微膨隆 ,无压痛 ,右中腹可扪及 2个鸡蛋大小包块 ,表浅 ,坐位时较明显 ,边界不清 ,不活动 ,欠光滑 ,无触痛。辅助检查 :血红蛋白 10 6g/L ,粪隐血 2次阳性 ,胆碱脂酶 2 .2 2U/L、白蛋白 /球蛋白 0 .6 0 ,血及腹水甲胎蛋白、癌胚抗原、CA19 9、CA12 5正常 ,血腺苷脱氨酶 (ADA) 71U/L ,肝炎病毒学标志物均为阴性 ,血沉 115mm/1h。血清蛋白电泳 :白蛋白 32 .1、α1 球蛋白 7.0、α2 球蛋白 11.4、β 球蛋白 13.4、γ 球蛋白 36 .1。腹水淡黄色 ,浑浊 ,蛋白定性 (+) ,细胞计数4…     

Multidrug resistance reversal in human gastric carcinoma cells by neferine

AIIVI: To investigate the reversal effect of neferine on multidrug resistance in human gastric carcinoma cell line. METHODS: Cells of a human gastric cancer cells line, SGC7901, and its vincristine (VCR) -resistant variant, SGC7901/VCR, were cultivated with or without neferine and/or VCR. The cytotoxic effect of VCR was evaluated by the MTT assay. Cell apoptosis induced by VCR was determined by flow cytometry(FCM). The expression of P-glycoprotein (P-gp) and a multidrug-resistance-associated protein (MRP) in cells was examined by immunofluorescence and FCM. RESULTS: Neferine at the concentration from 2.5 μmol/L to 10 μmol/L had no cytotoxicity to SGC7901 cells, and its variant SGC7901/VCR cells. The ICso of VCR against SGC7901 and SGC7901/VCR cells was 0.059 μg/mL and 2.32 μg/mL, respectively, indicating that SGC7901/VCR cells were 39 times more resistant to VCR than its parent SGC7 901 cells. After treatment with neferine at concentrations of 2.5, 5 and 10 μmol/L, the IC50 of VCR to SGC7901/VCR cell line decreased to 0.340, 0.128 and 0.053 μg/mL, respectively,thus, increased the chemosensitivity by 6.8-, 18.1- and 43.8-fold, respectively. SGC7901/VCR cells were apoptosis resistant to VCR. Neferine (2.5, 5 and 10 μmol/L) promoted the VCR-induced apoptosis of SGC7901/VCR cells in a dosedependent manner. The expressions of P-gp and MRP were strongly positive in SGC7901/VCR cells, which were significantly down-regulated after treatment with neferine (10 μmol/L)for 24 h. CONCLUSION: Neferine reverses multidrug resistance of human gastric carcinoma SGC7901/VCR cells, which may be associated with the down-regulations of P-gp and MRP expression in SGC701/VCR cells.     

自制悬吊式腹腔拉钩的应用

材料、结构与组成 :选用不锈钢材料经加工 ,电镀精制而成。由固定支柱、吊臂、拉钩组成。固定支柱 ,长 40 cm,宽 2 cm,上端 5 cm的厚度为 1.5 cm,距顶端 1cm处有一直径为 1.5 cm小孔 ,此孔为吊臂上的螺纹钩穿入处 ;下端 3 5 cm厚度为 0 .8cm,与手术床上的固定旋钮相连。吊臂 :由摇把和套筒螺纹钩组成。螺纹钩长 2 0 cm,直径 1cm,前端稍细为一 45°角小钩 ,后 1/2为螺纹状 ,并与螺纹套筒相连接 ,套筒长 10 cm,前端膨大 ,呈2 .5 cm直径球状 (当吊臂前端螺纹钩通过支柱小孔时起固定作用 ) ,末端有一 0 .8cm直径小孔 ,为摇把穿入处。摇把长5 cm …     

177Lu-FA-DOTA-PEG-PLGA靶向可降解纳米粒子腹腔灌注治疗小鼠卵巢癌伴腹膜转移的实验研究

目的 观察放射性核素¹⁷⁷Lu标记的叶酸-二乙烯三胺五乙酸-聚乙二醇-聚乳酸共聚物(¹⁷⁷Lu-FA-DOTA-PEG-PLGA)纳米粒子的体内靶向分布,评价腹腔灌注纳米粒子治疗小鼠卵巢癌腹膜转移瘤及腹水疗效。方法 制备¹⁷⁷Lu-FA-DOTA-PEG-PLGA纳米粒子,向人卵巢癌移植瘤荷瘤小鼠尾静脉注射纳米粒子后4、24、72 h和7 d,行微型单光子发射计算机断层显像仪(micro-SPECT/CT)显像,观察纳米粒子体内分布情况。将12只人卵巢癌腹腔转移瘤裸鼠模型按随机抽签法分为阴性对照组(生理盐水)、化疗组(顺铂3 mg/kg,2次/周)和粒子组(¹⁷⁷Lu-FA-DOTA-PEG-PLGA粒子18.5 MBq),每组4只,腹腔灌注给药。7 d后行活体荧光成像评价腹腔肿瘤生长情况,计算相对抑瘤率,TUNEL法检测肿瘤细胞凋亡率,免疫组织化学法检测肿瘤Ki67增殖活性,比较治疗后各组腹水体积。结果 micro-SPECT/CT显像显示,移植瘤放射性浓聚,24 h肿瘤肌肉摄取比值(T/M)最高,为2.81±0.49。活体荧光成像显示,腹腔给药治疗后,粒子组、化疗组和阴性对照组的腹腔肿瘤荧光强度分别为(1.45±0.19)×10¹⁰、(2.21±0.36)×10¹⁰和(2.63±0.79)×10¹⁰,差异有统计学意义(F=6.09,P=0.029);粒子组和化疗组的相对肿瘤抑制率(TGI)分别为35.6%和18.6%。粒子组和化疗组的肿瘤细胞凋亡率(AI)均高于阴性对照组(F=9.96,P=0.009),粒子组和化疗组的Ki67指数均低于阴性对照组(F=9.93,P=0.013),粒子组和化疗组腹水体积均小于阴性对照组(F=13.43,P=0.006)。结论 ¹⁷⁷Lu-FA-DOTA-PEG-PLGA纳米粒子可行小鼠卵巢癌靶向显像,腹腔灌注后局部滞留和降解吸收,抑制卵巢癌腹膜转移瘤和腹水生长,为晚期卵巢癌伴腹膜转移患者诊疗提供新思路。     

游离型腰椎间盘突出症的发病危险因素分析

将经手术确诊的游离型腰椎间盘突出症(观察组)、非游离型腰椎间盘突出症患者(对照组)各290例,按1:1配对,对两组相关资料采用Logistic回归模型行单因素和多因素分析.结果显示,病程>10a、曾行牵引治疗、按摩治疗、剧烈活动、血清IgM升高、血糖升高是游离型腰椎间盘突出症的发病危险因素.认为游离型腰椎间盘突出症并非由单一因素所致,对相关危险因素进行干预可降低其发病率并改善预后.     

内镜超声无水酒精注射腹腔神经丛治疗上腹部癌痛

目的探讨内镜超声(EUS)引导下腹腔神经丛注射无水酒精对癌痛的治疗作用.方法选择癌痛病例记录疼痛分数并随访,用纵轴式彩色EUS显示腹主动脉第一分支,在其两侧注射无水酒精.结果10例胰腺癌,1例胆囊癌,1例胃癌.全部病例均有转移征象.注射前疼痛分数(0～10分级)为:胰腺癌6.7 ± 0.3、胆囊癌5.9、胃癌6.0;注射后12周为胰腺癌1.2±1.0、胆囊癌1.3、胃癌1.5.并发症:8例注射后发生体位性低血压,6例出现腹泻,3例出现注射部位轻微渗血,用镜身压迫止血.全部病例无感染及穿孔发生.结论EUS引导下腹腔神经丛注射能够安全有效缓解腹腔内癌痛.     

真性红细胞增多症并腹腔自发性血肿1例

患者 ,男 ,48岁。皮肤紫红 3年 ,间断性头痛半年 ,近日加重于 2 0 0 1年 1 2月 8日下午入院。既往健康 ,有十二指肠球部溃疡史 3年 ,无外伤史 ,无任何药物服用史 ,已戒烟 1 0年。体检 :血压 2 1 0 /1 2 0ｍｍＨｇ(1ｍｍＨｇ=0 .1 3 3ｋＰａ) ,面部、颈部及手掌皮肤发红 ,肝、脾和淋巴结无肿大。血常规 :血红蛋白2 2 0ｇ/Ｌ ,红细胞 9.1 5× 1 0 12 /Ｌ ,红细胞压积 (Ｈｃｔ)0 .66,血小板 41 4× 1 0 9/Ｌ ,白细胞 1 8.5× 1 0 9/Ｌ ,中性分叶核细胞 0 .87,淋巴细胞 0 .1 3。尿常规蛋白 ++++,红细胞 +++。肝、肾功能正常。动脉血氧饱和度0 .9…     

榄香烯对人肺腺癌SPC-A-1细胞VEGF-C及VEGFR-3表达的影响

目的探讨榄香烯对体外培养的人肺腺癌SPC-A-1细胞株血管内皮生长因子（VEGF-C）及其受体VEGFR-3表达水平的影响。方法采用免疫细胞化学方法对药物作用后的SPC-A-1细胞VEGF-C、VEGFR-3的表达水平进行检测。结果榄香烯能明显抑制肺腺癌SPC-A-1细胞的生长并降低VEGF-C、VEGFR-3的表达水平,而且有时间和浓度依赖性。结论榄香烯通过降低肺腺癌细胞VEGF-C、VEGFR-3的表达水平,从而遏制了肿瘤血管、淋巴管转移。