腹壁会阴切口子宫内膜异位症30例临床分析

目的探讨腹壁子宫内膜异位症(内异症)的发病机制、诊断和治疗。方法回顾性分析我院1987年-2003年收治的30例腹壁会阴切口内异症的临床特点、治疗方法。结果30例患者中,腹壁内异症患者22例,均有剖宫产手术史,会阴EP切口内异症8例。均有典型周期性腹痛,肿块,手术切除均取得良好效果,未有复发。结论子宫内膜异位种植是本症的主要发病机制。根据典型的症状、体征,结合B超可正确诊断。彻底手术是唯一确实有效的治疗方法。     

Repeated sequences and the sites of genome rearrangements in bacteriophages ofLactobacillus delbrueckii subsp.lactis

Summary We have sequenced the KIS-element, a 1.5 kb insertion segment present in the genome ofLactobacillus delbrueckii subsp.lactis phage LL-K, but absent from its close relative, phage LL-H. The KIS-element showed some sequence features of a transposable element: it was flanked by direct repeats of a 20 nt long sequence which was in the genome of LL-H as a target sequence. The KIS-element contained two putative ORFs. The C-terminal part of ORF333 consisted of clusters of direct repeats, capable of coding Lys/Arg-Gly-Asp motifs, which are known to be able to bind to glycoproteins. A homologous counterpart of the KIS-element was also found in the genome of prolate-headedL. delbrueckii subsp.lactis phage JCL1032, even though the phage JCL1032 is not a close relative of phage LL-K. The nucleotide sequence comparison between KIS-element and its homologous counterpart in JCL1032 showed that there have occurred several genome rearrangements at the repeat clusters.     

Paraplegia after thoracotomy--not caused by the epidural catheter

BACKGROUND: Paraplegia and peripheral nerve injuries may arise after general anaesthesia from many causes but are easily ascribed to central block if the latter has been used. CASE REPORT: A 56-yr-old woman, with Bechterev disease but otherwise healthy, was operated with left-sided thoracotomy to remove a tumour in the left lower lobe. She had an epidural catheter inserted in the mid-thoracic area before general anaesthesia was started. Bupivacaine 0.5% 5 ml was injected once and the infusion of bupivacaine 0.1% with 2 micrograms/ml fentanyl and 2 micrograms/ml adrenaline (5 ml/h) started at the end of surgery. The patient woke up with total paralysis in the lower limb and sensory analgesia at the level of T8, which remained unchanged at several observations. Laminectomy, performed 17 h after the primary operation, showed a large piece of a haemostatic sponge (Surgicel) compressing the spinal cord, which was then decompressed but the motor and sensory deficit remained virtually unchanged both then and a year later. CONCLUSIONS: This case shows--once again--that although central blocks may cause serious neurological complications and paraplegia, other causes are possible and have to be considered. However, all patients with an epidural catheter must be monitored for early signs and symptoms of an intraspinal process and the appropriate treatment has to be instituted instantly.     

Increasing mitochondrial ATP synthesis with butyrate normalizes ADP and contractile function in metabolic heart disease

Metabolic heart disease (MHD), which is strongly associated with heart failure with preserved ejection fraction, is characterized by reduced mitochondrial energy production and contractile performance. In this study, we tested the hypothesis that an acute increase in ATP synthesis, via short chain fatty acid (butyrate) perfusion, restores contractile function in MHD. Isolated hearts of mice with MHD due to consumption of a high fat high sucrose (HFHS) diet or on a control diet (CD) for 4 months were studied using ³¹P NMR spectroscopy to measure high energy phosphates and ATP synthesis rates during increased work demand. At baseline, HFHS hearts had increased ADP and decreased free energy of ATP hydrolysis (ΔG _{~ ATP}), although contractile function was similar between the two groups. At high work demand, the ATP synthesis rate in HFHS hearts was reduced by over 50%. Unlike CD hearts, HFHS hearts did not increase contractile function at high work demand, indicating a lack of contractile reserve. However, acutely supplementing HFHS hearts with 4mM butyrate normalized ATP synthesis, ADP, ΔG _{~ ATP} and contractile reserve. Thus, acute reversal of depressed mitochondrial ATP production improves contractile dysfunction in MHD. These findings suggest that energy starvation may be a reversible cause of myocardial dysfunction in MHD, and opens new therapeutic opportunities.     

Antibacterial Activity of Pepducins,Allosterical Modulators of Formyl Peptide Receptor Signaling

Pepducins containing a fatty acid linked to an amino acid sequence derived from cytosolic parts of a G-protein-coupled receptor (GPCR) constitute a new group of lipopeptide tools in GPCR studies. Pepducins corresponding to the third intracellular loop of formyl peptide receptor 2 (FPR2) activate human neutrophils, and we show here that, in addition, these allosteric modulators of receptor activity also kill bacteria. The functional dualism of FPR2 pepducins could potentially be explored as a novel class of antibacterial drugs with immunomodulatory properties.     

脑源性神经营养因子在乳鼠结肠扩张刺激诱导的慢性内脏高敏感和肠道动力异常中的作用

背景：慢性内脏高敏感和肠道动力异常是肠易激综合征（IBS）的主要病理生理特征，但两者的形成机制至今尚未明确。目的：研究乳鼠结肠扩张刺激动物模型成年后内脏感觉和肠道动力的变化以及脑源性神经营养因子（BDNF）在其中所起的作用，从而探讨BDNF在IBS发病机制中的作用。方法：建立乳鼠结肠扩张动物模型，通过检测成年大鼠对结直肠扩张的行为学反应评估内脏感觉．通过检测全胃肠和小肠传输功能评估肠道动力。比较腹腔注射BDNF抗体后内脏感觉和肠道动力的变化情况。以逆转录聚合酶链反应（RT-PCR）、蛋白质印迹法、酶联免疫吸附测定（EUSA）检测各组回肠、结肠BDNF及其受体TrkB的表达。结果：模型组成年后内脏敏感性增高，肠道动力增强。应用BDNF抗体后模型组内脏敏感性降低，肠道动力减弱。除成年期模型组结肠TrkB mRNA表达外，其余各组BDNF和TrkB mRNA表达均显著高于对照组（P〈0．05）。乳鼠期和成年期模型组回肠、结肠BDNF和TrkB蛋白表达均显著高于对照组（P〈0．05）。结论：BDNF在慢性内脏高敏感和肠道动力的变化中起一定作用，参与了IBS的发生。     

238例支气管肺泡灌洗液细胞病理学结果分析与临床意义

目的通过对2012年3月至2014年11月贵阳市第五人民医院238例支气管肺泡灌洗液(bronchoalvelar lavage fluid,BALF)细胞病理学检查结果分析,探讨其在临床肺部疾病诊治中的意义。方法留取支气管肺泡灌洗液15~20m L,所有标本用Thin Prep液基细胞学技术涂片后行HE染色、过碘酸-雪夫(PAS)染色、六胺银(GMS)染色、抗酸染色。结果238例BALF标本中查见异常成分的80例(33.6%);其中卡氏肺囊虫47例,分枝杆菌15例,真菌8例,巨细胞病毒2例,复合感染3例,查见肿瘤细胞5例。结论本院送检支气管肺泡灌洗液标本异常检出率高,细胞病理学检查为肺部疾病诊断提供方便快捷的形态学依据,有重要临床应用价值。     

Combined detection of preoperative serum CEA,CA19-9 and CA242 improve prognostic prediction of surgically treated colorectal cancer patients

We assessed the prognostic significance of preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 242 (CA242) levels in surgically treated colorectal cancer patients. The relationship of preoperative serum CEA, CA19-9 and CA242 levels with disease characteristics was investigated in 310 patients. Correlation between tumor markers was investigated using Pearson correlation test. Univariate and multivariate survival analyses were used to study the relationship between preoperative tumor markers and prognosis [disease free survival (DFS) and overall survival (OS)]. Kaplan-Meier analysis with log rank test was used to assess the impact of tumor marker levels on survival. Positive rate of preoperative serum CEA, CA19-9 and CA242 were 54.84%, 47.42% and 37.10%, respectively. High preoperative CEA level was associated with tumor size (P = 0.038), T stage (P < 0.001) and AJCC stage (P = 0.002). High preoperative CA19-9 level was associated with tumor AJCC stage (P = 0.023). Preoperative CA242 positively correlated with CEA (P < 0.001) and CA19-9 (P < 0.001). Combining the three markers was of independent prognostic value in CRC (HR = 2.532, 95% CI: 1.400-4.579, P = 0.002 for OS; and HR = 2.366, 95% CI: 1.334-4.196, P = 0.003 for DFS). Combined detection of preoperative serum CEA, CA19-9 and CA242 is of independent prognostic value for management of CRC patients treated surgically.     

A Robust Approach for Blind Detection of Balanced Chromosomal Rearrangements with Whole‐Genome Low‐Coverage Sequencing

Balanced chromosomal rearrangement (or balanced chromosome abnormality, BCA) is a common chromosomal structural variation. Next‐generation sequencing has been reported to detect BCA‐associated breakpoints with the aid of karyotyping. However, the complications associated with this approach and the requirement for cytogenetics information has limited its application. Here, we provide a whole‐genome low‐coverage sequencing approach to detect BCA events independent of knowing the affected regions and with low false positives. First, six samples containing BCAs were used to establish a detection protocol and assess the efficacy of different library construction approaches. By clustering anomalous read pairs and filtering out the false‐positive results with a control cohort and the concomitant mapping information, we could directly detect BCA events for each sample. Through optimizing the read depth, BCAs in all samples could be blindly detected with only 120 million read pairs per sample for data from a small‐insert library and 30 million per sample for data from nonsize‐selected mate‐pair library. This approach was further validated using another 13 samples that contained BCAs. Our approach advances the application of high‐throughput whole‐genome low‐coverage analysis for robust BCA detection—especially for clinical samples—without the need for karyotyping.