• 2008年第28卷第6期文章目次
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    • >南京医科大学学报(英文版)
    • The clinical application of clopidogrel in current coronary artery surgery

      2008, 28(6):329-334. DOI: 10.7655

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      摘要:The article presents an overview of the current clinical application of clopidogrel in coronary artery surgery. The viewpoint is that clopidogrel can reduce preoperative and postoperative ischemic events of coronary artery bypass grafting(CABG). With the development of standardized medication and the corresponding preventive technique, it will be of great value to reduce hemorrhage complications and obtain the maximum benefit from clopidogrel’s anti-platelet properties.

    • The Research of Artificial Cervical Disc Replacement

      2008, 28(6):335-337. DOI: 10.7655

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      摘要:Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new times of the management of cervical spine disease.

    • Critical Amino Acid Residues for Nicotine 5’-Hydroxylation in Human CYP2A Enzymes

      2008, 28(6):338-345. DOI: 10.7655

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      摘要:Objective: We have continued previous work in which we demonstrated that #117 and #372 amino acids contrib-uted to the high activities of human CYP2A13 in catalyzing 4-methylnitrosamino-1-(3-pyridyl)-1-butanone(NNK) and aflatoxin B1(AFB1) carcinogenic activation. The present study was designed to identify other potential amino acid residues that contribute to the different catalytic characteristics of two CYP2A enzymes, CYP2A6 and CYP2A13, in nicotine metabolism and provide insights of the substrate and related amino acid residues interactions. Methods:A series of reciprocally substituted mutants of CYP2A6Ile300→Phe, CYP2A6Gly301Ala, CYP2A6Ser369→Gly, CYP2A13Phe300→Ile, CYP2A13Ala301→Gly and CYP2A13Gly369→Ser were generated by site-directed mutagenesis/baculovirus-Sf9 insect cells expression. Comparative kinetic analysis of nicotine 5’hydroxylatin by wild type and mutant CYP2A proteins was performed. Results:All amino acid residue substitutions at 300, 301 and 369 caused significant kinetic property changes in nicotine metabolism. While CYP2A6Ile300→Phe and CYP2A6Gly301→Ala mutations had notable catalytic efficiency increases compared to that for the wild type CYP2A6, CYP2A13Phe300→Ile and CYP2A13Ala301→Gly replacement introduced remarkable catalytic efficiency decreases. In addition, all these catalytic efficiency alterations were caused by Vmax variations rather than Km changes. Substi-tution of #369 residue significantly affected both Km and Vmax values. CYP2A6Ser369→Gly increase the catalytic efficiency via a significant Km decrease versus Vmax enhancement, while the opposite effects were seen with CYP2A13Gly369→Ser. Conclusion:#300, #301 and #369 residues in human CYP2A6/13 play important roles in nicotine 5’-oxidation. Switching #300 or #301 residues did not affect the CYP2A protein affinities toward nicotine, although these amino acids are located in the active center. Ser369 to Gly substitution indirectly affected nicotine binding by creating more space and conformational flexibility for the nearby residues, such as Leu370 which is crucial for many hydroxylations.

    • Discrimination of mitochondrial DNA 10400 locus by SNP-operated on/off Switch

      2008, 28(6):346-350. DOI: 10.7655

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      摘要:Objective:To apply reformed AS-PCR, which combined phosphorothioate-modified primers with exo+ polymerase, in single nucle-otide polymorphism discrimination of mitochondrial DNA 10400 locus. Methods: We used the mtDNA 10400 locus to design unmodi-fied and 3′phosphorothioate-modified allele-specific primers for PCR, which was performed using polymerases with and without 3′exonuclease activities. The effects of these primers on primer-extension were evaluated by agarose gel electrophoresis. Results: The unmodified primers were extended by both exo- and exo+ polymerase irrespective of whether the primers were matched or mismatched with the templates. However, the 3′phosphorothioate-modified primers with a terminal mismatch triggered an “off-switch”of exo+ polymerase when compared to exo-polymerase. Conclusion: The“on/off”switch constituted by the combination of 3′phosphorothioate-modified primers with exo+ polymerase is a cost-effective, high-throughput and reliable method for SNP typing, which will be of enormous application in association studies by single nucleotide polymorphism screening.

    • Effect of Atorvastatin on Serum MMP-2, MMP-9 and TIMP-1 in Rabbits with Chronic Heart Failure

      2008, 28(6):351-355. DOI: 10.7655

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      摘要:Objective: To observe the effects of atorvastatin on serum matrix metalloproteinase-2(MMP-2), matrix metalloproteinase-9(MMP-9), and the tissue inhibitor of metalloproteinase-1(TIMP-1) in the development of chronic heart failure. To investigate the role of atorvastatin in the therapy of chronic heart failure and determine its possible mechanism of action. Methods: Thirty Japanese Big Ear rabbits were randomly selected and divided into 3 groups: sham-operated group(SO group), heart failure control group(HC group) and heart failure atorvastatin therapy group(HA group), with 6, 12 and 12 animals in the respective groups. Volume overloading was produced in the HC group and HA group animals by creating an aortic insufficiency, induced by damaging the aortic valve with a catheter introduced through the carotid artery. After 14 days, abdominal aorta constriction was performed in order to obtain a pressure overload. Six weeks later rabbits in the HA group were administered atorvastatin 3mg. Kg-1.d-1 for 4 weeks, at which time the experiment was terminated. Arterial blood was drawn and serum levels of MMP-2, MMP-9 and TIMP-1 were measured in all groups at the same time using an ELISA method. Results: Structural and functional indicators of chronic heart failure(CHF) were seen in both the HC and HA groups, but atorvastatin significantly reduced the observed effects. The serum concentrations of MMP-2, MMP-9 and TIMP-1 were at low levels in all three groups at the start of the study, with no difference between them(P < 0.05). At the end of 6th week concentrations were significantly increased in the HC and HA groups compared with the SO group(P < 0.05), but there were no differences between the HC group and HA group(P > 0.05). The increased concentrations in HC group continued to the end of the experiment, but values in the HA group were all lower than those in the HC group by the end of the experiment(P < 0.05). Conclusion: Serum concentrations of MMP-2, MMP-9 and TIMP-1 increase significantly during the course of CHF, paralleling the pathological progress of CHF. Atorvastatin benefits CHF, and the decreased serum levels of MMP-2, MMP-9 and TIMP-1 may be one of the drug’s mechanism of action.

    • Downregulation of metabotropic glutamate receptors mGluR5 and glutamate transporter EAAC1 in the myenteric plexus of the diabetic rat ileum

      2008, 28(6):356-361. DOI: 10.7655

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      摘要:Objective: To study the morphologic abnormalities of the myenteric plexus in diabetic rats and to explore the mechanism of their effect on gastrointestinal motility. Methods: Forty rats were randomly divided into a diabetic group and a control group, Gastric emptying and small intestine transit rates were measured and histologic and molecular changes in glutamatergic nerves in the ileal myenteric plexus were observed, mGluR5 receptor and EAAC1 transporter changes in the diabetic rats were studied using fluorescence immunohistochemistry and RT-PCR. Results:Eighteen weeks after the establishment of the diabetic rats model, gastric emptying and small intestine transit rates were found to be significantly delayed in the diabetic group when compared with the control group. The density of glutamatergic ganglia and neurons in the ileal myenterie plexus were significantly decreased in the diabetic group when compared with control group(P < 0.05) and the mGluR5 receptors and EAAC1 transporters were downregulated in the diabetic rats(P < 0.05). Conclusion: Decreased glutamatergic enteric ganglia and neurons and decreased mGluR5 receptors and EAAC1 transporters in the intestinal myenteric plexus is one of the mechanisms of diabetic gastroenteropathy in rats.

    • Value of Apparent Diffusion Coefficient(ADC) of Diffusion eighted Magnetic Resonance Imaging in Common Renal Disease Diagnosis

      2008, 28(6):362-365. DOI: 10.7655

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      摘要:Objective:To find the value of the apparent diffusion coefficient (ADC) of diffusion weighted magnetic resonance imaging of common renal diseases. Methods: There were 30 healthy subjects and 81 patients with renal lesions (56 cases of renal carcinoma, 18 lesions of 12 cases of renal angiomyolipoma, and 21 lesions of 13 cases of renal cysts). Conventional magnetic resonance imaging and diffusion weighted magnetic resonance imaging were carried out. We measured the average ADC value of the renal lesions and normal kidneys. ADC maps from different b values were generated by a statistical package. Results: The ADC values of normal kidneys with three different motion-probing gradients(b=500, 800, 1000 sec/mm2) were 2.78±0.14×10-3mm2s-1, 2.45±0.13×10-3mm2s-1, 2.13±0.14×10-3mm2s-1, respectively. The ADC values of renal cell carcinoma with three different motion-probing gradients(b=500, 800, 1000 sec/mm2) were 1.63±0.14×10-3mm2s-1, 1.31±0.18×10-3mm2s-1, 1.07±0.15×10-3mm2s-1, respectively. Among the renal cell carcinoma, the ADC value of clear cell type were 1.67±0.09×10-3mm2s-1, 1.36±0.13×10-3mm2s-1, 1.15±0.14×10-3mm2s-1,respectively; the ADC values of granular cell type were 1.59±0.19×10-3mm2s-1, 1.25±0.22×10-3mm2s-1, 0.97±0.12×10-3mm2s-1, respectively. The ADC values of renal angiomyolipoma with three different motion-probing gradients(b=500, 800, 1000 sec/mm2) were 0.88±0.08×10-3mm2s-1, 0.63±0.07×10-3mm2s-1, 0.43±0.04×10-3mm2s-1, respectively. The ADC values of renal cystic lesions with three different motion-probing gradients(b=500, 800, 1000 sec/mm2) were 3.73±0.18×10-3mm2s-1, 3.44±0.13×10-3mm2s-1, 3.09±0.21×10-3mm2s-1, respectively. Statistically significant differences exists between the ADC values of normal kidney, renal carcinomas, renal angiomyolipomas and renal cysts when the b value is the same. Among the different cell types of renal carcinomas, the ADC value of granular cell carcinoma is lower than that of clear cell carcinomas. Conclusion: It is of benefit in diagnosing and distinguishing between benign and malignant renal tumors to know the ADC values in diffusion weighted magnetic resonance imaging. Furthermore, these values help to know the internal structure of the tumor and the tumor typel, which is helpful to the treatment and in predicting the patient’s prognosis.

    • TNF-alpha-induced metastasis gene changes in MCF-7 cells

      2008, 28(6):366-371. DOI: 10.7655

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      摘要:Objective: Studies have shown that TNF-αsecreted by tumor cells and macrophages infiltrated into the tumor microenvironment might promote the metastasis of a variety of malignant cancers, including breast cancer. The present study was designed to detect global metastasis-related gene expression changes of MCF-7 cells treated by low dose TNF-α and to further explore the mechanisms by which TNF-αcontributes to metastasis. Methods: MCF-7 cells were cultured and treated with low dose TNF-α(20 ng/ml). cDNA array analysis was applied to detect the metastasis related gene expressions. Results: A total of 36 gene expressions were significantly regulated by TNF-α. Functional analysis indicates that the altered genes belong to different functional group. Most of the genes changed may promote the metastasis of MCF-7 cells while the others may inhibit metastasis. The changes observed in gene expression following TNF-αwere somewhat time dependent. Conclusion: TNF-αcan enhance the invasive ability of MCF-7 cells, partly by regulating a series of metastasis related genes, and these genes may take part in every step of metastasis. Some of the genes deserve further study.

    • Experimental study of natural hydroxyapatite/chitosan composite on reconstructing bone defects

      2008, 28(6):372-375. DOI: 10.7655

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      摘要:Objective:To study the possibility of natural hydroxyapatite/chitosan composite on repairing bone defects. Methods:We developed a natural hydroxyapatite/chitosan composite that could be molded into any desired shape. The powder component consists of natural hydroxyapatite, which is epurated from bone of pigs. The liquid component consists of malic acid and chitosan. Operations were performed on the left tibias of 15 white rabbits to create two square bone defects. One of the defects was reconstructed with the composite, while the other was not repaired and used as a blank control. Three of the animals were killed at the end of 2 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks respectively and implants were evaluated anatomically and histologically. Results:No apparent rejection reaction was found, except for a mild inflammatory infiltration observed 2 weeks after surgery. Fibrous tissue became thinner 2 ~8 weeks after surgery and bony connections were detected 12 weeks after surgery. The new bone was the same as the recipient bone by the 16th postoperative week. Conclusion:The hydroxyapatite/chitosan composite has good biocompatibility and osteoconduction. It is a potential repairing material for clinical application.

    • A Study of the electronic information monitoring of bruxism

      2008, 28(6):376-378. DOI: 10.7655

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      摘要:Objective:Bruxism is the term used for teeth grinding or jaw clenching. An electronic monitor of bruxism was developed to evaluate bruxism duration and frequency. Methods: Ten cases were selected in the Department of Prosthodontics of Jiangsu Stomatological Hospital to evaluate the monitor. A stabilization occlusal splint was fabricated for each of the 10 cases. The vertical dimension for each splint was 0.5 mm lower than mandibular postural position. Some sensors had been prearranged at each splint which could transfer the variation of the biting force into electronic signals. The data of sleeping duration, grinding duration and grinding frequency were recorded with this new type of bruxism monitor, which had been specifically invented to study bruxism. Results:The data from 10 bruxism cases were collected and the results were considered reliable. Subjects nocturnal duration parameters did not change significantly from night-to-night. Conclusion:The bruxism monitor can automatically measure and record bruxism data using an occlusal splint. This device is valuable for diagnosis and evaluation of bruxism.

    • Clinical evaluation of Xive implants 3-year after placement

      2008, 28(6):379-381. DOI: 10.7655

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      摘要:Objective: The main purpose of this retrospective study is to evaluate clinical outcomes of Xive implants 3-year after insertion. Methods: 219 Xive implants were placed in 139 patients and their clinical effects were evaluated using the Albrektsson Standard. Results:The 3-year survival rate of the Xive implants is 97.26%(213/219). Eleven cases of immediate implants and 15 cases of implant insertion after maxillary sinus lifting all succeeded. The failure ratio is 6/219(2.74%) with failures resulting from excess bone loss in the implant region, peri-implant mucosal inflammation or continuous pain caused by some unknown reasons. Conclusion: Xive implants are clinically effective for the restoration of missing teeth. Immediate implant and implant following maxillary sinus lifting were also successful.

    • Comparisons of different methods of anesthesia and analgesia on the levels of glycometabolism rate-limiting enzymes in erythrocytes and plasma glucose and stress hormones in patients undergoing esophagus surgery

      2008, 28(6):382-386. DOI: 10.7655

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      摘要:Objective: To compare the effects of different methods of anesthesia and analgesia on the activities of phosphofructokinase(PFK), glucose-6-phosphate dehydrogenase(G-6PD) and aldose reductase(AR) in erythrocytes and levels of plasma glucose and stress hormones in patients undergoing esophagus surgery. Methods: Sixty-two patients scheduled for esophagus surgery were randomly divided into three groups: groupⅠ(n = 20) receiving only general anesthesia(GA) followed by intravenous patient controlled analgesia(PCA) with fentanyl 15μg/kg. The other two groups receiving both general anesthesia combined with thoracic epidural anesthesia (GEA) and either intravenous PCA with fentanyl 15μg/kg (groupⅡ, n = 21) or thoracic epidural analgesia(TEA) with 0.125% ropivacaine and 0.0002% fentanyl mixture(groupⅢ, n = 21) after the operation. Venous blood samples were collected for measurements of PFK, G-6PD and AR activities in erythrocytes and plasma glucose, cortisol, epinephrine and norepinephrine before induction (T1), 60 min following the incision (T2), 60 min(T3) after operation, on the 1st(T4) and 2nd postoperative day(T5). Results: The activities of PFK decreased(P < 0.01 or P = 0.004) and the activities of G-6PD and AR increased(P < 0. 01) in groupsⅠand Ⅱ on T4 compared with those on T1. Between the two groups, the activities of these enzymes in groupⅡchanged less than those of groupⅠ(P < 0.01 or P < 0.05). These enzymes activities changed slightly in group Ⅲ on T4(P > 0.05). There were significant differences between group Ⅲ and the other two groups(P < 0.01 or P < 0.05). The levels of plasma glucose increased significantly on T2(P < 0.01), reached peak values on T4(P < 0.01) and fell on T5 in the three groups. Compared to those of groupsⅠandⅡ, the values of plasma glucose in group Ⅲ were lower on T4 and T5(P < 0.05 or P < 0.01). The cortisol concentration in each group increased significantly at T2(P < 0.01 or P < 0.05), and remained elevated on T5(P < 0.01 or P < 0.05), while on T2 and T3 the cortisol levels of groupⅠwere higher than that of groupsⅡand Ⅲ(P < 0.05). The levels of group Ⅲwere lower than those of the other groups on T4 and T5(P < 0.01 or P < 0.05). The levels of epinephrine and norepinephrine were also significantly higher in group I than those of the other two groups on T2(P < 0.01 or P < 0.05), and their levels in groupⅠandⅡwere higher than that of group Ⅲ on T4. The patients of the three groups obtained satisfactory pain relief, with all Vidual Analogue Scale(VAS) scores less than 3. VAS scores of groupⅠwere much greater 4h after operation. Group Ⅲ VAS scores were the lowest 24h after operation. However, the number of times patients pressed the bolus switch was higher in groupⅡ(P < 0.01). Conclusion: Compared with GA and intravenous PCA, general anesthesia combined with thoracic epidural anesthesia and analgesia obtain better pain relief and could markedly alleviate the stress response and improve these erythrocyte glucose metabolism changes after esophagus surgery.

    • Clinical Investigation and Experience with Distal phalanx Replantation

      2008, 28(6):387-390. DOI: 10.7655

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      摘要:Objective: To explore the measures and methods for improving distal phalanx replantation. Methods: One hundred and forty-eight cases with distal phalanx replantation from Sep 2004 to Sep 2007 were investigated. The indication for surgery and the operative program was determined by the trauma type and the degree of injury. As many microcirculation pathways as possible were reconstructed during the operation, and postoperative tissue decompression was also performed. Results: The survival rate of distal phalanx replantation was 89.9%(169/148). Conclusion: To improve the survival rate of distal phalanx replantation it is essential to reconstruct an effective local blood circulation, determine the degree of injury in cases with ecchymosis, and employ comprehensive postoperative measures.

    • A Study on the Factors influencing insulin resistance in obese adolescents

      2008, 28(6):391-394. DOI: 10.7655

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      摘要:Objective: To explore the factors influencing insulin resistance in obese Chinese children. Methods: We randomly selected 53 children with uncomplicated obesity between 9 to14 years of age, and 29 normal healthy children, matched for age and sex. Anthropometric and plasma biochemical variables(including lipid profiles, glucose and insulin) were measured using standard methods. We calculated insulin resistance(IR) index using homeostasis model assessment(HOMA) methods and measured plasma high-sensitivity C-reactive protein(hs-CRP) levels using nephelometric methods. All statistical analyses were conducted using the statistical package SPSS. Results: Levels of fasting serum insulin, hs-CRP, total cholesterol(TC), low density lipoproteins cholesterol(LDL-C) and IR index were higher in obese children than in controls, while high-density lipoprotein cholesterol(HDL-C) values were lower in the obese children. There was no significant difference in levels of fasting blood glucose between the two groups. HOMA-IR was used as the dependent variable in multivariate regression analysis. Significant independent predictors for insulin resistance adjusted for waist/hip ratio, diastolic pressure (DBP), BMI, triglycerides and HDL-C level were waist circumference(WC), weight and systolic pressure(SBP). Conclusion: Waist circumference, weight and SBP are predictors of insulin resistance syndrome in Chinese adolescents

    • The feasibility of left radial artery approach for coronary angiography

      2008, 28(6):395-397. DOI: 10.7655

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      摘要:Objective:To study the feasibility of the left radial approach for coronary angiography. Methods:195 patients diagnosed with coronary atherosclerotic heart disease were randomly divided for coronary angiography(CAG) into a left radial artery approach group(98 cases) and a right radial artery approach group(97 cases) from Jan 2006 to Dec 2006. Selective coronary angiographies were performed with 5F TIG catheters. The time of puncturing, duration under X-ray fluoroscopy and of the operation, successful rates of puncturing and coronary angiography were recorded. Results:There was no difference in the time of puncturing(2.25±1.58 min vs 2.19±1.62 min), duration under X-ray fluoroscopy(3.12±1.53 min vs 3.21±1.49 min) and the duration of the operation(12.87±2.52 min vs 12.98±2.85 min), nor in the success rates of puncturing(95.91% vs 95.87%) and coronary angiography(94.90% vs 94.85%). Conclusion: Coronary angiography can be accomplished via the left radial artery approach, indicating that this is a worthwhile clinical approach.

    • Nursing of advanced colorectal cancer patients treated with Cetuximab combined with chemotherapy

      2008, 28(6):398-400. DOI: 10.7655

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      摘要:Cetuximab is a new medication that has recently been approved for the treatment of advanced colorectal cancer. To date we have had little experience in using this targeted agent. Eleven patients in our hospital with advanced colorectal cancer were treated with cetuximab and chemotherapy. Based on the curative effect of this combination therapy, we have concluded that the following nursing practices make an important contribution to the patients’prognosis and wellbeing: to establish a good nurse-patient relationship, to increase patient understanding of the side effects, to standardize the medications, to observe and to deal with the side effects of the medications(for example skin reaction, neutropenia, and diarrhea), and to provide continuous mental health care support and education.

    • >南京医科大学学报(自然科学版)
    • 血糖和胰岛素对糖尿病小鼠胃窦Cajal细胞的影响

      2008, 28(6):693-696. DOI: 10.7655

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      摘要:目的:探讨高血糖及胰岛素不足对正常及糖尿病(DM)小鼠胃窦Cajal间质细胞(ICC)数量及超微结构的影响-方法:链脲佐菌素腹腔注射建立DM模型;分组:正常对照组(A组)-正常+高糖组(B组,予葡萄糖腹腔注射)-DM未干预组(C组)-DM+胰岛素组(D组,予长效胰岛素);监测血糖;饲养6周后ELISA测血清胰岛素,流式细胞法检测胃窦ICC数量,透射电镜观察ICC超微结构-结果:DM小鼠建模并干预6周后,与A组相比,B组血糖呈一过性增高,C组明显增高(P < 0.05),D组无明显差异(P > 0.05)-血清内源性胰岛素:B组与A组无显著差异;C-D组间也无显著差异(P > 0.05),但均较A组低(P < 0.05)-ICC数量:B组及DM各组均较A组减少(P < 0.05),C组与D组无差异(P > 0.05)-ICC超微结构:与A组比较,各实验组均可见:ICC细胞器溶解减少-线粒体空泡样变-细胞间隙增宽,尤以B-C组改变最突出-结论:DM小鼠胃窦ICC数量减少-伴有超微结构的改变;一过性及持续性高血糖主要使ICC超微结构严重破坏-数量也有减少;内源性胰岛素不足可能使ICC数量减少;但与ICC超微结构无明显相关,补充外源性胰岛素不能预防或阻止ICC数量改变,但可能通过降低高血糖而预防ICC细胞结构损害-

    • 人源天然Fab噬菌体抗体库的构建及抗c-Met抗体的筛选?鉴定

      2008, 28(6):697-701. DOI: 10.7655

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      摘要:目的:构建大容量人源天然Fab噬菌体抗体库,筛选抗c-Met特异性抗体并进行初步鉴定-方法:采集20位健康成人的骨髓淋巴细胞,用PCR扩增人Fab片断抗体基因,插入载体pComb3XSS内,构建人源天然Fab抗体库-以固相化的抗原对抗体库进行6轮筛选后,随机挑选60个克隆用Phage ELISA-BstOⅠ酶切片断分析进行检测,阳性克隆作可溶性表达和鉴定-结果:构建的Fab噬菌体抗体库的库容为1.2 × 109,从中筛选到1株与c-Met特异性结合的人源抗体克隆,命名为AM2-26-DNA序列分析证明为人免疫球蛋白可变区基因,Western blot证实为人源抗c-Met Fab抗体片段,ELISA特异性鉴定阳性-结论:构建了大容量人源天然Fab抗体库,从中获得1株抗c-Met人源Fab抗体片段,有望为抗肿瘤药物的研制提供新的候选分子-

    • HIV-1 Rev基因编码蛋白在PEL细胞系中的表达及其表达蛋白抑制HHV-8溶解性周期复制

      2008, 28(6):702-706. DOI: 10.7655

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      摘要:目的:构建含人类免疫缺陷病毒1型(HIV-1)病毒颗粒蛋白表达调节因子(regulator of virion protein expression,Rev)编码基因的重组真核表达质粒并初步探索Rev基因编码蛋白对人类疱疹病毒8型(HHV-8)溶解性周期复制的影响-方法:构建pRev-Flag重组质粒并进行酶切鉴定和序列测定;将pRev-Flag重组质粒瞬时转染原发性渗出性淋巴瘤细胞系(PEL)BCBL-1细胞和小鼠胚胎成纤维细胞NIH/3T3,采用RT-PCR-Western blot分别从mRNA和蛋白水平检测Rev基因的表达情况;提取瞬时转染pRev-Flag重组质粒的BCBL-1细胞总RNA,进行RT-PCR检测HHV-8次要衣壳蛋白编码基因ORF26 mRNA转录水平-结果:核酸序列分析结果表明,克隆的Rev基因序列与GenBank中已登记的Rev序列100%同源,RT-PCR和Western blot都在Rev预期位置检测到特异性条带-RT-PCR检测显示,Rev基因编码蛋白能够降低HHV-8 ORF26 mRNA转录水平-结论:成功构建含Rev基因序列的重组质粒并在真核细胞中获得正确表达;初步探索表明Rev蛋白能够抑制HHV-8溶解性周期复制-

    • 离心应力下构建组织工程髓核

      2008, 28(6):707-711. DOI: 10.7655

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      摘要:目的:探讨离心应力对髓核细胞功能表达和组织工程髓核结构的影响-方法:取兔胸腰段椎间盘髓核组织,经胰蛋白酶,Ⅱ型胶原酶消化分离出细胞,在含15%灭活胎牛血清的DMEM/F12培养基中体外扩增至第3代,以3 × 107/ml的细胞悬液种植于PLGA无纺网支架上-实验组在离心力下培养(实验1组相对离心力为134.16 g,实验2组相对离心力为301.86 g,每天2次,每次离心20 min),对照组静态培养,每组4个标本,培养4周后取出髓核细胞与支架复合物,行大体标本,扫描电镜,组织学和免疫组织化学染色观察离心应力对组织工程髓核结构及Ⅱ型胶原分泌情况的影响-结果:离心应力下构建的组织工程髓核的厚度和直径大于对照组,细胞外基质明显多于对照组,Ⅱ型胶原免疫组化染色,实验1组阳性染色面积为(14.36 ± 2.82)%,实验2组阳性染色面积为(18.71 ± 2.14)%,对照组为(9.13 ± 1.58)%,实验1组-实验2组与对照组差异有统计学意义(P < 0.01),实验2组与实验1组差异有统计学意义(P < 0.05)-结论:一定范围的离心应力刺激髓核细胞增加Ⅱ型胶原的分泌,有利于在体外构建组织工程髓核-

    • 抗人胰岛素样生长因子-1单克隆抗体的制备与鉴定

      2008, 28(6):712-716741. DOI: 10.7655

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      摘要:目的:制备稳定分泌抗人胰岛素样生长因子-1(hIGF-1)单克隆抗体(mAb) 的杂交瘤细胞系,并对其分泌的mAb进行鉴定-方法:用纯化后的hIGF-1重组蛋白免疫Balb/c小鼠,利用杂交瘤细胞融合技术制备抗hIGF-1的mAb,用Western blot法鉴定mAb的特异性,用间接ELISA法检测mAb腹水效价及mAb的亲和力,杂交瘤细胞染色体分析,鉴定Ig亚类-结果:获得2株能稳定分泌抗hIGF-1的mAb杂交瘤细胞系,Western blot分析显示,该mAb能与具有生物学活性的成熟IGF-1蛋白结合-腹水mAb效价可达6 × 104-mAb相对亲和力为2.1×109/mol~7.8×109/mol-2株单抗属IgM亚类-染色体分析符合杂交瘤细胞特征-结论:成功制备出抗hIGF-1的2株mAb杂交瘤细胞,为进一步用于hIGF-1的临床检测和实验研究创造了条件-

    • Bmi-1基因表达与人骨髓间充质干细胞增殖关系的探讨

      2008, 28(6):717-721. DOI: 10.7655

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      摘要:目的:建立人骨髓间充质干细胞(hMSCs)的体外培养体系,研究hMSCs表面抗原的表达情况,以及体外传代培养对Bmi-1基因表达变化的影响,为进一步探讨Bmi-1基因在hMSCs增殖中的作用及调控机制提供依据-方法:骨穿抽取骨髓,以1.077 g/ml的Ficoll分离液梯度密度离心,收集单个核细胞进行培养和传代,观察细胞形态和生长周期-取P4代的hMSCs,流式细胞仪检测细胞表面抗原的表达情况-通过SA-β-gal的染色检测细胞的老化程度,通过抽提各代次细胞的RNA,逆转录PCR定量Bmi-1基因量的变化,分析与细胞倍增代数的关系-结果:体外培养的hMSCs贴壁生长,呈长梭形,可增殖形成克隆-经分离纯化培养后,流式细胞仪显示细胞表型为CD13,CD105,少量表达CD33,不表达造血细胞的标志CD34及CD117-SA-β-gal的染色显示随细胞培养时间延长,SA-β-gal染色更明显和清晰-逆转录PCR显示随传代次数的增加,hMSCs的增殖能力逐渐下降,Bmi-1基因表达随培养时间而减少-结论:本培养体系可获得纯度较高的hMSCs,具有强大的增殖能力-Bmi-1基因极可能是影响MSC增殖能力的一个重要基因-

    • HCV不同编码区重组基因的蛋白表达丰度分析

      2008, 28(6):722-725766. DOI: 10.7655

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      摘要:目的:探讨丙型肝炎病毒(HCV)不同基因片段重组载体在pET大肠杆菌系统中的蛋白表达情况-方法:分别将构建好的含有HCV C-NS3-NS5片段基因的pET重组质粒转化至大肠杆菌BL21(DE3)中,通过卡那霉素抗性筛选转化子-经过IPTG诱导表达相应的重组蛋白,通过Ni-NTA凝胶亲和层析纯化各目标蛋白,并分别计算各重组蛋白的浓度-结果:分别诱导表达含有HCVC-NS3-NS5片段基因的重组蛋白,各蛋白的浓度分别为:3.557(1型NS3)-4.238(6型NS3)-2.087(NS5)-1.490 g/L(C)-结论:在相同条件下,诱导表达含有HCV不同基因片段的重组载体,所得到的蛋白丰度存在差异-

    • 肝癌切除术后经肝动脉化疗栓塞对预防复发和提高生存率疗效的系统评价

      2008, 28(6):726-732. DOI: 10.7655

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      摘要:目的:评价肝癌术后早期经肝动脉化疗栓塞对预防复发及提高总生存率的疗效和安全性-方法:计算机检索Medline-Embase-Cochrane图书馆和中国生物医学文献数据库-中国期刊全文数据库和万方数据库中的相关文献,语种不限,所有检索均截止至2007年10月10日-检索所有有关肝癌术后经肝动脉化疗栓塞的随机对照试验,由2名评价员筛选和提取资料,并用改良后的Jadad量表进行质量评估,对符合纳入标准的研究采用RevMan4.2软件进行分析-结果:共纳入9个随机对照试验,6篇中文,3篇英文,总共586例-Meta分析结果显示:与单用手术治疗肝癌组相比,术后早期经肝动脉化疗栓塞可以明显降低复发率:术后6个月-1-3-5年复发率的相对危险度RR(95%CI) 分别为0.38(0.23~0.62)-0.61(0.41~0.90)-0.63(0.50~0.80)-0.74(0.60~0.90);术后早期经肝动脉化疗栓塞可以明显提高术后的总生存率:1-2-3-5年总生存率的RR值(95%CI) 分别为1.27(1.15~1.40)-1.52(1.25~1.85)-1.60(1.27~2.02)-1.78(1.09~2.90)-有3篇研究报道了与术后经肝动脉化疗栓塞治疗相关的不良反应,主要为轻中度的肝功能损害,消化道反应和暂时性发热,没有与术后经肝动脉化疗栓塞治疗相关死亡的报道-结论:现有证据显示肝癌术后早期经肝动脉化疗栓塞可以显著降低复发率,提高总生存率,尤其是大肝癌且伴有肝炎肝硬化-肉眼可见癌栓-无包膜或包膜不完整等复发高危因素的患者-但由于纳入的研究多数方法学质量较低,尚需更多更高质量的临床随机对照试验进一步评估证实其疗效和安全性-

    • 川芎嗪预处理在预防大鼠移植肝缺血再灌注损伤中的作用探讨

      2008, 28(6):733-736. DOI: 10.7655

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      摘要:目的:探讨川芎嗪预处理对大鼠移植肝缺血再灌注损伤的作用及可能的机制-方法:将125只雄性SD大鼠随机分成3组:假手术组-对照组(生理盐水作为肝脏灌注液)-实验组(川芎嗪预处理,生理盐水作为肝脏灌注液)-假手术组仅结扎肝动脉,对照组和实验组行大鼠原位肝移植,分别于术后1-6-24-72 h剖杀各组大鼠各5只,检测各组大鼠血浆丙氨酸氨基转移酶(ALT)-天门冬氨酸氨基转移酶(AST)的含量以及血清内毒素水平;检测肝脏组织肿瘤坏死因子-α(TNF-α)-白介素-1-茁(IL-1-茁)的含量,观察大鼠肝脏组织病理学和Kuffer’s细胞超微结构改变-结果:实验组大鼠的ALT-AST-TNF-α-IL-1-茁的表达明显低于对照组,但高于假手术组(P < 0.05);实验组炎症反应及Kuffer’s细胞活跃程度明显轻于对照组-结论:川芎嗪预处理能抑制kuffer’s细胞吞噬活性,减轻大鼠移植肝缺血再灌注损伤-

    • NF-κB活化及livin,survivin表达上调与胃癌细胞耐药的关系

      2008, 28(6):737-741. DOI: 10.7655

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      摘要:目的:探讨核转录调节因子NF-κB活性及凋亡抑制蛋白livin,survivin的表达与胃癌细胞耐药的关系-方法:MTT法检测化疗药物长春新碱(VCR)对胃癌细胞SGC7901及耐药细胞SGC7901/VCR的生长抑制作用;流式细胞仪检测VCR作用后细胞的凋亡率;ELISA法检测NF-κB核转录活性;Western blot检测livin,survivin蛋白表达-结果:化疗药VCR对SGC7901/VCR细胞的生长抑制作用较SGC7901细胞显著降低,VCR作用SGC7901/VCR细胞的凋亡率减少;SGC7901/VCR细胞中NF-κB核转录活性增强(P < 0.01);livin,survivin在SGC7901/VCR细胞中表达上调(P < 0.05)-结论:胃癌细胞SGC7901在化疗药VCR长期诱导后产生的继发耐药可能与NF-κB活化及livin,survivin表达上调有关;NF-κB活化是livin,survivin表达上调可能的调控因素-

    • 缺氧条件下雷帕霉素抗人乳腺癌MCF-7细胞增殖作用的研究

      2008, 28(6):742-746770. DOI: 10.7655

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      摘要:目的:比较雷帕霉素-阿霉素单药或联合应用在常氧和缺氧条件下体外抗人乳腺癌MCF-7细胞的增殖能力-方法:采用MTT法和流式细胞仪检测在常氧或缺氧状态下雷帕霉素-阿霉素单独或联合使用时,对MCF-7细胞增殖和细胞周期的影响-Western blot 检测不同氧浓度下及不同药物处理下MCF-7细胞HIF-1α-pAkt的表达-结果:与阿霉素相反,在缺氧条件下,雷帕霉素对MCF-7细胞的增殖抑制能力高于常氧条件-在2种氧浓度下,临床常用浓度(10 ng/ml)的雷帕霉素和阿霉素联合使用无协同作用-雷帕霉素单独作用于MCF-7细胞主要表现为G1期阻滞,与阿霉素联用则表现为G2期细胞增多-缺氧使HIF-1α-pAkt表达增加-但10 ng/ml的雷帕霉素对HIF-1α-pAkt表达无明显影响-结论:临床常用浓度范围内的雷帕霉素在缺氧状态下抗MCF-7细胞增殖能力增强,其原因可能是雷帕霉素对细胞的增值抑制作用不受HIF-1α表达的影响,缺氧使肿瘤细胞pAkt表达增加可能使其对雷帕霉素敏感性增加-

    • 应用二维电泳和质谱技术筛选乳腺癌相关差异表达蛋白质的初步研究

      2008, 28(6):747-751. DOI: 10.7655

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      摘要:目的:通过分离并鉴定乳腺癌-癌旁和正常乳腺组织的差异表达蛋白质,以发现可能用于早期诊断的乳腺癌肿瘤标志物-方法:提取人乳腺癌-癌旁和正常乳腺组织的总蛋白质,用双向电泳分离蛋白并进行比较-选择在乳腺癌组织中明显差异表达的蛋白点,行质谱分析-结果:获得了分辨率和重复性均很好的凝胶蛋白图谱-对筛选出的在乳腺癌组织中明显差异表达的20个蛋白点,共有13个蛋白点被成功鉴定,其中在乳腺癌组织中高表达的为8个,低表达的为5个-结论:乳腺癌组织相对于癌旁-正常乳腺组织蛋白存在明显的差异,通过蛋白质组学方法筛选并鉴定出的这些蛋白质可能成为用于早期诊断和评价预后的乳腺癌标志物-

    • 血管外膜和平滑肌细胞增殖活性及胶原分布对血管重塑影响

      2008, 28(6):752-757. DOI: 10.7655

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      摘要:目的:动态观察静脉桥再狭窄动物模型中血管外膜和平滑肌细胞增殖活性以及胶原分布的变化,以评价血管外膜及细胞增殖和胶原分布对血管重塑的影响-方法:建立猪静脉桥再狭窄模型,采用血管病理形态学和免疫组化方法,结合Masson染色,观察术后7-30-45天血管重塑-外膜细胞和平滑肌细胞增生指数及胶原的动态变化-结果: ①术后7天新生内膜形成逐渐增厚,于术后45天达最大,外膜厚度和细胞密度于术后7天起逐渐增大,术后30天达最高,术后45天较30天相对减少(P < 0.05);PCNA染色显示,血管外膜细胞和平滑肌细胞增生指数7天显著增加,术后30天PCNA阳性表达达到高峰,45天回到基线水准;②术后7天血管外膜和内膜中胶原增多,术后30~45天见新内膜中含大量胶原,呈进行性增多趋势;血管外膜中胶原术后30天达高峰,而术后45天胶原含量下降,并见局部纤维化;③管腔面积和IELA于术后7天逐渐减小,术后30~45天管腔面积明显小于对照组,术后45天管腔面积最小(P < 0.05);剩余狭窄率与管腔面积相反,于术后7天出现逐渐增大,术后45天达最大;重塑指数和EELA术后7天稍有增大,其后不断减小,术后30~45天明显减小(P < 0.05)-结论:血管外膜细胞和平滑肌细胞的增殖活性改变以及外膜的增厚-纤维化和胶原的重排对内膜增生和血管重塑起着重要作用,参与并促进了血管桥再狭窄的发生过程-

    • 风湿性心脏病合并肺动脉高压体外循环中西地那非降肺动脉压及心肌保护作用

      2008, 28(6):758-761. DOI: 10.7655

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      摘要:目的:探讨风湿性心脏病(RHD)合并肺动脉高压(PH)患者在行瓣膜置换术中,西地那非(SIL)降低肺动脉压及心肌保护作用-方法:本院2007年6月至11月RHD合并PH行瓣膜置换术-术中经Swan-Ganz漂浮导管测定平均肺动脉压(mPAP)≥30 mmHg的患者纳入研究-符合上述条件28例患者分为2组:实验组(SIL治疗组)14例,对照组14例-实验组于麻醉诱导-Swan-Ganz漂浮导管置入后,经鼻饲SIL100 mg;对照组14例,同法用生理盐水对照-连续记录2组给药前(T0)及给药后20 min(T1)-40 min(T2)-60 min(T3)的血流动力学变化-并分别于转流前-主动脉开放后2-6-16 h采集患者桡动脉血,测血清CK-MB-cTn-T,观测术后机械通气时间及术后正性肌力药物的应用情况-结果:与对照组比较,实验组在降低平均肺动脉压(mPAP),mPAP/有创平均桡动脉压(mAP)方面差异均具有统计学意义(P < 0.01)-实验组主动脉开放后2 h的CK-MB及开放后16h的cTn-T均较对照组降低(P < 0.05)-结论:CPB心脏手术中,西地那非能高选择降低此类患者肺动脉压力,并有显著心肌保护作用-

    • 前列腺素E1在心肺转流过程中对血小板功能影响的研究

      2008, 28(6):762-766. DOI: 10.7655

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      摘要:目的:研究前列腺素E1(PGE1)在心肺转流(CPB)过程中对血小板的影响-方法:选取行CPB下瓣膜置换手术的风湿性心脏病患者24例,随机分成实验组(PGE1干预组)和空白对照组,每组12例-用放射-免疫法分别检测肝素化后(T1)-CPB 30 min(T2)-CPB结束时(T3)和结束后1 h(T4)动脉血中的血栓烷B2(TXB2)-6-酮-前列腺素F1α(6-K-PGF1α)的浓度,并用透射电镜观察T1,T2,T3时血小板超微结构的变化-结果:2组中TXB2-6-K-PGF1α在T2-T3时均较T1时明显升高(P < 0.01),T3时达到最高,T4时恢复至CPB前水平-在T2-T3时6-K-PGF1α实验组明显高于对照组(P < 0.01),而TXB2及二者比值TXB2/6-K-PGF1α则明显低于对照组(P < 0.01)-电镜观察中,对照组未活化(圆型和展平型)的血小板在CPB中均较实验组明显减少,而活化(聚集型和树突型)的血小板明显较实验组增加(P < 0.01)-结论:PGE1能抑制CPB引起的血小板活化,保护血小板功能,降低血小板损耗,减轻凝血功能紊乱,减少术后血液丢失-

    • 罗格列酮抑制糖基化-人白蛋白诱导的人单核细胞源树突状细胞的免疫成熟

      2008, 28(6):767-770. DOI: 10.7655

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      摘要:目的:研究过氧化物酶体增殖物激活受体-γ(PPAR-γ)激动剂罗格列酮(rosiglitazone)对糖基化终产物(AGEs)诱导的人单核细胞源树突状细胞(DC)的免疫成熟的影响-方法:采用免疫磁珠法分离人外周血CD14+单核细胞,经含重组人粒细胞—巨噬细胞集落刺激因子(GM-CSF,100 μg/L)和重组人白细胞介素4(IL-4,20 μg/L)的RPMI1640 培养5 天,使其分化为未成熟DC-先经罗格列酮(50 μmol/L)干预24 h后,加入糖基化-人血清白蛋白(AGE-HSA,200 μg/ml)再干预48 h,采用流式细胞术检测树突状细胞表型(CD1a-CD80-CD86 和HLA-DR),混合T 淋巴细胞反应检测DC对淋巴细胞增殖的影响,酶联免疫吸附法检测细胞培养上清白细胞介素10(IL-10)-白细胞介素12(IL-12)-肿瘤坏死因子α(TNF-α)和γ干扰素(INF-γ)的浓度-结果:与对照组相比,经罗格列酮处理的DC可明显下调由AGE-HSA促进的CD80-CD86-HLA-DR 和CD1a的表达,使AGE-HSA促进的对T 淋巴细胞的增殖作用明显减弱,明显抑制DC细胞因子IL-10-IL-12-TNF-α和IFN-γ的分泌(P < 0. 05)-结论:过氧化物酶体增殖物激活型受体γ激动剂罗格列酮可以抑制糖基化-人血清白蛋白诱导的树突状细胞的免疫成熟及其免疫功能,这可能是它抗炎的重要机制之一-

    • 糖尿病患者尿微量白蛋白与动脉硬化指数之间的关系

      2008, 28(6):771-774. DOI: 10.7655

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      摘要:目的:探讨糖尿病患者动脉僵硬度与尿中微量白蛋白的关系,并对影响动脉硬化指数(arterial stiffness index,ASI)的因素进行初步探讨-方法:对入选的135例糖尿病患者,应用CardioVisionMS-2000动脉硬度测量仪测定ASI,反映外周血管弹性-并对所有入选对象进行晨尿尿白蛋白/肌酐比值(albumin/creatinine ratio,ACR) 测定,据结果分为增高-正常2组,应用统计学方法进行组间差异比较分析-并对影响ASI的因素进行探讨-结果:尿白蛋白/肌酐比值增高患者ASI明显高于正常组(P < 0.01),2组之间年龄-收缩压(SBP)-脉压(PP)-高密度脂蛋白胆固醇(HDL-C)-肾小球滤过率(GFR)-糖化血红蛋白(HbA1C),以及糖尿病病程亦有明显差异(P < 0.05).单因素相关分析显示,年龄-SBP-PP-低密度脂蛋白胆固醇(LDL-C)-GFR-HbA1C-尿白蛋白/肌酐比值-糖尿病病程与ASI明显相关(P < 0.05)-多因素逐步线性回归分析确定PP-HbA1C-尿白蛋白/肌酐比值以及糖尿病病程为ASI的独立影响因素-结论:糖尿病患者中,尿白蛋白/肌酐比值与应用ASI反应的血管硬化情况明显相关-

    • 抑郁症患者血浆血管紧张素Ⅱ水平的变化及其相关性研究

      2008, 28(6):775-778. DOI: 10.7655

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      摘要:目的:探讨抑郁症患者血浆血管紧张素Ⅱ水平的变化及其与抑郁症的关系-方法:调查31例单相抑郁症的住院患者(抑郁症组),应用选择性5-羟色胺回收抑制剂(SSRI)药物西酞普兰治疗6周,分别于治疗前和治疗后第6周末采用放射免疫法测定患者血浆血管紧张素Ⅱ的含量;同时以汉密尔顿抑郁量表(HAMD)-汉密尔顿焦虑量表(HAMA)评定症状的严重程度,以HAMD减分率评定疗效-以30名健康志愿者为对照组-结果:抑郁症组患者治疗前血浆血管紧张素Ⅱ水平[(436.75 ± 239.14)pg/ml]明显高于对照组[(130.42 ± 47.85)pg/ml],差异有统计学意义(P = 0.000);治疗后血浆血管紧张素Ⅱ水平[(205.97 ± 155.00)pg/ml]较治疗前明显下降,差异有统计学意义(P = 0.000);治疗前后血浆血管紧张素Ⅱ水平的变化与HAMD及HAMA总分值的减分率呈显著负相关[HAMD(r = -0.457,P = 0.022);HAMA(r = -0.473,P = 0.017)]-结论:抑郁症患者的血浆血管紧张素Ⅱ水平存在异常,血管紧张素Ⅱ可能参与了抑郁的病理生理过程-

    • 结核性胸膜炎纤溶活性的测定及意义

      2008, 28(6):779-782. DOI: 10.7655

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      摘要:目的:探讨结核性胸腔积液的纤溶活性特点和预后的关系-方法:通过ELISA法测定结核性胸腔积液-肺癌并癌性胸腔积液-充血性心力衰竭伴漏出性胸腔积液患者血浆及胸液中纤溶酶原激活物抑制剂-1(PAI-1)-组织型纤溶酶原激活物(t-PA)及D-二聚体(D-D)水平-其中结核性胸腔积液根据X胸片在疗程结束时被分为伴有胸膜增厚组和不伴有胸膜增厚组-结果:3组患者的血浆PAI-1-t-PA和D-D无显著性差异(P > 0.05);结核性胸液中PAI-1较癌性胸液-心衰伴漏出性胸液升高(P < 0.05),t-PA较癌性胸液-心衰伴漏出性胸液明显下降(P < 0.05)-伴有胸膜增厚组的结核性胸液中PAI-1较不伴有胸膜增厚组升高(P < 0.05),t-PA较不伴有胸膜增厚组下降(P < 0.05)-胸液D-D在不同病因的3组胸腔积液之间及2组结核性胸液之间无显著性差异(P > 0.05)-结论:与癌性胸腔积液及心衰伴漏出性胸腔积液比较,结核性胸液内PAI-1上升,t-PA下降,PAI-1与t-PA 的失衡显著-胸膜腔内PAI-1-t-PA 的失衡与胸膜纤维化形成密切相关-胸液纤溶因子PAI-1与t-PA的检测有助于结核性胸膜炎预后的判断,而胸液D-D的检测对胸腔积液的鉴别诊断及预后判断没有帮助-

    • 阻塞性睡眠呼吸暂停患者多导睡眠图?临床表现与上气道阻塞部位关系的探讨

      2008, 28(6):783-786. DOI: 10.7655

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      摘要:目的:观察一组呼吸暂停低通气指数(apnea hypopnea index,AHI)-接近的阻塞性睡眠呼吸暂停综合征(OSAS)患者中上气道阻塞部位对多导睡眠监测(PSG)图及临床表现的影响-方法:选取36例AHI为30~40的成年男性OSAS患者行再次整夜PSG,加同步上气道及食道压力监测确定上气道最低阻塞部位-比较上气道最低阻塞部位在软腭水平-舌根水平和下咽水平的不同患者中PSG相关参数:平均SaO2-最低SaO2-最长阻塞性呼吸暂停事件时间-呼吸暂停事件中SaO2下降率(dSaO2/dt)-微觉醒指数;以及部分临床表现参数:白日嗜睡程度-入睡前收缩压/清晨收缩压-入睡前舒张压/清晨舒张压以及高血压发生率-结果:平均SaO2-最长阻塞性呼吸暂停事件时间和入睡前收缩压/清晨收缩压比值在3种不同上气道最低阻塞部位患者中无显著差异(P > 0.05),但与软腭水平相比,舌根水平和下咽水平的最低SaO2降低(P > 0.05),dSaO2/dt(%/s)比值增高(P < 0.05),微觉醒指数及白日嗜睡评分增高(P < 0.01),入睡前舒张压/清晨舒张压比值降低(P < 0.05),最低SaO2 < 80%的发生率增高(P < 0.01)以及高血压的发生率增高(P < 0.01)-结论:AHI接近的OSAS患者上气道阻塞部位在舌跟水平以下者与软腭以上水平者相比,阻塞性呼吸暂停事件的致缺氧效率和程度提高,OSAS的临床表现加重-

    • 胰岛素抵抗与非酒精性脂肪肝的关系研究

      2008, 28(6):787-789. DOI: 10.7655

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      摘要:目的:研究胰岛素抵抗与非酒精性脂肪肝发病之间的关系-方法:连续观察体检人群81例,其中非酒精性脂肪肝患者59例,测身高-体重-腰围-臀围,计算体质指数(BMI)及腰臀比(WHR),检测空腹血清血糖-胰岛素-总胆固醇-甘油三酯,比较2组人群之间的差异-结果:非酒精性脂肪肝组较对照组BMI-WHR及血甘油三脂更高-胰岛素敏感指数更低,多元Logistic回归分析显示:对非酒精性脂肪肝的发病具有影响的是WHR和胰岛素敏感指数-结论:WHR和胰岛素敏感指数是非酒精性脂肪肝发病的独立影响因素-

    • 不同麻醉和镇痛方法对食管癌开胸手术患者外周血Th细胞分化的影响

      2008, 28(6):790-793797. DOI: 10.7655

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      摘要:目的:观察不同麻醉和镇痛方法对食管癌开胸手术患者外周静脉血辅助性T细胞分化的影响-方法:60例ASAⅠ~Ⅱ级择期食管癌开胸手术患者随机均分为3组:Ⅰ组采用全凭静脉麻醉,术后行患者自控静脉镇痛(PCIA);Ⅱ组采用胸段硬膜外阻滞复合静脉全麻,术后行PCIA;Ⅲ组麻醉方法同Ⅱ组,术后行患者自控硬膜外镇痛(PCEA)-3组分别于麻醉前(T0),切皮后2 h(T1),术后4 h(T2),术后24 h(T3),术后48 h(T4)抽取肘静脉血,用流式细胞检测技术测定Th1-Th2细胞胞内因子γ-干扰素(IFN-γ)-IL-4的水平,用CD3+CD8-IFN-γ+标识Th1细胞,用CD3+CD8-IL-4+标识Th2细胞,通过计算IFN-γ+%/IL-4+%来测Thl/Th2值-结果:与T0时比较,Ⅰ组Thl/Th2值在T2时明显降低(P < 0.05),Ⅱ-Ⅲ组在T3时Thl/Th2值均明显降低(P < 0.05)-组间比较,Ⅱ-Ⅲ组Thl/Th2值在T2时高于Ⅰ组,Ⅲ组Thl/Th2值在T3和T4时均高于Ⅱ组-结论:食管癌开胸手术患者术后皆出现Thl/Th2值的降低;硬膜外阻滞复合静脉全麻辅以术后硬膜外镇痛能够抑制Th0细胞向Th2细胞的过度分化-

    • 维甲酸对新生大鼠高氧性肺损伤转化生长因子-β1 表达的影响

      2008, 28(6):794-797. DOI: 10.7655

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      摘要:目的:探讨高氧性肺损伤新生大鼠肺损伤过程中转化生长因子-β1(transforming growth factor-β1,TGF-β1)的表达情况,并观察维甲酸(retinoic acid,RA)的干预效果,以期为临床防治高氧性肺损伤提供一条新的有效途径-方法:80只出生12 h内的清洁级Sprague-Dawley(SD)大鼠作为研究对象-随机分成4组(每组20只):A组:空气对照组;B组:空气+RA组;C组:高氧组;D组:高氧+RA组-14天时观察大鼠的一般状况-体质量-肺湿重/干重值;光镜观察各组大鼠肺组织病理形态学;RT-PCR方法检测TGF-β1mRNA水平;免疫组织化学染色方法检测TGF-β1蛋白表达-结果:14天时高氧组体质量明显减轻,肺组织肺湿重/干重比值-TGF-β1 mRNA及蛋白表达水平显著高于其他各组(P < 0.05);高氧+RA组14天时病理改变减轻,肺湿重/干重值-TGF-β1 mRNA及蛋白表达水平较高氧组明显降低(P < 0.05),与空气对照组及空气+RA组相比差异无显著性(P > 0.05)-结论:高氧性肺损伤新生大鼠TGF-β1表达增加,RA早期干预可以通过下调TGF-β1的表达对高氧性肺损伤具有改善作用-

    • 点时间尿蛋白与尿肌酐比值与24 h尿蛋白定量对应关系的研究

      2008, 28(6):798-800. DOI: 10.7655

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      摘要:目的:研究随机尿蛋白与尿肌酐比值与24 h尿蛋白定量之间的相关性及对应数值关系-方法:选取35例患者,对其随机尿蛋白与尿肌酐比值与24 h尿蛋白定量进行相关性分析-应用ROC曲线分析24 h尿蛋白定量3.5-1.0和0.3 g与随机尿蛋白与尿肌酐比值之间的对应关系-结果:随机尿蛋白与尿肌酐比值与24 h尿蛋白定量中度相关(r = 0.615,P < 0.001)-应用ROC曲线分析24 h尿蛋白定量3.5-1.0和0.3 g与随机尿蛋白与尿肌酐比值之间的对应关系分别为2.99-1.15和0.45 g/g,敏感性与特异性均最佳-结论:点时间尿蛋白与尿肌酐比值可以替代24 h尿蛋白定量-

    • 自体树突状细胞疫苗对非小细胞肺癌患者术后免疫功能的影响

      2008, 28(6):801-803. DOI: 10.7655

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      摘要:目的:对非小细胞肺癌的患者手术后进行自体树突状细胞(DC)疫苗的回输,评价机体的免疫反应-临床应用后的不良反应-方法:10例肺癌患者行肺癌根治术,术中收集患者肺癌标本-术后取患者外周血,收获DC细胞-同时将肺癌标本经热休克法诱导肿瘤细胞凋亡,负载于DC,制成DC疫苗-术后采用患者双侧腹股沟皮下注射DC疫苗,每周1次,共4次-并于每次疫苗回输后1周做外周血免疫细胞T细胞亚群(CD4+-CD8+)-NK细胞的水平和细胞因子(肿瘤坏死因子-α-γ-干扰素-白介素-2-白介素-12)水平的免疫指标检测,并观察DC疫苗临床应用后的不良反应-结果:术后第1次DC疫苗回输后各免疫指标检测值与术前比较无显著差异(P > 0.05)-第2-3-4次回输后各免疫指标检测值与术前比较有显著差异(P < 0.05)-10例患者在DC疫苗回输后未出现发热寒战-注射部位红肿-皮肤过敏等不良反应-结论:自体DC疫苗回输后能有效提高患者的各项免疫指标,证实了DC疫苗在肺癌生物治疗的临床应用的可行性-

    • 颈侧入路切除咽旁间隙肿瘤

      2008, 28(6):804-806. DOI: 10.7655

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      摘要:目的:探讨咽旁间隙肿瘤的诊断-手术径路和愈后-方法:对15例咽旁间隙肿瘤进行临床分析,男7例,女8例,平均年龄38.3岁-术前常规行增强CT扫描,并有6例接受MRI扫描,所有手术均采用颈侧入路,其中有7例患者切除部分下颌骨-术后4例恶性肿瘤患者均接受放射治疗-结果:15例患者中良性肿瘤11例(73.3%),恶性肿瘤4例(26.7%),肿瘤主要为腮腺和神经来源-14例肿瘤完整切除,姑息性切除1例,术后随访3年,恶性肿瘤中,死亡2例,1例复发后再次手术,1例无瘤生存至今,良性肿瘤中术后均未复发-结论:颈侧入路可以切除大部分咽旁间隙肿瘤,对一些常规切口难以暴露的肿瘤可以采用切除部分下颌骨的方法,无需截断下颌骨-

    • 输尿管镜下钬激光碎石治疗输尿管结石(附168例分析)

      2008, 28(6):807-808. DOI: 10.7655

      摘要 (2613) HTML (63) PDF 0.00 Byte (187) 评论 (0) 收藏

      摘要:目的:分析和总结168例输尿管镜下钬激光碎石术的手术方法,评价其临床疗效-方法:回顾分析168例应用输尿管镜下钬激光碎石治疗的输尿管结石患者资料,输尿管上段结石20例-中段45例-下段103例,结石直径0.6~2.2 cm,29例患者曾行体外冲击波碎石,结石并发输尿管息肉31例-手术采用硬膜外或全身麻醉,导丝引导下插入输尿管镜,行钬激光碎石,术后留置双J管2-4周-结果:手术时间18~55 min,平均25 min,其中输尿管上段结石一次碎石成功率85.0%,中-下段结石一次性碎石成功率98.4%-合并输尿管肉芽或息肉者均一次碎石成功-术中并发输尿管穿孔3例,术中无中转开放手术者,术后泌尿系统感染5例,术后平均住院时间3天-随访1~6个月,无结石残留及输尿管狭窄-结论:输尿管镜下钬激光碎石是一种治疗输尿管结石安全有效手术方法-

    • 内镜筋膜下交通静脉结扎术治疗静脉性溃疡

      2008, 28(6):809-811. DOI: 10.7655

      摘要 (1912) HTML (48) PDF 0.00 Byte (78) 评论 (0) 收藏

      摘要:目的:探讨内镜筋膜下交通静脉结扎术(SEPS)对慢性下肢静脉性溃疡的疗效和安全性-方法:对12例(13条肢体)慢性下肢静脉性溃疡患者的临床资料进行回顾性分析-13条肢体中,7条为已愈合溃疡(C5),6条为活动性溃疡(C6),均行大隐静脉高位结扎+抽剥术+内镜筋膜下交通静脉结扎术-结果:①所有患者随访2~12个月,6例活动性溃疡术后全部愈合,随访期内,所有患者溃疡无复发-②术后并发症:1例小腿筋膜下血肿-1例切口延迟愈合-结论:内镜筋膜下交通静脉结扎术治疗慢性下肢静脉性溃疡是安全-可行的;与大隐静脉高位结扎加剥脱术联合应用可有效地提高慢性下肢静脉性溃疡的疗效-

    • 腔内钬激光治疗下肢大隐静脉曲张疗效分析

      2008, 28(6):811-812. DOI: 10.7655

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      摘要:

    • 颞浅筋膜瓣在头面部骨外露创面和凹陷畸形修复中的应用

      2008, 28(6):813-815. DOI: 10.7655

      摘要 (1927) HTML (46) PDF 0.00 Byte (86) 评论 (0) 收藏

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    • 9例电视胸腔镜下胸腺切除治疗重症肌无力报告

      2008, 28(6):815-816. DOI: 10.7655

      摘要 (1973) HTML (62) PDF 0.00 Byte (90) 评论 (0) 收藏

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    • 重型颅脑损伤后吸入性肺炎诊治临床研究

      2008, 28(6):816-818. DOI: 10.7655

      摘要 (2042) HTML (48) PDF 0.00 Byte (103) 评论 (0) 收藏

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    • CT增强扫描造影剂不良反应26例分析

      2008, 28(6):818-819821. DOI: 10.7655

      摘要 (1728) HTML (59) PDF 0.00 Byte (81) 评论 (0) 收藏

      摘要:

    • 黑棘皮病合并贲门鳞腺癌1例

      2008, 28(6):820-821. DOI: 10.7655

      摘要 (1647) HTML (55) PDF 0.00 Byte (77) 评论 (0) 收藏

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    • 30例成人麻疹的临床特点及护理体会

      2008, 28(6):822-824. DOI: 10.7655

      摘要 (1678) HTML (60) PDF 0.00 Byte (79) 评论 (0) 收藏

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    • 冠心病患者实施“生命网”干预提高他汀药物的使用

      2008, 28(6):824-826. DOI: 10.7655

      摘要 (1681) HTML (43) PDF 0.00 Byte (78) 评论 (0) 收藏

      摘要: