• 2009年第29卷第5期文章目次
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    • >南京医科大学学报(英文版)
    • Effects of (-)-Epigallocatechin gallate on some protein factors involved in the epidermal growth factor receptor signaling pathway

      2009, 29(5):293-299. DOI: 10.7655

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      摘要:(-)-Epigallocatechin gallate (EGCG), a major polyphenolic constituent of green tea, can inhibit activity of specific receptor tyrosine kinases (RTKs) and related downstream signal transduction pathways, resulting in the control of unwanted cell proliferation. The epidermal growth factor receptor (EGFR) signaling pathway is one of the most important pathways that regulates growth, survival, proliferation and differentiation in mammalian cells. This review addresses the effects of EGCG on some protein factors involved in the EGFR signaling pathway in a direct or indirect manner. Based on our understanding of the interaction between EGCG and these factors, and based on their structures, EGCG could be used as a lead compound for designing and synthesizing novel drugs with significant biological activity.

    • Relationship of GSTM1 and GSTT1 genetic variant and markers of oxidative stress and inflammation in smokers with coronary artery disease

      2009, 29(5):300-304. DOI: 10.7655

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      摘要:To investigate the role of glutathione S-transferase (GST) genetic variants and markers of oxidative stress and inflammation in smoking- related coronary artery disease (CAD) patients. Methods: Five hundred and thirty-five Chinese CAD patients were successfully genotyped. Plasma total antioxidant status (TAOS), glutathione, C-reactive protein (CRP), fibrinogen(FIB) and white blood cell count (WBC) were determined to evaluate the oxidative stress and inflammatory response. Results: GSTM1-0/GSTT1-0 subjects had a higher CRP, FIB, WBC and GSH and a lower TAOS compared to patients with wild-type GSTM1/GSTT1 genes, but there was significant difference only with regards to TAOS. Smokers with the null genotype of GSTT1 had the highest CRP and the lowest TAOS and GSH when compared to the GSTT1-1 genotype with smoking status, or the GSTT1-0 genotype with non-smoking status, or the GSTT1-1 genotype with non-smoking status. However, we found no significant difference between these groups. Also, no significant interaction was observed between genotypes and smoking status in determining CRP levels. Conclusion: Our results suggest that GST polymorphisms do not modify the effect of smoking on markers of oxidative stress and inflammation in Chinese CAD patients.

    • Diagnosis and surgical treatment of intraveneous leiomyomatosis extending into the heart: two cases report and review of the literature

      2009, 29(5):305-310. DOI: 10.7655

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      摘要:Objective: To investigate the clinical characteristics, diagnosis and surgical treatment of intravenous leiomyomatosis (IVL), and outline the differences between Chinese and overseas cases. Methods: Clinical data of two IVL cases, treated in our hospital, were analyzed retrospectively and the related literature was also reviewed. The data of preoperative diagnostic rate, surgical procedures, and postoperative recurrence between patients in China and other countries were compared. Results: The first stage operation was performed successfully in 2 patients. However, they refused subsequent therapies, including a second stage operation to excise the remnants of the tumor, uterus, bilateral oviducts and ovaries, and anti-estrogen therapy. Both suffered from IVL recurrence, one at 6-month and the other at 9-month, and died at 16-month and 12-month respectively after the first stage surgery. Worldwide reports of 110 IVL cases were reviewed, which included 28 cases in China and 82 cases in other countries. In the majority of the Chinese patients, tumors only extended into the right atrium rather than the right ventricle (RA 22 cases vs RV 4 cases). However, among the overseas patients, the rate of extension into the right atrium was similar to that of extension into the right ventricle (RA 41 cases vs RV 38 cases). The rate of hysterectomies was not significantly different between Chinese and overseas patients ( 67.86% vs 55.9%, P=0.278). The rate of correct preoperative diagnosis in the Chinese patients was significantly lower than that in the overseas patients (32.14% vs 80%, P=0.000002), as well as the rate of complete excision of the tumor (22.7% vs 75.5%, P=0.000001). The proportion of patients who undergoing a single-stage or a two-stage operation was similar in Chinese and overseas patients. The recurrence rate was significantly higher in the Chinese patients than in the overseas patients (36.8% vs 9.1%, P=0.0055), and the patients with tumor recurrence were partial tumor excision patients. Conclusion: The possibility of IVL should be considered if echocardiography in female patients demonstrates a tumor in the right heart and a mass in the inferior vena cava (IVC). Further imaging should be performed to confirm the diagnosis. The correct diagnosis and accurate preoperative delineation of tumor extension are essential for an optimal surgical outcome. The key point in IVL treatment is the complete excision of tumors (single-stage or two-stage surgical procedure).

    • Effects and its possible mechanism of Radix Saposhnikoviae on rat colonic smooth muscle in vitro

      2009, 29(5):311-316. DOI: 10.7655

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      摘要:Objective: To determine the effect of different concentrations of Radix Saposhnikoviae (RS) on the contraction of smooth muscle strips and the Ca2+ mobilization of cultured smooth muscle cells of rat colon and its possible mechanism of action. Methods: Strips of rat colon longitudinal muscle were prepared and smooth muscle cells from rat colon were isolated and cultured. In the experiments, in vitro muscle strips were suspended in an organ bath and the contraction of the strips was recorded. In the cell-experiments, intracellular Ca2+ was assessed using fluorescent intensity (FI) of smooth muscle cells loaded with Fluo-4/AM, measured with a laser scanning confocal microscope and related software. Results: In the in vitro experiment, RS (0.02, 0.2, 2, 20 g/L) inhibited contraction of muscle strips in a concentration-dependent manner, and this inhibition was significant for the three higher RS concentrations (P < 0.01) for both Peak (the maximal contraction amplitude) and Area (the area under curves). Similarly, RS inhibited Ach-induced contraction. In these experiments the inhibition of the Peak values in the RS 2 and 20 g/L groups was significant (P < 0.01), as was the inhibition of the Area values in all RS groups (P < 0.05). Naloxone and propranolol did not significantly affect the inhibitory effect of RS on smooth muscle contractility, while phentolamine significantly reduced the inhibitory effect (P < 0.01). In experiments using primary smooth muscle cell cultures in Ca2+ - containing buffer, the post-treatment fluorescence of cells in the RS 0.2, 2 and 20 g/L groups differed significantly from pre-treatment values (P < 0.05), and the percent inhibition of fluorescence in the RS 2 g/L and 20 g/L groups was significant (P < 0.01). However, in Ca2+-free buffer, FS had no significant effect on cell fluorescence. Conclusion: RS inhibited both the spontaneous and Ach-stimulated contraction of rat colonic smooth muscle strips. This RS effect appeared to involve α-adrenoceptors, but not β-adrenoceptors or opioid receptors. In cultured primary smooth muscle cells, RS reduced the mobilization of Ca2+ from extracellular sources, but may had no effect on the release of Ca2+ from sarcoplasmic reticulum and endoplasmic reticulum.

    • Evaluation of the immunochromatographic strip test for the rapid diagnosis of antenatal syphilis in women in Eldoret, Kenya

      2009, 29(5):317-321. DOI: 10.7655

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      摘要:Objective: This study compared the performance of the immunochromatographic strip (ICS) to the Venereal Disease Research Laboratory (VDRL) test and Treponema pallidum haemagglutination assay (TPHA) at a primary health care setting. Methods: The study group was comprised of 150 females randomly drawn from a population of pregnant women attending their first antenatal visit or follow-up visits at West Maternity Hospital in Eldoret Kenya, but without a previous syphilis test during that pregnancy. On-site VDRL, ICS and TPHA tests were performed and immediate treatment provided where appropriate. The performance of the three tests was compared. Results: The sero-prevalence of syphilis as determined by the VDRL test was 3%. There was no significant difference between the ICS and the VDRL test (P > 0.05). The sensitivity and specificity of the ICS test were 80% and 98.6% respectively, while the negative predictive value (NPV) and positive predictive value (PPV) were both 100%. On the other hand, the sensitivity and specificity of the VDRL test were 66.7% and 99.3%, while the NPV and PPV were 80% and 98.6% respectively. The Treponema pallidum haemagglutination assay was used as a reference test and had sensitivity, specificity, NPV and PPV of 100%. Conclusion: The diagnostic accuracy of the ICS compared favorably with theVDRL gold standard. The use of the ICS in Kenya can improve the diagnosis of syphilis in health facilities both with and without laboratories and allow community health care workers to make a rapid diagnosis of the disease, and consequently make immediate therapeutic decisions.

    • The efficacy and tolerability of lamotrigine adjunctive/ monotherapy in patients with partial seizures refractory to poly-AEDs

      2009, 29(5):322-327. DOI: 10.7655

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      摘要:Objective: This study was designed as an open-label trial to assess the effects of changing the antiepileptic drugs (AEDs) regi-men to lamotrigine (LTG) as adjunctive/monotherapy in patients with partial seizures who were dissatisfied with their drug regimen because of intractable seizures. Methods: The patients were recruited from multicenters using the following criteria: age≥18 years; at least 3 seizures per month during the last 16 weeks; previous use of at least 3 AEDs. The study involved a baseline phase and 2 experimental phases: LTG was first added to the regimen, and then patients could gradually change to LTG monotherapy if their seizures were reduced by at least 50 percent/month. Tolerability, the primary end point, was assessed using the Liverpool Adverse Experience Profile (LAEP). Secondary end points included quality of life, as measured with the Quality of Life in Epilepsy-31 inven-tory. Reductions in seizures from baseline throughout each phase were also analyzed. Results: One hundred and fourteen patients aged between 18 and 52 years (age 27.8±13.2 years; 71 men and 43 women) were enrolled. After adding LTG, 105 patients (92.11%) completed adjunctive therapy. Upon completion of the adjunctive phase, mean improvement from baseline was 2.6 points on the LAEP (p=0.037). The overall score on the QOLIE-31 improved by 8.49 points from baseline (p=0.023). At the end of the trial, 26 (22.81%) of patients completed LTG monotherapy, and 65 patients (57.02%) experienced at least 50% reduction in seizure frequency compared to baseline, The mean improvement from baseline was 5.1 points on the LAEP (p=0.0059), and the overall score on the QOLIE-31 score improved by 12.72 points from baseline(p=0.0071). Twenty-two (19.30%) patients reported adverse effects and 9 patients discontinued participation in the trial because of adverse effects. Conclusion: For patients with partial seizures who were dissatisfied with their AED regimen because of intractable seizures, adding LTG to the drug regimen was well tolerated and effective in improving the quality of life and controlling seizures. Furthermore, switching to LTG monotherapy was associated with further improvement.

    • Reduction in pulmonary complications in high risk patients undergoing surgery for total hip replacement under general anesthesia by preoperative intensive inspiratory muscle training : A randomized controlled clinical trial

      2009, 29(5):328-334. DOI: 10.7655

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      摘要:Objective: To evaluate the effects of preoperative inspiratory muscle training (IMT) on the incidence of atelectasis in patients at high risk of postoperative pulmonary complications scheduled for elective total hip replacement surgery under general anesthesia. Methods: Thirty two high-risk patients undergoing elective total hip replacement surgery under general anesthesia were chosen from Nanjing Medical University, Affiliated Nanjing First Hospital. In this single-blind randomized controlled clinical trial, patients were randomly assigned to receive preoperative inspiratory muscle training or conventional treatment (CT). The major effectiveness outcome variables were atelectasis and duration of postoperative hospitalization. Results: Both groups were comparable prior to surgery. Seven patients in the CT group and 3 in the IMT group developed atelectasis (P = 0.25). Median duration of postoperative hospitalization was 13 days (range, 10~17 days) in the IMT group versus 16 days (range, 11~23 days) in the CT group (Mann-Whitney U statistics, Z = -2.22, P = 0.03). Mean postoperative inspiratory pressure was 5% higher in the IMT group. Conclusion: Preoperative intensive inspiratory muscle training appears to reduce the incidence of atelectasis and duration of postoperative hospitalization in patients at high risk of developing postoperative pulmonary complications who were scheduled for elective total hip replacement surgery under general anesthesia.

    • A prospective study: intraoperative 125I radioactive seed implant therapy in advanced esophageal squamous cell carcinoma

      2009, 29(5):335-339. DOI: 10.7655

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      摘要:Objective: To investigated the role of intraoperative iodine-125 (125I) brachytherapy as a treatment option for advanced thoracic esophageal squamous cell carcinoma (ESCC). Methods: Using preoperative computed tomography (CT)-based staging criteria, between 2000 and 2008, 298 patients with ESCC (stage II-III) were enrolled in this prospective study. With informed consent, patients were randomized into two groups: intraoperative 125I seed implantation and surgery alone (control group). Twenty to forty 125I seeds (0.5 mCi per seed), with a total activity in 10~30 mCi, and a matched peripheral dose (MPD) of 60~70 Gy, were implanted under direct visualization. The surgical procedure used in this study was either a radical resection, which involved an esophagectomy through a left thoracotomy with two-field lymphadenectomy, or palliative resection. The postoperative complications were observed and recorded. The location and quality assessment of 125I seeds were assessed using CT scans or X-ray imaging. The short-term efficacy was evaluated according to WHO criteria. The 1, 3, 5 and 7-year survival rates were determined on follow-up. Results: There was no displacement or loss of 125I seeds. The local recurrence rates in the intraoperative 125I seed implantation group and control group were 14.9% and 38.7%, respectively (P < 0.05). An objective response rate of 92% was observed in the seed implant group, which was significantly higher than 0% in the control group (P < 0.05). There was no significant difference between the two groups when comparing of complications (P > 0.05). The 1-year survival rate of the two groups were not significantly different (P > 0.05). However, the 3, 5 and 7-year survival rates in the united 125I group (64%, 55.3% and 8%, respectively) were statistically different from those in the control group (52%, 29.1% and 1.4%,respectively)(P < 0.05). Conclusion: Intraoperative 125I seed implantation is safe and effective for advanced ESCC. Seed implantation may reduce the local recurrence rate and improve survival in patients with ESCC. The MPD of 60~70 Gy, with single 125I seed activity of 0.5 mCi, is reasonable.

    • Manganese superoxide dismutase polymorphism and prostate cancer risk: a meta-analysis

      2009, 29(5):340-346. DOI: 10.7655

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      摘要:Objective: MnSOD plays a vital role in carcinogenesis, partly in that it converts superoxide radical to oxygen and hydrogen peroxide. The conflicting results of studies on the role of MnSOD polymorphism (Val-9Ala) with the risk of prostate cancer encouraged us to perform a meta-analysis to examine the association. Methods: A comprehensive search was conducted to examine all the eligible studies of MnSOD polymorphism and prostate cancer risk. We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association. The pooled estimates of ORs were computed using the fixed-effects model or random-effects model. Results: Ten eligible studies, including 4 608 cases and 5 861 controls, were included in this meta-analysis. Overall, individuals with Ala/Ala and Ala/Val genotypes have an increased risk of prostate cancer, compared with those carrying the Val/Val genotype (Ala/Ala vs. Val/Val: OR=1.13; 95% CI=1.02~1.25; P = 0.020, Pheterogeneity=0.370; Ala/Val vs. Val/Val: OR=1.14; 95% CI=1.04~1.25; P = 0.004, Pheterogeneity=0.940). This significant association was also found in a dominant model with -9Ala allele (Ala/Ala+Ala/Val vs. Val/Val: OR=1.12; 95% CI: 1.03~1.22; P = 0.009, Pheterogeneity=0.64). In the subgroup by ethnicity, it was observed that significantly elevated prostate cancer risk was associated with -9Ala allele in Caucasians (Ala/Ala vs. Val/Val: OR=1.14; 95% CI=1.03~1.27; P = 0.01, Pheterogeneity=0.31; Ala/Val vs. Val/Val: OR=1.14; 95% CI=1.04~1.24; P = 0.006, Pheterogeneity=0.87) but not in African-Americans. Furthermore, this meta-analysis showed that the -9Ala allele was associated with both nonaggressive and aggressive prostate cancer risks. Conclusion: Our meta-analysis suggests that MnSOD Val-9Ala polymorphism is associated with prostate cancer risk, especially in Caucasians.

    • Expression of co-stimulatory molecules B7-2 and PD-L1 on peripheral blood mononuclear cells in patients with chronic hepatitis B virus infection

      2009, 29(5):347-351. DOI: 10.7655

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      摘要:Objective: To explore the roles of the expression of the co-stimulatory molecule, B7-2, and the co-inhibitory molecule, PD-L1, on peripheral blood mononuclear cells in the mechanism of immunotolerance in chronic hepatitis B virus infection. Methods: Thirty HBV infected patients in the immunoreactive phase and 20 patients in the immunotolerant phase were enrolled in the study, while 20 healthy volunteers were used as controls. RT- PCR and real-time PCR methods were used to detect the expression levels of B7-2 and PD-L1 mRNA in peripheral blood mononuclear cells in chronic HBV infected patients. Results: The B7-2 expression in immunoreactive and immunotolerant patients was significantly lower than that in the controls (P all < 0.01 ); B7-2 expression in immunoreactive patients was significantly lower than in immunotolerant patients (P < 0.01). PD-L1 expression in immunoreactive patients and immunotolerant patients was significantly higher than that in normal controls (P all < 0.01). The PD-L1/B7-2 ratios in immunoreactive and immunotolerant patients were significantly higher than that of the healthy controls (P all < 0.01); the PD-L1/B7-2 ratio was significantly higher in the immunoreactive patients than in the immunotolerant patients (P < 0.01). Conclusion: In chronic HBV infection, changes in the expression of co-stimulatory and co-inhibitory molecules imply a protective adjustment against the patient's immune response that may result in increased immunotolerance and persistent HBV infection.

    • Differentially expressed gene in osteosarcoma cell lines with different metastatic potentials

      2009, 29(5):352-358. DOI: 10.7655

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      摘要:Objective: To study the expression of osteosarcoma metastasis associated gene using a cDNA microarray, and screen new candidate genes related to the development, progress and osteosarcoma metastasis. Methods: Total RNA of a low metastatic osteosarcoma and a high metastatic osteosarcoma (M6 and M8 cell lines, respectively) was extracted, purified to mRNA and then reverse transcribed to cDNA. M6 was used as the experimental group and M8 as the control group, and the gene expression of cells from both of these two sublines was investigated using cDNA microarrays containig 8064 cDNA clones. The cDNA of M6 was labeled with cy3 and the cDNA of M8 was labeled with cy5. The two sublines were hybridized with the cDNA microarray. The hybridization signals were scanned with a Generation III array scanner and analyzed by Imagequant 5.0 software. Results: There were 330 differentially expressed genes between M6 and M8. In the M6 subline,152 genes were up-regulated and 178 genes were down-regulated compared to the M8 subline. These genes could be classified according to their function. Cell growth-related genes that were down-regulated included CCNG1, CDC2, APC10,and RPA3, while expression of the tumor suppressor genes, CDKN1A and CDKN2D, was up-regulated. Other genes that were differentially expressed included those that have been implicated in the regulation of signal transduction, metabolism and apoptosis. Conclusion: This study exploits a cDNA microarray approach to identifying genes that may be associated with metastasis. The gene expression profiles of osteosarcoma cell lines is a potentially important index in the search of new candidate genes related to tumor occurrence, development and metastasis.

    • >南京医科大学学报(自然科学版)
    • PGE2对HuH7细胞Survivin表达影响的研究

      2009, 29(5):589-593. DOI: 10.7655

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      摘要:目的:研究前列腺素E2(PGE2)对人肝癌细胞HuH7 Survivin表达的影响及其与PI3K/AKT信号转导通路的相关性-方法:用PGE2-EP受体激动剂-EP受体抑制剂-PI3K抑制剂(LY294002)处理HuH7细胞,用Western blot检测Survivin蛋白表达-结果:5 μmol/L PGE2处理HuH7细胞8 h后,Survivin的表达水平与对照组相比上升了63.59%(P < 0.01);5 μmol/L EP1-5 μmol/L EP3-5 μmol/L EP4受体激动剂分别处理HuH7细胞8 h后,Survivin的表达水平与对照组相比分别上升了114.76%(P < 0.01),76.68%(P < 0.01),70.01%(P < 0.01),而5 μmol/L EP2受体激动剂处理HuH7细胞8 h后,Survivin的表达水平与对照组相比无明显改变(P > 0.05);10 μmol/L EP1,10 μmol/L EP4受体抑制剂分别处理HuH7细胞8 h后,Survivin的表达水平与PGE2组相比分别下降了32.95%(P < 0.01),28.36%(P < 0.05),而10 μmol/L EP2受体抑制剂处理HuH7细胞8 h后,Survivin的表达水平与PGE2组相比无明显改变(P > 0.05);10 μmol/L PI3K抑制剂(LY294002)处理HuH7细胞8 h后,Survivin的表达水平与PGE2组相比下降了28.05%(P < 0.01)-结论:PGE2可能通过EP1-EP3-EP4这3种受体影响HuH7细胞中Survivin的表达,且这种调节作用可能与PI3K/Akt信号转导通路有关-

    • 大鼠野生型Gadd45γ基因和Gadd45γ shRNA真核表达质粒的构建及鉴定

      2009, 29(5):594-599. DOI: 10.7655

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      摘要:目的:构建大鼠野生型Gadd45γ基因和其特异性短发卡状小干涉RNA(shRNA)真核表达质粒,并观察其在大鼠肾小球系膜细胞(GMC)中过表达及沉默Gadd45γ基因的情况-方法:用DNA重组技术将针对大鼠Gadd45γ基因的cds区序列或针对其不同位点所设计的4对shRNA序列分别克隆到真核表达质粒pcDNA3.1/HA或pGCsi.U6.neo.GFP中-在酶切分析及序列测定正确后,用GenEscortTM Ⅲ转染试剂将上述两种质粒分别转染至大鼠GMCs中,用免疫细胞化学和Western blot检测HA-Gadd45γ融合蛋白的表达及筛选最佳沉默效率的shRNA-结果:限制性酶切及核酸序列分析证明两种重组质粒均构建正确-免疫细胞化学和Western blot分析表明构建的pcDNA3.1/Gadd45γ质粒在大鼠GMCs中能够表达;Gadd45γ shRNA-3具有最佳沉默效率-结论:成功构建了大鼠野生型Gadd45γ基因和其特异性的shRNA真核表达质粒,该实验结果为进一步研究Gadd45γ基因的生物学功能奠定了基础-

    • 大鼠ATF3基因shRNA真核表达质粒的构建及鉴定

      2009, 29(5):600-604. DOI: 10.7655

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      摘要:目的:构建针对大鼠ATF3(activating transcription factor 3,ATF3)基因的特异性短发卡RNA(small hairpin RNA,shRNA)真核表达质粒-方法:用DNA重组技术将针对大鼠ATF3基因不同位点所设计的5个shRNA序列克隆到真核表达质粒pGenesil-1中-在酶切分析及序列测定后,用脂质体将5个shRNA分别转染至大鼠肾小球系膜细胞(glomerular mesangial cells,GMC),随后用Western blot检测蛋白的相对表达量来筛选最佳沉默效率的shRNA-结果:限制性酶切及核酸序列分析证明重组质粒构建正确-Western blot证实在重组质粒中,shATF3-1具有最佳的沉默效率-结论:成功构建了针对ATF3基因的shRNA的真核表达质粒,并且该shRNA可以特异性地降低大鼠肾小球系膜细胞ATF3的蛋白表达-

    • 人源抗Met基因工程抗体scFv的改造与特性分析

      2009, 29(5):605-608617. DOI: 10.7655

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      摘要:目的:将已制备的抗Met 单链抗体基因与人IgG Fc基因片段融合,表达有活性的融合蛋白分子,以增强单链抗体的可溶性-方法:从人淋巴细胞提取总RNA,经RT-PCR扩增并制备人IgG 的Fc基因片段,并克隆于已构建好的pBAD-scFv原核表达载体中,转化大肠杆菌Top10,经阿拉伯糖诱导表达融合蛋白scFv-Fc-所表达的可溶性蛋白经亲和层析纯化-SDS-PAGE-Western blot分析鉴定,并用ELISA检测抗体效价-结果:序列分析表明重组质粒pBAD-scFv-Fc基因序列正确;SDS-PAGE分析表明,scFv-Fc融合蛋白分子量为60 ku,且为可溶性蛋白;该蛋白经过His亲和层析纯化-ELISA检测,结果表明,该融合蛋白能够与抗原分子Met特异性结合-结论:改造后的抗体融合蛋白scFv-Fc能与人Met特异性结合,增加了抗体蛋白溶解度,有利于抗体的大量制备-

    • 肌动蛋白磷酸化在溶血磷脂酸致乳腺癌细胞迁移中的作用

      2009, 29(5):609-612. DOI: 10.7655

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      摘要:目的:研究肌动蛋白磷酸化在溶血磷脂酸(LPA)致乳腺癌细胞(MDA-MB-231)肌动蛋白细胞骨架重构及细胞迁移中的作用-方法:10 μmol/L LPA 孵育MDA-MB-231细胞4 h,用Transwell法检测细胞迁移速度;用Western blot及免疫印迹技术检测细胞内骨架组分及胞浆组分中肌动蛋白的分布改变;用二维电泳法分离并比较细胞内骨架组分及胞浆组分中磷酸化和非磷酸化的肌动蛋白含量-结果:10 μmol/L浓度的LPA可明显增加MDA-MB-231细胞迁移速度-LPA处理后细胞内F-肌动蛋白含量明显增加,而肌动蛋白总量并未出现明显变化-此外,LPA处理还可明显升高细胞内胞浆组分中磷酸化的肌动蛋白量;在骨架组分中,肌动蛋白仅以磷酸化的形式存在,且含量在LPA刺激前后无明显差异-结论:LPA可促进乳腺癌细胞的迁移能力及细胞骨架发生聚合,其作用可能与其改变细胞胞浆中肌动蛋白的磷酸化水平有关-

    • 皮下注射的骨髓间充质干细胞在正常小鼠体内的迁移分化

      2009, 29(5):613-617. DOI: 10.7655

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      摘要:目的:探讨骨髓间充质干细胞(BM-MSCs)在正常小鼠体内从皮下向不同器官迁移的能力-方法:从β半乳糖苷酶(β-gal+)转基因小鼠分离骨髓细胞,经贴壁和传代培养获得第3代β-gal+ BM-MSCs,皮下注射给正常6周龄C57BL/6J野生型小鼠-8周后通过LacZ染色示踪β-gal+ BM-MSCs在受体小鼠不同组织器官的分布,并对供体第3代β-gal+ BM-MSCs 基质金属蛋白酶(MMPs)的基因表达水平进行检测-结果:β-gal转基因小鼠来源的供体第3代BM-MSCs呈现LacZ 染色阳性-第3代的β-gal阳性 BM-MSCs皮下注射8周后,在受体小鼠肺-脑-心-肝-肾内检测到LacZ 染色阳性的细胞-第3代β-gal+ BM-MSCs表达MMPs基因-结论:皮下注射的BM-MSCs能够在正常小鼠体内经血液循环迁移到不同器官,并可能分化成为不同器官的终末分化细胞,参与正常组织的自我更新-

    • 活性维生素 D缺乏导致牙齿和下颌骨的发育障碍

      2009, 29(5):618-622. DOI: 10.7655

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      摘要:目的:为了检测活性维生素D缺乏及其母乳成分的改变是否影响小鼠下颌骨以及牙齿的发育-方法:通过采用X线摄影-微CT和组织学等方法比较分析25羟维生素D3的1α羟化酶杂合子[1α(OH)ase+/-]和纯合子[1α(OH)ase-/-]母鼠所喂养的纯合子和杂合子小鼠下颌骨以及牙齿的表型差异-结果:母乳中的钙水平在1α(OH)ase-/-母鼠较1α(OH)ase+/-母鼠为低-1α(OH)ase-/-仔鼠的牙量和骨量较同窝1α(OH)ase+/-仔鼠明显下降,而由1α(OH)ase-/-母鼠所喂养仔鼠的牙量和下颌骨骨量比由1α(OH)ase+/-母鼠喂养的仔鼠要低-由1α(OH)ase+/-母鼠所喂养的1α(OH)ase+/-仔鼠牙量和下颌骨量最高,而由1α(OH)ase-/-母鼠所喂养的1α(OH)ase-/-仔鼠牙量和下颌骨量最低-结论:活性维生素D和高乳钙摄入各自具有刺激下颌骨和牙齿矿化和发育的作用,又具有协同作用-

    • 血管紧张素Ⅱ参与肾小管上皮细胞转分化的实验研究

      2009, 29(5):623-627. DOI: 10.7655

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      摘要:目的:本文通过观察血管紧张素Ⅱ(angiotensin Ⅱ,Ang Ⅱ)影响肾小管上皮细胞转分化(epithelial-mesenchymal transition,EMT)的作用,以及和转化生长因子--茁1(transforming growth factor,TGF--茁1)作用的关系,探讨AngⅡ参与肾小管间质纤维化的作用机制-方法:以人肾小管上皮细胞株(human kidney cell)HKC细胞为研究对象,采用蛋白印迹等方法,观察AngⅡ(10-9-10-8-10-7-10-6 mol/L),及其与TGF--茁1共同作用对该细胞表达-琢-平滑肌肌动蛋白(-琢-smooth muscle actin,-琢-SMA)-E-钙黏蛋白(E-cadherin)和纤维连接蛋白(fibronectin,FN)的影响-明胶酶谱法检测细胞培养上清液中基质金属蛋白酶-2和基质金属蛋白酶-9(MMP-2和MMP-9)的变化,Boyden小室检测HKC细胞的迁移能力-结果:①单独应用Ang Ⅱ不能够造成HKC细胞E-cadherin表达的变化,也不能诱导-琢-SMA表达,但是却能上调FN的表达;②与TGF--茁1共同作用时能够加强TGF--茁1影响E-cadherin,-琢-SMA和FN表达的作用;③AngⅡ能够增加HKC生成MMP-2和MMP-9;④AngⅡ能够(10-7和10-6 mol/L)增加HKC细胞迁移至Boyden小室膜下侧面的数目-结论:①AngⅡ可以参与EMT过程,但不是导致EMT的关键因素;②Ang Ⅱ能够以协同的方式参与TGF--茁1导致的EMT,可能以此方式加重肾小管间质的纤维化-

    • PTH缺乏经细胞外钙介导卵巢血管生成障碍而致生殖能力降低

      2009, 29(5):628-633. DOI: 10.7655

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      摘要:目的:探讨甲状旁腺素(PTH)缺乏引起生殖功能降低的机制-方法:使用组织学,免疫组织化学和Western blot的方法比较分析了同窝4个月PTH基因敲除纯合子小鼠和野生型小鼠分别给予正常钙(1%)-低钙(0.01%)及高钙饮食(2%)后生殖能力-卵巢成熟卵泡数量-黄体形成及血管生成的差异-结果:与同窝野生型雌性小鼠(PTH+/+)相比,正常饮食PTH基因敲除纯合子小鼠(PTH-/-)生殖能力下降,成熟卵泡数量及黄体生成减少,卵巢血管发生减少;低钙饮食PTH-/-表现为完全不孕,成熟卵泡数量进一步减少和黄体缺失,卵巢血管发生减少更为明显;而高钙饮食PTH-/-生殖能力-成熟卵泡数量-黄体形成及血管发生均恢复正常-结论:PTH缺乏经细胞外钙介导卵巢血管生成障碍而致生殖能力降低-

    • 甲状旁腺素在胸腺的表达及血钙对其表达的调节

      2009, 29(5):634-639. DOI: 10.7655

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      摘要:目的:为了证实PTH基因在胸腺的表达,明确PTH蛋白在胸腺组织的定位以及胸腺来源的PTH是否受到血钙水平改变的调节-方法:使用RT-PCR-real-time PCR和免疫组织化学的方法比较分析同窝2周龄PTH基因敲除纯合子(PTH-/-)和野生型(WT)小鼠以及1-α 羟化酶基因敲除纯合子[1α(OH)ase-/-]和野生型(WT)小鼠的甲状旁腺和胸腺的PTH表达差异-结果:PTH-/-小鼠的甲状旁腺和胸腺无PTH表达;同窝WT小鼠甲状旁腺和胸腺均有PTH表达,但胸腺表达水平较甲状旁腺低-PTH在胸腺上皮细胞表达,而不在胸腺淋巴细胞表达-1α(OH)ase-/-小鼠表现为低钙血症-与正常血钙的WT小鼠相比,PTH基因和蛋白的表达水平在1α(OH)ase-/-小鼠胸腺组织中均明显升高-结论:胸腺组织不仅是产生PTH的辅助器官,而且其PTH表达也受到血钙水平的调节-

    • 中国汉族非综合征耳聋患者SLC26A5 IVS2-2A>G的突变

      2009, 29(5):640-642. DOI: 10.7655

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      摘要:目的:探讨SLC26A5基因IVS2-2A > G突变与中国汉族非综合征型感音神经性聋的相关性-方法:收集南京市聋校非综合征型感音神经性聋患者120例及同地区听力正常人100例外周血样本,常规方法提取DNA,聚合酶链反应(PCR)扩增SLC26A5 IVS2-2区域,对PCR产物直接测序进行突变性质的鉴定-结果:所有研究对象的基因区域均扩增成功,序列分析在120名散发聋患者及100例听力正常人中均未检测到SLC26A5基因IVS2-2位点任何形式的碱基变异-结论:SLC26A5 IVS2-2A > G在中国汉族非综合征耳聋及听力正常人群中携带率较低或无突变,其与遗传聋的相关性需进一步研究评价-

    • siRNA干扰人宫颈癌基因(HCCR)的表达对胰腺癌PANC1细胞增殖?凋亡和侵袭的影响

      2009, 29(5):643-647. DOI: 10.7655

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      摘要:目的:建立稳定转染人宫颈癌癌基因(human cervical cancer oncogene,HCCR)siRNA真核表达质粒的人胰腺癌PANC1细胞株,探讨siRNA干扰HCCR的表达后对人胰腺癌PANC1细胞增殖-凋亡和侵袭的影响-方法:通过脂质体转染法将含HCCRsiRNA的真核表达质粒pGCsi-HCCR稳定转染至人胰腺癌细胞株PANC1,抗生素G418筛选获得稳转细胞株;Western blot检测PANC1细胞中HCCR的表达,同时检测肿瘤相关基因p53蛋白表达的变化;流式细胞仪检测PANC1细胞的细胞周期和凋亡率变化;MTT比色法检测siRNA干扰后对PANC1细胞增殖能力的影响;Transwell侵袭实验观察siRNA干扰后对PANC1细胞侵袭能力的影响-结果:Western blot证实siRNA稳转组的PANC1细胞株和空载体稳转组比较HCCR蛋白表达水平下调,稳转细胞株建立成功-siRNA稳转组p53蛋白表达下降-siRNA稳转组的S期细胞数目减少而G0/G1期细胞数目增加,细胞凋亡增加-MTT结果显示siRNA稳转组1和稳转组2细胞吸光度分别为空载体组细胞的0.65倍和0.68倍,细胞增殖能力下降-Transwell侵袭实验显示siRNA稳转组细胞和空载体组细胞穿膜数分别为24.4 ± 9.9和49.1 ± 15.4(P < 0.01),稳转组细胞侵袭能力下降-结论:siRNA干扰HCCR的表达后能抑制胰腺癌PANC1细胞增殖和侵袭,促进其凋亡-

    • 溃疡性结肠炎小鼠结肠Cajal间质细胞及干细胞因子的变化

      2009, 29(5):648-651. DOI: 10.7655

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      摘要:目的:探讨结肠Cajal间质细胞(ICC)-干细胞因子(SCF)在溃疡性结肠炎(UC)发病中的作用-方法:将BALB/c小鼠随机分为正常对照组(n = 8)和UC组(n = 24),于造模后1-4-7天分别处死UC组8只小鼠,取远端结肠,用Western blot方法检测SCF的表达;免疫组化检测结肠ICC的变化,并进行结肠组织学评分-结果:结肠组织学评分在7天达最高值(P < 0.05)-与正常小鼠比较,UC小鼠结肠肌间ICC表达明显减少(P < 0.05),结肠SCF的表达也显著减少(P < 0.01),SCF与ICC呈正相关(UC 4天时,r = 0.862,P = 0.027;UC 7天时,r = 0.948,P = 0.004)-结论:UC小鼠远端结肠组织内SCF表达下降,伴随ICC数量减少,提示UC病变可能与SCF/Kit系统下调有一定的相关性-

    • Rac1?HIF-1α在缺氧的人食管鳞癌Eca109细胞株中的表达及其对细胞增殖水平的影响

      2009, 29(5):652-655710. DOI: 10.7655

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      摘要:目的:探讨Rac1-HIF-1α mRNA和蛋白在缺氧的人食管鳞癌Eca109细胞株中的表达及其对细胞增殖水平的影响-方法:应用半定量RT-PCR-Western blot法检测缺氧条件下Eca109细胞株Rac1-HIF-1α的mRNA和蛋白表达水平;应用半定量RT-PCR和MTT法检测常氧和缺氧下Rac1特异性抑制剂NSC23766处理后人食管鳞癌Eca109细胞株HIF-1α的mRNA表达水平和细胞增殖水平-结果:缺氧条件下,人食管鳞癌Eca109细胞株中Rac1-HIF-1α的mRNA和蛋白表达水平均明显增高,约24 h到达高峰-用NSC23766处理人食管鳞癌Eca109细胞株后,HIF-1ɑ mRNA表达水平降低,细胞增殖明显受到抑制-结论:Rac1和HIF-1α在缺氧状态下被激活,且可能均与缺氧诱导的肿瘤增殖相关-

    • 实时荧光定量RT-PCR检测结肠癌中Musashi-1 mRNA的表达

      2009, 29(5):656-659668. DOI: 10.7655

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      摘要:目的:了解正常结肠干/祖细胞标志Musashi-1mRNA在结肠癌中的表达情况-方法:应用实时荧光相对定量RT- PCR的方法检测25例结肠癌组织和18例远端正常结肠组织中Musashi-1mRNA的表达,用2-△△CT的方法计算相对于远端正常组织结肠癌组织中Musashi-1mRNA的表达倍数-结果:经实时荧光定量RT-PCR 法检测,结肠癌组织中Musashi-1mRNA的表达与远端正常结肠组织相比有差异(P < 0.01),且是远端正常结肠组织的4.24倍(1.95~9.23)-低分化组织与高-中分化组织相比,Musashi-1mRNA的表达有差异(分别为P < 0.001-P < 0.005)-低分化组织中Musashi-1的表达是高分化组织的5.54倍(3.07~9.98)-结论:正常肠干/祖细胞标志物Musashi-1在结肠癌组织中尤其是低分化组织中的高表达提示Musashi-1可能在结肠肿瘤的发生发展中起着一定的作用-

    • 前列腺素E1?腺苷对离体兔肺保护作用良好

      2009, 29(5):660-663. DOI: 10.7655

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      摘要:目的:研究前列腺素E1以及腺苷对离体兔肺的保护作用-方法:将18只新西兰大白兔分为3个实验组,分别为单纯UW液(A组-对照组)-UW液 + 前列腺素E1(B组)-UW液 + 腺苷(C组)-切取实验兔整体心肺作为离体心肺模型,对心肺模型进行冷灌注-低温保存-分别在2 h 末和4 h末,取肺部分标本做电镜分析-于4 h末,结扎右肺门,取右肺检测肺湿/干重比(W/D)-测肺气道压力(Paw)-左侧离体心肺接呼吸机模拟移植手术后呼吸,并将自身静脉血用泵从主肺动脉泵入,用负压吸引真空试管取左心房血液做血气分析-结果:B组肺组织气体交换功能的保护作用以及降低供体肺保存过程中含水量的作用明显优于其他组;降低气道压力和C组相当,明显优于对照组-C组肺实质细胞的气体交换功能的保护-降低肺含水量以及降低气道压力明显优于A组-结论:UW液中加入前列腺素E1进行离体肺灌注可以使肺保存时间明显延长-肺气体交换功能保存良好-

    • 吡格列酮对前脂肪细胞分化过程中盐皮质激素受体表达的影响

      2009, 29(5):664-668. DOI: 10.7655

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      摘要:目的:通过研究过氧化物酶体增生物激活受体γ(peroxisome proliferator-activated receptor γ,PPARγ)激动剂吡格列酮对前脂肪细胞(3T3-L1)分化过程中盐皮质激素受体(mineralocorticoid receptor,MR)表达的影响,探讨PPARγ在肥胖及胰岛素抵抗中的作用机制-方法:用吡格列酮对小鼠前脂肪细胞3T3-L1进行刺激,利用实时定量PCR,检测在前脂肪细胞分化为成熟脂肪细胞的过程中,盐皮质激素受体及其相关基因的mRNA表达量-结果:前脂肪细胞分化过程中,给予吡格列酮刺激后细胞分化效率明显增加的同时,盐皮质激素受体及11β-羟化类固醇脱氢酶1(11β-hydroxysteroid dehydrogenase type 1,11β-HSD1)的表达量增加-结论:PPARγ在促进前脂肪细胞的分化的同时,明显增加盐皮质激素受体的表达-

    • RNA干扰沉默VDR基因对小鼠成骨细胞Dmp1?Cbfa1及BMP-2 mRNA 表达的影响

      2009, 29(5):669-673. DOI: 10.7655

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      摘要:目的:利用RNA干扰技术,阻断VDR在小鼠成骨细胞株mc3t3-E1中的表达,观察VDR表达受抑后对小鼠成骨细胞Dmp1-Cbfa1及BMP-2基因 mRNA 表达的影响-方法:针对小鼠VDR mRNA 144-594-852-3 628 位点设计-合成4 对21核苷酸siRNA(siRNA1-siRNA2-siRNA3-siRNA4);在阳离子脂质体介导下转染mc3t3-E1细胞,以空白及非特异性siRNA 作为对照,各组于转染24 h及72 h后收集细胞分别抽提RNA及蛋白-采用RT-PCR 法检测细胞中VDR mRNA 表达水平的改变,Western blot法检测VDR 蛋白表达的变化,从而筛选有效序列-进一步应用SYBR Green荧光实时PCR方法定量检测成骨细胞功能基因-Dmp1-Cbfa1及BMP-2基因 mRNA 表达情况-结果:与空白对照组相比,转染siRNA3-siRNA4的mc3t3-E1细胞VDR mRNA 和蛋白表达明显下调(P < 0.01),转染siRNA1-2及非特异性siRNA 的mc3t3-E1细胞VDR的表达与对照组相比无显著差异(P > 0.05)-荧光定量PCR结果显示,转染siRNA3-siRNA4 的mc3t3-E1 细胞Dmp1-Cbfa1-BMP-2mRNA 表达明显下调(P < 0.01)-结论:针对小鼠VDR mRNA 852-3 628位点设计-合成的siRNA 可有效抑制小鼠成骨细胞株VDR 的转录和表达;VDR表达受抑可下调mc3t3-E1细胞功能基因Dmp1-Cbfa1-BMP-2mRNA的表达;VDR在维持成骨细胞功能中起着一定的作用-

    • 蟾蜍灵对脂多糖诱导的大鼠肾小球系膜细胞凋亡的影响

      2009, 29(5):674-677714. DOI: 10.7655

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      摘要:目的:探讨蟾蜍灵(bufalin)对脂多糖(lipopolysaccharides,LPS)诱导的大鼠肾小球系膜细胞(glomerular mesangial cell,GMC)凋亡的影响-方法:体外培养大鼠肾小球系膜细胞,分为对照组-LPS刺激组和蟾蜍灵干预组,应用台盼蓝拒染法检测蟾蜍灵对GMC的细胞毒性作用,应用透射电镜观察系膜细胞超微结构的变化,采用逆转录PCR检测Bax和Bcl-2基因mRNA的表达,Western blot法检测Bax和Bcl-2的蛋白表达-结果:透射电镜观察蟾蜍灵干预组可见凋亡早期形态学改变-逆转录PCR和Western blot结果显示蟾蜍灵组较脂多糖组Bax表达增多,Bcl-2表达减少,差异均具有统计学意义(P < 0.01),蟾蜍灵干预后,Bax较Bcl-2表达过量-结论:蟾蜍灵可能通过调节Bax和Bcl-2的相对表达量而诱导脂多糖作用后肾小球系膜细胞发生凋亡-

    • 心房组织中5-HT4受体亚型mRNA的变化与房颤发生与维持

      2009, 29(5):678-681. DOI: 10.7655

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      摘要:目的:探讨房颤患者房间隔5-HT4受体4种亚型(5-HT4Ra-5-HT4Rb-5-HT4Rg-5-HT4Ri)mRNA的表达及其临床意义-方法:将行瓣膜置换手术的患者36例,分为窦性心律(SR)组和房颤(AF)组-术中取房间隔组织,采用SYBR Green实时荧光定量PCR检测各组中5-HT4受体亚型mRNA的表达-结果:5-HT4Ra mRNA在SR组和AF组中的表达水平分别为(19.89 ± 9.68) × 10-4和(336.86 ± 255.56) × 10-4,AF组比SR组增加了1 593.61%(P < 0.01);5-HT4Rb mRNA在SR组和AF组中的表达水平分别为(23.32 ± 8.37) × 10-4 和(240.32 ± 242.49) × 10-4,AF组比SR组增加了930.53%(P < 0.01);5-HT4Rg mRNA在SR组和AF组中的表达水平分别为(2.23 ± 0.77) × 10-4和(0.72 ± 0.45) × 10-4,AF组比SR组减少了67.71%(P < 0.01);5-HT4Ri mRNA在SR组和AF组中的表达水平分别为(34.95 ± 8.08) × 10-4和(392.15 ± 347.75) × 10-4,AF组比SR组增加了1 022.03%(P < 0.01)-结论:5-HT4受体亚型mRNA表达的变化可能在房颤的发生和维持中发挥一定的作用-

    • Runx1基因mRNA表达与非小细胞肺癌发生及淋巴转移的相关性研究

      2009, 29(5):682-685. DOI: 10.7655

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      摘要:目的:探讨Runx1基因mRNA表达与人非小细胞肺癌(NSCLC)发生-发展的关系-方法:取37例NSCLC标本,1O例肺良性病变旁正常肺组织,应用逆转录-多聚合酶链反应(RT-PCR)的方法检测NSCLC中Runx1的mRNA表达水平,进行统计分析-结果:肺癌肿瘤组织中Runx1基因表达水平显著低于肺良性病变旁正常肺组织(P < 0.01),肺癌组织中Runx1基因表达水平降低与淋巴结转移相关(P < 0.05),与肺癌组织学类型-细胞分化程度以及患者的年龄-性别无关(P > 0.05)-结论:与良性病变旁正常肺组织相比,Runx1基因的mRNA水平在肿瘤组织中表达下降,并且与淋巴结转移相关,提示其可能参与肺癌的发生发展过程-

    • 阿仑膦酸钠对人工关节磨损微粒刺激破骨细胞分化形成的影响

      2009, 29(5):686-690. DOI: 10.7655

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      摘要:目的:观察二磷酸盐类药物阿仑膦酸钠对人工关节磨损微粒刺激破骨细胞分化形成的影响,探讨二磷酸盐防治人工关节无菌性松动的可能机制-方法:体外用巨噬细胞集落刺激因子(M-CSF)诱导小鼠骨髓造血干细胞分化为破骨前体细胞(osteoclast precursors,OCPs),然后用核因子-κB受体活化因子配体(RANKL)和M-CSF两种细胞因子协同诱导OCPs向成熟破骨细胞分化,同时在培养体系中加入高分子聚乙烯微粒(103/ml)和不同浓度的阿仑膦酸钠(0.4-2.0-10.0-50.0 -滋g/ml),对获得的各组破骨细胞行抗酒石酸酸性磷酸酶(TRAP)染色计数阳性破骨细胞(核 ≥ 3)的数目;提取总RNA用逆转录-聚合酶链反应(RT-PCR)检测TRAP mRNA的表达-结果:高分子聚乙烯微粒组TRAP阳性破骨细胞数目和TRAP mRNA的表达显著高于空白对照组(P < 0.05);阿仑膦酸钠组TRAP阳性破骨细胞数目和TRAP mRNA的表达均显著低于高分子聚乙烯组(P < 0.05),且随着阿仑膦酸钠浓度增高TRAP阳性破骨细胞数目和TRAP mRNA的表达呈递减趋势,组间差异均有统计学意义(P < 0.05)-结论:阿仑膦酸钠可以抑制人工关节磨损微粒刺激破骨细胞分化形成-

    • 埃他卡林对低氧性肺动脉高压大鼠内皮素受体mRNA表达的影响

      2009, 29(5):691-694. DOI: 10.7655

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      摘要:目的:研究新型ATP敏感性钾通道开放剂埃他卡林(IPT)对低氧性肺动脉高压(HPH)大鼠内皮素A受体(ETAR)-内皮素B受体(ETBR)mRNA表达的影响-方法:SD大鼠平均分成正常对照组-HPH组-IPT处理组(对每天缺氧饲养的大鼠给予IPT 1.5 mg/kg灌胃),后两组置于常压低氧舱中每天8 h,每周6天,4周后逆转录多聚酶联式反应(RT-PCR)方法检测肺组织ETAR和ETBR mRNA表达-结果:与正常对照组相比,HPH组大鼠ETAR mRNA表达水平明显上升(P < 0.01),ETBR mRNA表达水平明显下降(P < 0.01);与HPH组相比,埃他卡林干预的缺氧大鼠ETAR mRNA表达明显降低(P < 0.01),ETBR mRNA表达明显增加(P < 0.01)-结论:HPH模型大鼠肺组织内皮素受体mRNA表达发生异常,而埃他卡林可部分逆转这种异常,有助于抑制HPH血管收缩和平滑肌增殖-

    • 血必净对急性肺动脉栓塞有保护作用

      2009, 29(5):695-701. DOI: 10.7655

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      摘要:目的:探讨兔急性肺血栓栓塞症(APTE)时肺血管内皮-支气管和肺泡上皮等部位内皮素1(ET-1)-血清炎症因子血栓素A2(TXA2)和前列环素(PGI2)-动脉血气的表达状况及尿激酶(UK)溶栓或血必净抗炎治疗对其的影响-方法:30只大耳白兔随机分为对照组-PTE 模型组-UK 组-血必净组-和UK + 血必净组,每组6只-采用自体血栓回输法建立动物模型-常规取造模前-造模后1-2-4-8 h行动脉血气分析-放免法测定TXA2和PGI2-最后病理学检查及免疫组化法检测肺血管内皮-支气管和肺泡上皮等部位ET-1的表达水平-结果:①血气分析:模型组栓塞后血氧分压(PO2)-二氧化碳分压(PCO2)与对照组相比均明显下降,血必净组与模型组比较无差异-UK及UK + 血必净组后PO2指标较模型组提前好转;②放免法测定结果:TXA2-PGI2 栓塞组1 h升高,2 h达高峰,4 h后开始降低,1-2-4 h与对照组比较都有显著性差异(P < 0.01),血必净组-UK组及血必净 + UK组均1 h升高,2 h达高峰,2 h后开始下降,且各治疗组高峰值均较栓塞组低-各组术前无显著性差异;1-2-4 h各治疗组与模型组和对照组相比有显著性差异(P < 0.01)-且各治疗组组间比较也有显著性差异,其中以血必净 + UK组浓度下降最快,UK组次之,血必净组较慢-8 h各组无显著性差异;③病理检查显示:PTE 组兔肺组织病理损伤明显,血必净-UK组肺组织损伤较PTE组减轻,UK + 血必净组肺组织损伤最轻;④免疫组化检测显示:PTE组和血必净组ET-1蛋白表达的相对含量显著高于对照组,UK组和UK + 血必净组与对照组比较无统计学意义-结论:APTE 后溶栓结合抗炎治疗可明显改善动脉血气,降低TXA2- PGI2炎症因子和ET-1 介导的急性肺损伤,提示血必净能减轻APTE时的肺损伤,同时对患者开展溶栓治疗时,也要重视必要的抗炎治疗使用-

    • 胱抑素C与冠心病的相关性研究

      2009, 29(5):702. DOI: 10.7655

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      摘要:目的:研究血清胱抑素C(Cys C)与冠心病的相关性-方法:回顾性分析525例高度怀疑冠心病而行冠脉造影患者的临床资料,从冠心病病情程度-冠脉病变支数和冠脉病变Gensini总积分3方面研究血清Cys C水平与冠心病之间的关系-应用免疫比浊法检测血清Cys C浓度,对Cys C水平与冠心病病情-冠脉病变程度和冠脉病变Gensini总积分进行单因素和多因分析-结果:①随着血清Cys C水平的升高,冠心病患者病情逐渐加重,冠脉病变支数和Gensini总积分增加;在急性心梗时由于急性时相反应血清Cys C水平出现下降;②Logistic回归结果显示Cys C与冠脉有无病变显著相关(OR值5.346,95% CI为2.225~12.846,P < 0.01);③多元逐步回归结果显示在校正了年龄-性别等因素之后,Cys C与冠脉病变Gensini总积分(β = 0.149,P < 0.01)仍然独立相关-结论:血清Cys C水平与冠心病有密切关系-随着血清Cys C水平升高,冠心病患者病情逐渐加重,冠脉病变程度也更加严重-

    • 伊班膦酸钠与阿仑膦酸钠对绝经后骨质疏松疗效的比较

      2009, 29(5):707-710. DOI: 10.7655

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      摘要:目的:评价伊班膦酸钠与阿仑膦酸钠对绝经后骨质疏松的疗效-方法:绝经后骨质疏松妇女32例,随机分为2组,所有患者每天在接受元素钙500 mg和维生素D 200 IU治疗的同时,分别接受伊班膦酸钠和阿仑膦酸钠治疗,其中伊班膦酸钠150 mg每月1次;阿仑膦酸钠70 mg每周1次-2种药物治疗时间均为1年-通过双能X线吸收仪(DEXA)及血清I型胶原交联C端肽(CTX-1)观察治疗中及治疗后的骨量及骨转换的变化-结果:2组患者经过1年治疗,与用药前比较,腰椎(L2-4)骨量显著上升(P < 0.05),髋部骨量增加但没有统计学意义(P > 0.05):其中伊班瞵酸钠治疗组腰椎L2-4-股骨颈-股骨大转子和全髋骨密度分别上升15.34%-4.15%-5.05%和2.49%;阿仑瞵酸钠治疗组分别上升14.50%-4.42%-1.18%和2.64%;破骨指标血清CTX-1在2组均明显下降(P < 0.05)-2组之间各时点的各部位骨密度值-血清CTX-1值均无统计学差异(P > 0.05)-结论:伊班膦酸钠服用方便,且对于绝经后骨质疏松的治疗效果与阿仑膦酸钠无明显差异-

    • 胎盘绒毛组织孕激素受体表达与分娩发动的关系

      2009, 29(5):711-714. DOI: 10.7655

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      摘要:目的:探讨胎盘绒毛组织孕激素受体(progesterone receptor,PR)表达变化与分娩发动的关系-方法:采用免疫组化和Western blot印迹杂交法检测正常足月剖宫产产妇胎盘绒毛组织(临产组15例,未临产组15例)孕激素受体表达变化情况-结果:免疫组化结果显示15例未临产组均存在核PR染色阳性,15例临产组出现弱阳性结果-Western blot结果显示,临产组PR-A表达量较未临产组下调,同时临产组PR-B表达量较未临产组也下调,两者均存在显著性差异,具有统计学意义(P < 0.01);临产组PR-A/PR-B较未临产组高,存在统计学意义(P < 0.05)-结论:PR-A/PR-B比值升高可能是参与分娩发动的机制之一-

    • 肝癌的动态CT灌注成像具有可重复性

      2009, 29(5):715-720. DOI: 10.7655

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      摘要:目的:研究肝癌的动态CT灌注成像(CTP)的可重复性-方法:采用德国Siemens sensation 64层螺旋CT机,应用Body PCT肝脏灌注软件进行处理,该软件应用的数学模型是斜率法和Patlak分析法-首先建立一个相对一致的标准后处理方法,应用软件处理后得到灌注彩图,用鼠标划出各感兴趣区,包括按肿瘤大小和按肿瘤直径一半划出的兴趣区(ROI)-然后建立1个后处理对比的方法,观察观测者之内的可重复性:2个技能和经验都不相同的观测者(甲-乙)采用双盲法分别进行(CTP)的后处理-分别对甲和乙的前后2次后处理的结果进行统计学分析,评价其前后2次后处理的一致性;观察观测者之间的可重复性:对甲和乙后处理分析的数据进行比较,评价不同操作人员对CTP可重复性的影响-结果:在第1次后处理时,甲乙2人有一致性;甲前后2次后处理有一致性;乙前后2次后处理也有一致性-结论:肝癌的动态CT灌注成像具有可重复性-

    • 国内人工关节术后假体周围感染的细菌学分析

      2009, 29(5):721-725. DOI: 10.7655

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      摘要:目的:总结分析人工关节术后假体周围感染病例的细菌学特点,为该并发症的抗生素治疗提供依据-方法:通过文献检索,对2003~2008年我国学者在国内发表的有关人工关节置换术后假体周围感染的细菌学检查结果进行汇总-归纳和分析-结果:共有49篇文献入选,细菌谱显示G+菌占80.49%,G-菌占17.74%,真菌占1.33%,分支杆菌占0.44%-发现G+细菌中,金黄色葡萄球菌占总菌株数的34.59%,表皮葡萄球菌占总菌株数的37.48%-结论:我国人工关节术后假体周围感染以G+菌为主,且大多数为金黄色葡萄球菌和表皮葡萄球菌感染,应有针对性的使用抗生素-

    • 先天性二叶式主动脉瓣畸形的外科治疗

      2009, 29(5):726-728. DOI: 10.7655

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      摘要:目的:探讨先天性二叶式主动脉瓣畸形(congenital bicuspid aortic valve,CBAV)的临床特点-诊断和外科治疗-方法:回顾性分析CBAV患者83例的临床资料,总结诊断和外科治疗经验-结果:83例患者术前超声心动图明确诊断61例,术中诊断22例-行主动脉瓣置换术65例,行双瓣置换术(主动脉瓣 + 二尖瓣)18例-同时行三尖瓣成形术10例,主动脉窦瘤破裂修补术4例,室间隔缺损修补术7例,动脉导管未闭缝扎术5例,升主动脉成形术2例,冠状动脉搭桥术2例-术后早期死亡5例,病死率6.0%-死于低心排综合症2例,多器官功能衰竭1例,急性肾功能衰竭1例,顽固性心律失常1例-结论:CBAV主要表现为主动脉瓣的狭窄和/或关闭不全-二维超声心动图是常用的诊断技术,主动脉瓣置换术是常规有效的外科治疗方法-

    • 经腹腔镜与开腹结直肠癌根治的疗效比较

      2009, 29(5):729-731. DOI: 10.7655

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      摘要:目的:对腹腔镜和开腹行结直肠癌根治术的治疗效果进行临床对照研究-方法:选择2004年5月~2008年2月本科行腹腔镜结直肠癌病例120例及开腹结直肠癌根治术病例310例,比较术中及术后情况-结果:腹腔镜组手术时间为(165.3 ± 32.4) min,开腹手术组手术时间为(140.5 ± 31.8) min,差异有显著性(P < 0.01);腹腔镜组术后并发症发生率为6.67%(8/120),开腹组为4.83%(15/310);腹腔镜组术中出血为(82.0 ± 22.5) ml,开腹组为(156.2 ± 42.4) ml,腹腔镜组明显少于开腹组(P < 0.05);两组在肠段切除长度,肿块距离下切缘的距离和淋巴结清扫数量方面比较差异无显著性(P > 0.05)-两组术后肠道功能恢复时间分别为(2.60 ± 1.47)天和(3.6 ± 1.3)天,差异有显著性(P < 0.05)-结论:腹腔镜结直肠癌根治术能取得与开腹手术同样的治疗效果,并具有手术视野好,出血少,术后恢复快,应激反应小等优点-

    • 老年萎缩性胃炎胃泌素?T淋巴细胞及幽门螺杆菌结果分析

      2009, 29(5):732-735. DOI: 10.7655

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      摘要:目的:研究血清胃泌素水平-T淋巴细胞亚群变化及幽门螺杆菌(Hp)感染与老年慢性萎缩性胃炎(CAG)之间的相互关系,探讨老年人更容易接受的CAG的诊断方法-方法:对经胃镜及病理检查确诊的48例慢性萎缩性胃炎及40例浅表性胃炎(CSG)患者,进行血清胃泌素水平-Hp-T淋巴细胞亚群检测,并对检测结果进行分析-结果:两组病例比较:CAG组血清胃泌素水平较CSG组有显著降低(P < 0.01);CAG Hp阳性组较CSG Hp阳性组也有明显降低(P < 0.05);CAG组CD4-CD4/CD8较CSG组有显著降低,特别在Hp阳性组降低更明显(P < 0.01),CD8也有显著性差异(P < 0.05)-根据接受者操作特征(ROC)曲线,血清胃泌素-CD4-CD8-CD4/CD8诊断CAG的最佳界值分别为9.2(敏感度0.702,特异性0.974),27.7(敏感度0.787,特异性0.513),28.6(敏感度0.787,特异性0.872)和0.95(敏感度0.617,特异性0.769)- 结论:血清胃泌素可作为CAG的非侵入性诊断方法,结合T淋巴细胞亚群(CD4-CD8-CD4/CD8)变化及Hp检测,对老年人CAG筛选-病情发展及预后的评估均有一定意义,对难以接受内镜检查的老年人增加了一些辅助诊断手段-

    • 黄连素治疗2型糖尿病的临床疗效观察

      2009, 29(5):736-738. DOI: 10.7655

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      摘要:目的:本文研究黄连素治疗2型糖尿病的适合人群-方法:72例糖尿病分为2组:肥胖组40例,非肥胖组32例-采用黄连素0.02 g/(kg.d),分3次口服,治疗观察8~10周,观察治疗前后的体质指数(BMI)-空腹胰岛素(FINS)-糖化血红蛋白(HbA1c)-空腹血糖(FPG)-血总胆固醇(TC)-血甘油三酯(TG)-高密度脂蛋白胆固醇(HDL-c)-低密度脂蛋白胆固醇(LDL-c)-肝功(ALT-AST-GGT-B-T)及肾功(BUN-Cr)-利用稳态模式胰岛素抵抗指数(HOMA-IR)和胰岛素敏感指数(HOMA-IAI)评价治疗前后胰岛素抵抗及胰岛素敏感性-结果:所有病例经黄连素(BBR)治疗后,FPG-HbA1c-IR-BMI-TC-TG-LDL均明显下降,治疗前后具有显著性差异(P ≤ 0.001)-肥胖组较非肥胖组存在更明显的胰岛素抵抗(P < 0.01),经BBR治疗后所有病例胰岛素抵抗均有显著改善(P < 0.001)-肥胖组与非肥胖组相比,治疗前后BMI下降幅度有显著性差异(P < 0.05)-相关分析提示FPG下降与IR改善具有显著相关性(P < 0.001)-同时发现BBR可显著改善肝功能(ALT-AST-GGT)(P < 0.01),而对肾功能的影响没有显著性意义-结论:BBR具有显著的降糖疗效,改善高胰岛素血症,调节血脂,减轻体重,具有良好的改善胰岛素抵抗作用,更适用于治疗以胰岛素抵抗为优势的糖尿病前期和2型糖尿病早期阶段-

    • 心理干预在心脏介入手术中的价值

      2009, 29(5):739-740. DOI: 10.7655

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      摘要:目的:该研究探讨心理干预对心脏介入治疗患者的疗效-方法:选取96例进行介入治疗的患者,随机分为干预组和对照组,采用心理健康教育等干预方法对干预组实施近9个月的干预,运用焦虑抑郁量表(HAD)来评估心理干预的效果-结果:两组内HAD的得分值,干预组有显著差异(P < 0.001),对照组无显著差异(P > 0.05);两组之间HAD的得分值有显著的差异(P < 0.05),提示心理干预对提高介入治疗患者的疗效有效-结论:心理干预对提高介入治疗患者的疗效有一定的价值-

    • B-Flow技术在评估颈动脉狭窄处管腔面积中的应用价值

      2009, 29(5):741-743. DOI: 10.7655

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      摘要:目的:探讨二维灰阶血流成像技术(B-Flow)在颈动脉狭窄处管腔面积测定中的应用价值-方法:拟诊为颈动脉狭窄病变患者62例,选择二维超声(2D)模式下狭窄处管腔内面清晰的颈动脉共74条,在管腔狭窄处分别记录2D-彩色多普勒血流显像(CDFI)-能量多普勒血流显像(PDI)和B-Flow 横切面声像图,用 LOGIQ9系统自带软件,分别测定残余管腔面积-结果:病变处的颈动脉B-Flow表现动脉内膜粗糙-局部增厚或有斑块突入管腔,B-Flow 血流在斑块处往往呈涡流改变-颈动脉狭窄处残余管腔面积测值,B-Flow与2D间差异无显著的统计学差异(P > 0. 05),与CDFI-PDI的测值差异有统计学意义(P < 0.05)-结论:B-Flow 能以高帧频和高空间分辨力,同时显示血管解剖结构与病变处血流状态,与二维超声相结合,将会使所测量的血管面积更加准确,从而为临床评估颈动脉狭窄程度提供更可靠的依据-

    • 经尿道等离子电切治疗女性原发性膀胱颈梗阻48例临床分析

      2009, 29(5):744-745. DOI: 10.7655

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      摘要:目的:分析经尿道等离子电切术治疗女性原发性膀胱颈梗阻的疗效及安全性-方法:女性48例,平均年龄62岁,病程平均3.5年-诊断依据症状-膀胱镜检查及尿动力学为主,辅以影像学和实验室检查-药物治疗无效,采用经尿道等离子电切治疗-结果:48例行经尿道等离子电切术,46例(95. 8%)术后排尿症状明显改善-随访4~30个月,平均20个月-最大尿流率(Qmax)18.3~26.8 ml/s,平均21.8 ml/s-剩余尿量0~65 ml,平均22 ml-无尿瘘-尿失禁-尿道狭窄等严重并发症-结论:女性原发性膀胱颈梗阻多由膀胱颈纤维化或平滑肌增生引起,经尿道等离子电切对于α受体阻滞剂无效的患者,疗效确切-安全可靠-且能同期处理尿道息肉等伴发疾病-

    • FOLFOX7方案治疗晚期胃癌临床观察

      2009, 29(5):746-748. DOI: 10.7655

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      摘要:目的:观察奥沙利铂(OXA)联合氟尿嘧啶(5-Fu)-亚叶酸钙(CF)组成的FOLFOX7方案治疗晚期胃癌的疗效和不良反应-方法:43例晚期胃癌患者接受奥沙利铂130 mg/m2,第1天静脉滴注3 h;亚叶酸钙400 mg/m2,第1天静脉滴注2 h;氟尿嘧啶2 400 mg/m2,静脉持续滴注46 h,14天为1周期,应用2个周期后评价疗效-结果:43例共完成178个周期化疗,中位数4个周期(1~6个周期)-41例可评价疗效,总有效率(ORR)48.7%(20/41),完全缓解(CR)4.8%(2/41),部分缓解(PR)43.9%(18/41),稳定(SD)41.4%(17/41),进展(PD)9.7%(4/41)-1年生存率为43.9%(18/41)-43例可评价毒性,主要的不良反应为胃肠道反应,发生率88.3%(38/41),白细胞减少39.6%(17/43),神经毒性11.6%(5/43)-结论:FOLFOX7方案治疗晚期胃癌不良反应可耐受-

    • 经胸微创镶嵌治疗婴幼儿室间隔缺损18例报告

      2009, 29(5):748-750. DOI: 10.7655

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    • 显微神经外科手术切除小脑血管网织细胞瘤

      2009, 29(5):750-752. DOI: 10.7655

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    • 两种方法处理产程活跃期停滞的临床效果比较

      2009, 29(5):752-754. DOI: 10.7655

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    • 激光周边虹膜成形术治疗18例急性房角关闭

      2009, 29(5):754-755. DOI: 10.7655

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    • 以消化道症状首发伴双肾积水输尿管扩张的儿童狼疮性肾炎1例

      2009, 29(5):756-756. DOI: 10.7655

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      摘要: