目的:探讨Livin基因在人胆管癌组织及胆管癌细胞系中的表达情况及其与胆管癌发 生发展之间的关系。方法:采用免疫组织化学技术（SP法）检测Livin基因蛋白在45例人胆管 癌标本及及40例癌旁胆管组织、20例正常胆管组织标本中的表达；同时采用RTPCR法及SP 法检测了Livin基因mRNA和蛋白在人胆管癌细胞系QBC939及非肿瘤细胞系HT1080中表达。 结果:Livin在胆管癌组织中表达阳性率为57.8%，而癌旁胆管组织、非癌胆管组织中未能检 测到Livin表达。Livin表达与性别、年龄、肿瘤大小及肿瘤分化程度无关。在有淋巴结转组 中，Livin阳性表达率（70.4%）明显高于无淋巴结转移组（38.9%）。在人胆管癌细胞QBC939 中，Livin mRNA及蛋白均特异性表达，而非肿瘤细胞系HT1080未见Livin表达。结论:Livin 基因在人类胆管癌组织和细胞系中选择性高表达，其可能与胆管癌发生、发展及预后密切相 关。
Objective To investigate the effects of one-lung ventilation time on the concentration of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in the bronchoalveolar lavage fluid (BALF), serum inflammatory markers and early pulmonary infection after radical resection of esophageal cancer. Methods Ninety patients with thoracoscope and laparoscopic radical resection of esophageal carcinoma were chosen. According to the thoracoscope operation time, the patients were divided into 3 groups including a T1 (0.5–1.5 hours) group, a T2 (1.5–2.5 hours) group and a T3 (>2.5 hours) group. Immediately after the operation, the ventilated and collapsed BALF were taken. Enzyme-linked immunosorbent assay (ELISA) method was used to determine the concentration of IL-6 and tumour necrosis TNF-α. The concentrations of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) were measured on the first, third, fifth day after operation. The incidence of pulmonary infection was observed within 3 days after operation. Result The IL-6 values of the right collapsed lung in all groups were higher than those in the left ventilated lung. The TNF-α value of the right collapsed lung in the T2 group and T3 group was higher than that in the left ventilated lung (P<0.05). Compared with in the right collapsed lung, the TNF-α and IL-6 values gradually increased with the the duration of one-lung ventilation (P<0.05). Compared with the left ventilated lung groups, the IL-6 value increased gradually with the duration of one-lung ventilation time (P<0.05). The TNF-α value of the T3 group was higher than that of the T1 and T2 groups (P<0.05). The PCT value of the T3 group was higher than that of the T1 group and T2 group on the third, fifth day after operation (P<0.05). But there was no significant difference in CRP and WBC among the three groups at different time points. The incidence of pulmonary infection in the T3 group was significantly higher than that in the T1 group within 3 days after operation (P<0.05). Conclusion With the extension of one-lung ventilation time, the release of local and systemic inflammatory mediators is increased, and the probability of pulmonary infection is higher.
Objective To investigate perindopiI influence for the complication in hypertensive patients with stroke history by lowering blood pressure. Methods One-hundred and fifty-five essential hypertensive patients with stroke history were randomly assigned to either perindopril group or placebo group, receiving a randomized, double-blind, placebo-controlled trial as long as 3 years. Their blood pressure, the morbidity and mortality of cardiocerebral complications were monitored. At the end of trial, three days Ambulatory Blood Pressure Monitoring were performed. Result It was shown that in perindopril group blood pressure was controlled satisfactorily, and the morbidity and mortality of cardiocerebral incidences (6.85 % and 2.74 %repectively) were lower than those of placebo group (17.10% and 9.21% respectively). Conclusions Perindopril lowers blood pressure effectively and persistently. It has important clinical effect for prevention the cardiocerebral complications in hypertensive patients with stroke history by lowering blood pressure.
目的 探讨二级医院神经内外科整合的可行性及优越性，观察组织化医疗模式的临床效果。 方法 将神经内、外科整合为一个一级临床科室——脑系科，建立完善的多学科一体化治疗的组织化医疗网络体系。入选重型颅脑外伤和脑出血患者共289例，其中2004年8月-2008年12月在脑系科住院的重型颅脑外伤、脑出血患者共147例接受组织化医疗模式治疗，作为治疗组；2001年1月-2004年8月分散在我院内科、外科住院的重型颅脑外伤、脑出血患者共142例接受传统常规治疗，作为对照组。比较观察两组患者的治疗效果。 结果 治疗组神经功能缺损评分、日常生活活动能力评分和GCS分别为7.47±5.24、59.74±15.56和13.72±1.06；对照组分别为16.18±9.89、34.00±10.54和10.84±1.58。两组比较，差异有统计学意义(Plt;0.05)。治疗组与对照组比较，临床治愈率提高55.64%，平均住院日缩短10.34 d，病死率降低21.26%，并发症降低20.15%，致残率降低20.24%。 结论 采用组织化医疗模式能明显改善患者预后，缩短住院时间，提高患者的生活质量，是适合我国基层医院神经内、外科危急重症的治疗模式，具有其可行性及优越性。
Objective To explore the method of preparing the electrospinning of synthesized triblock copolymers of ε-caprolactone and L-lactide (PCLA) for the biodegradable vascular tissue engineering scaffold and to investigateits biocompatibil ity in vitro. Methods The biodegradable vascular tissue engineering scaffold was made by the electrospinning process of PCLA. A series of biocompatibil ity tests were performed. Cytotoxicity test: the L929 cells were cultured in 96-wellflat-bottomed plates with extraction media of PCLA in the experimental group and with the complete DMEM in control group, and MTT method was used to detect absorbance (A) value (570 nm) every day after culture. Acute general toxicity test: the extraction media and sal ine were injected into the mice’s abdominal cavity of experimental and control groups, respectively, and the toxicity effects on the mice were observed within 72 hours. Hemolysis test: anticoagulated blood of rabbit was added into the extracting solution, sal ine, and distilled water in 3 groups, and MTT method was used to detect A value in 3 groups. Cell attachment test: the L929 cells were seeded on the PCLA material and scanning electron microscope (SEM) observation was performed 4 hours and 3 days after culture. Subcutaneous implantation test: the PCLA material was implanted subcutaneously in rats and the histology observation was performed at 1 and 8 weeks. Results Scaffolds had the characteristics of white color, uniform texture, good elasticity, and tenacity. The SEM showed that the PCLA ultrafine fibers had a smooth surface and proper porosity; the fiber diameter was 1-5 μm and the pore diameter was in the range of 10-30 μm. MTT detection suggested that there was no significant difference in A value among 3 groups every day after culturing (P gt; 0.05). The mice in 2 groups were in good physical condition and had no respiratory depression, paralysis, convulsion, and death. The hemolysis rate was 1.18% and was lower than the normal level (5%). The SEM showed a large number of attached L929 cells were visible on the surface of the PCLA material at 4 hours after implantation and the cells grew well after 3 days. The PCLA material was infiltrated by the inflammatory cells after 1 week. The inflammatory cells reduced significantly and the fiber began abruption after 8 weeks. Conclusion The biodegradable vascular tissue engineering scaffold material made by the electrospinning process of PCLA has good microstructure without cytotoxicity and has good biocompatibil ity. It can be used as an ideal scaffold for vascular tissue engineering.
目的 探讨尤瑞克林对不同结构性影像类型进展性脑梗死的CT与临床效果。 方法 2007年3月－2011年6月按入院时不同结构性影像类型将进展性脑梗死分为大灶梗死、中灶梗死、小灶梗死及腔隙梗死4型，共235例，采用分层随机分组的方法将患者分为尤瑞克林组（治疗组）119例，对照组116例。两组基础用药均为疏血通6 mL+生理盐水250 mL静脉滴注，胞磷胆碱0.5 g+生理盐水250 mL静脉滴注，阿司匹林0.1 g口服，以上用药均为1次/d，连用4周。治疗组同时给予生理盐水100 mL+尤瑞克林0.15 PNAu静脉滴注，对照组同时给予生理盐水100 mL静脉滴注，1次/d，连用7～14 d，两组治疗前后均测量梗死的最大层面最大梗死灶的长度与宽度，计算并记录梗死面积；统计分析各型的临床疗效。 结果 ① 梗死面积改变：治疗前各亚型治疗组与对照组梗死面积差异均无统计学意义（P＞0.05）；治疗后，大灶梗死组、中灶梗死组、小灶梗死组中的治疗组梗死面积均比治疗前显著缩小（P＜0.01），而对照组的梗死面积较治疗前差异无统计学意义（P＞0.05）；腔隙梗死组中，治疗组及对照组治疗后梗死面积均无明显改变（P＞0.05）。② 临床疗效：各亚型进展性脑梗死，治疗组均取得优于对照组的效果；大灶梗死及中灶梗死的显著进步率分别为47.6%和66.7%，而对照组的显著进步率分别为0.0%和33.3%。 结论 大灶梗死组、中灶梗死组、小灶梗死组进展性脑梗死使用尤瑞克林治疗后梗死面积均比治疗前明显缩小；各亚型进展性脑梗死使用尤瑞克林后临床疗效均优于对照组，尤其是大灶梗死及中灶梗死的临床效果更加显著。