miR-26a抑制ST3GAL6基因介导mTOR信号通路对小鼠Lewis肺癌细胞增殖凋亡的作用机制

目的:探究miR-26a靶向调控ST3GAL6基因介导mTOR信号通路对小鼠Lewis肺癌细胞增殖凋亡的作用机制。方法:构建肺癌小鼠模型，将小鼠分为正常组和模型组；免疫组化检测ST3GAL6在肺组织中的表达情况，qRT-PCR法检测miR-26a在组织中的表达；细胞分为空白组、阴性对照组、miR-26a mimic组、miR-26a inhibitor组、si-ST3GAL6组、miR-26a inhibitor+si-ST3GAL6组和miR-26a mimic+RAD001（mTOR抑制剂）组；qRT-PCR法检测细胞中miR-26a和ST3GAL6 mRNA的表达情况；MTT法和流式细胞术分别检测各组细胞的增殖和凋亡情况；Western blot法测定各组细胞ST3GAL6、p-mTOR、Akt蛋白相对表达量。结果:miR-26a和ST3GAL6在肺癌小鼠肺癌组织中均高表达（均P<0.05）。与空白组相比，miR-26a mimic组ST3GAL6 mRNA及蛋白表达上升，Akt、p-mTOR蛋白表达上升，细胞增殖率上升、凋亡率下降（均P<0.05）；而miR-26a inhibitor组、si-ST3GAL6组和miR-26a inhibitor+si-ST3GAL6组ST3GAL6 mRNA及蛋白表达下调，Akt、p-mTOR蛋白表达下降，细胞增殖率下降、凋亡率上升（均P<0.05）。同时，miR-26a表达在miR-26a mimic组和miR-26a mimic+RAD001组中上升，miR-26a inhibitor组和miR-26a inhibitor+si-ST3GAL6组中下降（均P<0.05）。结论:miR-26a下调ST3GAL6基因，抑制mTOR信号通路活化，抑制肺癌细胞增殖及促进细胞的凋亡。     

口服阿卡波糖片致不良反应1例

1 病历报告 患者,男,38岁.于2012年2月9日以"双手双足冻伤"收住入院.患者既往有糖尿病史,一直未正规治疗.入院后查空腹血糖16.25mmol/L,考虑应激作用,于2月17日复查空腹血糖18.22mmol/L,餐后2小时血糖27mmol/L,请内分泌科医生会诊后使用胰岛素控制,效果不理想.于2月20日加大胰岛素剂量,同时口服二甲双胍500mg/d,血糖有所下降;于2月29日再次请内分泌科医生会诊,血糖监测记录显示早餐后2小时血糖欠理想,诊断为Ⅱ型糖尿病,加用阿卡波糖片100mg/d,同时患者静脉应用活血化瘀药物丹参多酚酸盐针200mg,患者于3月1日出现全身发痒,未予处理.于3月2日腹部背部出现片状皮疹.考虑丹参多芬酸盐过敏,给予停用,并肌注地塞米松5mg,症状未消失,于3月5日停用阿卡波糖片,3月6日症状消失.     

钴合金椎弓根螺钉植入修复脊柱结核重度后凸畸形：自身对照临床试验方案

BACKGROUND: There is evidence that internal fixation through an anterior or posterior approach for treatment of severe kyphotic deformity in spinal tuberculosis exhibits good curative effects. However, few prospective, long-term follow-up case control studies are reported.     

比较不同方式置入椎弓根钉内固定修复胸腰椎爆裂骨折的生物相容性

BACKGROUND: During the repair of thoracolumbar fracture, pedicle screw fixation is a commonly used treatment method. In the process of fixation, the different approaches can be used.  OBJECTIVE: To compare effect and biocompatibility of pedicle screw by percutaneous approach, posterior median approach, and intervertebral space approach for thoracolumbar fracture.  METHODS: 118 cases of thoracolumbar fracture were included after pedicle screw fixation. All patients were divided into three groups according to the approach: posterior median approach group (38 cases), intervertebral space approach group (40 cases) and percutaneous approach group (40 cases). After 12 months of follow-up, perioperative conditions, pain score, vertebral height of anterior border, kyphosis correction effect, adverse events and biological compatibility were compared among three groups. RESULTS AND CONCLUSION: (1) Operation time, intraoperative bleeding and time in bed after surgery were shorter or less in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group. Postoperative drainage was better in percutaneous approach and intervertebral space approach groups than in the posterior median approach group (all P < 0.05). Except drainage in the percutaneous approach and intervertebral space approach groups, no significant difference in other indicators was found. (2) Patients received imaging examination at different time points. The percentage of anterior vertebral height and kyphosis were significantly improved immediately after treatment and in final follow-up (all P < 0.05). No significant difference was detected before treatment, immediately after treatment and in final follow-up. (3) Visual Analogue score was identical before treatment. Visual analogue score was lower in the percutaneous approach and intervertebral space approach groups than in the posterior median approach group at 24 hours and 3 days after treatment and in final follow-up (all P < 0.05). No significant difference was detectable at 24 hours and 3 days after treatment and in final follow-up between the percutaneous approach and intervertebral space approach groups. (4) No rejection or wound non-healing was seen at 12 months after treatment. Some patients suffered from mild low back pain, which was improved by active symptomatic treatment. (5) These findings suggest that intervertebral space approach percutaneous approach obtained satisfactory outcomes compared with posterior median approach for treatment of thoracolumbar spine fractures, and good biocompatibility was found.        

McCune-Albright综合征伴巨人症临床特点及长期随访研究

目的 探讨伴有巨人症的McCune-Albright综合征患者的临床特点、病程以及对治疗的反应。方法 长期随访北京协和医院收治的2例伴有巨人症的McCune-Albright综合征患者的临床治疗及实验室检查情况。结果 2例患者均接受了神经导航下经蝶入路垂体瘤切除手术,术后生长激素(GH)、胰岛素样生长因子-1(IGF-1)均明显下降,其中例2完全降至正常,随诊3年未见垂体瘤复发迹象;例1术后接受了溴隐亭和长效生长抑素的治疗,生长速度明显降低,GH和IGF-1下降。2例患者均接受了双膦酸盐治疗,骨骼病变进展均得到了有效控制。2例患者均在病程中出现了性腺功能减退。结论 治疗是一个长期的过程,需要临床医生根据患者的特点决定,采用个体化的综合治疗措施。神经导航下经蝶入路垂体瘤切除手术、长效生长抑素和双膦酸盐是控制本病的重要措施。     

阵发性头痛,血压升高

患者女,31岁,维吾尔族人。因“阵发性头痛,血压升高8a”,于2009年11月20日收入院。患者2001年1月妊娠3个月时无诱因出现阵发性头枕部胀痛、持续2—24h,外院妊娠常规体检测血压140／100mmHg,未予治疗。2001年5月出现头胀痛、意识淡漠、血压升高,外院降压治疗后引产（具体血压及治疗不详）。     

低磷血症-骨软化-右股骨头占位

肿瘤相关性低血磷性骨软化症为罕见疾病。本文报道1例39岁男性,10余年前起逐渐出现乏力、多部位骨痛,进行性加重的活动困难,辅助检查提示低血磷,高尿磷,血钙正常,碱性磷酸酶(ALP)轻度增高,血pH正常,影像学有骨质疏松及骨软化表现,可见肋骨多发骨折,椎体双凹变。诊断为低血磷性骨软化症,因其成年起病,且无家族史,考虑肿瘤相关性低血磷性骨软化症可能性大,分别于2004年及2006年2次住院均未能明确定位诊断,对症服用中性磷制剂后症状明显改善。2010年第3次入院后通过PET-CT、奥曲肽显像及CT检查发现右股骨头内有占位性病变,行手术切除,术后血磷恢复正常,临床症状改善,病理学检查证实为磷酸盐尿性间叶组织肿瘤。     

肢端肥大症合并妊娠一例并文献复习

本文报道1例肢端肥大症患者妊娠期服用溴隐亭并成功分娩的诊治经过。回顾性总结了该患者2次妊娠前后的临床资料及治疗结局。该患者第2次妊娠期间口服溴隐亭, 妊娠期病情较稳定, 并足月剖宫产1女婴。本文提示肢端肥大症患者在病情稳定后妊娠可获得良好结局, 妊娠期服用多巴胺受体激动剂没有增加围产期不良事件。     

肝细胞刺激物质对感染鸭乙型肝炎病毒的雏鸭体内抗病毒作用的实验研究

以感染鸭乙型肝炎病毒（ＤＨＢＶ）的北京雏鸭为体内实验动物模型，观察了肝细胞刺激物质（ＨＳＳ）对鸭乙型肝炎病毒的抗病毒作用。１日龄北京鸭实验感染ＤＨＢＶ，７天后血清ＤＨＢＶＤＮＡ阳性，给予药物治疗１０天，用斑点杂交方法检测用药前后血清ＤＨＢＶＤＮＡ，分析药物对血清ＤＨＢＶＤＮＡ是否有抑制作用，结果显示：ＨＳＳ大、小两个剂量组（分别为５０ｍｇ／ｋｇ／ｄ和２００ｍｇ／ｋｇ／ｄ）均对ＤＨＢＶＤＮＡ有抑制作用，大剂量组出现ＤＨＢＶＤＮＡ抑制作用时间早于小剂量组，用药５天、１０天及停药３天血清ＤＨＢＶＤＮＡ中位抑制率显著高于生理盐水对照组（Ｐ＜０．０５）；两个剂量组均无停药反跳；生理盐水组用药前后ＤＨＢＶＤＮＡ的Ａ值比较差异无显著性意义（Ｐ＞０．０５）。停药后３天肝组织病理光镜及电镜均显示ＨＳＳ组病变较生理盐水组轻。结论：肝细胞刺激物质有一定的保肝和抑制ＤＨＢＶＤＮＡ复制的作用     

三黄汤加减治疗痰湿热结型多囊卵巢综合征临床观察

目的?观察三黄汤对痰湿热结型多囊卵巢综合征（PCOS）的临床疗效。方法?随机将65例痰湿热结型多囊卵巢综合征患者分为中药组和对照组,均采用二甲双胍口服,中药组在此基础上,给予三黄汤颗粒并随症加减口服,进行3月的疗效观察。对治疗前后临床症状、性激素水平、体质量及胰岛素抵抗代谢指标等进行分析。结果?加用中药组在改善患者临床症状、性激素水平、月经周期恢复、体质量和胰岛素抵抗指标等方面优于对照组（P<0.05~0.01）。结论?加用三黄汤加减组临床疗效优于单用西药对照组。