肾上腺-脑白质营养不良的实验室诊断进展

肾上腺脑白质营养不良是遗传性代谢疾病 ,由于基因突变 ,极长链饱和脂肪酸在患者血浆和组织中累积 ,引起脑白质脱髓鞘改变和肾上腺功能不全。对血浆、培养皮肤成纤维细胞极长链饱和脂肪酸的测定是诊断本病的主要生化指标 ,基因突变分析能准确发现发病家系的基因突变类型和突变位点 ,应用免疫学方法检测突变基因所表达的蛋白 ,联合极长链饱和脂肪酸测定、基因突变分析两种方法 ,能提高肾上腺脑白质营养不良的确诊率。     

新型化学转染试剂对人脐带间充质干细胞的转染优化

背景:人脐带间充质干细胞的基因修饰技术多种多样,它们在效率、可靠性及安全性方面各有不同。目的:对比3种新型化学转染试剂在人脐带间充质干细胞中的瞬时转染效率。方法:采用FugeneHD、LipofectamineLTX及Attractene分别转染人脐带间充质干细胞,荧光显微镜下观察阳性细胞,流式细胞术分析不同转染试剂的转染效率,锥虫蓝染色观察转染后人脐带间充质干细胞的生存率。结果与结论:LipofectamineLTX转染效率最高,显著高于FugeneHD和Attractene[(32.50±2.12)%,(4.30±0.64)%,(1.70±0.08)%,P<0.05]。LipofectamineLTX转染后的细胞生存率略低于FugeneHD及Attractene,但差异无显著性意义[(69.8±6.3)%,(92.4±4.2)%,(106.6±3.9)%,P>0.05]。提示LipofectamineLTX是人脐带间充质干细胞较为理想的化学转染试剂。     

损伤控制理念在腹部急诊与外伤中的应用经验（附120例报告）

目的 探讨损伤控制理念在腹部外伤与继发性腹膜炎病人中的应用价值。方法 回顾性分析2008年1月至2013年2月应用损伤控制手术救治120例腹部急诊与创伤病人的临床资料。结果 共完成消化道穿孔、继发性腹膜炎病人急诊溃疡穿孔修补术97例,十二指肠造瘘5例,平均手术时间（65±12） min,平均术中出血量（50±21） mL。无围术期死亡发生。术后并发症包括肺部感染8例,切口感染4例,无消化道漏、腹腔感染的发生。完成腹部损伤病人十二指肠造瘘术6例,胰腺损伤快速止血、清创及引流术5例,创伤性肝破裂肝深部缝扎及大网膜填塞术7例。平均手术时间为（100±28） min,术中平均出血量（250±65） mL。8例病人术后入ICU复苏。1例严重胰腺损伤病人术后3 d死亡。围术期并发症包括肺部感染4例,肾功能不全2例,胰漏1例,胆漏1例,肝脓肿1例。结论 行损伤控制手术病人,围术期死亡率和并发症发生率低。在外科创伤和急诊病人中疗效满意。     

年龄对人骨髓间充质干细胞分离培养的影响

目的:探讨年龄对骨髓间充质干细胞分离培养的影响以及在临床治疗中的意义.方法:通过分析183例人骨髓间充质干细胞分离培养情况,对比不同年龄段骨髓单个核细胞数、原代间充质干细胞数量、细胞增殖速度、细胞形态等方面的差异.结果:不同年龄段骨髓有核细胞、间充质干细胞免疫表型没有明显差异,单个核细胞数随年龄增长逐渐减少,但没有统计学差异.不同年龄段收获原代间充质干细胞数量、细胞增殖速度有明显差异(P<0.01).年轻组、中年组收获原代MSC细胞明显多于年老组,增殖能力明显强于年老组.结论:随着年龄的增长,骨髓中间充质干细胞的数量减少,增殖能力衰退,在干细胞临床治疗中,不适宜从老年患者中获取骨髓来源的间充质干细胞.     

大鼠胰岛细胞经门静脉肝内移植模型的建立

背景:由于肝脏既是胰岛索的作用部位,又是相对的免疫特惠区,排斥反应小,肝窦及其小静脉结构还有利于胰岛的居留和生长,可供移植容积大,有利于胰岛的生存,因此肝脏是一个较为理想的移植部位.目的:建立一种经门静脉胰岛细胞肝内移植治疗SD大鼠1型糖尿病的动物模型.方法:采用文献方法制备SD大鼠胰岛细胞.以腹腔注射链尿佐菌素诱导建立SD大鼠1型糖尿病模型,随机数字表法分为2组:实验组经门静脉主干穿刺输注SD大鼠胰岛1000胰岛当量1.5 mL;对照组经门静脉主干穿刺输注无血清1640液1.5 mL.术后未给予免疫抑制剂,观察两组大鼠出血量、血糖、胰岛素水平及肝脏组织形态学变化.结果与结论:所有大鼠均移植成活,门静脉穿刺一次成功率90%,出血量＜0.5 mL.胰岛移植大鼠血糖降为正常的时间1～6(3.7±1.7)d,移植胰岛存活时间为2~15(8.4±4.1)d.术后2周内实验组大鼠空腹血清胰岛素水平明显高于对照组(P＜0.05,P＜0.01).病理结果证实,移植大鼠肝细胞形态、肝小叶结构均正常,肝实质未见坏死灶,血管内无血栓形成;门静脉主干未见狭窄,亦未发生感染,说明胰岛细胞在肝窦内存活并能发挥功能.证实大鼠胰岛经门静脉主干穿刺输注肝内移植是胰岛移植基础研究的理想模型.     

结肠中血管根部切断在右侧结肠癌根治术中的价值

Objective To compare the long-term outcome of ligating the middle colic artery in radical surgical treatment of right hemicolon cancer. Methods The operation safety, complications and short-term outcome between two groups of patients undergone either ligating the middle colic artery from its root (A group) or ligating the middle colic artery from its right branch (B group) in right bemicolectomy for colon cancer. Results Between January 1981 and December 2004, 308 patients underwent radical right hemicolectomy in which 103 patients were treated by ligating the middle colic artery from its roots (Jan. 1996 to Dec. 2004, A group), and 205 patients via ligating the middle colic artery from the roots of its right branch (Jan. 1981 to Dec. 1995, B group). The complications were compared between the two groups (P>0.05). The mean follow-up time of A and B group were (50.1±7.2) months and (49.1±7.2) months respectively. Local recurrences of 1-year, 3-year and cumulative survival probability at the 60th month in group A were 1.9%, 13.6% and (78.3±3.4)% respectively, which were significantly better than 19.0%, 24.9% and (64.8±2.8)% in group B (P<0.05). Conclusion Ligating the middle colic artery from its root in right hemicolectomy can be performed safely and effectively, which is to be highly recommended in curative resection of right colon.     

住院患者六种主要致病菌分离率及药敏分析

为给医院感染管理机构及临床医生合理用药提供科学依据,本文分析总结了1997年2月-1998年5月本院六种主要致病菌分离率及常用抗生索敏感性,以供临床参考。     

结肠中血管根部切断在右侧结肠癌根治术中的价值

Objective To compare the long-term outcome of ligating the middle colic artery in radical surgical treatment of right hemicolon cancer. Methods The operation safety, complications and short-term outcome between two groups of patients undergone either ligating the middle colic artery from its root (A group) or ligating the middle colic artery from its right branch (B group) in right bemicolectomy for colon cancer. Results Between January 1981 and December 2004, 308 patients underwent radical right hemicolectomy in which 103 patients were treated by ligating the middle colic artery from its roots (Jan. 1996 to Dec. 2004, A group), and 205 patients via ligating the middle colic artery from the roots of its right branch (Jan. 1981 to Dec. 1995, B group). The complications were compared between the two groups (P>0.05). The mean follow-up time of A and B group were (50.1±7.2) months and (49.1±7.2) months respectively. Local recurrences of 1-year, 3-year and cumulative survival probability at the 60th month in group A were 1.9%, 13.6% and (78.3±3.4)% respectively, which were significantly better than 19.0%, 24.9% and (64.8±2.8)% in group B (P<0.05). Conclusion Ligating the middle colic artery from its root in right hemicolectomy can be performed safely and effectively, which is to be highly recommended in curative resection of right colon.     

成人胰岛细胞的分离纯化与应用

目的 探讨成人胰岛细胞分离纯化技术,为胰岛细胞移植治疗1型糖尿病提供大量高质量的胰岛细胞.方法 使用LiberaseHI复合胶原酶和改良的Recordi自动胰岛细胞分离技术分离胰岛,采用COBE2991细胞淘洗仪连续密度梯度离心纯化胰岛细胞,用DTZ和AO-PI染色显微镜下评价胰岛细胞的数量、纯度和活性.结果 该组研究共分离30例胰腺的胰岛,获得胰岛细胞数量平均为(316626±191972)IEQ,平均每克胰腺收获胰岛细胞3389 IEQ,收获的胰岛纯度平均为(74.70±7.84)%,活度平均为(94.10±2.19)%,胰岛细胞刺激指数平均为(3.68±0.58).在此基础上,成功实施7人12次的成人胰岛细胞移植.结论 成功建立了改良的Recordi自动胰岛分离技术,获得大量高纯度有活性的胰岛细胞,为开展胰岛细胞临床移植提供了保障.