脊髓运动诱发电位在脊髓肿瘤手术中的监测应用

目的探讨脊髓运动诱发电位(SCMEP)在脊髓肿瘤手术中监测的应用价值.方法采用硬膜外电极在椎管内直接刺激脊髓记录脊髓运动诱发电位(SCMEP)监测脊髓肿瘤手术,并对17例肿瘤患者的手术监测的记录结果进行回顾性分析.结果SCMEP由于病变部位及性质、刺激电极与记录电极间的距离不同,波幅及潜伏期的差异较大,电极安放后与手术结束时的结果个体对照,相差不显著(P=0.083;P=0.387).7例术中波幅降低超过预警值20%,5例经短暂休息或改变手术方向后,波幅恢复正常.结论SCMEP的波幅变化是提示脊髓损伤的可靠性灵敏指标,对辅助医生进行手术安全操作,缩短手术时间,提高手术质量,减少术后神经功能障碍起到重要作用.     

脑外科手术后发生正常灌注压突破的发病机制及超微病理基础

目的:探讨脑外科手术后部分患者病变邻近脑组织发生正常灌注压突破并发症的发病机制及其超微病理基础.材料和方法:对68例脑内血管畸形病变邻近的脑组织进行电子显微镜观察.结果:病灶邻近脑组织内部分毛细血管外周的星形细胞足突缺失或出现血管基膜疏松、分层等发育不良的情况,甚至有些血管壁组织结构破损.结论:电子显微镜检查证实,在血管畸形病灶周围的脑组织内可见病理性血管.该血管的基膜发生病变,血管周围的星形细胞足突明显减少或破坏.当血液灌注压力突然变化时,这种病变的血管就可能发生液体外渗及破裂.这就是在神经外科手术中或手术后发生正常灌注压突破并发症的超微病理基础.     

34例淋巴瘤骨髓浸润患者治疗与预后分析

目的 探讨淋巴瘤骨髓浸润患者的治疗与预后。方法 34例淋巴瘤骨髓浸润患者分为单纯化疗组、化疗+放疗组、大剂量化疗+自体干细胞移植组进行治疗,长期随访,分析其预后状况。结果 全组中位生存期为20个月;1年和3年生存率分别为76.47％和26.47％,最初疗效为完全缓解和部分缓解患者的1年和3年生存率均大于未缓解患者(P<0.05);大剂量化疗+自体干细胞移植组的3年生存率大于单纯化疗组和化疗+放疗组(P<0.05)。结论 淋巴瘤骨髓浸润患者的生存率与最初疗效有关;大剂量化疗+自体干细胞移植能提高其生存率,改善预后。     

山东产四种菟丝子免疫增强作用的比较研究

目的 比较山东产四种菟丝子对小鼠免疫功能、抗疲劳、耐缺氧等方面的作用。方法 选用昆明种小鼠，用山东产四种菟丝子的水、醇提取物灌胃，观察小鼠腹腔巨噬细胞吞噬功能、免疫器官重量的变化、游泳实验和耐缺氧等指标。结果 山东产四种菟丝子均可增加小鼠吞噬百分率，使幼龄小鼠的胸腺和脾脏增重，并可显著延长小鼠的游泳及缺氧存活时间。其中以菟丝子和南方菟丝子的作用较好，水提取物的作用优于醇提取物。结论 山东产四种菟丝子具有增强机体免疫功能、抗疲劳、耐缺氧作用。菟丝子中的多糖是其提高机体免疫力，增强体质的有效物质之一。     

人野生型parkin基因真核表达载体的构建及其在PC12细胞中的表达

目的 克隆人野生型parkin基因并构建真核表达载体pCDNA3．1—parkin，将重组质粒转染PC12细胞获得高表达人野生型parkin基因的PC12细胞克隆。方法 从胎脑组织中提取总RNA，用RT—PCR方法获得人野生型parkin基因的全长cDNA，插入pCR2．1—TA克隆载体中进行序列测定，测序正确后将其亚克隆至表达载体pCD—NA3．1，利用脂质体将重组质粒转染PC12细胞，经G418筛选获得抗性细胞克隆，采用RT—PCR和Western Blot方法鉴定人野生型parkin基因在PC12细胞中的过表达。结果 经限制性内切酶酶切图谱分析和DNA序列测定证实目的基因已插入重组质粒，RT—PCR和Western Blot证明经G418筛选得到的转基因PC12细胞克隆中存在人野生型parkin基因的表达。结论 成功构建了人野生型parkin基因的真核表达载体，获得了稳定表达人野生型parkin基因的PC12细胞克隆，为进一步研究parkin的生物学功能以及parkin在帕金森病发病机制中的作用奠定了良好的基础。     

微创疗法在骨不连中的应用现状

骨不连是骨折术后常见并发症,据统计约有5%~10%的骨折可因各种原因发生骨折不愈合和迟缓愈合。骨不连的治疗方法虽很多,但治疗效果不一。近年来,随着影像学及内镜技术的发展以及在外科领域的成功实践,微创技术在骨科中的应用较为迅速,已取得了可喜成绩。根据近年来的文献,介绍微创技术在治疗骨不连方面的一些进展。     

Genome-wide scan identified QTLs underlying femoral neck cross-sectional geometry that are novel studied risk factors of osteoporosis.

A genome-wide screen was conducted using a large white sample to identify QTLs for FNCS geometry. We found significant linkage of FNCS parameters to 20q12 and Xq25, plus significant epistatic interactions and sex-specific QTLs influencing FNCS geometry variation. INTRODUCTION: Bone geometry, a highly heritable trait, is a critical component of bone strength that significantly determines osteoporotic fracture risk. Specifically, femoral neck cross-sectional (FNCS) geometry is significantly associated with hip fracture risk as well as genetic factors. However, genetic research in this respect is still in its infancy. MATERIALS AND METHODS: To identify the underlying genomic regions influencing FNCS variables, we performed a remarkably large-scale whole genome linkage scan involving 3998 individuals from 434 pedigrees for four FNCS geometry parameters, namely buckling ratio (BR), cross-sectional area (CSA), cortical thickness (CT), and section modulus (Z). The major statistical approach adopted is the variance component method implemented in SOLAR. RESULTS: Significant linkage evidence (threshold LOD = 3.72 after correction for tests of multiple phenotypes) was found in the regions of 20q12 and Xq25 for CT (LOD = 4.28 and 3.90, respectively). We also identified eight suggestive linkage signals (threshold LOD = 2.31 after correction for multiple tests) for the respective geometry traits. The above findings were supported by principal component linkage analysis. Of them, 20q12 was of particular interest because it was linked to multiple FNCS geometry traits and significantly interacted with five other genomic loci to influence CSA variation. The effects of 20q12 on FNCS geometry were present in both male and female subgroups. Subgroup analysis also revealed the presence of sex-specific quantitative trait loci (QTLs) for FNCS traits in the regions such as 2p14, 3q26, 7q21 and 15q21. CONCLUSIONS: Our findings laid a foundation for further replication and fine-mapping studies as well as for positional and functional candidate gene studies, aiming at eventually finding the causal genetic variants and hidden mechanisms concerning FNCS geometry variation and the associated hip fractures.     

INTRAVENOUS LEIOMYOMATOSIS OF THE UTERUS WITH EARLY PREGNANCY

Intravenous leiomyomatosis is a rare uterineneoplasm, histologically characterized by nodularmasses of benign smooth muscle growing withinthe uterine and pelvic veins. The entity has ty-pical gross and microscopic features. A case of intravenous leiomyomatosisassociated with uterine leiomyoma, adenomyosisand early pregnancy was reported. The condi-tion was recognized during surgery for uterinefibroids. This is, to our knowledge, the thirdcase of intravenOUs leiomyomatosis associatedwith pregnancy so far reported.     

Interleukin-1 and cancer progression: the emerging role of interleukin-1 receptor antagonist as a novel therapeutic agent in cancer treatment

The tumor microenvironment consists of tumor, immune, stromal, and inflammatory cells which produce cytokines, growth factors, and adhesion molecules that promote tumor progression and metastasis. Of particular interest in this setting is interleukin-1 (IL-1), a pleiotropic cytokine with numerous roles in both physiological and pathological states. It is known to be up regulated in many tumor types and has been implicated as a factor in tumor progression via the expression of metastatic and angiogenic genes and growth factors. A number of studies have reported that high IL-1 concentrations within the tumor microenvironment are associated with a more virulent tumor phenotype. Solid tumors in which IL-1 has been shown to be up regulated include breast, colon, lung, head and neck cancers, and melanomas, and patients with IL-1 producing tumors have generally bad prognoses. The exact mechanisms by which IL-1 promotes tumor growth remain unclear, though the protein is believed to act via induction of pro-metastatic genes such as matrix metalloproteinases and through the stimulation of adjacent cells to produce angiogenic proteins and growth factors such as VEGF, IL-8, IL-6, TNFα, and TGFβ. The IL-1 receptor antagonist (IL-1ra) is a naturally occurring inhibitor to IL-1 and acts by binding to the IL-1 receptor without activating it. The protein has been shown to decrease tumor growth, angiogenesis, and metastases in murine xenograft models. Our focus in this review is to summarize the known data on the role of IL-1 in tumor progression and metastasis and the use of IL-1 inhibition as a novel therapeutic approach in the treatment of solid organ malignancies.     

急性等容性血液稀释对血浆ET和CGRP水平的影响

目的　探讨急性等容性血液稀释 (ANH)对血浆内皮素 (ET)和降钙基因相关肽(CGRP)水平的影响。方法　选择非心脏手术ASAⅠ～Ⅱ级患者 2 0例 ,麻醉前快速输入复方乳酸钠1 0～ 1 5ml/kg。麻醉后从桡动脉放血 1 0ml/kg ,同时经静脉输入等量的 4 %琥珀酰明胶。观察ANH麻醉前 (T0 )、血液稀释完成后 1 0min(T1 )、2 0min(T2 )、30min(T3 )的血液动力学、血浆ET和CGRP浓度的变化。结果　ANH前后MAP、HR、SpO2 和ECG均较稳定。ANH后 1 0min、2 0min血浆ET水平分别为 (1 4 4 4 7± 1 9 1 7) pg/ml和 (1 5 7 1 7± 1 2 4 5 ) pg/ml,但明显高于ANH前的 (1 2 7 6 8±2 0 92 ) pg/ml(P <0 0 5 )。ANH后 1 0min、2 0min血浆CGRP水平分别为 (5 4 72± 2 5 6 5 )pg/ml和(5 5 32± 1 7 94 )pg/ml,也明显高于ANH前的 (4 4 6 2± 1 6 90 ) pg/ml(P <0 0 5 )。而ET/CGRP比值无明显变化。结论　ANH近期血浆ET和CGRP水平均有一定的增加 ,但ET/CGRP比值的变化无统计学意义 ,同时心血管反应不明显 ,表明血浆ET和CGRP的动态平衡对ANH时的循环稳定起着重要的作用