中国实用医刊杂志   部级期刊

摘要：目的 构建含有胰腺-十二指肠同源盒-1(Pdx-1)的真核表达载体,并研究其在大鼠骨髓间充质干细胞(MSCs)中的表达情况.方法 克隆Pdx-1基因,构建含Pdx-1的真核表达载体pEGFP-Pdx-1及pcDNA3.1-Pdx-1,转染MSCs,倒置荧光显微镜及逆转录聚合酶链反应(RT-PCR)检测MSCs中Pdx-1的表达.结果 测序结果 表明克隆的Pdx-1基因序列正确,构建的含Pdx-1的真核表达载体能有效的转染MSCs,并检测到该基因mRNA的表达.结论 完成Pdx-1基因克隆,成功构建含有Pdx-1基因真核表达载体,并在转化株中检测到该基因的表达,为糖尿病的细胞替代及基因治疗提供基础. Abstract： Objective To construct eukaryotic expression vector containing the pancreatic-duodenum homeobox-1(Pdx-1)and to study the expression in rat bone marrow-derived mesenchymal stem cells (MSCs). Methods Cloned Pdx-1 gene and constructed containing Pdx-1 eukaryotic expression vector pEGFP-Pdx-1 and pcDNA3.1-Pdx-1, transfected MSCs, detected the Pdx-1 expression in MSCs by invert fluorescence microscope and RT-PCR.Results Sequencing results showed that the cloned Pdx-1 gene sequence was correct, the eukaryotic expression vector containing Pdx-1 could effectively transfected MSCs and detected the gene expression at mRNA level.Conclusions The completion of Pdx-1 gene is cloned successfully and constructed containing Pdx-1 gene eukaryotic expression vector, detected the expression of the gene in the stable transfected MSCs,making preparations for the cell replacement and gene therapy of diabetes.

摘要：目的 探讨选择性环氧合酶-2(COX-2)抑制剂塞来昔布联合叶酸预防食管癌的有效性.方法 将84例食管上皮轻、中重度不典型增生患者随机分为叶酸组(28例)、塞来昔布联合叶酸组(28例)以及安慰剂组(28例),连续服用12个月后,再行胃镜及病理复查.终点指标定义为食管上皮不典型增生的组织学分级有严重程度的改变,记录其逆转、稳定、进展变化,比较各治疗组疗效.结果 塞来昔布联合叶酸组的不典型增生的好转率为60.7%(17/28),显著高于对照组(P＜0.05).叶酸组对食管上皮各级不典型增生并未有显著影响.结论 塞来昔布和叶酸联合应用可能降低食管癌发病的危险,尚需进一步扩大样本量的研究. Abstract： Objective To determine the validity of celecoxib combined with folate for the prevention of esophageal carcinoma.Methods Eighty four subjects completed the trial. Subjects had histologically confirmed mild or moderate esophageal dysplasia at baseline. And they were randomly divided into three groups: folate group,celecoxib plus folate group and control group.Esophagogastroduodenoscopy was performed before and after a 12-month intervention. Per-subject change (regression, stable or progression) in the worst dysplasia grade was defined as the primary end point. Results were compared by agent group.Results The relative reverse rate of celecoxib plus folate group was 60.7%(17/28), significantly higher than that in placebo group (P＜0.05). Folate alone did not influence changes in dysplasia grade by baseline histology subgroup(P＞0.05).Conclusions Celecoxib and folate have better effects than celecoxib alone in the chemoprevention of esophageal carcinoma for high risk subjects. Further trials with larger numbers are needed to confirm these results.

摘要：目的 探讨抗肿瘤药物性肺损害的高分辨率CT(HRCT) 表现及其临床应用价值.方法 回顾性分析诊断明确的12例抗肿瘤药物性肺损害的患者胸部HRCT表现.结果 本组抗肿瘤药物性肺损害HRCT 表现为间质性肺炎和肺纤维化7例,闭塞性细支气管炎伴机化性肺炎2例,嗜酸细胞性肺炎1例,过敏性肺炎2例.结论 抗肿瘤药物性肺损害的影像学表现是非特异性的,HRCT可以清楚的显示肺损害的病理改变,及早发现肺损害并对一些疾病的鉴别诊断有所帮助,对临床制定或修改治疗方案有重要的提示或指导意义. Abstract： Objective To investigate HRCT findings of anticancer drug-induced pulmonary lesions and its clinical application value. Methods HRCT findings in 12 patients with diagnosis explicit anticancer drug-induced pulmonary lesions were retrospectively analyzed. Results The group of anticancer drug-induced pulmonary lesions HRCT findings of seven cases of interstitial pneumonia and interstitial fibrosis, bronchiolitis obliterans organizing pneumonia two cases, one case of acidophilia granular cell pneumonia, one case of allergic pneumonia. Conclusions HRCT findings of anticancer drug-induced pulmonary lesions are non-specific, and HRCT can clearly show that the pulmonary lesion to the pathological changes, and to detect the pulmonary lesion as soon as possible, develop or modify the clinical treatment has important suggestion or guidance significance.

摘要：目的 评价重组人改构肿瘤坏死因子(rmh-TNF)治疗恶性胸腔积液的疗效和不良反应.方法 38例恶性胸腔积液患者排尽胸水后,注入单药rmh-TNF 2×106 IU,2次/周,观察其疗效、生活质量和不良反应.结果 38例中完全缓解12例,部分缓解23例,无效3例,总有效率92%;不良反应发生率有发热76%(29/38),胸痛44%(17/38).结论 rmh-TNF局部治疗恶性胸腔积液疗效可靠,不良反应少,生活质量提高,是治疗恶性胸腔积液的有效药物,尤其是治疗因恶性胸腔积液不能耐受全身静脉化疗的患者. Abstract： Objective To evaluate the effect and side effect of recombinant mutant human tumour necrosis factor (rmh-TNF) in the treatment of malignant hydrothorax. Methods Thirty-eight patients with malignant hydrothorax were observed rmh-TNF 2×106 IU were injected intrapleurally after complete drainage, two times a week,until the malignant effusion no longer appeared,to observe the effect,quality of life and side effect.Results Among 38 patients with malignant hydrothorax,12 patients obtained complete response(CR),23 patients partial response (PR)and 3 patients no change (NC), the overall response rate was 92%. The adverse reactions were fever 76%(29/38), and chest pain 44%(17/38).Conclusions The rmh-TNF is effective with minor side effect in the treatment of malignant hydrothorax,improve the quality of life.Therefore it is a favorable treatment of choice,especilly to that who can't tolerant chemotherapy.

摘要：目的 通过临床分析及文献复习,探讨肺泡蛋白沉着症(PAP)的临床表现、诊断方法 、治疗及预后,提高对该病的认识.方法 回顾性分析12例PAP患者的临床资料.结果 活动后气促和咳嗽是PAP的主要症状,体征较少,肺部影像学表现多样化,肺功能主要为限制性通气功能障碍和弥散功能障碍,需病理确诊.结论 PAP临床体征与影像学表现不平衡,影像学表现较体征重,易误诊、漏诊.加强对该病的认识是提高诊断率的关键. Abstract： Objective To improve the understanding of pulmonary alveolar proteinosis (PAP) by exploring clinical manifestation, diagnosis,treatment and prognosis of PAP through clinical analysis and the literature review. Methods Retrospectively analysis of clinical characteristics of 12 patients with PAP.Results PAP,with few physical signs, whose common symptoms included dyspnea after physical activities and cough. The radiological features of PAP could be characterized as geographic.The pulmonary function of PAP appeared restriction of ventilation function and impairment of lung diffusion function. The accurate diagnosis of PAP need pathologic evidence. Conclusions The typical features are stabilization of the shadow and that the shadow is more serious than the symptoms, often causing a significant delay in the diagnosis or misdiagnosis.Increase the knowledge of PAP is crucial in improving the rate of diagnosis.

摘要：目的 研究近视屈光手术人群眼角膜非球面特性(Q值)的分布特征以及相关因素对Q值的影响.方法 随机收集近视屈光手术患者300例(600眼),使用Orbscan Ⅱz眼前节分析系统K&Q计算软件获得眼角膜6 mm分析区域的Q值,并针对Q值的分布特征及其与相关的屈光度、角膜曲率和角膜直径等因素进行相关分析.结果 300例600眼角膜Q值分布范围-0.51～1.03,平均(-0.16±0.15).Q值与角膜曲率、模拟角膜镜读数、5 mm区不规则指数和角膜前表面Diff值之间呈负相关,与前房深度和角膜直径呈正相关,而与球镜度数、等效球镜度、柱镜度数、3 mm区不规则指数、角膜后表面Diff值、年龄、眼压和角膜厚度之间不相关.同一个体双眼的Q值差异无统计学意义,但是男女之间的Q值差异有统计学意义.结论 近视屈光手术人群眼角膜Q值呈近似正态分布,角膜Q值不是一个独立的参数,与眼部多个因素相关. Abstract： Objective To study the distribution characters of corneal asphericity (Q-value) in myopia population for corneal laser refractive surgery and the related influencing factors.Methods Six hundred eyes of 300 patients with myopia for corneal laser refractive surgery were enrolled in this study with each patient selected randomly. The K&Q calculator of Orbscan Ⅱz anterior segment system was used to obtain the Q-value of 6 mm optical zone in 300 cases (600 eyes),and statistical analysis was used to comprehend the distribution characters of Q-value and its relations with diopter,cornea curvature and cornea diameter and so on. Results The Q-value of 600 eyes ranged from -0.51-1.03 with the mean value -0.16±0.15.The Q-value showed a negative correlation with cornea curvature, simulated keratometry, irregular index of 5 mm zone, diff value of anterior surface and a positive correlation with anterior chamber depth and cornea diameter, but no relate with spherical diopter,spherical equivalent,astigmatism diopter, irregular index of 3

摘要：目的 探讨血管内皮生长因子-C(VEGF-C)和sonic hedgehog(SHH)在食管鳞状细胞癌(ESCC)组织中的表达及其与淋巴结转移的关系.方法 应用免疫组织化学法检测40例ESCC组织和30例癌旁正常黏膜组织中VEGF-C及SHH的表达.结果 40例ESCC组织中25例(62.5%)出现VEGF-C阳性,24例(60.0%)出现SHH阳性;癌旁正常食管黏膜组织30例中仅5例(16.7%)出现VEGF-C阳性,8例(26.7%)出现SHH阳性,其差异均有统计学意义(P＜0.05).在VEGF-C阳性的25例ESCC组织中19例出现淋巴结转移,而在VEGF-C阴性的15例ESCC组织中仅2例出现淋巴结转移,其差异有统计学意义(P＜0.05);SHH表达阳性的24例ESCC中18例有淋巴结转移,而SHH表达阴性的16例ESCC中7例有淋巴结转移,其差异有统计学意义(P＜0.05).结论 VEGF-C和SHH参与了ECSS的发生发展,且与其淋巴结转移的发生有关.对于VEGF-C及SHH表达阳性的ESCC患者,术前和术中应分别加强对淋巴结转移的评估及清扫,以提高其生存率. Abstract： Objective To study the expression of vascular endothelial growth factor-C(VEGF-C)and sonic hedgehog(SHH) in esophageal squamous cell carcinoma(ESSC)and explore the relationship between lymph node metastasis of ESCC and them.Methods The expression of VEGF-C and SHH was detectde using immunohistochemical method on 40 specimens from patients with ESSC and 30 cases of non-cancerous esophageal tissues. Results In the 40 specimens from patients with ESSC, 25 cases(62.5%) were VEGF-C positive,24 cases(60.0%)were SHH positive. In 30 cases of non-cancerous esophageal tissues,only 5 cases(16.7%)were VEGF-C positive,8 cases(26.7%)were SHH positive,there were both significant differences between the 2 types of tissues (P＜0.05).There were 19 cases had lymph node metastasis in the 25 cases whose VEGF-C were positive,while only 2 cases had lymph node metastasis in the 15 cases whose VEGF-C were negative (P＜0.05). There were 18 cases had lymph node metastasis in the 24 cases whose SHH were positive,while o

摘要：目的 探讨多排螺旋CT对肺动脉栓塞(PE) 的诊断价值.方法 回顾性分析35例肺栓塞CT肺动脉血管成像患者的临床资料.结果 肺栓塞的多排螺旋CT增强表现:直接征象为充盈缺损,完全阻塞型39支,中心型25支,偏心型20支,附壁型8支;间接征象为与肺叶或段分布一致的栓塞处肺窗示肺纹理稀疏17例,胸膜下梗死灶19个,胸腔积液9例,肺动脉高压5例.结论 多排螺旋CT肺动脉造影是一种安全、有效、无创的检查方法 ,对肺动脉栓塞有较高的临床价值. Abstract： Objective To explore the diagnostic value of multi-slice spiral CT in pulmonary embolism patients.Methods Thirty-five cases of multi-slice spiral CT pulmonary embolism imagining were retrospectively analyzed. Results The features of post-contrast multi-slice spiral CT were as follows:Direct signs was the filling defect in pulmonary artery,total occlusion of pulmonary arteries in 39 branches,central filling defect in 25 branches,eccentric filling defect in 20 branches,embolism attached to the wall of host artery in 8 branches;Indirect sign was reduced pulmonary vascular markings in 17 cases,subpleural infarction in 19 foci,pleural effusion in 9 cases,pulmonary hypertension in 5 cases.Conclusions Multi-slice spiral CT angiography imaging of pulmonary embolism is a safe,effective and non-invasive diagnostic method.There is higher clinical value with pulmonary embolism.

摘要：目的 观察眼挫伤性近视的临床特点并探讨其发生机制.方法 对28例(31眼)眼挫伤性近视患者的临床资料进行回顾性分析.结果 小瞳检影验光发现所有挫伤眼均存在近视性屈光改变,其中93%的挫伤眼表现为轻、中度近视.经合适的凹透镜矫正后多数外伤眼视力均可达1.0,个别有所提高.睫状肌麻痹剂散瞳后验光发现所有外伤眼的近视度数均不同程度地减轻甚至消失.对症治疗后大多数可在4周内恢复至伤前视力.结论 挫伤性近视病程短,药物治疗4周内可以恢复,预后良好.