OBJECTIVE: To review the role of thyroid hormone in the peripheral nerve regeneration. METHODS: The recent literatures of experimental study and clinical application on the role of thyroid hormone in nerve regeneration were reviewed. The researches on expression, isoform and changes of thyroid hormones in rat sciatic nerve in normal or injury were summarized. The effect of thyroid hormone on local rat sciatic nerve was studied, too. RESULTS: Nuclear thyroid hormone receptors expressed in numerous nuclei of sciatic nerve during a limited period of development extending from the third week of embryonic life to the end of the second postnatal week and after injury of adult sciatic nerve. A single and local administration of thyroid hormone at the level of the transected sciatic nerve produced a lasting effect on peripheral nerve regeneration. CONCLUSION: The beneficial effects of thyroid hormones upon injured peripheral nerve may have considerable therapeutic potential.
Objective To review the application of genipin for the modification of natural biomaterials as a crosslinking agent and progress in research. Methods Domestic and foreign literature on application of genipin for the modification of natural biomaterials as a crosslinking agent was thoroughly reviewed. Results Genipin is an effective natural crosslinking agent with a very low level of cytotoxicity compared with conventional synthetic crosslinking agents. Tissues fixed with genipin can maintain a high level of stability as well as resistance to enzymatic degradation. Conclusion Genipin is a promising substitute for conventional synthetic crosslinking agents, which has offered an alternative for modification of natural biomaterials for tissue engineering.
New functional evaluation methods for coronary artery lesions have received widespread attention at home and abroad. As a new functional evaluation technique, the clinical value of quantitative flow ratio (QFR) in the accuracy and feasibility of diagnosing myocardial ischemia caused by coronary artery stenosis has been confirmed in many clinical trials. Compared with the traditional gold standard fractional flow reserve (FFR) for diagnosing coronary artery stenosis, QFR has the advantages of simple operation, time-saving and low cost. This article reviews the comparison of the diagnostic accuracy of FFR and QFR and the progress of clinical research, aiming to explore whether QFR may replace FFR as a functional evaluation method of coronary artery disease and guide clinical blood circulation reconstruction.
Objective To summarize ultrasonography, CT and (or) MRI imaging features of cystic liver lesions so as to improve its diagnostic accuracy. Methods The literatures relevant imaging studies of different types of cystic liver lesions at home and abroad were searched. Then with the etiology as clue, the imaging fetures of ultrasonography, CT and (or) MRI plain scan and enhancement scan were summarized. Results The cystic liver lesions had many types, their imaging findings were different and existed overlaps. The diagnosis and differential diagnosis of atypical cases were difficult. ① For the simple hepatic cyst, it was a round cystic mass with water-like echo, density and signal. The boundary was clear, and there was no separation in the cyst, without contrast enhancement. The sensitivity and specificity of diagnosing were higher by ultrasonography and MRI as compared with CT. ② For the bile duct hamartoma and Caroli diease, they were manifested as multiple cysts, widely distributed in the whole liver, without enhancement for the most lesions. The multiple cystic lesions without communicating with the bile duct was the key sign of differential diagnosis for these two dieases. ③ Enhancing mural nodules were more common in cystadenocarcinoma than cystadenoma. The accurate diagnosis of biliary cystadenoma depended on combination of ultrasonography, CT, and MRI findings. ④ For the cystic liver metastatic tumor, it was multiple cystic neoplasms in the liver parenchyma or around the liver. CT was the main method for the diagnosis, and which showed that the density was lower than that of the liver parenchyma, peripheral ring-enhanced lesion as enhanced scan. It was easy to distinguish with simple hepatic cyst by MRI. ⑤ For the cystic hepatocellular carcinoma, it presented as a multilocular cystic solid tumor. The presence of tumor thrombus in portal vein could help to the diagnosis. ⑥ For the undifferentiated embryonal sarcoma, CT plain scan showed the cystic low density mass with clear boundary, the edge with calcification, enhanced scan showed that the soft tissue composition presented continuous strengthening sign. There was no specific signal in MRI plain scan, and the periphery of the tumor was slowly strengthening. ⑦ For the liver abscess, it was easy to diagnose because it had different characteristic features in different pathological phase, but it was misdiagnosis of intrahepatic cholangiocarcinoma when its symptoms were atypical. ⑧ The ultrasonography and the CT were the optimal methods for the hepatic cystic echinococcosis and the hepatic alveolar echinococcosis respectively. The significances of imaging were to determine the activity of hydatid cyst and to identify anatomy structure among alveolar echinococcosis, bile duct and blood vessel, and judge invasion or not, MRCP was important for diagnosis. Conclusions Abdominal ultrasonography could be used as the first choice for diagnosis of cystic liver lesions, CT and MRI could be used as effective supplementary methods for it. A combination of various imaging techniques is key to diagnosis. Moreover, number and morphology of lesion, and solid component or not are important imaging features of diagnosis and differential diagnosis of cystic liver lesion.
目的 構建實用性及操作性強的衛生監督統計指標體系。 方法 2011年9月－11月采用德爾菲專家咨詢法對指標的實用性、代表性進行評價，利用問卷調查法對指標的操作性進行評價，利用制定的評價原則對指標進行實用性與操作性評價。 結果 評價出實用性及操作性較強的衛生監督統計指標57個，兩輪專家咨詢的積極系數均為100.00%，操作性指標的積極系數也為100.00%；專家權威程度兩輪分別為0.75和0.79；協調系數第一輪專家咨詢實用性為0.27、代表性為0.24，第二輪實用性為0.23、代表性為0.22（P＜0.05）。 結論 評價出的實用性衛生監督統計指標體系較為實用、可靠，可用于評價衛生監督工作。
Coronary microvascular dysfunction (CMD), as an urgent clinical challenge after percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI), has become a research hotspot in the cardiovascular field for its pathophysiological mechanisms and early accurate assessment strategies. The paper systematically summarizes the molecular mechanisms of CMD after reperfusion therapy in STEMI patients, and at the level of diagnostic technology, it deeply analyzes the clinical application value of invasive assessment tools such as coronary flow reserve fraction and index of microcirculatory resistance, and focuses on the unique advantages of quantitative cardiac magnetic resonance analysis for visual assessment of microcirculatory function, aiming to construct a multidimensional assessment system for CMD after STEMI, which will provide a theoretical basis for optimizing the risk stratification of cardiovascular events and formulating individualized treatment strategies.
Objective To design, construct and select the optimal repl ication-defective recombinant adenovirus mediated short hairpin RNA (shRNA) which is transduced into human osteosarcoma cells to silence c-myc gene expression, and to construct the recombinant adenovirus vector expressing c-myc-shRNA and determine its viral titer. Methods Three pairs of complementary single-stranded ol igonucleotides (ss ol igos) were designed and synthesized, and then they were annealed to create a double-stranded ol igonucleotide (ds ol igos).The ds ol igos were cloned into pENTR/U6 vector to produce the shuttle plasmid pENTR/U6-shRNA, which was transduced into osteosarcoma cells by l iposome after sequencing. The plasmid with good silence effect was chosen by RT-PCR to perform the LR recombination reaction to the adenovirus backbone plasmid. The expression clone was transfected into HEK293A cells to produce repl ication-incompetent recombinant adenovirus mediated shRNA against c-myc whose cytopathic effect was observed and viral titer was determined by the viral particle (VP) method and 50% tissue culture infective dose (TCID50). Results Ds ol igos, which was verified by electrophoresis, was cloned into pENTR/U6 vector to produce pENTR/U6-shRNA shuttle plasmid, which was confirmed to be corrected by sequencing. The optimal plasmid with good silence effect was chosen by RT-PCR from the three pairs of double-stranded ol igonucleotide. By Pac I enzyme, the l inearrization repl ication-defective recombinant adenovirus mediated shRNA was constructed to perform the LR recombination reaction to the adenovirus backbone plasmid. The cytopathic effect and vacuole phenomenon of adenovirus mediated shRNA appeared at 3 days and became obvious at 6 days. The adenovirus virus titer in the first generation was 5.23 × 109 VP/mL, and reached 2.26 × 1012 VP/mL via 3-4 generations’ ampl ification. The viral titer was 10-3.8/0.1 mL determined by VP method and TCID50. Conclusion The recombinant adenovirus mediated shRNA c-myc is constructed in vitro through RNA interference technology.
【摘要】 目的 觀察經皮導管介入治療急性肺栓塞的療效。 方法 選擇2003年1月-2009年6月收治的急性肺栓塞患者15例，采用經皮導管吸栓術、碎栓術及溶栓術治療。溶栓術用局部灌注加即刻靜脈注射尿激酶，總量100萬U。溶栓后給予低分子肝素7~10 d，口服華法林3~6個月。觀察臨床癥狀、體征改善情況、并發癥、平均肺動脈壓（mPAP）與動脈血氧分壓（PO2）的變化，以及肺動脈開通情況。 結果 12例肺動脈完全開通，3例部分開通，顯效率89%，有效率100%。mPAP從（41.07±6.97） mm Hg降到（21.00±5.66） mm Hg，PO2從（46.26±9.30） mm Hg升到（79.49±8.04） mm Hg，治療前后差異有統計學意義（Plt;0.05）。即刻臨床癥狀明顯改善，mPAP迅速降低11例。隨訪3~6個月，療效持續，未見復發。 結論 介入治療急性肺栓塞療效顯著，安全可行，對搶救危重患者、改善臨床癥狀、維持血流動力學穩定有重要作用。【Abstract】 Objective To observe the clinical curative effect on acute pulmonary embolism(PE)via percutaneous catheter intervention. Methods Fifteen acute PE patients admitted from January 2003 to June 2009 were treated with percutaneous catheter drawing of thrombus, thrombectomy, and thrombolysis. Local infusion and immediate intra-venous injection of urokinase with 100 000 000 U in total were used for thrombolysis. Afterwards, the low molecular weight heparin was given for seven to ten days, and an oral intake of warfarin lasts for three to six months. Observe the clinical symptoms, improvement of physical signs, occurrence of complications, change of mean pulmonary arterial pressure (mPAP) and arterial partial pressure of oxygen (PO2), as well as the patency condition of pulmonary artery. Results Twelve of fifteer patients gained complete patency of pulmonary artery, and the other three patients gained partial patency, with an obvious effectiveness rate of 89% and an effectiveness rate of 100%. mPAP decreased from (41. 07±6. 97) mm Hg to (21. 00±5. 66) mm Hg, and PO2 elevated from (46. 26±9. 30) mm Hg to (79. 49±8. 04) mm Hg, showing a significant difference (Plt;0. 05) before and after the therapy. The immediate clinical symptoms exhibited a significant improvement. The pulmonary artery pressure of 11 patients dropped rapidly. During three to six months’ follow up, the therapeutic effects persisted and no recurrence was found. Conclusion The interventional treatment of acute PE demonstrates remarkable effectiveness, safety and feasibility, which plays an important role in the rescue of critical patients, improvement of clinical symptoms, and maintenance of hemodynamic stability.
目的:探討宮頸癌體外放射治療加后裝腔內治療的療效和放射反應。方法:對76例宮頸癌患者均采用體外放射治療加60Co 后裝腔內治療臨床資料進行回顧性分析。結果:全組 5年總生存率為 63.7%,Ⅰ期生存率為88.9%,Ⅱ期為 71.9%,Ⅲ期為48.1%,Ⅳ期為 20.0%。10年總生存率為 31.6%,Ⅰ期生存率為 53.3%,Ⅱ期為33.3%,Ⅲ期為 22.0%,Ⅳ期為 0.0%,經Log Rank法檢驗各期生存率有顯著差異(Plt;0.01)。放射治療后發生陰道粘連 9例(11.8%),放射性膀胱炎 6例(7.9%),放射性直腸炎13例(17.1%)。放射性直腸炎按 RTOG 晚期放射損傷分級方案分級,1級7例(53.8%),2級4例(30.8%),3級 2例(15.4%),4級 0例(0.0%)。結論:體外放射治療加60Co后裝腔內治療宮頸癌療效肯定,副作用少。但如何進一步提高生存率,盡可能減少放射反應仍是今后研究的方向。
Objective To prepare nerve growth factor (NGF)-insulin composite gel and observe the effects of NGF-insulin composite gel on deep second degree scald wound healing in diabetic rats. Methods Carbomer 980, NGF (4 000 U), and insulin (800 U) were used to prepare the insulin gel, NGF gel, and NGF-insulin composite gel. The character of NGF-insulin composite gel was observed, and the in vitro drug release was tested. Seventy-five SPF Wistar male rats, weighing 200-250 g, were divided into 5 groups randomly, 15 rats each group: normal control group (group A), diabetes control group (group B), insulin gel treatment group (group C), NGF gel treatment group (group D), and NGF-insulin composite gel treatment group (group E). The type 1 diabetes rat model was established by intraperitoneal injection of Streptozotocin (55 mg/kg) in groups B, C, D, and E, while the rats in group A were injected with the same dose of citric acid and calcium citrate buffer. After modeling success, deep second degree scald wound on the back was made with constant temperature water bath box. Wounds were treated with carbomer blank gel in groups A and B, with insulin composite gel in group C, with NGF gel in group D, and with NGF-insulin composite gel in group E, once a day. At 3, 7, 11, 15, and 21 days after injury, the scald wound healing was observed and healing rate was calculated; the full-thickness skin specimens were harvested from 3 rats of each group for histological and immuohistochemical staining observation. Results The NGF-insulin composite gel was clear and transparent, and had good moisture retention capacity and adhesion; it was easy to apply and clean up. The drug release in vitro lasted more than 24 hours and maintained for 30 days. No rat died during the experiment. At 3 days after injury, wound area did not reduce in all groups; at 7, 11, 15, and 21 days, group E had the highest wound healing rate, and group B had the lowest; significant differences were found between group E and group B and when compared with the other groups (P lt; 0.05). HE staining showed that group E surpassed other groups in the growth of granulation tissue and collagen fiber. Immunohistochemical results showed that the CD34 and proliferating cell nuclear antigen (PCNA) expressed at 3 days, and the number of positive cells increased gradually with time; the microvessel density and PCNA expression were highest in group E and were lowest in group B, showing significant differences when compared with the other groups and between group E and group B (P lt; 0.05). Conclusion NGF-insulin composite gel can improve deep second degree scald wound healing in diabetic rats.