Abstract:Objective：To investigate the inhibitory effects of obestatin on proliferation and differentiation of 3T3-L1 preadipocytes. Methods: Obestatin (10-8 mmol/L, 10-9 mmol/ L, 10-10 mmol/ L, 10-11 mmol/ L,and 10-12 mmol/L) and ghrelin (10-10 mmol/L) were used to treat 3T3-L1 preadipocytes. Cell proliferation was assessed by MTT assay and the results were compared with that of blank control group. The differentiation of 3T3-L1 preadipocytes (from day 1 to day 10) was interfered with obestatin or ghrelin (both at 10-10 mmol/L). Intracellular fat accumulation in differentiated adipocytes was determined by oil red O staining and the expression of PPARγ2 mRNA was detected by RT-PCR; the results were compared with that of control group (induced with routine inducer). Results: Compared with the blank control group, obestatin-treated groups (various concentrations of obestatin) had significantly less cells(P<0.05). Oil red O staining revealed that, compared with control group, the formation of lipid droplets was significantly decreased after 10 days’ of treatment with 10-10mmol/L obestatin (P<0.05). The expression of PPARγ2 gene increased with the progress of 3T3-L1 preadipocytes differentiation. PPARγ2 mRNA level in mature adipocytes of obestatin group was significantly lower than that in the cells of control group. The effect of ghrelin was contrary to that of obestatin. Conclusion: Obestatin can inhibit the proliferation and differentiation of 3T3-L1 preadipocyes.

Abstract:Objective：To investigate the correlation between the microsatellite polymorphisms in ob gene 3′flanking region with obesity in Chinese Han ethnicity in Shanghai.Methods: The genotypes of polymorphisms in ob gene 3′flanking region were determined by PCR in 232 Chinese Han subjects (including 130 obese patients and 102 normal controls).The clinical data,including height,weight,waist circumference,hip circumference,body mass index,waist-to hip ratio (WHR),blood glucose,serum insulin,blood lipids,and uric acid,were compared between the 2 groups.Results: No significant difference of genotype frequency (Ⅰ/Ⅰ 0.115,Ⅰ/Ⅱ 0.331,Ⅱ/Ⅱ 0.554 vs Ⅰ/Ⅰ 0.059,Ⅰ/Ⅱ 0.333,Ⅱ/Ⅱ 0.608) and allele frequency (Ⅰ 0.281,Ⅱ 0.719 vs Ⅰ 0.225,Ⅱ 0.775) of ob gene 3′flanking region was observed between the 2 groups.In obese group,patients with Ⅰ+Ⅱ genotype was associated with increased WHR compared with those with Ⅱ/Ⅱ genotype (0.91±0.05 vs 0.86±0.03,P=0.047).Logistic regression analysis showed that WHR was independently correlated with ob gene polymorphisms (P=0.042).Conclusion: Polymorphisms in ob gene 3′ flanking region are correlated with central obesity in obese patients of Chinese Han ethnicity in Shanghai.

Abstract:Objective：To analyze the correlation between single nucleotide polymorphisms (SNP) of solute carrier family 22 member4 (SLC22A4) and runt-related transcription factor 1(RUNX1) gene with rheumatoid arthritis (RA) and ankylosing spondylitis（AS） in Chinese Han ethnicity. Methods: Case-control studies were conducted with an RA cohort (104 RA patients and 109 healthy subjects) and an AS cohort (278 AS patients and 417 healthy controls). Three SNPs of SLC22A4 gene and an SNP of RUNX1 gene were genotyped by direct sequencing; we also assessed whether these alleles and genotypes were associated with RA and AS. Results: No significant differences in the distribution of the alleles and genotypes of SLC22A4 and RUNX1 polymorphisms were found between patients with RA and AS and healthy controls. Conclusion: Our results suggest that SLC22A4 and RUNX1 polymorphisms analyzed in the present study are not the susceptible genes for RA and AS in Chinese Han ethnicity.

Abstract:Objective：To prepare a pig model of obstructive sleep apnea-hypopnea syndrome (OSAHS) and to observe the hemodynamics and pathological characteristics of common carotid artery, so as to lay a foundation for further studying the effect of OSAHS on cardiovascular system.Methods: Twelve male small-type pigs were randomly divided into model group and control group (n=6). Animals in the model group were housed in a negative pressure chamber for 6 months to establish OSAHS model and those in the normal control group were fed routinely. After pigs in the model group presented the symptoms of OSAHS, the changes in hemodynamics of carotid artery were detected with color Doppler ultrasound. The morphological changes of common carotid artery were analyzed under light microscope and electron microscope. Results: Animal model of OSAHS was successfully created. The internal diameter of carotid artery of pigs in the model group was decreased, the intima was increased, and the peak-systolic mean velocity (S) and the resistance index (RI) were both increased compared with those of the control group (P<0.05) . The results of light and electron microscope revealed that the elastic plate was incomplete, the media thickness was increased, the morphology of smooth muscle cell became irregular, the collagen fiber bundles were increased, and some elastic fibers and smooth muscle layers were in disorder. Quatitative analysis showed that the elastic fibers in the media of carotid artery increased significantly in the model group(P<0.01).Conclusion: Pathological changes in tissue structure and haemodynamics occur in negative pressure-induced pig OSAHS model. Alterations in upper airway pressure can cause damage to the cardiovascular system.

Abstract:Objective：To study the morphological changes of posterior cricoarytenoid muscles (PCM) in patients with long-term denervation of recurrent laryngeal nerve (RLN), so as to provide theoretical evidence for repair of recurrent laryngeal nerve at advanced clinical stage. Methods: Thirty-eight patients with damaged RLN were divided into 4 groups according to the duration of their RLN damage: 6-12 months group (n=12), 1-2 years group (n=10), 2-3 years group (n=8), and over 3 years group (n=8). Twelve subjects with normal PCM served as control. Trichrome Masson staining and imaging analyzing system were used to quantitatively analyze the transverse section areas of myofibers, collagen fiber and connective tissues. SDH and AchE staining and cell counting method were used to analyze changes of two kinds of myofibers and motor end plate numbers at different times after denervation of recurrent laryngeal nerve. Results: The transverse areas of myofibers gradually decreased and those of collagen fibers gradually increased with the prolongation of denervation; the difference was significant between different groups (P<0.01).The ratio of transverse area of myofiber to that of collagen fibers reached the lowest level 0.5-2 years after denervation. The fibrosis of muscle obviously slowed down 2 years after denervation. The transverse section of 48％ of myofibers remained 3 years after denervation. Long-term denervation resulted in the changes of muscle fiber types: the ratio of red muscles was increased and the ratio of white muscles was decreased after denervation; the difference was significant between different groups (P<0.01). The number of motor end plate decreased with the prolongation of denervation and disappeared after 1 year. Conclusion: The morphological alteration in long-term denervation PCM indicates the worst myofibrosis occurs within 2 years of denervation, but 48％of myofibers remain 3 years after denervation. The type alteration of denervated muscles may decrease the apoptosis of skeletal muscle. The structure of myoceptors disappears within 1 year of denervation. Our experiment indicates that there is a morphological basis for regaining total or partial muscle function by nerve repair after long-term denervation.

Abstract:Objective：To investigate the change in myogenin expression at different time in long-term denervated human posterior cricoarytenoid muscles（PCAMs）, so as to provide a theoretical basis for timing of reinnervation. Methods: Thirty-eight specimens of denervated human PCAMs were divided into 4 groups according to the period of denervation: 6-12 months denervation group（n=12） , 1-2 years denervation group（n=10）, 2-3 years denervation group（n=8）, and over 3 years denervation group（n=8）. Another 12 specimens of normal PCAMs served as control. The patients in all groups were age- and sex-matched. The expression of myogenin protein and mRNA was studied using immunofluorescence staining and real-time PCR analysis, respectively. Results: Immunofluorescence staining showed that the positive myogenin expression was mainly found in the myonuclei of PCAMs with a denervation period less than 3 years; no positive staining was found in the myonuclei of control group. The expression of myogenin in myonuclei and the ratio of positive cells were up-regulated in the 6-12 month denervation group compared with those in the control group; the expression and the ratio peaked in 1-2 years denervation group and decreased again in the 2-3 years denervation group, but was still significantly higher than those of the control group (all P<0.01). There was hardly any expression of myogenin 3 years after denervation. Results of RT-PCR showed no myogenin mRNA expression in the control group; the expression in 1-2 years, 2-3 years, and more than 3 years denervation groups were 4 times, 64 times, and half that of the 6-12 months denervation group, respectively (all P<0.05). Conclusion: It is indicated that there is a potential for muscle regeneration within 3 years of denervation.

Abstract:Objective：To study the inhibitory and apoptosis-inducing effect of vitamin E succinate (VES) on androgen-independent prostate cancer cell line PC-3 in vitro.Methods: VES was dissolved with ethanol to obtain VES solution.PC-3 cells of logarithmic growth phase were treated with various concentrations of VES solution (25,50,75,100,and 125mg/L); cells in control group were treated with 1.25% ethanol.MTT method was used to measure the viability and inhibitory rate of cells in each group 24h,48h and 72h after VES treatment; flow cytometry was employed to determine the apoptosis rate of the PC-3 cells.Results: The viability of cells in the experimental groups was significantly lower than that in the control group (P<0.05).The viability of cells in the experimental groups was negatively correlated with the concentration and exposure period of VES solution; the viability of cells in the control group was positively correlated with the exposure period of VES solution.The apoptosis rate of cells in the experimental groups was much higher than that in the control group; the rate in the experimental group was positively correlated with the concentration and exposure period of VES solution.The optimal induction of apoptosis was achieved after 48 h exposure to 75 mg/L VES solution,with a apoptosis rate above 80%.Conclusion: VES can inhibit the proliferation of PC-3 cells and can induce apoptosis of them,which casts new lights on prevention and treatment of prostate cancer.

Abstract:1临床资料 患者，女，76岁，因“反复头晕10年余，左侧肢体乏力8年，加重10 d”入我院内科，诊断为：（1）高血压病3级极高危，（2）冠心病，（3）频发房性早搏、Ⅰ度房室传导阻滞，（4）脑出血后遗症。入院后测体温：38.4℃，查血常规提示：WBC 7.1×109/L，HGB 127 g/L，中性比 0.803，查AFP、CEA、CA50、CA19-9，补体C3、C4，抗“O”、类风湿因子、生化常规均正常范围，铁蛋白468.08 ng/ml，CA125 974.6 U/ml，下腹部增强CT提示：腹水、右侧附件区囊性占位。腹水未找到癌细胞，经静脉抗炎、利尿等综合治疗后，体温、血常规均正常，腹水明显减少。因患者近期有消瘦史，每2～3个月10 kg，CA125异常升高974.6 U/ml，CT提示右侧附件区囊性占位，患者家属有手术要求，转入妇科。行全身PET-CT检查，提示：右侧卵巢囊性占位，考虑囊腺瘤，囊壁局部FDG代谢增高。排除手术禁忌证后剖腹探查，术中见：盆腔积液约300 ml，盆腔内充血、水肿明显，大网膜与横结肠粘连成团，网膜、侧腹膜、盆底后腹膜浆膜表面可见多发粟粒样小结节，色苍白，子宫前位，萎缩明显，右侧附件可见一约10 cm×8 cm大小囊肿，包膜完整，未见明显卵巢实质，与周围组织粘连明显，左侧附件已萎缩，故决定行：“右侧附件切除+网膜结节活检术”。手术顺利，常规病理提示：卵巢浆液性囊腺瘤，输卵管未见异常，网膜慢性炎症结节。术后9 d拆线，复查CA125 225.8 U/ml。[第一段]

Abstract:Objective：To investigate the expression of MMP-13 in breast cancer tissues and its relationship with clinical prognosis of patients. Methods: Tissue microarray and immunohistochemical SP method were used to detect the expression of MMP-13 in 183 specimens of breast cancer. The association between the expression of MMP-13 and the clinicopathologic parameters of patients was analyzed; the association between MMP-13 and the prognosis of breast cancer was also discussed based on 10 years’ follow-up data. Results: The positive rate of MMP-13 in the breast cancer tissue (54.1%) was significantly higher than that in the benign breast tissues (13.3%,P<0.01).MMP-13 expression was significantly correlated with the clinical TNM stage, histological grade and lymph node metastasis status of the malignancy(P<0.01), but was not correlated with patients’ age, tumor size, pathological type, period status, and the status of estrogen receptor and progesterone receptors.The 10-year survival rate of patients with over- expression of MMP-13 was lower than patients with low MMP-13 expression(P<0.01). Conclusion: MMP-13 expression is upregulated in breast cancer tissues, which is an indicator of poor prognosis of patients.

Abstract:Objective：To investigate the effects of enriched environment on learning and memory abilities in senescence accelerated-prone 8 (SAMP8) mice. Methods: Twenty 3-month-old male SAMP8 mice and 20 male SAMR1 mice (normal aging) were randomly divided into 2 groups according to their body weight: enriched environment (EE) group and standard environment (SE) group. Animals in the 2 groups were subjected to different environments for 8 weeks. The learning and memory abilities of animals were evaluated by step-down avoidance test and Morris water maze test. Results: The learning and memory abilities of EE group were significantly better than those of SE group in step-down avoidance test（P<0.05 for memory ability）. The average latent period of animals in EE group was significantly shorter than that in SE group in Morris water maze test in both SAMP8 and SAMR1 mice（P<0.05 for SAMP8 mice）. Spatial probe test revealed that the ability to search for platform of EE group was better than that of SE group. Conclusion: Enriched environmental intervention can improve the learning and memory abilities in senescence SAMP8 mice, especially for memory ability.

Abstract:Objective：To compare the diagnostic value of conventional fine needle aspiration biopsy(C-FNAB) and Ultrasound-guided FNAB(US-FNAB) for thyroid nodules by Meta-analysis.Methods: PubMed and CNKI database were searched for English and Chinese language articles related to FNAB diagnosis for thyroid nodules.The literatures were assessed and screened according to the Standards for Reporting of Diagnostic Accuracy (STARD).Data were pooled by Metadisc software.Results: A total of 8 810 specimens were included in conventional FANA group and the pooled sensitivity,specificity,and the AUC of weighted summary receiver operating characteristic (SROC) curve were 84.9%,76.3% and 0.919 4,respectively; 2 393 specimens were included in US-FNAB group and the above numbers were 84.0%， 80.8% and 0.935 6,respectively.Conclusion: FNAB has high accuracy in diagnosing thyroid nodules; the accuracy of ultrasound-guided FNAB is higher than conventional FNAB.

Abstract:Objective:To investigate the clinical efficacy and safety of compound bismuth potassium citrate capsules(CBPCC) combined with omeprazole capsules in eradication of Helicobacter pylori(H.pylori) infection.Methods: A total of 240 patients with gastric H.pylori infection were enrolled in this double-blinded,randomized controlled study.Patients in group A(control group) were given a combination of bismuth potassium citrate/tinidazole/clarithromycin tablets and ormprazole capsule (n=120); those in group B(treatment group) were given compound bismuth potassium citrate capsules and ormprazole capsules(n=120).H.pylori eradication rates and clinical safety of both treatment regimens were analyzed using SAS 6.12 software system. Results: A total of 236 patients from 6 resreach centers completed in this study,with 117 in group A and 119 in group B.Two patients in the contol group and 8 in the treatment group did not complete the experiment; six patients in the control group were excluded due to other reasons.There were 236 patients entered full analysis sets(FAS),220 entered per-protocol set(PPS),and 236 entered safety analysis sets(SS).FAS showed that the eradication rates of H.pylori were 84.87% in group B and 74.36% in group A(P<0.05); PPS showed the eradication rates were 76.15% in group A and 90.09% in group B(P<0.05).Intragroup comparison showed that the symptoms of patients in both groups were effectively improved; intergroup comparison showed that the symptom improvement rates were similar between the 2 groups.The rates of adverse events were 14.53% in group A and 14.29% in group B(P>0.05), with no severe adverse event found in both groups.The treatment regimen in group B was more cost-effective than that in group A(P＜0.05).Conclusion：This study demonstrates that compound bismuth potassium citrate capsules combined with omeprazole capsules have a high efficacy in eradication of H.pylori infection,and it is safe,cost-effective and worth popularizing in clinic.

Abstract:Objective：To assess the influence of absorbable poly-D,L-lactide acid (PDLLA) rods on the development of epiphyseal plate after implanted into the distal femoral epiphysis in skeletally immature New Zealand white rabbits.Methods: Seventy-five New Zealand white rabbits were evenly randomized into 3 groups according to the diameter of rods:1.5 mm PDLLA rod group,2.2 mm PDLLA rod group,and 3.2 mm PDLLA rod group.The absorbable PDLLA rods were placed into a drill hole of equal size in the intercondylar portion of the right femur,crossing the central portion of epiphyseal plate; empty drill holes of same size were made across the left femoral physis,which served as a control.The area of injured epiphyseal plates was calculated before operation.The animals were sacrificed at 3,6,9,12 and 24 weeks after operation.Measurement of femur bone length,radiographic measurement of both knee joint valgus angles,histology sections and transmission electron microscopic examination of the physis and adjacent bones were performed to evaluate the influence of implanted rods on epiphyseal plate.Results: The proportions of injured area caused by the drill holes in 1.5 mm group,2.2 mm group,and 3.2mm group were (1.86±0.10)%,(4.03±0.52)% and (7.52±1.02)%,respectively.At 24 weeks after operation,femur bone lengths (mm) of experimental and control sides were 90.60±0.55 and 90.27±0.84 in 1.5 mm group,87.53±0.67 and 87.06±0.78 in 2.2 mm group,and 85.30±1.39 and 84.91±1.40 in 3.2 mm groups, respectively; their knee joint valgus angles (°) were 7.863±1.26 and 8.110±1.18 in 1.5 mm group,8.858±1.30 and 9.453±1.95 in 2.2 mm group,and 11.90±2.80 and 14.448±5.17 in 3.2 mm group,respectively.There was no significant difference in femur lengths and valgus angles between 2 sides in each group(P>0.05).Both femur bone lengths in 3.2mm group were shorter than those in the 1.5 mm and 2.2 mm groups.No abnormalities of cartilage cells were observed,without obvious histological evidence of inflammation; only nonspecific foreign body reaction and macrophage infiltration were noticed.Conclusion: PDLLA rod itself does not cause any disturbance to the development of the epiphyseal plate.The growth disturbance of epiphyseal plate depends on the area of injured epiphyseal plate; a injured area over 7% of epiphyseal plate may cause the growth disturbance of epiphyseal plate.

Abstract:Objective：To evaluate the feasibility of diffusion-weighted imaging (DWI) application in follow-up of patients receiving transcatheter arterial chemoembolization (TACE) for liver cancer and its clinical value. Methods: DWI and routine non-enhanced MRI were performed in 16 liver cancer patients after TACE with the same SE-EPI sequence (b=500 s/mm2 and 0) on 1.5 T MRI. The numbers of the new lesions detected by DWI, T1WI and T2WI were counted. Contrast noise ratios (CNR) between new lesions and liver tissues on DWI and T2WI were calculated and compared. The efficacy of SWI in diagnosis of residual tumor and recurrent cancer was qualitatively evaluated by comparing with DSA results. Results: DWI revealed 46 new lesions, T2WI revealed 43, and T1WI revealed 38. There was significant difference in CNR between new lesions and liver tissues on DWI and T2WI (P＜0.05). The signal intensities of liver cancer on DWI were complicated after TACE. Homogeneous accumulation of iodized oil was observed on DSA in 2 of 16 patients with liver cancer after TACE; there was no tumor staining on DSA at the corresponding site of homogeneous hypointensity on DWI. Partial defect of accumulation of iodized oil was noticed in 2 of 16 patients; there was tumor staining on DSA at the corresponding site of hyperintensity on DWI. No or faint accumulation of iodized oil was noticed in 12 patients; there was strong tumor staining at the corresponding site of hyperintensity on DWI; necrosis tumor had no or slight tumor staining on DSA at the corresponding site of hypointensity on DWI. Conclusion: Diffusion MRI is a sensitive method for detecting new lesions in patients with liver cancer after TACE, and can be used to monitor residual, recurrent cancer and iodized oil accumulation during follow-up of patients after TACE.

Abstract:Objective：To evaluate the value of multi-slice computed tomography (CT) in differential diagnosis of renal clear cell carcinoma and renal papillary carcinoma. Methods: The CT images of 47 patients with renal cell carcinoma (RCC) were reviewed. The RCC patients were divided into 2 groups pathologically, including 37 cases of clear cell RCC and 10 cases of papillary RCC. Plain scan and three phase (corticomedullary,nephrographic and excretory phases) CT were performed in all patients. Age and sex of patients, tumor size, enhancement degree and pattern (homogeneous, heterogeneous and predominantly peripheral), the presence of calcification or cystic degeneration (necrotic or hemorrhagic areas within the tumor) and tumor spreading (including perinephric change, venous invasion and lymphadenopathy) were compared between the 2 subtypes. Results: The degrees of enhancement were significantly different between the 2 subtypes in the corticomedullary, parenchymal and excretory phases (P＜0.05). Necrosis and cystic degeneration were more evident in the clear cell RCC than in papillary RCC regardless of tumor size (P＜0.05). A hypervascular pattern (higher tumor enhancement after contrast material injection due to higher vascularity) was noted in 21.6% of clear cell RCC cases and in 10% of papillary RCC (P＜0.05). Half of the clear cell RCC and 2.7% of papillary RCC patients showed homogeneous enhancement (P＜0.05). Calcification was evident in 21.6% of clear cell RCC patients and 20% of papillary RCC patients. Conclusion: The degree of enhancement is the most valuable parameter for differentiation of clear cell RCC and papillary RCC. The presence of cystic degeneration, hemorrhage, vascularity and enhancement patterns can also contribute to the differentiation of the 2 subtypes.

Abstract:Objective：To summarize our experience on anesthetic management for liver re-transplantation. Methods: The clinical data of 20 patients who received liver re-transplantation under general anesthesia were retrospectively analyzed. General anesthesia was given to all patients. Ambulatory blood pressure (ABP), electrocardiogram (ECG), central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary artery wedge pressure continuous cardiac output (CCO), cardiac index (CI), partial pressure of end-tidal carbon dioxide pressure (PetCO2), auditory evoked potentials index (AEPI), body temperature (T), and urine volume were continuously monitored during the operation. Pulse-induced contour cardiac output (PiCCO) technology was used to measure global end-diastolic volume (GEDV), intrathoracic blood volume (ITBV), extravascular lung water (EVLW),systemic vascular resistance(SVR),and stroke volume variation（SVV) . The following data of patients, including the periods between the 2 operation, the presence of abdominal infection and multiple organ system failure (MOSF), the mode of re-operation, the operation duration, non-liver time, blood loss, blood transfusion, prothrombin time (PT), international normalized ratio (INR), preoperative creatinine, preoperative bilirubin, and the use of volven, albumin, 5% sodium bicarbonate, fibrinogen and thrombin, were all investigated and compared between the 2 operations. Results: All the 20 patients survived after liver re-transplantation. During the operation the hemodynamic state, urine volume, electrolytes, and acid-base balance were all stable. The duration of the re-operation was significantly longer compared with that of the first operation (P<0.05), and the blood loss, blood transfusion, and the used of fibrinogen, thrombin and 5% sodium bicarbonate were all significantly more than those of the first operation (P<0.05).Conclusion: Anesthetic management for liver re-transplantation is very complicated; better understanding of patients condition and operation, careful observation during operation, and correct management in time are the keys for successful operation.

Abstract:Objective：To search for a satisfactory method for establishing Stanford B type aortic dissection model in canine.Methods: Totally 12 adult dogs were used in the present study.The proximal descending aorta was clamped partially and laterally after a left thoracotomy; half circumference of the aorta,including the media and adventitia,was cut open transversely,with the intima kept intact.The aortic wall was then separated inferiorly,laterally and superiorly at a special dissecting space with a unique dissecting device.Then the intima at the same site was also cut open transversely and the two ends of the distal intimal flap were sutured to the adjacent aorta to allow blood entry.The distal adventitia and media were sutured to the proximal aorta to close the incision.Follow-up was carried out with pigtail catheter guided digital subtraction angiography (DSA) using omnipaque (16-18 ml/s) via either of the common iliac arteries and color Doppler ultrasound.Results: Formation and distal extension of aortic dissections were observed immediately after the procedure and were further confirmed by intra-operative color Doppler ultrasound,DSA,and post-operative biopsy at different time points.Conclusion: The present two-end intimal flap suturing method can be used for establishing Stanford B type aortic dissection model in canine; the model is similar to human Stanford B type aortic dissection.

Abstract:1临床资料患者一，女，71岁，因胸闷、活动后气急2个月，门诊以右侧大量胸腔积液原因待查收入呼吸科。行胸腔穿刺，引出2 500 ml黄色稍浑浊胸水，为渗出液，结核杆菌及脱落细胞检查为阴性；CT：子宫小肌瘤，盆腔实性包块，腹腔积液。妇科检查：子宫大小正常，盆腔可及直径8~10 cm包块，质硬，活动度差，边界不清。各项肿瘤标志物在正常范围。转入妇科手术探查：腹腔有淡黄色腹水300 ml，子宫略小于正常，右侧卵巢肿瘤13 cm×11 cm×7 cm，灰白色，局部有黄色改变，左侧附件外观无异常，术中冰冻及术后病理：右侧卵巢卵泡膜细胞瘤。术后一般情况好，1个月后复查胸、腹水消失。[第一段]

Abstract:Objective：To introduce a “Four-step method” for extraction and separation of Candida albicans total proteins.Methods: Proteins of C. albicans were extracted step-by-step with 4 kinds of solutions with different solubilities. After quantification,the protein samples were separated by isoelectric focusing electrophoresis and then by SDS-PAGE. Results: Proteins with different solubilities were successfully extracted step-by-step from C. albicans and were separated by two-dimensional gel electrophoresis. Conclusion: The “Four-step method” for extraction of C. albicans proteins is an effective approach to study C. albicans membrane proteome and lays a foundation for further investigation of the mechanisms of antifungal agents and drug resistance in C. albicans.

Abstract:The interaction between co-stimulatory ligands and their receptors of T cells and antigen presenting cells is crucial for the activation or resting of the immune cells. The tumor necrosis factor receptor superfamily and CD28-B7 family contain many such regulatory molecules. Herpesvirus entry mediator (HVEM), also named as tumor necrosis factor superfamily member 14, is noted for its pivotal role in regulating immune responses through binding LIGHT as a ligand to develop T-cell immunity, and in interacting with B and T lymphocyte attenuator(BTLA) as a receptor to negatively regulate T-cell responses. In antitumor immunity, increasing amount of evidence demonstrates that HVEM is an indispensable receptor on lymphocyte for LIGHT to co-stimulate tumor antigen-specific CTL. This article discusses the role of HVEM in regulating immune response and antitumor-immunity.

Abstract:Previous studies have showed that sulfonylureas possess a bidirectional effect on cardiovascular system：they can raise the coronary artery tone,aggravate ischemic injury to the cardiovascular tissues,and accelerate cardiac hypertrophy through closing cardiovascular ATP-sensitive K+ channels; meanwhile,they can also regulate glucolipid metabolism,modulate inflammatory reaction and inhibit atherosclerosis through activating peroxisome proliferator-activated receptors.Clinical-epidemiological study showed different opinions on whether sulfonylureas can increase the mortality of patients with cardiovascular diseases.

Abstract:Objective：To establish a quality control method for Gene-Viral Therapy system CNHK200-hEndostatin. Methods: According to “The Guideline on Quality Control Methods of Human Gene Therapy Products”, a quality control method for adenovirus was set up, which consisted of adenovirus protein identification, genomic identification, hEndostatin gene identification, hEndostatin protein quantitation, adenovirus particle quantitation, virus titer quantitation, determination of particle to PFU ratio, purity detection, AdWT detection, host cell DNA residue detection, bovine serum protein residue detection, etc. The purified adenovirus product of CNHK200-hEndostatin was subjected to the above process. Results: We set up a SDS-PAGE method to identify the adenovirus protein and identified adenovirus genomic DNA by restriction endonuclease enzyme analysis. Human endostatin gene was identified by PCR method and its expression product was quantitated by ELISA. The number of adenovirus particle was quantitated by D260 method and HPLC method. The purity of adenovirus was determined by D260/D280 method and HPLC method. A PCR reaction was introduced to detect AdWT and hybridization method was used in host cell DNA residue detection. Bovine serum protein residue was detected by reverse indirect hemagglutination assay. All these methods were confirmed feasible in adenovirus quality control and our purified adenovirus sample was eligible in all test items.Conclusion: A series of basic methods have been successfully established for quality control of gene-viral therapy system CNHK200-hEndostatin. Our modified method for adenovirus particle quantitation by HPLC is more rapid and accurate than traditional method. The established methods have been approved in testing the purified adenovirus samples.

Abstract:目的: 研究人工合成的β淀粉样蛋白β-AP25-35对原代培养的大鼠海马神经元内活性氧的影响以及五味子酮的保护作用。方法：原代培养7～9 d的大鼠海马神经元随机分为β-AP25-35处理组、五味子酮干预组和空白对照组3组,分别给予β-AP25-35（1 μmol/L）、β-AP25-35（1 μmol/L）+五味子酮（100 μmol/L）或仅予Neuro-basal＋B27培养基。继续培养48 h后,测定并计算各组细胞内活性氧。结果：各组神经元内活性氧的含量为:β-AP25-35处理组（44.58±3.86） U/ml, 五味子酮干预组（15.70±2.13） U/ml, 空白对照组(5.46±1.58) U/ml。β-AP25-35处理组、五味子酮干预组两组神经元内活性氧的含量与空白对照组比较,均有明显升高（P<0.01）,β-AP25-35处理组活性氧含量又明显高于五味子酮干预组（P<0.01）。结论：β-AP25-35可以引起原代培养的大鼠海马神经元内的活性氧增加,五味子酮对此有部分阻断作用,对神经元有一定程度的保护作用。

Abstract:目的：用ELISA方法评价Bender MedSystems公司的“研究用”human sCD30 ELISA定量测定试剂盒的方法学及其在临床应用。方法：收集到458例尿毒症等待肾移植、淋巴瘤病和一些恶性肿瘤患者及健康成人的血清、尿液、腔积液，采用ELISA定量检测sCD30浓度，并进行比较；另对该方法的精密度、准确性及曲线的线性与测定范围作了观察。结果： 249例肾移植术前患者的sCD30浓度为(178.1±80.3)Ｕ／ml、11例非霍奇金淋巴瘤患者为(233.3±61.2)Ｕ／ml，比58名健康成人(45.5±16.8)Ｕ／ml显著增高(P<0.01)；而肾移植术前及术后均增高患者在术后1周内发生急排率为38.5%；8 例霍奇金病患者和9例恶性肿瘤患者的sCD30分别为(86.1±46.0)和(92.1±40.6)Ｕ／ml，也明显高于健康成人(P<0.01)。ELISA定量测定sCD30的批内CV 3.9%，批间CV 6.3%，回收率为(101.2±2.9)%，线性相关性系数 r=0.999 2。结论：ELISA定量测定sCD30方法简便，重复性好，结果可靠，适用于各种体液标本的检测。在以免疫应答为主流的疾病中，血清中sCD30浓度增高常与疾病的活动性加重有关。而从目前接受肾移植的患者血清中的初步结果可以看出其浓度与急性排斥反应相关，有望成为预测排斥风险的有用标志物。

Abstract:目的:评价国产C-L双叶机械瓣的动物实验结果。 方法：选择杂交绵羊6只为实验动物,在体外循环下将直径23 mm的C-L双叶机械瓣植入其二尖瓣位置,通过观察术中的有创血流动力学表现、术后长期成活率、超声多普勒血流动力学表现和病理检查,全面评价C-L双叶瓣的生物相容性和血流动力学表现并与目前使用的同类瓣膜进行比较。结果：瓣膜植入顺利,3只动物存活超过3个月,术后早期左房压仅有轻度升高（术前10.8 mmHg vs 术后13 mmHg）。超声检测显示瓣膜活动良好,在峰流速（C-L瓣218 cm/s vs Carbomedic瓣210 cm/s）、峰值跨瓣压差（C-L瓣19.2 mmHg vs Carbomedic瓣18 mmHg）、有效瓣口面积、返流量等指标上与同类进口瓣膜无显著性差异；病理结果显示在其他重要器官内未见明显微血栓形成。结论：C-L双叶瓣的生物相容性和血流动力学性指标满意,与同类进口瓣膜相比无显著差别。

Abstract:目的：评价应用国产C-L短柱倾斜碟瓣心脏瓣膜置换术的近期与远期疗效,分析影响手术疗效的因素。方法：回顾性分析自1991年10月至2003年12月,607例行国产C-L短柱倾斜碟瓣置换术患者的临床资料和长期随访结果,其中二尖瓣置换259例，主动脉瓣置换91例，二尖瓣、主动脉瓣双瓣置换257例。年龄平均（40.00±12.12）岁。术前纽约心功能分级：Ⅳ级88例，Ⅲ级366例，Ⅱ级255例，Ⅰ级4例；术前合并脑梗17例，房颤309例，左房血栓25例，严重肺动脉高压35例，冠心病4例，高血压病1例，糖尿病1例。结果：本组早期死亡40例,手术死亡率为6.59%。1996年后手术死亡率降至3.64%。死亡原因主要为心功能衰竭和多脏器功能衰竭。术后早期未出现与瓣膜相关的并发症。出院的567例患者随访率为94.89%，随访时平均（7.32±3.25）年。晚期死亡患者58例，主要死亡原因为心功能衰竭，在已知的死亡原因中没有由于瓣膜结构损坏造成患者死亡。出院患者5年、10年和12年的生存率分别为（96.66±1.42）%、（85.29±1.94）%和（76.56±5.22）%；无血栓栓塞率分别为（97.86±0.71）%、（91.50±1.97）%和（91.50±1.97）%；无出血率分别为（95.61±1.02）%、（91.97±1.26）%和（88.90±2.73）%。480例存活患者中，NYHA心功能恢复至Ⅰ级334例（69.58%），Ⅱ级120例（25.00%），Ⅲ级21例（4.38%），Ⅳ级5例（1.04%）。结论：通过12年的长期随访显示，国产C-L短柱侧倾碟瓣是人造机械心脏瓣膜可靠的选择。

Abstract:目的:观察泛影葡胺胶缓释剂对腹股沟区各类血管手术术后创口淋巴瘘的预防作用。方法：将选择进入实验的540名需行腹股沟区血管手术的各类血管病患者随机分成实验组和对照组。术中减少不必要的解剖,尽量结扎可视的淋巴管。实验组手术结束时于腹股沟创口逐层喷涂泛影葡胺胶缓释剂,对照组不喷涂。观察对比两组术后腹股沟创面的渗液及创口并发症情况。结果：实验组的术后第1日引流量、至拔管时总引流量、淋巴瘘及感染等创口并发症数均少于对照组,差异有统计学意义（P<0.05）。 结论：术中减少不必要的解剖,尽量结扎可视的淋巴管的情况下,泛影葡胺胶缓释剂可进一步预防腹股沟区血管手术术后淋巴瘘的发生。

Abstract:颈动脉内膜切除术(carotid endarterectomy，CEA)是治疗颈动脉严重狭窄、预防脑卒中的有效方法，但由于患者多系老年人，且合并症多，术后容易发生心脑血管和肺部并发症。术后一旦发生呼吸功能障碍，往往需要在ICU接受机械通气支持治疗。而在机械通气期间或撤离机械通气后，为了减少呼吸做功和确保气道的通畅及痰液引流，许多患者需行气管切开术。然而，传统的气管切开术，气切口缘的感染发生率相对较高，这对于临近的颈动脉内膜切除术伤口有潜在的危险。有许多研究表明，经皮扩张气管切开术（PDT）较外科气管切开术（ST）而言有许多优势，包括微创、快捷、简单易学、感染发生率低等\[1-2\]。本研究的目的在于比较两种方法对于CEA术后患者在气管切开术中和术后早期的并发症。[第一段]

Abstract:阿片受体为G蛋白偶联受体，激活后作用于下游效应蛋白腺苷酸环化酶，进而通过cAMP信使系统发挥镇痛作用。有研究证实成人慢性膝关节炎患者的关节滑膜上的μ-阿片受体及mRNA表达增加\[1\]，但其所影响的信号通路有何改变未见相关人体研究报道。本研究采用放射受体结合法和放射免疫法分别测定滑膜组织G蛋白及cAMP表达变化情况，以探讨其在阿片外周局部镇痛中的可能作用。[第一段]

Abstract:发育、细胞生长、分化和癌变等过程与全基因组表达的选择性激活和时空调节密切相关，因此这些过程中基因表达模式的改变已成为当今生物学研究的热点之一。但是高等生物作为高度分化的系统，其差异基因表达分析往往需要大量纯化的同质细胞。尽管原位杂交/PCR能检测到未纯化细胞中的RNA或蛋白，但前提是目的细胞能通过可见的或位置标记加以确认，并且每次只能检测单个已知基因，从而限制了这些技术的应用范围。消减杂交、差异显示等技术虽可研究多基因表达的异同，但是需要大量的同质细胞提取RNA以制备探针。用PCR方法分析单个细胞中的基因组DNA或mRNA已成为可能，自20世纪90年代Brady等\[1\]成功从单个血细胞中扩增出所有mRNA以来，该技术已被迅速应用于单细胞水平上的基因表达研究。本研究在上述方法基础之上对各步条件加以优化改进，建立了稳定可靠的单细胞RT-PCR实验体系，包括序列非依赖性扩增全细胞mRNA的SC-Poly(A)PCR方法和引物特异性扩增目的基因的SC-RT-PCR方法。[第一段]

Abstract:原发性骶骨肿瘤非常罕见，一项统计中此类患者仅占同期入院患者的1/40 000\[1\]。由于解剖位置深在，其临床症状隐匿而复杂。因此，骶骨肿瘤在病程中通常不能获得早期诊断。在确诊的时候，这类肿瘤往往已经体积很大，这使得外科手术面临着巨大的挑战。肿瘤边缘切除或囊内刮除手术无论对于骶骨的恶性肿瘤、良性肿瘤还是进展性肿瘤（如巨细胞瘤）都很少能达到根治的效果。其局部复发率非常高\[2-3\]。根治性手术，如骶骨的部分或全部切除，通常能达到良好的治疗效果\[4\]。感染、术中大量失血、伤口并发症以及神经功能异常是骶骨切除术面临的主要并发症\[5-7\]。而高位骶骨肿瘤（即S1、S2肿瘤）切除术后脊柱和骨盆完全分离，如何重建脊柱和骨盆的稳定性，至今尚无较好的方法\[8\]。本研究回顾了我科近年来对高位骶骨肿瘤手术切除患者的临床资料，并提出了应用ISOLA 系统重建骨盆环和腰椎稳定性的初步经验。[第一段]

Abstract:贲门失弛缓是神经食管肌肉失调导致食管运动障碍性疾病，以食管下端括约肌张力增高、食管体部正常蠕动消失及食管下端括约肌在吞咽时松弛障碍为特征。临床上以吞咽困难、胸骨后疼痛、不同程度呕吐为主要症状，严重者可以出现体质量下降。目前治疗贲门失弛缓的常用方法均具一定的局限性\[1\]：药物治疗和中医中药治疗作用有限；内镜下球囊扩张需要反复扩张，并有穿孔、出血等并发症；内镜下肉毒毒素注射治疗作用仅持续3~12个月，且费用昂贵；经胸手术治疗游离食管较长，效果较好，但手术创伤大，需要切除一根肋骨，患者痛苦大，术后恢复慢。近年来发展起来的微创式Heller肌切开术（包括经腹腔镜和经胸腔镜两种方式）效果与传统手术类似，但简化了手术操作，减少了创伤，缩短了术后住院和康复时间，效果较好，易于被患者接受。现将我科采用腹腔镜改良Heller手术治疗7例贲门失弛缓的经验总结如下。[第一段]

Abstract:V-Y皮瓣是临床常用的皮瓣之一，已广泛应用于头面部、躯干、四肢等全身各个部位皮肤缺损的修复\[1-4\]。经典的V-Y皮瓣经推进方式转移修复缺损，也有许多改良的报道\[3-7\]，但由于V-Y皮瓣仅能以推进或者推进结合旋转的方式转移，皮瓣的推进幅度受到一定的限制。我们着眼于V-Y皮瓣转移方式的改良，设计了一种改良的以易位方式转移的V-Y皮瓣，应用于临床并作了初步临床报道\[8\]。自2005年2月至2006年8月，应用此皮瓣修复面部中等大小皮肤缺损共16处，获得了满意效果。[第一段]

Abstract:造血干细胞移植是目前治愈白血病最为有效的疗法,造血干细胞数量和质量是影响移植成功的一个主要环节，目前临床上广泛采用集落刺激因子或化疗联合集落刺激因子的动员方法。高压氧是一种非常安全有效的治疗方法，广泛应用于临床，高压氧与外周血造血干细胞之间的关系国内尚无明确报道。我中心在2006年11月至2007年1月期间观察了11例长期接受高压氧治疗患者的外周血造血干细胞水平，以及7例脑外伤患者接受高压氧治疗前后其外周血造血干细胞绝对计数的变化情况，现报道如下。[第一段]

Abstract:多发性骨髓瘤(multiple myeloma，MM)是克隆性浆细胞异常增生性疾病，随着人口老龄化，MM的发病率呈上升趋势。据国内外统计，多发性骨髓瘤肾损害发生率为60％~90％。蛋白尿是MM肾病早期的表现，部分患者仅表现为蛋白尿，数年后才出现骨髓瘤的其他症状或肾功能不全，故易误诊为肾小球肾炎、无症状性蛋白尿或隐匿性肾炎。本研究回顾了我科自1996年至今以蛋白尿为首发症状的MM患者61例的临床资料，旨在提高肾内科医生对该病的认识，避免漏诊和误诊。[第一段]

Abstract:1临床资料患者男性，52岁，头痛1年起病。患者于2005年１月无明显诱因出现头痛，以前额胀痛为主。每3～4 d出现1次，每次头胀10～30 s。此后症状逐渐加重，逐渐出现复视、畏光、眼部胀痛、视力模糊。先后在各地医院求诊，行MRI、MRA、DSA检查，发现脑室扩大，FLAIR序列脑室周围高信号，排除了颅内占位和脑血管静脉窦血栓，查体发现视乳头水肿、视力下降。腰穿发现颅内压290~390 mmH2O(1 mmH2O=0.098 kPa)，脑脊液蛋白1.98~2.94 g/L，先后查HIV、梅毒、抗酸杆菌、新生隐球菌、类风湿因子、自身免疫抗体，结果均为阴性。曾经按脑血管痉挛、偏头痛、三叉神经痛、细菌性脑膜炎、结核性脑膜炎、良性颅内压增高等治疗，长期反复使用甘露醇等脱水。脑脊液蛋白波动于1.8~2.4 g/L，颅内压波动于200~350 mmH2O。病情反复迁延，由于脱水剂使用较久，患者后期还出现下肢深静脉血栓等并发症。头痛症状逐渐加重，复视明显，双眼视力由发病初的1.0下降至0.5和0.4。患者于2006年3月向我院求诊，我科建议其进行神经系统全面影像学检查，MRI发现胸2~3椎管内巨大占位，考虑为神经鞘瘤。于2006年3月行后正中入路椎管内肿瘤切除术，术后病理报告：神经鞘瘤。术后患者头痛、视物模糊、视乳头水肿等症状完全缓解。3个月后复查MRI示肿瘤完全切除未见复发;腰穿示脑脊液压力蛋白正常。[第一段]

Abstract:1临床资料患者，男性，73岁，退休工人。因“水肿，泡沫尿2个月余”于2004年9月29日入院。患者于2004年７月中旬无明显诱因出现双下肢、颜面部水肿，泡沫尿，伴头昏、乏力、食欲减退，在当地医院治疗未见好转。9月15日来我院门诊，查尿常规：蛋白质1.5 g/L、红细胞10/μl；血尿素、肌酐正常；白蛋白/球蛋白：33/31；总胆固醇：8.36 mmol/L;24 h尿蛋白定量5.22 g。以“肾病综合征”收治入院。既往有反复咯血史，30年前即出现过一次咯血，治疗后好转（具体情况不详）。近5年，每遇“感冒”后出现咳嗽、咳痰，痰中带少量暗红色血丝，每次发作均可自行缓解。今年5月下旬，患者“感冒”后再次出现咳嗽、咳痰，痰中带血，随后逐渐加重，并于5月20日开始出现咯血十余次，每次量在10～30 ml左右，且治疗效果不佳。无药敏、特殊用药、毒物及疫区接触史。吸烟800年支。入院体检：体温37℃，脉搏80次/min，呼吸18次/min，血压 120/60 mmHg（1 mmHg=0.133 kPa）。神志清，自动体位；皮肤黏膜未见黄染、出血点及淤斑，浅表淋巴结未触及肿大。眼睑、颜面无浮肿；气管居中，无颈静脉怒张；胸廓无畸形，双侧呼吸动度对称，双肺语颤正常，叩诊清音，右肺可闻及少量干湿性音；心率80次/min，齐，各瓣膜听诊区未闻及病理性杂音；腹软，无压痛，肝、脾肋下未及，移动性浊音阴性；四肢活动自如，双下肢中度凹限性水肿，双肋腰点无压痛；双侧膝反射正常，克氏征、布氏征、巴氏征均阴性。入院后查尿常规：蛋白1.5 g/L（手工），白细胞（手工）20~30/HP,红（手工）1~3/HP；24 h尿蛋白定量：2.5 g\[使用福辛普利钠(蒙诺)治疗2周后\]；尿本周蛋白：阴性；肝功能：总蛋白52 g/L,白蛋白28 g/L，球蛋白24 g/L；血脂：总胆固醇6.62 mmol/L，甘油三酯1.5 mmol/L。血生化：葡萄糖4.4 mmol/L，尿素4.3 mmol/L，肌酐73 μmol/L。血常规、粪常规均正常。血CRP 3.19 mg/L，血ESR 25 mm/1h。痰培养检出：包曼不动杆菌（＋）；痰涂片查见革兰阴性杆菌；痰浓缩查抗酸杆菌未检出。[第一段]

Abstract:1临床资料病例1，男，45岁，因进行性四肢无力2年于2006年10月31日入院。2004年11月开始出现腰背部酸痛和上下楼梯及下蹲起立时双下肢无力，并有足跟及足背部针刺感。2个月后出现双上肢无力，同时双下肢无力加重，上下楼梯需手扶，2006年8月上下楼梯困难，丧失劳动力，近半年尚感咀嚼力弱。近1年来小便量增多，夜间明显。既往健康，无类似疾病家族史。体格检查：神志清楚，语言清晰，双侧咀嚼肌肌力轻度减退，余颅神经检查（－），双上肢肩胛带、近端肌肉及双下肢近端肌肉轻度萎缩，四肢肌张力正常，双上肢近端肌力4级、远端4+级,左下肢近端肌力4-级、右下肢近端3级、双下肢远端肌力4+级，行走时呈鸭步。四肢有短手套袜套样痛触觉减退，深感觉正常。双上肢腱反射、双侧膝腱反射（），双侧踝反射未引出。病理反射阴性。肌电图检查示：双侧股直肌、三角肌见短棘波多相电位，四肢运动感觉神经传导速度减慢。入院后查血尿粪常规、肝肾功能正常，CK、LDH均正常，碱性磷酸酶(AKP) 1 113 U/L(参考值 32~92 U/L)，血叶酸、B12水平正常，免疫指标全套、肿瘤标志物均正常，尿本周蛋白阴性，甲状腺功能正常，甲状腺球蛋白抗体（TGAb）42.2％（参考值<30％），抗甲状腺微粒体抗体（TMAb）34.5％（参考值<15％）。血清钙 2.73 mmol/L（参考值2.15~2.6 mmol/L）、磷 0.79 mmol/L（参考值0.82~1.6 mmol/L），PTH 1 854 pg/ml(参考值15~16 pg/ml）。脑脊液检查正常。心电图正常。双手正位片示：手掌指骨骨皮质变薄、毛糙，部分皮质下见小囊状透光区，骨小梁显示清晰，各小关节正常，提示符合甲旁亢性骨改变。左足跟骨密度检测示骨密度下降。肌肉活检示：肌纤维萎缩，肌横纹及纵纹均存在，肌核边集，数目减少，肌间隙增宽(图1)。B超示：双侧甲状旁腺实性结节，考虑腺瘤可能；右侧甲状腺结节伴钙化，倾向髓样癌；双侧肾上腺实性结节，考虑腺瘤可能。CT及ECT检查考虑为多发性内分泌腺瘤。诊断为：（1）甲状旁腺功能亢进性神经肌肉病；（2）多发性内分泌瘤病Ⅱ型。2006年11月30日患者在本院外科行右甲状腺癌清扫加双侧甲状旁腺瘤切除术，术后病理：（1）(左下、右下)甲状旁腺腺瘤；（2）(右上甲状腺)髓样癌。术后1周内出现低钙性搐愵，经补钙治疗后好转，肌无力症状明显好转，能单独上下楼梯。[第一段]