手术切除与介入栓塞治疗肝癌术后复发患者的临床对比研究

目的:比较手术切除与介入栓塞治疗肝癌术后复发患者的临床疗效。方法:选择2010年6月到2011年6月本院收治的92例肝癌手术切除术后复发患者,按随机数字表法分为手术切除组和介入栓塞组,各46例。手术切除组患者给予再次切除治疗,介入栓塞组患者给予介入栓塞治疗。记录并比较两组患者治疗后1年、3年及5年的生存率。检测并比较两组患者治疗前后血清肝纤维化指标,包括血清透明质酸(HA)、层黏蛋白(LN)、人Ⅲ型前胶原(HPC-Ⅲ)及IV型胶原(IV-C)水平。检测并比较两组患者治疗前后血清白细胞(WBC)、甲胎蛋白(AFP)及癌胚抗原(CEA)水平。结果:手术切除组患者治疗后1年、3年、5年的生存率均明显高于介入栓塞组,差异均具有统计学意义(P0.05)。治疗后,介入栓塞组血清HA、LN、HPC-Ⅲ及IV-C明显高于治疗前,且均明显高于手术切除组,差异均具有统计学意义(P0.05)。两组患者治疗后血清WBC、AFP及CEA水平均明显低于治疗前,且手术切除组患者血清WBC明显高于介入栓塞组,而血清AFP、CEA水平明显低于介入栓塞组,差异均具有统计学意义(P0.05)。结论:手术切除治疗肝癌术后复发能够明显提高患者生存率,降低肝纤维化程度,改善血清AFP及CEA水平,值得在临床上推广应用。     

Predicting changes in mechanical properties of trabecular bone by adaptive remodeling

Because changes in the mechanical properties of bone are closely related to trabecular bone remodeling, methods that consider the temporal morphological changes induced by adaptive remodeling of trabecular bone are needed to estimate long-term fracture risk and bone quality in osteoporosis. We simulated bone remodeling using simplified and pig trabecular bone models and estimated the morphology of healthy and osteoporotic cases. We then displayed the fracture risk of the remodeled models based on a cumulative histogram from high stress. The histogram showed more elements had higher stresses in the osteoporosis model, indicating that the osteoporosis model had a greater risk.     

不同剂量右美托嘧啶对胸腔镜下食管癌根治术患者心肌氧供及血流动力学的影响

目的:探讨不同剂量右美托嘧啶(DEX)对胸腔镜下食管癌根治术患者心肌氧供及血流动力学的影响。方法:选取66例我院拟行腔镜下食管癌根治术患者,随机分为三组,每组各22例:低剂量右美托嘧啶组(L组)(0.5μg/kg)、高剂量右美托嘧啶组(H组)(1.0μg/kg)、对照组(N组)(与L组和H组同等速率输注生理盐水),而后H组和L组均以0.5μg/kg/h维持输注DEX。记录各组输注前(T1)、输注后5 min(T2)、输注后10 min(T3)、输注后15 min(T4)、输注后30 min(T5)各组血流动力学指标:心率(HR)、收缩压(SBP)、平均动脉压(MAP)、每搏输出量(SV)、中心静脉压(CVP)、心排量(CO),计算HR与SBP的乘积RPP,抽取挠动脉和肺动脉血进行动脉血气分析,采用反向FICK法计算氧供(DO2)和氧耗(VO2)。结果:HR:H组和L组患者HR随时间的推移呈下降趋势,H组T3、T4、T5时间点HR较T1时间点显著降低(P0.05);与N组相比,H组和L组T3、T4、T5时间点HR显著降低(P0.05)。MAP:H组T3、T4、T5时间点MAP显著低于L组(P0.05);H组T3、T4时间点MAP显著低于N组(P0.05);H组T5时间点MAP显著低于同组T1、T2时间点(P0.05)。SBP:H组T3、T4、T5时间点SBP与L组和N组比较显著降低(P0.05);H组T5时间点SBP较同组T1、T2时间点显著降低(P0.05)。RPP:H组T3、T4、T5时间点RPP与同组T1、T2时间点和N组比较显著降低(P0.05)。DO2:H组T5时间点DO2与L组和N组比较显著降低(P0.05)。VO2:L组患者VO2T3、T4、T5时间点与组内T1、T2时间点和N组相比显著降低(P0.05);H组VO2T3、T4、T5时间点与组内T1、T2时间点和N组相比显著降低(P0.05)。结论:小剂量(0.5μg/kg)输注DEX能降低胸腔镜下食管癌患者心肌氧耗,维持血流动力学稳定,高剂量(1.0μg/kg)输注DEX降低心肌氧耗的同时会降低心肌氧供,存在一定风险,对于患有冠心病以及心肺功能低下的老年患者,建议给予小剂量输注DEX,并监测血流动力学指标,及时调整DEX用量。     

Genomic and chromatin features shaping meiotic double-strand break formation and repair in mice

The SPO11-generated DNA double-strand breaks (DSBs) that initiate meiotic recombination occur non-randomly across genomes, but mechanisms shaping their distribution and repair remain incompletely understood. Here, we expand on recent studies of nucleotide-resolution DSB maps in mouse spermatocytes. We find that trimethylation of histone H3 lysine 36 around DSB hotspots is highly correlated, both spatially and quantitatively, with trimethylation of H3 lysine 4, consistent with coordinated formation and action of both PRDM9-dependent histone modifications. In contrast, the DSB-responsive kinase ATM contributes independently of PRDM9 to controlling hotspot activity, and combined action of ATM and PRDM9 can explain nearly two-thirds of the variation in DSB frequency between hotspots. DSBs were modestly underrepresented in most repetitive sequences such as segmental duplications and transposons. Nonetheless, numerous DSBs form within repetitive sequences in each meiosis and some classes of repeats are preferentially targeted. Implications of these findings are discussed for evolution of PRDM9 and its role in hybrid strain sterility in mice. Finally, we document the relationship between mouse strain-specific DNA sequence variants within PRDM9 recognition motifs and attendant differences in recombination outcomes. Our results provide further insights into the complex web of factors that influence meiotic recombination patterns.     

53BP1 Enforces Distinct Pre- and Post-resection Blocks on Homologous Recombination

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Regulation of autophagy protects against liver injury in liver surgery-induced ischaemia/reperfusion

Transient ischaemia and reperfusion in liver tissue induce hepatic ischaemia/reperfusion (I/R) tissue injury and a profound inflammatory response in vivo. Hepatic I/R can be classified into warm I/R and cold I/R and is characterized by three main types of cell death, apoptosis, necrosis and autophagy, in rodents or patients following I/R. Warm I/R is observed in patients or animal models undergoing liver resection, haemorrhagic shock, trauma, cardiac arrest or hepatic sinusoidal obstruction syndrome when vascular occlusion inhibits normal blood perfusion in liver tissue. Cold I/R is a condition that affects only patients who have undergone liver transplantation (LT) and is caused by donated liver graft preservation in a hypothermic environment prior to entering a warm reperfusion phase. Under stress conditions, autophagy plays a critical role in promoting cell survival and maintaining liver homeostasis by generating new adenosine triphosphate (ATP) and organelle components after the degradation of macromolecules and organelles in liver tissue. This role of autophagy may contribute to the protection of hepatic I/R-induced liver injury; however, a considerable amount of evidence has shown that autophagy inhibition also protects against hepatic I/R injury by inhibiting autophagic cell death under specific circumstances. In this review, we comprehensively discuss current strategies and underlying mechanisms of autophagy regulation that alleviates I/R injury after liver resection and LT. Directed autophagy regulation can maintain liver homeostasis and improve liver function in individuals undergoing warm or cold I/R. In this way, autophagy regulation can contribute to improving the prognosis of patients undergoing liver resection or LT.     

血流阻断的缺血预处理技术在肝癌切除术中的临床应用价值

目的:探讨血流阻断的缺血预处理技术在肝癌切除术中的临床应用价值。方法:选取2010年4月至2013年7月我院收治的96名原发性肝癌并采用肝脏部分切除术进行治疗的患者,将患者随机分为观察组和对照组,每组各48例,观察组在肝脏部分切除术阻断肝门血流前先分别给予1个5 min缺血和再灌注的处理。对照组不采取任何干预措施。术前、术后1天、3天、7天时分别进行生化检查,并于术前及术后1h对Fas-mRNA表达、Caspasc-3活性及AI进行测定,观察记录患者术后的并发症情况、手术时间、术中出血量以及住院时间。结果:术后1天、3天、7天时两组间的AST、ALT、TBIL等生化指标的含量情况相比,观察组均显著优于对照组(P0.05);术后l d,两组患者ALB均有不同程度的降低,对照组低于观察组(P0.05);术后住院时间观察组为13.28±3.85天,对照组为19.48±4.92天,观察组明显低于对照组(P0.05);术后1h,两组患者的Fas-mRNA表达、Caspasc-3活性相比于阻断前均显著提高,但观察组提高幅度明显低于对照组,差异有统计学意义(P0.05);两组阻断前均未见肝细胞凋亡,术后l h时,两组组均可见肝细胞凋亡,且对照组明显高于观察组组(P0.05)。结论:血流阻断的缺血预处理技术具有操作简便、副作用小的重要特点,应用于肝癌切除术中在保护肝功能方面具有显著的优势。     

The effect of two teeth resection procedures on the welfare of piglets in farrowing crates. Part 1

Teeth resection is a method of controlling the injurious effects of the aggression displayed when newborn piglets fight to establish a teat order. Recent European legislation discourages the practice. The objective of this study was to assess the effect of clipping and grinding piglets’ needle teeth, compared to leaving them intact, on the welfare of piglets in farrowing crates.

Six days pre-partum, 60 sows were assigned to one of three treatments. Litters had their teeth clipped (C), ground (G) or left intact (I) at birth. The time taken to carry out each procedure was recorded. Piglet weights and facial lesions, which were scored according to severity, were recorded on days 1, 4, 11, 18 and 27. Piglet weights were also recorded at birth. Mouth lesions were recorded on days 1, 4 and 27. Instantaneous scan samples of piglet behaviour were carried out for 30 min post-teeth resection procedure (1 min intervals), and for 6 h on days 1, 4, 8, 14, 21 and 26 (5 min intervals). One male and one female piglet per litter were chosen as focal animals and observed for 5 min each post-procedure and for 10 min each twice per day on days 1, 5, 12, 20 and 26. Mortalities were recorded throughout lactation.

Grinding took significantly longer than clipping the teeth or leaving them intact (F = 638.87, P < 0.001). I piglets had higher facial lesion scores than C and G piglets (F = 10.58, P < 0.001). A smaller proportion of piglets in I litters than C and G litters and a smaller proportion of piglets in G litters than C litters had at least one mouth lesion (F = 4.74, P < 0.001). During 30 min post-procedure, I piglets were active on the heatpad in more observations than C and G piglets (F = 3.49, P < 0.05). During 5 min post-procedure C piglets spent longer chomping than I piglets (F = 5.92, P = 0.05). On day 21, I piglets were active in more observations than G piglets (F = 2.11, P < 0.05). On day 26, G piglets were inactive in more observations than C and I piglets (F = 5.02, P < 0.05). On days 14 and 26, C piglets were sleeping in more observations than G piglets (F = 2.87, P = 0.05). There was a tendency for a larger proportion of I than C piglets to die due to overlying (F = 2.68, P = 0.08).

In conclusion, although all three options were associated with welfare problems, grinding can be recommended in preference to clipping or leaving the teeth intact.     

体外培养的小梁细胞表达水通道蛋白-1

目的观察体外培养条件下的牛眼小梁细胞(bovine trabecular meshwork cell,BTMC)是否表达水通道蛋白-1(Aquaporin-1,AQP-1)。方法采用免疫组织化学方法检测AQP-1在BTMC上的表达,并进行半定量分析。结果正常BTMC可见AQP-1蛋白表达,其灰度值为:167.94±1.18;阴性对照为:195.64±1.62,统计学分析其差异具有显著性(P<0.05)。结论在体外培养条件下,BTMC表达AQP-1,这有助于在体外条件下研究房水流出阻力、并探讨青光眼的药物治疗。