在戊四氮致痫大鼠早期前脑中OX-42和Fos蛋白的表达变化

研究大鼠在戊四氮导致癫痫发作早期前脑内小胶质细胞的变化及其与神经元的关系,本研究应用免疫组织化学法分别显示前脑内OX-42和Fos蛋白表达的时程变化,并用双重标记显示OX-42和Fos阳性细胞的相互关系。结果发现:在戊四氮导致大鼠癫痫发作早期(从15min到360min),前脑的小胶质细胞OX-42表达阳性,随着存活时间的变化,OX-42的阳性反应经历逐渐升高又降低的过程;Fos蛋白在神经元和小胶质细胞中有表达,也呈现逐渐升高又降低的变化;Fos在小胶质细胞表达高峰的时间早于在神经元的表达;另外OX-42阳性小胶质细胞和Fos阳性神经元在前脑分布基本相同,主要分布在大脑皮层、海马、杏仁核等部位。以上结果表明,前脑的小胶质细胞和神经元一样在戊四氮所致癫痫发作的早期表现明显的反应,但小胶质细胞反应的意义有待进一步研究。     

Reciprocal modification of Fas activation and stress protein response decides apoptosis or resistance development of cells

Activation of heat shock factor (HSF)-1 DNA binding and heat shock protein (hsp)-70 expression enable resistance of cells to various forms of stress and maintain cell survival. Fas, a membrane-bound protein, is a central pro-apoptotic factor. Its activation leads to a cascade of events resulting in programmed cell death. Herein, these two mechanisms with contrary functions, promoting either cell survival or death, were addressed for their potential to inhibit each other's activation. Induction of Fas-mediated signalling was followed by a rapid decrease of HSF1 DNA binding and inducible hsp70 expression. Inhibition of HSF1 DNA binding was demonstrated to be based on absent hyperphosphorylation of HSF1 during FAS-signalling. These effects of Fas-activation on the HSF1/hsp70 stress response were blocked by ICE (caspase 1)-inhibitors, suggesting an ICE-mediated process. Furthermore, inhibition of HSF1/hsp70 was accompanied by an increase of apoptosis rates from 20% to 50% in response to heat stress. When analyzing Fas-mediated apoptosis in the presence of HSF1/hsp70 activation, decreased apoptosis rates were detected with induced expression of hsp70 but not with activation of HSF1-DNA binding alone. Thus, we conclude that inhibition of the HSF1/hsp70 stress response during Fas-mediated apoptosis and vice versa may facilitate a cell to pass a previously chosen pathway, stress resistance or apoptosis.     

胫骨平台骨折的现代治疗探讨

目的总结近年来治疗胫骨平台骨折的经验教训，为临床选择更好的治疗方法、提高胫骨平台骨折手术疗效提供参考。方法回顾分析自2001-2007年收治的胫骨平台骨折89例，其中按照Schatzker分型复杂胫骨平台骨折（Ⅴ型，Ⅵ型）67例，男性75例，女性14例。均行切开复位，严格按照内固定原则分别采用螺丝钉和／或外固定架、钢板、微创内固定系统固定骨折进行治疗，必要时辅以关节镜探查镜下手术。结果75例得到随访，最短6个月，最长6年，平均31个月。骨折均愈合，疗效评定参照Merchant标准，术后6个月优良率为81．6％，术后1年优良率为89．3％。结论胫骨平台骨折应当考虑手术治疗，周密的术前计划、妥善处理软组织损伤、正确选择切口、灵活应用内外固定物及关节镜辅助均是手术成功的重要因素。     

异种神经脱细胞移植物修复周围神经缺损的实验研究

目的 探讨异种神经脱细胞移植物桥接大鼠坐骨神经缺损后的神经再生及其再生过程中免疫排斥反应. 方法用脱细胞兔周围神经作为移植物桥接大鼠坐骨神经1 cm缺损;术后3、5、8、11、15天检测血液中淋巴细胞占白细胞百分比;3个月后取移植物及腓肠肌,用甲苯胺蓝、乙酰胆碱酯酶（AchE）、琥珀酸脱氢酶（SDH）组化染色,光、电镜观察神经再生及腓肠肌运动终板的恢复情况. 结果术后大鼠血液中淋巴细胞占白细胞的百分比与正常大鼠相比较无显著性差异,3个月后大鼠术侧下肢足趾能分开,行走时后蹬动作有力,针刺足底有逃避反应,桥接物内见有大量再生的坐骨神经纤维,腓肠肌肌纤维上见有呈AchE阳性的运动终板和神经纤维.结论 异种神经脱细胞移植物桥接大鼠坐骨神经缺损具有促进其再生的作用.     

取腱器配合腓肠肌筋膜瓣翻转术治疗跟腱断裂疗效观察

目的介绍利用取腱器切取腓肠肌筋膜瓣,翻转缝合断裂跟腱的临床效果。方法选取2008年1月~2012年12月我院跟腱断裂病人21例,男15例,女6例,平均年龄33.5岁,为剧烈运动后跟腱撕裂伤,均采用手术治疗。俯卧位,跟腱断裂部位纵行手术切口,马尾状撕裂部位梳理整齐后编织缝合,根据需要腱膜的长度于切口近端相应部位作纵行小切口,用取腱器取筋膜条,自皮下隧道牵出远端切口,翻转,光滑面朝后加固缝合断裂跟腱。术后长腿石膏固定4周,短腿石膏固定2周。结果 21例患者均获得术后随访,平均随访时间2.3年(1~5年)。根据Arner Lindholm评分标准,优16例,良4例,差1例,优良率95.2%。结论取腱器微创小切口下取腓肠肌腱膜方法具有小切口,创伤小,美观等优点,术后正规康复功能锻炼后临床效果良好。     

Tissue-specific homing receptor mediates lymphocyte adhesion to cytokine-stimulated lymph node high endothelial venule cells.

Lymphocytes bind to high endothelial venule (HEV) cells as the first step in the migration of these cells into lymph nodes (LN) and Peyer's patches (PP). In this study we isolated and cultured HEV cells from rat LN and investigated the effects of cytokines on the adhesiveness of these cells for lymphocytes. The results showed that lymphocytes from thoracic duct, spleen and LN adhered preferentially to the cultured LN HEV cells compared to cells isolated from the thymus and bone marrow. The adhesiveness of LN HEV cells for thoracic duct lymphocytes (TDL) was significantly increased in a dose- and time-dependent manner by pretreatment of the HEV cells with tumour necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) or interleukin-4 (IL-4). In contrast, pretreatment of HEV cells with IL-1, IL-6 or IL-7 did not alter the capacity of LN HEV cells to adhere lymphocytes. Furthermore, incubation of LN HEV cells with suboptimal doses of TNF and IL-4, IFN-gamma and IL-4, or TNF-alpha and IFN-gamma increased significantly the endothelial adhesiveness. Interestingly, although IL-1 alone did not promote the adhesiveness of HEV cells, the cytokine synergized with suboptimal doses of IL-4 and TNF-alpha to increase the adhesiveness. The adhesion of TDL to non-stimulated and IL-4-stimulated LN HEV cells could be blocked specifically by treatment of lymphocytes with the LN homing-receptor-specific A.11.5 monoclonal antibody (mAb). In contrast, lymphocytes pretreated with the PP-homing receptor-specific 1B.2.6 mAb or the antileucocyte common antigen (OX1) mAb adhered normally to the HEV cells. Taken together, these results indicate that the baseline and cytokine-stimulated bindings between lymphocytes and LN HEV cells are mediated by adhesive mechanisms that regulate lymphocyte migration into LN in vivo and provide strong evidence that cytokines are central mediators of organ-specific lymphocyte migration.     

特发性肺含铁血黄素沉着症和肺出血-肾炎综合征

报告3例特发性肺含铁血黄素沉着症和1例肺出血—肾炎综合征。4例肺部病变相同,所异者肺出血—肾炎综合征在后期出现新月体型肾小球肾炎。讨论了肺病变的形态发生和两病的病因、发病。     

41例女性慢性输血后丙型肝炎10～15年后的感染状态

目的　了解我国女性输血后丙型肝炎病毒 (HCV)感染的慢性化规律和影响因素。方法　对河北省固安县 1989～ 1993年 4 1例女性慢性输血后丙型肝炎患者的现状进行调查 ,包括临床表现 ,血清生物化学指标 ,病毒学标志检测及B型超声检查。其中 ,HCVRNA的测定采用荧光定量PCR方法 ,抗 HIV ,抗 HCV和HBsAg测定采用酶联免疫吸附试验。结果　 4 1例女性丙型肝炎患者平均年龄 (40± 7)岁 ,随访时间 10～ 15年 ,HCVRNA间隔半年两次检测 ,自然阴转率为 19 5 1% (8 4 1)。 30例(73% )现在有症状 ,以乏力最为常见 (77% )。总的丙氨酸转氨酶 (ALT)和 (或 )天冬氨酸转氨酶 (AST)异常率为 32 % (13 4 1) ,均为轻度异常 ,无中度和重度。B超轻度慢性肝炎占 83% (34 4 1) ,中度占 17%(7 4 1) ,无重度。结论　平均感染 (13± 1)年的女性输血后慢性丙型肝炎患者多数肝脏炎症轻微慢性感染进程中有部分感染者出现HCVRNA自发阴转。     

细胞低温显微图象的计算机处理及定量分析

本文用计算机图象处理技术对细胞显微图象进行处理和定量分析,求出了细胞面积在低温保存中极其重要的参数。实验证明,计算机测量比人工精度高,误差小,同时新颖的标号去噪方法也非常有效。     

Linkage exclusion and mutational analysis of the noggin gene in patients with fibrodysplasia ossificans progressiva (FOP)

Fibrodysplasia ossificans progressiva (FOP) is an extremely rare and disabling genetic disorder characterized by congenital malformation of the great toes and by progressive heterotopic endochondral ossification in predictable anatomical patterns. Although elevated levels of bone morphogenetic protein 4 (BMP4) occur in lymphoblastoid cells and in lesional cells of patients with FOP, mutations have not been identified in the BMP4 gene, suggesting that the mutation in FOP may reside in a BMP4-interacting factor or in another component of the BMP4 pathway. A powerful antagonist of BMP4 is the secreted polypeptide noggin. A recent case report described a heterozygous 42-bp deletion in the protein-coding region of the noggin gene in a patient with FOP. In order to determine if noggin mutations are a widespread finding in FOP, we examined 31 families with 1 or more FOP patients. Linkage analysis with an array of highly polymorphic microsatellite markers closely linked to the noggin gene was performed in four classically-affected multigenerational FOP families and excluded linkage of the noggin locus to FOP (the multipoint lod score was -2 or less throughout the entire range of markers). We sequenced the noggin gene in affected members of all four families, as well as in 18 patients with sporadic FOP, and failed to detect any mutations. Single-strand conformation polymorphism (SSCP) analysis of 4 of these patients plus an additional 9 patients also failed to reveal any mutations. Among the samples analyzed by SSCP and DNA sequencing was an independently obtained DNA sample from the identical FOP patient previously described with the 42-bp noggin deletion; no mutation was detected. Examination of the DNA sequences of 20 cloned noggin PCR products, undertaken to evaluate the possibility of a somatic mutation in the noggin gene which could be carried by a small subset of white blood cells, also failed to detect the presence of the reported 42-bp deletion. We conclude that mutations in the coding region of noggin are not associated with FOP.