外阴部、阴囊疣状黄瘤临床病理特点及文献复习

目的 探讨外阴部、阴囊疣状黄瘤（verruciform xanthoma,VX）的临床病理学特征、诊断、鉴别诊断及发病机制。方法 对1例阴囊VX、2例外阴VX进行光镜、免疫组化、特殊染色、HPV原位杂交观察并结合文献分析。结果 VX表皮疣状增生,棘层增厚,钉突延长位于真皮同一水平;表面过度角化伴角化不全,内有中性粒细胞浸润;真皮乳头层内上皮钉突间见黄色瘤样细胞（泡沫细胞）浸润。免疫组化标记黄色瘤样细胞CD68、α1-AT、Mac387阳性,CK（AE1/AE3）弱阳性,S-100、Ki-67、HPV阴性。PAS阳性。原位杂交HPV6/11呈阴性。结论 外阴部、阴囊VX与发生于口腔黏膜的VX临床病理学特征相似,黄色瘤样细胞来源于单核/巨噬细胞。     

骶骨骨折的动态冲击试验研究

目的:探讨骶骨在冲击载荷作用下发生骨折的机理。方法:采集人体新鲜骨盆标本10具,分别行动态冲击试验和静态破坏试验,测量动态骨折时的一系列动力学参数,确定骨折的动力学特性。结果:⑴骶骨受垂直冲击时按应力波的传递方向发生骨折,其动力学性质呈粘弹性,应力波呈周期性衰减,得到了骶骨的载荷响应曲线与应变响应曲线;骶骨骨折的平均冲击载荷为(9366±514) N,冲击时间为(2.78±1.02) s,动荷系数为1.21。⑵骶骨的动态破坏机制与静态破坏机制有很大的不同,不但极限载荷不同,而且前者随应变速率的提高而快速增加,冲击能量在25 J以上时呈脆性劈裂状通过骶孔或骶髂关节骨折,并累及神经根损伤,而静态大多为骶髂关节骨折。结论:骶骨骨折大都在高速冲击下发生,与其动力学特性、力的传导以及动载荷响应等诸多因素相关。     

内脏高敏感大鼠结肠电活动及运动异常

目的探讨内脏高敏感大鼠结肠电活动及运动的特点。方法实验分对照组和模型组,模型组腹腔注射鸡卵清蛋白使大鼠内脏致敏。2周后,记录结肠快波、慢波及收缩波,观察消化间期移行性综合肌电IMC的周期、Ⅲ期持续时间、快波和慢波的波动频率及平均最大振幅,记录结肠收缩波数目及收缩波指数。结果模型组消化间期复合肌电的周期延长(P<0·01),Ⅲ期持续时间延长(P<0·01),快波的波动率加快(P<0·05),平均最大振幅增大(P<0·01)。慢波的波动频率加快(P<0·05),平均最大振幅增大(P<0·01)。收缩波数目增加(P<0·05),收缩波指数增大(P<0·05)。结论内脏高敏感大鼠结肠电活动及运动有明显异常。     

IL-6和IL-11对脐血CD34+细胞诱导分化为巨核细胞的影响

目的： 探讨白细胞介素－6(IL-6)和白细胞介素－11(IL-11)对脐血CD34+细胞诱导分化为巨核细胞及其产生血小板的影响。方法: 采用免疫磁珠法(MACS)分选8例健康产妇足月顺产的胎儿脐血中CD34+细胞，以含血小板生成素（TPO 50 μg/L）、白细胞介素-3（IL-3 10 μg/L）、干细胞因子（SCF 50 μg/L）的无血清培养基作为对照组，分别添加10 μg/L IL-6、IL-11、IL-6+IL-11作为实验组，培养14 d后观察结果。利用细胞计数仪检测单个核细胞数；流式细胞仪计数培养体系中的CD41+细胞和血小板；用倒置显微镜观察培养体系中的细胞生长情况；用显微镜和流式细胞仪观察凝血酶诱导后的血小板凝集情况。结果: 各实验组单个核细胞数与对照组无明显区别（P>0.05），而CD41+细胞和血小板数量明显多于对照组(P<0.05)。培养第14 d后倒置显微镜下可见实验组中血小板样颗粒物明显多于对照组，而且经凝血酶诱导后有明显血小板凝集。结论: IL-6和IL-11可诱导脐血中CD34+细胞分化为巨核细胞并产生功能性血小板。     

茶多酚对正常大鼠及糖尿病大鼠右室乳头肌收缩功能的影响

目的：研究不同浓度的茶多酚（TP）对于正常大鼠及糖尿病大鼠成模后第6周、第8周右室乳头肌收缩功能的影响。 方法： 以四氧嘧啶复制糖尿病大鼠模型，将成模后第6周、第8周糖尿病大鼠右心室乳头肌游离，置于氧合台氏液中，电刺激状态下，记录乳头肌收缩功能，观察不同浓度的茶多酚的影响，并与对照组大鼠进行比较。 结果： 成模糖尿病大鼠第6周时舒张1/2间期延长（P<0.05），收缩速度:+dT/dtmax，-dT/dtmax均降低(P<0.01,P＜0.05)，至第8周张力增量，收缩速度:+dT/dtmax，-dT/dtmax降低（P<0.01）,舒张1/2间期延长（P<0.01）。正常SD大鼠和糖尿病大鼠右室乳头肌给予不同浓度的茶多酚，在15-120 mg/L的浓度范围内，茶多酚对于正常大鼠可以产生正性肌力作用;虽然糖尿病6周大鼠的右室乳头肌收缩功能有所降低,但对茶多酚产生与正常大鼠相似的反应，而糖尿病8周的大鼠对于茶多酚无明显反应。 结论： 茶多酚应用于早期的糖尿病性心肌病，可以产生正性肌力作用，但是对于有严重的心肌损害的糖尿病大鼠心肌，不能产生正性肌力作用。     

Detecting DNA repair capacity of peripheral lymphocytes from cancer patients with UVC challenge test and bleomycin challenge test

The objective of this study was to evaluate DNA repair capacity of cancer patients with the bleomycin (BLM) challenge test and the UVC challenge test. The human peripheral lymphocytes were collected from 33 patients with different kinds of cancers and 33 controls in the same hospital. The lymphocytes of each subject were divided into two groups: (1) In the BLM challenge test, the lymphocytes were treated with BLM (20 microgml(-1)) for 30 min, and repaired for 15 min. The DNA damage before and after BLM exposure was detected with comet assay to assess DNA repair capacity. (2) In the UVC challenge test, the lymphocytes were exposed to UVC (254 nm) at the dose of 1.5 Jm(-2). DNA damage of lymphocytes was measured before UVC exposure and at 90 and 240 min after UVC exposure using comet assay, then DNA repair percentage (DRP) was calculated. The results of this study indicate that the average DRPs of cancer patients were 75.63 +/- 3.11 and 68.98 +/- 4.19% calculated with tail length (TL) and tail moment (TM), respectively, in the BLM challenge test, which were significantly lower than those (91.11 +/- 1.09 and 88.19 +/- 1.71%) of controls (P < 0.01). Also, the mean DRPs of cancer patients were 49.19 +/- 3.47 and 58.27 +/- 3.64% calculated with TL and TM, respectively, in the UVC test, which were significantly lower than those (77.52 +/- 2.06 and 83.12 +/- 2.36%) of controls (P < 0.01). The correlation between the DRPs (%) drawn with TL and TM in the BLM test or between the DRPs (%) drawn with mean TL and mean TM in the UVC challenge test were significant (P < 0.05). The DNA repair capacity measured with the BLM and UVC challenge tests in 33 cancer patients was significantly lower than that in controls.     

国产重组人促卵泡激素在辅助生殖技术控制性超促排卵的临床应用

目的评价国产重组人促卵泡激素(recombinant human follicle-stimulating hormone,rhFSH)用于辅助生殖技术(assisted reproductive technology,ART)控制性超促排卵(controlled ovarian hyperstimulation,COH)的有效性及安全性。方法本试验采用多中心、随机、双盲、阳性平行对照、非劣效研究方法,于2017年7月至2019年6月间选取6家生殖医学中心纳入卵巢储备正常的不孕女性进行ART的COH治疗。受试者随机分为试验组(国产rhFSH,n=134)和对照组(进口rhFSH,n=133),研究过程中因各种因素排除受试者共8例,试验组7例,对照组1例,最终依照研究方案完成试验的受试者试验组127例,对照组132例。比较两组受试者COH周期中获得的卵母细胞总数、rhFSH用药情况、卵母细胞受精率、优质胚胎数、临床妊娠率、活产率、新生儿情况及不良反应发生率等指标。结果试验组和对照组在COH周期中获得的卵母细胞总数分别为(13.0±5.8)枚和(12.9±5.7)枚,差异无统计学意义(P>0.05);在82例卵胞质内单精子显微注射(intracytoplasmic sperm injection,ICSI)受试者中,试验组(39例)获得MII卵母细胞数[(9.9±3.9)枚]显著高于对照组(43例)[(7.5±3.0)枚,P=0.003];卵母细胞受精率试验组[63.82%(1048/1642)]显著高于对照组[56.19%(958/1705),P<0.001]。rhFSH用药时间和总量、优质胚胎数、临床妊娠率、早产率、活产率、新生儿异常发生率、新生儿体质量、Apgar评分等两组间差异无统计学意义(P均>0.05);治疗期间卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)和其他不良反应发生率差异无统计学意义(P均>0.05),且均为进口rhFSH已知的不良反应。结论在卵巢储备正常的不孕女性中使用相同卵巢刺激治疗方案,国产rhFSH有效性及安全性与进口rhFSH相当。     

抗纤合剂抗肝纤维化的动物实验

以柴胡疏肝散加味的抗纤合剂具有清热解毒、疏肝解郁、利水活血,提高白蛋白的作用。研究抗纤合剂对SD大鼠DMN二甲硝胺模型的病理组织学,透明质酸及肝功能的影响。抗纤合剂能减轻DMN二甲硝胺模型的肝纤维化程度,降低血清透明质酸的浓度。抗纤合剂在DMN二甲硝胺模型的SD大鼠实验中抗大鼠肝纤维化有效,具有抗肝纤维化及降解胶原的作用。     

Blood biomarkers of mild traumatic brain injury: State of art

BackgroundMild traumatic brain injury (mTBI) is one of the most common causes of emergency department visits around the world. Up to 90% of injuries are classified as mTBI. Cranial computed tomography (CCT) is a standard diagnosis tool to identify intracranial complications in adults with mTBI. Alternatively, children can be admitted for inpatient observation with CCT scans performed only on those with clinical deterioration. The use of blood biomarkers is a supplementary tool for identifying patients at risk of intracerebral lesions who may need imaging.MethodWe realised a bibliographic state of art providing a contemporary clinical and laboratory framework for blood biomarker testing in mTBI management.ResultsThe S100B protein is the only biomarker that can be used today in the clinical routine for management of mTBI with appropriate evidence-based medicine. Due to its excellent negative predictive value, S100B protein is an alternative choice to CCT scanning for mTBI management with considered, consensual and pragmatic use. In this state of art, we propose points to help clinicians and clinical pathologists use serum S100B protein in the clinical routine. A state of art on the different biomarkers (GFAP, UCH-L1, NF [H or L], tau, H-FABP, SNTF, NSE, miRNAs, MBP) is also conducted. Some of these other biomarkers, used alone (GFAP, UCH-L1) or in combination (GFAP + H-FABP ± S100B ± IL10) can improve the specificity of S100B.ConclusionUsing a bibliographic state of art, we highlighted the added values of the blood biomarkers for the clinical management of mTBI.