椎弓根固定结合椎体成形术治疗胸腰椎爆裂骨折

目的探讨椎弓根固定结合经椎弓根椎体内植骨行椎体成形术治疗胸腰椎爆裂骨折的疗效。方法采用椎管环形减压、短节段椎弓根螺钉系统固定结合经椎弓根椎体内植骨治疗胸腰椎爆裂骨折116例,其中93例获得随访。术前及术后随访行X线和CT检查,测量伤椎椎体中央高度值,比较植骨后椎体高度的恢复程度,同时观察植骨融合情况。采用配对t检验方法进行统计学分析。结果93例患者术后平均随访24.2个月,90%以上患者伤椎椎体高度恢复并维持良好,无塌陷。伤椎椎体中央高度值犤T12(3.14±0.41)cm,L1(3.33±0.34)cm犦与正常值犤(T12(3.26±0.38)cm,L1(3.47±0.61)cm)犦比较,差异无显著性意义(P>0.05)。未出现植骨操作引起的神经血管并发症。CT显示椎体内植骨块边缘模糊,融合良好,植骨块无吸收现象。结论后路椎管环形减压及内固定时,经伤椎椎弓根进行椎体内植骨行椎体成形术可恢复伤椎椎体高度,重建前、中柱的稳定性,预防术后椎体塌陷的发生。     

双介入并中药治疗胰腺癌35例

对３５例胰癌病人在超声引导下，局部注射纯乙醇顺铂溶液，由肿瘤远端边退针边注射，一般７－１０天注射１次，直至活栓组织中癌细胞转阴为止。并给予“胰宝康泰”辅治疗，该药具有免疫增强作用。本组３５例的半年、１年、２年活率分别为８５．７％、６８．８％、５１．４％，中位生丰了期为１０．３个月，疗效满意。     

神经酸及其在预防和治疗脑病中的应用研究进展

神经酸是大脑神经细胞和组织中的一种核心天然成分,具有特殊的生物学功能,对人体健康尤其是脑健康起到至关重要的作用。综述神经酸的生物功能和作用机制、神经酸的制备（包括从元宝枫油中提取分离、化学合成及转基因生物合成）以及神经酸在预防和治疗脑病（包括多发性硬化症、肾上腺脑白质营养不良、Zellweger综合征、阿尔茨海默病等）中的应用研究进展。     

Ableitende Tränenwege und Trockenes Auge

BACKGROUND: The knowledge regarding the pathogenesis, diagnosis, and treatment of dry eye has made large advances in recent years. However, many questions are still unanswered. Although the nasolacrimal ducts are part of the tear system they have been paid nearly no attention regarding dry eye. METHODS: The present knowledge about the nasolacrimal ducts is presented and discussed in a context with dry eye. A PubMED search was conducted for articles published from 1966 to the present; in addition, review articles as well as book chapters were considered and discussions with investigators in the field were performed. RESULTS: As a draining and secretory system, the nasolacrimal ducts play a role in tear transport and non-specific immune defense. Moreover, components of tear fluid are absorbed in the nasolacrimal passage and are transported into a vascular system that surrounds the nasolacrimal sac and nasolacrimal duct. This system is comparable to a cavernous body and it is connected to the blood vessels of the outer eye. Also it is subject to vegetative control. Organized mucosa-associated lymphoid tissue (MALT) is present in the nasolacrimal ducts displaying the cytomorphological and immunophenotypic features of MALT. CONCLUSIONS: The normally constant absorption of tear fluid components into the blood vessels of the surrounding cavernous body that are connected to the blood vessels of the outer eye, could be a feedback signal for tear fluid production, which comes to a halt if these tear components are not absorbed. Thus, dry eye could be initiated. Defective stimulation of tear duct-associated lymphoid tissue (TALT) could result in abnormal immune deviation at the ocular surface leading to an autoimmunological response that causes dry eye pathology.     

Paraneoplastische neurologische Syndrome¶Diagnostische und pathogenetische Bedeutung von Autoantikörpern

Zusammenfassung Paraneoplastische neurologische Syndrome (PNS) sind seltene Erkrankungen, die in Assoziation mit einem Tumor auftreten, ohne durch diesen oder dessen Metastasen direkt verursacht zu sein. Am h?ufigsten treten PNS in Assoziation mit kleinzelligen Bronchial-, Mamma- und Ovarialkarzinomen auf. Den h?chsten pr?diktiven Wert im Hinblick auf einen zugrundeliegenden Tumor hat das Lambert-Eaton-Syndrom, welches zugleich auch das h?ufigste PNS ist. Neben der Einteilung unter anatomischen Gesichtspunkten gewinnt eine solche aufgrund spezifischer Antik?rperbefunde zunehmend an Bedeutung. Bei bestimmten neurologischen Syndromen (sensible und autonome Polyneuropathie, Zerebellitis, limbische Enzephalitis, Opsoklonus-Myoklonus-Syndrom, Stiff-man-Syndrom, Neuromyotonie, subakute Amaurosis) hat den Nachweis entsprechender Autoantik?rper einen h?heren pr?diktiven Wert in Hinblick auf das Vorliegen eines Tumors als die klinische Symptomatik allein. Eine pathogenetische Relevanz der Autoantik?rper konnte bislang allerdings nur für das Lambert-Eaton-Syndrom (Antik?rper gegen spannungsabh?ngige Kalziumkan?le, VGCC), die Neuromyotonie (Antik?rper gegen spannungsabh?ngige Kaliumkan?le, VGKC) und die paraneoplastische Retinopathie (Antik?rper gegen Recoverin) nachgewiesen werden. In der übersicht werden die klinische Symptome der PNS, die assoziierten Tumoren und die Bedeutung der Antik?rper für die Diagnose und Pathogenese der PNS dargestellt.      

Clinical tolerance in allogeneic hematopoietic stem cell transplantation

Allogeneic hematopoietic stem cell transplantation (HSCT) has been a curative therapeutic option for a wide range of immune hematologic malignant and non-malignant disorders including genetic diseases and inborn errors. Once in the host, allogeneic transplanted cells have not only to ensure myeloid repopulation and immunological reconstitution but also to acquire tolerance to host human leukocyte antigens via central or peripheral mechanisms. Peripheral tolerance after allogeneic HSCT depends on several regulatory mechanisms aimed at blocking alloimmune reactivity while preserving immune responses to pathogens and tumor antigens. Patients transplanted with HSCT represent an ideal model system in humans to identify and characterize the key cellular and molecular players underlying these mechanisms. The knowledge gained from these studies has allowed the development of novel therapeutic strategies aimed at inducing long-term peripheral tolerance, which can be applicable not only in allogeneic HSCT but also in autoimmune diseases and solid-organ transplantation. In the present review, we describe Type 1 regulatory T cells, initially discovered and characterized in chimeric patients transplanted with human leukocyte antigen-mismatched HSCT, and how their presence correlates to tolerance induction and maintenance. Furthermore, we summarize different cell therapy approaches with regulatory T cells, designed to facilitate tolerance induction, minimizing pharmaceutical interventions.     

宫颈癌患者癌组织中Th17/Tr细胞明显升高与疾病进程相关

目的 了解宫颈癌患者外周血、肿瘤组织中Th17/Tr细胞的比例,分析其与疾病发生、发展的关系,探讨Th17/Tr比值改变在宫颈癌临床检测中的意义.方法 采用流式细胞术检测32例宫颈癌患者外周血、肿瘤组织标本和15例健康者对照标本中的Th17、Tr细胞;采用直线相关检验方法对晚期宫颈癌组的Th17、Tr细胞进行相关性分析.结果 宫颈癌患者外周血、肿瘤组织中Th17、Tr细胞显著高于健康对照组(P<0.05),晚期宫颈癌组Th17/Tr比值低于早期组(P<0.01),晚期宫颈癌组Th17、Tr表达呈负相关.结论 宫颈癌患者Th17、Tr细胞比例明显升高,提示Th17/Tr比值与宫颈癌的发生发展可能存在着一定的关系,为官颈癌的免疫治疗提供新思路.

Abstract：

Objective To detect the levels of Th17 and regulatory T(Tr)cells in Imripheral blood mononuclear and tumor tissue from patients with cervical cancer and analyze the relationship hetween Th17 and Tr cells in cervical cancer progression.In addition.the significance of the Th17/Tr cells ratio in cervical cancer pathogenesis was discussed.Methods The expression levels of Th17 and Tr cells were determined by flow cytometry from 32 patients with cervical cancer and 15 health people.The mechanism of involvement of Th17 and Tr cells proportionality in cervical cancer pathogenesis and the correlation between Th17 and Trwas assessed by bivariate correlation analysis.Results The expression levels of both Th17 and Tr in patients were higher than control groups,especially in late stage patients Th17 and Tr proportionality lower than early group,and there was a negative correlation between them.Conclusion Th17 and Tr cells proportionality may be involve in the development of cervical cancer so as to provide novel strategies for tumor immunotherapy.     

Prime–boost vaccination with a fowlpox vector and an inactivated avian influenza vaccine is highly immunogenic in Pekin ducks challenged with Asian H5N1 HPAI

The efficacy of different vaccination schedules was evaluated in 17-day-old Pekin ducks using an experimental inactivated whole virus vaccine based on the H5N9 A/chicken/Italy/22A/98 isolate (H5N9-It) and/or a fowlpox recombinant (vFP-H5) expressing a synthetic HA gene from an Asian H5N1 isolate (A/chicken/Indonesia/7/2003). Full protection against clinical signs and shedding was induced by the different vaccination schemes. However, the broadest antibody response and the lowest antibody increase after challenge were observed in the group of ducks whose immune system was primed with the fowlpox vectored vaccine and boosted with the inactivated vaccine, suggesting that this prime-boost strategy induced optimal immunity against H5N1 and minimal viral replication after challenge in ducks. In addition, this prime-boost vaccination scheme was shown to be immunogenic in 1-day-old ducklings.     

Ataxia and cranial neuropathies from subcutaneously injected elemental mercury

Context.?Although neurological toxicity from elemental mercury vapor and organic mercury exposure has been commonly reported in the literature, it is rarely reported from soft tissue injection of elemental mercury. We present a case of neurological dysfunction from subcutaneous injection of elemental mercury. Case details.?A 35‐year‐old Latin American man subacutely developed gait ataxia, diplopia, and vomiting 1 year after subcutaneous injection of elemental mercury, a practice common in Afro‐Caribbean and Latin‐American cultures. Physical examination showed an indurated plaque on his right shoulder at the injection site, left third nerve and bilateral sixth nerve palsies, nystagmus, dysarthria, and gait and limb ataxia. The patient’s serum and 24‐h urine mercury levels were significantly elevated; he underwent excision of the mercury reservoir and chelation with dimercaptosuccinic acid but experienced only mild improvement after 1 year. Discussion.?Neurological sequelae from elemental mercury, specifically cognitive dysfunction, tremor, cortical myoclonus, and peripheral neuropathy, have been reported but cranial neuropathies, ataxia, cerebrospinal fluid pleocytosis, and the presence of anti‐Purkinje cell type‐Tr antibody have not. Treatment involves removal of any existing mercury reservoir and chelation; however, improvement in neurological dysfunction after treatment has rarely been reported in the literature.