白内障伴青光眼患者术后胰岛素抵抗及炎症因子水平与视觉质量的关系

目的分析白内障伴青光眼患者术后胰岛素抵抗及炎症因子水平变化与视觉质量的关系。 方法选取47例(47眼)白内障伴青光眼患者为研究对象,均接受超声乳化+小梁切除术治疗。术前、术后7天、术后3个月检测患者客观散射指数(OSI)、点扩散函数(PSF)、调制传递函数截止频率(MTF cutoff)、胰岛素敏感指数及白细胞介素(IL)-1β、IL-10、IL-2水平。采用Pearson法分析视觉质量参数与胰岛素抵抗情况及炎症因子的相关性。 结果与术前比较,术后7天和术后3个月最佳校正视力、MTF cutoff及胰岛素敏感指数升高,且术后3个月更高(P＜0.05);与术前比较,术后7天和术后3个月眼压、角膜内皮细胞计数、PSF、OSI及血清IL-1β、IL-2、IL-10水平降低,且术后3个月更低(P＜0.05)。Pearson分析显示,术前、术后7天和术后3个月,白内障伴青光眼患者OSI与胰岛素敏感指数呈负相关(P＜0.05),与血清IL-1β、IL-2、IL-10水平呈正相关(P＜0.05);MTF cutoff与胰岛素敏感指数呈正相关(P＜0.05),与血清IL-1β、IL-2、IL-10水平呈负相关(P＜0.05);PSF与血清IL-1β水平呈负相关(P＜0.05)。术后7天和3个月,PSF与胰岛素敏感指数呈正相关(P＜0.05),与血清IL-2、IL-10水平呈负相关(P＜0.05)。 结论超声乳化联合小梁切除术对视觉质量的改善可能与胰岛素抵抗及炎症因子变化密切相关。     

HDL-C/ApoA1、MCP-1水平与中青年冠心病患者病变程度及炎症反应的相关性

目的 探讨高密度脂蛋白胆固醇（HDL-C）/载脂蛋白A1(ApoA1)及单核细胞趋化蛋白-1(MCP-1)水平与中青年冠状动脉粥样硬化性心脏病（以下简称冠心病）病变程度及炎症反应的相关性。方法 选取2021年10月—2022年10月在南通大学附属医院和如皋市人民医院就诊的中青年冠心病患者130例作为观察组,其中稳定型心绞痛（SAP）42例,不稳定型心绞痛（UAP）50例,急性心肌梗死（AMI）38例;病变支数：单支病变59例,双支病变39例,三支病变32例;按照狭窄程度分为轻度46例,中度54例,重度30例。另取同期该院冠状动脉CT血管造影或冠状动脉造影正常者130例作为对照组。比较各组HDL-C/ApoA1、MCP-1、肌酸激酶同工酶MB(CK-MB)、肌酸激酶（CK）、心肌肌钙蛋白Ⅰ（cTnⅠ）、白细胞计数（WBC）、超敏C反应蛋白（hs-CRP）、生长刺激表达基因2蛋白（ST2）及Gensini评分。结果 观察组HDL-C/ApoA1低于对照组（P <0.05）,MCP-1、CK-MB、CK、cTnⅠ、WBC、hs-CRP、ST2高于对照组（P <0.05）。AMI和...     

特发性炎性肌病的药物治疗

特发性炎性肌病(IIM)是一组与免疫失调有关的疾病,包括细胞免疫和体液免疫的异常.主要的治疗药物是精皮质激素和免疫抑制剂.对于难治性病例,现有的药物常常无效,这就需要针对IIM的发病机制开发新型的治疗药物.文中就特发性炎症性肌病的药物治疗进行综述,并且阐述了治疗效果的评估标准,讨论了药物治疗中存在的问题和今后的研究方向.     

Treatment of idiopathic inflammatory myositis associated interstitial lung disease: A systematic review and meta-analysis

Objective

Interstitial lung disease (ILD) is the most severe complication of idiopathic inflammatory myositis (IIM), resulting in significant increase in morbidity and mortality and for which the best treatment remains controversial. We conducted a meta-analysis to evaluate the efficacy of therapies used for the management of IIM-related ILD.

Quantitative study of mesangial injury with proteinuria induced by monoclonal antibody 1-22-3.

Murine MoAb 1-22-3 has already been reported to bind to the mesangial cell surface and to cause transient proteinuria and mesangial morphological changes characterized by mesangiolysis, subsequent mesangial cell proliferation and mesangial matrix increase by a single i.v. injection. In this study, MoAb-induced glomerulopathy was quantitatively analysed. No correlation between the severity of mesangial morphological changes and the degree of proteinuria was detected (r = 0.190). The minimum dose injected to induce abnormal proteinuria was 25 micrograms. This dose corresponded to 1.79 micrograms/2 kidneys 30 min after MoAb injection. The highest average level of proteinuria was observed in rats injected with 500 micrograms of MoAb, and less proteinuria was observed in rats injected with 10.0, 5.0 and 2.0 mg. Although the amounts of kidney-fixing MoAb and the subsequent deposition of rat C3 in the high-dose-injected group were larger than in the 500 micrograms injected group, the numbers of infiltrating inflammatory cells were the same in both groups. No correlations between the degrees of such mediators and proteinuria were observed.     

重症SIRS患者的正常甲状腺病态综合征

目的：探索全身炎症反应综合征（SIRS）患者的正常甲状腺病态综合征（ESS）的发生规律。 方法： 测定50例SIRS病人的总三碘甲状腺原氨酸（TT3）、总四碘甲状腺原氨酸（TT4）、游离三碘甲状腺原氨酸（FT3）、游离四碘甲状腺原氨酸（FT4）、促甲状腺素（TSH），并根据是否多脏器功能障碍综合征（MODS）分组。计算急性生理和慢性健康评估Ⅱ（APACHEⅡ）评分，记录病人转归以及从发病到检测的时间（患病时间）。 结果： TT3或FT3降低的45例。TT3与APACHEⅡ评分呈对数负相关（r＝－0.330，P<0.05）,TT3/TT4与患病时间呈对数负相关（r=－0.316, P<0.05）。MODS组的TT3、TT4、FT3水平显著低于无MODS组（P<0.05）。 结论： SIRS和MODS病人发生低T3、低T4可能性大，反映炎症反应对甲状腺轴的影响，随着病情加重、患病时间延长，影响进一步深化。     

5-羟色胺在大鼠腰骶髓后连合核和中间带外侧核参与盆腔内脏炎性痛调控的形态学研究

本研究运用荧光金(FG)逆行束路追踪与5-HT1A受体免疫荧光组织化学染色技术相结合,观察了大鼠腰骶髓后连合核(DCN)和中间带外侧核(IML)内感受盆腔内脏伤害性信息并向外侧臂旁核(LPB)发出投射的神经元呈5-HT1A受体免疫反应阳性。将FG注入一侧LPB后,可在腰骶节段(L6-S2)观察到大量的FG逆标神经元,这些FG逆标神经元主要集中于DCN和IML内,以同侧为主;5%福尔马林注入大鼠结肠后,Fos蛋白阳性神经元主要分布于腰骶髓DCN和IML,以同侧为主,在同侧脊髓背角I层、II层和深层也有少量的分布。另外,在腰骶髓DCN和IML内,还可观察到大量5-HT1A受体阳性的神经元胞体、纤维和终末,同时有部分Fos蛋白阳性的FG逆标神经元呈5-HT1A受体阳性。上述结果提示,大鼠腰骶髓DCN和IML内的5-HT能终末可能对盆腔内脏伤害性信息的传递发挥调控作用。     

Increased spontaneous secretion of rheumatoid factor by intestinal lamina propria mononuclear cells from Crohn's disease but not ulcerative colitis patients.

Increased levels of rheumatoid factors (RF) have been observed in the serum of Crohn's disease but not ulcerative colitis patients, and have been proposed to relate to an increased state of intestinal lymphocyte activation. We have therefore examined the spontaneous in vitro secretion of RF by intestinal lamina propria mononuclear cells (MNC) isolated from specimens from control and inflammatory bowel disease (Crohn's disease, ulcerative colitis) patients. Normal intestinal lamina propria MNC spontaneously secrete rheumatoid factors of different isotypes during 14 days of in vitro culture (9.7 ng/ml IgA RF, 11.6 ng/ml IgM RF and 64.6 ng/ml IgA anti-Fc (IgG)). In matched studies intestinal MNC isolated from normal large bowel exhibited significantly greater levels of RF synthesis and secretion in vitro than normal small bowel intestinal MNC. A large increase in spontaneous RF secretion was observed from Crohn's disease intestinal MNC (21.4 ng/ml IgA RF, 21.4 ng/ml IgM RF, and 108.15 ng/ml IgA anti-Fc (IgG)), when compared with normal controls. The amount of RF secreted was dependent on the amount of inflammatory activity of the bowel specimens, from which the MNC were isolated (198.3 ng/ml of IgA anti-Fc(IgG) from involved versus 50.0 ng/ml from matched non-involved tissue). Ulcerative colitis MNC released decreased amounts of RF (7.1 ng/ml IgA RF, 6.2 ng/ml IgM RF, and 42.3 ng/ml IgA anti-Fc(IgG)). These observations using isolated intestinal MNC may explain the findings of RF changes in the sera of inflammatory bowel disease patients. Our observations support the hypothesis of a heightened state of activation in normal intestinal lamina propria MNC, which is further increased in active Crohn's disease. The dissimilarities observed between Crohn's disease and ulcerative colitis may indicate fundamental differences in disease pathophysiology and will lead to further studies exploring intestinal immunoregulatory properties of RF.     

Inflammatory malignant fibrous histiocytomas and dedifferentiated liposarcomas: histological review, genomic profile, and MDM2 and CDK4 status favour a single entity

Inflammatory malignant fibrous histiocytoma (inflammatory MFH) is a very rare tumour that occurs most often in the retroperitoneum. So far, it has been considered to be a special subtype of MFH. As it is now widely accepted that most retroperitoneal pleomorphic MFHs are dedifferentiated liposarcomas, the present study compared histological features, genomic profile (CGH analysis), and MDM2 and CDK4 status (immunohistochemistry, FISH, and quantitative PCR) in inflammatory MFHs from 12 patients and dedifferentiated liposarcomas that had an inflammatory MFH component from eight patients. Metaphase cytogenetic and FISH analyses were also performed on one inflammatory MFH. Histological review showed areas of well-differentiated liposarcoma in nine inflammatory MFHs. CGH analysis showed 12q13-15 amplification or gain in six of seven inflammatory MFHs and in seven of seven dedifferentiated liposarcomas. Immunohistochemistry showed positivity of tumour cells for MDM2 in every tumour in both groups and for CDK4 in ten and seven inflammatory MFHs and dedifferentiated liposarcomas, respectively. Metaphase cytogenetic and FISH analysis performed on one inflammatory MFH showed the presence of a supernumerary large marker chromosome and ring chromosome with high-level amplification of both MDM2 and CDK4 genes. FISH analysis on paraffin wax-embedded sections showed amplifications of MDM2 and CDK4 in seven of seven inflammatory MFHs and in seven of seven dedifferentiated liposarcomas. Quantitative PCR showed amplification of MDM2 in six and of CDK4 in seven of nine inflammatory MFHs. In conclusion, this study strongly suggests that most so-called inflammatory MFHs are dedifferentiated liposarcomas.