20例成人耐药结核性脑膜炎临床观察

目的分析成人耐药结核性脑膜炎(结脑)的临床特点。方法对2008年1月—2008年12月住院的20例成人耐药结脑病例进行回顾性分析。结果20例脑脊液结核分枝杆菌培养阳性中,耐单药者10例,多耐药者6例,耐多药(MDR)者4例。耐药结脑病情危重,合并意识障碍者10例(50%),合并高颅压者18例(90%),脑脊液常规生化及细胞学符合典型结脑特点,脑膜脑炎8例(40%),脑脊髓膜炎4例(20%)。抗结核并辅助激素和脱水药物治疗好转19例,死亡1例。结论耐药结脑经早期抗结核并辅助治疗,疗效满意。     

4种检测脑脊液结核分枝杆菌法对结核性脑膜炎诊断价值的探讨

目的探讨脑脊液抗酸杆菌涂片、3D、PhaB和PCR检测对结脑的诊断价值。方法检测60例结脑和30例非结脑患者脑脊液涂片、3D、PhaB和PCR阳性率,经统计学处理后,评价4种方法对结脑诊断的灵敏度、特异度。结果结脑组和其他组脑脊液涂片阳性率均为0,3D阳性率分别为23.3%和0,PhaB的阳性率分别是23.3%和26.7%,PCR的阳性率分别是6%和0,4种方法差异无统计学意义。脑脊液3D灵敏度为23.3%,特异度为100%,PhaB灵敏度为23.3%,特异度为73.3%,PCR的灵敏度10%,特异度为100%。结论脑脊液结核分枝杆菌涂片、3D、PhaB和PCR4种检测方法灵敏度低,积极寻找脑脊液结核分枝杆菌的检测方法和提高阳性率是实验室亟需解决的问题。     

热凝脑膜中动脉对硝酸甘油致偏头痛大鼠三叉神经尾核c-fos基因表达的影响

目的探讨热凝脑膜中动脉对硝酸甘油诱发的偏头痛大鼠三叉神经尾核c-fos基因表达的影响。方法48只健康雌性Wistar大鼠随机分为4组(每组12只):生理盐水组(A组),硝酸甘油组(B组,10mg/kg),假手术组(C组),手术组(D组)。观察各组大鼠行为学表现,成功建模后每组随即平分为2小组分别采用RT-PCR和West-ernblot法检测大鼠三叉神经尾核c-fos基因表达。结果各组大鼠挠头、爬笼及耳红等行为学评分(x珋±s)分别为2.33±0.74,39.57±5.44,37.87±4.68,15.6±3.30。4组大鼠三叉神经尾核c-fosmRNA相对表达水平分别为0.50±0.08,0.94±0.12,0.91±0.09,0.71±0.08;c-fos蛋白相对表达水平分别为0.57±0.08,0.93±0.09,0.93±0.09,0.73±0.11。A组大鼠三叉神经尾核c-fosmRNA和蛋白相对表达水平低于B组,C组和D组,且D组大鼠三叉神经尾核c-fosmRNA和蛋白相对表达水平低于B组和C组,差异有统计学意义(P<0.05),但B组与C组之间差异无统计学意义(P>0.05)。结论热凝脑膜中动脉...     

结核性脑膜炎临床诊断的分析

目的:探讨结核性脑膜炎(TBM)的临床诊断.方法:对45例IBM和40例病毒性脑炎(病脑)患者的临床症状及辅助检查资料进行回顾性分析.结果:颅神经损害在TBM组发生率较高(P<0.05),发热、头痛、呕吐、精神异常、意识障碍、脑膜刺激征及颅内压等两组间无差别.TBM组结核菌素试验阳性率显著高于病脑组(P<0.05),而血沉无明显差异.TBM组EEG、头颅CT及MRI表现异常亦均高于病脑组(P<0.05).TBM组脑脊液的蛋白、免疫球蛋白IgG和IgM高于病脑组(P<0.05),而氯化物低于病脑组,葡萄糖及免疫球蛋白IgA两组之间无差别.TBM组脑脊液的中性粒细胞百分率、混合型细胞反应均高于病脑组,而淋巴样细胞反应低于病脑组(P<0.05).结论:综合分析患者的临床表现和实验室尤其是脑脊液细胞学检查结果,对TBM的诊断能起到非常重要的作用.     

VEGF和Ang-2在结核性腹膜炎与腹膜转移癌中的表达及意义

目的 研究VEGF与Ang-2在结核性腹膜炎与腹膜转移癌中的表达与意义.方法 使用免疫印迹法测定34例腹膜活检组织VEGF与Ang-2的蛋白表达并比较在结核性腹膜炎与腹膜转移癌组表达的组间差异.结果 VEGF与Ang-2在结核性腹膜炎与腹膜转移癌中均有表达,且在腹膜转移癌内的表达显著高于结核性腹膜炎.结论 VEGF与Ang-2是腹膜病变组织内血管生成的重要调节因子.     

Annexin 2 and hemorrhagic disorder in vascular intimal carcinomatosis

Vascular intimal carcinomatosis refers to a characteristic tumor proliferation on vascular intima that replaces normal endothelium. This pathological event of unknown cause is quite different from tumor thrombotic microangiopathy due to the absence of thrombi on the tumor cell surfaces. We analyzed renal transitional cell carcinoma cases with metastasis to the main pulmonary arteries and marked hyperfibrino(geno)lysis. The fibrinogen-derived products from patients' plasma were identified as D1A/gamma, D1/gamma, and D1/beta by immunoblotting with the NH2-terminus of the fragment D specific antibody JIF-23. In all cases, the neoplastic cells with vascular intimal carcinomatosis were stained positive for anti-human annexin 2, which is a unique cell surface co-receptor for plasminogen and tissue-type plasminogen activator. In contrast, normal renal pelvic mucosa or renal transitional cell carcinoma without vascular intimal carcinomatosis did not express any annexin 2. The isolated transitional cell carcinoma cells contained annexin 2 mRNA and expressed its protein. Anti-annexin 2 antibody and transfection of annexin 2 small interfering RNA into these carcinoma cells significantly inhibited tissue-type plasminogen activator dependent plasmin generation. These findings suggest that annexin 2 mediated fibrinolysis on the transitional cell carcinoma cells may play a role in inducing hemorrhagic disorder in vascular intimal carcinomatosis.     

Calponin is expressed by fibroblasts and meningeal cells but not olfactory ensheathing cells in the adult peripheral olfactory system

Olfactory ensheathing cells (OECs), the principal glial cells of the peripheral olfactory system, have many phenotypic similarities with Schwann cells of the peripheral nervous system. This makes reliably distinguishing these two cells types difficult, especially following transplantation into areas of injury in the central nervous system. In an attempt to identify markers by which these two cells types can be distinguished, a recent proteomic analysis of fetal OECs and adult Schwann cells identified the actin-binding protein calponin as a potential marker expressed by OECs but not Schwann cells. Since many studies designed with the translational goal of autologous transplantation in mind have used adult OECs, this study examined the expression of calponin by adult OECs, both in vivo within the peripheral olfactory system and in vitro. Calponin colocalized with strongly fibronectin positive fibroblasts in the olfactory mucosa (OM) and meningeal cells in the olfactory bulb (OB) but not with S100beta or neuropeptide-Y positive OECs. In tissue culture, calponin was strongly expressed by fibronectin-expressing fibroblasts from OM, sciatic nerve and skin and by meningeal cells from the OB, but not by p75(NTR)- and S100beta-expressing OECs. These data, supported by Western blotting, indicate that calponin can not be used to distinguish adult OECs and Schwann cells.     

A new standard of care for the management of peritoneal surface malignancy

Cancer dissemination to peritoneal surfaces was, in the past, a lethal condition with a limited survival. Clinical and pharmacologic research have shown that options for both treatment and prevention are now reality. The diseases most commonly treated include peritoneal dissemination from appendiceal malignancy, colorectal malignancy, and peritoneal mesothelioma. Selection factors are important to minimize the number of treated patients who will experience short-term benefit. Treatments involve cytoreductive surgery and perioperative chemotherapy. The intraperitoneal chemotherapy in the operating room is used with heat. Although this combined approach has been criticized, the informed oncologist will seek to identify those patients that may benefit from this more optimistic concept of peritoneal dissemination of cancer.     

Destruction of gastric cancer cells to mesothelial cells by apoptosis in the early peritoneal metastasis

This study examined the mechanism by which the gastric cancer cells lead to early peritoneal metastasis. HMrSV5 cells, a human peritoneal mesothelial cell line, were co-incubated with the supernatants of gastric cancer cells. Morphological changes of HMrSV5 cells were observed. The cell damage was quantitatively determined by MTT assay. The apoptosis of HMrSV5 cells was observed under transmission electron microscope. Acridine orange/ethidium bromide-stained condensed nuclei was detected by fluorescent microscopy and flow cytometry. The expressions of Bcl-2 and Bax was immunochemically evaluated. The results showed that conspicuous morphological changes of apoptosis were observed in HMrSV5 cells 24 h after treatment with the supernatants of gastric cancer cells. The supematants could induce apoptosis of HMrSV5 cells in a time-dependent manner. The supernatants could up-regulate the expression of Bax and suppress that of Bcl-2 in HMrSV5 cells. These findings demonstrated that gastric cancer cells can induce the apoptosis of HPMCs through supernatants in the early peritoneal metastasis, The abnormal expressions of Bcl-2 and Bax may contribute to the apoptosis. Anti-apoptosis drugs promise to be adjuvant chemotherapeutic agents in the treatment of peritoneal metastasis of gastric cancer.