Negative regulation of Nod‐like receptor protein 3 inflammasome activation by T cell Ig mucin‐3 protects against peritonitis

The Nod‐like receptor protein 3 (NLRP3) inflammasome plays roles in host defence against invading pathogens and in the development of autoimmune damage. Strict regulation of these responses is important to avoid detrimental effects. Here, we demonstrate that T cell Ig mucin‐3 (Tim‐3), an immune checkpoint inhibitor, inhibits NLRP3 inflammasome activation by damping basal and lipopolysaccharide‐induced nuclear factor‐κB‐mediated up‐regulation of NLRP3 and interleukin‐1β during the priming step and basal and ATP/lipopolysaccharide‐induced ATP production, K⁺ efflux, and reactive oxygen species production during the activation step. Residues Y256/Y263 in the C‐terminal region of Tim‐3 are required for these inhibitory effects on the NLRP3 inflammasome. In mice with alum‐induced peritonitis, blockade of Tim‐3 exacerbates peritonitis by overcoming the inhibitory effect of Tim‐3 on NLRP3 inflammasome activation, while transgenic expression of Tim‐3 attenuates inflammation by inhibiting NLRP3 inflammasome activation. Our results show that Tim‐3 is a critical negative regulator of NLRP3 inflammasome and provides a potential target for intervention of diseases with uncontrolled inflammasome activation.     

多排螺旋CT对回盲区癌与炎性假瘤鉴别诊断的应用研究

目的分析回盲区癌与炎性假瘤的CT征象,探讨其主要鉴别要点,提高诊断准确率,为临床提供更可靠的影像诊断依据。方法对36例回盲区实性占位的病例,采用16排螺旋CT进行平扫及3期增强扫描,薄层重建后发送到AW 4.2工作站进行图像重建并综合观察。CT诊断后追踪对比手术病理结果或其他临床治疗结果。结果36例病例中,23例为恶性肿瘤,13例为炎性假瘤,CT误诊8例。重新分析各病例CT征象及结合临床病史,寻找回盲区癌及炎性假瘤的不同CT征象及误诊原因,总结出鉴别要点。结论回盲区癌及炎性假瘤强化特点及其与邻近结构的关系等CT表现均有所不同,重视CT鉴别要点可提高诊断准确率。     

原发性t(10;11)易位白血病CALM和AF10融合转录检测及其体外化疗敏感性分析

为了研究CALM和AF10融合转录在原发性t( 10 ;11)易位白血病形成和治疗中的作用 ,采用RT PCR技术检测了 5例原发性t( 10 ;11)易位白血病患者CALM AF10融合转录 ,体外MTT法检测了其白血病细胞体外化疗敏感性。结果表明 :在 5例原发性t( 10 ;11)易位白血病患者中检测到 5种分子量的AF10 CALM融合转录和 4种分子量的CALM AF10融合转录 ;MTT法显示 5例原发性t( 10 ;11)易位白血病患者的白血病细胞有 2例对体外化疗敏感 ( 60 % ) ,3 6例非t( 10 ;11)易位白血病细胞有 3 1例对体外化疗敏感 ( 86% ) ,统计分析有显著差异 (P <0 0 1) ,与临床治疗结果一致。化疗药物处理 72小时 ,t( 10 ;11)白血病细胞的凋亡率为 ( 16.3 7± 2 .5 6) % ,而非t( 10 ;11)白血病细胞的为 ( 3 3 .75± 5 .5 9) % ,差异有显著性 (P <0 .0 1)。结论 :CALM AF10是t( 10 ;11)易位白血病的常见特点之一 ,可能与该白血病发生密切相关 ,且t( 10 ;11)易位白血病患者预后较差。     

Palliative care at home: Stress for nurses in urban and rural New South Wales, Australia

Nurses often experience positive and negative dimensions of caring for dying clients and their families. This project aimed to compare stress experienced by urban and rural community nurses working with palliative-care clients in the home. Participants included five nurses working in rural Australia and seven nurses working in an urban area. Transcribed data from unstructured audio-taped interviews were coded for common and contrasting themes, and a comparison was made of the stress experienced by the two groups of nurses. The major themes were role conflict and definition, family dynamics, time and workload. For both groups of nurses, the impact of family relationships and role conflict within the community impacted significantly to the stress they experienced. Debriefing opportunities for nurses to discuss stress, including educational and support sessions, is an essential component of best practice. Rural nurses had the additional stress of trying to provide a 24 h service over vast distances with a lack of financial resources.     

Trichinella infection and clinical disease

Trichinellosis is caused by ingestion of insufficiently cooked meat contaminated with infective larvae of <it>Trichinella</it> species. The clinical course is highly variable, ranging from no apparent infection to severe and even fatal disease. We report two illustrative cases of trichinellosis. Returning to Denmark a few days after having eaten roasted pork in the Republic of Serbia, a female patient suffered from severe vomiting, epigastric pain, diarrhoea, and later myalgia, generalized oedema, and prostration. A biopsy showed heavy infestation with <it>Trichinella spiralis</it>, 2000 larvae/g of muscle. Life-threatening cardiopulmonary, renal and central nervous system complications developed. The patient recovered after several months. Her husband, who also ate the pork, did not have clinical symptoms, but an increased eosinophil count and a single larva in a muscle biopsy confirmed infection. The epidemiology, clinical manifestations, diagnosis, treatment and prevention of trichinellosis are reviewed.      

超声造影定量分析对乳腺良恶性肿瘤血流灌注异质性的评价

目的 探讨乳腺良恶性肿瘤的血流灌注特征.方法 应用实时灰阶超声造影时间-强度曲线定量分析技术检测瘤灶边缘及中心部区域灌注参数及平均灌注参数峰值强度、曲线下面积、达峰时间、廓清时间,光、电镜观察瘤内新生血管显微结构及超微结构改变.结果 恶性组时间-强度曲线形态多数(87.88%,29/33)呈速升缓降型,良性组多数(80.00%,27/34)呈缓升速降型.恶性组平均曲线下面积、廓清时间大于良性组,差异有统计学意义(P<0.05),平均峰值强度、达峰时间两组比较差异无统计学意义(P>0.05).恶性组病灶边缘各灌注参数与中心区域相比差异有统计学意义(P<0.05),良性组病灶边缘各灌注参数与中心区域相比差异无统计学意义(P>0.05).光镜下恶性组90.91%(30/33)见坏死灶,间质中见弥漫分布粗细不均的新生血管,血管丰富区位于癌巢边缘,异常扩张的大血管和裂隙状的新生血管并存.良性组均未见坏死灶,血管管径和分布均一.电镜下恶性组新生血管内皮细胞超微结构具有不同于正常血管内皮细胞的分裂旺盛的特征,癌灶边缘以扩张、迂曲的大血管为多,癌灶中心常见狭窄、闭塞的幼稚新生血管及固缩、变形的内皮细胞、周细胞.结论 实时超声造影灌注曲线形态、各灌注指标及不同灌注区域灌注指标的差异为乳腺良恶性肿瘤的鉴别诊断提供了重要依据.肿瘤间质中新生微血管密度、形态、分布、结构及功能的差异性是影像学评价肿瘤血管生成的基础.     

急性混合型下肢深静脉血栓综合介入治疗与系统溶栓疗效的比较

目的：比较综合介入治疗与系统溶栓治疗对急性混合型下肢深静脉血栓（LEDVT）的疗效。方法：回顾分析12年间收治的229例急性混合型LEDVT患者的临床资料。122例采用血栓碎吸、溶栓等综合介入治疗（A组）,其中合并髂静脉狭窄或闭塞53例,采取腔内血管成形术（PTA）和支架植入辅助处理,术后辅以小剂量尿激酶溶栓、肝素抗凝治疗;另107例（B组）行尿激酶,肝素抗凝等系统溶栓治疗。结果：平均住院天数A组（6.2±2.2）d,B组（10.5±2.4）d;2周后复查,A,B两组的治愈率和有效率分别为40.98%,14.02%和96.72%,77.57%,差异均有统计学意义（均P<0.05）。随访12~85个月,患肢膝下15 cm处周径差A组为（0.53±0.42）cm,B组为（1.42±1.35）cm;水肿、色素沉着、溃疡等后遗症发生率A组分别23.15%,9.26%和0,B组分别为50.51%,80.81%和9.09%,A组静脉通畅率为81.48%,静脉瓣膜功能正常率为57.41%,B组为65.66%和15.15%,差异均有统计学意义（P<0.05）。结论：综合介入治疗对急性混合型LEDVT的近期、中远期疗效均优于系统溶栓,尤其在保护静脉瓣膜功能方面明显优于系统溶栓。