柳氮磺胺吡啶对溃疡性结肠炎病理学特征和分级的影响

目的　从病理学角度探讨柳氮磺胺吡啶 (SASP)治疗溃疡性结肠炎 (UC)的部分机制。方法　应用SASP 1g ,每日 3次 ,治疗活动期UC 6周 ,观察治疗前后的病理特征和组织学分级的变化。 结果　轻度UC治疗前黏膜固有层血管炎为 48.2 % ,治疗后为 17.4% (P <0 .0 0 1) ;中度UC治疗前为6 8.0 % ,治疗后为 2 6 .7% (P <0 .0 0 1)。治疗前 ,血管壁轻度坏死 1例 ,中度 2例 ;血栓形成中度 2例 ;在6周末 ,所有标本均未发现有血管壁坏死和血栓形成。治疗前轻度UC腺体异常为 30 .4% ,治疗后为13 .0 % (P <0 .0 5 ) ;治疗前中度UC为 42 .0 % ,治疗后为 40 .0 % (P >0 .0 5 )。轻度UC治疗前嗜酸性粒细胞浸润为 98.2 % ,治疗后为 80 .4% (P <0 .0 1) ;中度UC治疗前为 10 0 .0 % ,治疗后为 91.1% (P <0 .0 5 )。对隐窝脓肿的影响 ,轻度 :从 2 1.4%降到 4.4% (P <0 .0 5 ) ;中度 :从 48.0 %降到 13 .3% (P <0 .0 0 1)。黏膜组织学分级轻度 :治疗前为 2 .0 0± 0 .84,治疗后为 0 .91± 0 .46 (P <0 .0 0 1) ;中度 :治疗前为 2 .49± 0 .84,治疗后为 1.31± 0 .75 (P <0 .0 0 1)。结论　SASP能明显改善UC炎症黏膜的小血管病变与黏膜腺隐窝脓肿 ,减少中性粒细胞和嗜酸性粒细胞的浸润 ,从而减少炎症性反应物产生与前列腺素的合成 ,     

嗜酸性粒细胞分级在活动期溃疡性结肠炎严重性评价中的应用

从溃疡性结肠炎(UC)的病理组织学研究中发现，嗜酸性粒细胞在活动期UC黏膜中的浸润比例达99．2％，但其是否有浸润与临床分度无关。在炎症严重患者的肠黏膜中嗜酸性粒细胞计数较多，现我们试用嗜酸性粒细胞分级来评价活动期UC的严重性并观察柳氮磺胺吡啶(SASP)治疗对嗜酸性粒细胞分级的影响。     

嗜酸性粒细胞在溃疡性结肠炎患者中的临床及病理学意义

目的:探讨嗜酸性粒细胞(EG)与评判溃疡性结肠(UC)病情的其他指标的一致性,病理组织学特征与EG的关系.方法:选取2007-11/2008-12就诊于湘雅二医院并诊断为UC患者45例,将患者分为:活动组(n=45)与好转组(n=39,在治疗6wk到最后1d,经DAI、EAI组织病理学评分,完全缓解和部分缓解的患者).采用CAI积分、EAI积分及组织病理学积分评价疾病活动度,并进行EG计数.结果:UC患者结肠黏膜组织中的炎症细胞浸润以中性粒细胞、淋巴细胞、浆细胞以及EG为主,活动组较好转组为重.固有层小血管病变和腺体病变以及隐窝脓肿的出现均以活动组为重.间质改变好转组较多.EG计数与中性粒细胞计数在好转组呈负相关(r=0.568,P=0.001).EG浸润的出现在活动组与淋巴组织增生、淋巴滤泡形成呈正相关(r=0.755,0.524,均P<0.01),与灶性出血呈负相关(r=.0.385,P=0.010).而好转组患者中,仅有杯状细胞消失与EG浸润呈正相关(r=0.349,P=0.046).结论:EG可能为判断UC活动或好转的指标.     

乙酰肝素酶在溃疡性结肠炎肠黏膜中的表达及在致病机制中的作用

目的探讨乙酰肝素酶(heparanase，HPSE)在溃疡性结肠炎(ulcerative colitis，UC)患者肠黏膜中表达的改变，及其表达是否与不同临床分期和不同炎症程度相关。同时也讨沦了HPSE表达在UC致病机制中的作用。方法正常对照组为13名健康成人，确诊的28例UC患者中25例根据病情分为活动期11例、缓解期14例，并对24例的病理组织学炎症进行分级，Ⅲ、Ⅳ级10例，Ⅰ、Ⅱ级14例。分别采用RT-PCR和Western印迹法对不同分组的HPSE表达水平进行检测。结果HPSE在正常对照组肠黏膜中无表达，在缓解期和病理分级Ⅰ、Ⅱ级的肠黏膜中均呈现低表达，而在活动期和病理分级Ⅲ、Ⅳ级的肠黏膜中表达显著升高。结论HPSE在UC肠黏膜中呈阳性表达．且其表达水平与病情轻重和炎症严重程度呈正相关，它可能在UC肠黏膜上皮重塑和疾病的发生和发展中起重要作用，而HPSE抑制剂则有可能用于UC的治疗。     

溃疡性结肠炎临床严重度分型与内镜、病理分级的关系

目的研究溃疡性结肠炎（UC）的临床严重度分型与病变范围及内镜、病理分级的关系。方法收集本院1998年1月至2007年10月住院确诊的UC患者，采用分级的方法描述UC的临床严重程度及内镜、病理组织学特点。运用Spearman等级相关系数进行相关分析。结果轻度UC（112例）病变范围多见于直肠及左侧结肠，中度UC（56例）以左侧结肠炎及广泛性结肠炎为主，重度UC（18例）以广泛性结肠炎为主（X^2=26．079，P〈0．01）；患者临床严重度分级与病理组织学分级（r=0．520，P=0．000）、内镜分级（r=0．169，P=0．012）均呈正相关性；在临床完全缓解的88例中，肠镜及组织学分级为0级分别仅有21、24例，临床完全缓解和结肠镜分级为0级的21例中，10例组织学仍有Ⅰ级的改变。结论UC患者病变范围、内镜分级及活检黏膜的病理组织学分级能反映UC的活动性和严重性．在疗效评价中．组织学分级优于肠镜分级．肠镜分级优于临床分级。     

527例溃疡性结肠炎临床与病理分析

目的 评价临床、内镜及活检三者在溃疡性结肠炎(UC)诊断中的作用。方法 总结我院10年间经肠镜诊断为UC的病例，分析其临床、内镜表现及部分活检资料。结果 527例确诊为UC，其中误诊34例，结肠镜诊断正确率为93．9％。UC临床主要表现为腹泻(88％)、粘液脓血便(52％)。结肠镜表现以粘膜充血水肿(94％)、糜烂溃疡(75％)最多见，病变部位以直、乙结肠为主(51％)，呈弥漫性、连续性分布。活检特征性表现为炎症程度重(49％)，固有层弥漫性混合性炎细胞浸润(76％)、杯状细胞减少(71％)、隐窝扭曲(63％)、萎缩(47％)、隐窝炎(45％)、隐窝脓肿(36％)及绒毛状表面(39％)。结论 UC的诊断应强调临床、内镜及活检相结合。     

慢性糜烂性胃炎的病理形态学特征

为观察慢性糜烂性胃炎(CEG)黏膜病理形态学特征,分析120例CEG患者,发现黏膜的病理形态学变化以急、慢性炎症性病变(均为98.33%)、固有层小血管病变(95.83%)及上皮损伤(70.00%)为主,部分患者可发生1~2级的黏膜腺体病变(腺体萎缩、不典型增生及肠化生)。因此,急、慢性炎细胞浸润、固有层小血管病变及上皮损伤是CEG的主要病理形态特征,伴有轻度黏膜腺体病变。     

活动期溃疡性结肠炎活检黏膜的组织学分级与临床分级和内镜分级的关系

目的 研究活动期溃疡性结肠炎(AUC)患者的活检黏膜的组织学分级与临床分级和内镜下分级的相互关系及其在疗效评价中的作用。方法 采用分级的方法来描述133例AUC患者的病理、临床和内镜特征，采用记分方法描述各临床表现，运用Spearman等级相关系数进行相关分析。结果133例．AUC的组织学分级为I级29例，Ⅱ级45例，Ⅲ级37例，Ⅳ级22例；临床分级为I级85例，Ⅱ级39例，Ⅲ级9例；肠镜分级为I级8例，Ⅱ级30例，Ⅲ级16例，Ⅳ级79例。组织学分级与血便程度(r=0．49，P=0．000)、排便次数(r=0．30，P=0．001)、血沉(r=0．42，P=0．000)、临床活动指数(r=0．56，P=0．000)、临床分级(r=0．52，P=0．000)、结肠镜分级(r=0．35，P=0．000)均有正相关性，与血清白蛋白(r=-0．31，P=0．000)有负相关性，而与血红蛋白(r=-0．13，P=0．125)无明显相关。轻中度患者经柳氮磺胺吡啶治疗6周后，在临床为完全缓解的68例中，组织学分级为0级仅19例，肠镜分级为0级仅16例，大部分患者仍有组织学与肠镜分级I级的改变。临床缓解和肠镜分级为0级的16例中，仍有7例组织学分级为I级。临床缓解、肠镜分级和组织学分级均为0级者仅有9例。结论．AUC患者的组织学分级和临床分级、内镜分级的分布有不一致性。组织学分级与血便的程度、大便的次数、血沉、临床活动指数、临床分级和肠镜分级之间有正相关性；与血清白蛋白呈负相关性。在疗效评价中，组织学分级优于肠镜分级，肠镜分级优于临床分级。     

炎症性肠病诊断与治疗的共识意见(2012年·广州)病理诊断部分解读

炎症性肠病(IBD)是一组病因尚不十分清楚的慢性非特异性肠道炎症性疾病,包括溃疡性结肠炎(UC)和克罗恩病(CD)。UC在病理学上可表现为黏膜糜烂、浅溃疡、固有膜内重度弥漫性急性、慢性炎性细胞浸润、隐窝脓肿等,但缺乏特征性改变;CD可有透壁性炎症、裂隙状溃疡/阿弗他溃疡、非干酪样坏死性肉芽肿、神经节细胞增生等改变,但亦无诊断金标准。因此,UC和CD的确诊均不能单纯依靠病理检查,尤其是黏膜活检标本病理检查,而需结合临床、内镜、影像学和组织病理学表现进行综合分析并随访观察,在排除感染性和其他非感染性结肠炎的基础上作出诊断。     

溃疡性结肠炎结肠黏膜修复中HGF,c-Met,EGFR的作用

目的:观察并分析肝细胞生长因子(HGF)及其受体c-Met与表皮生长因子受体(EGFR)在溃疡性结肠炎(UC)活动和非活动阶段患者结肠黏膜的表达情况,探讨其表达的临床意义．方法:根据改良Williams疾病活动指数(DAI) 将42例UC患者分为活动期(n=25)和非活动期(n=17)2组,对照组(n=20)为门诊健康体检者或肠易激综合征患者．结肠镜下活检各组患者结肠黏膜组织,采用免疫组化SABC法检测各组患者结肠黏膜HGF及c-Met表达;SP法检测EGFR及增殖细胞核抗原(PCNA)表达．结果:对照组、活动期UC患者、非活动期 UC患者HGF阳性表达率分别为22％,88％, 100％(X2=62．84,P<0．01);c-Met阳性表达率分别为25％,92％,100％(X2=62．34,P<0．01); EGFR阳性表达率分别为25％,92％,1 00％(X2 =54．34,P<0．01);PCNA过表达率分别为0, 36％,100％(X2=67．50,P<0．01),组间比较差异显著．HGF,c-Met和EGFR在UC患者结肠黏膜表达与PCNA过表达正相关(r=0．648,0．645, 0．565,P<0．01)．结论:HGF,c-Met,EGFR及PCNA在非活动期UC患者结肠黏膜中的表达较活动期UC患者和对照组明显增加．HGF及其受体c-Met与 EGFR在UC患者结肠炎症黏膜修复过程中可能起一定作用．     

妊娠时间与肺结核复发的相关性研究及诊治对策

目的 分析肺结核史患者妊娠时间和肺结核复发间相关性.方法 选取我院收治的有肺结核史的妊娠妇女576例作为研究对象,对其妊娠前肺结核治疗、治愈后妊娠时间、妊娠后复发肺结核等进行分析,总结有肺结核史育龄女性的妊娠时间和肺结核复发之间的关系.结果 肺结核治愈后不同时间段妊娠者的结核复发率比较,差异具有显著性（P＜0.05）,停药后间隔时间越久妊娠,肺结核复发的几率越小.结论 加强孕期痰菌检查,及早发现复发肺结核,提高母婴安全.     

我国骨关节结核诊治的回顾与展望

骨关节结核是危害人们健康的严重感染性疾病,近95％由他处结核病继发而来.罹患骨关节结核疾病后几乎均将致残,严重影响人们的健康、工作和生活.建国以来在党和国家的关心和支持下,骨关节结核的诊治水平取得了长足进步.时至今日,由于多种原因,学科发展和被重视程度受到一定的制约,同整个医疗行业的发展不相适应.回顾过去,展望未来,我们需要重新审视骨关节结核的诊治方法,努力推进骨关节结核诊疗技术的科学发展.     

Effect of phosphorylation of MAPK and Stat3 and expression of c-fos and c-jun proteins on hepatocarcinogenesis and their clinical significance

AIM To study the effect of phosphorylation ofMAPK and Stat3 and the expression of c-fos andc-jun proteins on hepatocellular carcinogenesisand their clinical significance.METHODS SP immunohistochemistry was usedto detect the expression of p42/44~(MAPK), p-Stat3,c-fos and c-jun proteins in 55 hepatocellularcarcinomas (HCC) and their surrounding livertissues.RESULTS The positive rates and expressionlevels of p42/44~(MAPK), p-Stat3, c-fos and c-junproteins in HCCs were significantly higher thanthose in pericarcinomatous liver tissues (PCLT).A positive correlation was observed between theexpression of p42/44~(MAPK) and c-fos proteins, andbetween p-Stat3 and c-jun, but there was nosignificant correlation between P42/44~(MAPK) and p-Stat3 in HCCs and their surrounding livertissues.CONCLUSION The abnormalities of Ras/Raf/MAPK and JAKs/ Stat3 cascade reaction maycontribute to malignant transformation ofhepatocytes. Hepatocytes which are positive forp42/ 44~(MAPK), c-fos or c-jun proteins may bepotential malignant pre-cancerous cells.Activation of MAPK and Stat3 proteins may be anearly event in hepatocellular carcinogenesis.     

Overweight and Obesity and Progression of ADPKD

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Replication and Inhibitors of Enteroviruses and Parechoviruses

The Enterovirus (EV) and Parechovirus genera of the picornavirus family include many important human pathogens, including poliovirus, rhinovirus, EV-A71, EV-D68, and human parechoviruses (HPeV). They cause a wide variety of diseases, ranging from a simple common cold to life-threatening diseases such as encephalitis and myocarditis. At the moment, no antiviral therapy is available against these viruses and it is not feasible to develop vaccines against all EVs and HPeVs due to the great number of serotypes. Therefore, a lot of effort is being invested in the development of antiviral drugs. Both viral proteins and host proteins essential for virus replication can be used as targets for virus inhibitors. As such, a good understanding of the complex process of virus replication is pivotal in the design of antiviral strategies goes hand in hand with a good understanding of the complex process of virus replication. In this review, we will give an overview of the current state of knowledge of EV and HPeV replication and how this can be inhibited by small-molecule inhibitors.     

Effect of phosphorylation of MAPK and Stat3 and expression of c-fas and c-jun proteins on hepatocarcinogenesis and their clinical significance

AIM To study the effect of phosphorylation ofMAPK and Stat3 and the expression of c-fos andc-jun proteins on hepatocellular carcinogenesisand their clinical significance.METHODS SP immunohistochemistry was usedto detect the expression of p42/44MAPK, p-Stat3,c-fos and c-jun proteins in 55 hepatocellularcarcinomas (HCC) and their surrounding livertissues.RESULTS The positive rates and expressionlevels of p42/44MAPK, p-Stat3, c-fos and c-junproteins in HCCs were significantly higher thanthose in pericarcinomatous liver tissues (PCLT).A positive correlation was observed between theexpression of p42/44MAPK and c-fos proteins, andbetween p-Stat3 and c-jun, but there was nosignificant correlation between p42/44MAPK and p-Stat3 in HCCs and their surrounding livertissues.CONCLUSION The abnormalities of Ras/Rat/MAPK and JAKs/ Stat3 cascade reaction maycontribute to malignant transformation ofhepatocytes. Hepatocytes which are positive forp42/ 44MAPK, c-fos or c-jun proteins may bepotential malignant pre-cancerous cells.Activation of MAPK and Stat3 proteins may be anearly event in hepatocellular carcinogenesis.     

心电图、心电向量图与冠状动脉造影结果对比分析

目的:通过分析心电图(Electrocardiogram,ECG)和心电向量图(Vectorcardiogram,VCG)的改变与冠脉造影（CAG）结果进行对比,探讨ECG、VCG在冠状动脉病变中的诊断价值。方法: 选择2008年1月~2009年12月临床拟诊断为冠心病患者108例,行常规ECG、VCG检查,并于1周内进行CAG,对检查结果依据各自的诊断标准进行判定,以CAG为标准诊断法,利用四格表法,计算相关评价真实性的指标并进行比较。结果: ①VCG检测的灵敏度、特异度、准确度显著高于ECG(P<0.05,P<0．01)。②ECG、VCG阳性率与冠脉病变支数组间比较:在单支病变、双支病变中,VCG阳性率明显高于ECG(P<0.05),左主干或三支病变无统计学意义;组内比较:ECG组左主干或三支病变组较单支病变、双支病变阳性率高(P<0.05,P<0.01);VCG组左主干或三支病变组较单支病变阳性率高(P<0.05);与双支病变阳性率比较无统计学意义;③ECG、VCG阳性率与冠脉病变程度组间比较:冠脉病变狭窄50%～69%的VCG阳性率明显高于ECG (P<0.05),其他两组阳性率比较无统计学意义;组内比较:ECG组冠脉病变狭窄≥90%较50%～69%、70%～89%的阳性率高(P<0.05,P<0.01); VCG组狭窄≥90%较50%～69%阳性率高（P<0.01),其他无统计学意义。结论: VCG对冠心病检测价值显著高于ECG。     

Detection and characterization of the product of hydroethidine and intracellular superoxide by HPLC and limitations of fluorescence

Here we report the structural characterization of the product formed from the reaction between hydroethidine (HE) and superoxide (O(2)(.-)). By using mass spectral and NMR techniques, the chemical structure of this product was determined as 2-hydroxyethidium (2-OH-E(+)). By using an authentic standard, we developed an HPLC approach to detect and quantitate the reaction product of HE and O(2)(.-) formed in bovine aortic endothelial cells after treatment with menadione or antimycin A to induce intracellular reactive oxygen species. Concomitantly, we used a spin trap, 5-tert-butoxycarbonyl-5-methyl-1-pyrroline N-oxide (BMPO), to detect and identify the structure of reactive oxygen species formed. BMPO trapped the O(2)(.-) that formed extracellularly and was detected as the BMPO-OH adduct during use of the EPR technique. BMPO, being cell-permeable, inhibited the intracellular formation of 2-OH-E(+). However, the intracellular BMPO spin adduct was not detected. The definitive characterization of the reaction product of O(2)(.-) with HE described here forms the basis of an unambiguous assay for intracellular detection and quantitation of O(2)(.-). Analysis of the fluorescence characteristics of ethidium (E(+)) and 2-OH-E(+) strongly suggests that the currently available fluorescence methodology is not suitable for quantitating intracellular O(2)(.-). We conclude that the HPLC/fluorescence assay using HE as a probe is more suitable [corrected] for detecting intracellular O(2)(.-).     

Effects of sex and time of day on metabolism and excretion of corticosterone in urine and feces of mice

Non-invasive techniques to monitor stress hormones in small animals like mice offer several advantages and are highly demanded in laboratory as well as in field research. Since knowledge about the species-specific metabolism and excretion of glucocorticoids is essential to develop such a technique, we conducted radiometabolism studies in mice (Mus musculus f. domesticus, strain C57BL/6J). Each mouse was injected intraperitoneally with 740 kBq of 3H-labelled corticosterone and all voided urine and fecal samples were collected for five days. In a first experiment 16 animals (eight of each sex) received the injection at 9 a.m., while eight mice (four of each sex) were injected at 9 p.m. in a second experiment. In both experiments radioactive metabolites were recovered predominantly in the feces, although males excreted significantly higher proportions via the feces (about 73%) than females (about 53%). Peak radioactivity in the urine was detected within about 2h after injection, while in the feces peak concentrations were observed later (depending on the time of injection: about 10h postinjection in experiment 1 and about 4h postinjection in experiment 2, thus proving an effect of the time of day). The number and relative abundance of fecal [3H]corticosterone metabolites was determined by high performance liquid chromatography (HPLC). The HPLC separations revealed that corticosterone was extensively metabolized mainly to more polar substances. Regarding the types of metabolites formed, significant differences were found between males and females, but not between the experiments. Additionally, the immunoreactivity of these metabolites was assessed by screening the HPLC fractions with four enzyme immunoassays (EIA). However, only a newly established EIA for 5alpha-pregnane-3beta,11beta,21-triol-20-one (measuring corticosterone metabolites with a 5alpha-3beta,11beta-diol structure) detected several peaks of radioactive metabolites with high intensity in both sexes, while the other EIAs showed only minor immunoreactivity. Thus, our study for the first time provides substantial information about metabolism and excretion of corticosterone in urine and feces of mice and is the first demonstrating a significant impact of the animals' sex and the time of day. Based on these data it should be possible to monitor adrenocortical activity non-invasively in this species by measuring fecal corticosterone metabolites with the newly developed EIA. Since mice are extensively used in research world-wide, this could open new perspectives in various fields from ecology to behavioral endocrinology.     

大鼠骨髓间充质干细胞的分离培养和外源基因的导入

目的探讨绿色荧光蛋白基因转染骨髓间质干细胞的可行性。方法采用F icoll-PaqueTMP lus淋巴细胞分离液,根据细胞密度梯度原理,分离大鼠骨髓间充质干细胞(rM SC s)并进行体外原代培养和传代扩增,倒置相差显微镜观察细胞生长情况,免疫细胞化学法对其初步鉴定。流式细胞仪分析转染效率。结果原代和传代培养的细胞呈现梭形外观,具有较强的生长增殖能力;细胞均一表达CD44、CD54、CD106、CD29抗原。电穿孔法转染rM SC s转染率为32.8%±3%。结论采用比重为1.077 g/L的F icoll-PaqueTMP lus能分离获得大鼠骨髓间充质干细胞,经原代培养和传代培养能够迅速扩增。电穿孔法具有较高的介导外源基因表达于rM SC s的效率。