严重急性呼吸综合征肺脏及免疫器官淋巴细胞亚群分析

目的 探讨严重急性呼吸综合征(SARS)肺脏的免疫反应类型和状况，及免疫器官淋巴细胞亚群的数量变化。方法 采用免疫组织化学方法，以CD3、CD4、CD8、CD20、CD57、CD68、S-100、HLA-DR单克隆抗体，对1例重型SARS的肺组织及免疫器官中多种淋巴细胞亚群进行标记，并以健康人体脾脏及淋巴结作对照，观察分析各淋巴亚群的分布及数量变化。结果 该例重型SARS病例肺间质中主要以CD8^ 淋巴细胞浸润为主，杂以少数CD4^ 淋巴细胞。淋巴细胞亚群半定量分析显示，31枚胸腔淋巴结中，CD3^ 、CD4^ 、CD8^ 和CD20^ 细胞数减少的淋巴结百分率分别为74．2％、67．7％、74．2％、83．9％，其中各淋巴细胞亚群明显减少者比例较高，腹腔淋巴结中各淋巴细胞亚群减少较轻；脾脏中CD3^ 、CD4^ 、CD8^ 、CD20^ 细胞均呈不同程度的减少，其中以CD20^ 细胞数目减少最为显著；而淋巴结及脾脏中CD57^ 、CD68^ 、S-100^ 、HLA-DR^ 细胞数目呈相对增加改变。结论 结果提示SARS肺组织原位以细胞免疫反应为主，推测肺脏内细胞免疫反应可能具有清除受感染细胞内冠状病毒病原体和诱发肺组织免疫损伤的双重作用；疾病后期重型SARS病例免疫器官可能存在淋巴细胞亚群的不同程度减少及比例失衡，并呈围病变肺组织愈近，淋巴结内主要淋巴细胞亚群减少愈甚之趋势。     

致死照射小鼠移植骨髓后淋巴组织的重建

机体受致死量射线照射后,造血细胞移植对淋巴组织的重建已日益为人们所重视。这不仅因为淋巴组织是存活动物免疫机能的细胞学和组织学基础,而且移植后的一些合并症如GVHD等也与植入后增殖的免疫活性细胞的性能密切相关。非特异性酸性α萘醋酸酯酶染色法是近年来发展起来的鉴别T与B淋巴细胞的较方便的方法。本文即应用这种方法观察小鼠在受致死照射和移植骨髓后外周血和胸腺、脾脏以及肠系膜淋巴结中T与B淋巴细胞消长的动态变化。     

X射线全身照射对免疫细胞共刺激分子表达的影响

目的：探讨低剂量电离辐射对免疫细胞表面分子的影响，方法：用流式细胞术FITC－CD28／PE－CTLA－4双染染法观察了小鼠胸腺和脾细胞的CD28和CTLA－4表达变化，用免疫细胞化学（ABC）法观察了小鼠腹腔巨噬细胞B7－1和B7－2的表达变化。结果：低剂量电离辐射和较高剂量电离辐射均能增强腹腔巨噬细胞B7分子的表达；同时发现，低量电离辐射显著增强胸腺和脾细胞CD28的表达，而CTLA－4的表达降低，脾细胞较胸腺细胞更明显。较高剂量电离辐射显著增强胸腺和脾细胞CTLA－4的表达，同时抑制两种细胞CD28的表达，以脾细胞为更显著，结论：共刺激分子CD28和B7的表达上调可能是低剂量电离辐射免疫兴奋效应机理中的重要因素。     

131I-抗CD45单抗对淋巴造血组织选择性照射的研究

目的 探讨^131I—抗CD45单克隆抗体(McAb)对小鼠淋巴造血组织选择性照射的效果。方法 由鼠尾静脉注入^131I—抗CD45 McAb和^125I—IgG，观察^131I—抗CD45 McAb在小鼠体内的分布情况。结果 ^131I—抗CD45 McAb较^125I-IgG从血液中清除更快。骨髓、脾脏可快速摄取^131I—抗CD45 McAb，其在骨髓、脾脏中有选择性积聚^125I-IgG呈非特异性分布。结论 ^131I—抗CD45 McAb在小鼠体内分布具有特异性，可对淋巴造血组织产生选择性照射。     

组织蛋白酶D在霍奇金淋巴瘤组织的表达及意义

目的：探讨组织蛋白酶D(CaihepsinD，CathD)在霍奇金淋巴瘤(Hodgldn lymphoma，HL)组织中的表达及意义。方法：应用免疫组织化学方法对霍奇金淋巴瘤进行CathD、CD34、CD45RO、CD20染色。探讨组织蛋白酶D在霍奇金淋巴瘤发病中的作用。结果：CathD主要表达于阻组织中的组织细胞和树突状细胞，其表达明显多于反应性增生淋巴组织；CathD不表达于RS／Variants(RS／V)细胞；其表达与血管生成无相关性；HL中主要的反应性增生淋巴细胞为T细胞。结论：CathD的表达与HL中微血管生成无相关性，可能与局部细胞免疫增强有关。     

严重急性呼吸综合征不同时间死亡患者的病理变化及其特征

目的系统观察6例严重急性呼吸综合征(SARS)不同时间死亡患者近30个脏器的病理变化，探讨其病理发生发展过程及病变和病原体特点。方法采用光镜、透射电镜、组织化学和部分免疫组织化学方法观察各脏器的病理变化。结果①重症SARS死亡患者早期基本病变为以肺和免疫器官(脾、淋巴结、黏膜淋巴组织)为主的全身各脏器发生不同程度的实质细胞变性、凋亡和坏死等变质性改变和肺水肿、透明膜形成及出血等为主的血循环障碍；中后期则以肺上皮坏死脱落和问质纤维增生伴早期纤维化及免疫器官进行性萎缩等病变为主，再次证实肺和免疫器官为主要靶器官；②肺脏病变经历急性渗漏性炎症期(发病后2周内，主要病变为严重的弥漫性肺水肿和透明膜形成)、肺泡上皮坏死脱落伴增生机化性炎症期(发病后3～4周)和纤维增生伴早期纤维化期(发病后5～6周)，具有广泛性、速发性、进行性和阶段性、多样性等特点；③在重症SARS死亡患者中，脾和淋巴结等免疫器官发生严重的破坏和广泛出血，脾小体和淋巴滤泡极度萎缩，淋巴细胞迅速发生凋亡和坏死，T、B淋巴细胞数量极度减少，免疫功能极度低下，其病变同样具有广泛性、速发性和持续性等特点；④证实主要病原体为新型冠状病毒，衣原体样颗粒也是致病病原体之一，同时于肺和脾观察到性质未明的长杆棒状结构，于肺脏中观察到球菌菌团。结论重症SARS死亡尸检标本中，病原体具有多样性，其中冠状病毒累及全身多个器官、多种细胞，引起病毒血症；全身各脏器均发生不同程度病变，肺和淋巴组织为主要靶器官；肺脏病变呈进行性发展，经历3个阶段，于4～6周即发生纤维增生和早期纤维化；淋巴器官萎缩呈持续性、进行性发展，免疫功能长期低下。     

HPD的组织学效应:免疫器官

LACA小鼠腹腔注射HPD 0.4mg、2.0mg和2.0mg×3/只后,免疫器官都发生不同程度的组织学效应。主要为胸腺萎缩,脾和淋巴结(肠系膜)的胸腺依赖区萎缩及其中淋巴细胞减少;脾白髓边缘区内淋巴细胞减少或消失,淋巴滤泡萎缩,滤泡内中、小淋巴细胞对HPD的反应比生发中心细胞更明显。牌生发中心数量减少和截面积变小。文中强调,这些代表T、B淋巴细胞系统的组织结构变化,必然会影响或有损机体的细胞和体液免疫功能。     

重症肌无力患者外周血CD4^＋CD25^＋调节性T细胞的表达

目的：观察免疫治疗对重症肌无力（MG）患者外周血CD4＋CD25^＋T淋巴细胞表达的影响。方法：应用四色流式细胞术对MG30例（观察组）治疗前后和30例健康者（对照组）外周血CD4^＋CD25^＋、CD4^＋、CD25^＋ T淋巴细胞亚群等表达进行检测，以CD2。抗原荧光强度10的细胞定义为CD25^high细胞，分析其百分率和荧光强度，并结合临床资料进行相关分析。结果：观察组治疗前外周血CD4^＋CD25^＋、CD4^＋CD25^high、CD25^＋占总淋巴细胞的比例与正常对照组无显著差异（P〉O．05），但CD4^＋＋细胞数较正常增高（P〈0．05）；经类固醇激素或经胸腺切除治疗后，外周血CD4^＋CD25^＋、CD／CD25^high与治疗前及对照组比较，差异显著（P〈0．05）。结论：经免疫治疗后的MG患者外周血中存在高比例的CD4^＋CD25^＋表达，可能与病情缓解有关。     

免疫缺陷病的胃肠道X线表现

人体的免疫功能主要有细胞免疫和体液免疫二类。干细胞在骨髓中衍化成淋巴细胞后,一部分进入胸腺受胸腺激素培育成T淋巴细胞,进入周围血循环发挥细胞免疫作用。另一部分淋巴细胞发育成B 淋巴细胞。这一发育过程鸟类是在腔上进行,人类是在骨髓、消化道淋巴组织(扁桃体、肠壁     

自体骨髓在受致死照射小鼠淋巴器官重建中的作用

本文报告了小鼠屏蔽两侧后肢受1000和1200rad照射后周身淋巴组织重建的动态变化.至照后45天,1000rad组外周血T、B淋巴细胞的含量分别相当于对照组的69%和55%;1200rad组在照后30天分别相当于对照组的40.5%和18%.胸腺、淋巴结(肠系膜和腋窝)以及脾脏的白髓都处于重建不良状态.文中对保留大量自体骨髓而淋巴器官重建不良的原因进行了分析. 周围淋巴器官在照后重建过程中出现短期的髓外造血.在照后14～45天,肠系膜淋巴结内出现持续的浆细胞过度增生.文中强调研究肠粘膜免疫辐射损伤的重要性.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.