37 nm非计量点氧化铁颗粒致HepG2细胞凋亡的研究

本研究以肝癌细胞HepG2细胞为对象,观察37 nm粒径磁性纳米非计量点氧化铁颗粒(FeOx)在外加磁场作用下对其增殖,凋亡的影响,旨在为FeOx用于治疗肝癌提供理论依据.     

37 nm非计量点氧化铁颗粒致HepG2细胞凋亡的研究

本研究以肝癌细胞HepG2细胞为对象,观察37 nm粒径磁性纳米非计量点氧化铁颗粒(FeOx)在外加磁场作用下对其增殖,凋亡的影响,旨在为FeOx用于治疗肝癌提供理论依据.     

一种简便实用的大鼠Kupffer细胞的分离与鉴定方法

目的：研究一种简便实用的大鼠Kupffer细胞（KCs）的分离与鉴定方法.方法：原位两步灌流法对大鼠肝脏进行冲洗消化;利用Percoll液进行不连续密度梯度离心分离KCs;;选择性贴壁纯化KCs;台盼蓝染色法鉴定细胞存活率;吞噬实验鉴定细胞功能;ED1单克隆抗体免疫荧光细胞化学鉴定KCs;显微镜下观察KCs形态变化.结果：获取的KCs数量为（2.41±0.32）×107/只,其中活细胞数量占（92.3±2.12）％;吞噬实验显示（95.2±2.58）％的细胞内存在碳素颗粒;免疫荧光化学检测证明KCs纯度为（96.3±1.46）％;在显微镜下观察KCs形态,36h细胞形态变得不规则,3d后呈星形或多角形,体外培养可以存活7～10d.结论：此种KCs分离方法操作相对简便,获取的细胞数量、活性功能、纯度等方面均能达到进一步的实验要求,值得推广.     

大鼠库普弗细胞分离培养方法的改良

目的建立一种稳定、高效的大鼠库普弗细胞(KCs)分离培养方法。方法采用大鼠肝脏离体链酶蛋白酶E消化和胶原酶循环灌注消化。低速离心去除肝细胞,Histodenz不连续密度梯度离心和选择性贴壁的方法分离KCs。采用ED2 CD163、兔抗大鼠溶酶体膜相关蛋白2(LAMP2)免疫细胞化学．latex-beads吞噬实验和电镜观察来鉴定 KCs。结果KCs得率为5×107个,活率为98％,经鉴定ED2阳性细胞大于98％,LAMP2阳性细胞大于99％,吞噬试验及电镜观察证明分离所得为KCs。结论改良的分离培养方法稳定、高效,为进一步的研究打下了基础。     

肺透明细胞癌1例并文献复习

目的 分析肺透明细胞癌的临床特征、影像学表现及病理诊断要点.方法 报告1例经肺活检病理确诊的肺透明细胞癌病例,并结合文献资料对该病的临床特征、影像学表现及病理诊断要点进行分析.结果 本例患者为女性,45岁,以反复咳嗽2个月为首发症状,胸部CT示两肺多发结节灶合并肺门及纵隔淋巴结肿大,胸腔镜下肺活检病理确诊为原发性肺透明细胞癌.近20年国内外文献报道肺透明细胞癌病例仅27例,其中男性18例,女性9例,平均年龄(55±11)岁.临床表现主要为咳嗽(16/27)、胸痛(12/27)、咯血(10/27).影像学表现以周围型单发结节或团块影多见(22/27),病灶直径0.5～11 cm.该病罕见,属大细胞癌的变异型;确诊多依赖开胸肺组织病理活检,免疫组织化学染色有助于鉴别.结论 肺透明细胞癌的临床表现无特异性;影像学表现以肺部单发结节或团块影多见,亦可为两肺多发和弥漫型;确诊依赖肺组织病理活检,免疫组织化学染色有助于鉴别.     

DC活化的特异性CTL对裸鼠胃癌移植瘤的杀伤效应

用人胃癌细胞抗原致敏成熟树突状细胞（DC）。将DC活化的特异性细胞毒性T细胞（CTL）注射到胃癌裸鼠体内。用流式细胞术（FCM）检测移植瘤细胞C0／G1、S、G2／M期细胞凋亡情况。结果DC活化的特异性CTL作用于裸鼠皮下移植瘤,可显著抑制其生长,瘤细胞出现不同程度的坏死、变性。特异性CTL作用后,裸鼠皮下移植瘤细胞的增殖指数（PI）为（24.39±2.46）％,显著低于非抗原特异CTL作用后组的（31.24±3.85）％和对照组的（32.78±4.17）％;凋亡细胞比率为（15.83±2.77）％,显著高于非抗原特异CTL组的（7.28±2.26）％和对照组的（9.15±1.33）％,P均〈0.05。认为胃癌细胞抗原致敏DCs活化的CTL在体内可特异性的抑制裸鼠移植瘤细胞生长、增殖,促进瘤细胞凋亡,有效预防裸鼠移植瘤的发生。     

HIV感染与T细胞凋亡

艾滋病是由HIV感染引起的,CD_4~+T细胞显著减少,多克隆B细胞活化和细胞因子失调等为特征的获得性免疫缺陷综合征。临床上表现为免疫缺陷的同时伴各种机会菌感染及恶性肿瘤的临床症候群:包括卡波济肉瘤,肺外非空洞性结核,口腔念珠     

CIK细胞对鼻咽癌细胞株CNE-2Z的凋亡诱导作用研究

目的探讨杀伤细胞（CIK）能否诱导鼻咽癌细胞凋亡。方法 CIK细胞按常规方法从外周血中分离培养,以低分化鼻咽癌细胞株CNE-2Z为靶细胞,细胞因子诱导的CIK为效应细胞,采用荧光显微镜、电镜及流式细胞仪观察CNE-2Z细胞凋亡情况。结果荧光显微镜示实验组CNE-2Z细胞出现明显核浓缩现象和核小体结构,且呈时间依赖性,对照组为正常的形态;电镜示CNE-2Z细胞出现细胞核增大,胞质浓缩,核异染色质边集,可见大量凋亡瘤细胞和吞噬样细胞,对照组无变化。流式细胞仪示加入高浓度CIK细胞组凋亡率明显高于对照组和低浓度CIK细胞组。结论 CIK细胞在体外具有诱导鼻咽癌细胞凋亡作用。     

小儿嗜血细胞综合征8例临床观察

嗜血细胞综合征 (HPS)亦称嗜血细胞性网状细胞增生症 ,是一组以发热、肝脾肿大、全血细胞减少及组织细胞吞噬形态完整的红细胞、白细胞和血小板为主要表现的临床征候群。由于其骨髓象极似恶性组织细胞病 (恶组 ) ,临床工作中两者难以鉴别 ,现将我们收治的 8例分析如下 ,以提高临床医师对该病的认识。临床资料 :本组男 6例 ,女 2例 ,男 :女为 3:1;平均年龄 6岁 ;诊断时间最短为 6天 ,最长为半年。所有病例均以发热为首发表现 ,均做骨髓细胞学检查。临床表现 :持续高热 8例 ,病初肝脏肿大 7例 ,脾脏肿大 5例 ,皮肤瘀点瘀斑 1例。1例病初表现…     

肝癌细胞流变特性及其与细胞骨架结构的相关性研究

目的：研究正常肝细胞和肝癌细胞流变特性与细胞骨架结构的相关性。方法：以微管吸吮技术测定两种细胞的粘弹性系数和细胞在2ug/mlIV 型胶原／1．25ug/ml层连蛋白（laminin,LN )复合裱衬表面上的粘附力,以秋水仙素（colchicine,Col）和细胞松弛素D（cytochlasin,CD)处理细胞研究其对细胞粘性系数和粘附力的影响,结果：在质量浓度为1－60mg/L的Col作用下,肝细胞弹性系数及粘附力总体上明显增高或趋于增高,而肝癌细胞弹性系数及粘附力明显降低,在质量浓度为0．25－5．00mg/L的CD作用下,两种细胞焯弹性系数及粘附力均明显降低,肝癌细胞弹性系数K1,K2值及粘附力的下降幅度明显大于肝细胞相应值的下降幅度,细胞在IV型胶原／LN复合裱衬表面附力与细胞粘弹性系数呈相同的变化趋势,肝癌细胞粘附力变化与细胞弹性系数K1,K2的变化呈度正相关（P＜0．01）。结论：在CD和Col作用下肝细胞和肝癌细胞的流变特性呈不同的效应方式或强度,反映了肝细胞和肝癌细胞骨架结构和机能状态的差异。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。