沙眼衣原体致小鼠输卵管炎的病理研究

【: 目的】研究沙眼衣原体阴道内感染引起小鼠输卵管炎症的机理、病理改变。【方法】通过雌性小 鼠阴道内接种小鼠肺炎(MoPn)沙眼衣原体, 感染后不同时间观察小鼠输卵管病变情况, 并通过光镜、免疫组化 和电镜研究其病理改变。【结果】感染早期小鼠输卵管出现急性炎症改变, 病理表现为黏膜层水肿、脱落和坏 死; 电镜下, 在黏膜上皮细胞中找到沙眼衣原体。感染后期小鼠输卵管出现输卵管阻塞和积水, 病理表现为黏 膜皱襞减少, 黏膜层纤毛柱状上皮细胞成矮柱状, 顶部纤毛消失, 输卵管壁增厚、纤维组织增生和淋巴细胞浸 润, 免疫组化显示以CD4+ T 细胞浸润为主。【结论】阴道内沙眼衣原体感染可逆行感染引起输卵管炎症、粘 连、阻塞和积水; 其病理基础早期为黏膜层急性炎症改变和后期为输卵管壁增厚、纤维组织增生;局部以Th1 细胞介导为主的细胞免疫,导致了慢性输卵管炎的病理改变。     

人脐带间充质干细胞移植治疗小鼠慢性输卵管炎

摘 要： 【目的】 观察人脐带间充质干细胞（ｈＵＣ－ＭＳＣ）移植对小鼠慢性输卵管炎的治疗作用,为慢性输卵管炎的临床治疗提供新策略。【方法】 从脐带中分离培养人脐带间充质干细胞,流式细胞术鉴定其免疫表型,并诱导成脂、成骨分化验证其多向分化潜能。通过阴道内接种沙眼衣原体建立小鼠输卵管炎模型,感染后４周随机分成ｈＵＣ－ＭＳＣ移植组及对照组。ｈＵＣ－ＭＳＣ移植组小鼠阴道内接种人脐带间充质干细胞,对照组小鼠阴道内注射等体积ＰＢＳ。感染后８周,观察小鼠输卵管有无阻塞、积水等慢性输卵管炎表现,病理切片观察组织形态学改变。【结果】分离培养的人脐带间充质干细胞符合间充质干细胞的一般生物学特性。感染后８周,对照组小鼠均出现输卵管阻塞、积水等慢性输卵管炎表现,而ｈＵＣ－ＭＳＣ移植组仅２例出现输卵管阻塞及积水,对照组小鼠慢性输卵管炎的发生率明显高于ｈＵＣ－ＭＳＣ移植组,差异有统计学意义（Ｐ＜ ０．０１）。ｈＵＣ－ＭＳＣ移植组输卵管病理切片显示,输卵管周围炎症细胞浸润较少。【结论】 ｈＵＣ－ＭＳＣ移植可明显减少小鼠慢性输卵管炎的发生和减轻其炎症程度,有可能为输卵管性不孕的临床治疗提供新的途径。     

近端输卵管闭塞的病理形态及其超微结构探讨

目的探讨近端输卵管闭塞的病理形态和超微结构。方法采用回顾性方法对1985年1月-2004年12月间182例近端输卵管闭塞性不孕症患者进行分析，主要是闭塞的近端输卵管的病理形态改变，部分输卵管标本行透射电镜观察。结果导致输卵管近端闭塞的首位病因是输卵管非特异性慢性炎症，占67．02％，其次是输卯管管腔纤维闭塞和结节性输卯管炎，各占11．54％，再次为输卵管子宫内膜异位症，占6．60％，输卵管结核、输卵管异物结节以及未见明显病变者各占1．10％。透射电镜发现4例患者阻塞段输卵管切面为大量胶原纤维和少量的纤维细胞，排列较为紊乱，未见上皮和管腔；有1例仍可见输卵管上皮，但纤毛互相粘连填塞管腔，致使管腔变窄甚至闭锁，部分细胞纤毛出现退化或脱落，纤毛的横切面9＋2微管系统结构欠清晰，胞质内线粒体肿胀及内质网扩张，胞质内可见空泡。而邻近阻塞部位输卵管（通畅段）：电镜下上皮细胞主要由单层柱状分泌细胞和纤毛细胞构成，纤毛细胞顶端的纤毛排列比较规整，未见明显退化和脱落的现象。结论闭塞的近端输卵管呈多种病理类型改变，其主要病因是输卯管非特异性慢性炎症，其次为输卵管管腔纤维闭塞和结节性输卵管炎。感染及人工流产的增加可能是导致输卵管性不孕发病率增加的因素。     

金黄色葡萄球菌致小鼠慢性输卵管炎性不孕模型制作

目的通过金黄色葡萄球菌直接感染小鼠输卵管,建立炎症致不孕的动物模型。方法用1×109/mL的金黄色葡萄球菌接种小鼠,制作慢性输卵管炎症模型,观察输卵管病理炎性改变以及小鼠的受孕情况。结果造模术75 d后,模型组小鼠受孕率、输卵管通畅率显著低于对照组(P<0.001)。模型组肉眼观察输卵管有不同程度积水积脓、僵硬,输卵管与周围组织均有不同程度的粘连;病理学观察输卵管管腔被异物肉芽组织完全阻塞,全层均见大量慢性炎细胞浸润。结论输卵管内接种浓度1×109/mL的金黄色葡萄球菌可以成功建立小鼠输卵管炎性不孕模型。     

人胎儿喉黏膜上皮细胞的发育分化特点

【目的】研究中国人胎儿喉黏膜上皮细胞发育分化的特点。【方法】收集9—40周胎儿喉标本33例。应用连续切片HE染色、细胞角蛋白免疫组化染色、扫描电镜和透射电镜观察其黏膜上皮。【结果】9周胎喉黏膜由1—2层低柱状细胞组成，仅表层细胞表达微弱的角蛋白，13周后出现多种类型的上皮细胞．上皮全层均表达细胞角蛋白；会厌舌面、声带被覆鳞状上皮，会厌喉面、室带、喉室及声门下区被覆假复层纤毛柱状上皮，其基底细胞和中间细胞的胞浆内含有丰富的胞浆泡状系统、张力原纤维和桥粒：过渡上皮和纤毛上皮中均散在岛状鳞状上皮但出现时间不一致。【结论】人喉黏膜上皮细胞的分化发生于胎儿9-13周期间；纤毛上皮的基底细胞和中间细胞具有双向分化的潜能；过渡上皮和纤毛上皮中出现岛状鳞状上皮是生理现象，前者由复层立方上皮分化而来，后者由纤毛上皮分化而来。     

中药“附归参汤”修复混合菌所致小鼠输卵管炎性狭窄的病理改变

目的观察中药“附归参汤”灌胃给药后是否可改善混合菌导致的小鼠输卵管炎性狭窄的病理改变。为临床应用“附归参汤”治疗输卵管炎所致的不孕症提供实验依据。方法昆明小鼠随机分为对照组（n=10）、模型组（n=10）、模型组＋生理盐水处理组（n=10）、模型＋“附归参汤”处理组（n=20），输卵管炎性狭窄模型采用混合菌（溶血性链球菌、大肠埃希菌和金黄色葡萄球菌2：1：1）输卵管接种法制作，处理组分别胃饲生理盐水和“附归参汤”30天。应用组织学方法观察各组的病理学改变，评判各处理组病理学转归情况。结果在使用混合菌接种后，小鼠输卵管管壁结构发生改变，主要包括黏膜层水肿、上皮细胞顶端纤毛变短或消失、固有层炎性细胞浸润、毛细血管充血、管腔狭窄甚至闭塞。“附归参汤”长期给药后明显使上述病理改变向正常组织转归。结论中药“附归参汤”能够修复混合菌导致的小鼠输卵管炎性狭窄的病理改变，为临床应用该药治疗输卵管炎所致的不孕症提供了实验依据。     

中药骨脂公英汤修复混合菌所致小鼠输卵管炎性狭窄的实验研究

目的 观察中药骨脂公英汤灌胃给药后对混合菌导致的小鼠输卵管炎性狭窄的影响,为临床应用骨脂公英汤治疗输卵管炎性所致的不孕症提供实验依据.方法 将昆明小鼠随机分为对照组(n=10)、模型组(n=10)、模型+生理盐水处理组(n=10)、模型+骨脂公英汤处理组(n=20),输卵管炎性狭窄模型采用混合菌(溶血性链球菌、大肠埃希菌和金黄色葡萄球菌,2∶1∶1)输卵管接种法制作,处理组分别灌胃生理盐水和骨脂公英汤30天.应用组织学方法观察各组的病理学改变,评判各处理组病理学转归情况.结果在使用混合菌接种后,小鼠输卵管管壁结构发生改变,主要包括黏膜层水肿、上皮细胞顶端纤毛变短或消失、固有层炎性细胞浸润、毛细血管充血、管腔狭窄甚至闭塞.长期灌胃骨脂公英汤后明显使上述病理改变,向正常组织转归.结论中药骨脂公英汤能够修复混合菌导致的小鼠输卵管炎性狭窄的病理改变,为临床应用该药治疗输卵管炎性所致的不孕症提供了实验依据.     

沙眼衣原体所致家兔急性输卵管炎的病理变化

目的 :研究沙眼衣原体 (chlamydialtrachomatis,CT)感染后 ,输卵管粘膜上皮分泌细胞的结构及其分泌功能的改变。方法 :成年雌性家兔 ,单侧输卵管接种沙眼衣原体D型 ,于感染第 3d取材 ,中性福尔马林固定 ,常规石蜡包埋切片后 ,行HE、过碘酸 雪夫氏反应、标准阿利新蓝染色。结果 :输卵管受损部位主要局限于粘膜层 ,并可见以单个核细胞为主的炎性细胞浸润。PAS反应和标准阿利新蓝染色提示 ,沙眼衣原体的感染可导致分泌细胞内中性粘蛋白减少 ,粘膜上皮细胞游离面的酸性粘蛋白表达增加。结论 :外来微生物入侵时 ,由于机体的防御反应 ,粘膜上皮粘蛋白分泌增加 ,随着损伤的加重可能导致其粘蛋白合成障碍。无论是上皮受炎症刺激后粘蛋白过度分泌 ,还是受损严重后导致分泌减少 ,都可能影响输卵管上皮细胞与微生物或受精卵表面粘附分子的结合 ,从而使发生反复感染和宫外孕、输卵管性不孕的可能性增加     

慢性鼻-鼻窦炎上颌窦口黏膜的病理形态学研究

目的 探讨鼻窦炎发生的组织病理学基础.方法 选取接受鼻内镜鼻窦手术的慢性鼻-鼻窦炎患者40例作为病例组,选取筛窦骨瘤切除术患者10例作为对照组.术中取所选患者上颌窦口黏膜,经常规固定、包埋、切片后,进行HE染色,病理形态学观察.结果 对照组黏膜上皮以假复层纤毛柱状细胞为主,黏膜表面平整,杯状细胞数量少,基底膜无增厚,间质无水肿,黏膜固有层炎症细胞极少,腺体及其导管亦未见增生扩张.病例组患者黏膜上皮部分脱落,纤毛细胞明显减少,杯状细胞增多,基底膜部分增厚,上皮下腺体显著增生,处于高分泌状态,间质水肿,有程度不等的炎症细胞浸润,纤维组织增生.2组比较差异有统计学意义(P<0.05,P<0.01).结论 慢性鼻-鼻窦炎患者的上颌窦口黏膜与对照组(正常)窦口黏膜病理形态学差异显著,这些病理改变使得正常的黏液纤毛传输系统发生功能障碍,是导致慢性鼻-鼻窦炎发生的组织病理学基础.     

沙眼衣原体T细胞表位融合蛋白对小鼠生殖道沙眼衣原体感染的保护作用

目的：评价抗沙眼衣原体(Ct）感染的T细胞表位融合蛋白疫苗（H-ctm1）对小鼠生殖道感染的保护作用。方法：6～8周龄雌性C57BL/6小鼠分为3组：H-ctm1、热灭活Ct（HK-EBs）和磷酸盐缓冲液（PBS）免疫组（每组28只，其中9只用于衣原体感染包涵体数量的检测，10只用于组织病理学观察，9只用于输卵管积水情况分析）。3组分别用H-ctm1、HK-EBs和PBS免疫。通过阴道接种Ct感染小鼠，建立Ct感染小鼠生殖道的动物模型。接种前7 d皮下注射黄体酮以增加小鼠对Ct感染的敏感性。并通过该动物模型比较3组小鼠阴道分泌物中的Ct数量、阴道组织炎症病理积分及输卵管积水情况，评价H-ctm1抗沙眼衣原体感染的能力。结果：在阴道接种Ct后第3和6天，H-ctm1和HK-EBs两免疫组小鼠阴道分泌物中Ct数量比较差异均无显著性，但两组均明显少于PBS免疫组（P＜0.01）；在接种Ct后第9和18天，H-ctm1组小鼠阴道分泌物中Ct数量明显少于HK-EBs组（P＜0.01或P＜0.05）。在接种Ct后第6天，H-ctm1和HK-EBs组的炎症积分均明显低于PBS组（P＜0.01或P＜0.05）；在感染Ct后第12天， H-ctm1组的炎症积分明显低于HK-EBs组和PBS组（P＜0.05或P＜0.01）。在感染Ct后第40天，H-ctm1 和HK-EB_S组小鼠均未发生输卵管积水，而PBS组9只小鼠均发生单侧或双侧输卵管积水。结论：注射H-ctm1诱导小鼠产生较好的抗Ct感染的保护性免疫，且H-ctm1的免疫原性优于Ct灭活疫苗。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.