结节型淋巴细胞为主型霍奇金病临床病理分析

目的探讨结节型淋巴细胞为主型霍奇金病临床病理特征，方法结节型淋巴细胞为主型霍奇余病淋巴结石蜡包埋组织11例，冰冻组织1例。除HE切片外，还用抗CD3，CD19，CD20，CD30，CD45RB;及κ、λ中克隆抗体进行ABC法免疫组织化学标记，1例冰冻组织采用从组织切片上提取单个细胞行聚合酶链反应（PCR）。结果肿瘤组织以结节状排列的小淋巴细胞和组织细胞为背景，其间散在分布L＆H细胞。L＆H细胞表达CD19（10例），CD20（12例），CD45RB（12例）及κ轻链（11例），1例冰冻组织的单个L＆H细胞出现lgH和Vκ4家庭基因的重排。8例患者随访期超过5年以上。结论结节型淋巴细胞为主型霍奇金病临床过程非常缓慢，预后良好，其实质是一种特殊的B细胞肿瘤。     

CD 146标记的干细胞在子宫腺肌病中的表达

目的：：以CD146作为干细胞的标记物,检测 CD146在子宫腺肌病异位内膜、在位内膜及正常子宫内膜的表达,探讨CD146标记的干细胞与雌激素受体(ER)在子宫腺肌病发生过程中可能的作用。方法：采用SP免疫组化方法研究CD146和ER在腺肌病患者异位及在位内膜、正常子宫内膜中的表达情况。结果：CD146标记的干细胞在子宫腺肌病异位内膜、在位内膜、正常子宫内膜中的表达率分别为30.6%、63.9%、47.2%,差异有统计学意义(P<0.05);CD146标记的干细胞与表达 ER 的间质细胞在正常子宫内膜和子宫腺肌病在位内膜两者呈正相关性,在子宫腺肌病异位内膜两者呈负相关性。结论：CD146标记的干细胞可能参与了子宫腺肌病的发生。     

新型胃肠道间质瘤标记物DOG1的应用与探讨

目的 探讨新型胃肠道间质瘤（GIST）标记物DOG1的敏感性和特异性。方法 收集50例胃肠道间质瘤的完整临床资料及病理资料。复读切片,行免疫组化CD117、PDGFRA、DOG1标记,进行比较。另收集20例非GIST而CD117阳性的病例行DOG1标记。结果 在不同危险程度分级,CD117、PDGFRA阴性、弱阳性、阳性的病例,DOG1均呈较强的阳性表达。另20例非GIST而CD117阳性病例,DOG1则多为阴性或弱阳性。结论 DOG1是敏感、特异的胃肠道间质瘤标记物。DOG1与CD117、PDGFRA的联合使用进一步完善了诊断依据,不论对明确诊断或术后个性化靶向治疗,都有着非常重要的意义。     

CD105和MMP-2在子宫腺肌病组织中的表达及意义

目的探讨以CD105标记的微血管密度（MVD）与MMP-2在子宫腺肌病中的表达与发病机制的关系。方法收集我院2005-01～2006-01间治疗的30例子宫腺肌病病例,采用免疫组织化学染色检测子宫腺肌病在位组及异位组子宫内膜CD105、MMP-2的表达,并运用图像分析仪检测CD105标记的MVD。结果以CD105标记的MVD异位组为24.19±5.30,在位组为17.89±4.53,异位组子宫内膜中表达显著高于在位组子宫内膜（P〈0.05）,在位组子宫内膜分泌期MVD18.09±3.60、增生期17.69±5.57,无显著差异（P〉0.05）;MMP-2在子宫腺肌病异位组内膜的阳性表达率76.67%（23/30）,在位组阳性表达率为46.67%（14/30）,异位组内膜的表达水平显著高于在位组子宫内膜（P〈0.05）,在位组子宫内膜分泌期MMP-2的阳性表达率显著高于增生期（P〈0.05）。经过spearman相关性分析,MMP-2阳性率的表达与MVD呈显著正相关关系（r=0.489,P〈0.01）。结论CD105和MMP-2的过度表达与子宫腺肌病新生血管的生成有关,在子宫腺肌病发病过程中发挥重要作用,是子宫腺肌病具有侵袭性生长的原因之一。     

炎症性肠病药物治疗现状与进展

炎症性肠病（inflammatory bowel disease，IBD）是一种病因尚不明确的慢性非特异性肠道炎性病变，包括溃疡性结肠炎（ulcerative colitis，UC）和克罗恩病（crohn’s disease，CD）。在国外，特别是欧洲、北美IBD发病率较高。在我国，IBD的发病也有上升趋势，并已成为慢性腹泻的主要病因之一。近年来医学界对其病因、发病机理及治疗的研究取得了较大进展，目前对IBD的治疗，着眼于控制炎症和调节免疫紊乱，以有效控制疾病发作。     

膜联蛋白A2在炎症性肠病肠粘膜中的表达及临床意义

摘要：目的探讨膜联蛋白A2（ANXA2）在炎症性肠病（IBD）肠粘膜组织中的表达及临床意义。方法免疫组织化学、荧光定量
PCR方法检测ANXA2在54例溃疡性结肠炎（UC）、37例克罗恩病（CD）及15例正常肠粘膜组织中的表达,并分析其表达与IBD
临床、病理及内镜参数间的关系。结果ANXA2在UC的阳性表达显著高于CD及正常对照组（P<0.05）,且UC中临床表现严
重、内镜分级高的患者较临床表现轻、内镜分级低者表达显著升高（P<0.05）。ANXA2在CD的表达较正常对照组低（P<0.05）,
其表达与CD的临床病理参数无相关性（P>0.05）。与正常对照及CD相比较,ANXA2mRNA表达量在UC中明显升高（P<
0.05）。结论ANXA2可作为IBD的诊断与鉴别诊断指标,ANXA2表达在UC发生发展中可能起着重要作用,有望作为其早期
诊断及靶向治疗的分子标记。
     

种痘样水疱病样T细胞淋巴瘤1例及文献复习

目的　总结种痘样水疱病样T细胞淋巴瘤的临床表现、病理特点及诊断要点,提高临床工作者对该疾病的系统认识。　方法　对本院收治的1例种痘样水疱病样T细胞淋巴瘤患儿的临床表现、辅助检查、诊疗过程进行分析,并复习相关文献。　结果　该患儿在整个发病过程中主要表现为皮疹、发热、肝脾肿大、肝损害。皮疹呈多形性,表现为水肿性红斑、水疱、结痂、坏死及凹陷瘢痕,冬轻夏重,主要累及面部和四肢,头皮及躯干也可累及。EB（Epstein-Barr）病毒IgM抗体阴性,淋巴细胞比率明显升高。组织病理示皮肤真皮下脂肪小叶内见多量异型淋巴细胞弥漫性浸润,有血管累及血管炎表现,免疫组化：CD43（++）,CD45RO（++）,CD3（+）,CD4（+）,CD5（+）,CD8（+）,CD56（+）,Ki-67（+50～70%）,CD20（-）,CD30（-）,CD68（-）,CD79α（-）,PAX-5（-）,TdT（-）。结合患者的临床特点、皮损表现、实验室检查、病理及免疫组化结果,该疾病为种痘样水疱病样T细胞淋巴瘤可基本明确。　结论　种痘样水疱病样T细胞淋巴瘤的早期皮损表现类似于种痘样水疱病,然而后期常出现发热及合并其他脏器损害,确诊主要靠多次病损部位组织病理活检及免疫组化。该病预后较差。     

炎症性肠病患者中-137（G／C）IL-18启动子的多态性

目的：有明确证据提示遗传因素对炎症性肠病（IBD）易患性的影响。最近，IL-18启动子的多态性被认为是炎症性疾病的危险因素，如脓毒血症、哮喘、成人发作的Still病。该研究目的是确定-137（G／C）IL-18启动子多态性是否与IBD的易患性相关。材料与方法：选取470例克罗恩病（CD）患、235例溃疡性结肠炎（UC）患和347例对照进行相关性研究。并进一步对470例CD患、233例UC患进行分离分析。应用TaqMan MGB双等位基因区分系统确定基因型。结果：与对照相比，CD和UC患的基因型频率均无显性差异（分别为P=0．089，P=0．078）。但是，Cochran—Armitage趋势检验说明，根据病例一对照研究，随着G等位基因型数量增多，CD和UC也呈上升的趋势（分别为P=0．030；P=0．028）。对比之下，家系传递不平衡检验（TDT）显示在470例CD患和233例UC患中，G等位基因型与CD和UC无关（分别为P=0．53，P=0．79）。     

胃克罗恩病伴胰腺组织异位的影像学及病理2例

罗恩病（Crohn＇s Disease,CD）是炎症性肠病（inflammatory bowel disease,BD）的一种亚型,病因尚未明确,理论上从口腔到肛门均可发病,常见于回肠末端和回盲部.克罗恩病发生在胃罕见,常常误诊为胃癌或淋巴瘤.影像学检查可为胃CD的诊断提供重要信息,国内尚未见这方面的报道.本组分析了2007年7月及2009年2月本院收治的2例胃CD伴灶性胰腺组织异位患者的影像学表现,二者均经手术治疗及病理检查证实.     

炎症性肠病相关性大肠癌的发病机制与监测

炎症性肠病（Inflammatory bowel disease,IBD）包括克罗恩病（Crohn’s disease,CD）和溃疡性结肠炎（ulcerativecolitis,UC）,目前病因不明,临床经过反复,迁延数年至数十年,治愈十分困难,有很高的癌变风险,且癌变的分子机制至今仍不明确。对IBD患者的随访监测,有利于及早发现癌性病变,及时治疗。本文对IBD相关性结直肠癌的风险因素、分子机制的研究进展及监测管理进行综述。     

Tumour necrosis factor inhibitors

The cytokine, tumour necrosis factor-alpha (TNF-alpha) plays a key role in the pathogenesis of many chronic inflammatory and rheumatic diseases, in particular, Crohn's disease, rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Controlled trials have shown that the TNF inhibitors (etanercept, infliximab and adalimumab) significantly reduce symptoms and signs, improve function and quality of life, and reduce radiologically evident damage in patients with rheumatoid diseases. For reasons that are not entirely clear, etanercept does not work in Crohn's disease. Injection site and intravenous reactions and increased risk of infection (in particular, reactivation of tuberculosis) are associated with the use of these agents. Increased risk of lymphoproliferative disease, the development of lupus-like syndromes and demyelination, including optic neuritis and reactivation of multiple sclerosis, are under evaluation in long-term follow-up studies. The TNF inhibitors are expensive (about $18 000 per year), and in some patients need to be given continuously to maintain benefit, even in the presence of other immunosuppressive therapy.     

Crohn's colitis and idiopathic thrombocytopenic purpura

A 17 year old girl with active Crohn's colitis developed idiopathic thrombocytopenic purpura that was managed with intravenous immune globulins and cyclosporin A. The possible association between Crohn's disease and immune thrombocytopenia is explored.     

Immune-mediated inflammatory diseases (IMIDs) and biologic therapy: a medical revolution

Targeted biologic therapies have revolutionised treatment of immune-mediated inflammatory diseases (IMIDs) due to their efficacy, speed of onset and tolerability. The discovery that clinically unrelated conditions, such as rheumatoid arthritis and Crohn's disease, share similar immune dysregulation has led to a shift in the management of IMIDs from one of organ-based symptom relief to mechanism-based treatment. The fact that anticytokine therapy has been effective in treating multiple orphan inflammatory conditions confirms the IMID paradigm. In this review we examine the biologic agents currently licensed for use in the US and Europe: infliximab, etanercept, adalimumab, rituximab, abatacept, anakinra, alefacept and efalizumab. We also discuss the rationale behind the management of IMIDs using rheumatoid arthritis, Crohn's disease, psoriasis and psoriatic arthritis as examples. For the medical profession, IMID represents a breakthrough in the way pathology is classified. In this burgeoning era of biologic therapy the prospect of complete disease remission is conceivable.     

A new hypothesis for the aetiology of Crohn's disease--evidence from lipid metabolism and intestinal tuberculosis

The stimulus for the immune response in Crohn's disease is unknown. In each of 19 cases of Crohn's disease evaluated by electron microscopy, epithelial cells of the ileum contained phagolysosomes with lamellar layers of lipid. These structures, now termed R or reactant bodies, are the proffered antigenic stimulus. They are proposed to be an amalgam of lipid (cholesterol esters, or phospholipids) and bacterial fragments (mycoplasma, mycobacteria or streptococci), which in combination are hypothesized to produce a powerful immunological response analogous to the adjuvant effect. For disease expression to occur, lipids and specific bacterial populations are needed in the bowel lumen. These factors may account for the success of elemental diets that are low in fat in the treatment of Crohn's disease and for the regional distribution of disease along the intestinal tract.     

The impact of periodontal infections on systemic diseases. An update for medical practitioners

Oral health status is an integral component of a general health and well-being of an individual. Knowledge about the link between periodontal disease and systemic diseases are growing rapidly. Increasing evidence is available from many investigators to indicate periodontitis as a risk factor for cardiovascular diseases, diabetes mellitus, low birth weight infants and pulmonary diseases. Both epidemiologists and researchers in oral microbiology have contributed significantly to the new paradigm of periodontal disease. Although additional studies are needed to determine the mechanisms by which such associations exist; available research clearly demonstrates that oral diseases and conditions are not only markers for underlying health problems, but also important determinants influencing the development and management of adverse chronic health conditions. Physicians and dentists should be aware of this link and provide treatment that will greatly benefit the patients. A review of the relationship between periodontal infections and its possible impact on systemic diseases is discussed.     

免疫学的发展与展望：基于中医与中国文化的探索

The immunologically mediated disease is a big family which affects many people in the world, since the cures are not yet available for most immune diseases, the patients face a lifetime of illness and treatment. Chinese medicine inspires us to develop new methods for the treatment of immune diseases. Previous researches of immune system have revealed that an immune network exists. The immune system is like a complex highway; if we travel on these highways, we must have a map to avoid travelling in the wrong direction. Drawing the map of immune network will provide new tools for us to look directly at the basis of the immune system.     

三七及单体对P糖蛋白抑制作用的研究进展

P-糖蛋白属于ABC跨膜转运蛋白超家族中的一员,是一种ATP依赖性的外向型转运泵,参与生物的各种生理功能以及多类药物的体内转运过程,同时也是产生临床多药耐药作用的主要原因。三七作为云南的特色中草药,在很多疾病的治疗与预防方面有着显著疗效,其副作用小、多靶点及多途径的综合调节作用,在逆转Mdr1和P- gp表达的研究中,具有一定的前景。综述近年来从蛋白质水平和基因水平上通过多种途径下调P-gp及Mdr1基因的表达,以及三七及其单体成分对P-gp及Mdr1基因下调机制的进展研究及展望。     

噬血细胞综合征病因及发病机制研究进展

噬血细胞综合征 (HPS)是一类由多种不同疾病引起的 ,以高细胞因子血症、噬血细胞大量增生为特征的疾病。HPS包括原发性 (遗传性 )和继发性 (反应性 )两种类型。部分遗传性HPS患者有穿孔素基因突变 ,可能还有其他遗传学异常。继发性HPS病因多样 ,可由感染、恶性病变或未知的潜在疾病激发。近期的研究结果提示 ,HPS的发病与细胞毒活性缺陷、免疫活性细胞凋亡减少密切相关。     

The etiology of Mycobacterium avium subspecies paratuberculosis in Crohn's disease

The etiology of Crohn's disease (CD) has drawn heated controversy in the literature. Compelling evidence in the literature has accumulated lately that could incriminate the Mycobacterium avium subspecies paratuberculosis (MAP), the well-known agent of John's disease in cattle. The evidence is isolation of the organism or its DNA and RNA, detection of the anti-MAP antibodies in Crohn's patients, increasing incidents of CD in areas close to the cattle pastures, and the possibility of treating the disease with the antibiotics. The group that favors the immune dysregulation theory considered this evidence circumstantial due to the variations in these reports. The treatment of CD with humanized anti-tumor necrosis factor-alpha antibodies is considered great endorsement to the immune dysregulation theory. The endless debate could jeopardize public health rather than bring a final solution. Reconciliation between the 2 theories appears inevitable in view of possible classification of this disease as a zoonotic.     

安宫牛黄丸临床应用研究进展简

目的：探讨安宫牛黄丸的临床应用,为今后安宫牛黄丸的临床应用的深入研究奠定一定的基础。方法：通过查阅近十年安宫牛黄丸的相关著作与文献,从安宫牛黄丸的主治功效探讨安宫牛黄丸的临床应用。结果：研究发现安宫牛黄丸可治多种疾病,如脑部疾病、儿科疾病、精神疾病、血液免疫疾病等,但由于安宫牛黄丸中朱砂和雄黄的毒性,使其不能作为一种长期使用的药物。结论：研究表明安宫牛黄丸作用广泛,可治多方面多种疾病,有利于安宫牛黄丸的进一步开发与应用。