上皮细胞转分化、抗原提呈及区室化免疫调节

上皮细胞生物学及其与疾病发生发展的关系,近年已成为细胞生物学、免疫学等多学科交叉研究的切入点。转分化作为细胞分化发育的基本生物学现象,存在于机体诸多生理病理过程。上皮细胞是机体的重要防御屏障,依据其特殊的解剖位置与复杂的生物学功能,病生理条件下可经历转分化获得新表型与新功能,亦能转变为专职抗原提呈细胞诱发特异性免疫应答,并在所处微环境中发挥区室化免疫调节作用,参与调控局部乃至全身的免疫反应。对其中相关机制的深入研究,可为临床感染性疾病、炎症性疾病、自身免疫病及肿瘤的发病机制与防治措施,提供新的思路和应对策略。     

血管瘤局部注射平阳霉素的治疗分析

本文报告了40例血管瘤患儿采用了瘤体局部注射平阳霉素,解决了不能手术摘除血管瘤的难题,局部注射平阳霉素是一较有效的治疗方法.     

血管瘤局部注射平阳霉素的治疗分析

本文报告了 4 0例血管瘤患儿采用了瘤体局部注射平阳霉素 ,解决了不能手术摘除血管瘤的难题 ,局部注射平阳霉素是一较有效的治疗方法 .     

类固醇皮质激素局部注射治疗婴幼儿血管瘤疗效观察

血管瘤在婴幼儿中较常见。我院自1987年1月～1992年1月间应用类固醇皮质激素混合液局部注射治疗门诊41例婴幼儿血管瘤;有效率87.8%,治愈率为51.2%。注射后血管瘤消退快,无复发、感染及药物副作用。     

平阳霉素与鱼肝油酸钠注射治疗颌面部血管瘤的疗效比较

目的比较平阳霉素与鱼肝油酸钠对颌面部血管瘤的治疗效果。方法观察了67例口腔颌面部血管瘤患者,34例小剂量平阳霉素局部注射治疗,33例用5%鱼肝油酸钠局部注射治疗;结果平阳霉素有效率97.06%,鱼肝油酸钠有效率90.90%,不良反应发生率平阳霉素11.76%,鱼肝油酸钠90.90%,前者主要为全身反应;后者主要为局部反应。结论平阳霉素治疗颌面部血管瘤疗效好,疗程短,是一种简便、安全、有效的方法。平阳霉素疗效优于鱼肝油酸钠。     

平阳霉素联合地塞米松治疗口腔颌面部海绵状血管瘤的探讨

口腔颌面部海绵状血管瘤为静脉型血管畸形,多于出生时发现.治疗的方法有外科切除、放射治疗、低温治疗、激光治疗、硬化剂注射等.我科自2005年1月--2007年1月,采用平阳霉素联合地塞米松治疗海绵状血管瘤30例,效果良好,现分析报告如下:     

子宫血管缝扎在腹腔镜子宫切除术中的临床疗效研究

目的：探讨腹腔镜下全子宫切除(total laparoscopic hysterectomy,TLH)术中子宫血管缝扎的疗效、安全性以及临床应用价值。方法将78例行TLH患者随机分成子宫血管缝扎组(n=26)、子宫动脉游离结扎组(n=26)和子宫动脉电凝组(n=26),比较三组术中手术时间、出血量以及术后病率等情况。结果78例均在腹腔镜下完成手术,术后无1例并发症发生。子宫血管缝扎组在手术时间、出血量和术后病率等方面与子宫动脉游离结扎组相比,差异无统计学意义(>0.05);子宫血管缝扎组在手术时间和术后病率等方面与子宫动脉电凝组相比差异亦无统计学意义(>0.05),但出血量较后者明显减少,差异有统计学意义(<0.05)。结论子宫血管缝扎应用于TLH,有效阻断了子宫血供,减少了术中出血量,其疗效确切可靠,在TLH中具有较高的临床应用价值,可作为一种可行的手术方式在基层医院推广应用。     

溃疡周围缝扎技术在下肢静脉曲张并皮肤溃疡治疗中的应用

目的:探讨下肢静脉曲张并发慢性溃疡的有效治疗方法.方法:自2010年5月至2011年4月,对18例下肢静脉曲张并发慢性溃疡患者采取常规大隐静脉高位结扎术+抽剥术+溃疡周围缝扎术治疗.其中2例深静脉瓣膜功能不全及返流,2例为左髂静脉受压综合征,2例为布加综合征(下腔静脉型),均先行予以手术处理.结果:手术均顺利,所有溃疡均在术后11~35d内愈合.术后随访2~6个月,溃疡无复发,浅静脉曲张及皮肤瘙痒消失.结论:大隐静脉高位结扎术+抽剥术+溃疡周围缝扎术治疗下肢静脉曲张并发皮肤溃疡,疗效肯定,简单易行,易于推广,有较好的临床实用价值.     

探讨应用子宫浆肌层缝扎加双侧子宫动脉上行支结扎对产后出血的治疗效果

目的：探讨应用子宫浆肌层缝扎加双侧子宫动脉上行支结扎对产后出血的治疗效果。方法选取我院收治的68例剖宫产术中子宫腔内出血的患者,随机分为观察组和对照组,每组34例。对照组患者给予子宫按摩,并使用催产素干预治疗,观察组在对照组基础上行子宫浆肌层缝扎加双侧子宫动脉上行支结扎术。比较两组患者产后出血率、出血量、血性恶露消失时间差异。结果观察组出现产后出血3例,产后出血率为8.8%,显著低于对照组的20.6%(7/34)(<0.05)。观察组产后出血量和血性恶露消失时间分别为(624.7±41.3)mL、(5.1±1.3)d,均显著低于对照组(<0.05)。结论子宫浆肌层缝扎加双侧子宫动脉上行支结扎术对产后出血疗效显著,操作简单,能有效降低出血量,缩短血性恶露消失时间,值得临床推广使用。     

平阳霉素注射合并手术治疗小儿头颈部海绵状血管瘤

目的总结局部注射平阳霉素结合手术切除治疗小儿头颈部海绵状血管瘤的临床效果。方法本组68例小儿头颈部海绵状血管瘤,确诊后行手术切除大部分瘤体,应用平阳霉素作残余病变瘤体内注射1-3次。术前将配好的平阳霉素分点注射进肿瘤组织内,注射时根据患者的年龄,血管瘤的范围决定注射剂量,待注射瘤体面积减小后行手术切除。结果68例中,治愈57例（83．8％）,基本治愈8例（11．8%）,无效3例（4．496）,有效率占病例总数的95．6％。未见发生药物过敏或中毒现象。结论平阳霉素局部注射可以配合手术用于不能全部切除的头颈部海绵状血管瘤的治疗。     

Cerebral ventricular injections of CCK-octapeptide and feed intake: The importance of continuous injection

CCK-octapeptide (CCK-OP) is a potent suppressor of feed intake when administered as a continuous injection into the lateral cerebral ventricles of sheep. We compared the effect on feeding of CCK-OP given as bolus and continuous injections to assess the importance of the continuous injection method. A total dose of 30.6 pmoles of CCK-OP given as one, four, or eight bolus injections had no effect on feed intake; whereas the same total dose given as a 45 min continuous injection reduced feed intake 80 percent. We also compared the effects of beginning the continuous injection immediately before, 5 min before, and 15 min before the sheep began a meal. Feed intakes were significantly lower when CCK-OP injection was begun 15 min before the meal, than when injection was begun immediately before or 5 min before the meal, suggesting that the site of action of CCK-OP for its effect on feeding is not the immediate vicinity of the lateral ventricles. The complete lack of effect of bolus injections of CCK-OP is unexpected; the explanation probably awaits further information on kinetics of CSF formation and CCK-OP degradation, site of action of CCK-OP, and the role of the CSF in transport of the peptide.     

Twelve-year survey of fatal reactions to allergen injections and skin testing: 1990-2001

BACKGROUND: Fatal reactions associated with skin testing and injection immunotherapy have not been surveyed in North America since 1989. OBJECTIVE: A survey of fatal reactions related to skin testing and immunotherapy and of near-fatal immunotherapy reactions that transpired from 1990 through 2001 was conducted among member practices of the American Academy of Allergy, Asthma and Immunology. METHODS: A short survey of fatal reactions was sent to all American Academy of Allergy, Asthma and Immunology physicians, and an 87-item follow-up detailed questionnaire was sent to those reporting fatal reactions. RESULTS: Of 2404 members, 646 (25%) responded to the short survey. There were 20 fatal immunotherapy reactions that were directly reported and 21 indirectly reported cases by local physicians. There were 273 (42% of the responding sample) reports of near-fatal reactions. It was estimated that fatal reactions occurred every 1 per 2.5 million injections, with an average of 3.4 deaths per year. One fatality was confirmed after skin prick testing with multiple food allergens. Of 17 fatal deaths described in long questionnaires, 15 were in asthmatic patients, the majority of whose symptoms were not optimally controlled. Three reactions occurred in a medically unsupervised setting. None were receiving beta-blockers, and one was taking an angiotensin-converting enzyme inhibitor. Most fatal reactions (59%) occurred with maintenance allergen doses. The onset of 3 reactions began more than 30 minutes after injections, with a significant delay in starting epinephrine. Epinephrine was not administered in 3 other fatal reactors. CONCLUSIONS: Fatal reactions to immunotherapy injections occurred at similar rates reported in previous surveys. Certain clinical practices have improved (ie, exclusion of beta-blockers), and dosing errors were infrequent. Fatal reactions to immunotherapy often occur in settings inappropriate for optimal treatment of anaphylaxis. Strict adherence to practice guidelines might prevent or minimize future fatal reactions.     

Tissue engineered bulking agent with adipose-derived stem cells and silk fibroin microspheres for the treatment of intrinsic urethral sphincter deficiency

In this study we developed a tissue engineered bulking agent that consisted of adipose-derived stem cells (ADSCs) and silk fibroin microspheres to treat stress urinary incontinence caused by severe intrinsic sphincter deficiency (ISD). ISD models were established by completely transection of the bilateral pudendal nerve (PNT) and confirmed by the decreased leak-point pressure (LPP) and increased lumen area of urethra. Injection of silk fibroin microspheres could recover LPP and lumen area at 4 weeks but its efficacy disappears at 8, 12 weeks. Moreover, it was exciting to find that tissue engineered bulking agent brought long-term efficacy (at 4, 8, 12 weeks post-injection) on the recovery of LPP and lumen area. Concomitantly with the function, tissue engineered bulking agent treated group also improved the urethral sphincter structure as exhibited by better tissue regeneration. The findings showed that silk fibroin microspheres alone could work effectively in short-term, while tissue engineered bulking agent that combined silk fibroin microspheres with ADSCs exhibited promising long-term efficacy. This study developed a new strategy of tissue engineered bulking agent for future ISD therapy.     

黄芪注射液加地高辛治疗慢性充血性心功能不全疗效观察

目的:观察黄芪注射液加地高辛治疗慢性充血性心功能不全的疗效。方法:慢性充血性心功能不全病例57例,随机分为治疗组32例,年龄40～76岁,平均55.2±13.6岁。男性20例,女性12例;观察组25例,男性14例,女性11例,年龄42～74岁,平均53.6±5岁。心功能分级按美国纽约心脏病学会(NYHA)分级标准分为IV级。治疗组IV15例,Ⅲ级17例;对照组IV级10例,Ⅲ级15例。病因:治疗组冠心病7例、扩张性心肌病5例、高心病8例、风心病7例、肺心病5例;对照组:冠心病5例、扩张性心肌病3例、高心病6例、风心病7例、肺心病4例。两组之间病因及病情严重程度无显著差异。治疗组用黄芪注射液50ml加入200ml葡萄糖注射液中静脉点滴,地高辛0.25mg/d口服,7天后改为0.125mg/d,同时用卡托普利、利尿剂14天为一疗程。观察组地高辛卡托普利、利尿剂用法同治疗组。结果:治疗组显效5例为15.6%,有效17例为53.1%,有效率为68.7%。无效10例31.3%。观察组显效2例为8%,有效12例为48%,有效率为56%,无效11例为44%。两组比较有显著差异。结论:黄芪注射液加地高辛治疗慢性充血性心功能不全有明显的作用。     

腰大池持续外引流合并鞘内注射尿激酶治疗脑血管痉挛的临床效果

目的探讨鞘内局部注射尿激酶治疗蛛网膜下腔出血后脑血管痉挛的疗效。方法将动脉瘤性蛛网膜下腔出血患者随机分为对照组和实验组,对照组采用常规综合治疗加静脉泵入尼莫地平治疗,实验组在对照组的基础上放置腰大池引流管并脑池内注射尿激酶治疗,通过观察病情变化评价两组的治疗疗效。结果实验组剧烈头痛、恶心呕吐、意识障碍及脑膜刺激征等主要症状及体征的缓解率明显高于对照组（P〈0.05）,实验组（5/26）脑血管痉挛发生率明显低于对照组（10/24,P〈0.05）。结论早期鞘内注射尿激酶并持续外引流防治脑血管痉挛的效果良好,且术后脑积水的并发症少。     

中晚期食管癌患者经艾迪注射液联合放化疗治疗的临床疗效研究

目的：研究分析中晚期食管癌患者经艾迪注射液联合放化疗治疗的临床疗效。方法：选取在我院治疗的中晚期食管癌患者92例(2013年9月到2015年9月)。将其动态随机化分2组,研究组和对照组各46例。对照组患者给予同步放化疗治疗,研究组患者在同步放化疗的基础上联合使用艾迪注射液治疗,对比两组患者的临床疗效、生活质量与免疫变化情况。结果：研究组患者的总缓解率为80.43%、提高稳定率达到了76.09%,治疗后CD3+T细胞76.16%±6.61%、CD4+T细胞35.71%±4.33%、CD8+T细胞36.27%±9.13%,与对照组比较均有明显优势,P<0.05。结论：采用艾迪注射液与放化疗结合的方式对中晚期食管癌患者进行治疗的效果显著,可以广泛应用于临床上。     

The relevance of biomaterials to the prevention and treatment of osteoporosis

Osteoporosis is a worldwide disease with a very high prevalence in humans older than 50. The main clinical consequences are bone fractures, which often lead to patient disability or even death. A number of commercial biomaterials are currently used to treat osteoporotic bone fractures, but most of these have not been specifically designed for that purpose. Many drug- or cell-loaded biomaterials have been proposed in research laboratories, but very few have received approval for commercial use. In order to analyze this scenario and propose alternatives to overcome it, the Spanish and European Network of Excellence for the Prevention and Treatment of Osteoporotic Fractures, “Ageing”, was created. This network integrates three communities, e.g. clinicians, materials scientists and industrial advisors, tackling the same problem from three different points of view. Keeping in mind the premise “living longer, living better”, this commentary is the result of the thoughts, proposals and conclusions obtained after one year working in the framework of this network.     

The attitudes to CPAP treatment inventory: development and initial validation of a new tool for measuring attitudes to CPAP treatment

Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but low adherence rates are common. The aim was to develop the attitudes to CPAP treatment inventory (ACTI), and to investigate the validity and reliability of the instrument among patients with OSAS. ACTI was developed on the basis of: (i) in‐depth interviews with 23 patients; (ii) examination of the scientific literature; and (iii) consensus agreement of a multi‐professional expert panel. This yielded five different types of attitudes to CPAP treatment. A prospective longitudinal design was used. Two‐hundred and eighty‐nine patients with OSAS were recruited at three different CPAP centres. Data were collected with ACTI and obtained from medical records. The homogeneity and internal consistency reliability were satisfactorily reflected by the item‐total correlations (0.59–0.81) and Cronbach’s alpha (0.89), respectively. Construct validity was confirmed with factor analysis (principal component analysis with orthogonal rotation; PCF). The PCF based on baseline data resulted in a one single‐factor solution explaining 69% of the total variance. A confirmatory factor analysis was performed 2 weeks after CPAP initiation, resulting in the same factor solution. No indication of uniform differential item functioning was found. The predictive validity was tested with receiver operating characteristic analyses, and a cut‐off of 10 on the ACTI gave a sensitivity of 93% and a specificity of 44% for CPAP termination within 6 months. The satisfactory measurement properties of this new pragmatic instrument are promising and indicate that ACTI can be useful in clinical practice to reliably measure attitudes to CPAP treatment.     

鸟氨酸氨甲酰转移酶缺陷所致高氨血症的诊断与分析

目的：探讨ＯＴＣ缺陷的临床、生化与遗传特点及诊断治疗方法。方法：ＯＴＣ缺陷患儿血氨基酸、有机酸分析、临床经过及家系调查。结果：先证者为第四胎，４ 个月出现惊厥及进行性智力损害，１ 岁５ 个月时感冒出现呕吐、进行性意识障碍。生化检查显示：血氨，尿乳清酸异常增高－ 肌酐，血、尿瓜氨酸浓度为０，符合ＯＴＣ缺陷，２ 日后死亡。３ 例同胞均为男性，经过类似，分别于生后１２天、７ 天、１ 岁７ 个月时死亡。其父母表型正常。结论：本家系４ 例患儿均为ＯＴＣ缺陷死于高氨血急性发作。血氨基酸、有机酸分析是确诊的关键。如能早期诊断，低蛋白饮食可有效地改善预后。     

The sensitivity of the rat corticosterone response to environmental manipulations and to chronic chlordiazepoxide treatment

Rats that were exposed for 20 mins to an unfamiliar room had significant increases in plasma corticosterone concentrations, that were greater if the room was brightly lit than if it was dimly lit. Chlordiazepoxide (5 mg/kg for 5 days) significantly reduced the corticosterone response to a novel room, but was without effect on the levels in rats left undisturbed in the animal house. When pairs of rats were placed for 10 mins in an unfamiliar test box there was an increase in plasma corticosterone that was greater when the box was brightly lit; chlordiazepoxide (5 mg/kg for 5 days) significantly reduced these corticosterone responses. In rats repeatedly exposed to the same apparatus there was significant, but not complete, habituation of the corticosterone response in both singly tested rats and in those tested in pairs; manipulation of light levels no longer had a significant effect on the corticosterone levels; and chlordiazepoxide did not block the corticosterone response in these habituated rats.