胸腺瘤伴重症肌无力患者胸腺微环境研究

对10例胸腺瘤伴重症肌无力(MG)患者胸腺微环境行前瞻性对比观察。结果显示光镜下组织学分类均为皮质型胸腺瘤伴不同程度的浸润。超微结构改变以Ⅰ,Ⅱ型上皮细胞校增大、胞浆分泌颗粒增多为主。免疫组化 S-100标记阳性为髓质内散在的指突状细胞(IDC),皮、髓质上皮 CK 强阳性,髓质胸腺小体周围上皮EMA 阳性,珠心阴性,包膜下-血管旁上皮胸腺小体 CEA 强阳性。提示胸腺瘤本质是异质性上皮细胞性肿瘤。     

小鼠胸腺基质细胞的类型和分布

本文用特殊染色方法和酸性复红法对小鼠胸腺内各种基质细胞进行了鉴别,从染色特性及细胞形态,可区分出各型上皮网状细胞、保姆细胞、巨噬细胞、肥大细胞的?光镜下观察了小鼠胸腺内各种基质细胞的分布,并证实小鼠胸腺髓质内含有胸腺小体。本文就电镜所见髓质两种上皮细胞类型并结合PAS反应,对髓质内亮细胞的特性进行了讨论。     

大鼠胸腺增龄变化的形态学研究

目的:探讨胸腺组织结构的增龄性形态学改变,了解引起胸腺萎缩的可能机制。方法:大鼠胸腺切片制作、染色,在光镜、电镜下观察胸腺主要结构的增龄性变化,对胸腺皮、髓质的细胞密度之比的变化进行测试。结果:光镜观察显示,随着年龄增长,胸腺皮质变薄,胸腺细胞稀疏,皮、髓质分界不清;胸腺皮、髓质的细胞密度比例随增龄降低。而电镜下观察到胸腺细胞退化萎缩,出现了大量的脂肪、纤维、凋亡的胸腺细胞,线粒体肿胀,嵴减少,出现大小不等的空泡,核固缩。结论:随着鼠龄增大,胸腺细胞及上皮性网状细胞等线粒体结构的退化数目减少,胸腺萎缩退化。     

人胎胸腺的组织发生

本文在光镜和电镜下研究50例人胎的胸腺。8(1/2)周胎胸腺尚未分小叶,也不能分辨皮质和髓质。12周胸腺间充质隔分隔小叶,同时髓质内可见胸腺小体。14～16周小叶数量增多,皮质分化出内、外二区。外皮质色浅系T淋巴细胞繁殖区。17～20周胸腺的发育已较完善。胎期胸腺间充质隔及皮髓交界区发现一些非上皮网状细胞和大量嗜酸髓细胞。     

实验性糖尿病对大鼠胸腺巨噬细胞和交错突细胞的影响

目的 探讨糖尿病对大鼠胸腺巨噬细胞和交错突细胞的影响及其在胸腺退化中的作用。方法 采用四氧嘧啶型糖尿病动物模型，应用酶组织化学、免疫组织化学和透射电镜方法，对糖尿病大鼠胸腺巨噬细胞和交错突细胞进行定性和半定量分析及形态学观察。结果在糖尿病大鼠胸腺中，巨噬细胞呈ACP、NSE强阳性组化反应及呈Ly、AACT强阳性免疫反应，细胞数量明显增多，大量聚集于皮质和皮髓质交界区，皮质尤为明显。交错突细胞呈S-100蛋白强阳性免疫反应，细胞数量则明显减少，主要分布于髓质和皮髓质交界区。电镜观察皮质巨噬细胞胞质含有被吞噬的凋亡细胞或小体，而皮髓质交界区巨噬细胞胞质则含有囊泡和颗粒。结论 糖尿病大鼠胸腺巨噬细胞数量明显增多，酶活性明显增强，在酶活性、形态结构和功能上存在异质性变化。交错突细胞数量则明显减少。两者均在胸腺退化的过程中起重要作用。     

实验性糖尿病诱导大鼠胸腺细胞凋亡的电镜观察

目的：探讨糖尿病诱导大鼠胸腺细胞凋亡的形态学变化,从而了解其引起胸腺萎缩的可能机制。方法：采用四氧嘧啶诱导复制的大鼠实验性糖尿病动物模型,在电镜下观察了糖尿病大鼠胸腺细胞凋亡的形态学变化。结果：在糖尿病大鼠胸腺皮质中发现了大量凋亡的胸腺细胞,主要表现为细胞皱缩变小,表面形成许多皱突,似发泡状,细胞质浓缩,电子密度增强,线粒体肿胀,嵴减少与紊乱,空泡化细胞核染色质固缩边聚,核变成花瓣状,黑环状与黑洞状,核与细胞发生裂解形成凋亡小体,被巨噬细胞和上皮细胞吞噬清除。此外,在凋亡细胞与小体的周围还聚着许多浆细胞,结论：实验性糖尿病可诱导大鼠脑腺细胞发生大量凋亡,这可能是导致胸腺细胞大量减少及胸腺萎缩的主要机制之一。     

胸腺细胞渐进性凋亡对大鼠脾脏淋巴细胞增殖功能的影响

目的:研究胸腺内胸腺细胞电镜结构的渐进性、增龄性凋亡等形态学改变,探讨引起脾脏淋巴细胞增殖功能变化的可能机制.方法:光镜、电镜下观察胸腺主要结构的增龄性变化,测试凋亡细胞数.脾脏淋巴细胞增殖实验,脾脏组织流式细胞仪检测细胞凋亡率.并统计学分析.结果:在光镜下观察显示随着年龄增长,胸腺皮、髓质分界不清,胸腺细胞稀疏.电镜下胸腺细胞退化萎缩,出现大量凋亡小体.胸腺细胞凋亡百分率与成年年龄正相关(P<0.05),脾脏内淋巴细胞在进入老年后才出现凋亡.成年组脾脏淋巴细胞增殖活性就开始出现明显增强(P<0.05).结论:随着鼠龄增大,而胸腺比脾脏内淋巴细胞更易于凋亡,胸腺细胞凋亡直接或间接促进脾脏淋巴细胞增殖功能.     

八株小鼠胸腺基质细胞系的建立及鉴定

应用改良的长期培养法,建成8株小鼠胸腺基质细胞(MTSC)系,其中7株为胸腺上皮样细胞(MTEC)系(表达角蛋白桥粒及张力丝),1株为胸腺树突状细胞(MTDC)系(不表达角蛋白、桥粒及张力丝,但表达波形蛋白及S-100蛋白)。各株细胞生长稳定、倍增时间界于17.1～34.8小时之间。按特异MCAb鉴定,多数MTEC系来源于胸腺髓质及皮-髓质的上皮细胞。按染色体数目定,其中2株近似正常上皮细胞,其余6株均为转化细胞,但电镜下无可见病毒颗粒。     

大鼠胸腺神经分布的初步研究

采用改良的银染色法观察了大鼠胸腺神经纤维的分布。结果表明：胸腺皮质和髓质神经纤维的分布存在着明显的差异，即髓质神经纤维可形成复杂的网络状结构。认为这可能是与胸腺细胞发育的局部微环境不同有关，其微环境的变化可能受神经的支配。此处，神经纤维的分支末梢终止于胸腺细胞附近，有的分支与肥大细胞紧密相依，还有的分支伴随小血管走行，形成血管周围神经丛。由此认为，神经纤维对胸腺细胞、肥大细胞和血管均起调节作用。     

人胸腺上皮细胞及核超微形态定量分析

应用彩色图像分析系统,从超微结构水平对国人胸腺上皮细胞及核进行形态学定量分析,由二维平面及三维结构获取25个特征参数,进一步从形态功能联系上证实胸腺上皮细胞可分四种类型:Ⅰ型为包膜下-血管旁上皮细胞,分布于胸腺包膜下及皮髓交界区血管周围。Ⅱ型“淡染”上皮主要分布于外皮质和整个胸腺实质。Ⅲ型“深染”上皮和Ⅳ型“大髓质”上皮分布于髓质。提示异质性上皮细胞群在胸腺内构成不同局部微环境。本研究为深入认识胸腺病理状态与异质性上皮细胞的关系提供了客观形态定量指标。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.