胸腺组织移植对变应性鼻炎患者外周血T淋巴细胞亚群的影响

对８０例变应性鼻炎患者行经培养的人胚胎胸腺组织块移植术，观察患者免疫功能的变化以及对该类病的疗效。先将胚胎胸腺组织块培养７～１０天，然后移植至患者的股前肌群。测定患者手术前后的Ｔ细胞亚群、血清抗原特异性ＩｇＥ水平。术后随访３年，总有效率占随访数的９２．４％，ＣＤ８阳性细胞增高，与术前比较，差异有显著性（Ｐ＜０．０１），血清抗原特异性ＩｇＥ水平较术前明显降低（Ｐ＜０．０１）。认为胚胎胸腺组织移植可以调节变应性鼻炎患者机体的免疫功能，使抑制性Ｔ淋巴细胞的数量有所增加，功能增强，ＩｇＥ水平降低，可作为该病的治疗方法之一。     

CTLA4Ig基因在糖尿病大鼠胰岛移植中的作用

为探讨融合蛋白（ＣＴＬＡ４Ｉｇ） 基因在糖尿病大鼠体内表达及其产物延长胰岛移植物存活的作用，利用脂质体（Ｌｉｐｏｆｅｃｔｉｎ） 载体包裹ＣＴＬＡ４ＩｇｃＤＮＡ 质粒后转染鼠胰岛和肌肉细胞，检测移植后ＣＴＬＡ４Ｉｇ 基因表达水平和Ｔ 淋巴细胞转化率，观察ＣＴＬＡ４Ｉｇ 基因表达在延长糖尿病鼠胰岛移植物和大鼠存活时间的作用。结果： 胰岛移植术后实验（ Ａ） 组、对照（Ｂ） 组Ｔ 淋巴细胞转化率有明显差异（ Ｐ＜ ０ ．０５） 。Ａ 组胰岛移植后第７ 天２ 只大鼠血清ＣＴＬＡ４Ｉｇ 呈阳性（ 阳性率为２０ ％ ） ，分别为１４ ｎｇ／ ｍｌ 和３１ ｎｇ／ ｍｌ。Ｂ 组胰岛移植后维持血糖正常时间平均３ ．６ ±５ ．１ 天，Ａ 组胰岛移植后维持血糖正常时间平均１４ ．８ ±１２ ．３ 天，两组比较差异有显著性意义（ Ｐ＜ ０ ．０５ ） 。Ａ 组大鼠平均存活２４ ．０ ±１０ ．８ 天，最长４５ 天，Ｂ 组大鼠平均存活１０ ．８ ±４ ．８ 天，最长２１ 天，两组大鼠生存时间差异有统计学意义（ Ｐ＜ ０ ．０１） 。本实验结果提示：ＣＴＬＡ４Ｉｇ 基因可以在受体大鼠胰岛细胞或肌肉组织表达，其表达产物可使胰岛移植物和受体鼠存活时间明显延长。     

胚胎胸腺移植治疗中晚期恶性肿瘤

为增强恶性肿瘤患者的免疫功能，施行胚胎胸腺移植术。半胚胎胸腺组织剪成０．５ｘｍ×０．５ｃｍ×０．１ｃｍ的薄片，埋植入腹直肌内。术后３个月内Ｅ－玫瑰花环形成率及淋巴细胞率与移植前相比，差异显著，术后１，２，３，６及１２个月随访观察，患者的临床症症状明显改善，生活质量有所提高，总有效率达７６％。本组结果显示，胚胎胸腺移植作为中晚期恶性肿瘤的辅助治疗，具有一定效果。     

同种异体血管移植的实验研究与临床应用

选５０只Ｗｉｓｔａｒ鼠分成Ａ、Ｂ两组，每组２５只，Ａ组移植低温贮存的同种异体颈动脉３０条（其中５只行双侧颈动脉移植），Ｂ组移植自体颈动脉２５条．Ａ、Ｂ两组通畅率分别为９０％和９２％，两组组织学变化类似，无明显排异反应．作者用低温贮存的同种异体血管修复了６例７条血管，缺损血管平均长４．７５ｃｍ（１．０～１５．０ｃｍ），缺损血管平均外径２．０３ｍｍ，平均随访１９．６个月（１３～３６个月），５例良好，１例失败．     

辽宁绝经妇女骨密度与绝经年限、体重关系研究

目的　研究绝经年限、体重对辽宁地区绝经后女性不同部位骨密度的影响。方法　测定共９６ 例绝经后妇女腰椎（Ｌ２～４）、股骨颈（Ｎｅｃｋ）、大转子（Ｔｒｏｃｈ）、Ｗａｒｄ＇ｓ 区的ＢＭＤ,同时测定了血ＡＬＰ、血尿钙、肌肝（Ｃｒ）等指标,分析其相互关系。结果　１． 绝经后妇女各部位的ＢＭＤ 不同。２．Ｌ２～４的ＢＭＤ与体重（Ｗ ）、血小板、尿Ｃａ／Ｃｒ呈正相关（Ｐ＜ ０．０１、Ｐ＜ ０．０５、Ｐ＜ ０．０１）。与绝经年限的自然对数（ＰＦＮＬ）、ＡＬＰ呈负相关（Ｐ＜ ０．０１、Ｐ＜ ０．０１）。３．Ｎｅｃｋ 区ＢＭＤ 与体重、血小板呈正相关（Ｐ＜ ０．０１、Ｐ＜ ０．０５）,与ＰＦＮＬ呈负相关（Ｐ＜ ０．０５）。４．Ｗａｒｄ＇ｓ 区ＢＭＤ 与体重、血小板、尿Ｃａ／Ｃｒ 呈正相关（Ｐ＜ ０．０１、Ｐ＜ ０．０５、Ｐ＜ ０．０５）,与ＰＦＮＬ及ＡＬＰ呈负相关（Ｐ＜ ０．０１、Ｐ＜ ０．０５）。５． 大转子区骨密度与体重、血小板、转氨酶呈正相关（Ｐ＜ ０．０１、Ｐ＜ ０．０１、Ｐ＜ ０．０５）,与ＡＬＰ呈负相关（Ｐ＜ ０．０１）。结论　体重、绝经年限、尿Ｃａ／Ｃｒ、血小板及血ＡＬＰ能影响骨密度。     

大鼠胚胎脊髓移植物对成体损伤脊髓运用能修复的影响

为了探讨胚胎脊髓移植物对成体损伤脊髓运动功能修复的效应，取妊娠１４天胚胎大鼠脊髓组织，移植到成年大鼠脊髓半切洞损伤模型，术后进行联合行为记分（ＣＢＳ）和运动诱发电位（ＭＥＰ）检查。结果发现，移植组ＣＢＳ与对照组比较相差显著（Ｐ〈０．０５），移植术后４周以内两者相差非常显著（Ｐ〈０．０１）。移植组ＭＥＰ早期反应（Ｐ１，Ｎ１）的峰潜代恢复优于对照组（Ｐ〈０．０５）。结果提示，胚胎脊髓移植对成年宿主损伤     

冷冻保存对带血管异体关节移植排斥反应的影响实验研究

目的 观察冷冻保存和环孢霉素Ａ（ＣｙＡ）对鼠带智力这异体关节移植斥反应的作用。方法 ４０只ＳＤ大鼠随机分成４组：１组、新鲜同系移植;２组、新鲜异体移植;３组,冷冻保存异体移植;４组、冷冻保存异体移植术后用ＣｙＡ。术后进行血管造影,测定ＩＬ０－２活性及Ｔ细胞亚群（ＣＤ４／ＣＤ８）的变化,按照Ｓａｋａｉ等评分标准进行组织这评分。结果 ２组通畅率为０,与科各组比较差异有显著性（Ｐ〈０．０１）。ＩＬ－２及     

精氨酸增强梗阻性黄疸细胞免疫功能及其降低感染的临床疗效观察

研究非精氨酸（Ａ组）３７例（含１４例ＡＯＳＣ）和精氨酸组（Ｂ组）２９例（含１１例ＡＯＳＣ）细胞免疫变化和围手术期感染性并发症。结果显示：无论手术前，还是手术后Ｂ组ＣＤ３＾＋、ＣＤ４＾＋显著高于Ａ组（Ｐ〈０．０１），而Ｂ组ＳＩＬ－２Ｒ显著低于Ａ组（Ｐ〈０．０１）。在ＡＯＳＣ术后，Ｂ组体温、ＷＢＣ计数明显低于Ａ组（Ｐ〈０．０１），Ａ组术后感染性并发症非常显著高于Ｂ组（Ｐ〈０．０１）。研究表明精氨酸有显     

胸腺内胰岛移植的实验研究

目的观察胸腺内和肾包膜下胰岛移植对移植物存活时间的影响。方法以Ｃ５７ＢＬ／６小鼠为受体,ＢＡＬＢ／ｃ小鼠为供体,肾包膜下胰岛移植分为单纯移植和移植的同时加腹腔内一次性注射兔抗小鼠胸腺细胞血清（ＡＴＳ）两组,胸腺内移植组亦分为单纯移植和移植加用ＡＴＳ两组。结果单纯胸腺内移植组其移植物的存活期为（１９．５±１０．１）天,长于单纯肾包膜下移植组（１４．０±２．１）天;移植的同时加用ＡＴＳ,则肾包膜下移植组移植物的存活期为（４３．０±１１．７）天,胸腺内移植组可达（９３．８±２５．５）天以上,其中６只（６／８）胸腺内移植物获长期存活,并且诱导了受体对供体的特异无反应性。结论胸腺可能为胰岛移植的理想部位,而且在诱导免疫耐受中具有重要作用。     

大鼠胚胎脊髓移植物对成体损伤脊髓运动功能修复的影响

为了探讨胚胎脊髓移植物对成体损伤脊髓运动功能修复的效应，取妊娠１４天胚胎大鼠脊髓组织，移植到成年大鼠脊髓半切洞损伤模型，术后进行联合行为记分（ＣＢＳ）和运动诱发电位（ＭＥＰ）检查。结果发现，移植组ＣＢＳ与对照组比较相差显著（Ｐ＜０．０５），移植术后４周以内两者相差非常显著（Ｐ＜０．０１）。移植组ＭＥＰ早期反应（Ｐ１，Ｎ１）的峰潜伏时恢复优于对照组（Ｐ＜０．０５）。结果提示，胚胎脊髓移植对成年宿主损伤脊髓的功能修复具有促进作用。这可能与胚胎脊髓组织能分泌多种神经营养因子、神经生长因子、神经递质，或激素的调节作用有关。     

泌尿系统原发性原始神经外胚层瘤临床病理分析

目的 探讨泌尿系统原发性原始神经外胚层瘤(primitive neuroectodermal tumor,PNET)的临床病理特征、免疫学表型、治疗方法及预后.方法 回顾性分析3例泌尿系统原发性PNET患者资料.3例均为男性,年龄分别为29、32和75岁.2例原发于肾脏,1例原发于膀胱.2例肾肿瘤大小分别为7.7 cm×6.2 cm和12.6 cm×9.4 cm,影像学检查提示肿瘤边界尚清,内部回声欠均匀.膀胱肿瘤大小为10.0 cm×10.0 cm,影像学检查提示膀胱壁不规则增厚,其内密度不均匀.2例肾肿瘤行肿瘤根治术,膀胱肿瘤行血块取出术及肿瘤活检术.结果 光镜下,瘤细胞为形态一致的小圆形或卵圆形,被纤维结缔组织分隔成实性片状或巢状,并形成假菊形团或Homer-Wright菊形团,核分裂象多见.免疫组化标记:3例肿瘤CD99、突触素和波形蛋白均为阳性.1例肾肿瘤Ki67阳性率＜5%,另1例80%阳性.3例病理诊断均为PNET.例1肾肿瘤患者未行化疗,于术后14个月复发死亡;例2肾肿瘤及例3膀胱肿瘤患者术后予以化疗,分别于术后4、6个月死亡.结论泌尿系统原发性PNET是一种少见的高度恶性软组织肿瘤,诊断主要依据病理形态学特征及免疫组化标记.目前治疗方法主要是手术加放、化疗.

Abstract：

Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.     

腹膜后恶性蝾螈瘤2例报告

目的：总结恶性蝾螈瘤（malignant triton tumor,MTT）的临床及病理特点、诊治方法及预后。方法：回顾性分析2例腹膜后MTT患者的临床资料,均为女性,分别为8个月及44个月大婴幼儿。均因体检发现腹部肿物入院。下腹部均可触及质韧肿物,表面光滑,活动度可,无压痛。B超、CT、MRI等影像学检杏见中下腹或腹盆腔区有大小约14cm×12cm×9cm和15cm×13cm×10cm肿块,增强CT示肿物呈不均匀强化。2例患者均行肿瘤根治性切除术。结果：镜下见肿瘤由梭形细胞及多角形细胞组成,可见病理性核分裂,伴有横纹肌分化。免疫组织化学染色示NSE＋,Vimentin＋,Desmin＋,S-100＋。诊断为腹膜后MTT。1例患者随访3个月,术后2个月复发转移,近期肿物有所增长。另1例随访5个月,目前情况良好。结论：腹膜后MTT是一种罕见、高度恶性的肿瘤,确诊需依赖病理检查和免疫组织化学检测。本病以手术根治治疗为主,术后易复发和转移,预后差。     

Islet transplantation to the renal subcapsular space in streptozotocin-diabetic rats. Long-term effects on insulin and glucagon secretion

In previous studies on streptozotocin-diabetic rats, transplantation of 1,000 (but not of 400) pancreatic islets to the renal subcapsular space was followed within 10 days by near-normalization of the impaired insulin secretion and the hyperglycemia. The long-term effects were now studied by measuring insulin and glucagon secretion 3 months after transplantation of 1,000 collagenase-isolated islets in streptozotocin (70 mg/kg) diabetic rats. At this time, diabetic control rats showed marked hyperglycemia and hyperglucagonemia, whereas the basal glucose and glucagon levels had normalized in the transplanted rats. Furthermore, insulin secretion in response to glucose or arginine stimulation and glucagon secretion following arginine stimulation were normal in all transplant rats, but absent in all diabetic controls. Morphologically the transplanted islets in the renal subcapsular space appeared normal on hematoxylin-eosin staining and immunostaining with antisera directed against insulin, glucagon, somatostatin and chromogranin A/B. Thus the islet transplants normalized basal hyperglycemia and hyperglucagonemia and restored insulin and glucagon secretion on a long-term basis.     

Successful treatment of a case of advanced adult Wilms' tumor with pre-surgical chemotherapy, irradiation and radical nephrectomy

A 37-year-old male was referred with a huge renal mass and multiple lung lesions. Abdominal and chest computed tomographic scan revealed a 11×15×17. 5 cm right renal tumor and multiple lung metastases. Neither tumor was enhanced, and no lymph adenopathy was detected. Percutaneous needle core biopsy was performed and the tumors were diagnosed as Wilms' tumor histologically supported by immunohistological positive staining to WT-1 and CD56. Since lung metastases were detected and the renal tumor reached the abdominal aorta on the left side, presurgical systemic chemotherapy (ifosphamide＋ carboplatin＋etoposide ; ICEx 4 courses) was performed. The renal tumor and the lung metastases were markedly decreased in size and subjected to a radical nephrectomy. Histological examination confirmed the diagnosis of Wilms' tumor without anaplastic change categorized as mesenchymal type. As an adjuvant therapy, irradiation to renal bed (40 Gy/20 fr) and bilateral lung (12 Gy/8 fr) were performed. Six months after the end of the therapy, no evidence of recurrence was detected.     

胎儿骨移植修复良性骨肿瘤术后骨缺损

目的　总结胎儿骨移植修复良性骨肿瘤术后骨缺损的临床应用效果。方法　1994年1月～1999年6月,应用经酒精处理后的胎儿骨移植修复148例良性骨肿瘤术后骨缺损,其中骨囊肿63例,骨纤维异常增生症42例,骨巨细胞瘤26例,内生软骨瘤17例。骨缺损最大3.5cm×10.0cm,最小0.5cm×1.0cm。结果　148例良性骨肿瘤术后骨缺损修复均于3～12个月达骨性愈合,平均愈合时间为6.2个月。随访1～6年,平均14个月,肿瘤无复发,无局部及全身反应。结论　胎儿骨作为良性骨肿瘤术后的骨缺损修复材料无明显组织反应,临床效果满意。     

原发性肾窦肿瘤三例报告

目的 总结原发性肾窦肿瘤的临床特点及治疗方法.方法 原发性肾窦肿瘤患者3例.女2例,男1例.平均年龄40(33～55)岁.临床表现为腰痛伴血尿1例,单纯腰部疼痛2例.肿瘤位于右侧2例,左侧1例.直径平均5.5(3.5～8.5)cm.3例均经行手术治疗. 结果行右肾窦肿瘤探查术1例,术中病理提示良性肿瘤,单纯切除肿瘤,病理报告为血管平滑肌瘤,随访3年未见复发.1例术中因肿瘤出血及肾盂破坏严重,行右肾切除,病理报告为血管平滑肌脂肪瘤,随访10个月未见复发.1例因肿瘤包绕肾动静脉,局部严重黏连,行左肾切除术,病理报告为脂肪瘤,随访4年未见肿瘤复发.结论 原发性肾窦肿瘤临床罕见,多为良性,易误诊为肾盂肿瘤,CT、MRI、IVU检查有助于鉴别;良性肿瘤直径<4 cm且无症状者可密切随访,有症状或直径>4 cm者可行肿瘤切除;肿瘤累及肾蒂并严重破坏肾盂者可行单纯肾切除;恶性肿瘤应行根治性肾切除.     

Revascularization and function of pancreatic islet isografts in diabetic rats following transplantation

In pancreatic islet transplantation, revascularization is crucial for the graft's survival and function. In this study, the endothelium of isolated islets and revascularization and function of islet isografts in diabetic rat were investigated. Islets were isolated from Lewis rats by collagenase digestion method and were examined using immunohistochemistry (CD31 stain) on days 0, 1, 3, and 7 after isolation. The number of CD31-positive cells in these isolated islets was counted (mean +/- SD %). Isografts (freshly isolated islets: group A, and islets cultured for 7 days: group B) transplanted in the renal subcapsule of streptozotocin-induced diabetic Lewis rats were examined using immunohistochemistry (CD31 stain) on days 3, 5, and 7 after transplantation. Intravenous glucose tolerance tests (IVGTT) were performed on days 3 and 7 after transplantation. The number of CD31-positive cells in the isolated islets on days 0, 1, 3, and 7 after isolation were: 17.3 +/- 4.1%, 8.2 +/- 0.7%, 2.1 +/- 0.8%, and 0.8 +/- 0.5%, respectively (p < 0.05). On day 5 after transplantation, CD31-positive cells were not detected in group A and B grafts, but were detected in both groups in periphery of the islets. On day 7, CD31-positive microvessels were present throughout the entire graft. IVGTT values in groups A and B on days 3 and 7 after transplantation did not show significant differences. In renal subcapsular isografts in diabetic rats, revascularization into islet grafts occurs from the surrounding host tissue 5 days after transplantation, but has no influence on the response to glucose during this period.     

半相合基因骨髓细胞移植小鼠的嵌合体程度对移植物抗肿瘤效应的影响

目的 探讨半相合基因骨髓细胞移植后受体形成的嵌合体程度对抗肿瘤效果的影响.方法 25只BALB/C青春期小鼠随机分为3组:混合型嵌合体组(A组,10只)、完全型嵌合体组(B组,10只)、对照组(C组,5只).首先,A、B组小鼠行直线加速器全身照射,剂量分别为4、8Gy,照射后4～6 h内经尾静脉注射入CB6F1代小鼠的骨髓细胞(5×106/只),C组无处理.A、B、C三组均给予Renca肾癌细胞腋窝下注射,每只2.6×106.观察所有组别小鼠的肿瘤生长速率,通过流式细胞仪测定A、B组小鼠移植后不同时间的嵌合体水平.荷瘤32 d时断颈处死小鼠,取肿瘤组织称重.结果 (1)流式细胞术鉴定血液白细胞中供者源细胞比例:A组移植后2周后形成混合嵌合体(47.51%～72.64%)并达高峰,以后逐渐下降,3～4周时下降至10%以下.B组小鼠移植后14 d形成完全供者型嵌合体(供体细胞＞90%),28 d后仍达90%以上.(2)与对照组和混合型嵌合体组比较,完全型嵌合体组的肿瘤生长速度明显减慢,肿瘤重量显著减小(P＜0.01),抑瘤率高达52%.结论 半相合基因骨髓细胞移植后形成的稳定的完全型嵌合体状态是抗肿瘤效应的基础.     

半相合基因骨髓细胞移植联合抗原免疫对小鼠肾癌的抑制作用

目的 探讨半相合基因骨髓细胞移植联合抗原免疫对移植物抗肿瘤效应的影响及其机制.方法 26只BALB/c青春期小鼠为受者,随机分为单纯骨髓细胞移植组(A组,10只)、联合抗原免疫移植组(B组,10只)、对照组(C组,6只).取BALB/c(H-2d)和C57BL/6(H-2b)交配后产生的F1代小鼠为供者.A、B组小鼠均行直线加速器全身照射(8 Gy),照射4～6 h内经尾静脉分别注射入供者小鼠的骨髓细胞(5×106/只),C组无处理.1周后3组小鼠均给予Renca肾癌细胞腋窝下注射(2.6×106/只),B组小鼠在荷瘤1 d后给予33 Gy照射的Renca肾癌细胞(5×105/只)皮下注射免疫,间隔1周,重复免疫1次.通过流式细胞术(FACS)测定移植后不同时间的嵌合体水平.断颈处死小鼠后,观察所有组别受者小鼠的肿瘤质量、体积增加量、肿瘤抑瘤率,取肿瘤组织做成石蜡切片HE染色后,观察肿瘤坏死面积比,采用原位末端标记法(TUNEL)检测各组小鼠肿瘤组织的凋亡指数(AI).结果 (1)FACS检测嵌合体水平:A、B组小鼠移植后14 d供体细胞嵌合体水平均＞90%,28 d后仍＞90%.(2)与C组和A组相比,B组的肿瘤生长速率明显减慢,肿瘤质量明显减小(P＜0.05),体积增加量明显降低(P＜0.01),抑瘤率高达60%,肿瘤坏死面积比明显增高(P＜0.05),AI明显增高(P＜0.01).结论 抗原免疫能增强半相合基因骨髓细胞移植的抗肿瘤作用,其机制可能是促进肿瘤细胞坏死和细胞凋亡增加.