曲安奈德对鼻息肉中T细胞激活分泌调节因子及嗜酸性粒细胞的影响

目的 观察鼻息肉组织中T细胞激活分泌调节因子及嗜酸性粒细胞表达的变化,探讨糖皮质激素治疗鼻息肉的可能机制.方法 对60例鼻息肉患者分别采用曲安奈德1 mg鼻腔雾化治疗,并以30例生理盐水治疗作为对照,通过免疫组化方法测定鼻息肉治疗前后的T细胞激活分泌调节因子表达及嗜酸性粒细胞数量的变化.结果 经曲安奈德治疗后鼻息肉中T细胞激活分泌调节因子的表达较治疗前显著降低(P<0.05),且嗜酸性粒细胞也随之下降,二者有相关性;而对照组治疗前后差异无统计学意义(P>0.05).结论 T细胞激活分泌调节因子是诱导嗜酸性粒细胞在鼻息肉中浸润的重要趋化因子,曲安奈德可能通过下调T细胞激活分泌调节因子的表达,发挥抗EOS炎症的作用.     

TGF-α在鼻息肉中的表达及其与浸润嗜酸性粒细胞的关系

目的研究转化生长因子-α(TGF-α)对鼻息肉组织上皮细胞的增殖作用,二者相互关系及其与浸润嗜酸性粒细胞的关系,以进一步了解鼻息肉的发病机制。方法32例鼻息肉患者被分为A、B两组,A组为Ⅲ型鼻息肉患者(11例),B组为Ⅰ型及Ⅱ型鼻息肉患者(21例),并以C组8例正常下鼻甲粘膜作为对照,采用免疫组化SP法对鼻息肉组织中TGF-α、增殖细胞核抗原(PCNA)的表达进行了检测比较。结果①TGF-α、PCNA在鼻息肉[(A B)组]上皮细胞、腺上皮细胞中呈现中、高度表达,正常对照下鼻甲组(C组)均呈阴性,且上皮细胞、腺上皮细胞中TGF-α的表达与PCNA的表达显著相关(r1=0.77,P1<0.01,r2=0.84,P2<0.01);②(A B)组间质中TGF-α阳性表达程度与浸润嗜酸性粒细胞显著相关(r=0.55,P<0.05);③A组浸润嗜酸性粒细胞程度及TGF-α阳性表达程度均显著高于B组(P<0.05)。结论①TGF-α可能直接参与鼻息肉的病理变化,在鼻息肉的形成和发展中起一定作用;②嗜酸性粒细胞可能为TGF-α的主要来源;③鼻息肉组织中浸润嗜酸性粒细胞程度及TGF-α阳性表达程度与鼻息肉临床分型密切相关,提示二者在复发性鼻息肉的发病过程中发挥一定的作用。     

嗜酸性粒细胞凋亡在鼻息肉发病机制中的作用

鼻息肉(nasal polyps,NP)是耳鼻咽喉科常见病,成人发病率为1%~2%,术后或保守治疗后复发率高。组织学特点为上皮增生、间质水肿、腺体水肿增生等改变,同时伴有炎性细胞浸润,以嗜酸性粒细胞浸润为主,尚可见淋巴细胞、浆细胞、中性粒细胞及巨噬细胞等。嗜酸粒细胞浸润增多是鼻息肉发病的关键,近年来有研究表明,鼻息肉组织中嗜酸性粒细胞凋亡抑制是导致组织中嗜酸性粒细胞浸润增多的机制之一。本文对其研究进展综述如下。1息肉中的嗜酸性粒细胞与细胞凋亡细胞凋亡(apoptosis)又称程序性细胞死亡(programmed celldeath,PCD),是由基因调控的细胞自主的有序性死亡。嗜酸粒细胞凋亡调节基因主要有Bcl家族蛋白和Fas/FasL系统。研究表明,鼻息肉组织中嗜酸性粒细胞凋亡受到抑制是引起嗜酸性粒细胞浸润增多的原因之一[1]。鼻息肉的发生与嗜酸性粒细胞的凋亡是复杂的多因素、多基因共同作用的结果,嗜酸性粒细胞在凋亡抑制或诱导的过程中,相关的凋亡调控基因表达可能会发生变化。1.1Bcl家族在鼻息肉中嗜酸性粒细胞的表达B细胞淋巴瘤/白血病(B-celllymphoma/leukemia,Bcl)家族蛋白是目前已...     

白细胞介素17C在50例鼻息肉组织中的表达及其意义

[目的]观察白细胞介素17C(IL-17C)在鼻息肉组织中的表达情况,探讨其在慢性鼻-鼻窦炎伴鼻息肉发病过程中的作用机制.[方法]收集2016年1月—2016年6月间行鼻内窥镜下鼻窦手术的慢性鼻-鼻窦炎伴鼻息肉(CRSwNPs)患者的鼻息肉标本50例(鼻息肉组),同时收集同期住院行鼻中隔成形术的鼻中隔偏曲患者的中鼻甲黏膜标本10例(对照组).根据HE染色结果再将鼻息肉分为嗜酸性粒细胞型和非嗜酸性粒细胞型.应用免疫组织化学染色法检测IL-17C在鼻息肉组及对照组标本中的表达水平.[结果]鼻息肉组50例中嗜酸性粒细胞型24例(48.0%),非嗜酸性粒细胞型26例(52.0%);IL-17C主要在鼻息肉组织的上皮细胞中表达.鼻息肉组IL-17C的表达水平明显高于对照组(P<0.01),嗜酸性粒细胞型鼻息肉组中的IL-17C阳性表达率为87.5%,非嗜酸性粒细胞型鼻息肉组为73.1%,对照组为20.0%,嗜酸性粒细胞型鼻息肉组及非嗜酸性粒细胞型鼻息肉组与对照组比较差异均有统计学意义(P<0.01);IL-17C在嗜酸性粒细胞型鼻息肉的上皮细胞中的表达强度评分明显高于非嗜酸性粒细胞型(P<0.05).[结论] IL-17C是参与CRSwNPs发病的重要细胞因子.     

IL-12、TGF-β1在CRSwNP组织中的表达水平及其临床意义

目的 研究白介素-12 (IL-12)、转化生长因子β₁(TGF-β₁)在慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)组织中的表达水平及其临床意义。方法 将2020年1月至2020年12月于陕西中医药大学附属医院就诊的58例CRSwNP患者纳入观察组,另选择同期于本院就诊的55例慢性鼻-鼻窦炎不伴鼻息肉(CRSsNP)患者纳入对照组。比较观察组息肉组织及对照组鼻黏膜组织中IL-12、TGF-β₁表达水平的差异,根据Lund-Mackay内镜评分结果将观察组患者分为轻度组和重度组,根据炎性细胞浸润比例不同将观察组患者分为嗜酸性粒细胞组和非嗜酸性粒细胞组,根据疾病复发情况将观察组患者分为复发组和未复发组,比较不同组患者的IL-12、TGF-β₁表达水平,采用Spearman等级相关分析IL-12、TGF-β₁表达与嗜酸性粒细胞浸润百分比的相关性。结果 观察组患者的IL-12、TGF-β₁表达水平分别为(42.93±10.52) pg/mL、(529.89±147.6...     

白细胞介素17A,17C在24例鼻息肉组织中的表达及其意义

[目的]探讨白细胞介素(IL)-17A与IL-17C在鼻息肉组织中的表达及其意义.[方法]选择自2017年3月至2018年3月间行鼻内窥镜下鼻窦手术治疗的24例慢性鼻-鼻窦炎伴鼻息肉(CRSwNPs)患者的鼻息肉标本做为鼻息肉组,同时选择同期行鼻内窥镜下鼻中隔成形术治疗的鼻中隔偏曲患者的中鼻甲黏膜标本12例做为对照组,通过HE染色方法再将鼻息肉组分为嗜酸性粒细胞型和非嗜酸性粒细胞型,应用PCR方法测定IL-17A及IL-17C在对照组和鼻息肉组中的表达情况.[结果]鼻息肉组IL-17A表达水平明显高于对照组(P<0.05),嗜酸性粒细胞型鼻息肉组和非嗜酸性粒细胞型鼻息肉组IL-17A表达水平间差异无统计学意义(P>0.05);鼻息肉组IL-17C表达水平明显高于对照组(P<0.05),嗜酸性粒细胞型鼻息肉组IL-17C表达水平明显高于非嗜酸性粒细胞型鼻息肉组(P<0.01).[结论] IL-17A及IL-17C在CRSwNPs发病过程中起到促进炎症发生发展的作用.     

布地奈德对咳嗽变异性哮喘患儿血清IgE水平的影响

目的:探讨咳嗽变异性哮喘患儿吸入布地奈德治疗前后血清总IgE及外周血嗜酸性粒细胞计数的变化及意义。方法:选择2007年l月-2010年1月本院门诊咳嗽变异性哮喘患儿147例,随机分为对照组(56例),布地奈德治疗组(91例)。对照组与治疗组分别于治疗前和治疗2个月后测定血清IgE、外周血嗜酸性粒细胞计数。结果:对照组治疗前及治疗2个月IgE水平分别为(226.16±21.09)ng/L、(240.39±19.56)ng/L(P>0.05);治疗组治疗前后IgE分别为(255.48±23.67)ng/L、(169.00±15.72)ng/L,治疗前后比较差异有统计学意义(P<0.01),对照组治疗前后外周血嗜酸性粒细胞计数为(1.22±0.60)×109个/L、(0.98±0.41)×109个/L,治疗组治疗前后血嗜酸性粒细胞计数为(1.35±0.73)×109个/L、(0.41±0.20)×109个/L,治疗前后比较差异有统计学意义(P<0.01)。结论:布地奈德可降低咳嗽变异性哮喘儿童血清IgE水平,观察血清IgE水平和外周血嗜酸性粒细胞计数对咳嗽变异性哮喘的诊断和治疗效应的判断具有重要意义。     

蛋白激酶C在鼻息肉中的表达及意义

目的探讨蛋白激酶C在鼻息肉组织中的表达及其与嗜酸粒细胞凋亡的相关性。方法13例鼻息肉患者给予丙酸氟替卡松喷鼻治疗,采用流式细胞术检测激素治疗前后鼻息肉组织中蛋白激酶C表达及凋亡的嗜酸粒细胞,并与7例健康正常人下鼻甲黏膜进行比较。结果蛋白激酶C主要表达在嗜酸粒细胞,其次在血管内皮细胞、腺体周围的平滑肌细胞;13例鼻息肉组织中嗜酸粒细胞表面均有蛋白激酶C表达(100%),而7例健康下鼻甲黏膜中3例(42.86%)有蛋白激酶C表达,差异有显著意义(P<0.05)。糖皮质激素治疗后的鼻息肉组织中有蛋白激酶C表达的嗜酸粒细胞减少,与激素治疗前相比,差异有显著意义(P<0.05)。结论蛋白激酶C在鼻息肉组织中呈高表达,糖皮质激素可以有效抑制鼻息肉中蛋白激酶C的表达,减少嗜酸粒细胞的浸润。     

阿奇霉素联合布地奈德喷鼻治疗慢性鼻窦炎伴鼻息肉术后疗效及对嗜酸性粒细胞的影响

目的 观察阿奇霉素联合布地奈德喷鼻治疗慢性鼻窦炎鼻息肉术后疗效,并探讨其对嗜酸性粒细胞的影响.方法 60例慢性鼻窦炎伴鼻息肉并行鼻内镜手术治疗的患者为研究对象.对照组(30例)术后给予常规治疗,包括使用布地条德喷鼻和广谱抗生素治疗,术后生理盐水鼻腔冲洗.治疗组(30例)在常规治疗基础上加服阿奇霉素.两组随访3个月评价临床疗效,观察上皮化时间和复发情况,测定嗜酸性粒细胞个数.结果 治疗组临床疗效总有效率显著高于对照组(96.7%vs 70.0%,P<0.05);治疗组患者均上皮化,随访期无复发,对照组22例上皮化,3例复发,治疗组上皮化时间和复发率与对照组比较有显著性差异(P<0.05);治疗后两组嗜酸性粒细胞个数与手术时比较均显著下降(P<0.05),且治疗组与对照组比较下降明显(P<0.05).结论 阿奇霉索联合布地奈德喷鼻可以提高慢性鼻窦炎鼻息肉术后临床疗效,并且对嗜酸性粒细胞有抑制作用.     

川芎嗪对哮喘大鼠气道壁嗜酸细胞浸润和转化生长因子-β1表达的影响

目的:观察川芎嗪对哮喘大鼠模型气道壁嗜酸性粒细胞(EOS)浸润、转化生长因子-β1(TGF-β1)含量的影响。方法:32只SD大鼠随机分成正常对照组、哮喘模型组和大、小剂量川芎嗪干预组,以卵蛋白致敏,并长期吸入激发诱喘制备大鼠哮喘模型,干预组每次雾化吸入前腹腔注射川芎嗪(分别为80mg/kg和40mg/kg),模型组以生理盐水代替。肺组织石蜡切片行TGF-β1免疫组化染色,并经计算机图像分析测定其含量,同时HE染色计数气道壁嗜酸性粒细胞(EOS)数。结果:模型组气道壁EOS计数及TGF-β1含量均高于正常对照组(P均<0.001);两种剂量川芎嗪干预组EOS计数均低于模型组(P<0.01,P<0.05),但大小剂量组间无差别(P>0.05);干预组TGF-β1含量均显著低于模型组(P均<0.001),大、小剂量组间差异有显著性(P<0.01);TGF-β1的表达与EOS计数呈显著正相关(rs=0.7180,P<0.01)。结论:川芎嗪可以减少气道壁EOS浸润和TGF-β1的表达,其降低TGF-β1表达的作用可能部分通过抑制EOS浸润而实现。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.