培养猴颈交感神经节脑内移植治疗帕金森病的实验研究

目的探索帕金森病外科治疗的移植方法，并为培养交感神经节移植脑内能否长期存活寻找组织学证据。方法用１甲基－４苯基－１，２，３，６－四氢吡啶（ＭＰＴＰ）诱发猴帕金森病模型１１只，将自体腓神经培养２４～２８天所得的雪旺细胞与神经节组织共同培养后行脑尾状核移植，观察２年后取标本，用乙醛酸诱发多巴胺荧光和免疫组织化学方法检测。结果猴帕金森病症状明显好转，移植２年后脑尾状核仍可见存活的神经节细胞，移植物与脑组织间有轴、树突联系，多巴胺荧光及神经丝蛋白、突触素、铬粒素等染色阳性。结论神经节与雪旺细胞共同培养后移植脑内可存活２年，是治疗帕金森病的较好方法。组织学观察结合荧光及免疫组织化学染色结果是判定移植物存活与否的重要手段。     

单克隆抗体在恶性血液病造血干细胞移植中应用研究进展

B细胞单克隆抗体、CD34^＋细胞阳性选择单用或联合应用对淋巴瘤及急性白血病等,恶性血液病自体造血干细胞移植物体外净化作用及对移植疗效有显著改善;抗CD20单抗（美罗华）能明显减少移植物中肿瘤细胞的污染,提高自体移植疗效;抗CD52单抗能在体内外有效清除移植物或患者体内的T淋巴细胞,减少移植物抗宿主病的发生率,提高异基因造血干细胞移植疗效。     

移植部位和移植块大小对甲状腺组织自体移植物生长存活影响的实验研究

人们很早就想利用甲状腺同种移植治疗甲状腺低功。目前,在监床上已开始应用甲状腺自体移植治疗异位甲状腺,如舌叶甲状腺。甲状腺是人体内最大的内分泌腺,既可通过血管吻合进行移植,又可切成小块或制成混悬液进行种植(埋植)。埋植可在多种器官,组织内进行。但移植部位不同,对移植物究竟有何影响,尚未见报道。我们观察了不同移植部位的甲状腺自体移植物的形态结构和功能变化,此外,还观察了移植块大小对其生长存活的影响。结果如下:     

自体骨髓移植体外骨髓净化的研究进展

自体骨髓移植(ABMT)适用于造血系统的恶性肿瘤如淋巴瘤、白血病及某些非造血系统之实体瘸等.有人报道ABMT治疗成人急性白血病,可使50～65％的患者获3年以上的长期生存,其中一部分患者巳存活5年以上。ABMT与异基因或同基因BMT比较,具有以下优点:(1)不需要供髓者;(2)老年病人不受限制;(3)没有移植物排斥反应及移植物抗宿主病(GVHD);(4)缩短了治疗时间;(5)比较安全、简便、易行,一般有基本条件的医院均可开展。存在问题是输注的骨髓有残留的     

Notch信号通路在急性移植物抗宿主病中的作用

目的:分析异基因造血干细胞移植后患者Notch1的表达,了解Notch1信号通路与急性移植物抗宿主病发生、发展的关系。方法:采集54例异基因造血干细胞移植后患者外周血,同期采集26例自体造血干细胞移植患者和10例正常志愿者外周血标本作为对照,检测Notch1和Hes-1 mRNA的表达,分析其与急性移植物抗宿主病的关系。结果:异基因造血干细胞移植患者Notch1和Hes-1 mRNA表达较自体造血干细胞移植患者和正常志愿者高(P0.05),其中急性移植物抗宿主病患者Notch1 mRNA表达明显高于非急性移植物抗宿主病患者、自体造血干细胞移植患者及正常志愿者(P0.05)。Notch1 mRNA的表达与急性移植物抗宿主病总体分度呈正相关,急性移植物抗宿主病越严重,Notch1 mRNA的表达越高(P0.05)。结论:Notch1信号参与调节急性移植物抗宿主病;Notch1及其靶基因的表达与急性移植物抗宿主病的严重程度密切相关。     

多发性骨髓瘤存活期及影响因素研究

目的 探讨多发性骨髓瘤(MM)患者长期存活的相关因素.方法 统计天津医科大学总医院1983年1月至2007年9月MM患者存活期并分析其影响因素.结果 107例MM患者中位存活32个月.单因素分析显示发病年龄、髓外浸润、合并感染、外周血血小板计数、血清白蛋白、β2-微球蛋白、尿酸、骨髓浆细胞比例及形态、治疗后是否达到骨髓细胞形态学完全缓解(CR)是本组MM患者存活期的影响因素.多因素分析显示外周血血小板计数、血清β2-微球蛋白、骨髓细胞分类中浆细胞类型和治疗后是否达到骨髓细胞形态学CR是MM患者存活期的独立影响因素.结论 近20余年,MM患者中位存活近3年,其外周血血小板计数、血清β2-微球蛋白、骨髓浆细胞类型和治疗后达否骨髓细胞形态学CR是影响存活期的独立因素.     

再生障碍性贫血和急性白血病骨髓移植的现状

目前骨髓移植的研究包括组织相容性抗原的遗传,寻找预防宿主免疫排斥的免疫抑制方案和移植物抗宿主病(GVHD)的防治方法等三方面。著者认为若能提供骨髓相容的供体,则骨髓移植对重型再生障碍性贫血治疗效果较好,西雅图系移植后长期生存的68例中,死于移植物排斥19例,死于GVHD16例,其他原因死亡2例,维持移植并血象恢复存活8月～5年者31例。著者指出受体淋巴细胞对供体细胞的反应性(混合白细胞培养指数( )或Cr~(51)释放试验( ))和小量骨髓细胞移植对发生移     

自体骨髓移植治疗扩张型心肌病并心力衰竭的初步效果(附5例报告)

目的 观察自体骨髓移植(ABMT)治疗扩张型心肌病并心力衰竭的初步效果。方法 1)临床资料:收集自2002年1月以来的5例扩张型心肌病患者,年龄20～63岁,男性2例,女性3例,其中,心肌炎性心肌病1例,围生期心肌病1例,缺血性心肌病1例,酒精性心肌病1例。不明原因心肌病1例。伴糖尿病或糖耐量异常(IGT)2例,高血压2例,心房纤颤2例,室性心律失常1例,完全性左束支传导阻滞1例,安置人工心脏起搏器(双室起搏)1例:心功能Ⅱ～Ⅲ级(按NYHA分级标准)。2)自体骨髓移植(ABMT):于髂后上棘采集自体骨髓,左侧2例,右侧3例;经肘静脉输注自体骨髓细胞。3)应用彩色多普勒超声心动图检测患者左房内径(LAD),左室舒张末径(LVEDD),左室收缩末径(LVESD),左室射血分数(LVEF)和左室舒张功能(E/A值)。结果 1)全部病例采髓及移植均成功,移植骨髓细胞(单核细胞)数目8.03×10~8～1.70×10~9;无移植物抗宿主病(GVHD),无感染等并发症。2)ABMT术后一个月,患者心功能恢复至Ⅰ～Ⅱ级。超声检测表明,LVEF从17％～37％增加至24％～56％,LAD,LVESD均有不同程度缩小;然而,LVEDD,E/A没有显著变化:3)随访3个月～6个月,除1例因恶性室性心律失常死亡外,余均存活。结论:ABMT治疗扩张型心肌病并心力衰竭是一种安全、有效的细胞治疗,它能通过加强心肌收缩力改善患     

兔自体静脉移植物粥样硬化模型的建立

为研究自体静脉移植物粥样硬化的发病机制以进行干预研究，建立家兔动物模型。将30只雄性新西兰大白兔随机分为正常对照组(n=6)、单纯移植组(n=12)和高脂移植组(n=12)，分别给予普通饲料喂养、单纯自体颈外静脉移植加普通饲料喂养和自体颈外静脉移植加高脂饲料喂养。实验12周末处死动物，检测血脂水平，同时观察静脉移植段的形态特征。结果发现，高脂移植组出现明显的高脂血症，其颈静脉移植段出现较典型的粥样硬化病变。包括内皮细胞脱落、内膜增生、平滑肌细胞移行增殖、脂质沉积和泡沫细胞形成等；单纯移植组的颈静脉移植段仅有明显的内膜增生和平滑肌细胞表型转换及增殖，未见明显脂质沉积；而正常对照组及各移植组对侧颈外静脉未见明显异常。结果提示，自体颈外静脉移植结合高脂饲料喂养可成功建立兔自体静脉移植物粥样硬化模型，此模型可用于人自体静脉移植物粥样硬化发生机理及防治措施等的研究。     

多种体外预处理对胰岛移植物免疫原性影响的研究

胰岛移植物经２４℃培养、冷冻保存、激光照射在２４℃培养加冷冻保存等体外预处理后，其胰岛淋巴细胞混合培养（ＭＬＩＣ）的ｃｐｍ值、制备物内ＤＲ阳性细胞数及胰岛内淋巴样细胞数均比对照组明显降低，提示上述预处理可明显降低胰岛移植物的免疫原性，从而可能减少移植物排斥，延长移植物存活。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.