西山医院脊髓损伤功能量表内容介绍

目的:介绍一套新的脊髓损伤功能评价量表。方法:综合目前使用的各种常用脊髓功能量表,结合实际工作经验及脊髓损伤患者神经功能改善特点,制定了西山医院脊髓损伤功能量表。结果:西山医院脊髓损伤功能量表共分9大项16小项,采用4分制,正常为3分,最差为0分。总分0～48分,0～16分为重度残障,17～32分为中度残障;33～47分为轻度残障,48分正常。量表包括上肢运动功能(饮食、梳洗、书写)、下肢运动功能(站立、行走)、躯干运动功能(坐、翻身)、全身运动功能(床椅转移、穿脱衣服、洗澡)、括约肌功能(膀胱功能、直肠功能)、肌张力、泌汗、皮肤营养、疼痛、性功能。结论:西山医院脊髓损伤功能量表是一套专门应用于脊髓损伤患者功能评价量表。该量表能全面、精确评定患者功能,简便实用、费时短。应用这份功能量表,既能客观反映患者的功能变化,随访时又不增加患者负担,同时也能减轻医务工作者的负担。     

胚胎嗅鞘细胞再移植治疗晚期脊髓损伤1例

目的:对晚期脊髓损伤患者开展嗅鞘细胞再移植治疗,探讨其对神经功能的继续改善效果。方法:①患者男性,27岁,哈萨克斯坦籍,2001年9月20日遭霰弹枪击急诊手术后,双下肢不能运动及感觉消失,尿便失禁,右下肢阵发性钝痛。诊断为陈旧性完全性脊髓损伤(T12),美国脊髓损伤协会标准脊髓功能分级为A级。2002年9月30日第1次行脊髓胚胎嗅鞘细胞移植术,2007年2月5日行第2次脊髓胚胎嗅鞘细胞移植术。治疗方案患者知情同意。②取4个月流产胚胎(孕妇及其家属均知情同意)的嗅球,消化成单个嗅鞘细胞后培养2周,细胞浓度约2×1010L-1。于患者相应脊髓损伤上端(平T11椎体)做1个锁孔,直径约3cm,在脊髓损伤部位与正常脊髓交界处沿中线于无血管区,分两点用4.5号细针共注入100μL(第1次手术)、50μL(第2次手术)嗅鞘细胞悬液,细胞数均为1×106个。第2次移植术前进行供、受体细胞HLA配型,术后口服FK506胶囊2mg,2次/d,共42d。结果:①第1次术后3个月,排尿能控制6h,双足运动功能改善,性功能改善,阴茎勃起功能改善,疼痛减轻。②第2次术后10d,双下肢双足皮肤泌汗功能改善,右下肢疼痛减轻,腹部皮肤感觉稍有好转,针刺觉左侧由术前T10皮节消失好转至T10减退。较第2次移植前椎旁躯体感觉诱发电位有所改善,双侧椎旁电位从T10下降到T12。结论:胚胎嗅鞘细胞二次移植能继续改善晚期脊髓损伤患者的神经功能。但移植的细胞数量、容积、注射点位置等需深入探讨。     

Keratinocyte growth factor is a growth factor for type II pneumocytes in vivo.

Keratinocyte growth factor (KGF) administered as a single intratracheal injection causes a prominent dose-dependent proliferation of type II alveolar epithelial cells in the lungs of adult rats. The increase in mitotically active alveolar cells histologically appears as a micropapillary epithelial cell hyperplasia after 2 d and peaks after 3 d in the form of monolayers of cuboidal epithelial cells lining alveolar septae. Proliferating cell nuclear antigen immunohistochemistry confirmed the profound proliferative response induced by KGF. The hyperplastic alveolar lining cells contain immunoreactive surfactant protein B and are ultrastructurally noted to contain lamellar inclusions characteristic of surfactant-producing type II pneumocytes. Mild focal bronchiolar epithelial hyperplasia is noted but is much less striking than the proliferation of type II pneumocytes. Large airways are unaffected by KGF. Daily intravenous injection of KGF is also able to cause pneumocyte proliferation. The normal adult rat lung constitutively expresses both KGF and KGF receptor mRNA, suggesting that endogenous KGF may be implicated in the paracrine regulation of the growth of pneumocytes. In conclusion, KGF rapidly and specifically induces proliferation and differentiation of type II pneumocytes in the normal adult lung.     

胎盘免疫调节因子对子宫内膜异位症大鼠免疫功能的影响

目的:观察胎盘免疫调节因子对大鼠子宫内膜异位症动物模型的治疗效果和对大鼠免疫功能的影响。方法:实验于2005-10/2006-12在广西医科大学医学科学实验中心及广西肿瘤防治研究所实验病理室完成。①实验材料:健康6个月龄雌性SD大鼠60只,体质量为200～250g;健康产妇胎盘在经广西医科大学第一附属医院伦理委员会同意和产妇知情同意后获得。②实验干预及分组:利用自体子宫组织移植的方法,建立雌性子宫内膜异位症大鼠模型40只,随机分为胎盘免疫调节因子小剂量组、中剂量组、高剂量组和模型对照组,分别肌注胎盘免疫调节因子剂量为0.375,0.75,1.5mg/kg和等体积生理盐水,1次/d,连续8周。③用两脚规测量移植物的体积(V=长×宽×高/mm3),采用ATP生物荧光法测定大鼠脾细胞增殖能力;采用中性红法测定腹腔巨噬细胞的吞噬功能。采用ELISA法检测治疗后各组大鼠血清中白细胞介素2水平。结果:建模成功40只,均进入结果分析。①各组移植物外观及体积:用药后8周,各胎盘免疫调节因子组移植物体积不同程度缩小(P<0.05),呈扁平状,粘连受到明显的抑制。②各组大鼠脾细胞增殖试验、腹腔巨噬细胞吞噬功能及血清白细胞介素2水平的变化:胎盘免疫调节因子中,高剂量用药组脾细胞增殖能力较模型对照组升高(P<0.05);各剂量胎盘免疫调节因子组腹腔巨噬细胞吞噬功能、白细胞介素2水平均较模型对照组升高(P<0.05)。结论:胎盘免疫调节因子治疗大鼠子宫内膜异位症显示了较好的疗效,可显著缩小子宫异位内膜的体积,提高大鼠的免疫功能。     

Melanoma of the Oral Cavity: an Analysis of 46 New Cases with Emphasis on Clinical and Histopathologic Characteristics

Melanoma of the oral cavity is a rare malignancy that carries a poor prognosis. We identified 46 new cases of both primary and metastatic melanoma to the oral cavity. Following IRB approval, these cases were obtained from the Oral Pathology Biopsy Service archives of the UF College of Dentistry (1994–2014), the UK College of Dentistry (1997–2015), and the UM Medical Center (1988–2015). All slides were reviewed. The location, age, race, gender, clinical impression, duration of lesion, histopathologic diagnosis, and histopathologic features were recorded. Cases from the facial skin and those with an ambiguous diagnosis were excluded. Forty-six cases fulfilled the inclusion criteria with 32 primary cases, 11 known metastases, and 3 cases where metastasis could not be excluded. The primary cases included a total of 20 females and 12 males with an average age of 66.7 (range 27–95), and the majority (80 %) of the patients were Caucasian when race was known. Twenty-two of the 32 primary cases (68.8 %) were located in the maxillary mucosa, 5 in the mandibular mucosa or bone, and 5 in other locations. The clinicians’ impressions varied from benign fibrous growths to high grade malignancies. The histopathology varied widely among the cases, however two cell types predominated (often in combination): epithelioid cells (50.0 %) and spindle cells (50.0 %). Only 53.1 % demonstrated melanin pigmentation. Oral melanoma remains one of the most diverse clinical and histopathologic diagnoses. Better understanding of this neoplasm may promote earlier diagnosis and may lead to improved outcomes.     

Recent insights into the regulation of breathing

This mini review highlights recent research on the control of breathing that places gliotransmission and purinergic signaling as core drivers to the respiratory circuits in the brainstem. These elements underpin transduction of hypercapnia, hypoxia and acid sensing at central and peripheral chemoreceptors. The processes involve propagation of an extracellular ATP signal and associated P2 receptor activation, where ATP acts on both the glial cells and the associated output cells in the sensor complex - the respiratory rhythm generator neurons and the ventral inspiratory pre-motor neurons. At the peripheral carotid chemoreceptor, the hypoxia sensor likely involves the gasotransmitter H(2)S, complemented by purinergic neurotransmission.     

Transient expression of P2X(1) receptor subunits of ATP-gated ion channels in the developing rat cochlea

The expression pattern of the ATP-gated ion channel P2X(1) receptor subunit was studied in the developing rat cochlea by riboprobe in situ hybridisation and immunohistochemistry. Embryonic (E12, E14, E16 and E18) and postnatal (P0, P2, P4, P6, P10 and adult) rat cochleae were examined. Both mRNA and protein localisation techniques demonstrated comparable P2X(1) receptor expression from E16 until P6 but this expression was absent at later developmental stages. P2X(1) receptor mRNA expression was localised within the otic capsule and associated mesenchyme (from E16 to P6), spiral limbus (from P0 to P6) and within the spiral ligament adjacent to the insertion of Reissner's membrane (from P2 to P6). P2X(1) receptor protein had a similar distribution based upon immunoperoxidase localisation. P2X(1) receptor-like immunoreactivity was detected in the otic capsule and the surrounding mesenchyme (from E16 to P6), spiral limbus (from P0) and epithelial cells of Reissner's membrane (from P2 to P6). The spiral ganglion neurones showed the earliest P2X(1) receptor expression (from E16 to P6). This became associated with immunolabelling of their afferent neurite projections to the base of the developing inner and outer hair cells (observed from E18 and peaking at P2). Immunolabelling of the efferent nerve fibres of the intraganglionic spiral bundle (from E18 to P6) within the spiral ganglion was also observed. The results suggest that ATP-gated ion channels assembled from P2X(1) receptor subunits provide a signal transduction pathway for development of afferent and efferent innervation of the sensory hair cells and purinergic influence on cochlear morphogenesis.     

S-BLMs的发展及其在生物传感器中的应用

由于双层类脂膜(bilayer lipid membranes,BLMs)是生物膜极好的实验模型,因此在生物传感器的研制领域显示出广泛的应用前景。在对生物膜结构进化的简短总结后,介绍了有固态基底支撑的BLMs(supported bilayer lipid membranes,S-BLMs)的研究发展状况,并综述了其在生物传感器中的应用研究进展。     

延迟小骨窗开颅手术治疗硬膜外血肿96例

1临床资料1999-08/2004-08我科采用延迟小骨窗开颅手术治疗硬膜外血肿96(男75,女21)例,年龄13～18(平均35)岁.受伤原因车祸72例,坠落伤11例,打击伤13例.均于伤后72 h内就诊并经头颅CT确诊,表现头痛96例,呕吐21例,一侧肢体无力32例,偏身麻木23例,癫痫发作1例,原发昏迷92例,59例≤30 min,33例为30～120 min,头痛进行性加重36例.就诊时GCS记分10～12分15例,13～15分81例,运动性失语2例,混合性失语3例.CT示血肿位于额顶叶12例,额叶32例,颞叶5例,顶枕叶8例,颞顶后39例(1例合并对侧脑内血肿,5例合并额颞叶脑挫裂伤).血肿量30～80mL.入院后3～15 d内先给予脱水剂、激素、止血剂、抗生素、脑活性药物、镇痛剂等对症处理保守治疗.