3H-1,2-二氢-1-吡里酮衍生物的合成

发现3 H-1,2-二氢-1-吡咯里嗪酮具有明显的抗炎镇痛作用。用Friedel-Crafts酰化和Dieckmann缩合等反应制备了该酮的一些衍生物,其中五个未见于文献报道。药理实验证明,这些化合物均有不同程度的抗炎镇痛作用。     

改良第二掌背动脉皮瓣修复示中指中末节套脱伤

Objective To investigate the operative procedure and the clinical results of the modified reversed island flap based on the second dorsal metacarpal artery (SDMA) for repairing index or long finger degloving defects.Methods From May 2004 to January 2010, circumferential soft tissue defect in the middle and distal phalanx of the index or long fingers in 17 patients were repaired by the modified reversed island flaps based on SDMA.The dorsal digital nerve in the flap was coapted to the severed proper digital nerve.The area of the flaps ranged from 2.5 cm × 5.6 cm to 5.0 cm × 6.5 cm.The donor sites were closed by skin graft.Results Postoperatively blister and necrosis of the distal flap occurred in 2 cases which was cured by dressing change.All the other flaps survived uneventfully.Primary healing of the flaps and donor sites was achieved.All 17 patients were follow-up for 4 to 27 months with an average of 15.3 months.The flaps were pliable, full but not bulky.Two-point discrimination was 7 to 11 mm (mean 8.6 mm).Hand function as judged by the total active range of motion of the fingers was excellent in 8 fingers, good in 7 fingers and fair in 2 fingers.The satisfactory rate was 88.2%.Conclusion Modified SDMA reversed island flap transfer with dorsal digital nerve coaptation is an ideal procedure to repair index or long finger degloving injuries.The area of the harvested flap is large enough to cover the circumferential soft tissue defect in the middle and distal phalanx.The surgery is safe due to the reliable flap circulation.     

Regulated release of nitric oxide by nonhematopoietic stroma controls expansion of the activated T cell pool in lymph nodes

Fibroblastic reticular cells (FRCs) and lymphatic endothelial cells (LECs) are nonhematopoietic stromal cells of lymphoid organs. They influence the migration and homeostasis of naive T cells; however, their influence on activated T cells remains undescribed. Here we report that FRCs and LECs inhibited T cell proliferation through a tightly regulated mechanism dependent on nitric oxide synthase 2 (NOS2). Expression of NOS2 and production of nitric oxide paralleled the activation of T cells and required a tripartite synergism of interferon-γ, tumor necrosis factor and direct contact with activated T cells. Notably, in vivo expression of NOS2 by FRCs and LECs regulated the size of the activated T cell pool. Our study elucidates an as-yet-unrecognized role for the lymph node stromal niche in controlling T cell responses.     

Twist、E-cadherin和β-catenin在肝细胞肝癌中的表达及其与预后的关系*

目的:探讨Twist、E-cadherin 和β-catenin 在肝细胞肝癌复发与转移中的作用及与预后的相关性。方法:以石蜡包埋组织切片,免疫组化SP法染色分别检测97例肝细胞肝癌,其中复发与转移组49例,非复发与转移组48例Twist、E-cadherin 和β-catenin 的表达情况。结果:复发、转移与性别、年龄无关（P=0.424,P=0.738）,与临床分期密切相关（P=0.000）。 复发与转移组Twist、β-catenin 表达高于无复发与转移组（P=0.000;P=0.000）,复发与转移组E-cadherin 表达低于无复发与转移组（P=0.027）。Twist,β-catenin 阳性组平均生存时间分别为（28.880 ± 3.285）、（ 31.477 ± 3.359）个月,中位生存时间分别为26、28个月,阴性组平均生存时间分别为（44.603 ± 3.521）、（ 42.009 ± 3.720）个月,中位生存时间分别49、45个月,Twist、β-catenin 阳性组生存期较阴性组缩短差别具有统计学意义（P=0.002,P=0.029）。 E-cadherin 阳性组平均生存时间为（44.514 ± 3.447）个月,中位生存时间为49个月,阴性组为（29.110 ± 3.581）个月,中位生存时间为25个月,E-cadherin 阳性组生存时间较阴性组延长有统计学意义（P=0.002）。 结论:Twist、β–catenin 过度表达,E-cadherin 表达缺失可能与HCC 复发转移、不良生存预后存在相关性。      

Childhood chronic gastritis and duodenitis: Role of altered sensory neuromediators

AIM To investigate the roles of the neuropeptides vasoactive intestinal peptide(VIP), substance P(SP), and calcitonin gene-related peptide(CGRP) in chronic gastritis and duodenitis in children.METHODS Biopsy samples from the gastric and duodenal mucosa of 52 patients and 30 control subjects were obtained. Samples were taken for pathological examination, immunohistochemical staining, enzyme activity measurements and quantitative measurements of tissue peptide levels.RESULTS We observed differential effects of the disease on peptide levels, which were somewhat different from previously reported changes in chronic gastritis in adults. Specifically, SP was increased and CGRP and VIP were decreased in patients with gastritis. The changes were more prominent at sites where gastritis was severe, but significant changes were also observedin neighboring areas where gastritis was less severe. Furthermore, the degree of changes was correlated with the pathological grade of the disease. The expression of CD10, the enzyme primarily involved in SP hydrolysis, was also decreased in patients with duodenitis.CONCLUSION Based on these findings, we propose that decreased levels of VIP and CGRP and increased levels of SP contribute to pathological changes in gastric mucosa. Hence, new treatments targeting these molecules may have therapeutic and preventive effects.     

美国国家骨髓库20年回顾:成人无关供者造血干细胞移植

自1987年起,美国国家骨髓库(NMDP)提供了>30 000份URD-HCT,其中70%以上的受者是患有恶性血液病或获得性血液疾病的成人.在此期间发生很大变化,包括无偿捐献队伍的扩大、PBSCs采集、脐血库(UCB)的加入、HLA分型技术的进步、新药物的使用、低强度预处理(RIC)以及移植后免疫调节等.本文就过去20年NMDP成人受者HCT的数据及分析作一介绍.     

来比林镇痛复合液用于神经阻滞的临床研究

目的：探讨来比林（Aspegic)镇痛复合液用于神经阻滞的作用。方法：120例腰椎间盘突出症和颈椎病的患者随机分为四组。I组：对照组（30例）;Ⅱ组：来比林组（30例）;Ⅲ组：地塞米松组（30例）;Ⅳ组：来比林静滴组（30例）。Ⅰ－Ⅲ组患者均采用神经根或外周神经阻滞治疗,间隔3－4天治疗一次,一疗程4次。Ⅳ组患者用来比林静滴治疗,每天一次,7天为一疗程。各组治疗前后疼痛情况用VAS评估,并进行统计学处理。结果：（1）来比林组神经阻滞治疗后的镇痛效果明显优于对照组和来比林静滴组。（2）来比林组和地塞米松组神经阻滞治疗后镇痛效果无统计学差异。结论：来比林镇痛复合液用于神经阻滞治疗,镇痛效果优于单纯全身用药和常规局麻药镇痛复合液。来比林和地塞米松镇痛复合液比较,镇痛作用相似。     

Imaging characteristics of papillary renal cell carcinoma by computed tomography scan and magnetic resonance imaging

AIM: To analyse the differences in the patterns between clear and papillary renal cell carcinomas using magnetic resonance imaging (MRI) and dual-phase helical computed tomography (CT). METHODS: We examined seven patients with papillary renal cell carcinoma, and six with clear cell carcinoma. The highest attenuation value of tumors in the corticomedullary phase (CMP) and the excretory phase (EP) was measured using the observer-defined region of interest (ROI). MRI consisted of T1-weighted and T2-weighted spin-echo imaging. RESULTS: All five tumors except for one with papillary renal cell carcinoma showed homogenous hypointensity, but all six tumors with clear cell carcinoma showed heterogeneous hyperintensity on their T2-weighted images. In the CMP, the mean CT numbers of the papillary renal cell carcinomas were significantly lower than those of the clear cell carcinomas. The mean enhancement of the papillary renal cell carcinomas in the CMP and the EP was significantly lower than that of the clear renal cell carcinomas. The mean CT numbers of the clear cell carcinomas in the CMP were markedly increased from those on the unenhanced CT; those in the EP were decreased gradually. But the mean CT numbers of the papillary renal cell carcinomas in the EP were still slightly more increased than those in the CMP. The enhancement patterns of the papillary renal cell carcinomas in the CMP and the EP were homogenous, but those of the clear cell carcinomas were heterogeneous. CONCLUSIONS: We can speculate the differential diagnosis from clear to papillary renal cell carcinoma using MRI and dual-phase helical CT.