睡眠剥夺对HSP70表达及脑超微结构的影响

目的：观察睡眠剥夺（SD）后大鼠脑组织HSP70表达的变化及对超微结构的影响。方法：44只雄性SD大鼠随机分为11组，每组4只，免疫组织化学方法检测HSP70的表达，电镜观察海马超微结构的变化。结果：睡眠剥夺后12小时即可在大脑皮质及海马观察到HSP70阳性细胞，2—3天数量达到高峰，7天时明显下降。白天睡眠剥夺12小时（SDd12h）组HSP70阳性细胞数较夜晚睡眠剥夺12小时（SDn12h）组多（P〈0．05）。RS组大脑皮质HSP70阳性细胞数较白天睡眠剥夺1天（SDd1d）组减少（P〈0．05）。白天睡眠剥夺3天（SDd3d）海马出现超微结构改变，白天睡眠剥夺7天（SDd7d）后改变更加明显。结论：睡眠剥夺可影响大鼠脑组织HSP70表达及超微结构。     

人缺血脑组织中IP-10和IFN-γ的表达

目的：探讨趋化因子IP-10和细胞因子IFN-γ是否参与人缺血脑损伤过程。方法：将21例脑梗死死亡病例按发病持续时间分为〈7天、7～14天和15～21天3组，以非缺血侧半球做对照，用HE染色法观察炎性细胞浸润情况；通过免疫组织化学方法检测缺血半球脑组织与非缺血半球脑组织中趋化因子IP-10和细胞因子IFN-γ的表达。结果：在〈7天组和7～14天组中，缺血脑组织可见大量炎性细胞浸润。在〈7天组、7～14天组和15～2l天组中，趋化因子IP-10在缺血半球脑组织中的表达高于非缺血半球（分别是1．74倍增高，P〈0．01；1．41倍增高，P〈0．05和1．52倍增高，P〈0．01）。在对细胞因子IFN-γ的检测中发现〈7天和7～14天组中，IFN-γ在缺血半球脑组织中的表达高于非缺血半球（分别是1．65倍增高，P〈0．05和1．32倍增高，P〈0．05）；在15～21天组中，IFN-γ在缺血半球与非缺血半球中的表达没有显著差异（P〉0．05）。结论：在人缺血脑组织中观察到IP-10和IFN-γ的表达，提示IP-10和IFN-γ参与了炎症反应对脑组织的损伤过程。同时也提示IP-10可能参与后期对损伤脑组织的修复。     

The role of surgery in transmitting ≪ post-transfusion hepatitis ≫

The role of surgery as an additional risk in transmitting post-transfusion hepatitis was investigated in a retrospective study on acute hepatitis occurring in 77 transfused patients, 293 transfused and operated patients and 243 hepatitis cases with history of surgery without transfusion.Hepatitis A patients admitted to the same centres in the same period were utilized as controls. In transfused patients the percentage of NANB hepatitis was higher than that of type B (61.0% vs. 36.4%), while in the operated not transfused group the percentage of type B was twice that of type NANB (63.4% vs. 32.5%).In transfused and operated cases intermediate values were observed. The age-adjusted measures of association between exposures and the different hepatitis types showed a lack of effect of transfusion and a dominant role of surgery in transmitting type B hepatitis. In contrast, NANB post-transfusional cases were actually a mixture of post-transfusional and post-surgical cases, since both these exposures were found to be significantly associated with the disease.Our results suggest that studies on the incidence and the etiology of post-transfusion hepatitis should take into account the risk of surgical exposure which might have occurred.Corresponding author.     

肾综合症出血热血清蛋白与肝肾功能及临床关系的研究

目的 了解肾综合症出血热（HFRS）各期血清蛋白的变化特点及其与肝、肾功能的关系。方法 采用瑞士产COBAS MIRA PLUS CC全血动生化分析仪及日本产MA－4210尿液分析仪分别检测同时的空腹静脉血及晨尿。结果 150例HFRS患者217次检测血清总蛋白（T）平均为63.51g/L,白蛋白（A）为36.29g/L,球蛋白（G）为27.22g/L,A/G=1.33。其中A／G为1.49-1.0者137例（63.3%）,A／G＜1.0者27例（12.44%）,A／G≥1.5者53例（24.42%）。结论 HFRS患者有75.58%存在着低白蛋白血症,并贯穿于各期,异常程度与病情轻重呈正相关,主要原因是肾脏损害,大量白蛋白从尿中丢失,与肝脏的合成功能关系不大。     

人工流产术前宫颈及子宫内膜麻醉的镇痛效果探讨

目的　探讨宫颈与子宫内膜两部位联合麻醉、普鲁卡因与利多卡因两药物配合应用在人工流产术中的镇痛效果。方法　人工流产术前对麻醉组 10 6例行普鲁卡因宫颈浸润麻醉和利多卡因子宫内膜表面麻醉。术中记录受术者腹痛程度、无阻力插入宫颈内口的扩张器号、出血量、人流综合征例数等指标。按照世界卫生组织规定疼痛标准及人工流产综合征反应进行评价 ,同期选择按传统机械扩宫法 10 4例做对照。结果　麻醉组镇痛有效率95 3% ,宫口松驰有效率 95 3% ,人流综合征无 1例发生。两组比较P均 <0 0 0 1。两组出血量比较无差异 ,无利多卡因毒性反应发生。结论　人工流产术前普鲁卡因宫颈浸润麻醉和利多卡因子宫内膜表面麻醉镇痛效果显著 ,可大大降低人流综合征的发生 ,避免利多卡因的毒性反应     

幼兔近视模型及大光明护眼液的疗效

目的 :探讨学生近视眼的发病机制和有效治疗药物。方法 :选用 2 0只新西兰纯种幼兔建立近视模型 ,然后分别采用2种药物和生理盐水治疗。结果 :大光明护眼液治疗组的平均屈光度 (D)值为 (+ 2 5 0± 0 6 8)、平均裸眼觅食距离 (cm)值为(2 80 0 0± 2 7 30 )、平均体重 (g)增长值为 (72 6 0 0± 31 30 ) ;而珍视明滴眼液治疗组和生理盐水治疗组近视屈光度 (D)值分别为(+ 1 6 6± 0 2 9)和 (+ 0 85± 0 42 ) ,平均裸眼觅食距离 (cm)分别为 (2 5 6 0 0± 5 4 48)和 (196 0 0± 76 48) ,平均体重 (g)增长分别为 (6 2 2 0 0± 31 94)和 (5 6 0 0 0± 6 2 85 )。结论 :(1)长期限制视距、微弱光线照射和经常习惯性近距离视物是造成近视眼的直接因素 ;(2 )采用大光明护眼液治疗近视眼的疗效明显 ,优于珍视明滴眼液和生理盐水治疗组 (P <0 0 1)。     

Distinct immunopathological mechanisms of EBV-positive and EBV-negative posttransplant lymphoproliferative disorders

EBV-positive and EBV-negative posttransplant lymphoproliferative disorders (PTLDs) arise in different immunovirological contexts and might have distinct pathophysiologies. To examine this hypothesis, we conducted a multicentric prospective study with 56 EBV-positive and 39 EBV-negative PTLD patients of the K-VIROGREF cohort, recruited at PTLD diagnosis and before treatment (2013–2019), and compared them to PTLD-free Transplant Controls (TC, n = 21). We measured absolute lymphocyte counts (n = 108), analyzed NK- and T cell phenotypes (n = 49 and 94), and performed EBV-specific functional assays (n = 16 and 42) by multiparameter flow cytometry and ELISpot-IFNγ assays (n = 50). EBV-negative PTLD patients, NK cells overexpressed Tim-3; the 2-year progression-free survival (PFS) was poorer in patients with a CD4 lymphopenia (CD4⁺<300 cells/mm³, p <  .001). EBV-positive PTLD patients presented a profound NK-cell lymphopenia (median = 60 cells/mm³) and a high proportion of NK cells expressing PD-1 (vs. TC, p = .029) and apoptosis markers (vs. TC, p < .001). EBV-specific T cells of EBV-positive PTLD patients circulated in low proportions, showed immune exhaustion (p = .013 vs. TC) and poorly recognized the N-terminal portion of EBNA-3A viral protein. Altogether, this broad comparison of EBV-positive and EBV-negative PTLDs highlight distinct patterns of immunopathological mechanisms between these two diseases and provide new clues for immunotherapeutic strategies and PTLD prognosis.     

舌下神经-面神经直接侧端吻合的应用解剖学研究

目的:为舌下神经-面神经直接侧端吻合提供解剖学依据。方法:①在21例防腐固定的成人头颈部标本上,测量面神经干及其颞骨内乳突段、鼓室段长度;面神经干分叉处至舌下神经颈部的最短距离。②3例新鲜标本取舌下神经及面神经干行组织学检测,测定其神经束数目和横切面积。③2例标本摹拟术式设计。结果:舌下神经干在寰椎水平为单束形式,横切面积为(8.5±0.3)mm2;面神经干在出茎乳孔处为单束形式,横切面积为(5.1±0.2)mm2;面神经干的长度为(15.7±2.0)mm,颞骨内面神经乳突段的长度为(14.6±1.5)mm、鼓室段的长度为(9.6±1.2)mm;面神经干分叉处至舌下神经颈部的最短距离为(17.2±2.3)mm。结论:舌下神经-面神经直接侧端吻合治疗面瘫具有可行性。     

Early operation for fulminant acute pancreatitis: a possible way to decrease mortality

Background Although the indication and the timing for surgery in fulminant acute pancreatitis (FAP) are still controversial, our experience of surgical treatment for fulminant acute pancreaUtis may help improve the outcome for patients.Methods The clinical data of twenty-six patients with FAP from January 1, 2001 to October 1,2005 were analyzed. The diagnostic criteria fitted the 2007 Guidelines for the Management of Severe Acute Pancreatitis by the Chinese Medical Association.Results Twenty-six patients with FAP received surgical debridement, with a mortality rate of 42.3% (11/26). The postoperative mortalities in the ＞72 hour operation group and the <72 hour operation group were highly significantly different (7/8 vs 22.2% (4/18), respectively).Conclusions Early surgery may reduce the intraabdominal pressure and prevent the deterioration of FAP. An operation within 72 hours from the onset of symptoms might decrease the mortality of the disease.     

Preliminary study on immunotoxin for the prevention of Schistosomiasis japonica

To investigate the effects of immunotoxin (bio-missile) on the prevention of schistosomiasis. The monoclonal antibody NP11-4, located in out-layer membrane of adult worm, membrane of cercariae, membrane of schistosomula, shell of egg and membrane of miracidium in egg, was combined with artesunate (produced by Guilin Pharmaceutical Factory of China) by chemical method to fabricate immunotoxin.