肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

EIAV减毒疫苗诱导马外周血单个核细胞Th1型细胞因子的转录

目的：探讨马传染性贫血病毒驴白细胞减毒疫苗免疫马后,外周血单个核细胞中Th1型细胞因子转录水平与免疫保护应答的关系,揭示DLV的免疫保护机制。方法：应用分子克隆及实时定量RT-PCR技术,建立了马PBMC中IFNγ-、IL-2、IL-12 mRNA转录水平的定量检测方法,定期观察4组（疫苗免疫组、阴性对照组、强毒株阳性对照组、自然感染组）12匹马外周血PBMC中细胞因子的转录水平及分布特征,同时监测体温变化等指标。疫苗株免疫动物8个月后,用EIAV强毒株攻击,观察攻击前后细胞因子转录水平的变化。结果：DLV免疫马,在免疫后3周外周血PBMC中IFN-γ、IL-2转录量显著高于阴性对照组及自然感染组（P〈0.01）;免疫后用EIAV强毒株攻击,IFNγ-、IL-2和IL-12转录的量明显升高,免疫马获得完全保护;强毒株攻击阳性对照马IFN-γ、IL-2转录量随疾病进展波动,发热期下降。结论：本研究首次证明EIAV减毒疫苗可诱导马外周血PBMC中IFN-γ、IL-2、IL-12基因高效转录,其转录水平与DLV的免疫保护密切相关,此结果在分子水平为阐明DLV的免疫保护机制提供了新的实验依据。     

In vitro synergistic effect of minocycline combined with antifungals against Cryptococcus neoformans

BackgroundCryptococcus neoformans infections occur in immunocompromised patients, especially those with HIV infection, chemoradiotherapy after cancer, and organ transplantation. Infection can cause pneumonia and meningoencephalitis in severe cases with a high mortality rate if not treated. Although fluconazole and amphotericin B are the first-line treatments for cryptococcosis, the rate of fluconazole resistance has increased significantly due to long-term use. Minocycline is a derivative of tetracycline that exerts its antibacterial effect through inhibition of bacterial protein synthesis. It is also able to pass the blood-brain barrier to act on the central nervous system. The present study investigates the effects of minocycline in combination with antifungals in treating C. neoformans.ObjectiveTo determine in vitro interactions of minocycline combined with itraconazole, voriconazole, posaconazole, fluconazole and amphotericin B against C. neoformans.MethodsThe minimum inhibitory concentrations (MIC) of the antifungals were determined by the CLSI Clinical and Laboratory Standards Institute M27-A3 microdilution method. The in vitro synergistic effects of minocycline combined with itraconazole, voriconazole, posaconazole, fluconazole, and amphotericin B on C. neoformans were detected by the broth microdilution checkerboard technique and disk diffusion testing.Results and ConclusionThe working concentration ranges were 0.125–4 µg/mL for itraconazole, 0.03–0.125 µg/ml for voriconazole, 0.03–1 µg/ml for posaconazole, 0.25–16 µg/ml for fluconazole, and 0.125–2 µg/ml for amphotericin B. The synergistic rates of minocycline combinations against C. neoformans were 55% with itraconazole, 10% with voriconazole, 85% with posaconazole, 20% with fluconazole, and 70% with amphotericin B. The effective MIC value of minocycline in the synergistic combination decreased to 2–32 µg/ml, while the MIC of itraconazole decreased to 0.03–0.125 µg/ml, voriconazole 0.03–0.125 µg/ml, posaconazole 0.03–0.125 µg/ml, 0.125–4 µg/ml fluconazole, and 0.06–0.50 µg/ml amphotericin B. The disk diffusion assay showed that the plates containing minocycline and antifungal drugs produced inhibition zones with diameters larger than the single drug plates. Minocycline showed no antagonistic effect in the combinations. In conclusion, the combination of minocycline and azoles or amphotericin B has synergistic effects against C. neoformans in vitro.     

视频脑电图监测对小儿癫痫的诊断价值探讨

目的探讨视频脑电图(VEEG)对小儿癫痫的诊断价值。方法对102例临床拟诊为癫痫患儿进行4～8h视频脑电图监测,其中包括清醒、睡眠期记录;分析临床发作和异常放电的关系,异常放电出现的时相。结果监测到临床发作并且同步异常放电者23例,仅发作间期癫痫样放电者53例,两者共76例(76/102,74.51%)结合病史确定为癫痫,其中局灶性52例(52/76,68.42%),睡眠中出现55例(55/76,72.37%)。10例(10/102,9.80%)临床发作但无同步异常放电,判定为非癫性发作。结论视频脑电图可提高儿童癫痫诊断的正确率,有助于癫痫的定位,部分剥夺睡眠有助于癫痫样放电的检出率。     

间变性大细胞淋巴瘤形态学及免疫表型观察

目的：探讨间变性大细胞淋巴瘤（ALCL）的形态学和免疫表型特征。方法：对6例ALCL和2例弥温性大B细胞淋巴瘤（DLBCL）进行形态学和免疫组织化学染色（ABC法）观察。结果：6例ALCL中，普通型2例、淋巴组织细胞型2例、ALK－变型2例，均可见单型性或多形性的标志性大细胞。普通型和ALK－变型大细胞沿淋巴窦内生长，而淋巴组织细胞型大细胞则呈散在分布；2例DLBCL形态上颇似ALCL；6例ALCL均为T细胞，CD30＋，儿童患者共同表达ALK＋和EMA＋，年长者则ALK－和EMA－。2例DLBCL均为B细胞，ALK＋、CD30－和EMA－。结论：不论何型ALCL，均可见CD30＋的标志性大细胞，淋巴窦内生长多见于普通型和ALK－变型。ALCK均为T细胞，儿童常有ALK和EMA共同表达，年长者则ALK和EMA－。DLBCL的免疫表型不同于ALCL。     

碳纳米管及其复合材料在生物医学领域的研究进展

碳纳米管是一种新型碳材料，具有特殊的纳米结构和优异的力学、电学和磁学性能，在生物医学领域显示出诱人的潜在应用价值和前景，吸引了越来越多的研究者的关注。本文简要介绍了碳纳米管的基本结构与性能，并对近年来碳纳米管在生物大分子的修饰与特异性识别、细胞体外生长支架、植入性生物医学材料、生物医学传感器以及生物医学微电子器件等方面的研究进展和发展趋势进行了综合评述。     

具有三层管壁结构组织工程血管支架的生物力学性能

目的针对组织工程血管的体内培养技术路线，对所制备的具有三层管壁结构的组织工程血管支架的生物力学性能进行测试，并研究了壁厚对支架力学性能的影响，以保证后续的动物体内移植实验能顺利进行。方法采用涂敷，喷涂．滤沥的方法制备了具有三层管壁结构（多孔PLGA层．致密PU层．多孔PLGA层）的可降解组织工程血管支架，用自制的设备测试了其爆破强度和径向顺应性，并对血管支架进行了缝合强度的测试。结果所制备的厚度为0．295mm-0．432mm的三层结构血管支架的径向顺应性为3．80％／100mmHg-0．57％／100mmHg，爆破强度为160kPa～183kPa，缝合强度为0．63N／针～1．52N／针。结论支架的管壁厚度，尤其是中间层厚度，对支架的力学性能有重要影响。增大壁厚可导致径向顺应性急剧下降，爆破强度和缝合强度线性提高。在所制备的样品中，管壁厚度为0．295mm的支架其综合力学性能最优，可满足血管组织工程体内植入的力学性能要求。     

聚醚型聚氨酯材料表面纤维蛋白原的吸附性研究

本文采用放射性同位素标记的方法研究了嵌段聚醚型聚氨酯在纯纤维蛋白原溶液中和稀释血浆中的表面纤维蛋白原吸附性规律，考察了聚醚型聚氨酯的特性粘数及溶液体系中的ＮａＣｌ浓度对材料表面纤维蛋白原吸附性的影响，结果表明，随着聚合物特性粘数的增大，材料表面的纤维蛋白原吸附量呈降低的趋势；溶液体系中盐浓度的降低导致纤维蛋白原凝固性增强，在纯纤维蛋白原溶液中，材料表面纤维蛋白原的吸附量相应增多，而在稀释血浆中，纤维蛋白原的吸附量相应减少，在达到最低值后又有上升的趋向，表明纤维蛋白原在材料表面的吸附还受血浆中其它大分子的影响。     

重组猪戊型肝炎病毒ORF2区主要抗原域的原核表达及鉴定

目的：在大肠杆菌中表达猪戊型肝炎病毒ORF2区主要结构蛋白,并对其进行血清学鉴定。方法：通过RT-PCR技术从一份猪粪中扩增并克隆戊型肝炎病毒主要的结构基因片段,将该片段插入pET-32a表达载体,在原核系统中融合表达蛋白,Western blot和间接ELISA方法分析该蛋白的抗原性。结果：SDS-PAGE分析结果表明,获得45kD的目的蛋白,该重组蛋白可以与HEV阳性血清反应,而不与阴性血清反应,表明该蛋白具有良好的抗原性。结论：本研究获得了猪戊型肝炎病毒重组抗原,可与HEV阳性血清产生特异性的结合反应,可以作为诊断用的重组蛋白,为研制敏感、特异的HEV诊断试剂盒,行之有效的HEV基因工程疫苗及为HEV感染的预防和临床治疗提供资料。     

血管抑素抑制兔眼表碱烧伤角膜缘移植术后的角膜血管新生

目的:检测眼表碱烧伤角膜缘移植术后血管抑素抑制角膜新生血管的作用。方法:16只新西兰大白兔双眼制作碱烧伤模型1d后,双眼行角膜缘移植术,术后左眼局部应用血管抑素治疗2周,右眼作对照;观测4周,根据新生血管侵入角膜缘内的范围、角膜混浊与水肿程度进行分级并作统计学处理;同时测量术后7、14、21及28d的眼压。结果:术后4周时,应用血管抑素的左眼的新生血管的评分为1.19±0.10,而对照组为1.63±0.72,统计学处理显示左眼的新生血管较右眼的明显减少(P<0.05),角膜混浊与水肿程度亦明显下降。各时间点各术眼的眼压均在正常范围,无统计学差异。结论:局部应用血管抑素能有效抑制眼表碱烧伤角膜缘移植术后的新生血管增生。