Replicative multivirus infection with cytomegalovirus, herpes simplex virus 1, and parvovirus B19, and latent Epstein-Barr virus infection in the synovial tissue of a psoriatic arthritis patient.

BACKGROUND: Psoriatic arthropathy occurs as complicating feature in about 5-7% of psoriasis patients. Infectious mechanisms including viral antigens have been suggested by serologic data as CD8 T cellular specifity towards viral epitopes. OBJECTIVE AND RESULTS: We here reported a case of a 32-year-old male psoriatic arthritis patient, where we could demonstrate simultaneous infection with cytomegalovirus (CMV), herpes simplex virus type I (HSV1) and parvovirus B19 (B19), as well as latent Epstein-Barr virus (EBV) infection within the synovial tissue by immunohistochemistry (CMV, parvovirus B19, HSV1, EBV-LMP) and DNA-in situ-hybridization (CMV). Serologic examination revealed positive EBV and parvovirus B19-IgG-antibodies, but no antibody response to HSV1 and CMV. CONCLUSION: This case is of special interest, since replicative viral infections have not yet been demonstrated localised in the psoriatic arthritis synovia. Thus, with particular regard to the limited information of the serologic data and the possible need of immuno suppressive therapy direct synovial testing for viral antigenes may be considered in psoriatic arthritis patients.     

Monosomy 7p in meningiomas: a rare constituent of tumor progression

We present karyotypes of 15 meningiomas with structural aberrations of chromosome 7, which were taken from a consecutive series of 400 cytogenetically characterized meningiomas. Twelve of these tumors (80%) displayed partial or complete monosomy 7p with a consensus deleted region of 7p12 approximately pter, in 6 of 15 cases arising from an unbalanced whole-arm t(1;7)(q11;p11), and in 4 of 15 cases from a whole-arm translocation involving other chromosomes. Other types of partial aneusomy 7 (3/15 cases) or balanced aberrations of chromosome 7 (2/15 cases) were relatively rare. In most cases (11/15), the centromeric region of chromosome 7 was involved in the rearrangements. We conclude that in meningiomas, the near-centromeric region of chromosome 7 is particularly prone to structural rearrangements most frequently resulting in monosomy 7p. The investigation of the histopathologic features of this rare cytogenetic subgroup of meningiomas showed no clear genotype/phenotype correlation. As 7 of 11 of the meningiomas with monosomy 7p belonged to World Health Organization grades II or III, which usually comprise less than 20% of all meningiomas, partial loss of 7p appears to be involved in tumor progression in meningiomas. Because monosomy 7p is typically associated with the strongly progression-associated monosomy 1p, however, monosomy 7p represents a cofactor more than a stand-alone feature of meningioma progression.     

脂多糖诱导的小鼠腹腔巨噬细胞基因表达谱分析

目的　利用基因芯片技术分析脂多糖 (LPS)活化的小鼠腹腔巨噬细胞基因表达谱 ,以更全面地了解LPS诱导的巨噬细胞反应。方法　以未刺激的和用 1mg/LLPS刺激的小鼠腹腔巨噬细胞制备3 3 P标记的cDNA探针 ,分别与含有 1176个已知基因的小鼠cDNA芯片杂交。结果　活化组和未刺激组间的 2倍差异表达基因为 118个 ,3倍差异表达基因为 6 9个 ,其中 4 4个上调 ,2 5个下调。转录因子、细胞内信号调节蛋白、炎症细胞因子和细胞凋亡相关基因的转录发生明显的调节变化。结论提供了LPS活化的巨噬细胞综合基因表达信息 ,并筛选出一些新的可能与LPS活化相关的基因。     

Veno-occlusive disease (VOD) of the liver in Korean patients following allogeneic bone marrow transplantation (BMT): efficacy of recombinant human tissue plasminogen activator (rt-PA) treatment.

Veno-occlusive disease (VOD) of the liver is a clinical syndrome characterized by hyperbilirubinemia, painful hepatomegaly, and fluid retention. In the bone marrow transplantation (BMT) setting, VOD is caused by dose-intensive chemotherapy and/or radiotherapy used to prepare patients for transplant. VOD occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. Until recently, there was no proven effective medical therapy for this condition once it was clinically apparent. We report here on the frequency and treatment result of VOD with rt-PA in our allogeneic BMT patients. Eight patients (median age 28.5 years) underwent allogeneic BMT from December, 1993 to June, 1995 in Asan Medical Center. Six leukemia patients were prepared for BMT with busulfan and cyclophosphmide, while two aplastic anemia patients received cyclophosphamide and antithymocyte globulin. VOD was defined as having two of the following features before day 20 posttransplant: jaundice (bilirubin > or = 2 mg/dL), tender hepatomegaly and/or right upper quadrant pain, ascites and/or unexplained weight gain (> 2% from baseline). All patients who were diagnosed with VOD received rt-PA (10-20 mg/day) and heparin (10,000 U/day). Three (37.5%) of the eight patients developed VOD that occurred between 6 and 10 days posttransplant. All three patients developed jaundice, weight gain, and tender hepatomegaly. Ascites and renal insufficiency occurred in two patients and pleural effusion in one patient. rt-PA and heparin were begun 6 to 26 days posttransplant and rt-PA was administered for 7 to 14 days. All three patients responded to the therapy; bilirubin levels began to decrease at 4 to 13 days from the start of therapy. They are all alive at day 111, 316, and 548 days posttransplant. None of the patients had significant hemorrhagic complications after rt-PA treatment. Prolonged administration of rt-PA was feasible without bleeding episode and it seems that rt-PA may alter the natural course of VOD.     

Comparative genomic hybridization reveals recurrent enhancements on chromosome 20 and in one case combined amplification sites on 15q24q26 and 20p11p12 in glioblastomas

We examined homogenized tissue samples of biopsies from 19 astrocytomas of different grades for genetic imbalances using comparative genomic hybridization (CGH): three astrocytomas grade II, and 16 astrocytomas grade IV (glioblastoma multiforme), one of the glioblastomas representing the recurrence of a benign oligoastrocytoma. In two of three cases of astrocytoma grade II, a gain of chromosome 7 was found. The alterations in the glioblastomas were complex, and most frequently showed the characteristic gain of chromosome 7 and loss of chromosome 10. The single analyzed case of recurrence of an oligoastrocytoma was characterized by a unique CGH pattern. This tumor showed two distinct alterations: apart from an amplification on 15q24q26, we found a distinct amplification of a small region on 20p11.2p12, which has not been previously described in brain tumors. Partial or complete gains of chromosome 20 arose in six other tumors; we conclude that chromosome 20 in particular 20p11. 2p12, may harbor relevant genes for glioma progression.     

526例50岁以上男性前列腺增生与血清睾酮含量的变化

目的揭示老龄人群前列腺增生的发病现状及血清睾酮水平的变化规律.方法以一汽集团50岁以上男性为研究对象,另设2组年龄对照,均行直肠指诊、经腹前列腺超声检查、放免技术测定血清睾酮与皮质醇含量.结果(1)50岁以上人群中BPH发现率,直肠指诊诊断率为60.05%,经腹超声诊断率为69.57%,并且随增龄明显增高;(2)血清睾酮含量随增龄下降,二者间呈明显的负相关关系(r=-0.45,P＜0.0001);(3)前列腺体积与血清睾酮含量呈显著的负相关关系(r=-0.224,P＜0.001).结论在50岁以上人群中BPH的发现率超过60%,并发现BPH的发病可能与血清睾酮含量下降有关.     

Study of the mechanism of essential garlic oil inhibiting lnterleukin-1 α-induced monocyte adhesion to endothelial cells

Objective  

To observe the effects of essential garlic oil (EGO) on vascular cell adhesive molecule-1 (VCAM-1) expression of endothelial cells and monocyte-endothelial cell adhesion rate induced by interleukin-l_α(IL-l_α).     

Probucol improves erectile function by regulating endoplasmic reticulum stress in rats with streptozotocin-induced diabetes

This study was to explore the effect and mechanism of Probucol on STZ-induced erectile dysfunction in diabetic rats. Thirty SD male rats aged 12 weeks were given intraperitoneal injection of STZ after fasting for 12 hr. Diabetic rats were haphazardly partitioned under two assemblies and administered 0 or 500 mg/kg probucol by oral gavage to 12 weeks. Control group was intraperitoneally injected with physiological saline, and saline was administered by oral gavage daily. Intracorporeal pressure was used to evaluate erectile function. Levels of proteins were detected using immunohistochemistry and Western blotting. α-SMA and vWF were detected using immunofluorescence staining. After treatment, erectile function in probucol group was significantly improved. Endoplasmic reticulum stress-related proteins were expressed higher in DM group than in sham group, while expression of these proteins decreased significantly in probucol group. However, α-SMA and vWF were expressed at lower levels in DM group than in sham group, and probucol treatment reversed this phenomenon. Finally, Bax and Caspase3 were expressed at higher levels and Bcl-2 was expressed at lower levels in DM group, while the opposite result was obtained in probucol group. In conclusions, probucol improves erectile function by reducing endothelial dysfunction and inhibiting PERK/ATF4/CHOP pathway in STZ-induced diabetic rats.     

护理人员个人发展计划知信行现状及影响因素分析

目的 调查护理人员个人发展计划知信行现状及影响因素,为开展个人发展计划培训和人力资源管理提供参考.方法 采用自制护理人员一般资料问卷和个人发展计划知信行问卷对3298名护理人员进行调查.结果 护理人员个人发展计划知信行总分为(100.01±15.50)分,知识维度得分(17.82±6.07)分,态度维度得分(52.13±7.06)分,行为维度得分(30.06±7.13)分.多元线性回归分析显示,学历、职称、婚姻状况、岗位及对个人发展计划了解程度是护理人员个人发展计划知信行的影响因素(P＜0.05,P＜0.01).结论 护理人员的个人发展计划知信行水平处于中等水平,受护理人员个人特征的影响.医院管理者可通过开展相关培训以提高护理人员个人发展计划知信行水平.     

适形切除保肛术与经括约肌间切除术治疗低位直肠癌的临床疗效

目的探讨适形切除保肛术(CSPO)与经括约肌间切除术(ISR)治疗低位直肠癌的临床疗效。方法采用回顾性队列研究方法。收集2011年8月至2020年4月2家医学中心收治的183例(海军军医大学附属长海医院117例、复旦大学附属华山医院66例)低位直肠癌病人的临床病理资料;男110例,女73例;年龄为(57±11)岁。183例病人中,117例行CSPO设为CSPO组,66例行ISR设为ISR组。观察指标:(1)两组低位直肠癌病人手术情况。(2)两组低位直肠癌病人术后并发症情况。(3)随访情况。(4)影响低位直肠癌病人预后因素分析。(5)影响低位直肠癌病人肛门满意度因素分析。采用门诊、问卷和电话方式进行随访,了解病人肿瘤局部复发及远处转移、病人生存、造口还纳、肛门满意度评分情况。正态分布的计量资料以x±s表示,组间比较采用t检验;偏态分布的计量资料以M(范围)表示。计数资料以绝对数或百分比表示,组间比较采用χ²检验。等级资料比较采用秩和检验。采用Kaplan-Meier法绘制生存曲线,采用寿命表法计算生存率,采用Log-rank检验进行生存情况分析。单因素分析采用线性回归,将单因素线性回归分析中P<0.10的变量纳入多因素分析。多因素分析采用COX逐步回归分析模型和线性回归分析。结果(1)两组低位直肠癌病人手术情况:CSPO组和ISR组病人腹腔镜手术例数、手术时间、术中出血量、肿瘤远切缘、术后化疗、术后住院时间分别为44例和55例、(165±54)min和(268±101)min、(142±101)mL和(91±85)mL、(0.6±0.4)cm和(1.9±0.6)cm、76例和9例、(6.6±2.5)d和(7.9±4.7)d,两组病人上述指标比较,差异均有统计学意义(χ²=35.531,t=8.995、-3.437、-3.088,χ²=44.681,t=2.267,P<0.05)。(2)两组低位直肠癌病人术后并发症情况:CSPO组术后19例病人发生并发症,其中Ⅰ级并发症6例,Ⅱ级并发症12例,Ⅲb级并发症1例。ISR组术后14例病人发生并发症,其中Ⅰ级并发症4例,Ⅱ级并发症7例,Ⅲa级并发症1例,Ⅲb级并发症2例。两组病人术后总体并发症发生情况比较,差异无统计学意义(χ²=0.706,P>0.05)。两组病人并发症经对症支持治疗后均好转。两组病人均无围术期(术后30 d内)死亡病例。(3)随访情况:183例病人均获得随访,CSPO组和ISR组随访时间分别为(41±27)个月和(37±19)个月,两组病人比较,差异无统计学意义(t=-1.104,P>0.05)。CSPO组和ISR组病人中,肿瘤局部复发分别为2例和3例、肿瘤远处转移分别为9例和4例,两组病人上述指标比较,差异均无统计学意义(χ²=1.277、0.170,P>0.05)。CSPO组和ISR组病人3年无病生存率分别为84.0%和88.6%,3年总体生存率分别为99.0%和92.8%,两组病人无病生存情况和总体生存情况比较,差异均无统计学意义(χ²=0.218、0.002,P>0.05)。CSPO组和ISR组分别有102例和66例病人随访至CSPO或ISR术后12个月,其造口还纳率分别为92.16%(94/102)和96.97%(64/66),两组病人比较,差异无统计学意义(χ²=1.658,P>0.05)。CSPO组8例造口未还纳病人中,2例因高龄、4例主观拒绝还纳、2例因放疗致瘢痕无法还纳。ISR组2例造口未还纳病人中,术后因肝转移和主观拒绝还纳各1例。CSPO组和ISR组分别有92例和61例病人随访至造口还纳术后12个月,其中CSPO组75例和ISR组38例完成肛门功能满意度调查。CSPO组和ISR组病人肛门功能满意度评分分别为(6.8±2.8)分、(5.4±3.0)分,两组病人比较,差异有统计学意义(t=-2.542,P<0.05)。CSPO组和ISR组病人肛门功能满意度评分>5分分别为54例和21例,两组病人比较,差异无统计学意义(χ²=3.165,P>0.05)。(4)影响低位直肠癌病人预后因素分析:COX逐步回归分析结果为性别、肿瘤pT分期是影响低位直肠癌病人无病生存率的独立影响因素(风险比=2.883,1.963,95%可信区间为1.090~7.622,1.129~3.413,P<0.05);性别、肿瘤pT分期是影响低位直肠癌病人总体生存率的独立影响因素(风险比=10.963,3.187,95%可信区间为1.292~93.063,1.240~8.188,P<0.05)。(5)影响低位直肠癌病人肛门满意度因素分析:单因素分析结果显示手术方式和肿瘤分化程度是影响低位直肠癌病人肛门满意度的影响因素(偏回归系数=1.464,-1.580,95%可信区间为0.323~2.605,-2.950~-0.209,P<0.05)。多因素分析结果显示:手术方式、肿瘤分化程度、术前放疗是影响低位直肠癌病人肛门满意度的独立影响因素(偏回归系数=1.637,-1.456,-1.668,95%可信区间为0.485~2.788,-2.796~-0.116,-2.888~-0.447,P<0.05)。结论与ISR比较,低位直肠癌施行CSPO同样可实现超低位保肛,不增加术后并发症发生率,保障肿瘤学安全性,改善肛门功能,提升病人术后肛门功能满意度。