Cytokines and growth factors in keratinocytes and sweat glands in chronic venous leg ulcers. An immunohistochemical study

The role of growth factors and cytokines in the impaired healing of chronic leg ulcers remains uncertain. The aim of this study was to determine whether changes in the amount and location of cytokines and growth factors may be associated with impaired healing in chronic leg ulcers. Biopsies from leg ulcers of 21 patients and from normal skin of nine healthy volunteers were examined immunohistochemically for selected growth factors and cytokines. Greater staining intensity was found in keratinocytes at the edges of ulcers compared to normal skin, or skin adjacent to the ulcers. Staining at the ulcer edge was more intense in nonhealing ulcers for only vascular endothelial growth factor and platelet-derived growth factor, whereas staining in the adjacent skin was more intense for all factors in the nonhealing phase. For all factors staining was cytoplasmic, suggesting production in these areas. This study shows up-regulation of the production of cytokines and growth factors in keratinocytes of chronic leg ulcers that is greater when the ulcers are nonhealing.     

多层螺旋CTA:不同重建方法在主动脉瘤腔内隔绝术后的应用评价

目的：探讨多层螺旋CT血管造影不同重建方法在主动脉瘤腔内隔绝术后的临床应用价值。材料与方法：46例主动脉瘤腔内隔绝术后行多层螺旋CT血管造影，采用准直2.5mm，层厚3.0mm，螺距为6，重建方法为容积显示技术（volume rendering，VR）、表面阴影遮盖显示(shade surface display，SSD)及最大密度投影法（maximum intensity projection，MIP），并对三种方法进行比较。结果：46例中有1例术后内支架出现局限性断裂，VR及MIP均清晰显示了内支架的变化，SSD未能显示。1例内支架展开不良，三种重建方法均明确显示；6例术后出现渗漏，VR清晰显示渗漏的部位、形态及内漏量，MIP、SSD仅显示其中的5例，三者中以VR显示最佳。在显示支架内血流情况及瘤周血栓方面，VR能明确支架内有无血栓形成及腔内隔绝术后的转归变化，VR显示1例术后支架内血栓形成SSD及MIP未能显示。结论：多层螺旋CT能在较短时间内进行大范围的扫描，有利于主动脉病变的检查；VR图像优于SSD及MIP，能为术后内支架情况提供更多更准确的信息，VR技术应作为主动脉瘤内支架术后的首选三维重建方法。     

鼻息肉上皮细胞凋亡与bcl-2的表达及意义

目的　了解细胞的凋亡和癌基因bcl 2在鼻息肉的发病机制中的作用。方法　应用免疫组织化学的方法检测 45例鼻息肉细胞凋亡早期蛋白 (M3 0 )和bcl 2的表达 ,用下鼻甲粘膜作自身对照。结果　鼻息肉上皮和下鼻甲粘膜上皮的M3 0指数分别为 0 482± 0 3 2 ;1 0 62± 0 5 47,其差别有统计学意义 (P <0 0 1)。bcl 2阳性细胞在鼻息肉表层上皮和腺上皮均有表达 ,在下鼻甲中未见表达 ,其指数为 14 5 1± 4 46。结论　鼻息肉的发病机制及其生长过程与上皮细胞的增殖和凋亡的失平衡有关。bcl 2的表达可能是鼻息肉上皮凋亡抑制的原因 ,在鼻息肉上皮细胞增殖和凋亡失平衡的过程中起重要作用     

喉癌的颈清扫术(附5例报告)

本文报告5例喉癌颈清扫术,对其适应症、手术方式等进行了初步分析。认为CN_(1,2),无论病理LN是否阳性均应行ND。CN_3者ND要慎重考虑。CN_0一般不施行ND,除声门上癌或声门癌侵及声门上区时例外。术式以FND为宜。     

蛛网膜下腔注射神经降压素对大鼠血压和心率的影响

本文研究了蛛网膜下腔注射神经降压素（ｎｅｕｒｏｔｅｎｓｉｎ，ＮＴ）对大鼠血压和心率的影响，结果表明：注射ＮＴ后血压立即下降，继而有所回升，但不及正常水平，然后再次降低，持续６０ｍｉｎ；心率无明显改变。Ｈ１受体阻断剂苯海拉明能部分阻断ＮＴ的降血压效应，Ｈ２受体阻断剂甲氰咪胍无翻转作用。注射组胺释放剂Ｃｏｍｐｏｕｎｄ４８／８０使血压下降，待血压恢复正常水平后，再注射ＮＴ，其降压效应减弱。结果提示：蛛网     

Multiple sclerosis: myelin basic protein induced mRNA expression of proinflammatory cytokines in mononuclear cells is suppressed by interferon-β 1b in vitro

Beta-interferon (IFN-β) is a promising treatment in multiple sclerosis (MS), reducing the exacerbation rate and MRI lesion burden, as well as the disease progression in relapsing-remitting MS. IFN-β was originally defined by its antiviral effects, but the interest has recently been focused on its immunomodulatory properties. Myelin basic protein (MBP) is one of several autoantigens considered to be the target for autoaggressive immune responses, which eventually might lead to the development of MS. To study in-vitro effects of IFN-β1b on MBP induced cytokine expression, mRNA for the Th1 cytokines IFN-γ and TNF-α, the Th2 related IL-4 and IL-6, the cytolytic perforin and the immune response downregulating TGF-β was measured with in situ hybridization after culture of blood mononuclear cells (MNC) in the presence and absence of MBP. Numbers of cells expressing IFN-γ, TNF-α, perforin and IL-4 mRNA were significantly suppressed after culture with 10 U/ml IFN-β1b. No such effect was seen on MBP induced IL-6 or TGF-β mRNA expression. These observations suggest that one of the major effects of IFN-β1b is the induction of a shift in the cytokine mRNA profile towards a more immunosuppressive pattern. In parallel in vitro tests, the control substance dexametasone (40 μg/ml) reduced the numbers of cells expressing mRNA for all cytokines under study with the exception of TGF-β, to an extent equal to or even more pronounced than IFN-β1b.     

替尼泊苷和卡莫司汀对脑胶质瘤的治疗作用及耐药的研究

目的研究联合应用替尼泊苷、卡莫司汀对脑胶质瘤细胞的杀伤作用及联合用药的耐药机制.方法测定单独或联合应用替尼泊苷、卡莫司汀两种药物对20例胶质瘤细胞的体外敏感性,检测各标本中多药耐药基因(mdr-1)表达的情况.结果①替尼泊苷、卡莫司汀的敏感性为20%、15%,联合用药为45%,经统计学分析联合应用明显优于单独用药(P<0.05);②联合用药的耐药情况(8/20)与mdr-1基因表达(7/20)符合良好(P<0.05).结论亚硝脲类和鬼臼毒衍生物联合应用对胶质瘤有较好的治疗作用,联合用药的耐药性与mdr-1的表达有关.     

Elevated extracellular potassium is associated with a reduced extracellular space in rat neural lobe in vitro

Summary Increased neural activity of neurosecretory cells is accompanied by large increases in extracellular K⁺. The possibility that elevations of this ion might involve fluid redistribution and thus affect the size of the extracellular space and the relationship between pituicytes and axons in the rat neural lobe was explored using rapid freezing and freeze-substitution. Neural lobes were incubated for 15 min before freezing either in a normal medium or one containing a 10 mM increase in KCl (high KCl), a 10 mM increase in KCl balanced by an equimolar reduction in NaCl (high KCl-low NaCl), or only a 10 mM reduction in NaCl (low NaCl). A quantitative assessment of the region of good fixation was made to determine the relative fractions occupied by axons, pituicytes and the extracellular space near the neurohaemal contact zone. In addition, the percentage of basal lamina contacted by pituicytes and axons was calculated, as was the degree of enclosure of axons by pituicytes.In neural lobes incubated in normal medium, the extracellular space accounted for approximately 30% of the cross-sectional area of the neuropil and could be divided into two domains: an extended perivascular space (28–29% of total area); and a narrow (approximately 24 nm; approximately 1% of total) space between closely apposed neurosecretory processes or between these processes and pituicytes. Pituicytes occupied almost 60% of the basal lamina at the neurohaemal contact zone, while axons occupied approximately 20%. Neural lobes incubated in either the high KCl solution, or in the high KCl-low NaCl solution, exhibited a significantly reduced extracellular space, to about 20% of the total area, or a reduction from controls of about one-third. The reduction was complemented by an increased area occupied by axons plus pituicytes. In the high KCl group, the contribution of the narrow spaces (22–24 nm) between apposed processes to the total extracellular space was greatly increased. The group exposed to low NaCl showed high variability in the size of extracellular space, and was thus not significantly different from any other group. No changes in any group were observed in the enclosure of axons by pituicytes, or in the relative amounts of axon and pituicyte apposition to the basal lamina.The subsequent buffering of K⁺ and other ions during periods of increased neuronal activity may be affected by changes in the extracellular space, thereby influencing stimulus-secretion coupling. A shrinkage of the extracellular space and the relative increase in the narrow spaces between processes initiated by elevated K⁺ could also alter the diffusion properties of the neural lobe.     

青光眼患者相对性瞳孔反射传入障碍与其两眼视野面积差值的比较

对伴有相对性瞳孔反射传入障碍（RAPD）的26例非对称性青光眼（17例原发性开角型青光眼和9例青睫综合征）患者，将RAPD定量值与其两眼视野面积差值（VFAD）进行相关分析。结果显示Ⅰ2e、Ⅰ4e和Ⅲ4e等视线VFAD与RAPD值的相关系数分别为0.70、0.81和0.88，各相关系数经统计学检验均有极显著意义（P＜0.001）。表明RAPD测量在揭示青光眼不对称性视功能损害方面与视野检查具有一致性。因而RAPD可以作为非对称性青光眼视功能损害的重要体征之一。