Role of open lung biopsy in patients with diffuse lung infiltrates and acute respiratory failure.

BACKGROUND AND PURPOSE: Open lung biopsy (OLB) is the standard procedure for the diagnosis of specific parenchymal lung diseases. The purpose of this study was to investigate the influence of OLB on subsequent treatment strategy and outcome in patients with diffuse lung infiltrates and acute respiratory failure. METHODS: This retrospective review included 32 patients (aged 50.6 +/- 21.7 years) with acute respiratory failure and diffuse pulmonary infiltrates who underwent OLB from 1990-2002. Data analyzed included diagnoses, treatment alterations, 30-day survival, oxygenation status, and histologic results. RESULTS: Specific diagnoses were made in 53.1% of patients (17/32), 23 (71.9%) of whom had acute respiratory distress syndrome (ARDS). Diagnostic yields did not differ with immunity status or ARDS. OLB led to specific decisions of treatment in 46.9% of patients (15/32), and only 7 of these 32 patients (21.8%) survived. Overall mortality was 56.2% (18/32) and was not influenced by pre-OLB oxygenation or histologic results. Although perioperative complications affected 40.6% of patients (13/32), none of the deaths were surgery-related. Complication rates were significantly higher in patients with ARDS (p = 0.04). CONCLUSIONS: OLB is associated with a low perioperative mortality rate and acceptable morbidity rate in patients with diffuse lung infiltrates and acute respiratory failure, including those patients with ARDS. In this study, a specific diagnosis was obtained by OLB in more than half of patients with diffuse pulmonary infiltrates and ARDS. In addition, OLB resulted in either use of a new therapeutic strategy or elimination of unnecessary treatment in nearly one-half of patients (46.9%).     

Radiological and clinical outcome of selective thoracic fusion for patients with Lenke 1C and 2C adolescent idiopathic scoliosis with a minimum follow-up of 2 years

Background Context

In Lenke 1C and 2C curves, the choice between selective thoracic fusion (STF) versus non-selective thoracic fusion as the optimal surgical treatment is controversial.

β1‐integrin restricts astrocytic differentiation of adult hippocampal neural stem cells

Integrins are transmembrane receptors that mediate cell‐extracellular matrix and cell–cell interactions. The β1‐integrin subunit is highly expressed by embryonic neural stem cells (NSCs) and is critical for NSC maintenance in the developing nervous system, but its role in the adult hippocampal niche remains unexplored. We show that β1‐integrin expression in the adult mouse dentate gyrus (DG) is localized to radial NSCs and early progenitors, but is lost in more mature progeny. Although NSCs in the hippocampal subgranular zone (SGZ) normally only infrequently differentiate into astrocytes, deletion of β1‐integrin significantly enhanced astrocyte differentiation. Ablation of β1‐integrin also led to reduced neurogenesis as well as depletion of the radial NSC population. Activation of integrin‐linked kinase (ILK) in cultured adult NSCs from β1‐integrin knockout mice reduced astrocyte differentiation, suggesting that at least some of the inhibitory effects of β1‐integrin on astrocytic differentiation are mediated through ILK. In addition, β1‐integrin conditional knockout also resulted in extensive cellular disorganization of the SGZ as well as non‐neurogenic regions of the DG. The effects of β1‐integrin ablation on DG structure and astrogliogenesis show sex‐specific differences, with the effects following a substantially slower time‐course in males. β1‐integrin thus plays a dual role in maintaining the adult hippocampal NSC population by supporting the structural integrity of the NSC niche and by inhibiting astrocytic lineage commitment. GLIA 2016;64:1235–1251     

健脾宣肺防喘汤治疗小儿支气管哮喘的临床观察

目的健脾宣肺防喘汤用于支气管哮喘急性发作先兆期,观察临床疗效及总IgE、EOS、IgA、IgG、IgM的变化情况,据随机对照原则将60例患者分为治疗组和对照组,比较治疗前后的症状体征以及血中IgE、EOS、IgA、IgM、IgG等。结果①两组患者治疗后症状体征均较治疗前有改善(P<0.05);②两组治疗后总IgE、EOS、IgA、IgM、IgG均较治疗前改善(P<0.05),且治疗组的改善优于对照组(P<0.05)结论健脾防喘汤可明显改善哮喘患者的临床症状与体征;改善患者的免疫状态进而缓解哮喘症状,可明显改善患儿体质,提高机体的免疫调节功能,从而降低小儿哮喘病急性重症发作的几率,提高治愈率,值得临床推广使用。     

Establishment of an orthotopic transplantable gastric cancer animal model for studying the immunological effects of new cancer therapeutic modules

Tumor cell growth is influenced by the cellular microenvironment including the presence of immune cells and blood vessels. Currently, no transplantable gastric cancer syngeneic animal models exist; therefore, we set out to establish a mouse gastric carcinoma cell line, which was named mouse gastric carcinoma cell line 3I (MGCC3I), from forestomach carcinoma developed in benzo[a]pyrene‐treated ICR mice. MGCC3I cells showed epithelial‐like morphology, multinuclear giant cell formation, and retained an intestinal phenotype, which are similar to human gastric cancer carcinoma cells. The expression of gastric cancer markers MUC1, MUC2, and MUC5AC, and oncogenes c‐myc, c‐met, cyclin E1, and cancer stem cell marker CD44 was determined in MGCC3I cells. MGCC3I cells formed poorly differentiated stomach tumors following orthotopic implantation into the stomachs of syngeneic ICR mice. Histone deacetylase inhibitors are recognized as a new class of anticancer drugs. The immunological therapeutic effects of the histone deacetylase inhibitors sodium butyrate and valproic acid were evaluated in this new animal tumor model. Sodium butyrate inhibited MGCC3I stomach tumor formation in animal models. Increased tumor infiltration by CD8 T cells and neutrophils was observed in mice treated with sodium butyrate or valproic acid. Depletion of CD8 T cells significantly attenuated tumor regression mediated by histone deacetylase inhibitors, which is correlated with enhancement of the MHC class I pathway in MGCC3I cells. Taken together, we have successfully established an orthotopic transplantable gastric tumor animal model and demonstrated its usefulness in revealing the role of CD8 T cells in the therapeutic effects of sodium butyrate. © 2010 Wiley‐Liss, Inc.     

Chinese expert consensus on clinical practice of female fertility preservation

Many female fertility preservation-related technologies have recently been developed in response to increasing demand for such treatments. To establish standard...     

表面麻醉聯合前房麻醉行白内障超聲乳化摘除及人工晶體植入術

目的評價表面麻醉聯合前房麻醉行白内障超聲乳化摘除及人工晶體植入術的效果.方法各種白内障共37衹眼,術前15分鐘先使用1%丁卡因滴眼三次,每次1～2滴,間隔3～5分鐘.手術開始後,先作側切口,從側切口滴入2%利多卡因,0.1ml于前房内.結果分别以無痛感、輕微痛但能耐受手術及痛不能耐受手術來評價麻醉效果,術中無一例訴痛不能耐受者,四衹術眼在用齒镊爽結膜固定眼球或分開球結膜及角鞏缘切中時訴輕微疼痛.撕囊、超乳及人工晶體植入等前房内操作中一例訴眼部疼痛.結論表面麻醉聯合前房麻醉行白内障超聲乳化摘除及人工晶體植入術是可行的,可避免球後麻醉或周麻醉带來的并發癥.     

关节软骨细胞库

本文介绍了关节软骨细胞的分离、冷冻保存和复苏技术，并在阐明胶原酶的细胞毒性作用的基础上，提出了分阶段消化法，以减少分离细胞的损伤，由于低温保护剂ＤＭＳＯ也具有细胞毒性，因而应尽量缩短ＤＭＳＯ与软骨细胞在４℃以上的接触时间。降温和复温速度是影响细胞存活的关键因素。降温速度从４℃～－８０℃以Ｉ℃／ｍｉｎ为佳，之后迅速投入－１９６℃的液氮中长期保存，细胞复苏应采用３７℃水浴快速复温法，虽然检测冻存细胞的存活率可采用苔盼蓝拒染试验，但最可靠的方法是细胞培养，利用关节软骨细胞库进行细胞培养、电镜观察和激光流式细胞计量分析，结果证明冻存软骨细胞复苏后仍具有正常的结构和形态并保持新陈代谢和自我复制功能。     

多引物嵌套式聚合酶链反应在艾滋病病毒感染诊断中的应用

目的 评价多引物嵌套式聚合酶链反应(Nested-PCR)在艾滋病病毒(HIV)感染诊断中的应用。方法 采用柱离心式小量组织/细胞基因组脱氧核糖核酸(DNA)抽提试剂盒提取DNA。用3套分别来自于长末湍重复序列(LTR)-gag、pol、env不同区域的序列引物进行嵌套式PCR扩增。结果 用多引物嵌套式PCR对28例不同来源标本进行检测,其中13例为HIV感染者,4例为HIV可疑感染者,4例为人嗜T淋巴细胞病毒(HTLV)感染者且HIV抗体检测为阴性,7例为正常者。经过检测每一套引物均漏检了1份标本,即每一套引物敏感性均为92.3％。HTLV标本经检测均为HIV阴性。根据判断标准,该检测方法敏感性和特异性均达到100％,最低检测线达到103外周血单核细胞(PBMC)。结论 多引物嵌套式PCR具有高敏感性及特异性,在鉴定HTV感染方面有重要的意义.可作为蛋白印迹试验的补充和辅助诊断。     

A tale of two neurons in the upper airways: Pain versus itch

Pain and itch sensations are induced by depolarization of distinct populations of unmyelinated type C, and possibly other, neurons. Both sets of neurons and sensations serve critical protective mechanisms that maintain the integrity and patency of the upper airways. When noxious or pruritic stimuli are applied on the afferent nerve ending, pain and itch are appreciated at the thalamic and parietal cortex. In the mucosa, this neuronal depolarization spreads via the peripheral efferent axon response mechanism. Neuropeptides such as substance P and calcitonin gene-related peptide are released from neurosecretory varicosities on the nociceptive C fibers. The exact functions of axon responses differ between humans and rodents, and in health and disease. Separate itch- and pain-specific peripheral type C fibers, secondary relay interneurons in the spinal cord dorsal horn, anatomical locations in the lateral spinothalamic tract, and thalamic nuclei demonstrate that all nociceptive nerves are not the same. Other types of irritant-sensitive trigeminal neurons might be discovered that could mediate other unique sensations, specific axon responses, or central nervous system functions.