CD18-mediated neutrophil recruitment contributes to the pathogenesis of reperfused but not nonreperfused stroke

BACKGROUND AND PURPOSE: Neutrophil (PMN) recruitment mediated by increased expression of intercellular adhesion molecule-1 expression (ICAM-1, CD54) in the cerebral microvasculature contributes to the pathogenesis of tissue injury in stroke. However, studies using blocking antibodies against the common beta2-integrin subunit on the PMN, the counterligand for ICAM-1 (CD18), have demonstrated equivocal efficacy. The current study tested the hypothesis that mice deficient in CD18 would be protected in the setting of reperfused but not nonreperfused stroke. METHODS: Two groups of mice were studied, those whose PMNs could express CD18 (CD18 +/+) and those mice hypomorphic for the CD-18 gene (CD18 -/-). PMNs obtained from CD18 -/- or CD18 +/+ mice were fluorescently labeled and tested for binding to murine brain endothelial monolayers. Using a murine model of focal cerebral ischemia in which an occluding suture placed in the middle cerebral artery (MCA) is removed after 45 minutes (transient ischemia, reperfused stroke) or left in place (permanent ischemia, nonreperfused stroke), cerebral infarct volumes (% ipsilateral hemisphere by TTC staining), cerebral blood flow (CBF, % contralateral hemisphere by laser-Doppler flowmetry), and survival (%) were examined 24 hours after the initial ischemic event. Adoptive transfer studies used 111In-labeled PMNs (from either CD18 +/+ or CD18 -/- mice) to examine the relative accumulation of PMNs in the ischemic region. RESULTS: PMNs obtained from CD18 -/- mice exhibit reduced adhesivity (compared with CD18 +/+ PMNs) for both quiescent and cytokine-activated endothelial monolayers. CD18 -/- mice (n=14) subjected to transient focal cerebral ischemia demonstrated a 53% decrease in infarct volumes versus CD18 +/+ mice (n=26, P<0.05), improved penumbral CBF at 24 hours (1.8-fold, P=0.02), and a 3.7-fold decrease in mortality (P=0.02). However, when CD18 -/- mice (n=12) were subjected to permanent focal cerebral ischemia, no differences were noted in infarct volume, mortality, or CBF versus similarly treated CD18 +/+ mice (n=10). There was a greater accumulation of CD18 +/+ PMNs in the ischemic zone of CD18 +/+ animals than CD18 -/- animals subjected to reperfused stroke (82% increase, P=0.02), although there was no difference between groups when subjected to permanent MCA occlusion. CONCLUSIONS: Deficiency for the CD18 gene confers cerebral protection in a murine model of reperfused stroke, but this benefit does not extend to CD18-deficient animals subjected to permanent MCA occlusion. These data suggest that anti-PMN strategies should be targeted to reperfused stroke and may perhaps be used in conjunction with thrombolytic therapy that establishes reperfusion.     

Poisoning by Datura leaves used as edible wild vegetables.

The causes of Datura intoxication include medication overdose, misuse of edible vegetables, deliberate abuse as a hallucinogen, homicidal or robbery and accidental intoxication from contaminated food. We report an incident of 14 people with Datura intoxication caused by ingesting wild Datura suaveolans for food. The incubation period was 15 to 30 min. The symptoms/signs were dizziness, dry mouth, flushed skin, palpitation, nausea, drowsiness, tachycardia, blurred vision, mydriasis, hyperthermia, disorientation, vomiting, agitation, delirium, urine retention, hypertension and coma. Three patients were hospitalized for 2-3 days. Thirteen persons received supportive fluid therapy. One patient did not receive medical therapy, he induced vomiting and drank a lot of water. Four patients presented with delirium/coma and 3 received physostigmine therapy with good response. One patient was intubated because of coma and respiratory depression. Three persons needed Foley catheterization for urine retention or coma status. One patient had a complication of urinary tract infection and antibiotic management. All patients recovered with no sequelae.     

Renal vein thrombosis and selective arterial or venous thrombolytic therapy

Summary Background: Renal vein thrombosis (RVT) complicating the nephrotic syndrome is associated with a poor prognosis. Methods/Results: RVT was diagnosed in 12 of 60 patients with a diagnosis of nephrotic syndrome suggested by computed tomography (CT) and subsequently confirmed by selective renal angiography. Fifty patients carried a diagnosis of primary glomerulonephritis with various pathological findings, and 10 patients had lupus nephritis. Renal vein and peripheral vein blood samples were collected in the 12 patients with RVT and were assayed for fibrin(ogen) degradation products (FDP), antithrombin III (AT III), VIIIR:AG, and fibrinogen. The results suggested a state of hypercoagulation. Of these 12 patients, 7 were given 200,000 units of urokinase (UK) over 60 minutes in divided doses selectively via the renal vein. Five patients were given 200,000 units UK selectively into the renal artery. All patients also received 2.5 mg/day warfarin and 75 mg/day persantine. Except for three patients with focal glomerulosclerosis, all patients received 40 mg/day prednisone. After 1 month, the CT scan and blood samples for FDP, AT III, VIIIR:AG, and fibrinogen were repeated. Patients receiving intra-arterial UK had complete resolution of their thrombi. Complete resolution was also suggested in 2 of the 7 patients receiving UK by renal vein, and there was partial resolution in the other five. The hypercoagulation state decreased in all patients. Conclusions: We conclude that RVT is not an uncommon event in patients with nephrotic syndrome. The diagnosis can be supported reliably using abdominal CT scanning. Although a small number of patients were included in this nonrandomized study, it appeared that intra-arterial thrombolytic therapy yielded better results. The patients with minimal change disease have a good prognosis.     

.MYCOLOGIC IDENTIFICATION OF EMERICELLA NIDULANS AND ASPERGILLUS FLAVUS CAUSED PULMONARY INFECTION

A rare case of pulmonary infection caused by Emericella nidulans and Aspergillus flavus is reported for the first time in our country. "This diagnosis is of significance mycologically. :Direct microscopic examination and histopatho- logic cross section of expectorated mass show numerolus cleistoithecia of varying size, filled by asci and ascospores. Outside the cleistothecia 'were numerous thickwalled Hulle cells. The pa- tient was treated satisfactorily with antimyco- tics.     

口腔愈疡颗粒质量标准的建立

目的：建立口腔愈疡颗粒的质量标准。方法：采用高效液相色谱法对成品中芍药苷进行含量测定。结果：芍药香浓度线性范围为：0．104—0．520μg/ml,γ=0.9993。样品平均回收率为98．85％，RSD为1．27％(n＝5)。结论：该方法适用于口腔愈疡颗粒的质量控制。     

直电极与弯电极序列人工耳蜗植入深度的比较

目的测量比较Nucleus CI 24M直电极序列和CI24 Contour弯电极序列两种型号植入体的电极植入深度。方法对41例CI 24M和8例CI 24 Contour植入者,术后拍摄耳蜗位X线平片。应用图像处理技术,比照耳蜗螺旋模板,建立电极序列的极坐标图形,测量第22号电极与耳蜗开窗处的极坐标角度,两者之差代表了电极序列的植入深度。以t检验比较两种型号植入体的植入深度状况。结果 无内耳畸形、手术条件相当的情况下,CI 24 Contour植入体的平均插入角度为413°,CI 24M植入体的平均插入角度为316°,P=0.0001。结论CI 24 Contour植入体的植入深度明显深于CI 24M。前者更有利于医师进行植入。     

去势对大鼠阴茎组织细胞凋亡的影响

目的 :探讨雄激素对阴茎海绵体结构和功能的影响以及细胞凋亡与 NOS活性在阴茎勃起中的关系。方法 :将 30只成年雄性大白鼠随机分为 3组 ,阉割组、替代组及假手术组 ,阉割组与替代组分别切除双侧睾丸 ,其中替代组在切除睾丸后给予睾酮替代。于 1周后取阴茎海绵体 ,用紫外分光光度计测定其一氧化氮合酶 (NOS)活性 ,同时用 ISEL 法检测其细胞凋亡情况。结果 :阉割组海绵体 NOS活性下降 70 % ,并出现细胞凋亡 (P <0 .0 1) ,睾酮替代组和对照组 NOS活性及细胞凋亡差异无显著性 (P >0 .0 5 ) .结论 :雄激素可通过调节 NOS活性及细胞的增殖与凋亡而维持阴茎海绵体的结构与功能。     

长春瑞滨联合顺铂治疗晚期非小细胞肺癌47例疗效观察

目的：观察盖诺联合顺铂的NP方案治疗晚期NSCLC的疗效和毒性反应。方法：应用盖诺25mg／m^2静脉点滴，第1天、第8天，DDP60～80mg／m^2静脉点滴，第1天或分2天给药。结果：47例患中，无CR病例，PR25例，NC14例，PD7例，总有效率(CR PR)为53．19％(25／47)。结论：长春瑞滨联合顺铂的NP方案治疗晚期NSCLC有效率高，毒副反应可耐受。     

Expression of nm23 protein in human osteosarcoma in relationship with early metastasis

Nm23 protein expression was analyzed by immunohistochemical staining using formalin-fixed, paraffin-embedded sections from 39 cases with osteosarcomas and compared with the histologic findings and early metastasis for the purpose of detecting nm23 expression in osteosarcoma and elucidating the clinical significance of its expression. Immunoreactivity of nm23 protein was detected in 48.7% of the total cases. There was no statistical difference between nm23 expression and early metastasis, but there was a trend for cases with nm23 expression to progress to early metastasis within 1 year after operation. The role of nm23 as a tumor metastasis suppressor in osteosarcomas appeared less prominent.     

HPLC法测定复方阿替洛尔片中阿替洛尔与硝苯地平的含量

目的:采用高效液相色谱法考察并建立测定复方阿替洛尔片中阿替洛尔与硝苯地平含量的方法。方法:色谱柱为Phe-nomenex—ODS 3柱(250 mm×4.60 mm,5 μm),甲醇-水-磷酸盐缓冲溶液(取磷酸二氢钾6.8 g,加水1000 mL溶解后,用磷酸调pH至3.0)-庚烷磺酸钠适量摇匀(65:35:3:0.13 g=V:V:V:W)为流动相,流速为1.0 mL·min～1,检测波长为240 nm,进样量为10μL。结果:阿替洛尔的线性范围为10-250μg·mL-1(r=0.9999),硝苯地平的线性范围为4—100 μg·mL-1(r=1.0000),平均回收率分别为99.45％和99.51％。结论:本法精密度好,结果准确可靠,适用于该复方制剂的质量检验分析。