Innate Immunity and Organ Transplantation: The Potential Role of Toll-like Receptors

Traditionally, the recognition and tolerance of transplanted grafts has been considered to be within the realm of the adaptive immune system. Innate immunity, on the other hand, as the first line of host defense, plays a role in fighting against invading microorganisms. Recently, with the discovery of the Toll-like receptors (TLRs), the role of innate immune responses in the control of adaptive immunity has become a new area of interest. Emerging evidence suggests that in addition to responding to pathogen-associated molecular patterns of microorganisms, TLRs can be activated by endogenous ligands, expressed by mammalian cells. These 'danger signals' may participate in ischemia-reperfusion related organ damage and subsequently influence function and survival of transplanted grafts. Furthermore, it has been suggested that adaptive immune responses can enhance the acute inflammatory responses controlled by innate immunity in organ transplantation. This review addresses the potential involvement of TLRs in different stages of organ transplantation. Intriguing and controversial findings are presented and discussed in order to stimulate more attention to this emerging and potentially important area of research in organ transplantation.     

侯江红教授治疗小儿慢性湿疹亚健康状态的经验

侯江红教授擅长运用调脾和胃法调治处于亚健康状态的小儿，治疗小儿慢性湿疹，注重从“健脾和胃、消食清热”法入手，每获良效。     

残端肌瓣在保肢术中的应用——附2例报告

众所周知，截肢的一般原则为尽可能保留残肢长度，皮肤能达到满意愈合的部位进行。有些病人，虽然肢体毁损比较严重，但经过清创发现，残端的肌肉有很好的血运，为了保留近端关节的功能，我院采用残端肌瓣包埋术加翻取皮游离移植或带蒂皮瓣转移术治疗2例病人，取得了较好的效果，现报告如下。     

运动对大鼠腓肠肌一氧化氮含量和铁转运蛋白表达的影响

目的观察游泳运动后大鼠腓肠肌一氧化氮(NO)含量及铁转运相关蛋白表达的变化,探讨运动对骨骼肌铁代谢的调节机制。方法20只雌性SD大鼠随机分为对照组和运动组(每天游泳1.5小时,6次/周),每组10只。实验10周后分别采用试剂盒测定两组大鼠腓肠肌和血清一氧化氮合酶(NOS)活性及NO含量,免疫组织化学方法测定腓肠肌二价金属离子转运体1(DMT1)、膜铁转运蛋白1(FP1)和转铁蛋白受体1(TfR1)的表达,分析其平均光密度变化。结果(1)运动组大鼠血清和腓肠肌NO含量和NOS活性均显著高于对照组(P<0.05);(2)运动组大鼠腓肠肌DMT1(IRE)和TfR1表达较对照组显著增加,FP1表达显著减少(P<0.05),而DMT1(non-IRE)表达无明显变化。结果提示运动可能通过增加NOS活性刺激NO合成增加,进而调节腓肠肌铁转运蛋白的表达,提高腓肠肌摄铁能力,以满足运动中机体对铁的需求。     

短期用药对幽门螺杆菌检测结果的影响

目的：研究短期不规则用药对幽门螺杆菌(Hp)检测结果的影响。方法：136名慢性胃炎及消化性溃疡的住院患，根据病史分为服药组即Hp检查前一周内接受过铅剂、抑酸剂治疗的患，共四例。对照组即Hp检查前未接受过药物治疗的患考，共37例。Hp检查方法包括①血清学方法；②快速尿素酶试验(RUT)；③组织学方法；④13c—尿素呼气试验(13C—UBT)。结果：服药组RUT，组织学，13C—UBT方法Hp检出率分别为9．0％，21．2％，27．3％，均显低于对照组相应Hp检出率37．8％、40．5％、48．6％(P＜0．01，P＜0．05，P＜0．05)。两组血清学方法Hp IgG、IgM阳性率各为48．5％，51．5％和54．1％，54．1％(P＞0．05)。单独服用质子泵抑制剂组RUT，组织学方法Hp检出率4．0％，16．0％显低于对照组相应方法Hp检出率(P＜0．01，P＜0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂患中各方法Hp检出率与对照组检出率无显性差异(P＞0．05)。单独服用枸橼酸铋钾、H2受体拮抗剂、质子泵抑制剂三组Hp感染率14．3％、15．0％、16．0％均显低于对照组Hp感染率46．0％(P＜0．05)。结论：Hp检查前短期使用铋剂、抑酸剂可导致Hp检出率下降，短期使用质子泵抑制剂可显降低RUT、组织学方法Hp检出率；各方法中快速尿素酶试验检出率最低。血清学方法检测Hp抗体不受药物影响。     

LPS信号转导分子TLR4表达与小鼠肝损伤的关系

目的：探讨脂多糖(1ipopolysaccharide，LPS)信号转导分子，TLR4(Toil-like receptor 4,TLR4)与肝脏损伤的关系。方法：小鼠腹腔注射LPS后不同时间点取肝脏组织，HE染色观察病理改变，RT-PCR法检测肝组织，TLR4 mRNA的表达。结果：腹腔注射LPS后24h小鼠肝脏出现明显炎性浸润、坏死，肝组织TLR4 mRNA的表达在注射LPS后6，12h明显抑制，24h则基本恢复。结论：LPS致肝损伤呈时间依从性；LPS信号转导分子TLR4在介导LPS肝损伤中起重要作用。。     

Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantation in a diabetic patient with end-stage liver disease]

OBJECTIVE: To study the effect of combined transplantation of the liver and the pancreas in diabetic patients with end-stage liver disease, and explore the optimal surgical procedure. METHODS: Simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations were performed in a patient diagnosed as having chronic hepatitis B, hepatocirrhosis, hepatic cellular cancer, and insulin-dependent diabetes. Immunosuppression therapy utilized prednisone, tacrolimus (FK506), mycophenolate mofetil (MMF), and simulect. The function of the liver graft, serum amylase and lipase, blood glucose, and C-peptide were monitored after transplantation. RESULTS: Insulin was withdrawn at the 6th day after operation, good liver allograft functional recovery was achieved, without such complications as pancreatitis, thrombosis, and localized infections. CONCLUSION: End-stage liver disease with concomitant insulin-dependent diabetes is the indication for combined liver-pancreas transplantations, for which simultaneous orthotopic liver and heterotopic pancreas-duodenum transplantations may constitute the optimal surgical approaches as the primary choice.     

鼻咽癌放疗后咽部菌群的变化

目的:了解鼻咽癌放疗后患者咽部菌群的变化,为临床防治继发感染提供实验依据。方法:32例鼻咽癌放疗患者,于放疗前后分别在照射区域粘膜采集唾液标本,进行细菌的分离培养鉴定,测量可培养细菌的检出率、检出量和构成比。结果:与放疗前相比,放疗后照射区域的链球菌属、葡萄球菌属、白色念珠菌和绿脓杆菌检出增加;而放线菌属和奈瑟菌属检出减少(P<0.05)。结论:鼻咽癌放疗可影响咽部的微生态平衡,是导致鼻咽癌放疗后患者发生感染的重要原因之一。     

网络和现实社会交互环境对网民的健康效应及卫生策略

网络社会对人类社会活动和生活方式带来了极大的影响，对人群健康的作用也存在双重效应。网络成瘾、网络孤独以及生理损伤成为网络社会的主要健康问题，但提高网民社会化程度、提供虚拟支持、增加健康信息供给的途径也给网民带来了诸多的健康效益。目前，要积极制定网络社会卫生策略，以促进网络社会化、虚拟支持和网络健康赋权对网民健康的贡献。