获得性纯红再障患者外周血T细胞亚群分析

目的　本研究通过分析获得性纯红再障患者外周血T细胞亚群 ,进一步探讨该病的细胞免疫发病机制。方法　用抗人CD3、CD4、CD8、IFN γ及IL 4单抗结合人外周血单个核细胞 ,流式细胞术分析单个核细胞中CD3 +、CD4+、CD8+细胞数Th1、Th2、Tc1、Tc2细胞数以及CD4+/CD8+、Th1/Th2、Tc1/Tc2比值。结果　贫血组患者 ,外周血CD3 +细胞和CD8+细胞明显增加 (P <0 .0 1) ,CD4+/CD8+比例倒置 (P <0 .0 5 ) ;Tc2细胞明显增加 (P <0 .0 5 ) ,Tc1/Tc2比值降低(P <0 .0 5 ) ,治疗后血象恢复的患者各增高的亚群细胞均有所恢复 ,接近正常。结论　在获得性纯红再障患者T细胞明显增高 ,其中主要是CD8+细胞 ,而在CD8+细胞中 ,是Tc2细胞发挥了重要作用。经治疗有效的患者 ,其增高的T细胞亚群降低 ,提示以纠正病人细胞免疫异常为主的治疗方案有益于获得性纯红再障的治疗。     

Ainhum (dactylolysis spontanea): A Radiological survey of 6000 patients

Dactylolysis spontanea is an idiopathic condition affecting the fifth toe, and sometimes other toes, that is frequently bilateral, with lesions in different stages. Between 1977 and 1999, a total 6000 radiographic studies of the feet were reviewed in a mainly African American population in Chicago, Illinois. After an initial screening based on the Cole criteria, 581 patients were selected and re-examined, and amplification techniques were performed. After reviewing the complementary exams, 102 patients were diagnosed with dactylolysis spontanea or ainhum. Soft-tissue constriction was the most frequently presented radiological sign on the initial screening. Kurtosis at the digit plantar fold and marked rotation of the fifth toe were normal findings in asymptomatic patients. Demographics, comorbidities, and radiological findings were analyzed in the selected population. Associated diseases occurring in these patients appeared to have no specific etiologic correlation with ainhum. African Americans and the dark-skinned population are affected exclusively by this condition, presumably due to the fibrogenic tendency of these individuals. Early diagnosis and accurate staging of ainhum are facilitated by radiological examination of the feet. The findings suggest that this condition is underdiagnosed and overlooked because its low prevalence and variable clinical presentations that might mimic more common etiologies, including localized trauma.     

Adjunct therapies to bacterial sepsis in the neonate

Recent steps to prevent neonatal sepsis due to group B Streptococcal infection have lowered the attack rate from this organism, but may not have lowered overall sepsis rates. Mortality from sepsis stills remains between 20 and 40% and is probably so high due to the immunological immaturity of the newborn. Although antibiotics remain the mainstay for treatment, adjunctive therapies aimed at improving the immunological integrity of the neonatal patient have a role in treatment and may improve outcomes. We discuss several adjunctive therapies, along with the physiologic rationale for their use, and discuss an approach for their inclusion in therapy for neonatal sepsis.     

皮肤光老化皱纹形成机制及维A酸类药物的拮抗作用

日光中长波紫外线 (UVA)长期反复照射是户外工作者暴露部位皮肤光老化及相关皮肤肿瘤多发的重要因素 ,皱纹形成是皮肤光老化的最重要特征 ,研究其作用机制对紫外线辐射损伤的防护有重要意义。基质金属蛋白酶 (matrixmetal loproteinases,MMPs)家族在各种生理、病理条件下细胞外基质降解和重塑中起着关键作用。我们研究了皮肤光老化皱纹形成与真皮成纤维细胞MMPs及MMPs组织抑制剂 (tissueinhibitorofmatrixmetallo proteinases,TIMPs)表达的关系 ,并同时观察了维A酸类药物的拮抗作用。一、材料与方法1 真皮成纤维细胞培养 :标本为健康…     

Large Ulcerated Perianal Hidradenoma Papilliferum in a Young Female

BACKGROUND: Hidradenoma papilliferum is an uncommon benign tumor that is located almost exclusively in the vulvar and anal areas. It is usually very small and asymptomatic, and to make a correct diagnosis is clinically very difficult. Occasionally the tumor becomes elevated to form a reddish brown papillary mass, and the surface ulcerates, which may erroneously suggest malignancy. OBJECTIVE: We report a case of a large, perianal hidradenoma papilliferum with suspected malignancy in a young Japanese female. RESULTS: A 22-year-old female had been aware of a perianal nodule for approximately 1 year. Examination of the perianal area revealed a wide pedunculated, reddish nodule with several white maculae. It was ulcerated and bleeding, 2.0 x 1.2 x 0.8 cm in size, and located in the 3 o'clock position. The nodule was totally excised with a narrow margin. The histopathologic diagnosis was hidradenoma papilliferum. No recurrence was observed for 23 months. CONCLUSION: When dermatologists encounter tumors of the anogenital area of adult females, it is important to keep hidradenoma papilliferum in mind as the differential diagnosis. Dermatologists should recognize that the tumor is benign, eliminating the need for wide resection.     

关于课堂多媒体教学的思考

多媒体教学已成为课堂教学的一种常用手段，多媒体教学应从实际需要出发，以提高教学效果为目标；需要教师掌握多种计算机及多媒体知识技能，科学地进行教学设计；教学过程中应发挥多媒体的优势，注重师生交流。对此本文进行了探讨。     

Multiple Infundibulocystic Basal Cell Carcinomas: Case Report of Unique Unilateral Presentation

BACKGROUND: Basal cell carcinoma shows a wide spectrum of clinical and histologic appearances. A distinct tumor variant with follicular infundibulocystic differentiation is recognized, and there are only a few reports on its clinical presentation and management. OBJECTIVE: To report a case of multiple infundibulocystic basal cell carcinomas with a unique unilateral presentation. METHODS: A clinical history was obtained. Photographs were taken, and punch biopsies were performed. RESULTS: An 83-year-old Caucasian female presented with multiple unilateral, asymptomatic, skin-colored, dome-shaped papules around the right mouth for 11 years without apparent change. Punch biopsies revealed findings typical of infundibulocystic basal cell carcinoma. CONCLUSIONS: A patient with clinically indolent multiple unilateral infundibulocystic basal cell carcinomas is described. Given the location of these multiple lesions, standard treatment modalities for basal cell carcinomas would have significant cosmetic and functional implications. A management approach with clinical follow-up and surgical intervention only for changing lesions is discussed.     

通瘀注射液盆腔给药法治疗外在型子宫内膜异位症的临床研究

目的　运用通瘀注射液在非直视下经输卵管盆腔给药对子宫内膜异位症 (EEMs)的治疗作用 ,探讨活血化瘀法对EEMs的作用机理及此给药法的优势。方法　将临床治疗的EEMs患者 60例随机分为治疗组 (通瘀注射液组 )和对照组 (丹那唑组 ) ,疗程各为 3个月。用药前后测定下列指标 :临床症状与体征、内分泌激素、血液流变学、癌抗原 12 5 (CA12 5)和子宫内膜抗体 (EMAb)的阳性率变化。结果　治疗组的临床症状与体征、血液粘滞度和红细胞压积、CA12 5和EMAb的阳性率均降低 ,卵泡刺激素 (FSH)、黄体生成素 (LH)、雌二醇 (E2 )和孕激素 (P)的含量均受到调节 ,与对照组相比 ,差异有显著性。而治疗组对内分泌的调节能力弱于对照组 ,但作用柔和、均衡。结论　通瘀注射液对EEMs的作用是通过清除月经时异位内膜的瘀血、水肿、改善微循环及组织供氧、调节免疫功能和内分泌紊乱而实现的 ,与丹那唑相比其副作用小、并以治本为主。盆腔给药法则可使药物直达病灶 ,见效快