脑脊液白蛋白和免疫球蛋白IgG检测在儿童病毒性脑炎诊治中的应用

目的：探讨病毒性脑炎患儿脑脊液白蛋白比值（QAlb)、IgG和IgG指数变化与疾病严重程度的相关性。方法研究对象分病毒性脑炎组和对照组,病毒性脑炎组按临床特点分为轻症病毒性脑炎组和重症病毒性脑炎组,采用免疫散射比浊法测定血清和脑脊液的白蛋白、IgG,计算QAlb和IgG指数,判断病毒性脑炎患儿血脑屏障功能状态及免疫球蛋白鞘内合成情况与临床严重程度的关系。结果病毒性脑炎组的QAlb高于对照组;重症病毒性脑炎组的QAlb较轻症病毒性脑炎组和对照组增高,差异有统计学意义（P<0.05）。重症病毒性脑炎组脑脊液IgG、IgG指数比轻症病毒性脑炎组和对照组增高,差异有统计学意义（P<0.05）。结论重症病毒性脑炎组患儿的血脑屏障功能损害程度、鞘内IgG合成情况与临床病情严重程度相关。检测脑脊液和血清中白蛋白、IgG,计算QAlb和IgG指数能反映病毒性脑炎患儿血脑屏障功能状态及IgG鞘内合成情况,为判断病毒性脑炎临床病情的严重程度提供相关依据。     

白藜芦醇预防性给药诱导裸鼠胃癌移植瘤细胞凋亡的观察

目的研究白藜芦醇预防性给药诱导裸鼠胃癌移植瘤细胞凋亡的作用。方法用胃癌MGC-803细胞株建立裸鼠胃癌移植瘤模型,通过白藜芦醇预防性给药,采用瘤体体积计算、透射电镜及原位末端标记染色（TUNEL）方法观察不同剂量白藜芦醇对裸鼠胃癌移植瘤的生长和细胞凋亡的影响。所有数据均以（x±s）表示,数据分析采用SPSS13.0软件,多组间均数比较采用单因素方差分析,用SNK-q检验进行两两比较,P〈0.05为差异有统计学意义。结果白藜芦醇中、高剂量组能明显抑制裸鼠胃癌移植瘤的生长,抑制率达到49.38%（P〈0.05）;电镜观察白藜芦醇各用药组出现凋亡细胞的典型形态;TUNEL法检测模型组、白藜芦醇低、中和高剂量组的凋亡细胞阳性表达率（%）分别为（14.254±4.344）,（31.270±4.461）,（44.082±3.436）和（58.809±4.060）（P〈0.01）,随着白藜芦醇用药剂量的增加,肿瘤细胞凋亡率上升。结论通过预防性给药,白藜芦醇能够抑制裸鼠胃癌移植瘤的生长,诱导裸鼠胃癌移植瘤细胞发生凋亡。     

大豆异黄酮对阿尔茨海默病大鼠海马RAGE介导的信号转导通路的影响

目的观察大豆异黄酮(soybean isoflavones)对阿尔茨海默病(Alzheimer’s disease,AD)大鼠高级糖化终产物受体(receptor for advanced glycation end products,RAGE)介导的信号转导系统的影响。方法采用β淀粉样蛋白25-35片段(amyloidβ25-35,Aβ25-35)双侧海马注射建立AD大鼠模型,60只大鼠随机分为模型组、大豆异黄酮高剂量组[30mg/(kg·d)]、大豆异黄酮低剂量组[10mg/(kg·d)]、雌激素组[0.4mg/(kg·d)]及假手术组,每组12只。大豆异黄酮高、低剂量组和雌激素组造模后3天灌胃给药(2mL/只),模型组与假手术组给予等体积的0.5%羧甲基纤维素钠(CMC-Na)灌胃,连续21天。酶联免疫吸附法观察各组大鼠海马组织RAGE、白细胞介素-6(interleukin-6,IL-6)的含量。分光光度法检测大鼠海马组织天冬氨酸特异性半胱氨酸蛋白酶-3(cysteine-containing aspartate-specific protease-3,Caspase-3)活性。免疫组织化学法观察大鼠海马组织磷酸化细胞外信号调节激酶1/2(phosphorylation extracellular signal-regulatedkinase1/2,P-ERK1/2)的表达。结果与模型组比较,大豆异黄酮可显著降低AD大鼠海马RAGE蛋白、IL-6含量、Caspase-3活性及ERK1/2蛋白磷酸化水平(P<0.01)。结论大豆异黄酮对AD大鼠海马组织RAGE介导的炎症信号通路具有下调作用,减弱炎症反应,降低Aβ的神经毒性,抵抗海马神经元凋亡。     

Flexion compromises ventilation with the laryngeal tube suction II in children

Background: There are insufficient data as to the influence of the head and neck flexion, extension, and rotation on the ventilation with laryngeal tube suction II^® (LTS II). The purpose of this study was to investigate the influence of the head and neck position on oropharyngeal sealing pressure (primary outcome) and ventilation score (secondary outcome) during ventilation with the LTS II in children. Methods: We studied 33 children scheduled for elective surgery. Oropharyngeal sealing pressure and ventilation score were measured with the head and neck in a neutral position, flexed, extended and rotated to the right. The ventilation score was scored from 0 to 3 based on three items (no leakage with an airway pressure of 15 cmH₂O, bilateral chest excursion, and a square wave capnogram; each item scored 0 or 1 point). Peak inspiratory pressure (PIP) at a tidal volume of 10 ml·kg^?1 and fiberoptic laryngeal views were also assessed in each position. Results: Although the sealing pressure was lower in the extended position [22 (8) cmH₂O] than that in the neutral position [25 (7) cmH₂O], there was no significant leakage during ventilation with a tidal volume of 10 ml·kg^?1. In the neutral, extended and rotated positions, the median ventilation scores were better (3 point respectively) than that with the head and neck flexed (1 point). PIP was decreased with the head and neck extended or rotated but was significantly increased in flexion position. During fibreoptic examination, the vocal cords were more easily seen in extension and right rotation, compared with the neutral position and flexion. Conclusions: Although oropharyngeal sealing pressure is decreased with the head and neck extended, effective ventilation with LTS II can be performed like in the neutral position or the rotated position. While the sealing pressure is maintained with the head and neck flexed, flexion compromises the ventilation with LTS II in children.     

膀胱癌术后腹壁切口种植转移的治疗与预后

目的　总结膀胱部分切除术后腹壁切口种植转移患者的诊治效果。　方法　 1985～1999年共收治膀胱癌术后腹壁切口种植转移患者 10例。男 9例 ,女 1例。年龄 39～ 6 8岁。移行细胞癌 6例 ,均为低分化G3 肿瘤 ;移行细胞癌合并鳞癌和腺癌各 1例 ,鳞癌和粘液腺癌各 1例。腹壁转移灶 1.0～ 6 .9cm× 1.4～ 11.5cm。　结果　采用膀胱全切加腹壁转移灶切除 2例 ,经尿道膀胱肿瘤电切术 (TURBT)加腹壁转移灶切除 1例 ,尿流改道加放疗和 (或 )化疗 2例 ,腹壁转移灶切除加放疗和 (或 )化疗 3例 ,单纯放疗和 (或 )化疗 2例。 10例中死亡 7例 ,其中 6例生存 4～ 14个月 ,1例生存4 1个月 ;3例存活者随访 5～ 9个月 ,未见复发。　结论　膀胱癌术后腹壁切口种植转移癌一般分化差 ,或合并其他癌。膀胱全切加肿物切除 ,辅助放化疗虽然能延长患者生存期 ,但预后很差     

Protein Losing Enteropathy in Severe Atopic Dermatitis in an Exclusively Breast-Fed Infant

Abstract:   We first report a case of protein losing enteropathy in severe atopic dermatitis in an exclusively breast-fed 5-month-old infant. Protein losing enteropathy was confirmed by fecal α₁-antitrypsin clearance test and imaged successfully by ^99mTc-human serum albumin scintigraphy. The present case highlights that protein losing enteropathy in severe infantile atopic dermatitis is being a topic of concern and also an issue even in exclusive breast feeding patients.     

核基质蛋白22在上尿路移行细胞癌诊断中的作用

目的　探讨核基质蛋白 2 2 (NMP 2 2 )在上尿路移行细胞癌诊断中的作用。　方法　对2 4例肾盂癌及输尿管癌患者和 2 0例良性泌尿系疾病患者尿中NMP 2 2浓度及尿细胞学进行检测 ,计算诊断敏感性和特异性。　结果　 2 4例TCC患者尿液标本尿细胞学阳性 14例 ,NMP 2 2阳性 2 1例 ;2 0例良性泌尿系疾病患者尿液标本细胞学阳性 1例 ,NMP 2 2阳性 4例 ,NMP 2 2的诊断敏感性和特异性分别为 87.5 %和 80 .0 % ,尿细胞学为 5 8.3%和 95 .0 % ,比较二者敏感性差别有显著性意义。　结论　NMP 2 2可能成为检测上尿路移行细胞癌的良好辅助手段     

Huge adrenal haemangioma

Adrenal tumours are either functioning or non-functioning. Non-functioning adrenal tumours are generally asymptomatic and usually of enormous proportions at the time of presentation. A case is presented here of a patient with a huge right adrenal haemangioma which was successfully treated surgically. This unusual tumour was 25 cm in diameter, was well encapsulated and weighed 4 kg. The literature pertaining to this interesting case is reviewed.     

腹腔镜肾上腺手术中转开放手术及合并症分析

目的　分析腹腔镜肾上腺手术中转开放手术原因及合并症处理。　方法　对 19例腹腔镜肾上腺肿瘤切除术中 8例转开放手术的原因及合并症进行分析。　结果　 8例手术中转开放手术患者包括右肾上腺中静脉出血 1例 ,胰尾遮挡肾上腺肿瘤暴露困难 1例 ,左肾上腺囊肿被副脾遮挡1例 ,手术过程中气腹不满意 2例 ,未找到病灶 2例 ,腹膜后镜手术穿刺时引起腰大肌出血 1例。术后高热 3例 ,其中腹膜后脓肿 1例 ,反应性胸膜炎 1例。　结论　腹腔镜和腹膜后镜手术需要一定经验和熟练的配合 ,初学者操作易出现合并症 ,导致手术失败。腹膜后镜手术治疗肾上腺疾病更简便     

雄激素剥夺条件下阻断自噬增加LNCaP细胞凋亡

Objective To investigate the change of apoptosis in LNCaP cells after inhibition of autophagic process under androgen removal conditions. Methods The autophagic level was deter-mined by using confocal microscopy and RT-PCR. The DAPI staining was used to indicate the apopto-sis of LNCaP cells after inhibition of autophagic by 3-MA. Also, Z-VAD-FMK was used to extend the apoptosis results. Results ①Androgen deprivation led to increased autophagy in LNCaP cells. LN-CaP cells cultured in complete medium(CM) presented low autophagic process with 1.9 scores. After 24 hours, the punetate GFP-LC3 structures were accumulated in the cells cultured in serum-free medi-um (SF)(2.64 scores). In contrast, the number of punctate GFP-LC3 remained at a very low level (1.85 scores), when cells were incubated with DHT in SFA(serum-free medium+DHT). Statistical analysis showed the significant difference between SF and SFA (P<0.01). Semiquantitative RT-PCR was employed to examine the mRNA expression of LC3. Indeed, cells grown in the medium without serum had a higher LC3 mRNA expression with the highest at 12 hour time point as compared with the cells grown in CM. DHT treatment reduced the level of LC3 mRNA. ②Blockage of autophagy by 3-MA increased the apoptosis of LNCaP cells. LNCaP cells in SF and SFA just presented a basal level of apoptosis, which is (3.19±1.09)% and (3.01±0.33)% , respectively. Under androgen-free con-ditions, inhibition of autophagy by 3-MA could increase apoptosis significantly(10. 90±2.91%). While Z-VAD-FMK, a pan Caspase inhibitor, was able to suppress this apoptotic process to the level of (1.16±0.52)%, which was statistically significant(P<0.01). Conclusions Androgen removal can lead to the increase of autophagy in LNCaP cells. Moreover, inhibition of autophagy promotes the occurrence of apoptosis.