重型肝炎/肝衰竭临床分类的进一步探讨

目的提高对重型肝炎，肝衰竭临床分类的进一步认识。方法回顾分析25l例急性、亚急性肝衰竭患者的临床资料，按照病因分为无肝病基础组（第l组）、肝炎组（第2组）、肝硬化组（第3组）共3组，并对每组中急性、亚急性肝衰竭的实验室检查、肝性脑病的发病率及预后进行统计学分析。结果（1）转氨酶、胆碱脂酶及白蛋白的差异：无论是急性还是亚急性肝衰竭中，无肝病基础组转氨酶、胆碱脂酶及白蛋白均明显高于有肝病基础患者，特别是高于肝硬化组患者（P〈0．05）；（2）肝性脑病的发病率及各等级分布：在l、2、3组中，急性肝衰竭肝性脑病的发病率分别为100．00％，66．23％和51．02％；亚急性肝衰竭分别为71．42％，54．81％和49．99％；（3）在预后方面：在1、2、3组中急性肝衰竭的好转治愈率分别为15．38％、42．85％和26．09％；亚急性肝衰竭患者33．33％、51．39％和36．85％，3组具有统计学差异（P〈0．05）。结论无论是急性还是亚急性发病，3组重型肝炎，肝衰竭患者的临床特点及其预后均有差异，依此进行分类，有其临床实用性及科学性，将能更好的指导临床诊断、治疗和预后判断。     

海洛因依赖患者的MMPI与ERP电位研究

目的:探讨明尼苏达多项人格调查量表(MMPI)及事件相关电位(ERP)在海洛因依赖患者中的临床应用价值。方法:对44例海洛因依赖患者和43例正常健康者分别进行了MMPI及ERP测定,并将两组的结果加以比较。结果:海洛因依赖患者中MMPI测定异常率为63.64%(28/44),其量表中Hs(疑病),D(抑郁),Pd(心理变态)、Pa(偏执)、Pt(精神衰弱),Ma(轻躁狂)分显著高于对照组(P<0.01)。海洛因依赖患者ERP测定异常率为52.27%(23/44),其中N2波及P3波(即P300)潜伏期较对照组明显延长,波幅也降低,两组间比较差异有显著意义(P<0.01)。结论:MMPI及ERP电位对海洛因依赖患者临床诊治及预后判断有较高的价值。     

2004年中国甲3亚型流感病毒(H3N2)抗原性及基因特性研究

目的阐明2004年中国流行的甲3亚型流感病毒血凝素抗原性及其基因变异情况。方法对2004年分离的甲3亚型毒株先进行单向血凝抑制试验及交叉血凝抑制试验;在此基础上选取不同时间、地点的甲3亚型流感毒株进行血凝素基因HA1区核苷酸序列测定并推导出其氨基酸序列,然后进行基因进化特性分析。结果单向血凝抑制实验结果表明,2004年共有52.3%毒株与A/Fujian/411/2002(H3N2)(20042005毒株)有4倍或以上的血凝抑制滴度差异,交叉血凝抑制实验结果表明,它们间的抗原比为4。HA1区核苷酸序列和氨基酸序列分析表明,我国从2004年2月分离的甲3亚型毒株开始出现了与A/Fujian/411/2002(H3N2)和A/Wellington/1/2004(H3N2)(2005年国际代表株)相比较,在其HA1蛋白分子上存在有4个氨基酸位点(159位Y>F,189位S>N,145位K>N,226位V>I)发生了替换。此类毒株首发于我国南方,然后到我国北方。结论我国2004年2月份以后所分离的甲3亚型流感毒株已经发生抗原性及基因特性的改变。     

高糖对THP-1细胞及平滑肌细胞肿瘤坏死因子相关凋亡诱导配体受体4表达的影响

目的：探讨高糖对单核/巨噬细胞系THP-1细胞及人主动脉平滑肌细胞肿瘤坏死因子相关凋亡诱导配体受体4(TRAIL-R4)表达的影响。方法：用PMA孵育THP-1细胞，诱导其分化成为巨噬细胞。流式细胞仪检测成功诱导的巨噬细胞粘附分子CD11b及CD11c。采用不同糖浓度干预THP-1细胞，用Western blotting技术检测TRAIL-R4的表达。用25 mmol/L 高糖培养液在不同时点孵育人主动脉平滑肌细胞，观察TRAIL-R4蛋白表达的变化。用PKC激动剂干预THP-1细胞后，用Western blotting技术检测TRAIL-R4的表达。结果：佛波酯(PMA)孵育THP-1细胞48 h可诱导其分化成为巨噬细胞。20 mmol/L 高糖明显上调人THP-1细胞TRAIL-R4的表达。高糖对人主动脉平滑肌细胞TRAIL-R4表达上调的影响随着刺激时间的增加而增加。PKC激活后THP-1细胞TRAIL-R4的表达明显上调。结论：高糖上调TRAIL-R4蛋白表达，TRAIL-R4通过抑制巨噬细胞及平滑肌细胞的凋亡促进动脉粥样硬化。     

大鼠实验性牙周炎一氧化氮含量改变的研究(英文)

目的：通过建立大鼠牙周炎实验模型，测量牙龈组织中亚硝酸盐(NO2-)和硝酸盐(NO3-)的含量，比较一氧化氮(NO)含量与附着丧失(AL)的关系，探讨NO在牙周炎病理进程中的作用。 方法： 健康Sprague-Dawley大鼠共72只，随机分为两组：正常对照组和牙周炎组，每组36只。参照Di Paola法复制大鼠牙周炎动物模型。分别于术后1、4和8周时处死动物，每个时点每组处死的动物数为12只。采用分光光度仪测量大鼠牙龈组织中亚硝酸盐（NO2-）和硝酸盐(NO3-)的含量，以间接确定NO含量；采用组织切片法观察牙周组织的组织学改变；应用Tiger细胞图像仪测量AL。 结果： 术后4周和8周时，实验性牙周炎组牙龈组织NO2-/NO3-含量明显高于正常对照组(P<0.01)；在牙周炎组，术后8周牙龈组织NO2-/NO3-含量明显高于术后4周(P<0.01)。在牙周炎组，术后4周和8周与术后1周比较，AL显著增加(P<0.01)；术后8周与4周比较，AL显著增加(P<0.01)。 结论： 牙周炎组牙龈组织NO2-/NO3-含量明显高于正常对照组；NO2-/NO3-含量与牙周组织的AL直接相关。结果表明NO在牙周组织的炎症和破坏过程中发挥作用，提示在牙周炎的治疗中控制NO具有临床应用价值。     

APC mutation and tumour budding in colorectal cancer

AIM: To determine the frequency of tumour budding and somatic APC mutation in a series of colorectal cancers stratified according to DNA microsatellite instability (MSI) status. Material/Methods: Ninety five colorectal cancers were genotyped for APC mutation in the mutation cluster region (exon 15) and scored for the presence of tumour budding at the invasive margin in haematoxylin and eosin stained sections. A subset was immunostained for beta catenin and p16. RESULTS: The frequency of both somatic APC mutation and tumour budding increased pari passu in cancers stratified as sporadic MSI high (MSI-H), hereditary non-polyposis colorectal cancer (HNPCC), MSI low (MSI-L), and microsatellite stable (MSS). Both budding and APC mutation were significantly less frequent in sporadic MSI-H cancers than in MSI-L or MSS cancers. Tumour buds were characterised by increased immunostaining for both beta catenin and p16. CONCLUSION: Tumour budding is associated with an adverse prognosis. The lack of budding in MSI-H colorectal cancer may account for the improved prognosis of this subset and may be explained by an intact WNT signalling pathway and/or inactivated p16(INK4a).     

Morphometric evaluation of PGP9.5 and NCAM expressing nerve fibers in colonic muscle of patients with Hirschsprung's disease

A quantitative assessment of the density of the protein gene product 9.5 (PGP9.5), the neural cell adhesion molecule (NCAM), and the low-affinity nerve growth factor receptor (NGFR) expressing nerve fibers in the circular muscle layer in the colon was carried out by morphometric analyses from 13 patients with Hirschsprung's disease (HD). The difference in the nerve fiber density between the ganglionic and aganglionic segments was compared by calculating the ratio of the sum of the areas occupied by positively stained nerve fibers per unit area of the muscle after immunohistochemical staining on paraffin embedded tissue sections using computer software. There was an obvious difference in the density of the PGP9.5 stained nerve fibers between the ganglionic (0.0380 +/- 0.0171) and aganglionic segments (0.0143 +/- 0.01661). The NCAM-positive nerve fibers were fewer in number than those of both the PGP9.5-positive fibers and NCAM-positive fibers, which were also markedly lower in number in the aganglionic segment (0.0066 +/- 0.0076) than in the ganglionic segment (0.0230 +/- 0.0195). Immunostaining for low-affinity NGFR revealed much fainter staining in the ganglionic and aganglionic segment without a statistically significant difference in their density. Considering the fact that PGP9.5 is a very sensitive marker for nerve fibers, the results of this study reaffirm the innervation failure of the proper muscle in HD. The decreased NCAM expression level in the aganglionic segment appears to be caused not by the selective down-regulation of NCAM expression among the nerve fibers but by a markedly reduced number of nerve fibers.     

Effect of ketamine on apoptosis by energy deprivation in astroglioma cells using flow cytometry system

Apoptosis is a programmed, physiologic mode of cell death that plays an important role in tissue homeostasis. As for the central nervous system, ischemic insults can induce pathophysiologic cascade of apoptosis in neurophils. Impairment of astrocyte functions during brain ischemia can critically influence neuron survival by neuronglia interactions. We aimed to elucidate the protective effect of ketamine on apoptosis by energy deprivation in astrocytes. Ischemic insults was induced with iodoacetate/ carbonylcyanide m-chlorophenylhydrazone (IAA/CCCP) 1.5 mM/20 microm or 150 microm/2 microm for 1 hr in the HTB-15 and CRL-1690 astrocytoma cells. Then these cells were reperfused with normal media or ketamine (0.1 mM) containing media for 1 hr or 24 hr. FITC-annexin-V staining and propidium iodide binding were determined by using flow cytometry. Cell size and granularity were measured by forward and side light scattering properties of flow cytometry system, respectively. An addition of ketamine during reperfusion increased the proportion of viable cells. Ketamine alleviated cell shrinkage and increased granularity during the early period, and ameliorated cell swelling during the late reperfusion period. Ketamine may have a valuable effect on amelioration of early and late apoptosis in the astrocytoma cells, even though the exact mechanism remains to be verified.     

Relationships of lead, copper, zinc, and cadmium levels versus hematopoiesis and iron parameters in healthy adolescents

To investigate the relationships of trace element concentrations vs hematopoiesis and iron parameters, we measured lead, copper, zinc, cadmium, and ferritin levels in 251 healthy adolescents. Concentrations of trace metals were determined by atomic absorption spectrophotometry. There were no significant gender-related differences in serum copper or serum cadmium concentrations. However, blood lead and serum zinc levels were significantly higher in males than females (3.82+/- 1.24 and 118.4 +/- 43.7 microg/dl vs 2.86+/- 1.06 and 83.5+/- 35.2 microg/dl, p<0.05, respectively). Subjects with elevated lead and copper concentrations exhibited significantly higher leukocyte counts and significantly lower serum iron levels than those with decreased lead and copper concentrations, but no significant differences were observed in blood erythrocyte counts or hemoglobin levels between the 2 groups. Blood lead concentrations were 2-fold higher in male adolescents with leukocytes >9.1 x 10(3)/microl than in those with leukocytes <4.3 x 10(3)/microl (5.04+/- 1.67 microg/dl vs 2.51+/- 0.75 microg/dl, p<0.05). Leukocyte counts had significant correlations with blood lead (r=0.39, p<0.05) and serum copper (r=0.26, p<0.05) in males and zinc (r=0.28, p <0.05) in females. Serum iron levels were inversely correlated with blood lead and serum copper concentrations but were not correlated with serum zinc or cadmium levels. In short, blood lead and serum copper concentrations have important relationships to leukocyte counts and iron parameters in adolescents.     

Substantia nigra stimulation evoked antidromic responses in rat neostriatum

Summary Electrical stimulation of the substantia nigra of rats elicits a burst of small amplitude waves with a latency of 4–6 ms that may last for 10–15 ms throughout much of the neostriatum. Frontal cortex stimulation also elicits a burst response, which can occlude the substantia nigra response. The substantia nigra evoked burst response was still present after chronic neocortical ablation or thalamic transection or both treatments combined. The response corresponds to the first sharp negative wave of the substantia nigra evoked neostriatal field potential. Single substantia nigra evoked action potentials were recorded in neostriatum with a mean latency of 9.8 ms, ranging from 4–22 ms. These action potentials were considered to be antidromic because 1) they were occluded during appropriate collision intervals by orthodromic action potentials elicited by frontal cortex stimulation. Subthreshold frontal cortex conditioning stimulation did not alter the threshold for activation from substantia nigra. The refractory period for the axon was at least as long as that for the soma and ranged between 0.8–2.0 ms. The antidromic responses failed to follow low frequency stimulation (< 40 Hz for 3000 ms). This failure occurred in the axon between substantia nigra and globus pallidus. The burst response and first sharp negative wave of the field potential probably represent the antidromic activation of the ubiquitous and densely packed medium spiny neostriatal projection neurons. These responses 1) occur at the same latency, 2) respond in the same manner to twin pulse and repetitive stimulation and 3) are occluded by frontal cortex stimulation in the same manner as antidromic action potentials.