洁净手术部病理标本的管理

医疗标本是指用来化验或研究的血液、痰液,组织切片等[1]。我院于2006年1月正式启用洁净手术部。洁净手术部管理的目标是杜绝事故,减少差错,确保病人手术安全,其中病理标本的管理是最重要的项目之一。根据洁净手术部严格分区管理的特色,对日常工作中的病理标本管理在控制污染,严禁标本混淆、丢失、及时送检4个方面进行严格规范,取得了满意的效果。现介绍如下。1存在的问题1.1容易扩散污染手术结束后,手术医生穿着带有血渍的手术衣、手套到标本室填写病理检查单,接取保存液,再返回手术间处理手术后事宜,容易造成污染和血液传染性疾病的发生。…     

冷敷在重睑成形术中的应用效果观察

重睑成形术是眼睑美容手术之一。随着人民生活水平的提高,要求美容的人也越来越多[1]。由于该手术大部分需要切开剥离,去除眼轮匝肌或去脂去皮,容易引起皮下组织水肿、淤血,影响恢复和术后效果。2005年11月—2006年11月,笔者对124例重睑受术者进行术中冰生理盐水冷敷,在减轻水肿、淤血程度、缩短恢复期方面疗效显著。现报道如下。1资料与方法1.1临床资料本组共124例,其中女118例,男6例,年龄20岁～58岁。将受术者按手术时间先后顺序随机分为实验组和对照组各62例。1.2方法两组均使用电凝止血,5-0丝线缝合后用无菌纱布包扎伤口,口服5d抗生素。…     

Expression of CD68 CD45RO CD20 and proliferating cell nuclear antigen in nasal polyps]

OBJECTIVE: To study the cellular expression of CD45RO, CD20, CD68 and proliferating cell nuclear antigen (PCNA) in nasal polyps. METHODS: Nasal polyp tissues from 50 patients were evaluated for cellular expression of CD45RO, CD20, CD68 and PCNA using immunohistochemistry SP by counting the average number in 5 chosen high-power fields, Histopathological observations were combined with HE. Analyses were performed on SPSS10.0. RESULTS: CD68+ cells were expressed more in nasal polyps dominated by eosinophils than by neutrophils(P < 0.05). There was no difference between CD45RO and CD20, but both of them had negative correlation(P = 0.05). Significant correlation was found between CD68+ cells and eosinophils or PCNA positive cells on epithelium. PCNA positive cells on epithelium had significant correlation on fibroblast (P < 0.05). CONCLUSION: Inflammatory cell infiltration (eosinophilia CD45RO, CD20, CD68) and cell proliferating in epithelium cells, glandular cell and fibroblast are strongly correlated with formation of nasal polyps. The nasal polyps are not only characteristic of eosinophilia but also by lymphocytes dominated by CD45RO and CD68 positive cells. CD68 may be stem cell of nasal polyp.     

Expression of Eph receptor tyrosine kinases and their ligands in human Granulosa lutein cells and human umbilical vein endothelial cells.

Corpus luteum development is regulated by gonadotropins and accompanied by extremely rapid vascularization of the avascular granulosa cell compartiment by endothelial cells (EC). The proliferation of Granulosa cells (GC) and EC is a complex interplay and takes place in a spatially and temporarily coordinated manner. The erythropoietin-producing hepatoma amplified sequence (Eph) receptors and their ligands-the ephrins- are a recently detected family of membrane located protein tyrosine kinases which play a crucial role in the growth and development of nerve and blood vessel network. We report about the mRNA expression pattern of Ephs and their ligands in human GC, in human EC, and in carcinoma cell lines OvCar-3 and Hela. The mRNA of EphA4, EphA7, ephrinA4, ephrinB1 and ephrinB2 was detected in GC and EC, while EphA2 was expressed only in GC. The expression of various Ephs and ephrins did not change in GC after stimulation with human chorion gonadotropin. Our study analyzes for the first time the expression of the complete human Eph/ephriny-system in GC and in EC. The remarkable similarity between these two cell types supports the theory of a functional relationship of EC and GC. In addition, it was shown that hCG is not a major determinant of Eph/ephrin regulation in GC.     

Comparative study of renal sodium transport between ouabain-hypertensive rats and ouabain-nonhypertensive rats

Objective: To compare renal sodium transport, using fractional excretions of lithium(FELi) as a marker of proximal tubule sodium reabsorption, between hypertensive and non-hypertensive ouabain-treated rats and further to elucidate the role of ouabain in pathogenesis of hypertension. Methods: Thirty male Sprague-Dawley rats weighting 180-200 g were randomly divided into normal control group and ouabain treated group. Rats were infused with 1 ml/kg·d normal saline or 27. 8μg/kg·d ouabain in-traperitoneally once a day respectively. Systolic blood pressure (SBP), heart rate and body weight were recorded weekly. Rats were sacrificed 6 weeks after treatment. Blood and 24-hour urine sample were collected to measure the serum and urinary concentration of sodium, trace lithium and creatinine. Endogenous creatinine clearance rate(Ccr), fractional excretions of sodium (FENa), fractional excretions of lithium (FELi) and fractional reabsorption of sodium in the postproximal tubules (FDRNa) were calculated. Ouabain levels of plasma and renal tissue, plasma renin activity, angiotensin I and aldosterone concentration were determined. Results: 65% of the ouabain-treated rats achieved significantly higher SBP after 4 weeks, compared with that of the saline control groups or self baseline (P<0. 01). But in the other 35% of the ouabain-treated rats, their SBP was similar with control group during the experiment (P>0. 05). The body weight, heart rate and food intake between the 3 groups were no significant differences (P> 0. 05). FELi and FDRNa were significantly lower in ouabain-hypertensive group compared with ouabain-non-hypertensive group and control group(P<0. 01 and P<0. 05). The FEu and FDRn, of ouabain-nonhyper-tensive groups were similar with control group(P>0. 05). Ccr and FENa were comparable between the 3 groups (P>0. 05). Plasma and renal tissue ouabain levels, plasma renin activity, angiotensin I and aldosterone contents in ouabain-hypertensive rats were comparable with ouabain-nonhypertensive rats. Conclusion: Increase of proximal tubule sodium reabsorption play an important role in the pathogenesis of ouabain-hypertensive rats. The change of renal sodium transport may result from regulation to renal Na+ , K + -ATPase by ouabain.     

急性胆囊炎腹腔镜手术时机探讨及操作技巧

目的 探讨急性胆囊炎行腹腔镜胆囊切除术的手术时机，并总结操作技巧。方法 回顾性分析2000年6月～2005年6月265例腹腔镜胆囊切除术治疗急性胆囊炎的临床资料。结果 265例中手术成功244例，成功率92．1％。中转开腹21例，其中小于72小时（Ⅰ组），超过72小时（Ⅱ组）的中转率分别为3．1％（4／129），12．5％（17／136）。Ⅰ组与Ⅱ组比较成功率无明显差别（P〉0．05）。全组无死亡病例，也无严重并发症发生。结论 急性胆囊炎行腹腔镜胆囊切除术安全可行，只要无内科禁忌证，应积极开展腹腔镜手术。     

阿拉瑞林与小剂量利维爱联合应用治疗子宫内膜异位症合并不孕症的研究

目的:探讨阿拉瑞林与小剂量利维爱(替勃龙)联合应用治疗子宫内膜异位症合并不孕症的疗效及其耐受性。方法:研究对象为1998年1月～2001年6月期间在我院诊治的40例子宫内膜异位症合并不孕症患者。实验组给以阿拉瑞林及利维爱,对照组单用阿拉瑞林。结果:用药后两组患者血清E2、P、FSH、LH水平及AEMAb、CA125阳性率均明显下降;症状体征明显改善;在治疗结束后6个月,实验组中55％、对照组中45％患者妊娠,两组间差异无统计学意义(P>0.05)。实验组未出现低雌激素症候群,而对照组中85％患者出现该症候群,两组差异有统计学意义(P<0.05)。结论:阿拉瑞林与小剂量利维爱联合应用不仅疗效好,而且副作用小。     

Angiopoietin1/Tie2 and VEGF/Flk1 induced by MSC treatment amplifies angiogenesis and vascular stabilization after stroke.

Bone marrow stromal cells (MSCs) increase vascular endothelial growth factor (VEGF) expression and promote angiogenesis after stroke. Angiopoietin-1 (Ang1) and its receptor Tie2 mediate vascular integrity and angiogenesis as does VEGF and its receptors. In this study, we tested whether MSC treatment of stroke increases Ang1/Tie2 expression, and whether Ang1/Tie2 with VEGF/ vascular endothelial growth factor receptor 2 (VEGFR2) (Flk1), in combination, induced by MSCs enhances angiogenesis and vascular integrity. Male Wistar rats were subjected to middle cerebral artery occlusion (MCAo) and treated with or without MSCs. Marrow stromal cell treatment significantly decreased blood-brain barrier (BBB) leakage and increased Ang1, Tie2, and occludin (a tight junction protein) expression in the ischemic border compared with MCAo control. To further test the mechanisms of MSC-induced angiogenesis and vascular stabilization, cocultures of MSCs with mouse brain endothelial cells (MBECs) or astrocytes were performed. Supernatant derived from MSCs cocultured with MBECs significantly increased MBEC expression of Ang1/Tie2 and Flk1 compared with MBEC alone. Marrow stromal cells cocultured with astrocytes also significantly increased astrocyte VEGF and Ang1/Tie2 expression compared with astrocyte culture alone. Conditioned media from MSCs alone, and media from cocultures of MSCs with astrocytes or MBECs, all significantly increased capillary tube-like formation of MBEC compared with control Dulbecco's modified Eagle's medium media. Inhibition of Flk1 and/or Ang1 significantly decreased MSC-induced MBEC tube formation. Knockdown of Tie2 expression in MBECs significantly inhibited MSC-induced tube formation. Our data indicate MSC treatment of stroke promotes angiogenesis and vascular stabilization, which is at least partially mediated by VEGF/Flk1 and Ang1/Tie2.     

EEG source imaging: correlating source locations and extents with electrocorticography and surgical resections in epilepsy patients.

SUMMARY: It is desirable to estimate epileptogenic zones with both location and extent information from noninvasive EEG. In the present study, the authors use a subspace source localization method (FINE), combined with a local thresholding technique, to achieve such tasks. The performance of this method was evaluated in interictal spikes from three pediatric patients with medically intractable partial epilepsy. The thresholded subspace correlation, which is obtained from FINE scanning, is a favorable marker, which implies the extents of current sources associated with epileptic activities. The findings were validated by comparing the results with invasive electrocorticographic (ECoG) recordings of interictal spike activity. The surgical resections in these three patients correlated well with the epileptogenic zones identified from both EEG sources and ECoG potential distributions. The value of the proposed noninvasive technique for estimating epileptiform activity was supported by satisfactory surgery outcomes.     

The CLDN5 locus may be involved in the vulnerability to schizophrenia.

The present study was designed to detect three single nucleotide polymorphisms (SNPs) located on 22q11 that was thought as being of particularly importance for genetic research into schizophrenia. We recruited a total of 176 Chinese family trios of Han descent, consisting of mothers, fathers and affected offspring with schizophrenia for the genetic analysis. The transmission disequilibrium test (TDT) showed that of three SNPs, rs10314 in the 3'-untranslated region of the CLDN5 locus was associated with schizophrenia (chi(2) = 4.75, P = 0.029). The other two SNPs, rs1548359 present in the CDC45L locus centromeric of rs10314 and rs739371 in the 5'-flanking region of the CLDN5 locus, did not show such an association. The global chi-square (chi(2)) test showed that the 3-SNP haplotype system was not associated with schizophrenia although the 1-df test for individual haplotypes showed that the rs1548359(C)-rs10314(G)-rs739371(C) haplotype was excessively non-transmitted (chi(2) = 5.32, P = 0.02). Because the claudin proteins are a major component for barrier-forming tight junctions that could play a crucial role in response to changing natural, physiological and pathological conditions, the CLDN5 association with schizophrenia may be an important clue leading to look into a meeting point of genetic and environmental factors.