59例老年非何杰金氏淋巴瘤病理分析

本文报道老年非何杰金氏淋巴瘤(NHL)59例并与同期非老年患者138例相比。老年患者占同期NHL总数的29.9％。59例中有结内型43例,结外型16例;低度恶性与中度恶性各12例,高度恶性35例。与非老年组比较,老年组的就诊原因、病变部位、恶性程度、细胞类型和预后等方面无何差别,提示年龄对上述特征无明显影响。     

Increased expression of MHC class II antigens in rejecting canine lung allografts

Expression of major histocompatibility complex class II antigens was investigated in the normal lungs and in lung allografts of mongrel dogs after single-lung transplantation. Cryostat sections were stained with an indirect immunoperoxidase technique that used B1F6 and 7.5.10.1 as anti-MHC class II monoclonal antibodies. In the normal lungs and native lungs of the recipient dogs after single-lung transplantation, only some cells of lymphoid tissue and macrophages/dendritic cells were MHC class II-positive. During acute rejection, increased infiltration with MHC class II-positive cells in perivascular, peribronchial, and interstitial areas and intraalveolar spaces was found in lung allografts. In addition, expression of MHC class II antigens was induced on the bronchial epithelium and vascular endothelium. Induced expression of MHC class II antigens on the bronchial epithelium and vascular endothelium in rejecting lung allografts was found as early as two days after single-lung transplantation. The intensity of MHC class II antigen expression on bronchial epithelium and vascular endothelium in graft lungs increased with the progression of rejection response and directly correlated with the bronchoalveolar lavage fluid (BALF) levels of biochemical markers, as tumor necrosis factor alpha, gamma-interferon (IFN-gamma), interleukin 2 (IL-2) and soluble interleukin 2 receptor (SIL-2R). Abnormal expression of MHC class II antigens on bronchial epithelium and vascular endothelium and abnormal elevation of BALF levels of the cytokines in lung allografts could be prevented by cyclosporine (CsA) treatment. Our results suggested that MHC class II antigen expression could be induced on the bronchial epithelium and vascular endothelium of canine lung allografts during acute rejection. This abnormal expression of MHC class II antigens on bronchial epithelium and vascular endothelium of graft lungs may serve as a specific index for diagnosis of lung allograft rejection when infection as an inducing factor can be excluded. Furthermore, bronchial epithelium and vascular endothelium of lung allografts have become MHC class II-positive, and are likely to be the targets for low-grade rejection, resulting in the development of bronchiolitis obliterans and occlusive vascular disease in lung allografts.     

Gastrointestinal dysfunction among intensive care unit patients

This study used the Acute Physiological and Chronic Health Evaluation (APACHE II) system to select two groups of ICU patients with comparable risk of hospital death to evaluate the importance of GI dysfunction, defined as failure to tolerate enteral nutrition (EN), as a prognostic factor. In our ICU, patients who have not undergone recent bowel surgery are treated by EN. Those patients who cannot tolerate EN are treated by total parenteral nutrition (TPN). One hundred and eleven patients who tolerated EN (functioning gut) and 97 TPN patients who failed to tolerate EN (GI dysfunction) were studied. The mean APACHE II scores of the two groups were 17.7 +/- 6.5 (SD) and 17.7 +/- 5.1, respectively. The observed mortality of patients with GI dysfunction (51%) was significantly higher (p less than .0005) than that of patients with a functioning gut (25%). This was associated with significantly poorer APACHE II mean BP, oxygenation, and creatinine scores among the GI dysfunction patients. Our results suggest that shock, ischemia, and hypoxemia, in addition to causing impairment of renal function, may bring about changes in the GI tract, evident clinically only as a failure to tolerate EN, which have an adverse effect on the prognosis of ICU patients so affected.     

Biosynthesis of the antibiotic actinorhodin. Analysis of blocked mutants of Streptomyces coelicolor

From two types of class V act mutants of Streptomyces coelicolor two monomeric precursors of actinorhodin have been isolated and their structures determined. One is the known antibiotic kalafungin and the other a new compound. Their relationship to actinorhodin biosynthesis is discussed.     

重组O-GLcNAc糖基转移酶在昆虫细胞中的表达和纯化

蛋白质的 O- Glc NAc糖基化修饰是一种细胞核蛋白与细胞浆蛋白的蛋白质翻译后修饰。不同于膜蛋白和分泌蛋白的糖基化修饰 ,与蛋白质磷酸化修饰相似。催化蛋白质 O- Glc NAc糖基转移酶 ( OGT)已被克隆。用Hi5昆虫细胞系统表达并纯化了具有活性的重组 OGT。在 Hi5昆虫细胞中表达的鼠肝 OGT带有一 His 6标记片段。经镍离子螯合柱纯化后 ,其比活性达到 0 .88nmol· min- 1·m g- 1 OGT。因此本研究为进一步研究蛋白 O- Glc NAc糖基化修饰提供重要资源     

影响脐血IgE值因素的研究

目的　本研究对影响脐血IgE值的可疑因素进行分析 ,探讨影响儿童食物过敏的可疑因素。方法　选取孕期妇女 10 5名及其所生婴儿 ,采用标准问卷调查获取资料 ,对影响脐血IgE的因素进行分析。 结果　母亲的过敏性疾病史、父亲过敏性疾病史中的皮炎表现型、孕期妇女过敏性疾病发作史、有过敏史妇女孕后期摄入过量的牛奶和鸡蛋均与脐血IgE值的上升有关 ,且上述 5个因素对脐血IgE水平的影响依次降低。 结论　母亲的过敏性疾病史和父亲过敏性疾病史中的皮炎表现型是导致新生儿脐血IgE值升高的主要危险因素 ;同时 ,妊娠期加强对有过敏史妇女的保护 ,防止过敏性疾病的复发 ,在孕后期控制有过敏史妇女牛奶、鸡蛋等大分子食物致敏原的摄入 ,有助于降低脐血IgE值。     

Outcome after traumatic frontal intracerebral haemorrhage: a comparison of unilateral and bilateral haematomas

Frontal intracerebral haemorrhage (ICH) is a common result of cranial trauma. Outcome differences between bilateral and unilateral frontal ICH are not well studied but would be valuable to predict prognosis in clinical practice. Two aims are proposed in this study: first to compare the risk of developing delayed ICH after bilateral or unilateral frontal ICH, and second to determine the variables helpful to predict outcome according to the Glasgow Outcome Scale (GOS). Between January 1993 and December 1997, 694 consecutive patients with traumatic ICH were admitted to the Chang Gung Medical Center within 24 h of the trauma. Patients with ICH in sites other than the frontal lobes were excluded. A total of 161 cases (mean age 46.3+/-20.3 years), including 57 bilateral (mean age 52.5+/-18.7 years) and 104 unilateral (mean age 42.9+/-20.5 years) traumatic frontal ICH were studied. Twenty-eight of 57 patients (49%) with bifrontal ICH versus 17 of 104 patients (16%) with unilateral frontal ICH had a further, delayed ICH. In 42 of 45 patients (93%) with delayed ICH, this occurred within 5 days of the initial trauma. Multivariate logistic regression was used to select significant predictors of outcome. We found that delayed ICH (p<0.001), age (p=0.004) and mechanism of injury (p=0.001) explained the worse outcome in patients with bifrontal ICH. The best-fitting logistic regression model included three variables: delayed ICH (p=0.011), initial GCS (p=0.023), and a sum score of clinical and radiological variables (p=0.003). Bifrontal ICH tended to occur in older patients after a fall and was associated with a higher risk of developing delayed ICH or brain stem compression compared to unilateral ICH damage. Using these three variables - delayed ICH, initial GCS, and the sum score - in a logistical regression model is useful to predict outcome in patients with traumatic frontal ICH and may aid patient management.     

手助腹腔镜肝部分切除术治疗原发性肝癌

目的 探讨手助腹腔镜肝部分切除术治疗原发性肝癌的方法和应用价值。方法 经临床筛选的第Ⅱ、Ⅲ、Ⅵ段或边缘型的原发性肝癌6例，在腹腔镜辅助下．应用手助器、超声刀、切割器等特殊器械进行腹腔镜下肝癌切除术。结果 6例患者均成功完成手术，包括肝Ⅱ、Ⅲ段切除，Ⅵ段切除及非规则性肝段切除术，手术时间80～130min，术后住院6～9d，手术出血150～700ml，无中转开腹手术，无并发症。术后随访6～15个月，2例分别于手术后3和4个月肝内复发，其余4例随访至今无复发。结论 在经过临床选择的病例中，手助腹腔镜下作肝部分切除术治疗原发性肝癌是安全、可行的手术方式。     

自身免疫性感音神经性聋豚鼠的子代内耳生理功能研究

目的 :观察自身免疫性感音神经性聋 (ASHL)母豚鼠所产子代内耳生理功能的变化 ,探讨针对内耳的自身免疫因素对子代内耳生理功能的影响及其改变特点。方法 :同种内耳抗原 (CIEAg)持续免疫孕豚鼠 ,采用耳蜗电图 (记录cAP、CM )和眼震电图仪 (记录自发性眼震和冷热空气试验 )测试母鼠和子鼠的听觉和前庭功能 ,并检测血清特异性体液免疫反应。结果 :ASHL模型母豚鼠所产子鼠血清中发现有特异性抗体水平升高 ,部分 (3 /9)出现听觉损伤。非ASHL母鼠和对照组母鼠所产子代未见明显异常。结论 :ASHL雌鼠所产子代可出现感音神经性聋 ,其内耳损伤和功能障碍极可能与针对内耳组织的自身免疫反应 (尤其是体液免疫 )有关 ,从而提示内耳自身免疫因素可能为部分先天性非遗传性感音神经性聋的病因之一。     

免疫组织化学与眼病诊断

免疫组化(IHC)是一种极为实用的技术.其基本原理是使用多种抗体来检测组织表达的特异性抗原,从而对疾病作出诊断和分类.目前,免疫组化在眼病诊断中的应用主要包括:眼部肿瘤的诊断与分类、眼部转移性原发肿瘤位置的探测、眼部非肿瘤性疾病的辅助检查、眼底视网膜外膜组成成分的判断以及跌病预后评估和治疗的指导等.