关节软骨破坏与尿激酶型纤溶酶原激活物的影响

目的:观察尿激酶型纤溶酶原激活物对关节软骨的影响。方法:实验于2004-06/2006-06在石河子大学医学院第一附属医院中心实验室完成。实验选择健康新西兰大白兔42只并随机分为实验组24只,对照组18只;实验组在右膝关节内注射2mg/L尿激酶型纤溶酶原激活物0.2mL,对照组注射等容量的生理盐水;注射完成后在4,8,12周分批取兔软骨进行组织学观察、电镜检查及葡糖氨基聚糖测定。关节软骨退行性变采用组织-组化评分标准评定。结果:42只新西兰大白兔全部进入结果分析。①两组兔关节软骨大体观察结果:随着时间的延长,实验组关节软骨退行性变程度加重;对照组兔关节软骨外观无裂纹及软化。②两组兔关节软骨光镜组织学检查及评分:实验组关节软骨表面不规则、缺损及结构破坏,软骨细胞数目减少、纤维增生及异染性降低,潮线的完整性破坏;对照组关节软骨4层结构清晰可辨,软骨细胞排列整齐,潮线完整。③两组兔关节软骨超微结构观察结果:透射电镜下实验组软骨细胞明显固缩且外形不规则,胞膜上突起消失,核膜不完整,内质网扩张明显,细胞器数目减少,可见脂滴存在,细胞坏死、溶解多见;对照组可见软骨细胞呈椭圆形,细胞及胞膜完整,表面可见均匀分布的微绒毛突起,胞浆内可见丰富细胞器,基质中胶原纤维排列整齐。④两组关节软骨退行性变Mankin’s评分结果:实验组4,8,12周评分均高于对照组(P均<0.05)。⑤两组样品中葡糖氨基聚糖测定结果:对照组蛋白多糖含量无明显变化,实验组在不同时期的葡糖氨基聚糖含量均低于对照组(P<0.05);实验组8周时低于4周(P<0.01),12周虽低于8周,但差异无显著性。表明在不同时期,葡糖氨基聚糖的总含量均减少,这些改变随时间的延长而渐不明显。结论:尿激酶型纤溶酶原激活物能降解关节软骨蛋白多糖,进而导致关节软骨的破坏,尿激酶型纤溶酶原激活物可能是导致关节软骨破坏的相关因素之一。     

三种不同培养条件下兔关节软骨细胞增殖速率的差别

目的:观察兔关节软骨细胞在3种不同培养条件下增殖速率的差别。方法:实验于2004-10/2006-10在上海长海医院血管外科实验室完成。取4周龄新西兰雄性兔6只,利用机械与酶消化的方法获得均一性兔关节软骨细胞,在单层培养条件下增殖至第2代;将第2代细胞在高密度条件下转入藻酸盐凝胶24孔培养介质,进行三维培养。根据实验目的,将24孔培养板分为单层培养对照组,三维培养组(培养液不含胰岛素样生长因子Ⅰ),含胰岛素样生长因子Ⅰ三维培养组(培养液含50μg/L胰岛素样生长因子Ⅰ),每日在倒置相差显微镜下观察软骨细胞的生长状态,进行细胞计数1周,绘制细胞生长曲线,比较3种不同培养条件下兔关节软骨细胞的增殖速率。结果:①单层培养细胞24h后开始贴壁生长,细胞形态呈多角形、星形、圆形,72h后,倒置显微镜下观察细胞增殖数目明显增多,细胞增殖呈片状;三维培养条件下的软骨细胞,刚接种至藻酸钠凝胶时,细胞形态为圆形;三维培养(含胰岛素样生长因子Ⅰ)体系中的软骨细胞从转入三维培养的第3天起,发现细胞出现分裂增殖,局部有细胞团族形成,第7天,凝胶中开始有大量的细胞团族形成。在培养过程中,三维培养软骨细胞形态始终保持圆形。②1周内,单层培养条件下的软骨细胞增殖速率要明显高于三维培养组;含胰岛素样生长因子Ⅰ三维培养组的软骨细胞增殖速率明显高于不含胰岛素样生长因子Ⅰ三维培养组。结论:单层培养方法短期内(1周)对软骨细胞的增殖作用要优于三维培养方法;胰岛素样生长因子Ⅰ对三维培养条件下关节软骨细胞具有促进增殖的作用。     

一例FⅤ Leiden基因突变所致的抗活化的蛋白C现象

了解抗活性化的蛋白Ｃ在我国人群和血栓性疾患患者中发生情况。方法：用活化的蛋白－ＡＰＴＴ，我聚酶链反应及限制性内切酶分析，ＰＣＲ－ＳＳＰ及ＤＮＡ序列分析，对２８例正常人及１８例血栓性疾患患者进行ＡＰＣ测定及ＦⅤＬｅｉｄｅｎ突变杂合子；３例血栓性疾患患者ＡＰＣ－ＳＲ低于正常，但均无ＦⅤＬｅｉｄｅｎ突变。     

Fcalpha receptor (CD89) mediates the development of immunoglobulin A (IgA) nephropathy (Berger's disease). Evidence for pathogenic soluble receptor-Iga complexes in patients and CD89 transgenic mice

The pathogenesis of immunoglobulin A (IgA) nephropathy (IgAN), the most prevalent form of glomerulonephritis worldwide, involves circulating macromolecular IgA1 complexes. However, the molecular mechanism(s) of the disease remain poorly understood. We report here the presence of circulating soluble FcalphaR (CD89)-IgA complexes in patients with IgAN. Soluble CD89 was identified as a glycoprotein with a 24-kD backbone that corresponds to the expected size of CD89 extracellular domains. To demonstrate their pathogenic role, we generated transgenic (Tg) mice expressing human CD89 on macrophage/monocytes, as no CD89 homologue is found in mice. These mice spontaneously developed massive mesangial IgA deposition, glomerular and interstitial macrophage infiltration, mesangial matrix expansion, hematuria, and mild proteinuria. The molecular mechanism was shown to involve soluble CD89 released after interaction with IgA. This release was independent of CD89 association with the FcRgamma chain. The disease was induced in recombination activating gene (RAG)2(-/-) mice by injection of serum from Tg mice, and in severe combined immunodeficiency (SCID)-Tg mice by injection of patients' IgA. Depletion of soluble CD89 from serum abolished this effect. These results reveal the key role of soluble CD89 in the pathogenesis of IgAN and provide an in vivo model that will be useful for developing new treatments.     

冷水游泳对胃黏膜的保护作用

目的:长期冬泳运动是对外界应激刺激的一种适应,观察不同运动时间的冷水游泳对小鼠急性胃溃疡发生情况的影响。方法:实验于2004-04/08在河北师范大学体育学院运动人体科学专业实验室及河北师范大学生命科学学院细胞生物实验室完成,选用雄性小鼠53只,按随机数字表法分为5组,正常对照组、胃溃疡模型组、冷泳1min组及冷泳2min组各10只,冷泳力竭组13只。①游泳训练:正常对照组及胃溃疡模型组只抓取不游泳。其余各组均在4℃水中进行相应时间的游泳训练,每周训练6d,1次/d,共进行12周。冷泳1,2min组的训练时间分别为1min/次,2min/次;冷泳力竭组每次游泳的力竭标准为沉入水下10s不能上浮。②模型制作:训练结束后各冷泳组及胃溃疡模型组制作无水乙醇型胃溃疡模型,正常对照组灌服等量生理盐水。1h后麻醉处死各组小鼠,取胃,观察胃黏膜损伤情况,计算以下指标:a溃疡指数:点状出血为1分;线状出血长度<1mm为2分,3～4mm为5分;宽度>1mm,分值×2。全胃分数的总和为溃疡指数。b溃疡抑制率=(模型组溃疡指数-运动组溃疡指数)/模型组溃疡指数×100%。取胃组织匀浆上清液,测一氧化氮及丙二醛含量。结果:实验过程中,胃溃疡模型组因病死亡1只;冷泳力竭组死亡5只,均为训练中溺水窒息死亡。①胃黏膜面大体形态:胃溃疡模型组小鼠的胃溃疡程度重;冷泳力竭组胃溃疡程度与胃溃疡模型组小鼠相近,黏膜损伤较重;冷泳1min组、冷泳2min组胃溃疡程度较轻。②胃组织溃疡指数、溃疡抑制率:冷泳1min组、冷泳2min组小鼠的胃溃疡指数显著低于胃溃疡模型组(25.5±20.4,32.4±24.5,109.1±27.5,P<0.01),冷泳1min组、冷泳2min组的溃疡抑制率分别为76.63%,70.30%。冷泳力竭组胃黏膜损伤严重,无法计算其溃疡指数。③胃组织一氧化氮、丙二醛含量:其他4组小鼠胃组织的一氧化氮含量均显著低于正常对照组(P<0.01)。冷泳1min组、冷泳2min组基本相近,差异无显著性意义(P>0.05),均高于冷泳力竭组(P<0.05)及胃溃疡模型组(P<0.01)。冷泳力竭组与胃溃疡模型组相比,差异无显著性意义(P>0.05)。冷泳力竭组、胃溃疡模型组小鼠胃组织的丙二醛含量差异无显著性意义(P>0.05),均显著高于正常对照组(P<0.01)。冷泳1min组、冷泳2min组含量相近,差异无显著性意义(P>0.05),均显著低于冷泳力竭组(P<0.05)及胃溃疡模型组(P<0.01)。结论:①适量运动时间的冷水游泳能明显抑制小鼠无水乙醇型胃溃疡的形成。②力竭性冷水游泳运动对胃溃疡的形成无明显抑制作用。③在4℃水温中进行1次/d,2min/次的强迫游泳,持续12周,能达到与1min/次的冬泳小鼠模型相似的效果,也可以作为冬泳小鼠模型。     

Analysis of Diagnostic Value of Cytological Smear Method Versus Cell Block Method in Body Fluid Cytology: Study of 150 Cases

Background

Aspiration of serous cavities is a simple and relatively non-invasive technique to achieve diagnosis. Cytologic evaluation of body cavity fluid is diagnostically challenging.

Methods

A total of 150 fluid specimens were examined for conventional cytological smear (CS) and cell block method (CB). Out of 150 fluids, 79 were pleural fluid, 69 were ascitic fluid and 2 pericardial fluid. Each fluid specimen was divided in two equal parts: one part was subjected to conventional smear technique, while the other part was subjected to 10% alcohol-acetic acid-formalin cell block technique. Overall morphological details, cellularity, architecture, nuclear and cytoplasmic details were studied in both CS and CB techniques.

Results

In this study, the utility of the CB method in the cytodiagnosis of malignant effusions was found to be highly significant as compared to the CS method. The additional yield of malignancy was 10% more as was obtained by the CB method.

Conclusion

For the final cytodiagnosis of body fluid, there is statistically significant difference between the two techniques. In other words, CB is superior to CS method.     

Uveitis in Herpes zoster ophthalmicus

Background : Herpes zoster ophthalmicus (HZO) is a common condition occurring mostly in healthy people. Approximately 50% of HZO patients develop ocular complications, with iridocyclitis occurring in about 43%. This study aimed to identify the clinical features of uveitis secondary to HZO. Method : A retrospective case study was performed of consecutive patients with HZO and secondary uveitis seen in the past 10 years at the Royal Victorian Eye and Ear hospital as well as those seen in the private clinics of two ocular immunology consultants. The information collected included the time relationship between onset of rash and uveitis, duration and treatment of the uveitis, and rate and nature of ocular complications. Results : Thirty‐four patients fulfilled the enrolment criteria. The age range was from 24 to 83 years with an average age of 62.5 years. Of these, 28 patients (82%) were immunocompetent and six patients (18%) had underlying immunosuppression from various causes. Twenty‐three patients had a uniphasic episode of uveitis and 11 patients (32%) had a chronic relapsing course of uveitis. The duration of the uveitis was variable, ranging from 1 week to 3 years, with 68% of episodes resolving within 2 months. Nineteen patients (56%) developed secondary glaucoma. Five of these patients (26%) required trabeculectomies to control their intraocular pressures. Three patients (9%) had bilateral ocular involvement and five patients (15%) had a reduction in final Snellen visual acuity of more than two lines. Conclusion : In this study, most patients were immunocompetent individuals. The course of the uveitis was generally uniphasic in nature and of a relatively short duration. There was a high incidence of secondary glaucoma with 15% of all patients requiring surgical intervention. The visual loss in the five patients was not directly related to the uveitis and secondary glaucoma but to other complications associated with HZO.     

丙型肝炎与原发性肝癌关系研究现状

肝癌是世界上常见的恶性肿瘤，其病因研究主要集中在肝炎病毒、化学因素、饮水污染、烟酒嗜好、微量元素、性激素等，其中肝炎病毒是目前研究的主要课题之一．发展中国家以乙型肝炎为主、发达国家主要病因为丙型肝炎，随着近年来急性乙型肝炎发病率逐渐下降，肝癌发病率却...