新生儿白细胞介素2、γ干扰素水平的研究

通过检测15例正常新生儿、8例早产儿和33例患病新生儿(13例患非感染性疾病,20例患感染性疾病)的白细胞介素2(IL-2)和γ干扰素(IFNγ)水平。并比较两者间的关系。结果发现新生儿IL-2、IFNγ的产生能力较正常成人降低,早产儿降低更明显;感染性疾病能使新生儿IL-2、IFNγ的产生减少,而非感染性疾病对之无明显影响;各组的IL-2和IFNγ同有明显的相关关系。提示评价新生儿的免疫状态应结合淋巴因子水平的测定,临床上对严重感染性疾病的治疗试用IL-2和IFNγ有潜在的重要作用。     

Cytokine expression and endothelial cell and lymphocyte activation in human cardiac allograft rejection: an immunohistochemical study of endomyocardial biopsy samples.

We used monoclonal antibodies and immunohistochemical staining of frozen tissue sections to study the expression of cytokines in human cardiac allograft rejection. The 113 endomyocardial biopsy samples were stained for interleukin (IL)-2, IL-6, and interferon-gamma. The findings were compared to expression of the endothelial cell adhesion molecule ICAM-1, and the lymphocyte receptor for the adhesion molecule VCAM-1, VLA-4. Four biopsy samples from patients with idiopathic cardiomyopathy served as controls. IL-2 was not expressed in lymphocytes of controls and only occasionally in mild or moderate cellular rejection, humoral rejection, and Quilty lesions. IL-2 expression was prominent in severe cellular rejection. Interferon-gamma expression increased in proportion to the severity of cellular rejection and was not expressed in other conditions. IL-6 staining, which was only observed in occasional cases, was mild. Cytokine and adhesion molecule expression tended to increase with the severity of cellular rejection. This study shows that cytokine expression can be documented in human allograft endomyocardial biopsy samples with immunohistochemical techniques. The findings support the concept of an important role for cytokines in human cardiac allograft rejection.     

人胎黑质细胞的冷冻保存

采用台盼蓝染色法，观察了第３～６月人胎黑质细胞冷冻保存的细胞存活率，结果：①胎龄３～６月人胎黑质细胞冷冻保存后均可存活，但以胎龄３和４月细胞存活率较高。②液氮保存的细胞存活率不受保存时间的影响，而４℃保存的细胞存活率随保存时间的延长而逐渐降低。结果提示，液氮保存人胎黑质细胞的保存条件以胎龄３和４月为宜。     

晕得宁毒性的实验研究

晕得宁为复方中药制剂,济宁市第一人民医院耳科用于治疗美尼尔氏病疗效良好,我室对此方剂进行了毒理学研究。急性毒性实验表明,小鼠一次灌胃量达人用量的200倍(n=10),观察72小时,未见异常表现及死亡。亚急性毒性实验:实验组12只家兔(分成大、中、小剂量三组),连续给药三周,其观察指标包括体重、血常规、肝功(GPT)和肾功(BUN),与对照组(n=4)相比,均无异常(P>0.05);病理检查10兔正常,另2兔患有肺炎。其中1只病兔属大剂量组,于给药第20～21天出现腹泻并死亡,可能与方剂组成中半夏的毒性有关。作者认为晕得宁的毒性较小;鉴于半夏有毒,临床用药宜避免大剂量、长期应用。     

丁二酸酐交联羟基超支化聚(胺-酯)的反应及其交联膜的性质

以丁二酸酐(SA)为交联剂研究了端羟基超支化聚(胺-酯)(HPAE)的交联反应和交联膜的制备。结果表明:SA与HPAE的交联反应分为两个阶段,可以采用溶液法低温涂膜及高温交联得到HPAE/SA交联膜;改变SA的用量可控制膜的交联度,HPAE/SA交联膜的拉伸强度随SA用量的增大而提高,最高可达59.60 M Pa,膜表面的水接触角小于74.3°。     

正常人在静态和运动状态下"死腔/潮气"估测值和实测值的比较

目的研究正常人静态及运动状态下死腔/潮气(VD/VT)估测值和实测值的关系.方法23名受试者行心肺运动试验,同步实时测定摄氧量和二氧化碳排出量,分别在运动前及运动高峰时抽取动脉血,根据Bohr的公式,得出VD/VT实测值,同时再用呼气末CO2分压(PetCO2)代替PaCO2,计算VD/VT,得出VD/VT估测值.结果根据病史、体检、肺功能和运动前后的心电图判断23名受试者均为正常受试者.静态时的VD/VT估测值和VD/VT实测值分别为0.359±0.109和0.354±O.106,两者无显著性差异(P=0.710),相关分析显示两者高度相关(r=0.911,P＜0.001).运动高峰时的VD/VT估测值和VD/VT实测值分别为0.234±0.070和0.248±0.094,两者无显著性差异(P=0.748),相关分析表明两者显著相关(r=0.783,P＜0.001).与静态时比较,运动时估测和实测VD/VT均明显下降.结论对于正常成人,无论是在静态或最大运动状态下,可用无创方法计算VD/VT代替VD/VT实测值.     

The adverse effect of treatment prolongation in cervical cancer by high-dose-rate intracavitary brachytherapy.

BACKGROUND AND PURPOSE: The potential risk of prolongation of treatment time in cervical cancer has been reported for many low-dose rate (LDR) studies, with an estimated loss of local control ranging from 0.3 to 1.6% per day of treatment prolongation. Since the treatment schedule for fractionated high-dose rate intracavitary brachytherapy (HDRICB) is not directly comparable with that for low-dose rate studies, this report aims to evaluate the adverse effect of treatment prolongation specifically for cervical cancer treated with HDRICB. MATERIAL AND METHODS: From September 1992 to December 1997, 257 patients diagnosed with uterine cervical cancer (35 Ib, 26 IIa, 122 IIb, 10 IIIa, 57 IIIb, 7 IVa), who underwent external radiotherapy combined with between two and four courses of HDRICB and a minimum of 3 years of follow-up (median 57 months), were analyzed. Treatment consisted of irradiation of the whole pelvis with 44-45 Gy consisting of 22-25 fractions by 5 weeks, with the dose boosted to 54-58 Gy (with central shielding) for patients diagnosed as FIGO stage IIb-IVa bilateral parametrial disease. HDRICB was performed using an Ir-192 remote afterloading technique at 1-week intervals. The standard prescribed dose for each course of HDRICB was 7.2 Gy to point A for three insertions (before July 1995), or 6.0 Gy to point A for four insertions (after July 1995). Total prescribed point A doses (external beam radiotherapy+HDRICB) ranged from 58 to 71.6 Gy (median, 65.6 Gy) for stage IB-IIA, while analogous dosage for larger lesions (stage IIb-IVa) ranged from 59 to 75.6 Gy (median, 65.6 Gy). Kaplan-Meier and multivariate analyses were used to test the effect of treatment time on pelvic control rate (PCR) and cause-specific survival (CSS) at 5 years. RESULTS: Median treatment time was 63 days. For all stages of disease, the 5-year CSS and PCR were significantly different comparing treatment times of less than and greater than or equal to 63 days [83% and 65% (P=0.004], 93% and 83% (P=0.02), respectively]. These associations were also significant for stage Ib/IIa [97% and 79% (P=0.01), and 100% and 87% (P=0.02), respectively), but not for stage IIb [75% and 72% (P=0.79), and 93% and 87% (P=0.83), respectively] or stage III [66% and 49% (P=0.2), and 83% and 72% (P=0.21), respectively]. Multivariate analysis identified three prognostic factors for CSS, stage (P<0.001), tumor response to external RT (P=0.001), and overall treatment time (OTT; P=0.006). Prognostic factors for pelvic failure were stage (P<0.001), tumor response to external RT (P=0.001), and OTT (P=0.03). Prolongation of treatment time resulted in a daily decrease in pelvic control rate of 0.67% overall, and 0.43% for stage Ib-IIa, 0.57% for stage IIb, and 0.73% for stage III patients. CONCLUSION: Analysis of the data from the current study demonstrates that the adverse effect of treatment prolongation was observed later in the treatment course for the high-dose rate (HDR) series compared to the LDR analog, however, treatment-time prolongation still negatively influenced the cause-specific survival and pelvic control rate for both dosage groups.     

严重烧伤后肠道损伤与肠源性高代谢的关系

目的　探讨烧伤后肠道损害与“肠源性高代谢”的关系。方法　在建立严重烧伤加清洁肠道动物模型的基础上 ,将 96只Wistar大鼠随机分为烧伤对照 (B)组和烧伤加清洁肠道 (SDD)组。观察了伤后 0～ 10d大鼠静息能量代谢率(REE)的变化 ,同时检测了伤后 0、1、3、5、7、10d血中内毒素 (LPS)、肿瘤坏死因子 (TNF)和二胺氧化酶 (DAO)的含量 ,并进行相关分析。结果　烧伤后两组大鼠的REE、TNF、LPS和DAO均明显高于伤前 ,两组相比 ,SDD组的REE、TNF和LPS较B组均有不同程度的降低 ,而DAO则明显高于B组。相关分析显示 ,REE同LPS和TNF呈显著正相关 (r1 =0 .77,P <0 .0 5 ,r2 =0 .81,P <0 .0 5 ) ,与DAO相关不显著 (r >0 .0 5 )。结论　烧伤后肠源性高代谢与血中炎症介质含量呈正比 ,但肠道损伤程度加重并不引起代谢率相应增加 ,二者不存在线性关系     

p21对缺血-再灌注损伤后肾小管上皮细胞演变的影响

目的 探讨p21对缺血-再灌注损伤（IRI）后肾小管上皮细胞演变的影响。方法 选择低龄（2个月龄）和高龄（12个月龄）p21（＋／＋）和p21（-／-）鼠，建立左肾IRI模型。于IRI后0、1、3、7d及1、3、6个月光镜下观察肾小管组织学变化，采用免疫组化法检测肾小管上皮细胞增殖细胞核抗原（PCNA）表达，组织化学染色观察肾小管上皮细胞衰老相关β-半乳糖苷酶（SA-β-gal）活力，末端脱氧核糖转移酶介导的生物素化脱氧尿嘧啶缺刻标记技术（TUNEL）检测肾小管上皮细胞凋亡。结果 IRI后0d，肾小管以坏死为主，高龄鼠比低龄鼠严重、p21（-／-）鼠比p21（＋／＋）鼠严重（P均〈0．05）。肾小管上皮细胞凋亡在IRI 1d后出现，7d达高峰，且高龄鼠比低龄鼠明显、p21（-／-）鼠比p21（＋／＋）鼠明显（P均d0．05）。低龄鼠IRI后1个月出现SA—β-gal染色阳性的肾小管上皮细胞，而对侧肾此时未见衰老细胞，3和6个月时衰老的肾小管上皮细胞显著增多，且p21（＋／＋）鼠比p21（-／-）鼠明显（P〈0．05）；p21（＋／＋）高龄鼠IRI后0d双肾即可见大量的SA-β-gal染色阳性肾小管上皮细胞，且较p21（-／-）鼠显著增多（P〈O．05），但1d后，p21（＋／＋）和p21（-／-）鼠IRI肾衰老细胞均明显减少（P均〈0．05），1个月后又呈进行性增加，且p21（＋／＋）鼠始终比p21（-／-）鼠严重。高龄和低龄p21（＋／＋）鼠PCNA阳性染色细胞出现的几率差异无显著性（P〉0．05），但低龄鼠细胞增殖能力要强于高龄鼠；而p21（-／-）鼠的细胞增殖能力明显强于p21（＋／＋）鼠，低龄鼠更为显著（P均〈0．05）。对高龄鼠IRI后1d细胞衰老和凋亡进行相关分析显示，二者呈显著负相关Cp21（＋／＋）鼠：r=-0．82，P〈0．001,p21（-／-）鼠：r=-0．76，P〈0．0013。结论 ①IRI可促进正常肾小管上皮细胞衰老的进程；②已经进入衰老状态的肾小管上皮细胞在遭受IRI刺激后，更易走向死亡[坏死和（或）凋亡]；③p21在IRI所致肾小管上皮细胞演变过程中发挥重要的调控作用。     

急性低氧对家兔微血管及心电图的影响

目的　观察不同程度急性低氧对家兔微血管和心电图的影响。方法　实验采用两组家兔分别人工吸入 12 .5 %(Ⅰ组 )和 8.5 %氦氧混合气体 (Ⅱ组 ) ,模拟 40 0 0m和 65 0 0m高原急性低氧。急性低氧时间分别为 5min、10min、15min、2 0min ,于急性低氧前后观察微血管和QTc与JTc间期变化。结果　两组血流速度减慢 ,微血管口径变大。Ⅰ组QTc和JTc间期有延长 ;Ⅱ组QTc间期有延长 ,而JTc间期有缩短或不变。结论　急性低氧可使微血管血流速度减慢 ,口径变大 ,心肌去、复极化发生改变