米非司酮治疗后VEGF-165在异位和在位子宫内膜中的表达

目的探讨米非司酮对VEGF-165在子宫腺肌症中表达的影响。方法43例子宫腺肌症患者分为对照组(n=21)和米非司酮治疗组(n=22),采用放射免疫法测定对照组(月经第3天)和米非司酮组(术前)血清中FSH、LH、E2、PRL、P及T的水平。采用免疫组化法测定两组患者在在位和异位子宫内膜中的VEGF-165蛋白水平。结果米非司酮组较对照组血清FSH、LH、E2、P明显降低(P<0.05),而血清PRL和T的水平两组间无统计学差异(P>0.05)。VEGF-165在子宫内膜腺上皮细胞内的表达,异位内膜均明显高于在位内膜(P<0.05);而其在间质细胞内的表达,异位内膜与在位内膜无统计学差异(P>0.05)。米非司酮组异位和在位内膜腺上皮细胞、间质细胞中VEGF-165的表达水平均较对照组明显降低(P<0.05)。VEGF-165在对照组异位内膜腺上皮细胞中的表达,增殖期高于分泌期(P<0.05)。结论米非司酮治疗后,VEGF-165在异位和在位内膜中的表达明显下降,可能是通过抑制VEGF蛋白合成,降低血管通透性,抑制新生血管生成,从而有效地控制子宫内膜异位症的发生发展。     

慢性乙肝患者肝组织纤维化程度与HBV-DNA复制水平的相关性研究

目的:探讨HBV-DNA复制水平与肝纤维化之间的相关性。方法:对210例慢性乙型肝炎患者进行HBV-DNA和肝纤维化血清学标志透明质酸(HA)、层粘蛋白(LN)、III型前胶原(PCIII)、IV型胶原(IV-C)进行定量检测。应用SPSS10.0统计软件对结果数据进行分析处理。结果:随慢性乙肝临床类型的加重,肝纤维化血清学标志逐渐升高(P<0.01),而肝纤维化血清学标志与HBV复制水平呈正相关(P<0.05);结论:HBV复制水平与肝纤维化之间呈正相关。     

米非司酮对不同月经周期异位和在位子宫内膜雌激素受体α和孕激素受体表达的影响

目的 探讨米非司酮对雌激素受体α(ERα)和孕激素受体(PR)在不同月经周期的子宫腺肌症中表达的影响.方法 47例行全子宫切除术的子宫腺肌症患者分为米非司酮组(n=24)和未用药组(n=23);无腺肌症的正常子宫内膜作为对照组(n=15).运用免疫组化的方法测定异位和在位子宫内膜及正常子宫内膜在不同月经周期的腺上皮及间质细胞中ERα和PR水平.结果 未用药组ERα和PR在异位子宫内膜腺上皮及间质细胞中的表达均低于在位内膜及对照组正常内膜(P<0.05).对照组及未用药组ERα和PR在在位内膜腺上皮细胞中的表达,增生期高于分泌期(P<0.05),而在未用药组异位内膜,差异无统计学意义(P>0.05).ERα和PR在异位和在位子宫内膜中的表达,米非司酮组低于未用药组(P<0.05).结论 ERα和PR在异位子宫内膜中的表达与在位子宫内膜不同;异位内膜丧失了正常内膜的周期性变化规律;米非司酮通过下调其性激素受体(ERα和PR)含量治疗子宫腺肌症.     

Global vascular expression of murine CD34, a sialomucin-like endothelial ligand for L-selectin

Extravasation of leukocytes into organized lymphoid tissues and into sites of inflammation is critical to immune surveillance. Leukocyte migration to peripheral lymph nodes (PLN), mesenteric lymph nodes (MLN) and Peyer's patches (PP) depends on L-selectin, which recognizes carbohydrate-bearing, sialomucin-like endothelial cell surface glycoproteins. Two of these ligands have been identified at the molecular level. One is the potentially soluble mucin, GlyCAM 1, which is almost exclusively produced by high endothelial venules (HEV) of PLN and MLN. The second HEV ligand for L-selectin is the membrane-bound sialomucin CD34. Historically, this molecule has been successfully used to purify human pluripotent bone marrow stem cells, and limited data suggest that human CD34 is present on the vascular endothelium of several organs. Here we describe a comprehensive analysis of the vascular expression of CD34 in murine tissues using a highly specific antimurine CD34 polyclonal antibody. CD34 was detected on vessels in all organs examined and was expressed during pancreatic and skin inflammatory episodes. A subset of HEV-like vessels in the inflamed pancreas of nonobese diabetic (NOD) mice are positive for both CD34 and GlyCAM 1, and bind to an L-selectin/immunoglobulin G (IgG) chimeric probe. Finally, we found that CD34 is present on vessels of deafferentiated PLN, despite the fact that these vessels are no longer able to interact with L-selectin or support lymphocyte binding in vitro or trafficking in vivo. Our data suggest that the regulation of posttranslational carbohydrate modifications of CD34 is critical in determining its capability to act as an L-selectin ligand. Based on its ubiquitous expression, we propose that an appropriately glycosylated form of vascular CD34 may act as a ligand for L-selectin-mediated leukocyte trafficking to both lymphoid and nonlymphoid sites.     

A state of the art review on optimal practices to prevent,recognize, and manage complications associated with intravascular devices in the critically ill

Intravascular catheters are inserted into almost all critically ill patients. This review provides up-to-date insight into available knowledge on epidemiology and diagnosis of complications of central vein and arterial catheters in ICU. It discusses the optimal therapy of catheter-related infections and thrombosis. Prevention of complications is a multidisciplinary task that combines both improvement of the process of care and introduction of new technologies. We emphasize the main component of the prevention strategies that should be used in critical care and propose areas of future investigation in this field.     

A New Variant of Hereditary Hemolytic Anemia With Stomatocytosis and Erythrocyte Cation Abnormality

A new variant of congenital hemolyticanemia associated with stomatocytosis,reticulocytosis, decreased osmotic fragility, type I autohemolysis and shortened erythrocyte survival without specific splenic sequestration was discoveredin three siblings of Swiss-German ancestry. Increased intracellular sodium(two to three times normal) and slightlydecreased intracellular potassium weredetected. Total sodium efflux was eight-fold greater than normal but total potassium influx was normal and ouabain-sensitive potassium influx was decreased.The ouabain-sensitive sodium efflux:potassium influx ratio was 26:1 ratherthan the 3:2 ratio noted in normal cells.The consanguineous parents, four othersiblings, and 44 other family membershad mild stomatocytosis, reticulocytosis,and, when studied, decreased osmoticfragility, increased autohemolysis, intermediate abnormalities of cation content,cation flux, and moderate shortening oferythrocyte survival. Autosomal dominant inheritance was suggested. Noabnormalities of RBC enzymes, hemoglobin or lipids were observed. No abnormalities of membrane protein weredetected on acrylamide gel. Substratedepletion of these hypermetabolic cellsresulted in intracellular dehydrationwith potassium loss in excess of sodiumgain and decreased deformability. Although the exact nature of the defectresponsible for hemolysis is unknown,this syndrome differs from other hereditary hemolytic anemias associated withstomatocytosis.

Submitted on December 21, 1970 Revised on March 16, 1971 Accepted on March 29, 1971     

Enhanced Bone Regeneration Using Porcine Small Intestinal Submucosa

Small instestinal submucosa (SIS) is an easily produced material that has been used experimentally for tissue engineering. To evaluate the ability of SIS to facilitate bone growth within a long-bone defect, a segment of the radius was surgically removed in adult, female Sprague-Dawley rats. The defect was either left unfilled or implanted with SIS, demineralized cortical bone (DMCB), or ovalbumin. The defect was evaluated radiographically and histologically after 3, 6, 12, and 24 weeks. Tissue remodeling within the defect was evident by week 3 in SIS- and DMCB-treated rats. Filling was characterized initially by infiltration of mononuclear cells and extracellular material in SIS-implanted rats and multifocal remodeling bone particles and cartilage formation in DMCB implanted rats. Cartilage was observed as early as 3 weeks and bone as early as 6 weeks in SIS-implanted rats. Filling of the defect arose from multiple foci in DMCB-implanted rats, but was contiguous with and parallel to the ulnar shaft in SIS-implanted rats, suggesting that defect repair by SIS may be conductive rather than inductive. Rats in which the defect was left unfilled demonstrated slow but progressive filling of the defect, characterized by mononuclear cell infiltrates and fibrous extracellular material. In summary, SIS facilitated rapid filling of a longbone defect. These results suggest that SIS may be useful as a bone repair material.