胎盘免疫调节因子对子宫内膜异位症大鼠免疫功能的影响

目的:观察胎盘免疫调节因子对大鼠子宫内膜异位症动物模型的治疗效果和对大鼠免疫功能的影响。方法:实验于2005-10/2006-12在广西医科大学医学科学实验中心及广西肿瘤防治研究所实验病理室完成。①实验材料:健康6个月龄雌性SD大鼠60只,体质量为200～250g;健康产妇胎盘在经广西医科大学第一附属医院伦理委员会同意和产妇知情同意后获得。②实验干预及分组:利用自体子宫组织移植的方法,建立雌性子宫内膜异位症大鼠模型40只,随机分为胎盘免疫调节因子小剂量组、中剂量组、高剂量组和模型对照组,分别肌注胎盘免疫调节因子剂量为0.375,0.75,1.5mg/kg和等体积生理盐水,1次/d,连续8周。③用两脚规测量移植物的体积(V=长×宽×高/mm3),采用ATP生物荧光法测定大鼠脾细胞增殖能力;采用中性红法测定腹腔巨噬细胞的吞噬功能。采用ELISA法检测治疗后各组大鼠血清中白细胞介素2水平。结果:建模成功40只,均进入结果分析。①各组移植物外观及体积:用药后8周,各胎盘免疫调节因子组移植物体积不同程度缩小(P<0.05),呈扁平状,粘连受到明显的抑制。②各组大鼠脾细胞增殖试验、腹腔巨噬细胞吞噬功能及血清白细胞介素2水平的变化:胎盘免疫调节因子中,高剂量用药组脾细胞增殖能力较模型对照组升高(P<0.05);各剂量胎盘免疫调节因子组腹腔巨噬细胞吞噬功能、白细胞介素2水平均较模型对照组升高(P<0.05)。结论:胎盘免疫调节因子治疗大鼠子宫内膜异位症显示了较好的疗效,可显著缩小子宫异位内膜的体积,提高大鼠的免疫功能。     

S-BLMs的发展及其在生物传感器中的应用

由于双层类脂膜(bilayer lipid membranes,BLMs)是生物膜极好的实验模型,因此在生物传感器的研制领域显示出广泛的应用前景。在对生物膜结构进化的简短总结后,介绍了有固态基底支撑的BLMs(supported bilayer lipid membranes,S-BLMs)的研究发展状况,并综述了其在生物传感器中的应用研究进展。     

Diffusion weighted MR imaging in the differential diagnosis of haemangiomas and metastases of the liver

Background

The purpose of the study was to evaluate the value of diffusion-weighted imaging in the differential diagnosis of haemangiomas from metastases of the liver.

Patients and methods.

We analyzed 69 lesions in 38 patients (33 haemangiomas; 36 metastases) in the retrospective study. Diffusion-weighted imaging was performed using a breath-hold single-shot echo-planar spin echo sequence with three b factors (0, 500 and 1000 sec/mm²), and apparent diffusion coefficients (ADCs) were calculated. For the quantitative evaluation, signal intensity of the lesions, lesion-to-liver signal intensity ratios, ADC of the lesions, and lesion-to-liver ADC ratios were compared between the groups. The statistical significance was determined by student’s-t test.

Results

With the b factor 500 sec/mm², no statistical significance was achieved (p>0.05). With the b factor of 1000 sec/mm², both the signal intensity and lesion-to-liver signal intensity ratio of the metastases were significantly higher than those for haemangiomas (p<0.001). The cut-off value at 2.6 yielded a sensitivity of 86% and a specificity of 82% for the lesion-to-liver signal intensity ratio. The ADC, and lesion-to-liver ADC ratio of the metastases were significantly lower than those of haemangiomas (p<0.001). With cut-off value of 1.7, ADC ratio had a sensitivity of 88% and a specificity of 72% for ADC lesion/liver.

Conclusions

Diffusion-weighted imaging with high b value may help in the differential diagnosis of metastases from haemangiomas of the liver.     

延迟小骨窗开颅手术治疗硬膜外血肿96例

1临床资料1999-08/2004-08我科采用延迟小骨窗开颅手术治疗硬膜外血肿96(男75,女21)例,年龄13～18(平均35)岁.受伤原因车祸72例,坠落伤11例,打击伤13例.均于伤后72 h内就诊并经头颅CT确诊,表现头痛96例,呕吐21例,一侧肢体无力32例,偏身麻木23例,癫痫发作1例,原发昏迷92例,59例≤30 min,33例为30～120 min,头痛进行性加重36例.就诊时GCS记分10～12分15例,13～15分81例,运动性失语2例,混合性失语3例.CT示血肿位于额顶叶12例,额叶32例,颞叶5例,顶枕叶8例,颞顶后39例(1例合并对侧脑内血肿,5例合并额颞叶脑挫裂伤).血肿量30～80mL.入院后3～15 d内先给予脱水剂、激素、止血剂、抗生素、脑活性药物、镇痛剂等对症处理保守治疗.     

Experimental evaluation of ten clinically used arterial prostheses

The arterial grafts currently in use are classified into five basic categories; 10 different commercially available prostheses were chosen to represent these categories. The Vascutek and Bionit are made from knitted Dacron and have medium porosity, requiring preclotting by the surgeon. The DeBakey Soft Woven and Plasma TFE grafts are made from woven Dacron and have low porosity, not requiring preclotting under most circumstances. Also studied were woven and knitted grafts with leakage resistance referred to as impervious Dacron grafts: the Vascutek Gelseal, the Bard Albumin Coated DeBakey Vasculour II, the Microvel with Hemashield, and the albumin saturated, autoclaved DeBakey Soft Woven graft. Gore-Tex and Impra are expanded polytetrafluoroethylene grafts which do not require preclotting. For each type, five grafts 6 cm long and 8 mm in diameter were implanted in the descending thoracic aorta of healthy adult dogs for 16 weeks. The physical characteristics, biocompatibility, and healing patterns varied according to the structure and treatment of the grafts. Pretreatment with biomaterials during manufacture is quite effective in preventing transinterstices blood loss during implantation, but results in altered physical qualities, increased thrombogenicity and delayed healing in comparison to the effects of preclotting with autogenous blood at the time of implantation.     

The LIFESTYLE study: costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial

Background

In the Netherlands, 30% of subfertile women are overweight or obese, and at present there is no agreement on fertility care for them. Data from observational and small intervention studies suggest that reduction of weight will increase the chances of conception, decrease pregnancy complications and improve perinatal outcome, but this has not been confirmed in randomised controlled trials. This study will assess the cost and effects of a six-months structured lifestyle program aiming at weight reduction followed by conventional fertility care (intervention group) as compared to conventional fertility care only (control group) in overweight and obese subfertile women. We hypothesize that the intervention will decrease the need for fertility treatment, diminish overweight-related pregnancy complications, and will improve perinatal outcome.

Methods/Design

Multicenter randomised controlled trial in subfertile women (age 18-39 year) with a body mass index between 29 and 40 kg/m². Exclusion criteria are azoospermia, use of donor semen, severe endometriosis, premature ovarian failure, endocrinopathies or pre-existent hypertensive disorders. In the intervention group the aim is a weight loss of at least 5% to10% in a six-month period, to be achieved by the combination of a diet, increase of physical activity and behavioural modification. After six months, in case no conception has been achieved, these patients will start fertility treatment according to the Dutch fertility guidelines. In the control group treatment will be started according to Dutch fertility guidelines, independently of the patient's weight.

Outcome measures and analysis

The primary outcome measure is a healthy singleton born after at least 37 weeks of gestation after vaginal delivery. Secondary outcome parameters including pregnancy outcome and complications, percentage of women needing fertility treatment, clinical and ongoing pregnancy rates, body weight, quality of life and costs. Data will be analysed according to the intention to treat principle, and cost-effectiveness analysis will be performed to compare the costs and health effects in the intervention and control group.

Discussion

The trial will provide evidence for costs and effects of a lifestyle intervention aiming at weight reduction in overweight and obese subfertile women and will offer guidance to clinicians for the treatment of these patients.

Trial registration

Dutch Trial Register NTR1530