新生儿锁骨骨折41例分析

目的　探讨引起新生儿锁骨骨折的产科相关因素。方法　对我院 1997年 1月～ 2 0 0 0年 12月新生儿锁骨骨折 4 1例进行回顾性分析。结果　新生儿锁骨骨折的发生率阴道难产高于阴道顺产 ,剖宫产中无新生儿锁骨骨折的发生。新生儿出生体重≥ 35 0 0g组锁骨骨折发生率较 <35 0 0g组高 (P <0 0 0 5 ) ,差异有显著性。产后常规的新生儿体验可早期发现新生儿锁骨骨折和及时处理。新生儿锁骨骨折的预后良好。结论　提高阴道助产技术 ,正确掌握分娩机转 ,可降低新生儿锁骨骨折的发生率。     

内分泌和化疗对乳腺肿瘤患者干细胞的影响

BACKGROUND:Tumor stem cells are the root of cancer recurrence and metastasis, so clinical researches should focus on the effects of different treatments on tumor stem cells. OBJECTIVE:To explore the effects of endocrine therapy and chemotherapy on stem cells in patients with breast cancer. METHODS:After recovery and cultivation of estrogen receptor-positive human breast cancer cell lines MCF-7, passage 3 cells in logarithmic phase were selected and divided into three groups containing control, estradiol and estradiol with tamoxifen groups. The estradiol group was divided into three subgroups: 10^-7, 10^-8 and 10^-9 mol/L estradiol was added into the medium, respectively; the estradiol with tamoxifen group was divided into three subgroups: 10^-7, 10^-8 and 10^-9 mol/L estradiol with 10^-6 mol/L tamoxifen were added into the medium, respectively. The same amount of absolute ethyl ethanol was added into the medium of control group. Fifteen female patients with late recurrence and metastasis of breast cancer received chemotherapy as recurrence and metastasis group. Another 15 healthy volunteers were selected as healthy control group. RESULTS AND CONCLUSION:The proportion of CD44⁺CD24^-/low cell subsets in the estradiol and estradiol with tamoxifen groups was significantly higher than that of the control group (P < 0.05), and the proportion of CD44⁺CD24^-/low cell subsets in the estradiol group was significantly higher than that of the estradiol with tamoxifen group at the same concentration (P < 0.05). The proportion of CD44+CD24-/low cell subsets had no significant differences among groups at 10 and 20 days of culture (P < 0.05). The proportion of CD44⁺CD24^-/low cell subsets significantly increased in MCF-7 cells after 24-hour intervention with different chemotherapy drugs. But only the proportion of CD44⁺CD24^-/low cell subsets in the paclitaxel and doxorubicin groups was significantly higher than that of the control group after 20-day intervention (P < 0.05). Besides, the proportion of CD44⁺CD24^-/low cell subsets in the peripheral blood of healthy volunteers was significantly lower than that of the recurrence and metastasis group (P < 0.05). Among 15 patients with late recurrence and metastatic of breast cancer, 9 had stable disease, 5 had partial remission, 1 had failed chemotherapy and cancer progression. Moreover, the proportion of CD45^-CD44⁺CD24^-/low cell subsets in the peripheral blood of patients sensitive for chemotherapy was significantly lower than that before treatment (P < 0.05). In conclusion, both endocrine therapy and chemotherapy exert a certain effect on the CD44⁺CD24^-/low cell subsets of breast cancer positive for estrogen receptor. Given that CD44⁺CD24^-/low cell subsets in MCF-7 cells resist chemotherapy drugs, the proportion of CD45^-CD44⁺CD24^-/low cells in the peripheral blood of patients sensitive for chemotherapy is decreased.     

精神分裂症患者认知功能的随访观察

目的探讨缺陷型、非缺陷型精神分裂症患者的认知功能的长期随诊特点。方法对1997年9月曾进行认知功能检查,持续住院的缺陷型22例和非缺陷型30例精神分裂症患者于4年后再次进行评定,同时采用简明精神病评定量表(BPRS)评定其症状。结果4年后精神分裂症患者仅非缺陷型的注意和计算明显降低,缺陷型患者的记忆因子明显降低外,其它各因子及总分无明显降低。结论精神分裂症患者的认知功能损害随病程进展并无明显加重趋势。     

维甲酸下调结缔组织生长因子表达减轻新生大鼠高氧肺损伤的研究

目的：探讨维甲酸（RA）对高氧肺损伤保护作用的机制。方法：90 只Sprague Dawley新生鼠随机平分为空气组、高氧组和高氧+RA 组。高氧组、高氧+RA 组置于 85% 氧浓度的氧箱中,高氧+RA 组每日腹腔注射RA 500 μg/kg。分别于实验第 4天、7天、14天行开胸术取新生鼠肺组织,苏木精-伊红染色光镜下行辐射状肺泡计数,逆转录聚合酶链反应（RT-PCR）、免疫组化检测肺组织结缔组织生长因子（CTGF）表达。结果：与空气组相比,高氧组和高氧+RA 组肺组织随氧暴露时间延长,出现炎性细胞浸润,肺泡结构紊乱,肺泡数量减少,肺间隔增厚,其中高氧+RA 组病理改变明显轻于高氧组;在第7天和第14天,高氧组和高氧+RA组肺组织 CTGF 的 mRNA 和蛋白表达比空气组增加（P＜0.05）;且高氧+RA组中 CTGF 的 mRNA 和蛋白表达在第 14 d 比高氧组减少（P＜0.05）。结论：高氧暴露下新生鼠肺组织 CTGF 表达增加,RA 保护高氧肺损伤可能是通过下调 CTGF 表达。     

肺毛细血管瘤病二例临床病理观察及文献复习

目的 探讨肺毛细血管瘤病的临床病理特征,提高对其临床及病理改变的认识.方法 对2例肺毛细血管瘤病的临床资料和组织学形态进行回顾性分析,并采用组织化学染色和免疫组织化学染色(EnVision法)研究其形态和免疫表型特点.结果 患者主要临床表现为喘憋,影像学(CT及肺动脉造影)特点为双肺多发结节影,肺动脉增宽,组织学表现为灶状分布的肺问质和肺泡壁毛细血管增生,小动脉肌性化,免疫组织化学染色提示病灶中肥大细胞数量增多,血小板衍生生长因子受体(PDGFR)-β表达上调,Ki-67阳性指数小于1％,p53阴性.结论 肺毛细血管瘤病是一种肺毛细血管增生性疾病,其发病机制可能与肥大细胞数量和PDGFR-β上调有关.病理医师在肺毛细血管瘤病的正确诊断和治疗中起重要作用,应提高对该病的认识.     

Interleukin-33 alleviates psoriatic inflammation by suppressing the T helper type 17 immune response

Psoriasis is a chronic inflammatory skin disease with unclear pathogenesis. Interleukin-33 (IL-33) is highly expressed in patients with psoriasis, but its role in psoriasis is unknown. The aim of this study was to investigate the possible role of IL-33 in the pathogenesis and treatment of psoriasis. IL-33 expression was determined using enzyme-linked immunosorbent assay, real-time fluorescent quantitative polymerase chain reaction and immunohistochemical staining. CD4⁺ T cells were sorted using magnetic beads and treated with or without IL-33. Imiquimod (IMQ) was used to induce psoriatic inflammation in mice. The frequency of immune cells was determined using flow cytometry. The cytokine level in mouse skin was measured using cytometric bead array. Our results showed that IL-33 was highly expressed in the lesional skin and serum of patients with moderate-to-severe plaque psoriasis. IL-33 inhibited the expression of IL-17 in CD4⁺ T cells of psoriasis patients. Subcutaneous injection of IL-33 alleviated the IMQ-induced psoriatic inflammation in mice, reduced tumor necrosis factor-α and IL-23 expression, and decreased the proportion of T helper type 17 (Th17) cells in the skin-draining lymph nodes in the mice. Our results suggest that IL-33 plays a protective role in the pathogenesis of psoriasis by suppressing Th17 cell differentiation and function. The potential therapeutic effect of IL-33 in treating psoriasis warrants further investigation.     

Osteopontin affects the persistence of beta-glucan-induced hepatic granuloma formation and tissue injury through two distinct mechanisms

Osteopontin (OPN) plays a pivotal role in various immune responses and inflammatory diseases. OPN is expressed in various granulomatous diseases; however, the cellular and molecular role of OPN in these diseases is not well known. We analyzed the role of OPN in a beta-glucan-induced hepatic granuloma model. First, we found that neither OPN deficiency nor overexpression of OPN affected the number and the size of hepatic granulomas at day 7, indicating that OPN is not involved in the formation of hepatic granulomas at the early stages. Importantly, OPN did not influence the liver tissue damage as defined by alanine aminotransferase and aspartate aminotransferase levels at early stages. Second, OPN deficiency resulted in the reduction of IL-12 and IFN-gamma production at early stages. Third, at late stages, OPN deficiency resulted in a decrease in the number and size of hepatic granulomas, and a reduction of liver tissue injury. This was due to the reduction of the cellular recruitment including macrophages, CD4 T cells and dendritic cells into the liver, and the reduction of tumor necrosis factor (TNF)-alpha production in the liver. In contrast, overexpression of OPN resulted in the persistence of granuloma formation. These data suggest that OPN affects the persistence of hepatic granuloma formation. Our results indicate that OPN up-regulates the production of IL-12 and IFN-gamma within the granulomas at early stages, and OPN has an additional role in the regulation of cellular recruitment and TNF-alpha production at late stages that determine the severity of liver tissue injury.     

急性失血的模型及计算机仿真

在作者已建立的心脏-体循环-肺循环整体模型HSP的基础上引入了压力反射控制机制,进行人体急性失血现象的建模和计算机仿真.实验结果表明符合生理和病理现象,在心率(HR)、心室弹性模量(Emax)、外周阻力(Rep)和静脉非压力容积(Vuv)等诸因素中,Vuv在心血管系统应对急性失血中起着主要作用.     

大学新生的自杀意念与抑郁情绪、希望特质

目的:探讨大学新生自杀意念的检出率,以及与抑郁情绪、希望特质之间的关系。方法:选取某大学一年级全部新生4372名,采用症状自评量表(SCL-90)第15项评估自杀意念,采用抑郁自评量表(SDS)、希望量表(DHS)评估抑郁症状和希望特质。收回有效问卷4211份。结果:大学新生自杀意念发生率为4.5%(189/4211),女生自杀意念率高于男生(6.7%vs.3.7%,P0.05)。有自杀意念学生的SDS得分高于无自杀意念者[(42.0±7.3)vs.(34.2±6.3),P0.05],DHS得分低于无自杀意念者[(43.6±8.8)vs.(49.8±8.1),P0.05]。SDS得分越高,越容易产生自杀意念(OR=1.15,P0.01);而DHS得分越高,自杀意念产生的可能性越小(OR=0.95,P0.05)。结论:本研究发现提示大学新生自杀意念的产生可能与抑郁情绪相关,而希望特质可能是保护因素,对有自杀意念的大学生应重视抑郁情绪的评估。     

Rapid Disease Progression in HIV-1-Infected Men Who Have Sex with Men Is Negatively Correlated with Peripheral Plasmacytoid Dendritic Cell Counts at the Early Stage of Primary Infection

To explore the relationship between absolute dendritic cell (DC) counts at the early stage of primary human immunodeficiency virus type 1 (HIV-1) infection (PHI) and subsequent disease progression, we performed a prospective study of 16 rapid progressors (RPs) and 12 typical progressors (TPs) from a PHI cohort of men who have sex with men. Significantly decreased plasmacytoid DC (pDC) and myeloid DC (mDC) counts in the blood of RPs were observed at study entry as compared with TPs and healthy HIV-1-negative subjects. Low baseline pDC counts were significantly associated with rapid disease progression after adjustment for baseline CD4(+) T cell counts, mDC counts, and HIV-1 load. Kaplan-Meier survival analysis showed that low pDC counts were strongly associated with rapid disease progression. Our findings demonstrated the predictive value of blood absolute pDC counts at baseline in PHI for HIV-1 disease progression. Further studies are required to confirm this notion.