鼻息肉患者鼻腔淋巴系统核素显影的初步研究

目的 探讨鼻腔黏膜淋巴引流障碍在鼻息肉患者鼻黏膜中的表现.方法 应用核素显影技术对25例鼻息肉患者(试验组,又分为Malm-1、Malm-2、Malm-3级3个亚组)和需行前哨淋巴结核素检查且经鼻内镜检查鼻腔结构正常的6例甲状腺腺癌、喉癌等患者(对照组)的鼻腔黏膜特定部位进行核素注射,通过影像结果分析鼻腔黏膜淋巴引流状况.结果 试验组及对照组注射部位均未见到明显的淋巴显影及引流征象,但试验组注射点周围存在显影剂滞留现象.试验组、对照组感兴趣区(region of interest,ROI)内放射性计数比值((x)±s,以下同)分别为29.33 ±6.34、20.66 ±1.89,差异有统计学意义(t=3.275,P＜0.05).试验组中Malm-1、Malta-2、Malm-3级3个亚组ROI内放射性计数比值分别为24.40 ±3.19、29.31±3.39、39.21±3.15,3个亚组比较,差异有统计学意义(F=38.980,P＜0.05).结论 鼻息肉患者鼻黏膜淋巴引流存在功能紊乱.

Abstract：

Objective To explore the role of nasal mucosal lymphatic drainage in the pathogenesis of nasal polyps.Methods There were 25 cases in the experimental group who had nasal polyps ( which was further divided into Malm-1,Malm-2,Malm-3 level 3 subgroups)and 6 cases in the control group,including thyroid cancer and laryngeal cancer patients who had normal nasal structure.The nasal polyps in the experimental group and the middle turbinate in the control group were injected with a radionuclide and a radionuclide imaging technique was used to image the nasal mucosal lymphatics.The lymphatic drainage status of the nasal mucosa through the imaging results was analysed.Results The T/NT ratio ( radioactivity counting) of the region of interest( ROI) was 20.66 ± 1.89 in the control group and 29.33 ± 6.34 in the experimental group.The difference was significant (t =3.275 ,P ＜0.05 ) .The T/NT ratio of the ROI was 24.40 ±3.19 in the Malm-1 level group,29.31 ± 3.39 in the Malm-2 level group,39.21 ± 3.15 in the Malm-3 level group.The differences of qualitative analysis were significant ( F = 38.980,P ＜0.05 ) .The quantitative analysis showed that at the injection site,signs of lymphatic development and drainage were not found in the control group or experimental group,but the phenomenon of contrast media retention existed at the injection site in the experimental group.Conclusion Lymphatic drainage dysfunction exists in patients with nasal polyps,and it may play a role in the pathogenesis of nasal polyps.     

家族性甲状腺乳头状癌的生物学特征及治疗

目的 分析家族性甲状腺乳头状癌的临床生物学行为,并探讨其治疗方法.方法 回顾性分析2010年1月至2011年8月天津医科大学附属肿瘤医院收治的家族性甲状腺乳头状癌共15个家系36例患者的临床资料,并将随机抽取的同期散发性甲状腺乳头状癌95例患者作为对照组.结果 15例(41.7％)家族性甲状腺乳头状癌患者年龄≥45岁;12例(33.3％)双侧腺叶发病,20例(55.6％)多灶病变;27例(75.0％)伴颈部淋巴结转移;17例(47.2％)伴甲状腺良性结节.95例对照组中60例患者(63.2％)年龄≥45岁;12例(12.6％)双侧腺叶发病,21例(22.1％)多灶病变;51例(53.7％)伴颈部淋巴结转移;26例(27.4％)伴甲状腺良性结节.家族性甲状腺乳头状癌患者行甲状腺全切除22例,患侧腺叶及峡部切除14例;3例行单侧或双侧侧颈清扫及中央区颈清扫术,7例行单侧或双侧后侧颈清扫及中央区颈清扫术,6例行一侧后侧颈清扫及中央区颈清扫术+对侧中央区颈清扫术,20例行单侧或双侧中央区颈清扫术.结论 家族性甲状腺乳头状癌较散发性甲状腺乳头状癌具有发病年龄小,多灶发病及双侧发病比例高,颈部淋巴结转移率高的生物学特征.术前应详细询问家族史并评估病情,建议选择较为积极的治疗方式.     

The role of 1-h physical activity every day in preventing obesity in adolescents in Shandong, China

Several studies have reported that physical inactivity and sedentary lifestyle are associated with being overweight and obese in children and adults. A new policy of 1-h physical activity (PA) every day was released by the Chinese government. The present study examined the role of 1-h PA every day in preventing obesity in adolescents in Shandong, China. A total of 29,030 students (14,578 boys and 14,452 girls) aged 10–18 years participated in this study. Height, weight, waist circumference (WC), and skinfold thickness (SFT) of all subjects were measured; body mass index (BMI) of adolescents was calculated from their height and weight, and the prevalence of overweight and obesity was obtained according to the International Obesity Task Force cutoffs. All subjects were divided into two groups. Group 1 had a PA of more than 1 h/day while group 2 had less than 1 h/day. Comparisons of BMI, WC, SFT, and prevalences of overweight and obesity between the two groups were made. The overall percentages of students in group 1 were 34.29 % in boys and 30.15 % in girls. The prevalences of overweight and obesity for both boys and girls were all significantly lower in group 1 than in group 2 in all age categories. In conclusion, 1-h PA every day has a beneficial effect in preventing obesity in adolescents in Shandong, China. These observations highlight the importance of PA in the prevention of overweight and obesity in adolescents.     

Toll样受体在儿童ITP的表达及临床意义

目的探讨外周血血小板表面天然免疫分子TLR2、TLR4表达的变化及相关性在儿童特发性减少性紫癜(ITP)发病中的意义。方法采用流式细胞学技术检测24例急性特发性血小板减少性紫癜(AITP)患儿、20例慢性特发性血小板减少性紫癜(CITP)患儿和20例对照儿童外周血血小板表面TLR2、TLR4的水平。采用SPSS13.0进行统计学分析,P<0.01为差异有统计学意义。结果AITP组、CITP组患儿CD41+TLR2+、CD61+TLR4+阳性率显著低于对照组(P<0.01);并且AITP组显著低于CITP组(P<0.01);两者的表达呈正相关(rs=0.65,P<0.01)。结论联合检测外周血血小板表面TLR2和TLR4表达的变化有助于进一步研究儿童ITP的发病机制,有望成为ITP患儿早期分型的指标之一。     

The Emergence and Functional Fitness of Memory CD4+ T Cells Require the Transcription Factor Thpok

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The gut microbiome in food allergy

Objective

To review observational human, murine, and interventional trial studies that have examined the gut microbiome in food allergy, and to provide perspective on future investigations in this field.

Mucosal bromodomain-containing protein 4 mediates aeroallergen-induced inflammation and remodeling

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骨折不愈合的诊断及治疗建议

骨折的愈合是一个复杂的过程,能否成功愈合取决于多种内源和外源因子,愈合过程中的一些因素改变往往导致骨折的延迟愈合甚至骨不连。骨不连的发生率在5%～10%之间,随着严重损伤患者数量增多,骨不连发生率亦在随之增加。骨不连有很高的社会经济负担,主要是由间接成本造成的,如由于治疗时间长而造成的生产力损失。近年来,对于骨不连发病的影响因素、诊断及治疗方式的研究加深了外科医师对骨不连的认识。随着对骨不连认识的不断深入,外科医师对骨折的早期处理也进行了改善,从而降低了骨不连发生的风险,另外对骨不连本身的处理方式也得以进一步改良。本文的目的即在于回顾目前已发表的文献,以期增加临床医师对骨不连这一骨折并发症的认识以及为临床上选择恰当合理的治疗方法提供参考。