外用红花油引起皮肤过敏2例

例 1 .患者男 ,33岁 ,于 2 0 0 2年 1 1月因患腰肌纤维组织炎来我科治疗。我们采用外涂红花油并配合神灯照射 ,灯距 30 cm,照射 30 min,每日 1次。首次治疗结束后 ,患者述其治疗部位有痒感。查看皮肤为暗红色 ,并有红色血疹出现。次日 ,全身再行治疗后 ,上述症状加重 ,痒甚。停用红花油改为神灯照射 ,3次后过敏症状消失痊愈。例 2 .患者女 ,35岁 ,于 2 0 0 1年 8月因左脚背烫伤 ,即自涂红花油于患处 ,约 2 h后 ,涂红花油处皮肤呈深红色 ,并出现米粒样红色丘疹 ,瘙痒。为止痒 ,患者再次自行涂红花油于患处 ,约 1 h后局部出现烧灼感 ,奇痒 ,红…     

Recurrent acalculous cholecystitis and sclerosing cholangitis in a patient with X-linked hyper-immunoglobulin M syndrome.

X-linked hyper-immunoglobulin M (IgM) syndrome (XHIGM) is a rare genetic primary immunodeficiency disease caused by mutations of the CD40 ligand (CD40L) gene with normal or elevated levels of IgM and markedly decreased serum IgG, IgA, and IgE. Liver disease may occur as a clinical manifestation in XHIGM. This complication appears to increase with age. We report an 18-year-old male patient who had recurrent episodes of acalculous cholecystitis (AC) and sclerosing cholangitis (SC). The diagnosis of XHIGM was confirmed by the finding of CD40L expression < 1% of normal and a tyrosine 169 asparaginase (t526a) mutation in exon 5 (the tumor necrosis factor domain) of the CD40L gene. The patient had direct hyperbilirubinemia (direct bilirubin 5.5 mg/dL, total bilirubin 8.7 mg/dL), cholestasis (alkaline phosphatase 1133 U/L, gamma-glutamyl transferase 1019 U/L) and elevated transaminases (aspartate aminotransferase 70 U/L, alanine aminotransferase 101 U/L). Findings on abdominal ultrasound and abdominal computed tomography were compatible with AC. After the fourth episode of cholecystitis, cholecystectomy and liver biopsy were performed. Operative cholangiography revealed poor opacification of the hepatic duct and proximal common bile duct; the upstream intrahepatic bile ducts were not visualized. The biopsy specimen showed marked fibrosis of the portal areas. Enterococcus species was cultured from the bile. Children or adolescents with recurrent AC and SC should be evaluated for an underlying immunodeficiency syndrome such as XHIGM.     

Elimination of malignant clonogenic cells from human bone marrow using multiple myeloid cell-specific monoclonal antibodies and complement.

Single or combined monoclonal antibodies (McAbs) Zh53, Zh820, and Zh2-1 have been used to eliminate malignant clonogenic cells from human bone marrow. The test of cytotoxicity showed that all of these McAbs could express high specific cytotoxic action against HL-60 cells and were selectively complement-dependent cytotoxic to various types of fresh leukemic cells. Clonogenic assay detected that single treatment with antibody and rabbit complement (RC) could reduce clonogenic units of HL-60 cells by more than 2 logs and two treatments reduced clonogenic units by more than 4 logs. However, combination of 2 McAbs could reduce clonogenic units by 4-5 logs. The data suggest that multiple treatments with McAbs and RC or a combination of 2 McAbs are more effective than a single treatment in eliminating clonogenic tumor cells. Treatment of normal human bone marrow with Zh53, Zh2-1 and RC did not produce a loss of normal CFU-GM, but treatment with Zh820 reduced the clonic units of normal CFU-GM by 24%.

     

灯盏花素注射液对大鼠脑缺血-再灌注脑损害的凋亡抑制作用

目的:研究灯盏花素(Bre)对大鼠脑缺血-再灌注引起脑损伤的保护作用。方法:实验选用40只雄性Wistar大鼠,大鼠被随机分成5组:假手术组、对照组、硫酸镁(Mg-SO4)治疗组、灯盏花素治疗和组。自大鼠颈总动脉插入尼龙线栓栓塞大脑中动脉,造成大脑缺血,拔出线栓实现再灌注。脑缺血10min后给予75mg/kg和50mg/kgBre及30mg/kgMgSO4,分别于脑缺血1h,再灌注2h,5h和23h分别进行神经病学评分,并于脑缺血1h,再灌注23h时测定脑梗死面积,用TUNEL法和免疫组化法分别检测脑组织凋亡细胞和Caspase-3阳性细胞的变化。结果:灯盏花素降低脑缺血-再灌注大鼠神经病学评分,缩小脑梗死面积,降低脑组织凋亡细胞和Caspase-3阳性细胞数量,其作用强于硫酸镁。结论:灯盏花素通过抑制细胞凋亡可显著保护大脑缺血-再灌注引起的脑损伤,其作用优于单用硫酸镁。     

应用上唇外侧组织瓣旋转修复下唇缺损

目的:探求上唇外侧组织瓣在修复较大面积下唇缺损中的作用。方法:根据患者下唇缺损情况,设计上唇外侧组织瓣,旋转后插入缺损组织,同时在缺损吻合处,将上层外侧旋转瓣内侧粘膜肌肉向外牵拉形成部分新的红唇,然后逐层相对缝合,修复缺损。结果:自2003年1月应用此方法修复患者6例,术后随访1～2年,唇部外形好,无流涎,无口闭合不全,效果满意。     

Neurochemical studies on the mesolimbic circuitry of antinociception

Previous studies using the technique of microinjection into brain nuclei indicated that the periaqueductal gray (PAG), nucleus accumbens, habenula and amygdala play an essential role in pain modulation and that these nuclei possibly act through a ‘mesolimbic neural loop‘ to exert an analgesic effect, in which Met-enkephalin (MEK) and β-endorphin (β-EP) have been implicated as the two major opioid peptides involved in antinociception. In the present study performed in rabbits, intracranial microinjection was supplemented with push-pull perfusion and radioimmunoassay to determine whether the release of enkephalins (ENK) and β-EP was increased in these nuclei when the putative neural circuit was activated by morphine administered into one of the nuclei. The results showed: (1) microinjection of morphine into the PAG increased the release of ENK and β-EP in the N. accumbens, and vice versa; (2) microinjection of morphine into the N. accumbens increased the release of ENK and β-EP in the amygdala, and vice versa; (3) morphine microinjected into the PAG caused an increase in the release of ENK and β-EP in the amygdala and vice versa, although the release of ENK in PAG was statistically not significant. These results indicate that PAG, N. accumbens and amygdala are connected in a network served by a positive feedback circuitry.     

利福喷汀治疗耐利福平肺结核的疗效分析

目的分析增加利福喷汀的用药剂量对利福平耐药肺结核的疗效，以评价利福喷汀在治疗利福平耐药患者中的作用。方法根据药敏结果选取耐利福平肺结核患者101例，分为治疗1组（利福平低耐），治疗2组（利福平高耐），两组治疗方案中均含利福喷汀，对照组（利福平高耐）治疗方案中不合利福喷汀。观察治疗后3、18个月疗效。结果治疗1组在各阶段的痰菌阴转率、病灶吸收和空洞闭和情况明显优于治疗2组和对照组，两组差异有统计学意义；治疗2组的痰菌阴转率、病灶吸收和空洞闭和情况略优于对照组，两者差异无统计学意义。结论对利福平耐药的患者尤其在利福平低度耐药病例中，可以选择增加利福喷汀用药剂量的方案进行治疗，在利福平高度耐药病例中利福喷汀的作用不能确定。     

CT导向下经皮射频消融术治疗肾上腺恶性肿瘤

目的对29例肾上腺肿瘤患者行射频消融（RFA）治疗，研究其近期局部治疗效果、不良反应和副作用。方法肾上腺肿瘤患者共29例，病灶总数31个，其中直径≤2．0cm的病灶共5个，2．1-4．0cm者18个，4．1-6．0cm者5个，≥6．1cm者3个，经RFA治疗1个月后行螺旋CT双期增强扫描评价肿瘤治疗效果。结果上述病灶经消融治疗后达到完全坏死者分别为5个、18个、3个、2个。患者无严重并发症出现。结论RFA治疗安全可靠，副作用小，是治疗肾上腺恶性肿瘤的有效方法之一。     

中药内外并用抗尖锐湿疣复发的临床研究

目的：观察中药消疣丸/消疣擦剂内服外用防止尖锐湿疣复发的作用.方法：应用免疫学方法，检测患者治疗前后外周血T淋巴细胞亚群CD3、CD4、CD8的百分率和CD4/CD8的比值.结果：局部消除疣体后中药消疣丸/消疣擦剂内服外用对防止尖锐湿疣复发有显著疗效，痊愈率为99.66%，复发率为3.33%，与对照组相比有显著差异（P〈0.05）.结论：中药内服外用抗尖锐湿疣复发效果好。