双能X射线骨密度仪测量不同条件下腰椎骨矿含量、椎骨骨面积有临床意义的最小变化率

目的:骨密度仪的差异或漂移可以通过质控加以校正。比较双能X射线骨密度仪测量腰椎铝体模、活体腰椎、死体腰椎(带软组织)的骨矿含量、椎骨骨面积有临床意义的最小变化率差异,以便为重复测量同一个体的骨矿含量或骨密度评估临床药物疗效提供依据。方法:实验于2004-05/2006-12在川北医学院人体解剖实验室与川北医学院附属医院内分泌科骨密度室完成。采用美国Lunar公司生产的DPX-MD双能X射线骨密度仪测量铝体模、3个活体椎体、1个带软组织的死体椎体的骨矿含量与椎骨骨面积,3次/d,连续测定5d。3个活体椎体分别为38岁骨密度正常男性、40岁骨质疏松症男性及62岁轻微骨量减少女性的椎体,均为自愿参与实验的本院医生。死体椎体由川北医学院人体解剖实验室提供。实验得到医院伦理道德委员会批准。计算各椎体骨矿含量、椎骨骨面积的变异系数及有临床意义的最小骨矿含量、椎骨骨面积变化率。结果:①有临床意义的最小骨矿含量变化率:铝体模与正常男性椎体最小,骨质疏松症男性椎体、轻微骨量减少女性椎体与死体椎体呈依次增大趋势,且以死体椎体最大。②有临床意义的最小椎骨骨面积变化率:铝体模、正常男性椎体与骨质疏松症男性椎体最小,轻微骨量减少女性椎体与死体椎体较大,且以死体椎体最大。结论:双能X射线骨密度仪测量不同条件椎骨有临床意义的最小骨矿含量、椎骨骨面积变化率存在差异,骨质疏松的严重程度不同,骨矿含量、椎骨面积骨密度检测对临床药物疗效观察的影响不同,骨质疏松越严重或有骨质增生的存在对其影响越大。     

皮片和皮瓣移植在面部、颈部、手部及其他功能部位烧伤瘢痕修复中的应用

目的:介绍皮片和皮瓣移植在面部、颈部、手部及其他功能部位烧伤瘢痕修复中的应用情况。资料来源:应用计算机检索万方数据库2002-01/2006-12期间与面部、颈部、手及其他功能部位烧伤及烧伤后瘢痕挛缩畸形治疗方法有关的文章,检索词:“全厚皮片、扩张皮瓣、瘢痕挛缩畸形”,并限定文章语言种类为中文。资料选择:对资料进行初审。纳入标准:内容应与全厚皮片和皮瓣移植在面部、颈部、手部及其他功能部位烧伤及瘢痕挛缩畸形修复中应用的研究相关;以近5年且发表在较权威杂志者优先。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到330篇相关文献,排除277篇内容陈旧或重复的文献,53篇符合纳入标准,选用其中的30篇作为本文参考文献。其中10篇涉及修复手部烧伤及瘢痕挛缩畸形的康复治疗,12篇涉及面部、颈部烧伤及瘢痕挛缩畸形的应用,4篇涉及腋窝、腘窝烧伤及瘢痕挛缩畸形修复及后期康复治疗,4篇涉及其他功能部位烧伤及瘢痕挛缩畸形修复。资料综合:手术修复颜面部、颈部、手及其他功能部位烧伤及瘢痕挛缩畸形的方法很多,临床上应用颈部扩张皮瓣,全厚皮片,各种皮瓣及复合皮均取得了良好的效果。对不同部位烧伤及瘢痕,可按瘢痕大小,挛缩畸形程度,美学标准采用不同的方法修复。结论:随着烧伤创面处理水平不断提高及植皮技术的改进,在保证恢复受伤肢体功能的同时,应着眼于最大限度地恢复其外形,而且在考虑受区修复的同时,也应重视供区美观和功能的保护。     

Different colony-stimulating factors are detected by the "interleukin- 3"-dependent cell lines FDC-Pl and 32D cl-23

The cell lines FDC-Pl and 32D cl-23 have previously been used as unique indicators for the growth-promoting activity of interleukin-3. We show that FDC-Pl cells respond to granulocyte/macrophage colony-stimulating factor (GM-CSF, CSF-2) as well as to interleukin-3. In keeping with this finding, FDC-Pl cells express the macrophage-specific marker, F4/80. FDC-Pl cells do not, however, respond to macrophage CSF (M-CSF, CSF-1). In contrast, 32D cl-23 cells do not respond to GM-CSF and lack F4/80. Instead, 32D cl-23 cells respond to an as yet undefined factor in conditioned medium (CM) from the primate T cell line, MLA-144, and CM from mitogen-stimulated human lymphocytes (HLCM). 32D cl-23 cells are Lyt-1+. Both FDC-Pl and 32D cl-23 cells consume interleukin-3, but only FDC Pl cells consume GM-CSF. Similarly, 32D cl-23, but not FDC-Pl, cells consume 32D cl-23 growth factor from MLA-144 CM and HLCM. Interleukin-3-dependent cell lines must therefore concurrently express different functional cell surface receptors for a variety of biochemically distinct growth factors.     

ELISA versus Conventional Methods of Diagnosing Endemic Brucellosis

The diagnostic value of enzyme-linked immunosorbent assay (ELISA) was evaluated when blood specimens of 92 patients suspected of brucellosis underwent the ELISA (IgM and IgG), standard tube agglutination (SAT), and 2-mercaptoethanol (2-ME) tests and blood cultures; 38 sera from non-brucellosis patients and 34 sera from blood donors were also subjected to ELISA, SAT, and 2-ME tests. SAT was able to pinpoint only 23 (25%), whereas ELISA confirmed the etiology in 56 (60.9%; P < 0.001) patients with brucellosis, including 31 culture-confirmed cases. The sensitivity and specificity of ELISA were 100% and 71.31%, respectively. Because they were confirmed by ELISA, the diagnosis could never be excluded with SAT in 33 cases. ELISA has been found to be more sensitive in acute (28% higher sensitivity; P < 0.02) and chronic (55% higher sensitivity; P < 0.01) cases. For accurate diagnosis in suspected brucellosis cases detection, we recommend both ELISA IgM and IgG tests. ELISA IgG and 2-ME tests seem to be promising tools in judging prognosis.     

幽门螺杆菌相关胃黏膜疾病炎症、凋亡与乳酸杆菌的关系

幽门螺杆菌与慢性胃炎、消化性溃疡、胃癌及胃黏膜相关淋巴样组织淋巴瘤(MALT)等疾病的发生密切相关,后者是炎症发展以及凋亡-增殖失衡的渐进过程中不同阶段的表现形式．乳酸杆菌具有较好的抗H pylori的应用前景,能降低因以抗生素为主根治H pylori疗法引起的副作用,提高患者的依从性,调节菌群失调,其在H pylori诱导的胃黏膜炎症中具有抗炎作用．     

Age-related alterations in pituitary and testicular functions in long-lived growth hormone receptor gene-disrupted mice

The somatotropic axis, GH, and IGF-I interact with the hypothalamic-pituitary-gonadal axis in health and disease. GH-resistant GH receptor-disrupted knockout (GHRKO) male mice are fertile but exhibit delayed puberty and decreases in plasma FSH levels, testicular content of LH, and prolactin (PRL) receptors, whereas PRL levels are elevated. Because the lifespan of GHRKO mice is much greater than the lifespan of their normal siblings, it was of interest to compare age-related changes in the hypothalamic-pituitary-gonadal axis in GHRKO and normal animals. Plasma IGF-I, insulin, PRL, LH, FSH, androstenedione and testosterone levels, and acute responses to GnRH and LH were measured in young (2-4 and 5-6 months of age) and old (18-19 and 23-26 months of age) male GHRKO mice and their normal siblings. Plasma IGF-I was not detectable in GHRKO mice. Plasma PRL levels increased with age in normal mice but declined in GHRKO males, and did not differ in old GHRKO and normal animals. Plasma LH responses to acute GnRH stimulation were attenuated in GHRKO mice but increased with age only in normal mice. Plasma FSH levels were decreased in GHRKO mice regardless of age. Plasma testosterone responses to LH stimulation were attenuated in old mice regardless of genotype, whereas plasma androstenedione responses were reduced with age only in GHRKO mice. Testicular IGF-I mRNA levels were normal in young and increased in old GHRKO mice, whereas testicular concentrations and total IGF-I levels were decreased in these animals. These findings indicate that GH resistance due to targeted disruption of the GH receptor gene in mice leads to suppression of testicular IGF-I levels, and modifies the effects of aging on plasma PRL levels and responses of the pituitary and testes to GnRH and LH stimulation. Plasma testosterone levels declined during aging in normal but not in GHRKO mice, and the age-related increase in the LH responses to exogenous GnRH was absent in GHRKO mice, perhaps reflecting a delay of aging in these remarkably long-lived animals.     

Alcohol suppresses insulin-like growth factor-1 gene expression in prepubertal transgenic female mice overexpressing the bovine growth hormone gene

BACKGROUND: Alcohol (ALC) delays puberty in female rats and alters the development of a normal menstrual pattern in rhesus monkeys. These actions are associated with depressed serum levels of growth hormone (GH), luteinizing hormone and insulin-like growth factor-1 (IGF-1). The mechanism of this ALC-induced depression in IGF-1 is not known, however, could be due to depressed GH and, possibly, to an alteration in the hepatic GH receptor. To assess whether ALC has a direct action at the liver, we used a transgenic mouse model that overexpresses GH, allowing assessment of potential direct actions of ALC on the level of either the GH receptor or the IGF-1-synthesizing machinery within the hepatocyte. METHODS: One group of transgenic mice was fed a liquid diet containing ALC. The second group was pair-fed the companion isocaloric control liquid diet. The third group of transgenic mice was fed Lab Chow and water. The fourth group consisted of normal (nontransgenic) littermates fed Lab Chow and water. Animals received their respective diets for 5 days. Mice were killed during their late juvenile stage of development, and tissues and blood collected and frozen. RESULTS: The ALC-fed transgenic mice showed a decrease (p < 0.01) in hepatic IGF-1a and IGF-1b messenger RNA levels compared with transgenic controls, and this paralleled a decrease (p < 0.01) in serum IGF-1. ALC did not alter the circulating levels of bovine GH held constant by the promotor and did not alter mouse GH receptor protein levels as analyzed by Western blotting. CONCLUSIONS: Using this transgenic animal model that maintains circulating GH in the presence of ALC, we found that the ability of ALC to suppress prepubertal Igf1 gene expression can also occur independently of any alterations in the level of circulating GH. This direct effect on the hepatocyte is a postreceptor event because the GH receptor protein levels were not altered by ALC exposure.     

胎儿皮肤神经肽P物质和肥大细胞与无瘢痕愈合的关系

目的:比较胎儿、正常成人皮肤及瘢痕中神经肽P物质(substance P,SP)阳性细胞的形态、分布和数量差异,探讨P物质表达和肥大细胞数量与无瘢痕愈合之间的关系。方法:实验于2004-01/2005-01在重庆医科大学附属第一医院整形美容科和重庆医科大学病理教研室进行。收集胎龄为16～33周因车祸等原因引产的32例胎儿皮肤(家属知情同意)、26例整形手术中切除的正常成人皮肤以及18例不同时期的增生性瘢痕(患者均知情同意),用免疫组织化学的方法分别检测神经肽P物质的表达,P物质阳性细胞观察和计数采用分等级的方法。以细胞浆着色程度(浅、中、深)来判定。甲苯胺蓝染色的方法检测肥大细胞,在高倍镜下(×400倍)随机计数5个视野中阳性细胞数,取其平均值,为肥大细胞数。结果:①苏木精-伊红染色结果:孕早期胎儿皮肤表皮由1～3层细胞组成,真皮层细胞数量较多,胶原成分少、排列整齐,随着胎龄的增加,表皮细胞层数逐渐增加,出现角质层,逐渐分化为典型的五层细胞。②胎儿皮肤P物质的表达:孕22周以前胎儿皮肤中无P物质的表达,孕22周以后可见表皮细胞的下3层表达较多、且染色强度基本一致,随着胎龄的增加,至孕33周后的胎儿皮肤,P物质表达部位和阳性强度无明显变化。在正常成人皮肤中P物质表达于除角质层外的表皮全层,正常成人皮肤中的P物质染色强于胎儿皮肤;在瘢痕中P物质大量表达于表皮层、真皮中成纤维细胞及小血管周围,染色强。28周孕前胎儿皮肤、28周孕后胎儿皮肤、正常成人皮肤P物质的表达明显少于瘢痕组织(P<0.005)。③胎儿皮肤肥大细胞形态学观察结果:胎儿皮肤中未见典型的肥大细胞。正常皮肤肥大细胞计数少于瘢痕组织[(3.60±2.56),(8.41±4.06)个/视野,P<0.01]。结论:①胎儿发育早期(22周以前)皮肤中不表达P物质可能是早期胎儿皮肤无瘢痕愈合的原因之一。②瘢痕的形成同时与皮肤中的过多聚集并持续存在的肥大细胞和过多释放的P物质有关。     

重组人酸性成纤维细胞生长因子关节腔注射预防骨关节炎软骨退行性变

目的:验证重组人酸性成纤维细胞生长因子关节腔内注射对兔实验性早中期骨关节炎软骨退行性变的防治作用。方法:实验于2005-10/2006-04在暨南大学附属第一医院中心实验室完成。选用健康新西兰大白兔30只,切断膝关节前、后交叉韧带建立兔骨关节炎模型后,按随机数字表法分为3组,空白组、透明质酸钠组和重组人酸性成纤维细胞生长因子组。重组人酸性成纤维细胞生长因子组术后第8周起于手术侧膝关节腔内注射人酸性成纤维细胞生长因子8000IU/(只·周),透明质酸钠组关节腔内注射透明质酸钠1mL/(只·周)。空白组不进行干预。术后第16周空气栓塞法处死动物,大体观察及手术显微镜下观察软骨表面分级;取股骨髁负重面软骨标本进行苏木精-伊红、沙黄染色及骨关节炎组织病理学评分(正常为0～1,重度为10分以上)、分级。结果:30只动物全部进入结果分析。①重组人酸性成纤维细胞生长因子组和透明质酸钠组标本股骨髁负重软骨有轻度粗糙,关节软骨可见浅表溃疡形成。空白组标本股骨髁负重面软骨有轻～中度溃疡形成。②3组动物关节软骨表面分级差异有显著性意义(χ2=22.97,P=0.000)。③3组动物骨关节炎软骨的组织病理学分级差异有显著性意义(χ2=16.84,P=0.005),透明质酸钠组和重组人酸性成纤维细胞生长因子组的骨关节炎组织病理学评分均显著低于空白组(P<0.05)。结论:关节腔注射重组人酸性成纤维细胞生长因子可以较好的延缓兔膝骨关节炎软骨退行性变和预防骨关节炎的发展。