Tissue transplant-transmitted infections

Tissue bankers, as well as those transplanting tissues, have been sensitized to the possibility of transmission of fatal infection via tissue transplants, particularly following recent reports of a few cases of AIDS or HIV infection from bone, semen, and skin grafts. It is beyond the scope of this review to describe the steps taken by tissue banks to enhance the safety of tissue transplants. Of note is the fact that a number of new donor screening tests, such as those for antibody to HIV, HBcAg, hepatitis C virus, and human T cell lymphotropic virus type I, have recently been implemented. In addition, rapid advances in the medical history screening of tissue donors and tissue procurement, processing, and preservation continue. Viral inactivation studies are also being undertaken. All these measures are being introduced to increase the safety of tissue transplants.     

肿瘤坏死因子对内皮细胞组织因子表达及转录调控的影响

目的：研究肿瘤坏死因子（TNFα）对内皮细胞组织因子（TF）表达的影响,并探讨TF基因5′上游序列以及核转录因子NF－κB在该基因转录中的调控作用。方法：进行人脐静脉内皮细胞株（EVC304）及原代内皮细胞的培养。用发色底物显色法、RT－PCR和细胞原位杂交分别检测内皮细胞TF活性和mRNA水平,采用基因重组技术构建含有人TF基因不同上游序列荧光素酶报告基因质粒,经脂质体法转染内皮细胞,检测及分析报告基因活性。凝胶电泳迁移率改变法和western印迹法检测内皮细胞NF－κB与DNA结合活性和含量。结果：100u/ml TNFα诱导内皮细胞TF活性和mRNA表达量明显增高。在TF基因上游序列－244／＋121bp存在时,TNFα可使转染内皮细胞荧光素酶表达量明显增加,－111／＋121bp存在时表达量无明显差异,而且比存在－244／＋121bp时的表达量明显降低;同样浓度TNFα作用下,内皮细胞核抽提物与NF－κB探针的结合活性高于正常对照组,核内NF－κB含量明显增加。结论：TNFα可以增强内皮细胞TF活性及基因表达,其中TF基因上游－244／－112bp序列的存在起着重要的调节作用。此外,TNFα也能促进内皮细胞NF－κB的转位和与DNA结合活性增高。     

经方六经辨证治疗支气管哮喘临床体会

目的:阐述中医经方治疗支气管哮喘的临床应用体会。方法:作者收集近5年在临床上治疗支气管哮喘的案例,通过经方六经辨证,先辨阴阳,次辨归经,再辨方证,以求得方证对应来应对临床上各种病因导致的支气管哮喘病症。结果:中医经方通过六经辨证,临床应对支气管哮喘治愈率较高。结论:中医经方是祖国医学的智慧结晶,临床疗效确切,方小药简,效专力宏,能提高临床疗效,减轻患者的经济压力,因此,临床值得推广。     

早期系统的医院-家庭康复对早产儿发育的影响

目的探讨早期系统的医院-家庭综合康复模式对早产儿发育的影响。 方法将符合标准的早产儿256例分成早期干预组（148例）和常规对照组（108例）。早期干预组除接受常规育儿指导外,还进行早期评估、定期随访和医院-家庭康复治疗;对照组只接受常规育儿指导。采用小儿神经心理发育量表定期对2组患儿的粗大运动、精细运动、适应能力、语言、社交能力发育商和总体发育商进行评估。 结果经早期系统的医院-家庭综合康复干预后, 早期干预组在生后第6、12、18和24个月后时,以上各项评估指标均高于对照组,差异有统计学意义(P<0.01);早期干预组出现脑瘫1例,其粗大运动功能分级（GMFCS）为III级,脑瘫发生率为0.71% (1/148);对照组出现脑瘫5例,GMFCS分级III级1例、Ⅳ级4例,脑瘫发生率为5.1% (5/98),两组比较差异有统计学意义(2=4.516,P<0.05)。 结论早期医院-家庭综合康复模式能有效地提高早产儿的发育商,降低脑性瘫痪的发生率,减轻神经行为缺陷程度。     

脾气虚证胃粘膜超微结构及其发病机理的研究

目的:了解脾气虚证的胃粘膜病理形态及其发病机理。方法:慢性胃病24例,进行胃粘膜超微结构研究,超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量,及餐后/空腹血清胃液素检测。结果:脾气虚证其壁细胞线粒体、主细胞酶原颗粒、G细胞分泌颗粒的面数密度,及餐后/空腹血清胃液素比值均明显低于对照组肝胃不和证(P<0.01)。同时,线粒体结构亦有明显损伤。此外,脾虚证胃粘膜MDA含量高于对照组(P<0.05),而SOD活性则低于对照组(P<0.05)。结论:提示脾气虚证胃蛋白酶储备不足,G细胞分泌储备力差。线粒体质和量的改变,可能是脾气虚证病理形态改变的主要环节。脾气虚证的发病过程有氧自由基参与。     

CK19表达及其在结肠癌淋巴结微转移诊断中的应用

目的：研究用免疫组化方法检测CK19及其在结肠癌淋巴结微转移诊断中的应用与临床病理意义。方法：取材于50例结肠癌病人肿瘤组织及癌周淋巴结255枚，同时进行HE染色组织学检查和抗角蛋白19抗体的免疫组化检测。结果：50例结肠癌组织中CK19表达均为阳性。255枚淋巴结用HE染色检查阳性者56枚(22．0％)，皆同时表达CK19阳性；另20枚淋巴结HE染色阴性，而CK19表达阳性。50例中有12例淋巴结中发现微转移，其中6例常规组织学检查属淋巴结转移阴性而免疫组化染色诊断表现为转移阳性。占常规病理检查淋巴结转移阴性者的21．4％(6／28)。随着肿瘤分期增加,淋巴结CK19表达阳性率亦增加。CK19表达阳性者预后较阴性者为差。结论：CK19免疫组化法是检测结肠癌淋巴结微转移的敏感而便捷的方法，而检测结肠癌微转移有助于判断肿瘤进展程度与预后。特别对在筛选组织学检查淋巴结阴性但存在微转移的病人有实用价值。     

An 18-months' evaluation of self-etch and etch & rinse adhesive in non-carious cervical lesions

Objective. In this intra-individual comparison (an 18-months' randomized, controlled prospective study), we evaluated the clinical performance of one self-etch and one “etch & rinse” adhesive in non-carious cervical lesions. Methods. Twenty-five patients with at least two pairs of similar-sized non-carious cervical lesions participated. Seventy-eight restorations were placed; 39 with etch & rinse (Single-Bond) and 39 with self-etch (Adper Prompt). Both adhesives were combined with the microfilled resin composite Filtek-A110. The restorations were evaluated at baseline, 6, 12, and 18 months according to slightly modified USPHS criteria. Statistical differences between the adhesives was tested with McNemar's test and clinical degradation over time for each material with the Fisher exact test (α=0.05). Results. Thirty pairs were evaluated at 12 and 18 months. Two self-etch restorations were lost after 18 months. Nine Adper Prompt and four Single-Bond restorations scored bravo for marginal adaptation at 18 months (p<0.05). Nine Adper Prompt and three Single-Bond restorations scored bravo for marginal discoloration (p<0.05). Conclusions. Both adhesive systems showed acceptable clinical retention rates according to the ADA full acceptance criteria for enamel-bonding systems in class V non-carious lesions. The self-etch adhesive showed a faster progressive marginal degradation.     

Association of light-to-moderate alcohol drinking in pregnancy with preterm birth and birth weight: elucidating bias by pooling data from nine European cohorts

Women who drink light-to-moderately during pregnancy have been observed to have lower risk of unfavourable pregnancy outcomes than abstainers. This has been suggested to be a result of bias. In a pooled sample, including 193 747 live-born singletons from nine European cohorts, we examined the associations between light-to-moderate drinking and preterm birth, birth weight, and small-for-gestational age in term born children (term SGA). To address potential sources of bias, we compared the associations from the total sample with a sub-sample restricted to first-time pregnant women who conceived within six months of trying, and examined whether the associations varied across calendar time. In the total sample, drinking up to around six drinks per week as compared to abstaining was associated with lower risk of preterm birth, whereas no significant associations were found for birth weight or term SGA. Drinking six or more drinks per week was associated with lower birth weight and higher risk of term SGA, but no increased risk of preterm birth. The analyses restricted to women without reproductive experience revealed similar results. Before 2000 approximately half of pregnant women drank alcohol. This decreased to 39% in 2000–2004, and 14% in 2005–2011. Before 2000, every additional drink was associated with reduced mean birth weight, whereas in 2005–2011, the mean birth weight increased with increasing intake. The period-specific associations between low-to-moderate drinking and birth weight, which also were observed for term SGA, are indicative of bias. It is impossible to distinguish if the bias is attributable to unmeasured confounding, which change over time or cohort heterogeneity.