不同气体对大鼠腹腔液中巨噬细胞及TNF-α的影响

目的 研究二氧化碳(CO2)、氦气(He)在模拟气腹条件下,动物模型腹腔巨噬细胞的数量、免疫功能和腹腔液中肿瘤坏死因子-α(TNF-α)含量的变化,探讨不同气体对机体腹腔内局部免疫的影响.方法 在模拟CO2、氦气气腹及对照条件下,对大鼠腹腔液中细胞总数、TNF-α以及细胞中巨噬细胞的数量、百分率、吞噬指数、吞噬百分率的差别进行研究.结果 氦气气腹组腹腔液中细胞数多于其他两组(P＜0.05);CO2气腹组与对照组相比,细胞数无显著性差异,但腹腔液中TNF-α含量明显减少(P＜0.05);氦气气腹组与对照组相比,腹腔细胞释放的TNF-α量明显增多(P＜0.05).氦气气腹组腹腔液中巨噬细胞数量多于其他两组(P＜0.05),巨噬细胞所占腹腔液细胞百分率无显著性差异.氦气气腹组、CO2气腹组与对照组巨噬细胞吞噬指数及吞噬百分率均无显著性差异.结论 不同的气体对机体腹腔内局部免疫有不同影响.CO2对腹腔细胞释放TNF-α功能影响较大,而氦气则影响较小.在腹腔镜应用于恶性肿瘤患者时,应注意CO2对机体腹腔内局部免疫的影响.     

颗粒细胞抑制素B的表达及其在女性生殖中的意义

目的探讨抑制素B(INH-B)在颗粒细胞的表达与卵巢反应、卵子成熟及胚胎发育之间的关系。方法收集39名实施体外受精-胚胎移植(IVF-ET)者的颗粒细胞,通过免疫组化技术测定颗粒细胞INH-B表达强度。按照获卵数将患者分为三组,A组:获卵≤5枚;B组:获卵61~5枚;C组:获卵≥16枚。分析比较各组INH-B表达强度、胚胎实验室数据及临床结局。结果①A组的INH-B表达强度显著低于其他二组(P<0.001),B组与C组间INH-B表达强度无显著差异(P>0.05)。②颗粒细胞INH-B表达强度与获卵数、受精卵数、卵裂数及可用胚胎数呈正相关(均P<0.001)。③颗粒细胞INH-B表达强度与IVF-ET临床妊娠率无显著相关(P>0.05)。结论颗粒细胞INH-B表达可反映细胞自身的功能状态,颗粒细胞功能减退是卵巢反应减低、发育卵泡数目减少的主要原因之一。     

不同气体对大鼠腹腔液中巨噬细胞及TNF-α的影响

目的研究二氧化碳(CO2)、氦气(He)在模拟气腹条件下,动物模型腹腔巨噬细胞的数量、免疫功能和腹腔液中肿瘤坏死因子-α(TNF-α)含量的变化,探讨不同气体对机体腹腔内局部免疫的影响。方法在模拟CO2、氦气气腹及对照条件下,对大鼠腹腔液中细胞总数、TNF-α以及细胞中巨噬细胞的数量、百分率、吞噬指数、吞噬百分率的差别进行研究。结果氦气气腹组腹腔液中细胞数多于其他两组(P<0.05);CO2气腹组与对照组相比,细胞数无显著性差异,但腹腔液中TNF-α含量明显减少(P<0.05);氦气气腹组与对照组相比,腹腔细胞释放的TNF-α量明显增多(P<0.05)。氦气气腹组腹腔液中巨噬细胞数量多于其他两组(P<0.05),巨噬细胞所占腹腔液细胞百分率无显著性差异。氦气气腹组、CO2气腹组与对照组巨噬细胞吞噬指数及吞噬百分率均无显著性差异。结论不同的气体对机体腹腔内局部免疫有不同影响。CO2对腹腔细胞释放TNF-α功能影响较大,而氦气则影响较小。在腹腔镜应用于恶性肿瘤患者时,应注意CO2对机体腹腔内局部免疫的影响。     

米非司酮治疗后VEGF-165在异位和在位子宫内膜中的表达

目的 探讨米非司酮对VEGF-165在子宫腺肌症中表达的影响.方法 43例子宫腺肌症患者分为对照组(n=21)和米非司酮治疗组(n=22),采用放射免疫法测定对照组(月经第3天)和米非司酮组(术前)血清中FSH、LH、E2、PRL、P及T的水平.采用免疫组化法测定两组患者在在位和异位子宫内膜中的VEGF-165蛋白水平.结果 米非司酮组较对照组血清FSH、LH、E2、P明显降低(P＜0.05),而血清PRL和T的水平两组间无统计学差异(P＞0.05).VEGF-165在子宫内膜腺上皮细胞内的表达,异位内膜均明显高于在位内膜(P＜0.05);而其在间质细胞内的表达,异位内膜与在位内膜无统计学差异(P＞0.05).米非司酮组异位和在位内膜腺上皮细胞、间质细胞中VEGF-165的表达水平均较对照组明显降低(P＜0.05).VEGF-165在对照组异位内膜腺上皮细胞中的表达,增殖期高于分泌期(P＜0.05).结论 米非司酮治疗后,VEGF-165在异位和在位内膜中的表达明显下降,可能是通过抑制VEGF蛋白合成,降低血管通透性,抑制新生血管生成,从而有效地控制子宫内膜异位症的发生发展.     

Acute Left Ventricular Dyssynchrony Improvement Predicts Long-Term Benefit from Cardiac Resynchronization Therapy

Study Objective: To evaluate the relationship between acute response to cardiac resynchronization therapy (CRT) and long-term clinical outcome in patients with drug refractory heart failure.
Methods and Results: In 28 patients undergoing CRT implant, left ventricular (LV) dyssynchrony was evaluated by tissue Doppler imaging (TDI)-derived longitudinal strain by mean of septum-lateral basal asynchrony index (S-Li) and basal delayed longitudinal contraction (DLC). TDI measurements were made before, and 30 minutes and 1 year after implant. Baseline and 1-year follow-up New York Heart Association (NYHA) functional class, 6-minute walking test (6-MWT) distance, and quality of life (QoL) score were measured. Responders (n = 22) were defined by a ≥ 1 decrease in NYHA functional class and 6-MWT ≥25% at 1 year. At baseline, no differences were observed between responders and nonresponders in clinical and echocardiographic measurements. LV dyssynchrony acutely recovered only in responders 30 minutes after implantation, with a significant reduction in S-Li and DLC. Moreover, the percent decreases in S-Li and DLC were highly correlated with those observed in NYHA class (r = 0.70, and r = 0.81, respectively, P < 0.001), 6-MWT (r = 0.59, and r = 0.57, respectively, P < 0.001 and P < 0.01), and QoL score (r = 0.71, and r = 0.83, respectively, p < 0.001) at 1-year follow-up.
Conclusions: Acute recovery of LV intraventricular dyssynchrony is a major discriminator between responders and nonresponders to CRT, which strongly correlates with a favorable long-term clinical outcome.     

Sepsis associated with transfusion of red cells contaminated with Yersinia enterocolitica

Between April 1987 and May 1989, the Centers for Disease Control investigated seven cases of transfusion-associated Yersinia enterocolitica sepsis; four were caused by organisms of serotype O:3, and one each was caused by organisms of serotype O:1,2,3; O:5,27; and O:20. All seven recipients developed septic shock after receiving units of red cells (RBCs) contaminated with Y. enterocolitica; five recipients died. The cases occurred in seven states and were unrelated. There was no evidence for contamination of the RBC units during processing. Six of the seven donors had serologic evidence of recent Y. enterocolitica infection, and it is hypothesized that these donors had asymptomatic bacteremia when they donated the implicated blood. Four of the seven donors reported gastrointestinal illness in the 4 weeks before blood donation, and one donor became ill on the day he donated blood. Y. enterocolitica grows well at 4 degrees C and in the presence of dextrose and iron. If blood is contaminated at the time of collection, storage of the RBCs at 4 degrees C provides an ideal environment for bacterial growth and endotoxin production. These cases demonstrate the need for careful evaluation of patients with transfusion reactions for possible sepsis and suggest a need to screen prospective blood donors for mild gastrointestinal illness, including those illnesses not requiring physician evaluation or medication.