完全腹腔镜Roux—en—Y吻合术式应用于远端胃癌根治术20例

目的探讨完全腹腔镜Roux．en—Y吻合术式应用于远端胃癌根治术的安全性和可行性。方法回顾性分析福建省肿瘤医院腹部外科2012年8月至2013年3月对腹腔镜胃大部切除术后实施完全腹腔镜Roux．en—Y吻合术的20例胃癌患者的术中和术后临床资料。结果20例患者均成功实施完全腹腔镜远端胃癌根治术,无一例中转开腹或中转腹腔镜辅助手术。手术时间（190．8±53．6）min,术中出血量（122．4±57．7）ml,淋巴结清扫数（31．2±5．7）枚,术后病理切缘均为阴性。术后排气时间为（2．6±1．6）d,住院时间为（8．1±2．0）d。有1例术后出现肺部感染,但无吻合术相关并发症发生。结论完全腹腔镜Roux—en—Y吻合术式应用于远端胃癌根治术安全且可行。     

Proliferation of myeloid progenitor cells in human long-term bone marrow cultures is stimulated by interleukin-1 beta

To study the effect of interleukin-1 (IL-1) beta on the proliferation of hematopoietic progenitor cells (HPC) in long-term bone marrow cultures (LTBMC), stromal cell layers were established from normal human bone marrow. Autologous cryopreserved mononuclear phagocyte- and T-lymphocyte-depleted bone marrow cells were reinoculated on the stromal layers in fresh culture medium, with or without the addition of human IL-1 beta (30 U/mL). Once a week, half of the culture supernatant was replaced with fresh culture medium with or without IL-1, and all nonadherent cells were returned to the flasks. At weekly intervals during a period of 5 weeks, one culture was sacrificed to determine the total number of cells and hematopoietic progenitor cells, present in the adherent and the nonadherent cell fractions. In IL-1-stimulated cultures, the number of cells recovered during a period of 5 weeks exceeded the number of cells in unstimulated control cultures by 1.5 times. This difference was attributed to a twofold increase in the number of adherent cells. The number of HPC recovered from IL-1- stimulated cultures was not different from that recovered from controls. The levels of colony-stimulating activity (CSA) in supernatants from IL-1-stimulated cultures were significantly higher than those in supernatants from control cultures. These results indicate that IL-1 enhances the recovery of cells in LTBMC by stimulating the proliferation of HPC with the concurrent release of CSA from stromal cells, without diminishing the number of HPC.     

Interferon-alpha stimulates production of interleukin-10 in activated CD4+ T cells and monocytes

In the present study, we investigated the effect of interferon-alpha (IFN-alpha) on the expression of interleukin-10 (IL-10) mRNA and protein synthesis in human monocytes and CD4+ T cells. In mononuclear cells, IFN-alpha induced expression of IL-10 mRNA and further enhanced lipopolysaccharide (LPS)-stimulated IL-10 expression. In purified monocytes, a strong expression of IL-10 mRNA induced by LPS was not further enhanced by IFN-alpha. In highly purified CD4+ T cells, IFN- alpha upregulated IL-10 mRNA upon activation with phytohemagglutinin and phorbol myristate acetate. In purified monocytes, an effect of IFN- alpha on IL-10 protein synthesis was dependent on costimulation with LPS. Maximal stimulation of IL-10 protein by IFN-alpha was seen after prolonged incubation periods of 48 to 96 hours, whereas IFN-gamma reduced IL-10 production in the early incubation period. Similar effects of IFN-alpha were observed in CD4+ T cells activated with CD3 and CD28 monoclonal antibodies. Addition of IFN-alpha caused an increase of IL-10 in culture supernatants of activated T-helper cells of more than 100% after 96 hours of incubation. In contrast, other cytokines, including IFN-gamma and IL-4, had no influence on IL-10 secretion stimulated by CD3 and CD28 in CD4+ T cells. In serum samples of IFN-alpha-treated individuals, we failed to detect an influence of cytokine treatment on IL-10 serum levels, confirming the requirement of additional activating signals for IFN-alpha-mediated effects on IL-10 synthesis. In conclusion, IFN-alpha enhances the late induction of IL- 10, which physiologically occurs upon stimulation of monocytes and T cells. Biologically, this effect might enhance the negative-feedback mechanism ascribed to IL-10, which limits inflammatory reactions.     

Ongoing rabies outbreak in dogs of unprecedented scale and human cases in Nelson Mandela Bay Municipality,South Africa,up to 13 February 2022

More than 430 cases of rabies have been confirmed in dogs in the Nelson Mandela Bay Metropolitan Municipality of South Africa since July 2021. We describe the ongoing outbreak, its geographical spread and six related human deaths that have occurred. Further investigation of the outbreak and vaccination of the dog population is required. Raising awareness among healthcare providers, the public, and among international travellers planning to visit the region, is key for action to protect human and animal health.     

The enigma of sensitivity in Pacinian corpuscles: a critical review and hypothesis of mechano-electric transduction

The present report reviews the physiological and morphological specializations of Pacinian corpuscles and other mechanoreceptors that are present in the skin and connective tissues of the body as well as the cochlea. The remarkable sensitivity of Pacinian corpuscles is such that the only form of mechanical energy that could be perceived by a Pacinian corpuscle is a sound wave. In fact the human finger as demonstrated by Munger and Ide (1987) can perceive sound waves when water is the coupling agent. The structural specializations are equally remarkable with extensive membrane specializations of both the inner core and inner portion of the outer core. The halves of the inner core are each coupled with gap junctions and the inner portion of the outer core joined with numerous tight junctions. The cleft regions have specializations involving the axolemma that consist of numerous axonal spines containing bundles of filaments projecting into the cleft of the inner core. These structural specializations are thought to represent specializations for mechano-electric transduction analogous in many respects to the hair cells of the cochlea. A hypothesis for mechano-electric transduction is presented that may account in part for the extreme sensitivity of Pacinian corpuscles and other mechanoreceptors.     

Femoral nerve block with ropivacaine or bupivacaine in day case anterior crucial ligament reconstruction

Background/Objective: Our aim was to evaluate analgesia, motor block and pharmacokinetics of ropivacaine 0.2% and 0.75% in a femoral nerve block (FNB) in day case patients for anterior crucial ligament (ACL)‐reconstruction compared with bupivacaine 0.25% and placebo. Methods: Following ethics committee approval and informed consent, 280 patients were randomly allocated to four groups for single‐shot FNB [30 ml ropivacaine 0.2% (group RO2.0), 0.75% (RO7.5), bupivacaine 0.25% (BU2.5) and NaCl 0.9% (NaCl)]. Analgesia (pain scores, primary outcome) and motor block were assessed at 4 h (dismissal) and up to 24 h. Plasma concentration was determined up to 240 min thereafter. Results: Pain scores at 4 h were significantly higher for NaCl 4 (0–8) (median, range) (vs.) BU2.5 2 (0–8), RO2.0 3 (0–9) and RO7.5 2 (0–8) (NS within the LA groups). Patients of the NaCl group needed analgesics significantly more often (93%) within 4 h after surgery vs. 16% of group RO2.0, 19% of group RO7.5 and 19% of group BU2.5. Motor block was significantly increased with all local anesthetics without a significant difference within the LA groups 3 (0–5) in RO2.0, 3 (0–5) in RO7.5 and 3 (0–4) in BU2.5 vs. 0 (0–3) in group NaCl (median (range); scale from 0=full strength to 5=complete paralysis). Peak plasma concentrations differed significantly: RO7.5: 1.4 ± 0.4 (0.73–2.6) [μg/ml, mean ± SD (range)] after 33 ± 14 (10–40) min, RO2.0: 0.6 ± 0.3 (0.13–1.0) after 22+17 (10–60) and BU2.5: 0.3 ± 0.16 (0.05–0.62) at 31 ± 17 (10–60), respectively. Conclusion: FNB for ACL reconstruction with ropivacaine or bupivacaine provided better post‐operative analgesia than placebo without reaching toxic plasma concentrations. Significant motor block was observed after 4 h in all groups including the lowest concentration of ropivacaine but occurred even with placebo.     

幽门螺杆菌对人胃癌MKN45细胞p38MAPK信号转导通路激活作用的研究

背景与目的: 环氧合酶2(cyelooxygenase-2,COX-2)是花生四烯酸转化为前列腺素(prostaglandins,PGs)代谢中重要的限速酶,幽门螺杆菌(Helicobacterpylori,Hp)感染诱导胃黏膜COX-2的过度表达是胃癌发生的重要环节,但Hp感染胃黏膜细胞COX-2表达的机制尚不清楚.本研究旨在揭示Hp对人胃癌MKN45细胞COX-2表达和p38MAPK信号通路的影响,探讨COX-2表达的可能机制.方法: 采用实时荧光定量PCR(real time-PCR)检测Hp标准株NCTC11637感染对人胃痛MKN45细胞COX-2 mRNA转录的影响,Western blot检测坳COX-2蛋白表达的影响和p38MAPK信号通路的激活及其下游因子ATF-2的表达.结果: Hp感染人胃癌MKN45细胞后,COX-2 mRNA的表达明显上调,Hp感染3、6、9、12 h后COX-2 mRNA的表达量分别为正常值的3倍、7.2倍、5.1倍和4.3倍,各时间组COX-2 mRNA表达均明显高于对照组(P＜0.01);Up与MKN45细胞共培养24 h后,COX-2蛋白的表达亦显著增加(P＜0.01).Hp感染MKN45 20 min后,p38MAPK信号通路被激活,60 min达峰值;p38MAPK下游因子ATF-2的表达也明显增加,2 h达高峰,随着作用时间的延长,表达逐渐下降,24 h仍有表达.结论: Hp感染能诱导人胃癌MKN45细胞COX-2的表达;激活p38MAPK信号通路,增加其下游因子ATF-2的表达,可能是其诱导COX-2表达的机制.     

New paradigm for the treatment of myopia by refractive surgery

It is proposed that refractive surgery visual outcomes will be significantly improved when using refractive surgery profiles that maintain preoperative corneal aberrations following surgery. An equation to calculate postoperative corneal shapes is presented.