磁性纳米颗粒-Pluronic携带神经节苷脂-1对急性完全横断性脊髓损伤修复的影响

目的：温度敏感性磁性纳米颗粒即磁性纳米颗粒-Pluronic具有温度响应药物控制释放能力,并能穿透血脑屏障,实验检测其携带GM-1能力及在活体组织中药物释放能力,以及对脊髓损伤修复再生的影响。 方法：动物实验于2006-09/2007-02在首都医科大学北京神经科学研究所完成。将20只SD大鼠制作急性完全横断脊髓损伤模型,随机分为4组：①治疗组：于脊髓断端间注射磁性纳米颗粒-Pluronic-GM-1100μL＋纤维蛋白胶100μL。②对照组1：于脊髓断端间注射磁性纳米颗粒-Pluronic100μL＋纤维蛋白胶100μL。③对照组2：于脊髓断端间注射纤维蛋白胶100μL。④空白组：单纯横断不予以任何治疗。4周后,应用免疫组织化学方法（NF和GFAP）结合图像分析方法,对脊髓横断处远端、近端进行神经纤维计数及胶质细胞网格框架结构定量分析,以了解神经再生情况。 结果：20只大鼠均进入结果分析。①脊髓横断区神经纤维数量：治疗组近端、远端均高于其他3组（P〈0.05）,2个对照组高于空白组（P〈0.05）,对照组2高于对照组1（P〈0.05）。②脊髓横断区胶质纤维面积比：治疗组近端、远端均高于其他3组（P〈0.05）,2个对照组近端明显高于空白组（P〈0.05）,对照组2远端高于空白组（P〈0.05）。 结论：磁性纳米颗粒-Pluronic具有药物携带及释放作用,其携带GM-1对脊髓损伤具有一定程度的修复及促进神经再生的作用。     

骨髓间充质干细胞移植后大鼠脊髓损伤处多唾液酸神经细胞黏附分子的表达

目的:观察骨髓间充质干细胞移植治疗大鼠脊髓损伤对多唾液酸神经细胞黏附分子表达的影响及意义。方法:实验于2004-06/2005-06在中国医科大学实验动物中心完成。随机选择4只大鼠作骨髓间充质细胞的分离与培养,骨髓间充质干细胞传4代后大约长至60%汇合时,吸弃培养基,加入5溴脱氧尿嘧啶标记培养基。36只大鼠分成3组制作脊髓横断损伤模型:骨髓间充质干细胞移植组、磷酸盐缓冲液组、空白对照组,每组12只。制作大鼠脊髓损伤模型,于伤后立即移植骨髓间充质干细胞。应用免疫组化法观察细胞移植后7,14,28d不同时间点移植细胞的存活情况,苏木精-伊红染色及常规链酶亲和素-生物素-过氧化酶复合物免疫组化法检测5溴脱氧尿嘧啶和多唾液酸神经细胞黏附分子的阳性细胞表达。结果:40只大鼠中36只制作脊髓横断损伤模型,6只因感染死亡,给予补足。①骨髓间充质干细胞移植组5溴脱氧尿嘧啶阳性细胞在移植后第7天可检测到,呈棕黄色的核标记,临近损伤区阳性细胞增多,在向头尾端迁移过程中阳性细胞逐渐减少,切片中可见最远迁移至距离损伤区1.5cm。磷酸盐缓冲液组及空白对照组均未见阳性细胞。②骨髓间充质干细胞移植组在移植术后第7天可于近端检测到多唾液酸神经细胞黏附分子阳性表达的细胞;磷酸盐缓冲液组可见少量阳性细胞;空白对照组未见阳性细胞。棕色颗粒定位于神经元的胞质和胞膜。移植术后第14天,骨髓间充质干细胞移植组脊髓切片的阳性神经细胞数开始增多,与磷酸盐缓冲液组比较,差异显著(16.0±2.6,6.0±2.3,P<0.05)。移植术后第28天,骨髓间充质干细胞移植组脊髓切片的阳性神经细胞逐渐减少。结论:骨髓间充质干细胞在移植后可明显促进多唾液酸神经细胞黏附分子的表达,是修复脊髓损伤并参与突触重建的重要机制。     

胰肾联合移植术后肺部感染的防治4例

本文报道胰肾联合移植治疗终末期糖尿病伴肾功能衰竭6例,4例术后肺部感染,2例分别为巨细胞病毒和难羧辨杆菌感染者成功治愈,2例分别为埃希大肠杆菌和金黄色葡萄球菌感染,因呼吸衰竭死亡．胰肾联合移植术后并发肺部感染的防治,重在积极预防,术后一旦出现肺部感染,大幅度削减免疫抑制剂量,对提高抢救成功率尤为重要．     

Intestinal dissemination of gastric mucosa-associated lymphoid tissue lymphoma

Despite increasing identification of concurrent gastric and intestinal lymphomas of mucosa-associated lymphoid tissue (MALT), the clonal relationship between the two tumors and their sequential development are poorly understood. It is also unknown whether the development of these concurrent tumors is closely associated with direct antigen stimulation, which is thought to play an important role in the clonal expansion of low-grade MALT lymphomas. To investigate these, we have studied six cases of concurrent gastric and intestinal MALT lymphomas by polymerase chain reaction (PCR) amplification, cloning, and sequencing of the rearranged Ig gene, a strategy that has been widely used for analysis of clonality and antigen-driven properties of B-cell malignancies. In each case, an identical or nearly identical complementarity determining region (CDR) 3 sequence was observed between the dominant clones of concurrent gastric and intestinal MALT lymphomas. In four of six cases examined, sufficient Ig variable region sequence information was obtained to permit analysis of somatic mutations. The mutation patterns in one case suggest that the intestinal lesion is secondary to the gastric tumor, and the mutation patterns in two cases indicate that the gastric and intestinal lesions are derived from different tumour subclones, which emerge after expansion of a common early tumor clone. Furthermore, three of four cases showed ongoing Ig mutations among different PCR clones at each site. These results show that concurrent gastric and intestinal MALT lymphomas are derived from the same clone and suggest that the intestinal lesions result from dissemination of gastric tumours. Antigen stimulation may play a role in tumor evolution, particularly at an early stage.     

N0, N1期口腔癌术后淋巴结转移逐步判别分析

0　引言　口腔癌是头颈部最常见的恶性肿瘤 ,有较强的浸润性并常发生颈部淋巴路转移 [1 ] ,临床主要依靠物诊、B超等从淋巴结的大小、质地来判断其是否有转移灶 ,但由于亚临床转移的存在 [2 ] ,部分无确定转移体证的 N0 ,N1期病例可因未及时行颈清扫或清扫范围不足导致术后淋巴结转移 ,我们对此种情况的影响因素进行随访和统计研究 .1　对象和方法1.1　对象　病例为 1983～ 1995年期间于我院手术治疗的146例 N0 ,N1期病理确诊的口腔鳞状细胞癌患者 ,根据UICC1987年 TNM标准进行分期和详细分区 ,术后随访 3a以上或至患者死亡 (2 mo～ 15…     

Comparison of grading systems for estimating the prognosis of renal cell carcinoma

In this study histologic slides of 165 patients who were diagnosed as RCC between 1983 and 1993 were re-evaluated and each tumour was graded according to Thoenes, Fuhrman, Arner and Skinner's grading systems. According to Thoenes' system, patients with grade (G) 2 and 3 tumours had significantly shorter survival compared to patients with G 1 tumours. The survival difference between the subgroups of Fuhrman and Skinner's grading systems did not reach statistical significance. When the histologic differentiation was grouped as low grade (G 1&2) and high grade (G 3&4) tumours in Fuhrman and Skinner's systems, a statistically significant difference was noted between the groups in terms of survival.     

Hemoptysis provoked by voluntary diaphragmatic contractions in breath-hold divers.

Pulmonary barotrauma of descent (lung squeeze) has been described in breath-hold divers when the lung volume becomes smaller than the residual volume (RV), with the effect of increased ambient pressure. However, the ratio between the total lung capacity and the RV is not the only factor that plays a role in the lung squeeze. Blood shift into the thorax is another important factor. We report three cases of hemoptysis in breath-hold divers who dove for spear fishing in shallower depths than usual. All of the divers performed voluntary diaphragmatic contractions at the beginning of their ascent, while their mouths and noses were closed. We suggest that the negative intrathoracic pressure due to the forced attempt to breathe in with voluntary diaphragmatic contractions contributes to alveolar hemorrhage, since it may damage the pulmonary capillaries.