肥胖类型与脑卒中亚型的相关性研究

目的探讨肥胖类型与脑卒中亚型的相关性。方法将573例急性脑卒中患者分为脑出血组126例,脑梗死组447例,脑梗死组再分为脑血栓形成组(215例)和腔隙性脑梗死组(232例),另外选择277例无脑卒中者为对照组。测量腰围、臀围和体重,计算体重指数和腰臀比(WHR),分析肥胖参数与脑卒中各亚组的关系。结果脑卒中各亚组与对照组肥胖发生率差异无显著性意义(P>0.05);各组WHR明显大于对照组(P<0.05)。WHR增大明显增加脑卒中各亚组的危险性(P<0.05);女性腹围增大患腔隙性脑梗死危险性升高(P<0.05);男性体重增加患脑出血的危险性升高(P<0.01)。结论腹型肥胖是脑出血、脑血栓形成和腔隙性脑梗死的危险因素之一。     

新型纳米根管充填材料对成骨细胞生长的影响

通过体外培养的成骨细胞,采用二甲基噻唑二苯基四唑溴盐比色法和流式细胞术对新型纳米根管充填材料(nHA-PA66)作用下的成骨细胞生长情况的变化进行研究,评价其对成骨细胞生长的影响。以该材料的细胞培养基浸提液作用于实验组细胞,对照组采用培养基本身。实验组和对照组成骨细胞的生长情况和细胞周期无显著性差异,表明该新型纳米材料对成骨细胞的生长和细胞周期无不良影响。提示新型纳米根管充填材料的成骨细胞相容性较好,具有用作根充材料的基础。     

The role of neck dissection in the eradication of salivary carcinomas]

From 1955 to 1984, radical neck dissection (RND) had been done in 300 salivary carcinoma patients, 114 of which had regional lymph node metastasis, with a 38% metastatic rate. Respective 3, 5, 10, 15, 20 year survival rates were 76, 64, 47, 35, 35% in a 3 to 20 years follow-up study in 283 patients (94.33%). The following four points are concluded: 1. The metastatic rate is determined not only on tumor staging, but more to its typing (pathologic behaviour). 2. Elective RND gave a better prognosis than therapeutic and negative metastasis has a better survival chance than positive where the low level metastasis is the worst. 3. According to pathologic typing, Elective RND is indicated for undifferentiated adenocarcinoma, high malignant mucoepidermoid carcinoma, squamous cell carcinoma, adenocarcinoma and papillary cystic adenocarcinoma, therapeutic RND for malignant pleomorphic adenoma, acinic cell carcinoma and mucoepidermoid carcinoma. 4. Unilateral RND is indicated for all but sublingual and buccal tumors.     

Successful balloon pulmonary valvuloplasty for congenital valvular pulmonary stenosis in an octogenarian.

While balloon valvuloplasty has been widely used for the treatment of congenital valvular pulmonary stenosis (PS) in children and adults, its use in elderly patients is less common. An 80-year-old woman with congenital valvular PS received valvuloplasty with double-balloon technique. Right ventricle systolic pressure and pulmonary valve systolic pressure gradient decreased from 95 to 44 mm Hg and from 75 to 35 mm Hg, respectively. Follow-up Doppler echocardiography 2 months later showed further decrease in the transvalvular systolic pressure gradient to 29 mm Hg. The patient had symptomatic relief, and no major complication was noted. Balloon pulmonary valvuloplasty can be an effective treatment for elderly patients with congenital valvular PS.     

Recurrent acalculous cholecystitis and sclerosing cholangitis in a patient with X-linked hyper-immunoglobulin M syndrome.

X-linked hyper-immunoglobulin M (IgM) syndrome (XHIGM) is a rare genetic primary immunodeficiency disease caused by mutations of the CD40 ligand (CD40L) gene with normal or elevated levels of IgM and markedly decreased serum IgG, IgA, and IgE. Liver disease may occur as a clinical manifestation in XHIGM. This complication appears to increase with age. We report an 18-year-old male patient who had recurrent episodes of acalculous cholecystitis (AC) and sclerosing cholangitis (SC). The diagnosis of XHIGM was confirmed by the finding of CD40L expression < 1% of normal and a tyrosine 169 asparaginase (t526a) mutation in exon 5 (the tumor necrosis factor domain) of the CD40L gene. The patient had direct hyperbilirubinemia (direct bilirubin 5.5 mg/dL, total bilirubin 8.7 mg/dL), cholestasis (alkaline phosphatase 1133 U/L, gamma-glutamyl transferase 1019 U/L) and elevated transaminases (aspartate aminotransferase 70 U/L, alanine aminotransferase 101 U/L). Findings on abdominal ultrasound and abdominal computed tomography were compatible with AC. After the fourth episode of cholecystitis, cholecystectomy and liver biopsy were performed. Operative cholangiography revealed poor opacification of the hepatic duct and proximal common bile duct; the upstream intrahepatic bile ducts were not visualized. The biopsy specimen showed marked fibrosis of the portal areas. Enterococcus species was cultured from the bile. Children or adolescents with recurrent AC and SC should be evaluated for an underlying immunodeficiency syndrome such as XHIGM.     

Matched-unrelated-donor bone marrow transplantation for children with leukemia.

BACKGROUND AND PURPOSE: This report describes the results of matched-unrelated-donor transplant for leukemia or myelodysplasia in the first 23 recipient children at a single medical center in Taiwan. METHODS: Between August 1994 and February 2003, 23 consecutive children with leukemia or myelodysplasia underwent matched-unrelated-donor bone marrow transplantation (BMT). The preparative regimen consisted of fractionated total body irradiation and cyclophosphamide in 6 patients; busulfan in combination with etoposide and cyclophosphamide in 4 patients who received cranial irradiation before transplantation; and busulfan and cyclophosphamide in 13 patients. RESULTS: Engraftment was achieved in 91.3% of cases. Acute graft-versus-host disease (GVHD) occurred in 18 of 21 patients who engrafted (85.7%). Event-free survival for all patients was 24.46 +/- 9.24%. The 12 children with standard-risk disease had better event-free survival than the 11 children with high-risk disease (46.88 +/- 15.03% vs 0%, p < or = 0.001). CONCLUSIONS: The major obstacles to successful matched-unrelated-donor BMT are acute GVHD, relapse and infection. Early transplantation and patient selection, prophylactic and therapeutic maneuvers for GVHD, as well as appropriate donor selection and virus prophylaxis may improve the results.     

Morphology of corticotectal cells in the primary visual cortex of hooded rats

In primary visual cortex of hooded rats, pyramidal cells in layer V may be classified as long, medium, or short, on the basis of the layer in which the apical dendrite terminates. The present study determines which of these types of pyramidal cells project to the superior colliculus. Two different strategies were used to label corticotectal cells with horseradish peroxidase (HRP). In the first set of experiments, a large number of corticotectal cells were labeled by retrograde transport following injection of HRP into the superior colliculus. In the second set of experiments, single unit recording was used to identify corticotectal cells physiologically by antidromic activation from the superior colliculus. These cells were then impaled and labeled by intracellular iontophoresis of HRP. The results from both techniques suggest that only long pyramidal cells send an axon to the superior colliculus. These cells are distinguished by an apical dendrite that extends into layer I. We conclude that in hooded rats corticotectal cells in primary visual cortex are the long pyramids in layer V.     

肝癌多药耐药产生与低糖环境的关系

目的探讨局部微环境低糖与肝细胞癌多药耐药性(MDR)产生的关系及影响机制。方法低糖培养HepG2细胞,应用流式细胞术Annexin V/PI法检测低糖培养的细胞在化疗药物5-氟脲嘧啶(5-Fu)作用后的凋亡情况,分别应用荧光定量聚合酶链反应(PCR)技术和Western blot技术检测低糖培养后HepG2细胞内多药耐药相关基因mdr1、MRP1、LRP的mRNA和蛋白水平的表达。结果在低糖环境下生长时间越长的HepG2细胞对5-Fu的抵抗越强,而且随着低糖培养时间的增加,5-Fu诱导的HepG2细胞的凋亡高峰延迟。低糖培养的HepG2细胞内多药耐药相关基因mdr1、MRP1、LRP在mRNA和蛋白水平的表达随低糖培养时间的延长而升高,以LRP的改变最为显著。结论肝癌生长微环境葡萄糖耐量不足也是肝癌产生MDR的原因之一。低糖可通过上调一组多药耐药相关基因的表达而诱导肝癌的多药耐药性。     

急性冠状动脉综合征患者介入术前后血小板活化及血管内皮功能的变化

目的观察急性冠状动脉综合征患者介入治疗后血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物及内皮功能的改变。方法60例急性冠状动脉综合征患者在冠状动脉介入术前和术后即刻以及次日采用流式细胞仪检测血小板活化指标CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物;双抗体夹心固相酶联免疫吸附试验测定血浆假血友病因子的表达水平;放射免疫测定法测定血浆内皮素1表达水平;酶法测定血浆一氧化氮的含量;彩色多谱勒超声诊断仪测量内皮依赖性血管舒张功能。选择健康体检者和稳定型心绞痛患者各30例作对照,观察急性冠状动脉综合征患者冠状动脉介入前后指标的变化并与对照组比较。结果与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组CD62p、CD63及糖蛋白Ⅱb/Ⅲa受体复合物明显增高(P<0.05或0.01);急性冠状动脉综合征患者介入术后即刻CD62p、CD63和糖蛋白Ⅱb/Ⅲa受体复合物与术前相比明显增高(P<0.01),但术后24h较术前无明显变化(P>0.05)。与健康对照组和稳定型心绞痛组比,急性冠状动脉综合征组假血友病因子、内皮素1的表达水平明显增高(P<0.01),内皮依赖性血管舒张功能和一氧化氮降低(P<0.05或<0.01);急性冠状动脉综合征患者介入术后即刻血浆假血友病因子和内皮素1水平升高(P<0.05或P<0.01),内皮依赖性血管舒张功能和一氧化氮水平降低(P<0.05),且介入术后24h假血友病因子水平也较术前升高(P<0.05),内皮依赖性血管舒张功能降低(P<0.05),但内皮素1和一氧化氮水平与术前差异无显著性(P>0.05)。结论血小板活化和内皮功能的损伤在急性冠状动脉综合征发生和发展过程中起重要的作用,冠状动脉介入术后血管内皮受到一定损伤,血小板有一定程度的激活。