喉癌组织T淋巴细胞亚群与外周血前列环素及血栓素的检测

目的 探讨喉癌局部组织的细胞免疫状态与前列腺素类物质前列环素及血栓素的关系。方法 应用免疫组化法检测了28例喉鳞癌患者局部组织内淋巴细胞亚群的分布状况，并与该患者残喉健康侧组织及喉良性肿瘤患者的瘤组织进行对比；同时采用放射免疫分析法分别检测了上述喉鳞癌、喉良性肿瘤患者和正常人血浆前列环素(PGI2)及血栓素A2(TXA2)的含量，并以它们在健康人血浆中的含量为正常对照。结果 喉癌组织内浸润的CD4和CD8细胞数明显升高，而且CD8细胞多于CD4细胞，提示喉癌组织局部的细胞免疫功能受抑。同时喉癌患者血浆中PGI2和TXA2的稳定代谢产物6-酮-前列腺素F1α及血栓素B2(TXB2)的含量高于正常对照组，以TXB2升高更明显。结论 喉癌患者体内前列腺素类物质PGI2／TXA2与其癌组织局部细胞免疫受抑有关，因而可作为生物学标记提示喉癌组织局部的细胞免疫功能状态。     

大鼠骨髓间充质干细胞转染人TH基因的实验研究

目的评价酪氨酸羟化酶(tyrosine hydroxylase,TH)基因修饰骨髓间充质干细胞(mesenchymalstem cells,MSCs)后TH的表达情况及转染TH基因对MSCs的影响.方法构建含人TH基因的pCMV/hTH质粒,用脂质体转染原代培养的大鼠MSCs;Western blot及免疫细胞化学染色鉴定TH基因的表达及MSCs的分化情况;MTT比色法测定转染后的MSCs细胞活性,并与未转染的MSCs进行细胞活性比较.结果构建的pCMV/hTH质粒经ECoRI酶切后产生1.9okb和5.3kb的片段,与回收的目的基因及载体基因片段大小相符;转基因后的MSCs Western blot及免疫细胞化学染色显示TH染色阳性;转染后MSCs未见有NeuN,GFAP的表达;MTT比色法测定细胞活性,未转染与转染者差异无显著性.结论构建的TH基因能在体外培养的鼠MSCs中较好的表达,转染不会诱导MSCs向神经样细胞分化,对MSCs细胞活性无明显影响.     

Case report: Management of immediate post-car-diopulmonary bypass massive intra-cardiac thrombosis

PURPOSE: To describe the management of severe acute intracardiac thrombosis in a patient who underwent redo multiple valve replacement and valvular repair. The diagnostic features, associated risk factors, and anesthetic management are reviewed. CLINICAL FEATURES: A 67-yr-old woman undergoing redo mitral and aortic mechanical valve replacement and tricuspid annuloplasty under aprotinin prophylaxis exhibited severe refractory hypotension that began immediately after protamine reversal of intraoperative heparin anticoagulation following separation from cardiopulmonary bypass. Intraoperative transesophageal echocardiography revealed severe thrombosis in the right atrium, right ventricle and pulmonary artery. The patient was managed by immediate reheparinization and return to cardiopulmonary bypass (CPB), surgical thrombectomy, and intraoperative administration of recombinant tissue-plasminogen activator. After removal of the thrombi, and separation from CPB, no further protamine was given. One hundred units of blood products and two surgical re-explorations were required to manage subsequent massive postoperative bleeding. Acute heparin-induced thrombocytopenia (HIT) was ruled out using sensitive assays for HIT antibodies. After 16 days in the intensive care unit and 30 more days in hospital, the patient was subsequently transferred to a chronic care facility and succumbed several weeks later. CONCLUSION: Acute intraoperative thrombosis is a rare and potentially fatal complication of cardiac surgery. Intraoperative transesophageal echocardiography was essential for rapid diagnosis in this case. Multiple interacting prothrombotic factors (e.g., aprotinin use, acquired antithrombin deficiency, long pump time, post-protamine status, transfusion of blood components) were likely contributing factors related to this rare complication.     

Inhibitory effect of resveratrol on the proliferation of GH3 pituitary-adenoma cells and voltage-dependent potassium current

INTRODUCTION Resveratrol (RE), a natural phytoestrogen first found in grapes and wine, is widely existed in some kinds of tradition Chinese medicine, such as giant knotweed rhizome and cassia seed. RE has been reported to have a variety of healthy effects…     

新型记忆合金节段内固定器治疗腰椎峡部裂的实验研究

目的 :设计一种治疗腰椎峡部裂的新型记忆合金节段内固定器 ,测试其材料力学特性 ,并评价其生物力学稳定性。方法 :测量 2 0具干燥完整成人腰椎标本获得数据 ,按数据采用镍钛记忆合金设计固定器并行材料力学测试。取 6具新鲜成人腰椎标本 ,先后形成正常脊柱组、峡部裂组、横突棘突钢丝捆绑组、钩螺钉固定组、Buck螺钉固定组、新研制记忆合金固定器固定组 6组实验模型。利用脊柱三维运动实验机 ,分别测试 6组的前屈 /后伸、左 /右侧弯及左 /右轴向旋转 6种运动的活动范围。结果 :材料力学测试表明其形态记忆功能良好 ,体温状态下会产生稳定可靠的回复力。 6组在前屈、后伸及左右旋转状态 ,峡部裂组稳定性最差 ,同其他 5组差别明显。而使用新研制记忆合金内固定器组可明显恢复腰椎稳定性 ,同正常脊柱组及其他 3种内固定组均无显著差别。另两种状态左右侧弯 6组均无显著性差别。结论 :新设计的内固定器符合腰椎的生物力学要求 ,较先前的半环状内固定器优势明显 ,具有很好应用前景     

Neuropathological study 16 years after autologous adrenal medullary transplantation in a Parkinson's disease patient.

To date, there is no clinicopathological correlation of adrenal medullary transplant cases in patients with survival beyond a few years. Postmortem examination of a brain from a patient with Parkinson's disease (PD), 16 years after autologous adrenal medullary transplant, was performed using tyrosine hydroxylase (TH) and chromogranin A. The patient experienced a four-year initial improvement in motor function followed by resumption of the progressive nature of her disease that continued until her death. She expired 16 years following grafting. At autopsy, TH stain of the brain revealed severe loss of TH-immunoreactivity in the substantia nigra and Lewy bodies, confirming the diagnosis of PD. The transplant site was identified by the presence of scarring and there was complete absence of any TH staining cells at the site of the transplant. There were few surviving cells staining with chromogranin A. The absence of TH-staining cells in the transplant 16 years after surgery provides further evidence that adrenal medullary transplants do not survive in the long term.     

Pulmonary resection for metastases from colorectal cancer

Aim: The prognosis of patients with disseminated colorectal carcinoma is poor except for those with single organ pulmonary or hepatic metastases. The objective of the present study was to evaluate the result of pulmonary metastasectomy for colorectal secondary and to identify the prognostic factors. Methods: This was a retrospective study of 80 patients who had pulmonary metastasectomy for pulmonary secondary from colorectal carcinoma in Queen Elizabeth Hospital, Hong Kong. Results: The overall 5‐year and 10‐year survival rates of the entire cohort were 42.5% and 35.5%, respectively. High premetastasectomy carcinoembryonic antigen (> 20 μg/dL), short disease‐free interval (< 12 months) and incomplete resection were the independent prognostic factors. Neither the characteristics of the primary colorectal tumour nor the number of metastatic nodules had a significant contribution to the long‐term survival. Six patients underwent second pulmonary metastasectomy and three were still free from tumour recurrence after the second operation. Conclusion: Patients with pulmonary metastases from colorectal carcinoma would benefit from pulmonary metastasectomy. High premetastasectomy carcinoembryonic antigen and short disease‐free interval were negative predictive factors for survival. Long‐term follow‐up study is required, as recurrence can occur more than 5 years after pulmonary metastasectomy. Also, whether the survival benefit is due to surgical treatment effect or lead‐time bias remains undecided.     

Celecoxib induces functional recovery after intracerebral hemorrhage with reduction of brain edema and perihematomal cell death.

The selective cyclooxygenase-2 (COX-2) inhibitor has been reported to have antiinflammatory, neuroprotective, and antioxidant effects in ischemia models. In this study, the authors examined whether a selective COX-2 inhibitor (celecoxib) reduces cerebral inflammation and edema after intracerebral hemorrhage (ICH), and whether functional recovery is sustained with longer treatment. ICH was induced using collagenase in adult rats. Celecoxib (10 or 20 mg/kg) was administered intraperitoneally 20 minutes, 6 hours, and 24 hours after ICH and then daily thereafter. Seventy-two hours after ICH induction, the rats were killed for histologic assessment and measurement of brain edema and prostaglandin E2. Behavioral tests were performed before and 1, 7, 14, 21, and 28 days after ICH. The brain water content of celecoxib-treated rats decreased both in lesioned and nonlesioned hemispheres in a dose-dependent manner. Compared with the ICH-only group, the number of TUNEL-positive, myeloperoxidase-positive, or OX42-positive cells was decreased in the periphery of hematoma and brain prostaglandin E2 level was reduced in the celecoxib-treated group. Celecoxib-treated rats recovered better by the behavioral tests at 7 days after ICH throughout the 28-day period, and the earlier the drug was administered, the better the functional recovery. Evidence of similar effects in an autologous blood-injected model showed that direct collagenase toxicity was not the major cause of inflammation or cell death. These data suggest that celecoxib treatment after ICH reduces prostaglandin E2 production, brain edema, inflammation, and perihematomal cell death in the perihematomal zone and induces better functional recovery.     

CT影像学评分预测急性胰腺炎病情及转归的研究

目的 探讨CT影像学评分对急性胰腺炎病情和转归的预测价值。方法 回顾性分析入院后经CT检查的急性胰腺炎46例，按一定的规则对每例患进行CT影像学评分与分型，并与临床治疗中的有关资料进行对照。结果 46例患CT评分后获得：轻型24例，中型13例，重型9例。轻型患较重型住院日少、恢复顺利，中转手术及死亡率均以重型为高。结论 CT评分对急性胰腺炎病情及预后评估具有重要意义。