胰岛的血液引流与胰腺外分泌的机能和临床意义

目的　研究胰岛的血液引流与胰腺外分泌的机能联系与临床意义。方法　运用微血管树脂 /墨汁灌注扫描电镜 /光镜观察法、保留动态及组织信息在静态样本的微循环观察法、FITC标记红细胞 (FITC- RBC)荧光活体显微镜观察法以及计算机图像处理微血管三维重建法 ,对 11例男性尸体、40只猴、2 4只狗、62只鼠、2 4只兔的胰岛血液引流通道与胰腺外分泌腺泡的关系进行了系统研究。结果　不同动物的内分泌胰岛血液主要经胰岛的三种类型输出血管引流至不同的外分泌腺泡区域 ,灵长类的部分胰岛血液还引流至邻近的小胰岛 ,研究者根据胰岛引流系统的特征对其进行了分类及命名 :1连续型引流系统 ,所有胰岛具有这类引流 (输出 )管道 ,其管径细 ,行程短、引流至胰岛周围的腺泡毛细血管区域。 2聚合型引流系统 ,为部分胰岛所有 ,其管径粗、行程长 ,引流至远离胰岛的腺泡毛细血管区域。 3跨越型引流系统 ,为部分胰岛所有 ,其输出管道越过小叶间隔引流至另一胰腺小叶的腺泡毛细血管区域 ,而这一小叶往往没有胰岛存在。 4胰岛 -胰岛型引流系统 ,灵长类部分胰岛的血液通过胰岛 -胰岛型引流通道回流至邻近的小胰岛。结论　胰岛具有完善联系外分泌腺泡的引流系统 ,提示含有高浓度胰岛内分泌激素的胰岛血液可能对外分泌腺泡的机能     

c—myc反义寡核苷酸对白血病细胞凋亡的影响

目的 研究c-myc反义寡核苷酸对白血病细胞凋亡的影响。方法 用针对c-myc mRNA 5'端非翻译区的一个18bp的反义寡核苷酸与HL60细胞、分离的急性粒细胞白血病病人白细胞共培养10h,用凋亡细胞计数、DNA凝胶电泳、ELISA、流式细胞仪等方法测白血病细胞的调亡。结果 c-myc反义寡核苷酸能够诱导HL60细胞凋亡,且此作用随着作用浓度的提高而增加;此反义核酸只诱导白血病患者的白血病细胞凋亡,对正常白细胞的凋亡无影响。结论 c-myc反义核酸可以通过诱导白血病细胞凋亡来治疗急性粒细胞白血症,且该作用的特异性好。     

Incidence and risk factors of suicide among patients diagnosed with bladder cancer: A systematic review and meta-analysis

Background: Patients with bladder cancer have a high risk of suicide. This study aimed to assess how bladder cancer increases suicide risk and to identify the demographic and clinical factors associated with suicidal death among patients with bladder cancer. Methods: Literature search of MEDLINE, PsycINFO, Embase, Web of Sciences and Cochrane Library databases was conducted up to April 2020 to identify eligible studies related to the incidence and risk factors of suicide after bladder cancer diagnosis. Summary multivariate-adjusted risk estimates and their associated 95% confidence intervals (CIs) were calculated using inverse variance method with random or fixed-effect modeling. Results: Five retrospective cohorts comprising 563,680 patients with bladder cancer were included. Higher risk of suicide by 1.90-fold was observed among patients with bladder cancer (hazard ratio, HR = 1.90, 95% CI: 1.29–2.81; P = 0.001; I² = 81.2%), especially in those aged 70 years or older (HR = 1.36, 95% CI: 1.29–1.43; P < 0.001; I² = 0%), unmarried (HR = 1.72, 95% CI: 1.61–1.83; P < 0.001; I² = 0%), and those with regional bladder cancer (HR = 1.88, 95% CI: 1.10–3.21; P = 0.021; I² = 96.3%), compared with those without bladder cancer. Furthermore, gender and race were not associated with increased suicide risk among patients with bladder cancer. Conclusions: Suicide risk is increased among patients with bladder cancer, particularly those aged 70 years or older, unmarried and those with regional bladder cancer. Hence, early psychological support must be provided during the follow-up period of these special populations with a high suicide risk.     

经口入路机器人甲状腺手术的研究进展

近年来,甲状腺疾病的发病率逐年上升,其中青年女性患者占较大比例.随着年轻患者对美容的要求提高,多种入路的内镜甲状腺手术已广泛成功开展.这些术式尽管避免了在颈部做切口,并取得了较好的美容效果,但不可避免地在其他部位留下切口瘢痕.经口入路手术被认为是真正无痕的手术,具有更好的美容效果,随着近年来达芬奇手术系统的不断完善,经口入路机器人甲状腺手术也取得较大发展.与其他术式相比,经口入路机器人甲状腺手术具有多种优势,如提供中线入路、最低程度地减少组织损伤、3D高清放大视野、手臂震颤过滤及7个自由度Endo-wrist等.因此,本综述对近年来经口机器人甲状腺手术的研究进展进行总结,为临床甲状腺疾病的治疗提供学习借鉴.     

电离辐射对放射工作者职业健康的影响

目的 分析放射工作者外周血象、淋巴细胞微核及染色体畸变情况,为放射工作者职业防护和健康监测提供依据。方法 对2015年、2017年和2019年连续3次接受健康检查的127名放射工作者进行淋巴细胞微核、染色体及血象分析,将其设为放射组。另外选取133名无射线接触史的医务人员设为对照组;结果 放射组中淋巴细胞微核率和染色体畸变率高于对照组,白细胞和血小板计数低于对照组,均具有统计学意义（P < 0.05）。127名放射工作者外周血白细胞总数随着接触电离辐射时间的增长逐渐降低,染色体畸变率逐渐增加,均具有统计学意义（P < 0.05）。损害工龄大于20年的放射工作者染色体畸变率高于低工龄组,不同损害工龄之间比较无统计学意义（P > 0.05）。核医学与介入治疗工种染色体畸变率高于其他工种,具有统计学意义（P < 0.05）。结论 长时间接触低剂量电离辐射可使放射工作者白细胞总数降低和淋巴细胞染色体畸变率增加,应加强放射工作者防护措施以备降低电离辐射损伤程度,特别要加强核医学和介入治疗放射工作人员的职业防护。     

Osteosarcoma occurring in osteogenesis imperfecta

We describe a case history of a 24-year-old male with osteogenesis imperfecta (OI) who developed osteosarcoma of the left thigh. High-dose ifosfamide therapy caused marked tumor regression of multiple lung metastases. Immunohistochemically, the tumor cells were diffusely positive for the p53 protein. Mutation of the p53 gene was not detected by direct genomic sequencing of exons 4–8. The radiographic characteristics, including irregularly distributed osteolytic lesions and cortical discontinuity, should not be confused with hyperplastic callus formation, a benign process. A biopsy is critical to establish the differential diagnosis between osteosarcoma and common hyperplastic callus formation in OI; however, it must be applied with great care.     

球囊导管损伤后早期动脉平滑肌细胞的增殖

目的：研究动脉硬化早期中膜与内膜平滑肌细胞的增殖。方法：球囊导管损伤大鼠的颈总动脉后在电镜和光镜下观察其形态和生化指标变化。结果：术后24h 5-溴脱氧尿嘧啶尿苷阳性平滑肌细胞出现,阳性细胞率分别于术后第2,5d出现高峰。术后第2,3d迁移细胞的出现率最高。术后第3d,88.8%迁移细胞增殖细胞核抗原阳性。透射电子显微镜下,术后第3d中膜平滑肌细胞特别是内层的为合成型,并且与细胞外基质连接稀疏,基底膜、胶原纤维和弹性纤维被消失。结论：动脉损伤后,中膜平滑肌细胞呈高增殖性,由收缩型转变为合成型,与细胞外基质的结合性降低,中膜弹性纤维、胶原纤维被消化,增生活跃的细胞向内膜的迁移性增高。迁移至内膜的平滑肌细胞呈高增殖性。     

Effects of prolactin on HLA- DR and CD40 expressions by human thyrocytes

Objective To study the effects of prolactin (PRL) on HLA- DR and CD40 expressions by human thyrocytes, and to investigate the possible mechanisms for PRL to affect the de velopment of Graves’ disease (GD). Methods Thyrocytes in secondary culture, which were from GD thyroid glands and the tissu es adjacent to the lesions of multinodular goiter and adenoma (control group), w ere treated respectively with ovine PRL (oPRL), interferon- γ (IFN- γ), interl ukin- 4 (IL- 4) and oPRL plus IFN- γ (10 U/ml) or IL- 4 (5 ng/ml) for 7 days . HLA- DR and CD40 expressions on the thyrocytes were determined by immunofluor escent staining and flow cytometry. Results oPRL (12. 5 ng/ml-1000 ng/ml) had no significant direct effect on HLA- DR or C D40 expression. It did not significantly affect the stimulation of HLA- DR exp ressions on the two groups of thyrocyte treated with IFN- γ or on GD thyrocytes treated with IL- 4. oPRL could antagonize the stimulation of CD40 expressions by IFN- γ and the inhibition by IL- 4 on both groups of thyrocytes. The antago nizing effects were related to the concentrations of PRL. IFN- γ- stimulated p ercentages of CD40［+］ thyrocytes and delta mean fluorescence intensity (dMF) in both thyrocyte sources were significantly reduced in the presence of 200 ng/ml oPRL (both GD and Control: P&lt;0. 01 and P&lt;0. 05, respectively; Contro l: P&lt;0. 05) and 1000 ng/ml oPRL (GD: P&lt;0. 01; Control: P&lt;0. 05). oPRL caused significant increasing in IL- 4- inhibited percentages of CD40［+］ ce lls from the two groups of thyrocytes at 12. 5 ng/ml and 1000 ng/ml and dMF fr om GD thyrocytes at 1000 ng/ml (P&lt;0. 05). Conclusions PRL can exert indirect effects on CD40 expressions on thyrocytes by antagonizing the modulatory actions of IFN- γ and IL- 4 with dose- related effects. This m ay be one important mechanism for PRL to affect the development of GD.     

Clinical significance of elevated serum sICAM-1 in patients with nasopharyngeal carcinoma]

OBJECTIVE: To study the expression of serum sICAM-1(soluble intercellular adhesion molecule-1) and tissue ICAM-1 in nasopharyngeal carcinoma and its clinical significance. METHODS: Expression of ICAM-1 in frozen sections of 20 normal nasopharyngeal mucosa and 54 nasopharyngeal carcinoma samples were studied with immunohistochemical technique, and levels of serum sICAM-1 in 54 patients with nasopharyngeal carcinoma (NPC group) and 32 healthy adults (normal group) by ELISA. RESULTS: Positive expression (45/54) of tissue ICAM-1 and levels (2,044.48 +/- 640.05) microgram/L of serum sICAM-1 in NPC group were significantly higher than that of 2/20 and (313.70 +/- 114.98) microgram/L in normal group (P < 0.01, respectively), and there was a positive relationship between the expression of tissue ICAM-1 and levels of serum sICAM-1 in nasopharyngeal carcinoma(P < 0.05). The levels (2,177.31 +/- 642.13) microgram/L of serum sICAM-1 in patients with III-IV stages were higher than those (1,847.25 +/- 308.15) microgram/L in I-II stages (P < 0.05), and those (1,678.89 +/- 685.01) microgram/L in patients with no lymph node metastasis lower than that (2,134.34 +/- 609.60) microgram/L in lymph node metastasis (P < 0.05). The levels of serum sICAM-1 decreased significantly from (2,211.42 +/- 717.59) microgram/L to (926.55 +/- 207.72) microgram/L in disappearance of tumor and metastatic lymph node after radiotherapy (P < 0.01). CONCLUSION: sICAM-1 might be involved in the cellular immunopathogenesis of nasopharyngeal carcinoma, and the measurement of the serum sICAM-1 may reflect ability of neoplasm cell in freedom from host immunological surveillance. Dynamic measurement of serum sICAM-1 may be a useful objective index to evaluate NPC prognosis and curative effects.