肝移植术后肝功能动态变化规律及其临床意义

目的动态观察肝移植患者术前、术中、术后40d内肝功能恢复情况,明确肝功能指标变化规律,为临床治疗提供依据。方法回顾性分析136例肝移植受者术前、术中1、2、3、4、5h和术后2、5、10、20、30、40d丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、胆碱酯酶(ChE)、总胆汁酸(TBA)、总胆红素(TBIL)、直接胆红素(DBIL)等各项指标的变化,应用统计软件阐明其变化规律。结果 136例肝移植受者ALT、AST术中骤高,术后10d左右降低至正常值附近;TBA、TBIL、DBIL术后40d内逐渐下降至正常值附近;胆碱脂酶在术中变化不明显,维持在较低水平,在30d至40d上升到正常值范围下限。136例肝移植受者中62例原发病为肝硬化和41例原发性肝癌患者的各项肝功能指标变化规律与上述变化基本相同,而原发病为慢性重型肝炎的26例患者各项肝功能指标恢复至正常的时间较长。结论 ALT、AST、TBA是肝移植术后肝功能恢复的早期指标;ChE、TBIL、DBIL是肝移植后肝功能恢复的远期指标;慢性重型肝炎患者肝移植术后肝功能恢复较迟。     

细支气管肺泡癌的X线CT诊断

目的提高细支气管肺泡癌(BAC)的X线、CT诊断水平.材料与方法回顾性分析24例BAC的X线、CT表现,将其分为结节型、炎症型和弥漫型.结果结节型7例,均为单发结节.炎症型6例,两肺多发斑片状影4例,大叶实变2例.弥漫型11例,两肺呈细小结节影10例,网状结节影1例.单侧或双侧胸腔少量积液8例,心包大量积液5例,双侧肺门淋巴结增大3例.胸部及远处骨质破坏6例.结论BAC影像表现多种多样,炎症型需与肺结核、肺炎等鉴别.仔细观察、分析X线、CT征象并结合临床表现与治疗情况,可提高BAC的诊断正确率.     

影像学诊断质量评价和管理研究

影像学检查手段的多样化及其广泛应用一方面使得临床诊断的准确率得到大大提高,另一方面却使得影像学检查和诊断中存在的低效率和低效能的状况凸显;与此同时,影像学诊断质量的管理与快速发展的影像学技术手段相比则显得明显滞后.影像学诊断质量评价和管理研究的方法学的提出,为下一步进行疾病的影像学诊断质量评价与管理研究提供必要的理论指导.     

大鼠的富锌酵母生物利用率评价

以断奶大鼠为模型,观察了富锌酵母的生物利用率,并与无机锌制剂进行比较。结果表明,12ppm富锌酵母组的动物增重最多,饲料消耗量大,饲料效价最高,能有效地纠正锌缺乏状态。在同样剂量条件下,富锌酵母的毒性作用较无机锌为低。以富锌酵母作为食品添加剂,是补充锌的良好来源。     

The value of CT pulmonary angiography to the diagnosis of right ventricular dysfunction due to acute pulmonary embolism： compared with ultrasonographic cardiography

Objective:To analyze the value of CT pulmonary angiography(CTPA) in assessing right ventricular dysfunction(RVD) after acute pulmonary embolism. Methods:Thirty-six patients with CTPA-confirmed PE who underwent ultrasonic cardiography(UCG) within the ensuing 24 hours were retrospectively reviewed. According to the severity of the disease,the patients were divided into the massive PE group(24 cases) and non-massive PE group(12 cases) respectively. CT scans were analyzed for findings suggestive of RVD. Scans were considered positive for RVD if the right ventricle was dilated(RVd/LVd>1) or if the interventricular septum was straightened or deviated towards the left ventricle. Results were then compared with the results of UCG to estimate the value of CTPA in detecting RVD associated with PE. Results:In all cases,compared with UCG,the diagnostic sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,positive predictive value,and negative predictive value of CTPA was 84.61%,78.26%,3.892,0.197,68.75% and 90% respectively. Kappa value was 0.60,which suggested moderate agreement between CTPA and UCG in the whole level. In the massive PE group,the diagnostic sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,positive predictive value,negative predictive value of CTPA was 84.61%,72.73%,3.103,0.212,78.57% and 80% respectively. Kappa value was 0.58,which suggested moderate agreement between CTPA and UCG in the massive PE group. In the non-massive PE group,the diagnostic specificity of CTPA was 83.33%. By statistics,the value of RVd/LVd had significant difference between the massive PE and the non-massive PE group. Conclusion:CTPA can reliably detect RVD through the evaluation of cardiac morphology. However,this result requires confirmation using a larger prospective cohort study.     

Intracellular interleukin-1alpha mediates interleukin-8 production induced by Chlamydia trachomatis infection via a mechanism independent of type I interleukin-1 receptor

Chlamydia trachomatis infection induces a wide array of inflammatory cytokines and chemokines, which may contribute to chlamydia-induced pathologies. However, the precise mechanisms by which Chlamydia induces cytokines remain unclear. Here we demonstrate that the proinflammatory cytokine interleukin-1α (IL-1α) plays an essential role in chlamydial induction of the chemokine IL-8. Cells deficient in IL-1α expression or IL-1α-competent cells treated with IL-1α-specific small interfering RNA failed to produce IL-8 in response to chlamydial infection. However, neutralization of extracellular IL-1α or blockade of or deficiency in type I IL-1 receptor (IL-1RI) signaling did not affect chlamydial induction of IL-8 in cells capable of producing IL-1α. These results suggest that IL-1α can mediate the chlamydial induction of IL-8 via an intracellular mechanism independent of IL-1RI, especially during the early stage of the infection cycle. This conclusion is further supported by the observations that expression of a transgene-encoded full-length IL-1α fusion protein in the nuclei enhanced IL-8 production and that nuclear localization of chlamydia-induced precursor IL-1α correlated with chlamydial induction of IL-8. Thus, we have identified a novel mechanism for chlamydial induction of the chemokine IL-8.     

The role of metabotropic glutamate receptor mGlu5 in control of micturition and bladder nociception

In micturition control, the roles of ionotropic glutamate (iGlu) receptors NMDA and AMPA are well established, whereas little is known about the function of metabotropic glutamate (mGlu) receptors. Since antagonists for mGlu5 receptors are efficacious in animal models of inflammatory and neuropathic pain, we examined whether mGlu5 receptors play a role in the voiding reflex and bladder nociception and, if so, via centrally or peripherally localized receptors. The mGlu5 receptor antagonist MPEP dose-dependently increased the micturition threshold (MT) volume in the volume-induced micturition reflex (VIMR) model in anesthetized rats. Following doses of 5.2, 15.5 and 51.7 μmol/kg of MPEP (intraduodenal), the MT was increased by 24.7 ± 5.0%, 97.2 ± 12.5% (P < 0.01) and 128.0 ± 28.3% (P < 0.01) from the baseline, respectively (n = 4–5; compared with 0.8 ± 9.1% in the vehicle group). Infusing MPEP (0.3, 1 mM) directly into the bladder also raised MT. However, the efficacious plasma concentrations of MPEP following intravesical dosing were similar to that after intraduodenal dosing (EC₅₀ of 0.11 and 0.27 μM, respectively, P > 0.05). MPEP also dose-dependently attenuated the visceromotor responses (VMR, total number of abdominal EMG spikes during phasic bladder distension) in anesthetized rats. The VMR was decreased to 1332.4 ± 353.9 from control of 2886.5 ± 692.2 spikes/distension (n = 6, P < 0.01) following MPEP (10 μmol/kg, iv). Utilizing the isolated mouse bladder/pelvic nerve preparation, we found that neither MPEP (up to 3 μM) nor MTEP (up to 10 μM) affected afferent discharge in response to bladder distension (n = 4–6). In contrast, MPEP attenuated the responses of the mesenteric nerves to distension of the mouse jejunum in vitro. These data suggest that mGlu5 receptors play facilitatory roles in the processing of afferent input from the urinary bladder, and that central rather than peripheral mGlu5 receptors appear to be responsible.     

Requirement of the IFN-alpha/beta-induced CXCR3 chemokine signalling for CD8+ T cell activation

BACKGROUND: Activation of both CD4+ T and CD8+ T cells is triggered by the engagement of the T cell antigen receptor (TCR) with MHC/peptide complexes on antigen-presenting cells. This process also requires other molecular interactions, which transmit co-stimulatory signals to these T cells. To ensure an effective immune response, distinct T cell subsets may additionally employ unique mechanism(s) for efficient activation. RESULTS: We here show that mutant CD8+ T cells lacking the IFN-alpha/beta signalling components are hyporesponsive to antigen stimulation in vitro. We further show that IFN-alpha/beta-mediated signals are required for induction of the chemokines IP-10/I-TAC and their common receptor, CXCR3, and in turn provide evidence that CXCR3-mediated signals indeed function in the activation and proliferation of CD8+ T cells, particularly for the CD44low naive phenotype cells. CONCLUSION: The CXCR3 chemokine system is regulated by IFN-alpha/beta in CD8+ T cells, and it is critical for the efficient cell activation. The present study therefore reveals a novel role of the IFN-alpha/beta-CXCR3 signalling cascade in CD8+ T cell activation.