异位阑尾炎33例临床诊断分析

作者收集本院1994-01／2002-10期间异位阑尾炎33例，占本院阑尾炎收治总数3．37％，临床延误诊断分析如下。     

Evaluation of moxalactam with the BD phoenix system for detection of methicillin resistance in coagulase-negative staphylococci

The performance of moxalactam with the BD Phoenix system for the detection of methicillin resistance in coagulase-negative staphylococci was evaluated by use of a collection of 186 strains. Moxalactam was a better drug as an indicator of methicillin resistance for mecA-positive strains than oxacillin and cefoxitin were. For strains other than Staphylococcus saprophyticus, a moxalactam MIC >16 microg/ml was indicative of methicillin resistance.     

Specific involvement of caspases in the differentiation of monocytes into macrophages

Caspases are cysteine proteases involved in apoptosis and cytokine maturation. In erythroblasts, keratinocytes, and lens epithelial cells undergoing differentiation, enucleation has been regarded as a caspase-mediated incomplete apoptotic process. Here, we show that several caspases are activated in human peripheral blood monocytes whose differentiation into macrophages is induced by macrophage colony-stimulating factor (M-CSF). This activation is not associated with cell death and cannot be detected in monocytes undergoing dendritic cell differentiation in the presence of interleukin-4 (IL-4) and granulocyte-macrophage colony-stimulating factor (GM-CSF). The mechanisms and consequences of caspase activation were further studied in U937 human monocytic cells undergoing phorbol ester-induced differentiation into macrophages. Differentiation-associated caspase activation involves the release of cytochrome c from the mitochondria and leads to the cleavage of the protein acinus while the poly(ADP-ribose)polymerase remains uncleaved. Inhibition of caspases by either exposure to the broad-spectrum inhibitor benzyloxycarbonyl-Val-Ala-(DL)-Asp-fluoromethylketone (z-VAD-fmk) or expression of the p35 baculovirus inhibitory protein or overexpression of Bcl-2 inhibits the differentiation process. In addition, z-VAD-fmk amplifies the differentiation-associated production of radical oxygen species in both phorbol ester-differentiated U937 cells and M-CSF-treated monocytes, shifting the differentiation process to nonapoptotic cell death. Altogether, these results indicate that caspase activation specifically contributes to the differentiation of monocytes into macrophages, in the absence of cell death.     

beta3-Adrenergic regulation of an ion channel in the heart-inhibition of the slow delayed rectifier potassium current I(Ks) in guinea pig ventricular myocytes

OBJECTIVES: I(Ks), the slow component of the delayed rectifier potassium current, underlies a strong beta-adrenergic regulation in the heart. Catecholamines, like isoproterenol, induce a strong increase in I(Ks). Recent work has pointed to an opposing biological effect of beta(1)- and beta(3)-adrenoceptors in the heart. However the role of these subtypes in the regulation of cardiac ion channel function is unknown. METHODS: We investigated the effects of beta(1)- and beta(3)-adrenoceptor modulation on I(Ks) in guinea-pig ventricular myocytes, using patch-clamp techniques. RESULTS: Superfusion with 100 nmol/l isoproterenol increased the step current amplitude by 81.3+/-8.0%. In contrast, after block of beta(1)- (1 micromol/l atenolol) and beta(2)-receptors (1 micromol/l ICI118,551), isoproterenol induced a reduction of the step current amplitude by 34.3+/-3.5%. The beta(3)-selective agonist BRL37344 significantly reduced the I(Ks) step current at +70 mV in a concentration-dependent manner (IC(50): 5.01 nmol/l). In the presence of bupranolol (beta(1)-, beta(2)- and beta(3)-adrenoceptor antagonist), the effect of BRL37344 was markedly attenuated, from 27.3+/-5.6% (100 nmol/l BRL37344 alone) to 4.0+/-1.3% (100 nmol/l BRL37344+1 micromol/l bupranolol). BRL37344 (100 micromol/) did not alter current amplitudes of KvLQT1/minK expressed in CHO cells or in Xenopus oocytes, excluding a direct effect of BRL37344 on the channel. 1 micromol/l BRL37344 mildly prolonged action potentials in guinea pig ventricle (APD(90):+7.8%) CONCLUSIONS: We have demonstrated a functional coupling between the beta(3)-adrenoceptor and ion channel function in the mammalian heart. Our findings point to a potential role for beta(3)-adrenoceptors in cardiac electrophysiology and pathophysiology.     

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??Early detective value of serum CA19-9 levels for concomitant acute cholangitis in obstructive jaundice MEI Yong*, PENG Ci-jun, CHEN Li, et al. *Department of Hepatobiliary Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi563003, China
Corresponding author??PENG Ci-jun??E-mail??pengcijun@gmail.com
Abstract Objective To investigate the early diagnostic value of serum tumor markers and abnormal liver function parameters on the concomitant acute cholangitis in obstructive jaundice. Methods The clinical data of 412 choledocholithiasis patients with obstructive jaundice admitted between January 2009 and December 2013 in Department of Hepatobiliary Surgery, Affiliated Hospital of Zunyi Medical College were collected and divided into two groups. There were 257 patients in group of acute cholangitis and 155 patients in group of choledocholithiasis with obstructive jaundice. The relations of the serum tumor markers and abnormal liver function parameters with the acute cholangitis were analyzed. The receiver operating characteristic (ROC) curves for the significant parameters were generated to assess their sensitivities and specificities for diagnosis of the acute cholangitis. Results There were statistical difference of serum CA19-9 and CA125 levels between the acute cholangitis group and the obstructive jaundice group (P<0.05). The ROC curve analysis showed that area under the ROC curve of C19-9 and CA125 were 0.815 and 0.639, their correspondent cut-off value 53.6 kU/L and 17.5 kU/L, sensitivity 71.2% and 54.9%, specificity 78.1% and 75.5%, respectively. There was no statistical difference between two groups about serum tumor marker of CEA and abnormal liver function parameters of TBIL, DBIL, ALT, AST (P>0.05). Conclusions The increased serum CA19-9 level has major early detective value for the concomitant acute cholangitis in obstructive jaundice. It is possible that CA19-9 is one of the inflammatory markers for acute cholangitis.     

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??Abstract?? Objective To investigate the different clinical and immune features of variable phenotypes of severe combined immunodeficiency caused by RAG 1 mutations.Methods From 2012.9 to 2013.04?? three patients were included in the study??and records of clinical details were reviewed. Results The phenotypes of three patients were typical SCID for patient 1??Omenn syndrome for patient 2 and atypical SCID complicated with recurrent autoimmune hemolytic anemia for patients 3??respectively.RAG 1 mutations were compound heterozygous allele 1??1870 C??T/Arg624Cys??allele 2??2005 G??A/Glu669Lys??allele 1 was published mutation??allele 2 was de novel mutation?? for patient 1??compound heterozygous allele 1??994 C??T/Arg332X??allele 2??1439 G??A/Ser480Asn??both mutations were de novel mutations??for patient 2??homozygous 2095 C??T/R699W for patient 3 and was published mutation. First two patients died soon after discharge.Patient 3 was treated for recurrent autoimmune hemolytic anemia in our ward.Conclusion RAG1 mutations can lead to variable SCID phenotypes.Patients with typical SCID and Omenn syndrome were with poor prognosis??which need transplantation treatment.     

PI3K/AKT信号通路的抑制促进B7-H4分子的核转移

目的探讨磷脂酰肌醇-3-激酶/蛋白激酶B(PI3K/AKT)信号通路对负性共刺激分子B7-H4细胞定位的调控作用。方法体外培养稳定转染B7-H4/HEK293细胞,采用PI3K/AKT特异性抑制剂LY294002和/或出核转运抑制剂来普霉素B(LMB)处理细胞之后,免疫荧光技术结合激光共聚焦显微镜检测B7-H4蛋白在B7-H4/HEK293细胞中亚细胞定位的变化;Western blot法检测B7-H4蛋白在细胞膜、细胞质和细胞核表达水平的变化。结果激光共聚焦显微镜观察结果显示,PI3K抑制剂LY294002作用于B7-H4稳定转染的B7-H4/HEK293细胞后,与空白对照组相比,B7-H4发生核转移,加入出核转运抑制剂LMB后,核转移的程度显著增加;Western blot法结果显示,LY294002抑制PI3K/AKT信号通路活性24 h后,B7-H4在细胞膜和细胞质中的定位均显著降低(P0.05),而细胞核中B7-H4的定位显著增加(P0.05)。结论 PI3K/AKT信号通路可抑制B7-H4的核转移。