免疫抑制剂在肾移植急性排斥反应中的作用

目的:介绍免疫抑制剂分类及免疫抑制剂在肾移植急性排斥反应中的作用和安全性。资料来源:应用计算机检索中国期刊全文数据库2003-01/2006-03与免疫抑制剂在肾移植急性排斥反应中应用相关的文章,检索词为“免疫抑制剂,急性排斥反应,肾移植”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与免疫抑制剂预防、治疗肾移植术后急性排斥反应的研究相关;以近3年且发表在较权威杂志者优先。排除标准:重复研究或Meta分析类文章。资料提炼:有53篇文献检索到全文,选用其中的31篇作为本文参考文献:16篇涉及免疫抑制剂预防肾移植术后排斥反应;9篇涉及免疫抑制剂治疗肾移植术后排斥反应;6篇涉及免疫抑制剂和肾移植急性排斥反应的相关研究。资料综合:①分类:免疫抑制剂根据合成方法可分为微生物酵解产物、完全有机合成物、半合成化合物和生物制剂;根据其发展状况可分为第1～4代免疫抑制剂。②目前在肾移植中常用的免疫抑制剂有环孢菌素、他克莫司、雷帕霉素、霉酚酸酯、咪唑立宾和一些生物制剂,同时详细介绍了这些药物的药理作用和毒副作用。结论:免疫抑制剂能够通过细胞免疫和体液免疫影响受者的免疫功能,预防和治疗肾移植急性排斥反应;随着移植免疫学、分子生物学的不断深入研究,药物安全性不断提高。     

Prolactin delays gonadotrophin-induced ovulation and down-regulates expression of plasminogen-activator system in ovary

This study was conducted to determine whether prolactin (PRL) suppresses gonadotrophin-induced ovulation and disturbs the co- ordinated gene expression of tissue type plasminogen activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1) in rat ovary. Immature female rats were injected with 10 IU pregnant mare's serum gonadotrophin to stimulate follicle growth, and 48 h received different doses of prolactin followed by 7 IU human chorionic gonadotrophin (HCG). The oviducts were examined for the presence of ova, and the amounts of tPA and PAI-1 mRNA present in the ovary were measured at various times after the hormone treatment. PRL had no significant effect on ovarian weight but caused a dose-dependent decrease in ovulation number. In the control animals receiving HCG alone, 13.3 +/- 1.3 (mean +/- SEM) ova/oviduct were found; while in animals receiving HCG plus 50, 100 or 200 microg PRL, the ovulation number was dose- dependently suppressed by 53.6, 66.9 and 76% respectively at 18 h after treatment. PRL suppression of HCG-induced ovulation was time-dependent. By 24 h after treatment, the number of ova in the oviducts in HCG- and HCG plus PRL-treated groups was not significantly different. PRL also suppressed HCG-induced tPA gene expression in a dose- and time- dependent manner. At all time points examined, tPA mRNA content of whole ovaries and granulosa cells (GC) in PRL-treated groups was lower than in the HCG-treated controls. The activities of PAI-1 in ovarian extracellular fluid (OEF) and PAI-1 mRNA in the theca-interstitial cells (TI) in the PRL-treated groups were higher than in the HCG- treated controls. The highest stimulation by PRL of PAI-1 activity in OEF and of PAI-1 mRNA in TI was observed at 9 h and 6 h after HCG treatment respectively. The localization of tPA and PAI-1 antigens in the ovaries was consistent with changes in the mRNA and activity levels. These data suggest that PRL temporarily delays, but does not completely inhibit, HCG-induced ovulation, which may be caused by a suppression of PA-mediated proteolysis.      

褪黑激素（N－乙酰基－5－甲氧基色胺）的合成

褪黑激素（Ｎ－乙酰基－５－甲氧基色胺）的合成段传凤，杨依军（中国农业科学院特产研究所吉林１３２１０９）褪黑激素（ｍｅｌａｔｏｎｉｎ）是脊推动物脑中松果腺体合成和分泌的一种吲哚类激素，最早由Ｌｅｒｎｅｒ等人［１］报道从牛松果腺中提取的吲哚类化合物中分离...     

The “No-touch” technique improves the survival of patients with advanced hepatocellular carcinomas treated by liver transplantation: A single-center prospective randomized controlled trial

Background: Liver transplantation(LT) is the best treatment for patients with hepatocellular carcinoma(HCC). However, the surgical technique needs to be improved. The present study aimed to evaluate the “no-touch” technique in LT. Methods: From January 2018 to December 2019, we performed a prospective randomized controlled trial on HCC patients who underwent LT. The patients were randomized into two groups: a no-touch technique LT group(NT group, n = 38) and a conventional LT technique group(CT ...     

Sweet's syndrome following surgery: Cutaneous trauma as a possible aetiological co‐factor in neutrophilic dermatoses

A 47‐year‐old man presented with an acute, cutaneous eruption of exquisitely painful papules at the operative site 4 weeks after a right tibial osteotomy. Initially this was managed as a postoperative wound infection; however the exacerbation and spread of the cutaneous eruption prompted further investigation. Histopathology and clinical findings were consistent with the development of Sweet's syndrome and resolution was obtained after the initiation of dapsone. We propose that surgery may produce an acute inflammatory response in a similar manner to pathergy reactions, which play an aetiological role in other neutrophilic dermatoses, such as pyoderma gangrenosum. We conclude that there may be greater overlap between these neutrophilic dermatoses than previously appreciated.     

高通量透析器用于血液透析对MHD患者血P及PTH的影响

1临床资料选择在我院门诊维持性血液透析的慢性肾衰(CRF)患者30(男19,女11)例,年龄19～78(50±16)岁.原发病分别为慢性肾小球肾炎12例,糖尿病肾病8例,高血压肾病3例,慢性间质性肾炎3例,痛风性肾病2例,多囊肾2例.均已透析3 mo以上,平均透析时间5.8 a,最长透析时间14 a.     

女性绝经期糖尿病血清性激素及胰岛素的变化

1临床资料根据WHO1998年标准,确诊糖尿病患者47例,年龄48~65(52±3)岁.其中合并高血脂及心脑血管硬化者36例.健康对照50例,年龄50~64(52±2)岁.性激素检测药盒由中美合资天津德普公司提供.胰岛素检测药盒由北京海科锐生物技术中心提供.07:00空腹卧位肘静脉采血标本3mL注入干燥管内,1h内离心(4℃),取上清液置-20℃保存待测.用放射免疫法测定血清雌二醇(E2),睾酮(T),孕酮(Pro)和胰岛素(Ins),由专人同时用仪器盲法测定.结果糖尿病患者血清Pro,E,T及Ins明显降低(表1).2讨论2型糖尿病机制主要是胰岛素抵抗(IR)和胰岛素分泌减少而引起的代谢…     

外伤所致连枷胸102例的护理分析

1临床资料我院1985/2001共收治外伤所致连枷胸患者102(男81,女21)例,男女比例3.9:1.年龄5~70岁,平均46.2岁.致伤原因:交通事故伤75例,高处坠落伤18例,挤压伤9例.开放性损伤22例,闭合性损伤80例.合并伤情况:血胸82例,气胸78例,肺挫伤93例,支气管断裂2例,创伤性窒息8例,脑挫伤5例,硬膜外血肿9例,胸骨骨折3例,四肢骨折40例,脊柱伤10例,脾脏损伤47例,肝脏损伤18例.