Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

The high prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma

BACKGROUND: Although many histopathologic factors in squamous cell carcinoma of the tongue predict the prognosis, the major predictive factors have not been identified clearly. This study analyzed the prognostic value of the histologic grade at the deep invasive front of tongue squamous cell carcinoma. METHODS: The clinicopathologic features of 124 consecutive patients seen between January 1985 and December 1999 with previously untreated squamous cell carcinoma of the tongue were reviewed. Their mean age was 58.5 years (range: 23-90) and the male-female ratio was 1.8: 1 (79 men and 45 women). There were 41, 40, 30, and 13 cases at stage I to stage IV, respectively. The clinicopathologic factors, especially the histologic grade at the deep invasive front (invasive front grade, IFG), were analyzed to determine factors predicting prognosis. RESULTS: The 5-year disease-free survival rate of the patients treated with curative aim only was 66.7%. Clinicopathologic factors significantly associated with the prognosis were T classification, tumor size, stage classification, tumor depth, macroscopic appearance, cervical lymph node metastasis (nodal metastasis), microvascular invasion, and IFG. In a multivariate analysis, patients with tumor depth >/=4 mm, IFG >/=8 points, and nodal metastasis had a reduced disease-free survival and IFG >/=11 points had a predictive value for nodal metastasis (odds ratio: 7.34; P = 0.0019). CONCLUSION: This study found that a high IFG malignancy score had a high prognostic value for squamous cell carcinoma of the tongue.     

大陷胸汤灌肠治疗流出急性肾衰的观察与护理

目的 探讨中药大陷胸汤高位保留灌肠对流行性出血热（EHF）急性肾衰的治疗作用。方法 将60例EHF急性肾衰患者随机分为对照组与治疗组各30例，对照组予以常规治疗，治疗组在常规治疗的基础上加用大陷胸汤高位保留灌肠，观察两组患者治疗前后的疗效。结果 治疗组治愈23例，好转6例，无效1例，总有效率96．7％；对照组治愈17例，好转7例，无效6例，总有效率80．0％；两组疗效比较，有显著差异性p〈0．05（x^2=4．630）。结论 大陷胸汤高位保留灌肠治疗EHF急性肾衰疗效显著，且简便、安全、经济、病人乐于接受等优点。     

Gamma-glutamyl transpeptidase activity during carcinogenesis of hamster buccal pouch epithelium

Gamma-glutamyl transpeptidase (GGT) activity has been demonstratedhistochemically in a number of experimentally induced neoplasmsand has been suggested as a label for potential precursors forthe development of squamous cell carcinomas. This study exploresthe kinetics of GGT-stained cell populations, their correlationwith the hypothesized initiated cells and evidence of malignanttransformation of epithelium in hamster buccal pouch by a 15-weekregime of tri-weekly topical application of 7,12-dimethylbenz[a]anthracene(DMBA) in mineral oil. GGT-positive foci were detected histochemicallyin tissue sections as early as 1 week after application of thecarcinogen, when there was no morphological evidence of dysplasia.The average number of the GGT-positive foci in each experimentalperiod was found to increase with time. Even though the majorityof the foci were small, consisting of only a single cell ora small group of cells, a few larger GGT-positive lesions werenoted, particularly in the later period of the experiment. Atotal of 66 grossly visible neoplasms were found. Thirty-sevenof these were submitted for GGT staining. Thirty-two (86.5%)of these showed patchy GGT activity, primarily in the superficialepithelial cells and/or the keratin. In the non-neoplastic epithelium,the GGT staining could involve any or all layers of cells. GGTactivity was not detected in untreated or mineral oil-treatedmucosa. The results of this study support the hypothesis thatGGT activity may label potential precursors for the developmentof squamous cell carcinomas.     

Effects of Applying Acupuncture Therapy at Baihui （GV 20） and Zusanli （ST 36） on the Behave of Mice and Rats in the Depression Model （Abstract）

Objective: To study the effects of acupuncture therapy on the behave of depression model.     

外科交接班存在的问题及对策

对于新病人。护理人员可为病人拟订护理计划并自己执行护理活动。但多数时间。护理人员是连续其他护理人员已执行的护理活动，因此交接班的好坏对护理质量有极大的影响。做好充分的交接班准备和一个能把握住重点的报告，可以得到真实完整的资料，使护理活动一开始就进入良好状况，保证原来护理工作的连续进行，提高护理质量。为此，2004年5月-2006年5月我科开始规范临床护理交接班工作，收到较好的效果。现将工作中存在问题进行分析并提出对策。     

T-lymphocyte subsets and serum carcinoembryonic antigen in patients with lung cancer and its dynamic changes after therapy]

Using the indirect immunofluorescent assay, we observed the variation of T-lymphocyte subsets of peripheral blood in 100 patients of primary bronchogenic carcinoma and 31 cases with active pulmonary tuberculosis. Serum CEA were measured simultaneously. The decrease of OKT3+, OKT4+, OKT8+ lymphocytes were significant in patients with lung cancer than that in healthy controls (P less than 0.01). The ratio of OKT4+/OKT8+ increased. It suggested that both cellular immunoincompetence and immunoregulatory abnormality were present in patients with lung cancer. After the resection of tumors 65 cases, the percentage of OKT4+ cells increased at the first week. Fourty seven cases were observed continuously for six months, it was found that OKT8+ cells increased (P less than 0.01). After anticancer chemotherapy, the patients with small cell carcinoma revealed a similar changes too. After operation and chemotherapy, serum CEA level decreased significantly too.     

148例口腔颌面部恶性肿瘤的临床统计及随访观察

本文将我科1974年至1983年收治的148例口腔颌面部恶性肿瘤就性别、年龄、发病部位、肿瘤性质以及所随访的102例口腔领面部恶肿瘤的存活率与肿瘤性质、部位、治疗等的关系进行了统计分析,并评价了冷冻治疗及颈淋巴结根治术。同时阐明了唇癌、皮肤癌淋巴结根治术的指征。     

介入治疗下肢深静脉血栓的临床应用

目的 探讨介入治疗下肢深静脉血栓(deep venous thrombosis,DVT)的效果. 方法 38例DVT均行深静脉置管接触性溶栓,12例联合血管球囊扩张及血管内支架置入术.按我院疗效观察标准:治愈,造影检查示血栓完全溶解,静脉壁光滑;显效,静脉回流通畅,静脉内有附壁血栓,管腔内径≥2/3;有效,静脉内仍有血栓残留,管腔内径＜2/3;无效,造影检查示静脉回流不通畅. 结果 治愈22例,显效14例,有效2例.治疗中无严重并发症发生.34例随访3～24个月,其中3～6个月7例,7～12个月12例,13～24个月15例,血栓复发2例,经再次深静脉置管接触性溶栓治疗后部分再通. 结论 介入治疗DVT操作简便,安全有效.