早期声门癌显微手术治疗的临床观察

目的 提高早期声门癌患者术后生存质量,获得良好的发音效果。方法 在支撑喉镜、显微镜下对２２例早期声门癌（Ｔ１ａ１６例,原位癌６例）患者采用激光探刀切割,为了避免残留肿瘤,采用激光探头对创面及切缘汽化,并对术前、术后进行声学参数的客观分析及纤维喉镜检查,评估声带情况。结果 术后３年复发率为９．０％（２／２２）,３、４、５年生存率分别为１００％、９４．７％、９３．３％。患者术后比术前嗓音明显好转,但不     

Effect of superantigen on ion electrophysiology and permeability in rabbit maxillary sinus epithelia

Objective Superantigens are potent inflammatory stimuli which derive from pathogenic microbes such as bacteria, viruses and protozoa. The aim of this study was to investigate the role of superantigens on the function of rabbit maxillary sinus epithelium. Methods Twenty New Zealand white rabbits were divided into 4 groups. Rabbit sinus mucosa was separated under a surgical microscope and mounted in Ussing chambers to record short circuit current, conductance and permeability to horseradish peroxidase (HRP). Group A was used as normal control. Group B was stimulated with an injection of superantigen into the sinus for 4 hours. The sinus mucosa of Group C was stimulated by the addition of tumor necrosis factor α (TNF-α) into Ussing chambers. Group D sinus mucosa was stimulated by superantigen after pretreatment with anti-TNF-α antibody. Results Superantigen evoked increases in sinus epithelial cell baseline short circuit current, conductance and permeability to HRP stimulated by the addition of TNF-α into Ussing chambers. These were similar to results from superantigen stimulation in vivo. The effect of superantigen on sinus epithelial cells could be blocked by pretreatment with anti-TNF-α antibody. Conclusions Superantigen affected the function of sinus epithelial cells, including the capability of epithelial defensive barrier, which might be mediated by TNF-α.     

The role of bDMARDs in idiopathic inflammatory myopathies: A systematic literature review

Idiopathic inflammatory myopathies (IIM) are a group of different conditions typically affecting striate muscle, lung, joints, skin and gastrointestinal tract. Treatment typically relies on glucocorticoids and synthetic immunosuppressants, but the occurrence of refractory, difficult to treat, manifestations, may require more aggressive treatment, borrowed from other autoimmune diseases, including biologic disease modifying drugs (bDMARDs). In this regard, we conducted a systemic literature review in order to depict the current evidence about the use of bDMARDs in IIM. A total of 78 papers, published during the last 21 years, were retrieved. The majority of patients was treated with TNF-α inhibitors, whose effectiveness was assessed particularly in recalcitrant striate muscle, skin and joints involvement. Rituximab, whose evidence is supported by a large number of real-life studies and trials, seems to be an excellent option in case of ILD and anti-synthetase syndrome, while Tocilizumab, despite not meeting primary and secondary endpoints in a recently published clinical trial, proved its effectiveness in rapidly progressing ILD. Similarly, Abatacept, studied in a phase IIb clinical trial with conflicting evidence, was reported to be effective in some case reports of refractory dermatomyositis. Less data exist for anti-IL1 and anti-IL23 agents, which were employed particularly for inclusion body myositis and severe skin disease, respectively. This study provides an organ-focused assessment of bDMARDs in IIM, which display encouraging results in the treatment of refractory subsets of disease.     

Low-dose interleukin-2 treatment increases the proportion of regulatory T cells in patients with rheumatic diseases: A meta-analysis

BackgroundIt is now accepted that immune tolerance disorders caused by inadequate Treg cell function or number are important factors in the development and progression of rheumatic diseases. There is increasing evidence that ld IL-2 treatment increases the proportion of Treg cells in patients' peripheral blood, but this conclusion is still controversial. Here, we performed a meta-analysis of reports documenting the proportion of Treg cells and the rate of adverse events in patients with rheumatic disease before and after the administration of ld IL-2 to better understand its effect and safety on Treg cells in the field of rheumatic diseases.MethodsWe systematically searched PubMed, Embase, Scopus, Cochrane Library, and Web of science databases up to 15th November 2022 and identified studies that reported the proportion of peripheral blood Treg cells before and after ld IL-2 treatment in patients with rheumatic disease. Random-effects model was used to perform a meta-analysis of Treg cell proportions before and after ld IL-2 administration, and a meta-regression analysis was performed to explore heterogeneity. Inconsistency was evaluated using the I-squared index (I²), and publication bias was assessed by examining funnel plot asymmetry using the Egger tests.ResultsEighteen studies involving 1608 patients were included in the meta-analysis. The proportion of Treg cells in peripheral blood of these patients increased significantly after receiving ld IL-2 treatment [1.07 (95% CI 0.86,1.27), p < 0.001, I² = 67.3%]. Next, Meta-regression was performed for 5 variables including publish year, disease type, trail type and dosage and duration of the medication. The results suggest that these variables do not lead to high heterogeneity. (p = 0.698, 0.267, 0.502, 0.843, 0.560, respectively). And finally, statistical analysis showed no difference in adverse reactions between ld IL-2 group and control group in treatment [1.06 (95% CI 0.86,1.31), p = 0.586, I2 = 53.8%], which is unreliable because the data is so small.ConclusionsLd IL-2 does increase the proportion of peripheral blood Treg cells in patients with rheumatism, and single and cumulative doses must be considered when using ld IL-2. In addition, more studies on the safety of ld IL-2 are urgently needed.     

膀胱移行细胞癌微卫星不稳定性及其机制的研究

目的　探讨膀胱移行细胞癌 (BTCC)染色体微卫星不稳定性的表现及与基因突变的关系。方法　采用聚合酶链反应 (PCR)方法检测 4 0例 BTCC患者 5个微卫星位点的改变 ,同时用同样的方法检测癌组织中BAX基因和转化生长因子 (TGF) - β 型受体基因移码突变的情况。结果　至少发生一个微卫星位点改变的阳性率为 82 % (33/ 4 0 ) ,D9S16 2、D16 S4 76、D9S5 4、FGA和干扰素 (IFN) - A1位点改变各自的阳性率分别为 5 8%(2 3/ 4 0 )、 4 2 % (17/ 4 0 )、 38% (15 / 4 0 )、 4 8% (19/ 4 0 )和 5 5 % (2 2 / 4 0 ) ,阳性检出率与良性病变差异有显著性 ,与肿瘤的分期分级无显著相关性。发生微卫星改变的 33例中 ,33% (11/ 33)和 4 2 % (14 / 33)分别可见 TGF- β 型受体基因和 BAX基因的移码突变。结论　检测染色体微卫星的改变是 BTCC早期诊断、监测复发的有效手段 ,染色体微卫星改变可能是 BTCC发生过程中多基因突变的一种表现形式     

抑癌基因p15、Rb在喉鳞状细胞癌中表达的研究

目的 :研究抑癌基因p15、Rb蛋白表达对喉鳞状细胞癌诊断、治疗及预后判断的意义。方法 :用免疫组化SABC法检测喉癌组 45例石蜡标本与对照组 15例喉部正常或增生的黏膜上皮标本的 p15、Rb蛋白表达情况。结果 :喉鳞状细胞癌组p15蛋白阳性率 (48.9%)与对照组阳性率 (10 0 .0 %)比较 ,差异有极显著性意义 (P<0 .0 1) ;喉癌组中 0～Ⅱ期 p15蛋白阳性率 (6 6 .7%)与Ⅲ～Ⅳ期阳性率 (33.3%)比较 ,差异有显著性意义 (P <0 .0 5 ) ;喉癌组Rb蛋白阳性率 (88.9%)与对照组阳性率 (93.3%)比较 ,差异无显著性意义 (P >0 .0 5 ) ;2× 2列联表 χ2 检验 ,p15、Rb蛋白表达无相关性 (P >0 .0 5 ) ;对照组中 ,p15蛋白的表达以鳞状上皮组织中远离基膜的棘层细胞、颗粒层细胞明显 ,而Rb蛋白的表达则以基底层细胞及近侧棘层细胞明显。结论 :抑癌基因 p15的表达缺失对喉鳞状细胞癌的发生、发展有一定的作用 ,p15蛋白的检测对喉鳞状细胞癌的治疗及估计预后有指导意义 ;喉鳞状细胞癌组织中 p15、Rb的蛋白表达无相关性 ;正常及增生的喉部鳞状上皮的细胞层次间 ,p15、Rb蛋白表达不一致 ,p15蛋白表达对细胞增殖有抑制作用。     

精氨酸对大鼠急性肝损伤微循环和血液流变学的影响

目的探讨外源性精氨酸对硫代乙酰胺(thioacetamide,TAA)所致急性肝损伤微循环和血液流变学数据的影响。方法采用Wistar大鼠30只(雌雄各半),随机分为4组,即正常组(N组);精氨酸灌胃组(L-arg组);精氨酸灌胃+急性肝损伤组(L-arg+TAA组);急性肝损伤组(TAA组)。采用普利生全自动旋转式血液黏度计和血小板聚集仪分别测定全血黏度和最大血小板聚集率,同时测肝组织匀浆一氧化氮(NO)、丙二醛(MDA)、超氧化物歧化酶(SOD)及血栓素B2(TXB2)的含量,做Weigert改良革兰法特殊染色,光镜观察血管内微血栓并计数分析。结果L-arg组与其他3组相比,全血黏度、最大血小板聚集率及微血栓计数均明显降低(P<0.05), L-arg+TAA组与TAA组相比前组上述指标也明显降低(P<0.05)。L-arg组肝匀浆MDA、TXB2含量低于L-arg+TAA组,L-arg+TAA组低于TAA组,而SOD均为前组高于后组。结论给予外源性精氨酸后,SOD增加,MDA、TXB2降低,微血栓数减少,全血黏度和最大血小板聚集率降低,改善了肝微循环和血液流变学状况。     

中药双利肝在肝纤维化与肝硬化形成中的作用

目的探讨中药双利肝在肝纤维化与肝硬化发展中的作用。方法采用大鼠饮用TAA(0.03%)4个月复制肝硬化动物模型,从第4个月始加用中药双利肝合剂灌胃,进行内毒素水平、肿瘤坏死因子(TNF)-琢、内皮素(ET)-1及一氧化氮(NO)的检测,以及组织学观察。结果用中药双利肝治疗后,内毒素水平、TNF-琢、ET-1及NO均有明显下降;肝组织胶原蛋白含量显著减少。结论中药双利肝通过抑制细胞因子介导的细胞-细胞相互作用所引起的肝星状细胞(HSC)激活,从而间接抑制肝纤维增生。     

P物质对变应性鼻炎动物模型鼻粘膜上皮短路电流的影响

目的观察Ｐ物质（ＳＰ）作用于变应性鼻炎动物模型鼻粘膜引起的离子分泌改变导致的上皮表面短路电流（Ｓｈｏｒｔ－ｃｉｒｃｕｉｔｃｕｒｒｅｎｔ，Ｉｓｃ）的变化。方法以鸡蛋清蛋白致敏大鼠后，用Ｕｓｓ－ｉｎｇ室技术测定鼻粘膜上皮表面短路电流。并观察神经激肽受体（ＮＫ１）拮抗剂ＣＰ９６３４５、组胺Ｈ１受体拮抗剂吡拉明、Ｈ２受体拮抗剂雷尼替丁和河豚毒素对ＳＰ的阻断作用。结果经ＳＰ刺激，致敏大鼠鼻粘膜表面Ｉｓｃ显著增高。经四种物质预处理均能显著阻断ＳＰ引起的Ｉｓｃ变化。结论ＳＰ经感觉神经末梢释放后，可引起上皮表面离子电位变化、上皮通透性增高等一系列鼻粘膜病理变化。     

长春西汀注射液对实验性短暂脑缺血样发作磷脂水平的影响

目的 :研究长春西汀注射液对实验性短暂性脑缺血发作 (TIA)磷脂水平的影响。方法 :尾静脉注射过氧化物建立小鼠TIA模型 ,腹腔注射不同剂量的长春西汀 ,诱发 2次TIA后隔日断头取血测定血浆中溶血磷脂酸 (LPA)和酸性磷脂 (PA)的含量。结果 :实验对照组的评分为 7.0 90± 0 .6 96 ,给予0 .7mg·kg-1·d-1长春西汀后 ,评分为 3.5 76± 0 .5 6 9(P <0 .0 5 )。TIA组小鼠血浆中LPA比对照组明显升高 ,两组分别为 6 .30 5± 0 .190和 2 .170±0 .12 3μmol·L-1。长春西汀可逆转这一变化 ,为4 .5 2 3± 0 .4 0 6 μmol·L-1。TIA组小鼠血中PA比对照组明显升高 ,两组分别为 9.10 0± 0 .185和 3.80 1± 0 .2 5 7U ,而长春西汀组中PA可降至 6 .972±0 .2 4 7U。结论 :实验性TIA样小鼠出现血浆LPA和PA水平的异常。长春西汀有逆转作用 ,可用于缺血性脑血管病的治疗。