Présent et futur de la thérapie cellulaire des brûlures

Severe burned patients need definitive and efficient wound coverage. Outcome of massive burns has been improved by using cultured epithelial autografts (CEA). Despite fragility, percentages of success take, cost of treatment and long-term tendency to contracture, this surgical technique has been developed in few burn centres. First improvements were to combine CEA and dermis-like substitute. Cultured skin substitutes provide earlier skin closure and satisfying functional result. These methods have been used successfully in massive burns. Second improvement was to allow skin regeneration by using epidermal stem cells. Stem cells have capacity to differentiate into keratinocytes, to promote wound repair and to regenerate skin appendages. Human mesenchymal stem cells contribute to wound healing and were evaluated in cutaneous radiation syndrome. Skin regeneration and tissue engineering methods remain a complex challenge and offer the possibility of new treatment for injured and burned patients.     

卡介苗对支气管哮喘大鼠气道炎症的预防治疗作用及机制研究

目的 探讨卡介苗（BCG）对支气管哮喘气道炎症发生的预防治疗作用及机制.方法 Wistar雄性大鼠40只随机分为对照组、哮喘组、卡介苗治疗组（BCG组）、地塞米松治疗组（地米组）、卡介苗接种组（BCG接种组）,每组8只.除对照组外余各组每只大鼠于实验第1、8天腹腔注射10％卵白蛋白抗原混悬液致敏,第15天始超声雾化吸入1％卵白蛋白,20 min/d,共2周,制备哮喘气道炎症模型,各治疗组每次雾化前0.5h分别给予BCG、地米;卡介苗接种组在OVA致敏前7、3、1d,每只大鼠分别皮内注射BCG,余治疗同对照组用蒸馏水替代.各组于末次激发24 h后收集标本,检测大鼠支气管肺泡灌洗液（BALF）细胞总数及嗜酸性粒细胞（EOS）计数;HE染色观察气道重塑情况,计算机图像分析气道形态学参数,衡量气道重塑程度;ELISA法检测肺泡灌洗液及血清中转化生长因子-β1（TGF-β1）含量;免疫组织化学（SABC）法检测E钙黏蛋白（E-cadherin）、α平滑肌肌动蛋白（α-SMA）、纤维连接蛋白（Fibronectin）的表达.结果 哮喘大鼠支气管肺泡灌洗液细胞总数及嗜酸性粒细胞计数明显增多;HE染色光镜下可见哮喘组支气管管壁变厚、气道变窄,气道上皮受损肿胀,部分可见脱落;哮喘组BALF及血清中TGF-β1含量增加,上皮标志物E-cadherin表达下降,间质的标志物Fibronectin、α-SMA表达增加;BCG和地米治疗组及BCG接种组,BALF细胞总数、EOS计数及气道改变程度等较哮喘组明显减轻,BALF及血清TGF-β1含量较哮喘组下降,E-cadherin表达升高,Fibronectin、α-SMA的表达下降,与哮喘组、对照组相比差异均有统计学意义（P＜0.01）.结论 ①变应原刺激导致TGF-β1分泌增加,进而引起上皮细胞损伤间质转化是导致哮喘性气道炎症形成的重要机制之一;②卡介苗通过免疫调节作用减轻TGF-β1所致的气道上皮细胞损伤及间质转化对哮喘性气道炎症和气道阻?     

Intracerebral monitoring of a patient with vasopasm

Delayed neurological deficit occurs among 30% of patients after aneurysmal subarachnoid haemorrhage, mainly related to cerebral vasospasm. The early detection of cerebral ischemia remains problematic. Conventional cerebral monitoring (as intracranial pressure and cerebral perfusion pressure) appears to be insufficient, because cerebral ischemia may occur without elevated intracranial pressure. Global cerebral monitoring as venous jugular oxygen saturation are useful for regional monitoring. Local monitoring as oxygen tissue partial pressure (PtiO2) and microdialysis are sensible for brain ischemia detection, but may also ignore episodes occurring in non-monitored brain area. For the detection of most episodes of brain ischemia, several monitoring system should be use performing a multimodal intracerebral monitoring. Brain microdialysis and oxygen tissue partial pressure are promising monitoring system.     

(E)TUDE APPLIQ(E)E DE ENC(E)PHALE ATLAS DANS MALADES AVEC INFARCTION C(E)R(E)BRALE

目的:探讨脑电地形图在脑梗死中的应用价值。方法:在43例脑梗死患者中,进行了脑电地形图和脑CT检查,并进行了对比。结果:脑电地形图和脑CT的改变是一致的,但脑电地形图改变早于脑CT。结论:脑电地形图在脑梗死患者中有重要的应用价值。     

美丽芍药叶绿体全基因组解析及系统发育分析

本研究利用Illumina HiSeq X Ten测序平台对芍药属药用植物美丽芍药进行了叶绿体全基因组测序,通过生物信息学分析方法进行序列组装、注释和特征解析,并将其与芍药属其他11种植物的叶绿体全基因组进行了比较基因组学和系统发育分析。结果显示,美丽芍药叶绿体基因组全长152 731 bp, GC含量为38.4%,具有被子植物叶绿体基因组典型的四分体结构,包括一个大单拷贝区(large single copy, LSC)、一个小单拷贝区(small single copy, SSC)和一对反向重复区(inverted repeat sequence, IRa/IRb),长度分别为84 402、16 969和25 680 bp;共注释得到136个基因,包括90个蛋白编码基因, 38个tRNA基因和8个rRNA基因,其中7个蛋白编码基因、7个tRNA基因和4个rRNA基因分别在反向重复区发生了一次重复;此外,在美丽芍药叶绿体基因组中共检测出28个散在重复序列(dispersed repeats)、10个串联重复序列(tandem repeats)和64个简单重复序列(simple sequence repeats, SSRs)。芍药属12个物种的叶绿体基因组在大小、基因组成和排列顺序、GC含量等方面高度保守;同时,非编码区(包括基因间区和内含子)序列的种间变异高于蛋白编码基因序列, LSC区和SSC区序列变异高于IR区。系统发育分析结果以100%的支持率支持美丽芍药与芍药、草芍药和川赤芍共同构成一个单系分支,并与芍药亲缘关系最近。本研究首次报道了美丽芍药叶绿体全基因组,对其序列变异及结构特征进行了解析,并基于叶绿体全基因组序列构建系统发育树,明确了美丽芍药在芍药属内的系统发育位置,研究结果将为美丽芍药的保护遗传学和资源开发利用等研究提供理论基础。     

Les développements de la thérapie cellulaire de l''an 2000

For the past thirty years, hematology has switched from the concept of bone marrow transplantation to the concept of hematopoietic stem cell (HSC) transplantation, from allograft to autograft, from non-manipulated graft to hyper-selection, from hematopoietic cellular therapy to immunotherapy. Indications of these transplantations are now more clear for malignant diseases and are ongoing for auto-immune diseases. A better knowledge of the HSC allows the control of their proliferation and differentiation, opening the field of ex vivo expansion. Very recently, new stem cells have been identified, establishing that a differentiated cell retain its totipotency: a nervous system cell can differentiate into HSC, which will further give hematopoiesis, mesenchymental cells or hepatocytes. New tools are under development: human ES cells, biomaterials, functionalized materials, opening the field of cellular engineering in the year 2000.     

The incidence of giant cell arteritis in Ontario,Canada

Objective

The incidence of giant cell arteritis (GCA) is insufficiently documented for Canada, but important to ascertain for public health planning. We estimate the incidence of biopsy-proven GCA (BPGCA) in Kingston, Ontario, and for the province of Ontario.

L’exploration axillaire : un standard du bilan préthérapeutique<br/>Axillary Evaluation: a Standard in Pretreatment Staging

Axillary evaluation is a major step in the initial staging of breast cancer. Ultrasound guided biopsy is currently recommended in first-line. MRI and 18FDG PET/CT are useful in axillary lymph node evaluation. Imaging sensitivities and specificities are globally identical and their combination allows obtaining the best performances. Currently, sentinel node technique is essential in case of T1-T2 N0 mammary tumors and in case of suspected lymph node adenopathy with negative cytopuncture or microbiopsy.


Résumé
L’exploration préthérapeutique axillaire est une étape majeure du bilan initial du cancer du sein. L’échographie associée à un prélèvement est actuellement recommandée en première intention. L’IRM et la TEP/TDM au 18FDG sont utiles dans l’évaluation ganglionnaire axillaire. Les sensibilités et spécificités des examens d’imagerie sont globalement identiques, et leur combinaison permet d’obtenir les meilleures performances. Actuellement, la technique du ganglion sentinelle est indispensable en cas de tumeurs mammaires T1-T2 N0 et en cas d’adénopathie suspecte échographiquement avec cytoponction ou microbiopsie négative.