三级医院病人就诊流向探讨

研究通过对包括专科医院在内的多家三级医院住院病人资料的分析，将疾病种类按ICD－9编码分为19类，研究各类疾病应往低级别医院分流的比例。结果表明：各大类疾病的分流比例不同，分流比例较高的主要是常见病和多发病，总的分流比大约在60％左右。     

尿激酶溶栓对大鼠局灶性脑缺血基质金属蛋白酶-9表达的影响

目的研究大鼠局灶性脑缺血后应用尿激酶(urokinase,UK)溶栓对基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)表达的影响,探讨MMP-9在UK溶栓引起的再灌注损伤及出血性转化中的作用。方法将实验动物随机分成3组进行研究(1)UK溶栓组;(2)缺血对照组;(3)假手术组。分别用免疫组织化学方法分析3组缺血后24hMMP-9的表达,对比研究两组MMP-9表达的差异性。结果缺血后24h前两组均有MMP-9的表达,但是UK溶栓组表达的程度明显高于缺血对照组;假手术组无MMP-9的表达。结论(1)缺血能导致MMP- 9的表达。(2)UK溶栓引起MMP-9表达的上调。     

不同种属脱细胞真皮与自体皮复合移植的比较性研究

目的　观察不同种属脱细胞真皮基质 (acellulardermalmatrix,ADM)与自体皮复合移植的效果 ,为异种ADM的临床应用提供理论依据。　方法　本地产白色小猪 6头 ,分为异种 (人 )ADM +自体刃厚皮组 (A组 )、同种异体 (猪 )ADM +自体刃厚皮组 (B组 )、单纯自体刃厚皮组 (C组 )及单纯自体中厚皮组 (D组 )。观察术后 2、4、8、12、2 4周内移植物存活率 ,以及移植皮片收缩程度、移植区组织学变化等情况。　结果　A、B组移植后皮片外观光滑、有弹性 ;两组均获得了满意的皮片成活率 ,并可迅速诱导成纤维细胞、血管内皮细胞等宿主修复细胞的长入 ;两组移植皮片收缩面积有大于C、D组的趋势 (P <0.0 5);术后 2 4周移植区组织与单纯中厚皮移植组织结构一致。　结论　在观察期内(复合移植后 2 4周 ) ,与自体皮复合移植时 ,同、异种ADM具有相近的生物学作用 ,异种来源的ADM可能具有更广阔的应用前景     

Sural nerve biopsies in Guillain-Barre syndrome: axonal degeneration and macrophage-associated demyelination and absence of cytomegalovirus genome.

T-cell infiltration was detected by immunohistochemistry in only 2 of 10 sural nerve biopsies from patients with Guillain-Barré syndrome (GBS). The number of endoneurial macrophages, identified by the monoclonal antibody MAC 387, was increased, compared with the number in 10 cases of axonal neuropathy. Macrophage-associated demyelination was identified in 7 and axonal degeneration in 8 cases. Cytomegalovirus (CMV) genome was not detected with the polymerase chain reaction.     

Role of the extracellular matrix in neural crest cell migration

Development of the neural crest involves a remarkable feat of coordinated cell migration in which cells detach from the neural tube, take varying routes of migration through the embryonic tissues and then differentiate at the end of their journey to participate in the formation of a number of organ systems. In general, neural crest cells appear to migrate without the guidance of long-range physical or chemical cues, but rather they respond to heterogeneity in the extracellular matrix that forms their migration substrate. Molecules such as fibronectin and laminin act as permissive substrate components, encouraging neural crest cell attachment and spreading, whereas chondroitin sulphate proteoglycans are nonpermissive for migration. A balance between permissive and nonpermissive substrate components seems to be necessary to ensure successful migration, as indicated by a number of studies in mouse mutant systems where nonpermissive molecules are over-expressed, leading to inhibition of neural crest migration. The neural crest expresses cell surface receptors that permit interaction with the extracellular matrix and may also modify the matrix by secretion of proteases. Thus the principles that govern the complex migration of neural crest cells are beginning to emerge.     

Distribution of extracellular matrix components and their receptors in human lymphoid tissue and B-cell non-Hodgkin lymphomas

In this study the distribution patterns of various extracellular matrix components and their receptors (i.e. β1 integrins) in B-cell non-Hodgkin lymphomas were examined and compared to those in reactive lymphoid tissue. Neoplastic follicles within follicular lymphomas showed similar patterns to that observed in reactive follicles, which appeared to be strongly associated with the presence of follicular dendritic cells. Diffuse lymphomas of low and intermediate malignancy grade revealed features comparable to those of interfollicular areas of reactive lymphoid tissue, irrespective to which compartment the tumour cells were related. Highly malignant lymphomas, however, displayed unique extracellular matrix configurations, resulting from active matrix degradation by macrophages; this may support rapid tumour growth. Extranodal lymphomas showed virtually the same matrix patterns as their nodal counterparts, suggesting that (malignant) lymphoid cells generate (at least partly) their own specific microenvironment. In reactive lymphoid tissue β1 integrins were mainly found on resident cells and except for α4, α5 (and β1) the lymphoid cells expressed very little, if any, β1 integrins. In comparison, expression of these integrins on lymphoma cells was reduced (follicular lymphomas) or could not be detected at all (diffusely growing lymphomas); this might contribute to the growth pattern and metastatic properties of the tumours.     

异种骨基质明胶(BMG)诱导成骨活性的实验研究

本文按着 Urist 方法制备了人、兔、猪和羊四种骨基质明胶(BMG),分别将其植入25只成年 SD 大鼠的胸部和股部肌肉,在手术的第2、4、6和8周后,通过光学显微镜观察各种 BMG 在肌肉内的免疫排斥反应和诱导成骨活性。结果表明:异种 BMG 具有一定的诱导成骨能力。但在 BMG 周围亦出现程度不同的排斥反应。本文认为,进一步降低 BMG 的抗原性,提高其诱导成骨活性,对于异种 BMG的临床应用将具有重要意义。     

Nutrition et fonction immunitaireNutrition and immune function

A deficiency of total energy or of one or more essential nutrients, including vitamins A, B₆, B₁₂, C, and E, folic acid, zinc, iron, copper, selenium, essential amino acids and essential fatty acids, will impair immune function and increase susceptibility of the host to infectious pathogens. This is most likely because these nutrients are involved in the molecular and cellular responses to challenge of the immune system. Providing these nutrients to deficient individuals restores immune function and improves resistance to infection. Thus, appropriate nutrition is required in order for the host to maintain adequate immune defences towards bacteria, viruses, fungi, parasites and tumour celîs. Although the intakes of several nutrients which result in greatest enhancement of immune function appear to be greater than recommended intakes, excess intake of certain nutrients also impairs immune responses. Some nutrients (e.g. glutamine, arginine) may become limiting in critical illness and there is mounting evidence that provision of these will aid patient recovery.     

前列腺癌组织中细胞外基质的免疫组织化学研究

为探讨前列腺癌（ＰＣａ）细胞的转移机制，应用免疫组织化学ＡＢＣ法在良性前列腺增生（ＢＰＨ）及ＰＣａ组织中对基膜连接蛋白（ＬＮ），胶原Ⅳ型蛋白（ＣＯＬⅣ），纤维连接蛋白（ＦＮ）等细胞外基质（ＥＣＭ）蛋白的表达进行检测，结果ＢＰＨ组织中基底膜部位ＬＮ，ＣＯＬⅣ及ＦＮ的染色呈连续线状分布，ＰＣａ组组织基底膜部位ＬＮ，ＣＯＬⅣ及ＦＮ的阳性染色呈碎片状或断线状分布。ＣＯＬⅣ在ＢＰＨ与ＰＣａ组织中的强阳性率无显著性差异（Ｐ＞０．０５）。结果提示ＥＣＭ在ＰＣａ组织中基底膜部位的明显缺失（非连续线状分布）可能是肿瘤转移的重要因素。     

Treatment of diabetic polyneuropathy with the neurotrophic peptide ORG 2766

The efficacy of the neurotrophic peptide ORG 2766 in diabetic patients with polyneuropathy was evaluated in a double-blind, placebo-controlled, multicentre trial. One hundred and twenty four patients were randomised in five groups to receive 0.1, 0.4, 2 or 5 mg ORG 2766 or placebo, once daily, administered subcutaneously 52 weeks. Thermal discrimination thresholds (TDT) and vibration perception thresholds (VPT), motor and sensory nerve conduction velocity, Hoffmann reflex, heart rate variation during deep breathing and heart rate response after standing up, neurological examination score and neuropathic symptom score were determined at baseline and after 17, 34 and 52 weeks of treatment. Of the nerve function indices studied, at week 52 the TDT_warmth of the hand in the ORG 2766 0.1, 0.4 and 5 mg groups and the TDT_cold of the foot in the ORG 2766 0.1 and 0.4 mg groups significantly improved compared with placebo. Further significant improvement as compared with placebo was observed in the paraesthesia score at week 34 and week 52 in the ORG 2766 2 mg group. Only at week 34 had both the heartbeat variation during deep breathing and the VPT of the foot in the ORG 2766 0.1 mg group improved significantly, compared with placebo. No further statistically significant differences were observed at time for the other measures. No adverse reactions were observed. The only recorded drug-induced side effect was pain at the injection site. Taking all measures of efficacy into account, the statistically significant results observed did not show consistency within each measure. Therefore, it is concluded that ORG 2766, in contrast to earlier reports, is not effective in treating diabetic polyneuropathy.