52例十二指肠粘膜活检组织病理学观察

观察５２例纤维胃镜咬取的十二指肠粘膜标本，组织学显示９８％有慢性炎，８０％为萎缩性炎。按粘膜绒毛高度和萎缩程度分轻、中、重３级。结合临床，中、重度萎缩性十二指肠炎，可作为小肠吸收不良的诊断依据。５２例中，有ＭＧＥ、Ｂｒｕｎｎｅｒ’ｓ腺增生分别为２１％和５０％。组织化学染色证实十二指肠杯状细胞含混合性粘液。     

红外线对萎缩性胃炎大鼠PCNA及Bcl-2表达的影响

目的 观察红外线照射在大鼠慢性萎缩性胃炎（chronic atrophic gastritis,CAG）中对增殖细胞核抗原（proliferating cell nuclear antigen,PCNA）和B细胞淋巴瘤/白血病-2（B-cell lymphoma-2,Bcl-2）表达的影响,探讨红外线与胃黏膜癌前病变、细胞凋亡的关系.方法 应用水杨酸钠和酒精的混合溶液灌胃,并结合劳累、饥饱失常等多因素建立大鼠CAG模型,采用红外线灯照射CAG大鼠,免疫组化法检测各组大鼠PCNA及Bcl-2的表达.结果 PCNA及Bcl-2在模型对照组胃黏膜中均呈高表达（P〈0.05）,但在红外线组均无显著降低.结论 红外线照射未能降低PCNA及Bcl-2 的表达,细胞的增殖调节改善作用不明显.     

Beyond Helicobacter: dealing with other variants of gastritis—an algorithmic approach

In daily practice, the presence of inflammation in gastric biopsies prompts a mental algorithm, an early question being whether the lesion present is Helicobacter‐associated. If Helicobacter organisms are not found, then there is a further algorithm, governed by the predominant type of inflammatory cells present, and the presence of other features such as intraepithelial lymphocytosis, a subepithelial collagen band, granulomas, coexisting chronic inflammation, focality, and superimposed reactive changes including erosions and ulcers. Each of these generates its own differential diagnosis. If no inflammation is present, then the two major changes specifically looked for are the changes associated with hypergastrinaemia, by far the most common cause of which is treatment with proton pump inhibitors, and reactive changes. These may be present with and without accompanying inflammation, and, when the epithelial changes dominate, the term gastropathy is preferred. In this article, we present an approach to non‐Helicobacter inflammation and gastropathies.     

萎缩性阴道炎危险因素

目的探讨萎缩性阴道炎发病的危险因素。方法应用1：1配对病例对照研究方法,对52例萎缩性阴道炎患者及52例配对的绝经后妇女进行危险因素调查和统计分析。结果筛选出与萎缩性阴道炎的发生危险因素有绝经年限〉10年、高体重指数、清洗外阴方式、反复尿路感染和补充雌激素（P〈0．05）,进行多因素Logistic回归分析显示入选变量为绝经年限〉10年（OR=10．82）、反复尿路感染（OR=3．64）、补充雌激素（OR=0．57）。结论绝经年限长和反复尿路感染是萎缩性阴道炎发生的危险因素,而补充雌激素有保护作用。     

环形外固定架联合骨膜烧灼构建大鼠胫骨萎缩性骨不连的新模型

文题释义：萎缩性骨不连：骨折修复过程完全停止,骨端萎缩吸收,骨痂无明显生长,髓腔封闭不通,断端之间无骨性连接,是骨折术后常见的并发症之一,其发生与骨折端周围血供破坏明显、固定不稳、感染、口服药物及全身因素相关。 动物模型：在医学研究中,在动物身上建立或形成类似人类疾病的模型,通过动物模型可直接或间接反映疾病的发生或发展过程,在了解疾病的基础上开创或改进疾病的治疗。 背景：建立标准萎缩性骨不连动物模型是研究萎缩性骨不连的发生机制与治疗的必要条件,而目前常见的造模方法不能准确模拟萎缩性骨不连的临床实际。 目的：构建一种新型萎缩性骨不连动物模型。 方法：30只雄性SD大鼠随机分成实验组和对照组,均行右侧胫骨中下段截骨,采用环形外固定架固定,维持4 mm 缺损间距;其中实验组烧灼截骨端周围1 mm骨膜,对照组不处理骨膜。实验于2018-01-02经广州中医药大学第一附属医院实验动物伦理委员会批准,批号：TCMF1-2018002。结果与结论：造模后每组分别出现1例外固定架松动,2组均未发生感染;影像学检查显示造模后6周,2组胫骨骨折断端间均无骨性连接,且无进一步愈合迹象;实验组第12周时影像学与组织学显示呈典型萎缩性骨不连表现;对照组第12周影像学显示8只模型呈现肥大性骨不连特征,6只模型影像学具有萎缩性骨不连特征。提示采用环形外固定支架配合烧灼断端骨膜可成功构建萎缩性胫骨骨不连模型。ORCID: 0000-0002-9406-3242(张严) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Microarray analysis of gastric mucosa among children with Helicobacter pylori infection

Background: Although initial infection with Helicobacter pylori may occur before 5 years of age, the pediatric mucosal immune response against H. pylori is not clear. The aim of the present study was to evaluate immune responses in the H. pylori‐infected gastric mucosa of children using microarray and real‐time polymerase chain reaction (PCR) analysis of pediatric gastric samples. Methods: Gastric samples were obtained from 12 patients undergoing routine endoscopy of chronic abdominal complaints. Six patients (three boys, three girls) aged 10.1–14.6 years had evidence of H. pylori infection, and the remaining six (three boys, three girls) aged 10.3–15.5 years had no evidence of infection and presented no histological changes associated with gastritis. Microarray and real‐time PCR analyses were performed, and the changes in gene expression‐related immune response were also analyzed. Results: Using microarray analysis, the total number of significantly upregulated and downregulated genes (fold change >5, P < 0.01) was 21 in the antrum and 16 in the corpus when comparing patients with or without infection. Using real‐time PCR, the expression of lipocalin‐2 (Lcn2), C‐C motif chemokine ligand (CCL) 18, C‐X‐C motif chemokine ligand (CXCL) 9 and CXCL11 was upregulated, while the expression of pepsinogen (PG) I and PGII was downregulated when comparing patients with or without infection. Conclusions: Lcn2, CCL18, CXCL9, CXCL11, PGI and PGII play important roles in childhood H. pylori infection.     

Bone Graft Healing in Reconstruction of Maxillary Atrophy

Purpose: Evaluate correlations between volume change for iliac crest bone grafts in maxillary reconstruction (graft volume change [GVC]) and bone mineral density (BMD), bone volume fraction (BVF), hematologic bone metabolic factors (I), and identify indicators of implant failure (II). Material and Methods: Forty‐six consecutive patients had their edentulous atrophic maxilla reconstructed with free autogenous bone grafts from anterior iliac crest. Endosteal implants were placed 6 months after graft healing. Computer tomography was performed after 3 weeks and 6 months after grafting. Bone biopsies were taken from the internal table of donor site for calculation (BVF), and blood samples were collected. Implant stability was measured at placement with resonance frequency analysis and expressed as implant stability quotient (ISQ). Implant failure was registered. Results: GVC in onlay bone graft was 37%. The BVF in iliac crest biopsies was 32%. Serum‐IGFBP3 differed with 79% of the samples over normal range. Fifteen patients had one or more implant failures prior to loading (early failures). Forty‐two patients were followed for a minimum of 3 years after implant loading and, in addition, 6/42 patients had one or more implants removed during the follow‐up (late failures). GVC correlated to decreased BMD of lumbar vertebrae L2‐L4 (Kruskal–Wallis test, p = .017). No correlation was found between GVC and hematologic factors (Pearson correlation test) or between GVC and BVF (Kruskal–Wallis test). No correlation was found between ISQ and GVC (Pearson correlation test, p = .865). The association between implant failures and the described factors were evaluated, and no significant correlations were found (unconditional logistic regression). Conclusion: Onlay bone grafts decrease 37% during initial healing period, which correlate to BMD of lumbar vertebrae L2‐L4. No other evaluated parameters could explain GVC. The evaluated factors could not explain implant failure.     

胃窦部病理改变的血液流变学研究

慢性萎缩性胃炎（简称ＣＡＧ）是一常见多发病。目前与胃癌的关系尚未定论。但重度腺体萎缩伴胃粘膜肠化及非典型增生做为癌前表现这一点已被许多学者公认。因此，本文对ＣＡＧ窦部病理改变者进行了血液流变性观察。