Histological score for cells with irregular nuclear contours for the diagnosis of reflux esophagitis in children

Histological criteria for the diagnosis of reflux esophagitis include basal zone hyperplasia, stromal papillae elongation, and inflammatory infiltrate. However, endoscopic esophageal biopsy specimens may include little or no lamina propria. Intraepithelial T lymphocytes, seen in hematoxylin and eosin-stained sections as cells with irregular nuclear contours (CINC), may have a higher density in children with esophagitis. We evaluated the diagnostic accuracy of a numerical score built up by grading the "classical" parameters and its correlation with CINC density in grasp biopsy specimens obtained from children undergoing esophagogastroduodenoscopy with and without esophagitis. We analyzed esophageal biopsy specimens from 349 children (median age, 5 years) subdivided in 4 groups according to the previous routine histology report: group 1, 144 children with esophagitis; group 2, 65 controls; group 3, 51 children with dubious esophagitis; and group 4, 75 children with esophagitis on endoscopy but a normal histology report. A numerical value was assigned to each parameter; the sum of these values represented the histological score. We also evaluated intraepithelial CINC density (ie, number of CINC per high-power field). We separately analyzed histological sections with and without lamina propria. For both total score and for CINC density, we calculated a cutoff using a receiver operating characteristic curve. Cutoffs of 6 for score and of 4 for CINC density provided the best sensitivity and specificity. Sensitivity of the histological score was better in biopsy specimens containing lamina propria (94%) than in those without lamina propria (4%). Sensitivity of CINC density was satisfactory in both specimens with (78%) and without (75%) lamina propria. Specificity was satisfactory for both parameters. In conclusion, when lamina propria was present in sections of endoscopic esophageal biopsy specimens, histological score provided a better diagnostic accuracy for the diagnosis of esophagitis. However, when no lamina propria was present, as was the case in 67% of our children, CINC density had better sensitivity. In addition, this latter parameter showed esophageal mucosa damage in 34% of previously dubious cases or cases with esophagitis at endoscopy but a previous routine histology report of normal mucosa.     

Simultaneous quantitation of diphtheria and tetanus antibodies by double antigen, time-resolved fluorescence immunoassay

A dual, double antigen, time-resolved fluorescence immunoassay (DELFIA) for the simultaneous detection and quantitation of diphtheria (D) and tetanus (T) antibodies in sera has been developed. In the double antigen format one arm of the antibody binds to antigen coated microtitre wells and the other arm binds to labelled antigen to provide a fluorescent signal. This assay was found to be functionally specific for IgG antibodies and showed a good correlation with established toxin neutralization assays. Furthermore, the double antigen set-up was species independent, permitting the direct use of existing international references of animal origin to measure protective antibody levels in humans in international units (IU/ml). The detection limit corresponded to 0.0003 IU/ml with Eu³⁺-labelled toxoids and to 0.0035 IU/ml using Sm³⁺-labelled toxoids. The assay was fast with a high capacity making it a suitable method for serological surveillance studies.     

乙型肝炎表面抗原对BALB/c小鼠细胞免疫应答的影响

目的研究不同来源乙肝表面抗原(HBsAg)对BALB/c小鼠的某些细胞免疫应答的影响.方法采用血源、CHO和酵母HBsAg分别免疫BALB/c小鼠,于免疫后不同时间制备脾脏单个核细胞(MNC),测定MNC对刀豆蛋白(ConA)和细菌脂多糖(LPS)的增殖反应性;采用绵羊红细胞(SRBC)作为致敏原,测定不同HBsAg免疫小鼠后迟发性超敏反应(DTH)的发生程度.结果不同来源HBsAg对ConA或LPS刺激的反应指数(SI)表现出不同的时间曲线,一般于免疫20?d和25?d时显著升高,其中血源HBsAg较高,酵母较低.H.M.-HBsAg在免疫5?d时即显出较高的SI值.CHO-HBsAg对SRBC诱导的DTH反应具有显著的抑制作用(P＜0.05).结论不同来源HBsAg诱导细胞免疫反应的类型和程度存在差异,CHO细胞来源的HBsAg对TH1细胞介导的DTH反应有抑制作用.     

主动脉弓畸形及其临床意义

目的研究主有及其临床意义。方法：在历时１５年对３２０例主动脉弓的解剖中,发现４例主动脉弓畸形,并对此弓变形及其周围诸结构进行解剖和观察。结果：在４例主动脉弓畸形的病例,,２例为右食管后锁骨下动脉并存右非喉返神经,另２例为右主工存左食管后锁骨下一左背主动脉分离。食管后锁上动脉起始部形成憩中产生食管受压性咽下困难,左锁骨下动脉或左背主动脉经支汛管连接或发自左肺动脉,可形成先天性肺动脉一锁骨下动脉窃血症     

珍珠散协同爱宝疗治疗重度宫颈糜烂的临床疗效与药物经济学研究

目的观察中药珍珠散协同爱宝疗浓缩液治疗重度官颈糜烂临床疗效和药物经济学效益。方法将有生育要求的Ⅲ度官颈糜烂患者111例随机分为治疗组和对照组，治疗组用中药珍珠散联合爱宝疗浓缩液治疗，对照组则单用爱宝疗浓缩液治疗，均每3d治疗一次。45d后，比较两组疗效、疗程及治疗费用。结果治疗组治愈率明显高于对照组（67．9％vs36．4％），差异有统计学意义（P〈0．05）。治疗组费用明显低于对照组[（371．6±138．4）vs（483．6±36．6）]元（P〈0．01）。治疗组治疗时间比对照组显著缩短[（32．4±12．1）vs（44．0±3．3）]d（P〈0．01）。治疗组中提前结束治疗患者多于对照组（35／56vs6／55，P〈0．05）。治疗组与对照组均未见副作用发生。结论珍珠散协同爱宝疗浓缩液治疗重度官颈糜烂疗效好，药物经济学效益高，值得临床推广。     

全喉切除术后食管语康复实践

目的总结喉全切除术食管发声训练和效果。方法对我院自1998年6月～2003年6月的59例喉癌、下咽癌全喉切除术后患者,进行食管发声康复训练。结果53例(89.8%)获得不同程度的发声功能,46例无喉者的言语水平接近正常喉言语水平,他们的最大发音时程较长、听距较远,言语可懂度高,较流利;7例发音效果差,但言语可懂度仍高;不能发声者仅6例。结论与其它发声重建相比,食管发声能很快学会发基本音,并具有发声成功率高、发声质量良好等优点。     

断流术并吻合器横断食管治疗食管曲张静脉出血疗效观察

目的探讨采用断流术并吻合器横断食管治疗门静脉高压症所致食管曲张静脉破裂出血的手术方法和临床效果。方法对48例包括急性出血期急诊手术22例,有出血病史作择期手术的19例和无出血病史作预防性手术的7例,经腹采用吻合器横断食管下段同时进行食管下段及贲门周围血管的选择性离断,观察其近期和远期止血效果。结果术后近期和远期止血效果都比较满意。结论该手术为食管下段横断和对食管下段与贲门周围血管选择性离断的联合应用,术中使用一次性吻合器进行食管下段的横断与吻合,使手术方法简便快捷,可减少手术创伤。     

抑癌基因PTEN与食管癌

PTEN是近年发现的一种与细胞信号传导途径有关的具有双特异性磷酸酶活性的新型抑癌基因。研究表明,该基因的突变与人类多种恶性肿瘤的发生发展密切相关。近年来国内外的学者在食管癌组织中发现,虽然该基因发生突变的频率较低,但其蛋白表达却普遍下降,表达程度与食管癌的恶性程度及预后密切相关。因此,PTEN的低表达可能参与了食管癌的发生发展过程。     

Cat red nucleus activity preceding movement depends on initiation conditions

Summary The activity of 98 Red Nucleus neurons was recorded in 3 cats operantly conditioned to perform a ballistic forelimb flexion movement triggered after a brief sound in a simple Reaction Time condition, or Delayed after the same sound in the presence of a tone cue. Fifty-eight task related neurons presented changes of activity in either one or both conditions. Forty-four of them were studied quantitatively and classified in 3 categories: 1) only 16% of the units presented similar changes of firing preceding the triggered or delayed movement; 2) most units (55%) presented different changes of activity in the two conditions: in the Delayed condition, the activation occurred earlier before the movement, and/or the change in magnitude was reduced or the pattern of activity was modified; 3) moreover, for 29% of the units, the change of activity observed before movement in the Reaction Time condition was severely reduced or even absent in the Delayed condition. For some of these neurons a building-up of activity was observed very early in the Reaction Time condition, during the preparatory period, well before the occurrence of the conditioned stimulus. These results show that the Red Nucleus activity preceding a movement is clearly dependent on its initiation conditions. The distinct patterns of unit firing observed in the Reaction Time condition and in the Delayed condition are tentatively related to the different preparation and initiation constraints determined by the behavioral conditions.     

食管癌三维适形放射治疗疗效的Meta分析

目的分析三维适形放射治疗技术（3-DCRT）治疗食管癌的疗效和放射毒性反应。方法检索国内有关数据库查找符合条件的临床随机对照试验,采用Meta分析方法,对国内公开发表的有关3-DCRT治疗食管癌的临床随机对照试验研究文献进行综合分析,在RevMan4.2.7软件中统计分析相应的研究指标。结果有8项独立的临床随机对照试验研究进入了本次meta分析。3-DCRT组的近期疗效,1、2、3年局控率及1、2、3年生存率均优于对照组（p〈0.01）。两组毒副反应的差异无统计学显著性意义。结论3-DCRT治疗食管癌的近期疗效优于常规放射治疗方法,远期疗效和毒副反应有待进一步观察随访和研究。