多源耐药基因表达水平的检测在儿童白血病中的临床意义

应用逆转录ＰＣＲ结合同位素定量分析，对３２例儿童白血病患者的多源耐药基因表达水平进行了研究。结果显示，初发病人的表达均较低，复发病人表达较高，缓解期病人表达程度介于两者之间，为探讨多源耐药基因表达水平与临床化疗之间的相关性及逆转克服多源耐药性药物的应用，提供了一定的理论依据。     

傅立叶变换红外光谱用于不同状态胆囊组织的初步研究

目的:探索正常、炎性和癌变胆囊组织各自特异的傅立叶变换红外光谱(FT-IR)表现。方法:应用FT-IR对7例正常胆囊组织、7例炎性胆囊组织和2例胆囊癌组织标本进行检测,总结与组织状态相关的光谱特征。结果:胆囊正常、炎性和癌组织具有不同的FT-IR光谱表现,1550cm~(-1)处的酰Ⅱ带在癌组织中表现较弱,峰形低平,而在正常组织中则较强,峰形高尖。相叶强度Ⅰ1550与Ⅰ1647的比值在7例正常组织中为0.33,0.48.0.54,0.38,0.41,0.52,0.45,炎性组织中为0.32,0.27,0.34,0.25,0.33,0.28,0.29,2例癌组织分别为0.25和0.28;Ⅰ1080与Ⅰ1550的比值在正常组织中为0.059,0.042,0.077,0.085,0.092,0.100,0.081,炎性组织中为0.046,0.040,0.053,0.053,0.048,0.078,0.100,2例癌组织中为0.110和0.170。正常组织中1453cm~(-1)处的峰值高于1402cm~(-1)处,而在癌组织中则相反。结论:胆囊正常、炎性和癌组织的FT-IR表现不同,FT-IR有望成为胆道疾病临床诊断的一种新手段。     

Neoplastic involvement of the sacroiliac joint: MR and CT features

The radiological findings in five patients with pelvic sort tissue neo plasms directly involving the sacroiliac joint, are described. All patients had Computed Tomography (CT) examinations, two of the patients also having Magnetic Resonance Imaging (MRI). The role of imaging in this uncommon entity is discussed as well as the importance of making this diagnosis, thereby excluding unilateral sacroiliitis. The therapeutic implications of this diagnosis relate to local neural involvement, especially the sciatic nerve, and the fact that involvement of the sacroiliac joint by tumors significantly compromises chances of a successful surgical outcome. The role of MR in this condition is not yet certain, but it may prove to be the method of choice in view of its excellent depiction of skeletal neo plasms.     

654─2在小儿急性脑水肿及中枢性呼吸衰竭中的应用探讨

感染性脑水肿病儿在感染得到有效控制，应用654—2（山莨菪碱）后未再用脱水剂，笔者认为．654—2具有解除脑血管痉挛及微循环障碍的作用。急性脑水肿在脱水剂应用后，用654—2有利于脑水肿液的吸收和回流。目前，治疗小儿捂热综合征（IMS）之细胞内水肿仍没有有效的方法，研究结果表明654—2能改善脑细胞供氧．其还能通过解除呼吸中枢血管痉挛而治疗中枢性呼吸衰竭。     

Synthesis and cytotoxic activity of new alkyl[3-(2-chloroethyl)ureido]benzene derivatives

Several alkyl[3-(2-chloroethyl)ureido] (CEU) benzene derivatives were prepared as potential anticancer agents. These new compounds were readily prepared in good yields by addition of anilines to 2-chloroethylisocyanate. Their cytotoxic activity was evaluated on human breast cancer (MDA-MB-231), human colon adenocarcinoma (LoVo) and mouse lymphocytic leukemia (P388D₁) tumor cell lines. Several new CEUs were significantly more cytotoxic than the nitrogen mustard chlorambucil. The biological activity of these aromatic urea derivatives seems to be related to the nature and position of the alkyl substituents on the aromatic ring. Substitution by branched alkyl groups on position 4 of the aromatic ring led to cytotoxic molecules which are up to 5 times more potent than the standard chlorambucil.     

选择性肾动脉栓塞治疗肾剌伤的临床应用

目的:探讨选择性肾动脉栓塞治疗肾损伤的优越性及其临床应用。材料与方法:同时使用两种栓塞材料——可吸收的明胶海棉条和美国COOK公司产38-3-5弹簧栓子,治疗了两例肾剌伤患者,两例均为男性,年龄分别为20和35岁。结果:两例患者肾刺伤后均经受过保守治疗,治疗时间分别为14和22天,但未奏效。经超选择性肾内动脉分支栓塞、取得了十分满意的止血效果,后随访3～4年,患者一切感觉正常。结论:选择性肾动脉栓塞治疗肾刀刺伤后肾出血是一种安全、可靠、有效的方法。     

PTCD在诊治阻塞性黄疸中的应用及体会

对阻塞性黄疸病人,术前进行经皮肝穿刺胆道引流术(PTCD)能达到胆道减压,减轻全身黄疸的目的,为该类病人术前准备提供一项行之有效的方法。本文报告12例,其定位诊断符合率为100％,定性诊断符合率为75％,结合实践提出了进行PTCD的适应证选择和预防并发症的切实措施。     

小儿白血病瘤细胞P—糖蛋白测定方法及应用

本文介绍免疫组化法检测小儿白血病瘤细胞（Ｐ－ｇｐ）。检测３０例小儿白血病细胞膜Ｐ－ｇｐ，观察其原发耐药性。３０例中有８例ｐ－ｇｐ阳性，总阳性率２６．６７％，其中ＡＮＬＬ单项阳性率３３．３３％，ＡＬＬ为２０％。本组病例耐约性最高的是ＣＭＬ，其次是ＡＮＬＬ，ＡＬＬ组最低。同时发现ＭＤＲ阳性者复发率高，ＭＤＲ阴性者复发率低，多因素分析表明ＭＤＥＲ对初诊白血病患者预后及抗癌药物选择有重要意义。目的临床评价ＭＤＲ采用检测ｍｄｒ１ｍＲＮＡ或Ｆ－ｇｐ，本文认为采用简便、快速的免疫组化法检测Ｐ－ｇｐ在临床上具有较大的实用价值。     

Leukocyte Apheresis Using a Centrifugal Cell Separator in Refractory Ulcerative Colitis: A Multicenter Open Label Trial

Abstract: Recently, successful results of ulcerative colitis (UC) treatments with leukocyte apheresis have been reported by several institutes. To certify the efficacy of leukocyte apheresis in refractory UC patients, a multicenter open label trial was conducted, and results were analyzed. Fifty patients diagnosed with active steroid‐resistant UC were enrolled in this study from 14 medical centers. Using a centrifugal cell separator (Component Collection System, Haemonetics), leukocyte apheresis was performed once a week for 5 weeks. General conditions and abdominal symptoms were recorded daily, and laboratory tests were followed weekly. Changes of colonoscopic and histological manifestations of luminal activity through the study period were evaluated. At the end of the study period, stool frequency was decreased to less than 4 times a day in 68.4% (26 of 38) and serum C‐reactive protein (CRP) concentration was normalized in 56.7% (17 of 30) of the patients. Colonoscopic remission was achieved in 57.7% (26 of 45), and histological improvement was noted in 54.1% (20 of 37) of the patients tested. Improved disease activity was demonstrated in 74% (37 of 50) of the patients by general assessment criteria. Analysis of the trial data confirmed the valid clinical efficacy of leukocyte apheresis by centrifugal cell separator in refractory UC patients.     

Polyclonal and allergen-induced cytokine responses in children with elevated immunoglobulin E but no atopic disease

BACKGROUND: Reduced Th1 and elevated Th2 cytokine responses are considered to be a principal mechanism in the generation of the inflammation leading to the manifestations of atopic disease in the skin of atopic dermatitis and in the airways of asthma. If reduced Th1 and elevated Th2 responses are principal determinants of the manifestation of atopic disease it might be expected that subjects with established disease would exhibit differences in their cytokine profiles as compared with atopic patients without clinical disease. OBJECTIVE: To determine whether asymptomatic atopic children exhibit a cytokine imbalance similar to that seen in patients with established atopic disease or if they behave like non-atopic controls. Cytokine responses in a group of children with elevated IgE but no clinical manifestations of disease, atopic children with established disease and non-atopic controls were compared. METHODS: We examined allergen-induced (house dust mite, HDM, rye grass pollen and RYE) cytokine responses in parallel with polyclonal (staphylococcal enterotoxin B, SEB) cytokine responses in a group of children with elevated serum IgE levels without current or past evidence of atopic disease (median age 6.6 years) and compared these with a non-atopic control group (median age 6.5 years) and a group of children with atopic disease (median age 6.7 years). RESULTS: Symptomatic atopic children had reduced SEB-induced IFN-gamma and increased SEB-induced IL-4 and IL-5 as compared with non-atopic controls. In contrast, SEB-induced IFN-gamma, IL-4 and IL-5 production in asymptomatic atopics was not significantly different from the non-atopic control subjects. Allergen-induced Th1 (IFN-gamma) and Th2 (IL-5 and IL-13) cytokine production was increased in both symptomatic atopics and asymptomatic atopics when compared with non-atopic controls. CONCLUSION: The defect in polyclonally induced IFN-gamma production was associated with the clinical manifestation of atopic disease but not the atopic stateper se. This suggests that the global reduction in IFN-gamma is the key determinant of the development of overt atopic disease. In contrast, elevated allergen-induced Th2 cytokine responses in children related to the atopic state per se irrespective of the presence of clinical atopic disease.