The contribution of GABA-ergic neurons to horizontal intrinsic connections in upper layers of the cat's striate cortex

Summary The contribution of neurons containing -aminobutyric acid (GABA) to horizontal intrinsic projections in layers I–III of cat's striate cortex was investigated by combining GABA-immunohistochemistry with axonal tracing. After intracortical injections of Rhodamine-labelled latex microspheres Rhodamine-labelled neurons form patch- or bandlike aggregations (clusters) separated from each other by regions containing fewer, evenly distributed or no labelled neurons. Of the Rhodamine-labelled neurons about 5% display GABA-immunoreactive material (double labelled = DL-neurons). Approximately 70% of the DL-neurons occur at distances of less than 1 mm, and the remaining 30% at distances between 1 mm and 2.5 mm from the injection. About 60% of the DL-neurons reside within clusters and 40% are located in regions between clusters; the respective percentages of the Rhodamine labelled GABA-negative neurons are about 85 and 15. Considering their small number and their spatial distribution inhibitory interneurons seem to make only minor contributions to the clustered pattern of intrinsic connections. Our results demonstrate that the topographical organization of neurons giving origin to lateral inhibitory interactions in upper layers of cat's striate cortex is different from that of neurons mediating excitatory functions.     

环孢素对心脏移植大鼠外周血淋巴细胞多基因mRNA表达的影响

 目的 对大鼠心脏移植前后不同时间点外周血淋巴细胞mRNA差异表达的研究,探讨环孢素对免疫排斥反应过程中基因表达的影响.方法 心脏移植前后以15 mg·kg^-1·d^-1环孢素灌胃的大鼠,分别在移植前、移植后24,72 h,7,10,12d取血,提取总RNA,用mRNA差异显示法找出差异表达条带,克隆测序,用灰度扫描法计算差异表达基因的比密度。结果 对照组移植心脏存活率于移植后的10d内降至为0%,而此阶段环孢素组的移植心脏存活率始终保持在50％.移植后第10天,对照组与凋亡信号传导和线粒体蛋白构象重构与蛋白转运相关基因Ribosomal—12S和S25,MHC—Ⅲ(Hst-70)的表达水平显著高于移植前,与移植心脏存活率最低点同步.其2,3-bisphosphoglycerate和gig18基因表达水平的变化无统计学意义。环孢素组与细胞凋亡有关的gig18和Thbsl,以及T细胞受体(TCR)等基因的表达水平于移植后10 d内持续低于移植前,2,3-bisphosphoglycerate基因的表达水平于移植后24 h降低,只有钠通道β-1基因的表达水平于移植后10 d内高于移植前。结论 环孢素可负调心脏移植后大鼠外周血淋巴细胞凋亡相关基因gig18和Thbsl,正调钠通道基因的转录。     

Plasmapheresis-related hypotension

Hypotension is an uncommon complication of procedures involving extracorporeal circulation, including plasmapheresis. From November 1993 to March 1999, we treated 139 patients who underwent a total of 1,137 sessions of double filtration plasmapheresis (DFP). Hypotension was defined as a systolic blood pressure (BP) < 80 mm Hg or any decrease of systolic BP with systemic reactions. A total of 17 (1.5%) episodes of hypotension were documented in 15 patients during the study period. Hypotensive episodes occurred in 2.3% of patients with inflammatory neuropathy, 1.2% of patients with myasthenia gravis, and 1.2% of patients with all other medical diseases. Involvement of the autonomic nerve system (ANS) and a low baseline BP were associated with the occurrence of hypotension. Eight (47%) of 17 episodes were symptomatic and 2 were complicated with seizure. Patients with symptomatic hypotension had a higher level of systolic BP prior to DFP and a larger drop of systolic BP and pulse rate during hypotensive attacks compared to asymptomatic patients. Most hypotensive episodes were resolved briefly after intravenous infusion of saline within 30 min. Eight (47%) of the hypotensive episodes occurred during the first session of DFP treatment. Twelve (71%) of 17 episodes occurred during the last half period of treatment; 6 of them were noted during the terminating stage of DFP. In conclusion, in this series plasmapheresis-related hypotension occurred in 1.5% of DFP sessions and had a higher prevalence in patients with ANS instability and low BP. Extra caution in monitoring BP during DFP therapy is warranted in these vulnerable patients, especially during the termination phase of the first DFP session.     

小肠双重造影对小肠肿瘤的诊断价值

 目的　探讨各种类型小肠肿瘤的小肠造影表现及双重造影的诊断价值。方法　回顾性分析 5 3例小肠肿瘤的双重造影表现。结果　病变 1.0× 1.2cm～ 17× 19cm ,<6cm的病变 2 6例。小肠平滑肌肿瘤主要表现为充盈缺损。小肠淋巴瘤病变范围广 ,主要表现为多发结节状充盈缺损 ,伴肠管狭窄及扩张。小肠腺癌主要表现为肠管不规则狭窄 ,肠壁僵硬破坏 ,显示“果核征”。小肠转移瘤主要表现为多发压迹 ,肠管粘连固定。结论　小肠双重造影是目前诊断小肠肿瘤最有价值的方法之一。     

Double Outlet Right Ventricle with Intact Atrial Septum and Restrictive Ventricular Septal Defect: An Analysis of Two Cases

Two cases of double outlet right ventricle with restrictive ventricular septal defect are described. This is an uncommon presentation that causes left ventricular dysfunction because of left ventricular outflow tract obstruction. The presence of an intact atrial septum leads to severe pulmonary hypertension, which tends to aggravate the right ventricular output. In the presence of a normal left ventricle, the authors suggest the possibility of enlargement of the ventricular septal defect in order to perform a biventricular repair. The association of a supramitral valve ring in both cases, and the isolation of the left subclavian artery and an aortopulmonary fenestration in one of these cases, are also discussed. In addition we explore factors that cause restrictive ventricular septal defects as well as the mechanisms that may lead to spontaneous closure of ventricular septal defect in a double outlet right ventricle.     

377例双向分化恶性肿瘤血管生成拟态临床意义分析

目的:探讨双向分化恶性肿瘤组织中血管生成拟态的临床意义.方法:收集1955～2000年间我院病理科石蜡包埋双向分化恶性肿瘤样本887例,其中临床和病理资料完整的377例作为研究对象,分为有血管生成拟态组和无血管生成拟态组,分析具有血管生成拟态肿瘤的临床意义.结果:除滑膜肉瘤外(P=0.759),恶性黑色素瘤(P=0.038 2)、间皮肉瘤(P=0.035 6)、横纹肌肉瘤(P=0.028 2)中具有血管生成拟态的肿瘤患者生存时间明显低于无血管生成拟态肿瘤患者,两者比较差异有显著性.结论:具有血管生成拟态的双向分化恶性肿瘤恶性度高、血道转移早、临床预后差.     

Comparison between double-filtration plasmapheresis and immunoadsorption plasmapheresis in the treatment of patients with myasthenia gravis

Two techniques for plasmapheresis are used in the treatment of myasthenia gravis (MG): immunoadsorption (IA) and double filtration (DR). This controlled study evaluated the differences between these techniques in clinical effects and serological changes. Five patients with generalized MG (clinical states IIb and III) were enrolled; each patient received IA and DF plasmapheresis on separate occasions. Immunosorba TR-350 with an affinity to acetylcholine receptor antibodies (AchRAb) was used for IA, while Evaflux 4A was used as the plasma fractionator for DF. Each course of treatment consisted of five sessions of apheresis. MG score, titers of AchRAb, immunoglobulins (IG), and plasma biochemistry were assessed by blinded examiners before and immediately after the entire course of treatment. Both treatments effectively ameliorated symptoms of MG. There were no significant changes in MG score between the two groups (IA vs. DF: 2.2 vs. 2.6, P>0.5). IA had a higher clearance rate of AchRAb than DF (66 % vs. 54 %, P<0.05), while DF removed more IgA (72 % vs. 21 %, P< 0.05) and IgM (89 % vs. 57 %, P<0.01) than did IA. Although IA removed AchRAb more effectively than DF, the clinical effects between these two treatments were similar. The titers of AchRAb cannot reflect the clinical severity. Some circulating factors other than AchRAb may contribute to the pathogenesis of MG. Received: 10 September 1999, Received in revised form: 7 February 2000, Accepted: 24 February 2000     

上海市胆道癌病理形态特征的初步观察:附487例分析

目的研究上海市区居民胆道癌病理形态特征和鉴别诊断.方法自1997年6月～2001年5月在上海市区开展基于全人群的胆道癌病例-对照研究,总共收集病理切片1 228例,包括胆道癌487例(其中胆囊癌322例,肝外胆管癌105例和壶腹癌60例),胆道结石和胆囊炎对照病例721例,胆道腺瘤20例,由中、美资深病理医师复查,按世界卫生组织1991年胆囊和肝外胆管肿瘤组织学分型进行分类.结果病理标本以切除标本为主,肿瘤大小为多数小于4 cm,组织学类型中70%以上为腺癌,肿瘤组织学分级以高分化和中分化占绝大多数,TNM分期中0～Ⅱ期的胆囊癌和肝外胆管癌约占1/3,壶腹癌近2/3.病理复查结果显示诊断过头占1.8%,诊断不足占0.6%,漏诊占0.1%;随访结果显示根治术后的5年生存率:胆囊癌40.7%、肝外胆管癌11.1%和壶腹癌26.9%.结论病理复查可以统一诊断标准,提高确诊率,为全人群病例-对照研究和多学科协作积累经验.     

双向分化肿瘤血管生成拟态分子机制初步观察(英文)

目的研究肿瘤细胞分泌Ⅳ型胶原和 PAS 阳性物质在血管生成拟态(VM)中的作用以及 VM 对肿瘤细胞表达 VEGF 的影响。方法收集双向分化恶性肿瘤石蜡包埋样本158例,制作成组织芯片,进行 CD31和 VEGF 重复染色及Ⅳ型胶原染色。通过网格计数法,比较 CD31与 PAS 阳性图案围成的管道面积差别及分布特点,以及有 VM 的点阵和无 VM 的点阵 VEGF 表达的差别。结果 VM 的基底膜样结构表现为 PAS 及Ⅳ型胶原阳性;无 VM 的双向分化肿瘤 VEGF 表达高于有 VM 者,其中在恶性黑色素瘤及腺泡型横纹肌肉瘤中,二者 VEGF 的表达差异有显著性(P<0.05)。结论 PAS 阳性物质和Ⅳ型胶原参与构建了 VM 的管壁,VEGF 表达的差别表明 VM 的存在可以提供肿瘤细胞氧气和营养物质。