人类子宫肌瘤保宫治疗进展

子宫肌瘤是女性生殖器官最常见的良性肿瘤，现代妇女对保宫治疗需求不断增强，本文对近几年来子宫肌瘤治疗的进展进行综述。     

Leishmania donovani: Dynamics of L. donovani evasion of innate immune cell attack due to malnutrition in visceral leishmaniasis

ObjectiveMalnutrition may be significant in the modulation of immune responses in visceral leishmaniasis (VL). Data on the relationship between malnutrition and innate immune response in VL are limited. The aim of this study was to examine the effect of malnutrition on the profile of innate immune functions of polymorphonuclear neutrophil granulocytes (PMNs) and monocytes through comparison of well-nourished and malnourished Indian patients with VL.MethodsForty individuals were enrolled comprising 20 active and untreated cases of VL and 20 non-VL individuals from the endemic region of Bihar, India. The patients with VL were segregated into two groups of 10 well-nourished and 10 malnourished participants. Patients' blood samples were directed against a crude Leishmania donovani extract (soluble leishmanial antigen) and phorbol 12-myristate-13-acetate plus ionomycin. The transendothelial cell adherence migration abilities of the PMNs and monocytes directed against these antigens were determined in whole-blood assays by flow cytometry. The chemokine (interleukin [IL]-8, macrophage inflammatory protein [MIP]-1 α) and cytokine support (tumor necrosis factor -α, interferon [IFN]-γ, IL-10), which could be significant in transendothelial cell migration, and efficacies of antileishmanial phagocytic function and reactive oxygen species (ROS) generation were also determined.ResultsSevere hindrance in the adherence of innate immune cells to the endothelial wall due to Leishmania parasites, as revealed by decreased shedding of l-selectin (CD62 L) and down-regulation of CD11 b expression on the surface of the PMNs and monocytes, occurred in malnourished VL patients. The production of MIP-1 α and IL-8 in response to L. donovani antigen was reduced in malnourished patients. In contrast, malnutrition in VL patients significantly reduced the IFN-γ and TNF-α produced by these immune cells, whereas the levels of IL-10 were significantly elevated. Malnourished VL patients were observed with severely dysfunctional PMNs and monocytes in terms of ROS activity that could not be recovered by stimulation with L. donovani antigen.ConclusionsMalnutrition linked to VL can be a decisive factor in the dynamics of L. donovani evasion of innate immune cell function in VL patients.     

Soft tissue thickness in young north eastern Brazilian individuals with different skeletal classes

The aim of this study was to evaluate the variation in facial soft tissue thickness in young north eastern Brazilian individuals according to gender and skeletal class. Measurements were obtained from digitized teleradiographs of 300 children, aged from 8 to 12 years, using the Sidexis Xg program. Data of mean, standard deviation, maximum and minimum soft tissue thickness values of the faces of Angle's Class I, II and III individuals, were evaluated. The results demonstrated that there was no difference in soft tissue thickness among the skeletal classes for most of anthropological points. For the Class I, statistical differences were found (P < 0.05) between the genders in the rhinion point, subnasal and upper lip. It was concluded that there was no difference in soft tissue thickness among the skeletal classes, except between Class II and III for the points: Stomion, Bottom lip and Pogonion, allowing definition of parameters of this population for the purpose of facial reconstruction.     

Quercetin对人气道平滑肌细胞增殖和迁移的影响及机制

目的 体外培养人气道平滑肌细胞(human airway smooth muscle cells,HASMCs),探讨槲皮素(Quercetin,Que)对血小板源性生长因子BB(PDGF-BB)刺激的HASMCs增殖和迁移的影响及其机制.方法体外培养HASMCs,分为六组；对照组、PdGF-BB组、Que与PDGF-BB联合干预组、Que组、U0126组、U0126与PDGF-BB联合干预组.四甲基偶氮唑蓝(MTT)微量比色法测定HASMCs增殖,transwell法观察细胞迁移,Western blot法检测ERK的磷酸化及Cyclin D1表达水平.结果 与对照组相比,PDGF-BB(20μg/L)显著诱导HASMCs增殖和迁移(P＜0.05),Que(20～80μmol/L)呈浓度依赖性抑制PDGF-BB诱导的HASMCs的增殖和迁移(P＜0.05).PDGF-BB组ERK磷酸化及Cyclin D1 表达水平较对照组明显增高(P＜0.05).Que(80μmol/L)及PDGF-BB干预组其表达量低于PDGF-BB组,此抑制作用与ERK特异性拮抗剂U0126作用相当(P＞0.05).结论 Que抑制PDGF-BB诱导的HASMCs的增殖和迁移,可能是通过调节ERK/Cyelin D1通路起作用.     

Fall Prevention Research and Practice: A Total Worker Safety Approach

Slips, trips, and falls (STF) represent a serious hazard to workers and occupants in many industries, homes, and communities. Often, the cause of a STF incident is multifactorial, encompassing human, environmental, and task risk factors. A STF-related disability can greatly diminish the occupational capability and quality of life of individuals in both the workplace and the home. Countering STF hazards and risks both on and off the job and on all aspects of control measures is a “total worker safety” matter, a challenging yet tangible undertaking. As the federal organization responsible for conducting research for the prevention of work-related injuries in the United States, the National Institute for Occupational Safety and Health (NIOSH) has been conducting research on STF controls for some decades. Many NIOSH research outcomes have been utilized for STF prevention in workplaces, with potential for prevention in homes as well. This paper summarizes the concept of total worker safety for STF control, NIOSH priority research goals, major activities, and accomplishments, and some emerging issues on STF. The strategic planning process for the NIOSH research goals and some identified research focuses are applicable to the development and implementation of global STF research goals.     

昆明地区巴贝西虫病一例分析

该文报道了在昆明地区发现的一例人巴贝西原虫病例的诊断与治疗过程.依据光镜和透射电镜形态学观察,初步判断该病例系巴贝西虫感染,并使用抗原虫、抗感染联合治疗获得了良效.     

Molecular characterization,serotyping, and antibiotic susceptibility profile of Leptospira interrogans serovar Copenhageni isolates from Brazil

Leptospira interrogans serogroup Icterohaemorrhagiae is the major serogroup infecting humans worldwide, and rodents and dogs are the most significant transmission sources in urban environments. Knowledge of the prevalent serovars and their maintenance hosts is essential to understand the epidemiology of leptospirosis. In this study, 20 Leptospira isolates were evaluated by pulsed-field gel electrophoresis (PFGE), variable number tandem-repeat analysis (VNTR), serotyping, and determination of antimicrobial resistance profile. Isolates, originated from bovine, canine, human, and rodent sources, were characterized by microscopic agglutination test with polyclonal and monoclonal antibodies and were identified as L. interrogans serogroup Icterohaemorrhagiae serovar Copenhageni. MICs of antimicrobials often used in veterinary medicine were determined by broth microdilution test. Most of tested antibiotics were effective against isolates, including penicillin, ampicillin, and ceftiofur. Higher MIC variability was observed for fluoroquinolones and neomycin; all isolates were resistant to trimethoprim/sulfamethoxazole and sulphadimethoxine. Isolates were genotyped by PFGE and VNTR; both techniques were unable to discriminate between serovars Copenhageni and Icterohaemorrhagiae, as expected. PFGE clustered all isolates in 1 pulsotype, indicating that these serovars can be transmitted between species and that bovine, rodent, and dogs can maintain them in the environment endangering the human population.     

人微小病毒B19与自然流产的相关性研究

目的 探讨人微小病毒B19(HPV B19)与自然流产的相关性.方法 选取30例自然流产患者作为病例组.随机抽取30例同期正常妊娠的孕妇作为对照组.所有受试者均记录自然流产的潜在危险因素.抽取所有受试者肘静脉血,采用巢式聚合酶链反应法检测HPV B19 DNA,采用ELISA法检测HPV B19 IgM抗体.采用Logistic多元回归分析法进行多因素分析.结果 两组孕次≥2次,合并高血压、糖尿病,HPV B19 DNA阳性率比较差异有统计学意义[43.3％( 13/30)比13.3％(4/30)、33.3％( 10/30)比6.7％(2/30)、30.0％ (9/30)比6.7％(2/30)、36.7％(11/30)比3.3％(1/30)](P＜0.05)；而HPV B19 IgM抗体阳性率比较差异无统计学意义(P＞0.05).多因素分析显示,孕次≥2次、合并高血压、HPV B19 DNA阳性是孕妇发生自然流产的独立危险因素(OR=1.85、1.95、4.85,P＜0.05).HPV B19 DNA阳性患者早期自然流产发生的风险明显高于晚期自然流产,差异有统计学意义(P＜0.05).结论 HPV B19感染是自然流产患者的独立危险因素,需要早期检测并对妊娠孕妇进行必要的干预,以降低自然流产的发生.     

Hyperferritinemia in neonatal and infantile human parechovirus-3 infection in comparison with other infectious diseases

Human parechovirus-3 (HPeV-3) has been associated with severe clinical manifestations in neonates and infants in the form of sepsis or hemophagocytic lymphohistiocytosis (HLH)-like illness. To clarify the clinical features of HPeV-3 infection, we compared clinical signs and laboratory findings among enteroviruses (EVs), HPeV-3, and other infections. Participants were 26 febrile infants in whom EVs (n = 20) or HPeV-3 (n = 6) were isolated from throat swab or fecal specimens. Clinical and laboratory data were compared among EVs, HPeV-3, respiratory syncytial virus (RSV) infection (n = 15), and bacterial meningitis (n = 8) groups. Apnea was frequently seen in the HPeV-3 group although there were no significant differences in other clinical symptoms. Leukocyte count was significantly lower in the HPeV-3 group than in the EV and RSV group. Platelet count was significantly lower in the HPeV-3 group than in the RSV group. Serum ferritin levels in the HPeV-3 group (mean, 2437 ng/ml) and EV group (mean, 552 ng/ml) were significantly higher than in the RSV group (mean 237 ng/ml; P = 0.008 and P = 0.002, respectively). The frequency of patients with clearly high ferritin levels ≥1000 ng/ml was comparatively higher in the HPeV-3 group (4/6) than the EV group (3/20) (P = 0.03). In the HPeV-3 group, ferritin levels were high on Days 4–5. Elevated ferritin levels, decreased leukocyte and platelet counts could offer diagnostic clues to HPeV-3 infection in infant. These laboratory findings might be associated with aberrant immune response to HPeV-3, which could contribute to the development of sepsis or HLH-like illness in neonates.