中晚期宫颈癌超选择动脉灌注化疗栓塞术42例临床分析

目的:探讨超选择动脉灌注化疗栓塞术(以下简称介入治疗)对中晚期宫颈癌的临床治疗价值。方法:选择经活检确诊为宫颈癌,临床分期Ⅱb以上患者42例,进行介入治疗1～3次后观察其临床症状及肿瘤大小、病理变化。结果:经介入治疗后25例临床症状完全缓解,10例明显缓解,5例中度缓解,总缓解率95.2%(40/42);CR10例,PR27例,SD5例,近期有效率为88.1%(37/42);33例获降期后手术切除,占78.6%(33/42),28例术后至今无复发或转移;肿瘤组织病理检查显示,介入治疗后癌细胞变性坏死,以治疗后48小时明显,并随时间推移而增加。结论:介入治疗对中晚期宫颈癌有良好的近期疗效,是一种增加降期后手术切除率、提高疗效和生存质量的有效方法。     

三尖杉酯碱及氮烯苯酸诱导肿瘤细胞凋亡的时-效,量-效关系以及凋亡与坏死的消长变化

目的:研究三尖杉酯碱及氮烯苯酸诱导肿瘤细胞凋亡的量-效,时-效关系以及凋亡与坏死的消长变化.方法:以S180腹水癌荷瘤小鼠为体内模型,HL60细胞为体外模型,以Hoechst 33342染色细胞,荧光显微镜下观察并计算凋亡指数.透射电镜判定凋亡;流式细胞仪检测DNA分布加以验证.用重复测量方差分析对凋亡指数进行量化处理;以台盼蓝染色阳性作为坏死的参数,观察凋亡与坏死的关系.结果:三尖杉酯碱和氮烯苯酸均诱导了肿瘤细胞凋亡,在荧光显微镜及透射电镜下见典型的凋亡改变.DNA直方图出现亚G1峰.对HL60细胞,在2～24小时时间范围内,三尖杉酯碱在0.02～1.0μg/ml,氮烯苯酸在0.2～5μg/ml浓度范围内,凋亡指数随药物浓度增加及时间延长而上升,24小时后,凋亡指数下降,台盼蓝染色阳性坏死细胞明显增加.在本实验的最高浓度组(三尖杉酯碱5.0μg/ml,氮烯苯酸25μg/ml)凋亡指数最低,台盼蓝阳性率一直处于最高水平.在荷S180腹水癌小鼠,氮烯苯酸在25～250mg/kg和2～48小时范围内,凋亡指数随剂量增加及时间延长而上升,48小时后,凋亡指数下降,台盼蓝染色阳性细胞明显增加.结论:三尖杉酯碱及氮烯苯酸诱导肿瘤细胞凋亡,在一定剂量和时间范围内呈现明显的量-效,时-效关系;高剂量药物倾向于以坏死为主要方式杀灭肿瘤细胞.提示细胞凋亡和坏死的启动和调控可能与损伤强度阈值和时间阈值有关.     

Impact of pemetrexed on intracranial disease control and radiation necrosis in patients with brain metastases from non-small cell lung cancer receiving stereotactic radiation

Background

Pemetrexed is a folate antimetabolite used in the management of advanced adenocarcinoma of the lung. We sought to assess the impact of pemetrexed on intracranial disease control and radiation-related toxicity among patients with adenocarcinoma of the lung who received stereotactic radiation for brain metastases.

Role of staphylococcal superantigen in atopic dermatitis: influence on keratinocytes

Staphylococcus aureus may perform an crucial function in atopic dermatitis (AD), via the secretion of superantigens, including staphylococcal enterotoxins (SE) A or B, and toxic shock syndrome toxin-1 (TSST-1). Dysregulated cytokine production by keratinocytes (KCs) upon exposure to staphylococcal superantigens (SsAgs) may be principally involved in the pathophysiology of AD. We hypothesized that lesional KCs from AD may react differently to SsAgs compared to nonlesional skin or normal skin from nonatopics. We conducted a comparison of HLA-DR or CD1a expression in lesional skin as opposed to that in nonlesional or normal skin by immunohistochemistry (IHC). We also compared, using ELISA, the levels of IL-1alpha, IL-1beta, and TNF-alpha secreted by cultured KCs from lesional, nonlesional, and normal skin, after the addition of SEA, SEB and TSST-1. IHC revealed that both HLA-DR and CD1a expression increased significantly in the epidermis of lesional skin versus nonlesional or normal skin in quite a similar manner. IL-1alpha, IL-1beta, and TNF-alpha secretion was also significantly elevated in the cultured KCs from lesional skin after the addition of SsAgs. Our results indicated that KCs from lesional skin appear to react differently to SsAgs and increased proinflammatory cytokine production in response to SsAgs may contribute to the pathogenesis of AD.     

儿童股骨头无菌性坏死的手术治疗

目的：对儿童股骨无菌性坏死的三种手术方法进行疗效比较。方法：将89例(95髋)儿童股骨头无菌性坏死按3种不同的手术方法分组进行疗效观察。分组如下：A组(髋关节滑膜切除 股骨头钻孔减压 旋股外侧动静脉血管束植入)29髋;B组(A组方法 骨盆截骨术)34髋;C组(A组方法 股骨上端截骨术)32髋。结果：经2～13年随访,3组的优良率分别为：A组75．8％;B组：91．2％;C组：90．6％。B、C组疗效优于A组,B组和C组的疗效相差不大。结论：降低骨内压和关节内压以及改善股骨头血循环是治疗Perthes病的有效方法;在此基础上增加对股骨头的包容和减少对股骨头的机械压迫．疗效更好。     

玻璃体切除术治疗急性视网膜坏死的疗效分析

目的分析玻璃体切除术治疗急性视网膜坏死的效果。方法急性视网膜坏死施行玻璃体切除术24例（24眼）。其中视网膜脱离者13例,未脱离者11例。均行常规玻璃体切除术,其中3例联合白内障手术,15例行玻璃体切除术＋硅油填充,4例单纯玻璃体切除术,2例联合巩膜外垫压。5例硅油取出后再次出现视网膜脱离,进行二次玻璃体切除＋硅油填充术。结果24例中7例术后视力较术前提高两行,8例视力无明显改善,9例术后视力继续下降。其中有5例硅油取出后出现视网膜脱离复发,再次玻璃体切除＋硅油填充术,术后视力未见明显改善。结论玻璃体切除术在治疗急性视网膜坏死长期效果差,我们期待高效抗病毒药物及有效抑制眼内免疫反应的药物能够早日在临床上应用。     

结肠梗阻性坏死患者肠吻合术前后部分检验结果分析

目的研究梗阻性肠坏死及其肠吻合手术对部分检验结果的影响。方法分析本院收治的1例乙状结肠坏死患者从入院至肠吻合术后1个月内血清ALT、AST、ALP、γ-GGT、BUN、Crea、RBP、LDH、HBDH、CK、CK-Mb、UA、TnI、血和尿肌红蛋白、尿管型检验结果的变化。结果血清ALT、AST、BUN、LDH、HBDH、CK、CK-Mb、TnI、血和尿Mb、尿常规结果变化最大,患者呈现一过性管型尿,其中术后第2d和第3dALT、AST和CK浓度超过试剂盒检测范围,CK最高时54000U/L,ALP和γ-GGT变化较小。结论及时注意ALT、AST、ALP、γ-GGT、BUN、Crea、RBP、LDH、HBDH、CK、CK-Mb、UA、TnI、血和尿肌红蛋白、尿管型检验结果的变化,有助于判断病情预后;血清ALT、AST、LDH、HBDH、CK、CK-Mb、TnI、Mb是结肠梗阻性坏死重要潜在诊断指标。     

IL1ra、TNFα、US-CRP与多囊卵巢综合征发病的相关性研究

目的探讨血清炎症因子白细胞介素1受体拮抗剂（IL1ra）、肿瘤坏死因子（TNFα）、血超敏C反应蛋白（US-CRP）与多囊卵巢综合征（PCOS）发病的关系。方法采用酶放大化学发光法分别检测30例PCOS无糖尿病患者及30例正常对照组血清卵泡刺激素（FSH）、黄体生成素（LH）和睾酮（T）水平;葡萄糖氧化酶法测定血清空腹血糖（GLU）水平;酶联免疫吸附试验（ELISA）方法血清IL1ra、TNFα水平;用乳胶增强免疫比浊法检测血清US-CRP水平。并用统计学方法分析两实验组中各血清成分水平差异,以及各检测指标之间的相关关系。结果（1）PCOS组LH、T、LH/FSH、IL1ra、TNFα、US-CRP水平明显高于正常组,PCOS组FSH水平低于对照组,差异有显著性（P〈0.05）。（2）PCOS组血清IL1ra、TNFα、US-CRP、T水平与体重指数（BMI）呈正相关（P〈0.05）。（3）PCOS组血清IL1ra、TNFα、US-CRP水平与LH/FSH和睾酮水平呈正相关（P〈0.05）。（4）两组血清IL1ra、US-CRP、TNFα水平存在正相关。结论炎症因子IL1ra、TNFα、US-CRP在多囊卵巢综合征患者血清中明显升高,提示慢性亚临床炎症可能与多囊卵巢综合征发病相关。     

Effect of Acupuncture-moxibustion on TNF-α, sTNFR-I and sTNFR-Ⅱ of Rats with Crohn＇s Disease

目的：观察针灸对克罗恩病大鼠血清TNF—α、sTNFR—I、sTNFR-II的影响。方法：采用TNBs制备大鼠克罗恩病模型,随机分为模型组、隔药灸组、电针组,并与正常大鼠作对照,采用HE染色观察结肠黏膜组织病理学变化,应用ELISA方法检测血清TNF-α、sTNFR-Ⅰ、sTNFR—Ⅱ的含量。结果：与正常组比较,CD大鼠血清TNF—α显著升高、sTNFR-Ⅰ和sTNFR-Ⅱ无显著变化。经隔药灸和电针治疗后血清TNF—α水平显著降低,sTNFR-Ⅰ和sTNFR-Ⅱ无显著变化。CD大鼠结肠组织的炎症病变和异常的组织结构在隔药灸、电针治疗后得到明显改善。结论：隔药灸与电针均能够显著降低血清TNF-α的含量,该作用可能是隔药灸与电针治疗CD的作用机制之一。     

PMA and crystal‐induced neutrophil extracellular trap formation involves RIPK1‐RIPK3‐MLKL signaling

Neutrophil extracellular trap (NET) formation contributes to gout, autoimmune vasculitis, thrombosis, and atherosclerosis. The outside‐in signaling pathway triggering NET formation is unknown. Here, we show that the receptor‐interacting protein kinase (RIPK)‐1‐stabilizers necrostatin‐1 or necrostatin‐1s and the mixed lineage kinase domain‐like (MLKL)‐inhibitor necrosulfonamide prevent monosodium urate (MSU) crystal‐ or PMA‐induced NET formation in human and mouse neutrophils. These compounds do not affect PMA‐ or urate crystal‐induced production of ROS. Moreover, neutrophils of chronic granulomatous disease patients are shown to lack PMA‐induced MLKL phosphorylation. Genetic deficiency of RIPK3 in mice prevents MSU crystal‐induced NET formation in vitro and in vivo. Thus, neutrophil death and NET formation may involve the signaling pathway defining necroptosis downstream of ROS production. These data imply that RIPK1, RIPK3, and MLKL could represent molecular targets in gout or other crystallopathies.