Multiple epithelial cysts of the spleen and on the splenic capsule, and high serum levels of CA19-9, CA125 and soluble IL-2 receptor

An 18-year-old woman with abdominal pain was diagnosed as having splenic cysts by computed tomography scan. She had high serum levels of CA19-9 (2886.8 U/mL; normal value, <35 U/mL), CA125 (131.1 U/mL; normal value, <35 U/mL) and soluble IL-2 receptor (1490 U/mL; normal range, 220-530 U/mL). The resected spleen weighed 1050 g, was 14 x 28 cm, and had more than 10 macroscopic cysts up to 10.3 x 9.5 cm. There were numerous microscopic cysts in the spleen and several on the splenic capsule. The levels of CA19-9 and CA125 in the cyst fluid were 2165550 U/mL and 160400 U/mL, respectively. After the surgery, the serum levels of the tumor markers decreased gradually. The inside of the largest cyst was mainly covered by granulation tissue with a focal lining of epithelial cells, and the other macroscopic cysts had stratified squamous epithelium. The microscopic splenic cysts and cysts on the splenic capsule were lined by either attenuated single-layered or multilayered epithelial cells. The lining epithelial cells of these cysts were positive for epithelial membrane antigen and cytokeratins. CA19-9 and CA125 were detected in the lining cells of the splenic cysts. In the present case, it is suspected that the splenic cysts were derived from the capsular lining cells that showed migration from the capsule or formed microcysts on the splenic capsule, as in the case of ovarian inclusion cysts.     

多器官功能障碍综合征小鼠脾脏树突状细胞与炎症因子变化的关系

目的探讨多器官功能障碍综合征（MODS）病程中脾脏树突状细胞（DC）变化对炎症因子的影响与作用。方法采用腹腔注射酵母多糖的方法复制小鼠MODS模型，分为正常对照组和MODS组。采用流式细胞技术检测脾脏DC免疫表型，运用免疫组化技术检测脾脏中促炎因子IL-1β与抗炎因子IL-10的表达，计量观察DC与炎症因子在病程中的变化并做相关分析。结果伤后6h组，脾脏中CD11c^＋／MHC-Ⅱ’DC数目与IL-18’细胞数目均明显增多，至24h组达峰值。自48h组，CD11c^＋／MHC-Ⅱ’DC与IL-1β’细胞含量开始下降，在6天组和10～12天组降至正常组或低于正常组含量；而同时CD11c^＋／MHC-Ⅱ^-DC和IL-10阳性细胞含量则相对增多，至10～12天组阳性细胞含量显著升高达到峰值。结论DC的活性在MODS病程早期与IL-1β表达呈正相关性，在病程晚期与IL-10表达呈负相关，提示脾脏DC活性变化与促炎因子和抗炎因子均有密切的相关性。     

Isolated diffuse hemangiomatosis of the spleen with Kasabach-Merritt-like syndrome

AIMS: Diffuse haemangiomatosis of the spleen is a rare benign vascular condition occurring as a manifestation of systemic angiomatosis or, less commonly, confined to the spleen. It is sometimes accompanied by severe disturbance of blood coagulation. The goal of this study was to characterize an additional case of isolated diffuse haemangiomatosis of the spleen and to determine the histogenesis of this lesion which remains obscure. METHODS AND RESULTS: We describe a case of isolated diffuse haemangiomatosis of the spleen in which histological and immunohistological findings suggested the possibility of a malformative tumour-like lesion. The pathological cavernous vessels were distributed randomly through the red pulp, without continuity with sinuses. The endothelial cells expressed vimentin, factor VIII related antigen and CD34, but not CD8. Some cells lining the sinus lumen expressed CD68, lysozyme and myeloperoxidase. In addition, trabecular veins presented with intimal thickening. These results allow making a diagnosis between diffuse haemangiomatosis and other tumours/tumour-like lesions of the spleen, especially littoral cell angioma, splenoma and peliosis. CONCLUSION: If diffuse haemangiomatosis is usually classified as a benign proliferation of endothelial cells, we suggest that diffuse haemangiomatosis, when confined to the spleen, could be a tumour-like vascular lesion. In this hypothesis, the aetiology may be hamartomatous or malformative as is suspected in arterio-venous haemangioma of the lower extremities. The histogenesis is still questionable and no definitive proof in favour of one or the other hypothesis has been reported.     

Emigration of selected subsets of {gamma}{delta}+ T cells from the adult murine thymus

Cells bearing the form of the TCR make up only 1–3% ofT cells in the adult murine thymus and peripheral lymphold organs.Evidence from studies of nude mice suggests that the developmentof at least some T cells is thymus dependent; however, untilnow it has not been directly demonstrated that cells are exportedfrom the thymus. In this paper we have used the technique oflabelling thymocytes in vivo with FITC, followed by flow cytometrlcanalysis to trace cells emigrating from the thymus to the spleen.Using this approach we have been able to demonstrate for thefirst time that T cells are exported from the adult murinethymus to the spleen. We also demonstrate that the cells emigratingto the spleen are a selected subset of thymocytes being heatstable antigen positive, Thy-1⁺, and expressing low levels ofCD44 (Pgp-1). In addition, investigation of TCR V; gene usageamong adult ⁺ thymocytes, recent emigrants, and spleen cells,indicated a selective emigration of cells expressing certainVgenes.     

补肾健脾方药对卵巢切除大鼠骨密度、骨矿含量影响的实验研究

为探讨补肾健脾方药对卵巢切除大鼠骨密度、骨矿含量的影响,取10月龄SD雌性大鼠40只,随机分为模型组、正常对照组、E3阳性对照组、中药组,每组10只,正常对照组行假手术,其余3组行完整双侧卵巢除术。术后第3天开始灌胃给药,连续用药满12周后处死,分离L3腰椎体及左侧股骨,进行骨矿密度、骨矿含量、表观骨密度测定。结果显示补肾健脾方药能明显维持切除卵巢大鼠椎体及股骨的骨矿密度、骨矿含量和表观密度。     

慢性乙型肝炎病因病机探讨

慢性乙型肝炎的病因与湿热疫毒密切相关,湿热毒邪是乙肝发生的始动因素,脾运不健是乙肝发生发展的内在基础,肝络瘀阻是病变发展的重要病理环节,肝肾亏扣则病变发展的必然结果,病机特点为正虚邪恋,本虚标实,致病热缠绵,病情反复波动,治疗上必须有的效矢,才能取得满意的效果。     

基于数据挖掘的中医药治疗小儿湿疹组方用药规律研究

目的：通过应用中医传承辅助平台（V 2.5）挖掘中医药治疗小儿湿疹的组方用药规律,并对高频药物、用药模式及治疗思路进行探讨。方法：搜集国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）及中文科技期刊数据库（CCD）中2000—2021年应用中医药治疗小儿湿疹的相关文献,经过筛选后建立方药数据库,运用中医传承辅助平台（V 2.5）集成的改进互信息法、关联规则Apriori算法、复杂系统熵聚类与无监督熵聚类等算法对药物频次、性味归经、用药模式、规则分析及新处方等结果进行输出,并进行网络可视化展示。结果：纳入处方200首,共涉及206味中药,高频药物包括甘草、白鲜皮、薏苡仁、茯苓、生地黄、金银花、蝉蜕、地肤子、防风、牡丹皮等,药性以寒性（52.76%）居多,药味以甘（38.89%）、苦（33.37%）、辛（21.96%）味为主,归经以胃经（1 138次）、脾经（1 088次）、肝经（1 061次）居多,并且得到药物之间的关联规则,以及新处方6个。结论：小儿湿疹用药以补虚药、利水渗湿药、清热药、清热解毒药、解表药为主,治疗以疏风清热,燥湿健脾,养血活血为主要大法,分析结果与本病诊疗指南较为吻合,可为小儿湿疹的临床治疗及新药开发提供参考。     

健脾祛湿方对脾虚湿盛型高脂血症大鼠血脂、胃肠功能、水液代谢的影响及作用机制

目的：观察健脾祛湿方对脾虚湿盛型高脂血症大鼠血脂、胃肠功能、水液代谢的影响及作用机制。方法：将56只SD大鼠随机分为空白组（n=8）和造模组（n=48）,采用“劳倦过度+饮食不节+高脂饲料喂养”复制脾虚湿盛型高脂血症大鼠模型。造模4周后,根据总胆固醇（TC）水平将造模组随机分成6组：即模型组,血脂康组,参苓白术颗粒组,健脾祛湿方低、中、高剂量组,每组8只。分组后开始给药,灌胃剂量为1 mL/100 g,空白组、模型组给予生理盐水,其余组给予相应的受试物,连续给药6周。测定血脂四项TC、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-Ch）和高密度脂蛋白胆固醇（HDL-Ch）,胃肠激素,即胃动素（MTL）、促胃液素（GAS）和血管活性肠肽（VIP）,水液调节激素醛固酮（ALD）、抗利尿激素（ADH）和心房利尿钠肽（ANP）,以及白蛋白（ALB）和总蛋白（TP）,采用苏木精-伊红（HE）染色法观察胃、结肠组织形态,免疫荧光法检测结肠水孔蛋白(AQP)3、胃AQP4的表达位置及水平,采用蛋白质印迹法（Western Blotting）检测结肠、胃组织中闭合蛋白（Occludin）的表达量。结果：与正常组比较,模型组大鼠血清TC、TG、LDL-Ch水平升高（P<0.001）,HDL-Ch水平降低（P<0.05）,血清MTL、GAS水平降低（P<0.001,P<0.01）,VIP升高（P<0.001）,ALD、ADH升高（P<0.05,P<0.001）,ANP水平显著降低（P<0.001）,TP、ALB水平降低（P<0.001,P<0.05）。结肠绒毛、胃黏膜出现大量脱落情况,结肠AQP3荧光强度降低,胃AQP4荧光表达增强,结肠、胃组织Occludin表达水平降低。与模型组比较,血脂康组、参苓白术颗粒组、健脾祛湿方低、中、高剂量组大鼠血清TC、TG、LDL-Ch水平呈下降趋势,HDL-C水平升高,MTL、GAS显著升高,VIP水平显著降低,ALD、ADH水平降低,ANP显著升高,结肠、胃组织形态结构有所改善。结肠AQP3荧光表达增强,胃AQP4荧光强度减弱,结肠、胃组织Occludin表达水平增强。结论：健脾祛湿方可降低脾虚湿盛型高脂血症大鼠血脂,有健脾祛湿之功,其作用机制可能是通过调节Occludin、AQP3、AQP4的表达,保护紧密连接结构的完整性达到促进胃肠消化吸收功能,改善水液代谢障碍的作用。     

脾的形态及其应用解剖

本文测量统计了己固定的正常脾200例,结果如下:脾的度量,测得均值。成人脾长9.70±2.68,宽6.89±1.28。厚3.5±1.18厘米;儿童脾长6.41±1.24,宽3.91±1.03.厚1.93±0.59cm.脾的外形受各种因素影响变化较大,按外形投影图分为三角形106例(53.0±3.53％)。长圆形85例(42.5±3.50％),圆形9例(4.5±1.50％),脾的切迹与分叶,前上缘切迹1个者42例(21.0±2.88％),2个者66例(33.0±3.32％)3个者47例(23.5±2.99％),4个者19例,(9.5±2.10％),无切迹者15例(7.5±1089％),后下缘无切迹者124例(62.0±3.25％)。1个者54例(27.0±3014％)。多者达3个;脾分叶者24例(12.0±2.3％),副脾在脾门处出现8个(4％)。