CD4+CD25+调节性T细胞与系统性红斑狼疮病情活动性关系的研究

目的：检测系统性红斑狼疮患者外周血CD4^＋CD25^＋、CD4^＋CD8^＋调节性T细胞亚群，探讨其与疾病活动性、肾脏损伤、血清抗ds-DNA抗体及免疫球蛋白和补体C3含量的关系。方法：采用流式细胞术检测北京协和医院住院和门诊SLE患者（n=37）外周血CD4^＋CD25^＋T、CD4^＋CD8^＋T细胞群比例，以15例RA和15例SS组成自身免疫性疾病对照，30例健康体检者作为正常对照，观察调节性T细胞亚群与SLE患者疾病活动性指标SLEDAI、IgG、C3及血清抗ds-DNA抗体的关系。结果：①疾病活动期SLE患者外周血CD4^＋CD25^＋调节性T细胞群比例显著低于正常对照组（P〈0.01），疾病稳定期和风湿性疾病对照组与正常对照组结果差异无统计学意义。疾病活动期和稳定期SLE患者CD4＋CD8＋T细胞群比例都略高于正常对照组，但未发现结果差异有统计学意义（P〉0.05）。②疾病活动期SLE患者外周血CD4^＋CD25^＋T细胞比例及CD4^＋CD25^＋/CD4^＋值显著低于稳定期患者（P〈0.01）。SLE患者外周血CD4^＋CD25^＋/CD4^＋值与SLEDAI、补体C3呈低度相关（r分别为-0.491、0.368，P〈0.05），CD4^＋CD25^＋T细胞数量与SLEDAI呈负相关（r=-0.578，P〈0.05）。③SLE并发肾病组外周血CD4^＋CD25^＋T细胞群比例及CD4^＋CD25^＋/CD4^＋值显著低于非肾病组（P〈0.01；P〈0.05）。同一SLE患者治疗前后CD3^＋CD4^-CD8^-细胞和NK细胞降低，CD4^＋CD25^＋细胞、CD4^＋CD25^＋/CD4^＋值及CD8^＋T细胞增加，但未发现这些结果差异有统计学意义。本次研究未发现NK细胞、CD4^＋CD8＋T细胞、CD4^＋CD25^＋T细胞群比例在ds-DNA＋组与ds-DNA-组之间结果差异有统计学意义。结论：SLE患者外周血CD4^＋CD25^＋T细胞群比例与SLEDAI成负相关，与肾脏的损害也有密切关系，但与血清抗ds-DNA抗体产生的关系不明显。活动期SLE患者外周血CD4^＋CD25^＋T细胞减少，稳定期CD4^＋CD25^＋T细胞比例回升，因此推测CD4^＋CD25^＋T细胞的变化可能是导致疾病发生和病情发展及相关器官（如肾脏）损伤的关键环节之一。     

经皮椎间孔镜TESSYS技术治疗腰椎侧隐窝狭窄症

目的 探讨经皮椎间孔镜TESSYS技术治疗腰椎侧隐窝狭窄症的安全性及早期疗效.方法 2017年3月～2019年1月,本科收治单节段腰椎侧隐窝狭窄症患者35例,均采用经皮椎间孔镜TESSYS技术行侧隐窝及神经根减压.比较患者术前、术后即刻、术后1个月、术后3个月、术后6个月、术后1年的腿痛VAS评分及腰椎Oswestry功能障碍指数(Oswestry disability index,ODI)差异.术后1年采用改良MacNab标准评价手术疗效.结果 所有患者均顺利完成侧隐窝及神经根减压,手术时间50～125 min,平均(80.36±12.34)min;所有患者术后均获得随访12～15个月.患者术后即刻及各随访时期的腿痛VAS评分及ODI指数均较术前明显降低,差异有统计学意义(P<0.05).按改良MacNab标准评价疗效:优19例,良10例,可6例,优良率82.9％.结论 经皮椎间孔镜TESSYS技术治疗腰椎侧隐窝狭窄症的早期疗效显著,是有效的微创治疗方案.     

牛坐骨神经中神经再生抑制物的分离与鉴定

目的 在周围神经内寻找与中枢神经内轴突生长抑制因子有相同生物学活性的神经再生抑制物。方法 取新生小牛坐骨神经提取液经ＳｅｐｈａｃｒｙｌＳ－１００凝胶柱层析,得洗脱峰,再将各峰成分用不同分子的滤管超滤分别得到６组不同Ｍｒ的粗提液,将各组分加入到体外培养的ＰＣ１２细胞中观察细胞生长情况,并检测细胞活性。细胞活力检测指标是ＭＴＴ法细胞活性检测和细胞总蛋白含量测定。结果 有抑制活性的物质主要集中在Ｍｒ〈１     

全自动显微镜及图像分析系统处理免疫组化图像

目的 :探索全自动显微镜及图像分析系统处理免疫组化图像的新方法。方法 :利用全自动显微镜及图像分析系统采集肩袖撕裂患者肩峰下滑囊(SAB)及正常对照组白细胞介素6(IL-6)免疫组化染色切片图像,建立统一的图像采集、分割及处理标准,并对其分析,采用积分光密度评价阳性表达结果。传统的方法为手动显微镜及早期的图像分析处理软件,取其平均光密度,并对两种方法所测结果进行比较。结果 :新方法与传统方法均能够得出撕裂患者阳性表达数据,但新方法成像质量高,分析结果差异更为显著。结论: 新方法采集的图像质量较高,标准统一,误差较小,人为因素大为减少,结果更为准确,有更好的重复性和可比性。积分光密度与平均光密度相比将面积因素考虑在内,测量物质含量结果更为准确。     

慢性鼻-鼻窦炎鼻息肉内镜鼻窦术后上颌窦口黏膜恢复过程观察

目的 试图通过对内镜鼻窦手术(endoscopic sinus surgery，ESS)后患者鼻腔鼻窦黏膜的内镜、光镜、透射电镜和扫描电镜下连续动态观察，揭示病变黏膜转归的过程。方法 选取2001年1～12月行ESS的慢性鼻一鼻窦炎伴鼻息肉患者31例(53侧)作为研究对象，其中Ⅱ型2期11例(20侧)、3期12例(20侧)，Ⅲ型8例(13侧)。分别于ESS术前、术后2～3周、8～11周、13～16周钳取上颌窦口后囟相同部位的黏膜组织进行观察。结果 术前均可见上皮剥蚀、鳞状上皮化生、腺体及纤维组织增生(53侧)；微管结构异常、线粒体减少(53侧)。术后2～3周，形态学观察与术前比较没有明显的改变。术后8～11周，纤毛柱状细胞增多，并可见许多带有微绒毛的柱状细胞和大量短纤毛，所有病例均可见病理性腺体及纤维组织增生。术后13～16周，Ⅱ型2、3期和Ⅲ型患者术腔光滑干净，上皮化较好(50侧)，窦口通畅(53侧)。纤毛覆盖面积增加，方向一致(50侧)。微管结构清晰，线粒体狭长致密(49侧)。3侧无纤毛柱状细胞排列整齐，形成病理性修复。结论 ESS术后，黏膜形态的基本恢复一般需要3个月左右；有些病理改变是不可逆的；病变程度与黏膜修复情况有关；术中尽可能多地保留黏膜组织、术后局部及时清理换药，有利于黏膜纤毛的形态和功能的恢复。     

Hepatic epithelioid hemangioendothelioma: Update on diagnosis and therapy

With an estimated incidence of only 1-2 cases in every 1 million people, hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular endothelial cell tumor occurring in the liver and consisting of epithelioid and histiocyte-like vascular endothelial cells in mucus or a fibrotic matrix. HEHE is characterized as a low-to-moderate grade malignant tumor and is classified into three types: solitary, multiple, and diffuse. Both the etiology and characteristic clinical manifestations of HEHE are unclear. However, HEHE has a characteristic appearance on imaging including ultrasound, magnetic resonance imaging, and positron emission tomography/computerized tomography. Still, its diagnosis depends mainly on pathological findings, with immunohistochemical detection of endothelial markers cluster of differentiation 31 (CD31), CD34, CD10, vimentin, and factor VIII antigen as the basis of diagnosis. Hepatectomy and/or liver transplantation are the first choice for treatment, but various chemotherapeutic drugs are reportedly effective, providing a promising treatment option. In this review, we summarize the literature related to the diagnosis and treatment of HEHE, which provides future perspectives for the clinical management of HEHE.     

Identification of neuroanatomic circuits from spinal cord to stomach in mouse: retrograde transneuronal viral tracing study

To determine the spinal innervation and neuronal connections is important for studying gastric carbohydrate metabolism and motor responses. Neurons involved in the efferent control of the stomach were identified following visualization of pseudorabies virus (PRV)-614 retrograde tracing. PRV-614 was injected into the ventral stomach wall in 13 adult C57BL/6J strain male mice. On the fifth day postinjection, animals were humanely sacrificed, and spinal cords were removed and sectioned, and processed for PRV visualization. The virus injected into the ventral stomach wall was specifically transported to the thoracic spinal cord. At 5 d after injection of the PRV-614, stomach enlargement and tissue edema were found, and PRV-614 positive cells were found in the intermediolateral cell column, the intercalates nucleus or the central autonomic nucleus of spinal cord segments T3 to L1, and major PRV-614 labeled cells were focused in the T6-10 segment. Our results revealed neuroanatomical circuits between stomach and the spinal intermediolateral cell column neurons.     

Protective effect of Ruellia tuberosa L. extracts against abnormal expression of hepatic detoxification enzymes in diabetic rats

Ruellia tuberosa L. (RTL) has been used as a folk medicine for curing diabetes mellitus in East Asia decades. This study investigated the effect of RTL on hepatic detoxification enzyme expression in diabetic rats. Male Wistar rats were fed a high fat diet (HFD) and intraperitoneally injected with streptozotocin (STZ) to induce diabetes. Subsequently, rats received oral administrations of 100 or 400 mg kg⁻¹ body weight RTL extract, in either water (RTLW) or ethanol (RTLE), once a day for 4 weeks. The real-time PCR analyses showed that abnormality of hepatic phase I and II detoxification enzyme expression was observed in diabetic rats. However, both RTLW and RTLE significantly normalized the expression of hepatic phase I detoxification enzymes such as CYP 2E1, and expression of phase II detoxification enzymes such as UGT 1A7 and GST M1 in diabetic rats. Furthermore, we found that fasting serum glucose, hemoglobin A1C (HbA1C) and the area under the curve of oral glucose tolerance test (AUC_OGTT) levels were significantly reduced in both RTLW and RTLE treated diabetic rats. Moreover, both RTLW and RTLE significantly increased the activity of hepatic anti-oxidative enzymes such as superoxide dismutase (SOD) in diabetic rats. The present study suggests that RTL may ameliorate abnormal hepatic detoxification function via alleviating hyperglycemia and enhancing hepatic antioxidant capacity in HFD/STZ-induced diabetic rats.

Ruellia tuberosa L. (RTL) has been used as a folk medicine for curing diabetes mellitus in East Asia decades.     

Prone position combined with high-flow nasal oxygen could benefit spontaneously breathing,severe COVID-19 patients: A case report

BACKGROUNDSince the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China in December 2019, the overall fatality rate of severe and critical patients with COVID-19 is high and the effective therapy is limited. CASE SUMMARYIn this case report, we describe a case of the successful combination of the prone position (PP) and high-flow nasal oxygen (HFNO) therapy in a spontaneously breathing, severe COVID-19 patient who presented with fever, fatigue and hypoxemia and was diagnosed by positive throat swab COVID-19 RNA testing. The therapy significantly improved the patient''s clinical symptoms, oxygenation status, and radiological characteristics of lung injury during hospitalization, and the patient showed good tolerance and avoided intubation. Additionally, we did not find that medical staff wearing optimal airborne personal protective equipment (PPE) were infected by the new coronavirus in our institution.CONCLUSIONWe conclude that the combination of PP and HFNO could benefit spontaneously breathing, severe COVID-19 patients. The therapy does not increase risk of healthcare workers wearing optimal airborne PPE to become infected with virus particles.     

Incidence and related clinical factors of falls among older Chinese veterans in military communities: a prospective study

[Purpose] The aim of this study was to determine fall incidence and explore clinical factors of falls among older Chinese veterans in military communities. [Subjects and Methods] We carried out a 12-month prospective study among 13 military communities in Beijing, China. Fall events were obtained by self-report to military community liaisons and monthly telephone interviews by researchers. [Results] Among the final sample of 447 older veterans, 86 fell once, 25 fell twice or more, and 152 falls occurred altogether. The incidence of falls and fallers were 342/1,000 person-years and 249/1,000 person-years. In Cox regression models, independent clinical factors associated with falls were visual acuity (RR=0.47), stroke (RR=2.43), lumbar diseases (RR=1.73), sedatives (RR=1.80), fall history in the past 6 months (RR=2.77), multiple chronic diseases (RR=1.53), multiple medications (RR=1.34), and five-repetition sit-to-stand test score (RR=1.41). Hearing acuity was close to being statistically significant. [Conclusion] The incidences of falls and fallers among older Chinese veterans were lower than those of Hong Kong and western countries. The clinical risk factors of falls were poor senses, stroke, lumbar diseases, taking sedatives, fall history in the past 6 months, having multiple chronic diseases, taking multiple medications, and poor physical function. The preventive strategies targeting the above risk factors are very significant for reducing falls.Key words: Falls, Incidence, Clinical factors