鼻咽癌放疗患者T细胞亚群测定的临床分析

目的探讨鼻咽癌(NPC)分期及放疗对免疫与肿瘤复发、转移及肿瘤退缩的相关性.方法每位病人放疗前及放疗后各测定T细胞亚群指标一次.结果早、晚期鼻咽癌放疗前后T细胞亚群相比,除早期鼻咽癌CD3下降无统计学意义外,余CD3、CD4、CD4/CD8下降;CD8升高均有统计学意义,晚期鼻咽癌的改变尤为突出,有极显著统计学意义(P＜0.001).放疗后肿瘤退缩与否的T细胞亚群测定无统计学意义.放疗后肿瘤有复发或转移者CD4、CD4/CD8下降有极显著统计学意义(P＜0.001).CD8升高有统计学意义.结论T细胞亚群指标的测定,对鼻咽癌患者的免疫功能状况,放疗对免疫功能的影响,对鼻咽癌放疗后复发及转移的可能性判断均有一定的临床意义.     

A digest of the Evidence-Based Clinical Practice Guideline for Nephrotic Syndrome 2020

Clinical and Experimental Nephrology -     

食管测压在贲门失弛缓症的应用

目的：研究贲门失弛缓症的食管压力改变及经腹改良Heller手术的疗效。方法：应用SGY－3多功能消化道检测仪对9例贲门失弛缓症术前及其中的7例术后进行食管压力测定,同时与8例健康人对照。结果：贲门失弛症患者的食管体部静息压和下括约肌静息压分别为8．72mmHg和48．17mmHg,显著高于健康人的1．18mmHg和17．52mmHg,贲门失弛缓症患者手术前后食管体部均无原发性蠕动。结论：经腹改良Heller手术能有效缓解贲门失弛缓症的吞咽困难,但不能恢复食管的蠕动功能。     

Generation of full‐thickness skin equivalents using hair follicle‐derived primary human keratinocytes and fibroblasts

Skin equivalents are increasingly used as human‐based test systems for basic and preclinical research. Most of the established skin equivalents are composed of primary keratinocytes and fibroblasts, isolated either from excised human skin or juvenile foreskin following circumcisions. Although the potential of hair follicle‐derived cells for the generation of skin equivalents has been shown, this approach normally requires microdissections from the scalp for which there is limited subject compliance or ethical approval. In the present study, we report a novel method to isolate and cultivate keratinocytes and fibroblasts from plucked hair follicles that were then used to generate skin equivalents. The procedure is non‐invasive, inflicts little‐pain, and may allow easy access to patient‐derived cells without taking punch biopsies. Overall, minor differences in morphology, ultrastructure, expression of important structural proteins, or barrier function were observed between skin equivalents generated from hair follicle‐derived or interfollicular keratinocytes and fibroblasts. Interestingly, improved basal lamina formation was seen in the hair follicle‐derived skin equivalents. The presented method here allows easy and non‐invasive access to keratinocytes and fibroblasts from plucked hair follicles that may be useful particularly for the generation of skin disease equivalents.     

调强技术在鼻咽癌放疗中的应用

调强放疗是一种精确放疗技术，可以形成更适形的靶区剂量分布，安全地增加肿瘤的剂量，同时降低正常组织的受照剂量，从而提高肿瘤的局控率，改善患者的生活质量。本文从放射物理、放射生物及临床应用等方面综述调强技术在鼻咽癌治疗中的优越性，同时提出了一些尚待进一步研究的问题。     

Susceptibilities of bacteria isolated from patients with lower respiratory infectious diseases to antibiotics (2000)

From October 2000 to September 2001, we collected the specimen from 410 patients with lower respiratory tract infections in 16 institutions in Japan, and investigated the susceptibilities of isolated bacteria to various anti-bacterial agents and antibiotics and patients' characteristics. Of 499 strains that were isolated from specimen (mainly from sputum) and assumed to be bacteria causing in inflammation, 493 strains were investigated. The breakdown of the isolated bacteria were: Staphylococcus aureus 78, Streptococcus pneumoniae 73, Haemophilus infiuenzae 99, Pseudomonas aeruginosa (non-mucoid) 64, P. aeruginosa (mucoid) 14, Klebsiella pneumoniae 25, Moraxella subgenus Branhamella catarrhalis 21, etc. Of 78 S. aureus strains, those with 4 micrograms/ml or more of MIC of oxacillin (methicillin-resistant S. aureus: MRSA) occupied 53.8%. Vancomycin and arbekacin had the most potent activities against MRSA as observed in 1999. The frequency of S. pneumoniae exhibiting low sensitivity to penicillin (penicillin-intermediate S. pneumoniae: PISP + penicillin-resistant S. pneumoniae: PRSP) was 38.4% being consistent with that in 1999 (34.7%). PRSP accounted for 11.0% of the total, being more than that in 1999 (3.0%). Carbapenems had strong activities against S. pneumoniae. Especially, panipenem inhibited the growth of all 73 strains at 0.125 microgram/ml. Generally, all drugs had strong activities against H. influenzae with MIC80s of 8 micrograms/ml or less. The drug that had the strongest activity against H. infiuenzae was levofloxacin, which inhibited the growth of 94 of the 99 strains at 0.063 microgram/ml. Tobramycin had a strong activity against P. aeruginosa (both mucoid and non-mucoid) with MIC80 of 1 microgram/ml. The mucoid strain was little isolated (14 strains) but the susceptibilities to all drugs were better than the non-mucoid strain. K. pneumoniae showed good susceptibilities to all drugs except ampicillin and the MIC80S were 2 micrograms/ml or less. Particularly, cefpirome, cefozopran, and levofloxacin had strong bactericidal activities against K. pneumoniae with MIC80s of 0.125 microgram/ml, and cefotiam, second-generation cephems, also had a favorable activity being MIC80 of 0.25 microgram/ml. Also, all drugs generally had strong activities against M. (B.) catarrhalis. MIC80s of all drugs were 2 micrograms/ml or less. The drug having the strongest activity was imipenem and levofloxacin inhibiting all 21 strains at 0.063 microgram/ml. Most of the patients with respiratory infection were aged 70 years or older, accounting for approximately a half of the total (44.4%). As for the incidence by the diseases, bacterial pneumonia and chronic bronchitis were the highest, being noted in 38.0% and 31.7% of all the patients, respectively. The bacteria frequently isolated from the patients with bacterial pneumonia were S. aureus (18.3%) and S. pneumoniae (16.1%). In contrast, H. infiuenzae (20.4%) and P. aeruginosa (both mucoid and non-mucoid: 16.7%) were frequently isolated from the patients with chronic bronchitis. Before the drug administration, the bacteria frequently isolated from all the patients were S. pneumoniae (24.3%) and H. infiuenzae (26.7%). The frequency of isolated S. pneumoniae tended to decrease with the increase in the number of administration days while that of isolated H. infiuenzae did not. The frequency of isolated P. aeruginosa tended to increase with the duration of administration. The isolated bacteria were comparable between the patients already treated with penicillins and cephems. In the patients treated with aminoglycosides, macrolides, and quinolones, P. aeruginosa was most frequently isolated (33.3 to 40.0%).     

Blood pressure and urinary cations in urban Bantu of Zaire

The 24-hour urinary excretion of sodium, potassium, calcium, and magnesium and their relationship to arterial blood pressure were investigated from December 1983 to May 1984 in a 10% random sample (n = 666) of urban Bantu of Kinshasa, Za?re. In youths aged 10-19 years, blood pressure averaged 109/60 mmHg, and the 24-hour urinary excretion of sodium, potassium, calcium, and magnesium averaged 84 mmol, 30 mmol, 483 mumol, and 2 mmol, respectively. After adjustment for age and body weight, a weak positive association became apparent between diastolic pressure and the urinary sodium to potassium ratio in girls and all youths. In adults aged greater than or equal to 20 years, blood pressure averaged 124/72 mmHg, and the 24-hour urinary excretion of sodium, potassium, calcium, and magnesium averaged 87 mmol, 33 mmol, 828 mumol, and 1.88 mmol, respectively. After adjustment for sex, age, body weight, and pulse rate in all adults, systolic pressure was significantly and positively correlated with urinary sodium excretion and negatively correlated with urinary potassium excretion, while diastolic pressure was weakly associated with urinary calcium excretion. In women, an independent and significant association was also observed between systolic pressure and 24-hour urinary sodium. When instead of the 24-hour urinary excretion of sodium and potassium, the sodium to potassium ratio was considered as an independent variable in multiple regression analysis, both systolic and diastolic pressure were independently and positively related to the sodium to potassium ratio in all adults. These results indicate that in this urban Bantu population, age and body weight are the major predictors of systolic pressure in youths and the major predictors of both systolic and diastolic pressure in adults. The sodium to potassium ratio did contribute to the prediction of blood pressure in girls and when, in youths as well as in adults, both sexes were considered together. Urinary calcium was associated with diastolic pressure only in all adults.     

t—PA结膜下注射治疗术后眼内纤维蛋白渗出

为观察ｔ－ＰＡ（组织型纤溶酶原激活剂）结膜下注射对术后眼内纤维蛋白渗出的治疗效果，对２０例（２０眼）术后眼内纤维蛋白渗出患者用ｔ－ＰＡ结膜下注射。ｔ－ＰＡ治疗浓度为５０μｇ／ｍｌ，每次注射剂量为０．５ｍｌ，一次注射不能使纤维蛋白渗出完全溶解者间隔４８～７２小时重复给药，直至吸收。并与同期１９例（１９眼）用地塞米松治疗眼内纤维蛋白渗出的病人作对照。结果表明ｔ－ＰＡ组眼内纤维蛋白渗出完全吸收时间为注药后１～１４天，平均５．２０±３．４９天。对照组纤维蛋白渗出完全吸收时间为１～２１天，平均１０．３２±５．９６天，二者相比，有显著差异（Ｐ＜０．０１）。在ｔ－ＰＡ组治疗中未发现出血倾向、眼内压升高等并发症。全组病人随访一个月，未见眼内纤维蛋白渗出复发。认为ｔ－ＰＡ结膜下注射治疗眼内纤维蛋白渗出为一种安全有效的治疗方法。     

前列腺细菌感染与前列腺摘除术细菌感染的关系

目的：探讨增生前列腺组织细菌感染与前列腺摘除术细菌感染的关系。　方法：对７５ 例前列腺增生症病例作前列腺摘除术的前列腺组织进行细菌培养，同时作血液和尿液细菌培养。　结果：７５ 例中，前列腺组织细菌培养阳性 ３０ 例（４０％ ）。术前置管导尿的病例前列腺细菌感染率较高，为５４．５％ ；术前未行导尿的病例前列腺细菌感染率较低，为１９．４％ 。术前有菌尿症的病例，８７．５％ 有前列腺细菌感染；术前无菌尿症的病例，仅２１．３％ 有前列腺细菌感染。术中或术后菌血症占１０．７％ 。前列腺有细菌感染的病例，术后菌尿症发病率较高，为４０％ ；前列腺未发现细菌的病例，术后菌尿症发病率较低，为１１．１％ 。　结论：留置导尿管和菌尿症的病人前列腺细菌感染率较高，有前列腺细菌感染的病例发生术中、术后菌血症和术后菌尿症的危险性较高。