Changes in T .lymphocyte subsets after severe traumatic brain inJury

BACKGROUND： Besides local changes of cranial parenchymal cells, hemorrhage, etc., severe traumatic brain injuries also cause the changes of total body fluid and various functions, and the changes of lymphocytes and T lymphocyte subsets should be paid more attention to. OBJECTIVE： To reveal the changing laws of T lymphocyte subsets after severe traumatic brain injury, and compare with mild to moderate brain injury. DESIGN： A comparative observation. SETTINGS： Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City; Central Laboratory of Shenzhen Hospital of Prevention and Cure for Chronic Disease. PARTICIPANTS： All the subjects were selected from the Department of Neurosurgery, Longgang District Buji People＇s Hospital of Shenzhen City from August 2002 to August 2005. Thirty patients with severe brain injury, whose Glasgow coma score （GCS） was ≤ 8 points, were taken as the experimental group, including 21 males and 9 females, aging 16 - 62 years. Meanwhile, 30 patients with mild traumatic brain injury were taken as the control group （GCS ranged 14- 15 points）, including 18 males and 12 females, aging 15 -58 years. All the subjects were in admission at 6 hours after injury, without disease of major organs before injury Informed consents were obtained from all the patients or their relatives. METHODS： （1） The T lymphocytes and the subsets in peripheral blood were detected with immunofluorescent tricolor flow cytometry at l, 3, 7 and 14 days after injury in both groups. （2） The conditions of pulmonary infections were observed at 4 days after injury. The differences of measurement data were compared with the t test. MAIN OUTCOME MEASURES： Changes of T lymphocytes subsets at 1 - 14 days after severe and mild or moderate traumatic injury. RESULTS： Finally, 28 and 25 patients with mild to moderate traumatic brain injury, whereas 25 and 21 patients with severe traumatic brain injury were analyzed at 7 and 14 days respectively, and the missed ones died due to the development of disease. （1） Changes of T lymphocyte subsets： At 1 and 3 days after injury, CD3, CD4, CD8, CD4/CD8 began to decrease, whereas CD8 increased in the experimental group, which were very significantly different from those in the control group （t =2.77 - 3.26, P 〈 0.01）, and began to recover at 7 days, which were significantly different from those in the control group （t = 2.06 - 2.24, P 〈 0.05）, and generally recovered to the normal levels at 14 days （P 〉 0.05）. （2） Conditions of pulmonary infections： At 4 days after injury, the rate of pulmonary infection was significantly different between the experimental group and control group [73% （22/30）, 0, x2=37.29, P 〈 0.01]. CONCLUSION： Patients with severe traumatic brain injury suffer from damages of cellular immune function at early period （within 7 days）, and they are easily to be accompanied by pulmonary infections.     

酶组化显示睾丸LDH－X方法的再探讨

对小鼠睾丸冰冻切片ＬＤＨ－Ｘ的显示方法作了进一步探讨。实验表明，以Ｌ－２－羟基－３－甲基戊酸（ＨＭＶ）为特异性底物，能相当有效地显示睾丸ＬＤＨ－Ｘ的分布，且该底物的配制方法简便易行。在显示ＬＤＨ－Ｘ的孵育液中采用萘酚蓝（ＮＢ）作中间递电子体较吩嗪甲基硫酸酯更具优越性。     

基于TRPV1/TRPA1调控TLR/NLRP3通路探讨中医药干预动脉粥样硬化研究进展

动脉粥样硬化（AS）是一种脂质堆积、血管内皮功能障碍导致的慢性炎症性疾病,Toll样受体（TLR）/核转录因子-κB(NF-κB)通路与NOD样受体蛋白3(NLRP3)炎性小体通路在动脉粥样硬化的产生中发挥着重要的致炎作用,而瞬时受体电位香草酸亚型1(TRPV1)与瞬时受体电位锚蛋白1(TRPA1)在动脉粥样硬化的发生过程中发挥着重要的保护作用。作者对近10年国内外期刊发表的相关研究进行梳理,研究显示,TRPV1/TRPA1的激活可以通过多种途径激活内皮型一氧化氮合酶（eNOS）、抑制活性氧（ROS）、抑制胆固醇晶体（CC）的产生进而调控TLR/NF-κB与NLRP3炎性小体通路,抑制TLR/NLRP3介导的炎症反应。同时,中医药中多种单味药有效成分与方剂可有效激活TRPV1/TRPA1或其下游途径,其对动脉粥样硬化中TLR/NLRP3通路可能具有显著调控作用。该文进一步对已探明的方剂及中药单味药有效成分调控AS中TLR/NLRP3通路的机制进行梳理,将TRPV1/TRPA1调控TLR/NLRP3途径的机制与中药方剂与单体成分进行对应。为治疗动脉粥样硬化的中药药物相互作用机制提供新启发...     

视神经管减压术治疗视神经挫伤20例分析

目的：报告视神经挫伤行视神经管减压术的治疗效果。方法：手术治疗限定于外伤后不超过1月且无严重颅脑损伤及无严重全身疾病者。采用局麻筛蝶窦入口法,手术前后常规用糖皮质激素及神经生长因子。结果：20例术前无光感16例,术后1周视力有光感及手动以上12例,占75％;术前视力在手动－0．04以内4例,术后视力均提高。术后随访3个月除2例外视力均有提高,最好达到0．3。结论：视神经挫伤病期不超过1月虽视力已无光感也不应放弃行视神经管减压术。     

Neoadjuvant combination of pazopanib or axitinib and programmed cell death protein-1-activated dendritic cell-cytokine-induced killer cells immunotherapy may facilitate surgery in patients with renal cell carcinoma

BackgroundRadical/cytoreductive nephrectomy or nephron-sparing surgery may be thought to be not safe or unfeasible in some renal cell carcinoma (RCC) patients in which tumor is locally advanced or highly complicated. Neoadjuvant therapy may reduce the volume of the tumor, thus facilitates surgery. The aim the study is to evaluate the efficacy and safety of neoadjuvant combination of pazopanib or axitinib and PD-1-activated dendritic cell-cytokine-induced killer (PD-1/DC-CIK) cell immunotherapy in those patients.MethodsData from 16 RCC patients who received neoadjuvant pazopanib (Group P, n=9) or axitinib (Group A, n=7) plus PD-1/DC-CIK cells immunotherapy were reviewed retrospectively. A total of 9 participants that were potential candidates for radical/cytoreductive nephrectomy (RN/CN) had locally advanced tumor and 5 participants with partial nephrectomy (PN) absolute indications had highly complicated tumors. The efficacy outcomes were based on volume changes of the primary tumor, lymph nodes, and tumor thrombus in 13 participants with complete computed tomography (CT) imaging. The treatment-related toxicities and surgical complications were also reported.ResultsWith a median of 2.1 months treatment, the overall volume of the tumors decreased by a median of 42.30% [interquartile range (IQR): 19.37–66.78%]. Specifically, the median reduction of tumor volume was 88.77 and 15.50 cm³ in group P and group A, respectively (P=0.014). However, participants in Group P were more likely to experience grade 3 or 4 treatment-related adverse events (AEs) than those in Group A (44.4% vs. 0). Finally, all participants were candidates for appropriate surgery after neoadjuvant therapy (as assessed by the surgeon), and 10 participants accepted surgery, including 5 PN, 4 RN/CN, and 1 lymph node dissection. A solitary participant had Clavien grade IV acute renal failure required dialysis and another had grade II lymphatic leakage.ConclusionsNeoadjuvant combination of pazopanib or axitinib and PD-1/DC-CIK cells immunotherapy was well-tolerated and could effectively reduce the volume of tumors in locally advanced or highly complicated RCC patients.     

性病门诊病人性行为调查

了解性病门诊病人性行为的情况,采用不记名问卷、选择回答问题的调查方法,对101例就诊者进行性行为调查,结果表明,在就诊者中均有较多的婚前性行为(70%)和较多的婚外性行为(52.84%).性伴为1人的仅为18例(17.82%),大多为2人及以上,性伴较复杂,曾与各类服务员、暗娼发生性行为的有51例(50.50%),且多数人在发生性行为时不用避孕套.因此,存在着感染性病、艾滋病的危险性.     

早期大剂量纳洛酮对弥漫性轴索损伤患者β淀粉样前体蛋白的影响

目的观察早期大剂量纳洛酮对弥漫性轴索损伤(DAI)患者血浆β淀粉样前体蛋白(β-APP)的影响。方法经头颅CT及MRI检查诊断为DAI的56例患者纳入本研究。将患者随机分为对照组、小剂量治疗组及大剂量治疗组,分别为18、19、19例。对照组给予常规治疗,小剂量、大剂量治疗组在常规治疗基础上,分别按0.1、0.4mg.kg-1.d-1的剂量给予纳洛酮治疗。采用Western blot检测3组患者治疗前后血浆β-APP浓度。结果治疗后1、3、7d,3组患者血清中β-APP含量较治疗前均有统计学意义(F=0.131,P=0.010)。治疗后1d,3组患者血清中β-APP含量间差异均无统计学意义(F=0.570,P=0.612);治疗后3、7d,3组患者血清中β-APP含量间差异均有统计学意义(F=1.820,1.460;P=0.012,0.000)。结论早期大剂量纳洛酮可有效降低DAI患者血清中β-APP的表达。     

Novel predictive biomarkers for acute injury superimposed on chronic kidney disease

Introduction and objectivesChronic kidney disease (CKD) is a risk factor for the development of acute kidney injury (AKI). Recent studies have revealed numerous biomarkers eligible for AKI prediction. However, the expression and performance of AKI biomarkers in acute injury superimposed on preexisting CKD (AonC) remain elusive. The aim of this study was to evaluate whether biomarkers which robustly expressed in acute kidney injury could predict acute injury based on CKD.Materials and methodsMice were classified into cohorts: AKI, CKD, AonC and sham. The AonC model mice were subjected to renal bilateral ischemia/reperfusion (I/R) injury fourteen days after intraperitoneally administrated with 20 mg/kg aristolochic acid. Severity of acute ischemic injury was stratified by clamping the dissected bilateral renal arteries with non-traumatic microvascular clips for 20 or 35 min. The AKI mice were induced with renal bilateral I/R injury and CKD mice were crafted with 20 mg/kg aristolochic acid administrated intraperitoneally. Histology, genetic and protein expression of biomarkers were measured in three cohorts.ResultsWe found that serum creatinine dramatically increased in severe (sAonC) but not in moderate (mAonC) injury mice. Upregulation of Kidney injury molecule-1 (KIM-1) mRNA, tissue inhibitor of metalloproteinase-2 (TIMP-2), Syndecan-1 (SDC-1) mRNA and insulin-like growth factor binding protein-7 (IGFBP7) protein indicated the onset of mAonC. An increase in neutrophil gelatinase-associated lipocalin (NGAL), rhomboid-like protein 2 (RHBDL2), Syndecan-1 (SDC-1) mRNA and protein, and a decrease in IGFBP7 protein were associated with sAonC.ConclusionsOur study revealed the variational expression of AKI biomarkers in AonC kidneys, and uncovered IGFBP7 protein can be used as a sensitive biomarker to predict and differentiate AonC severity. The performance of RHBDL2 and SDC-1 in predicting severe AonC was promising, providing new biomarkers for predicting AonC.     

Prx1+骨骼干细胞的研究进展

配对相关同源基因1(paired related homeobox 1, Prx1/Prrx1/MHox）在胚胎肢芽和颅面发育中高表达,成体中的Prx1+细胞分布在长骨的骨膜、骨髓和颅骨的骨缝中,表现出间充质干细胞（mesenchymal stem cells,MSCs）或骨骼干细胞（skeletal stem cells,SSCs）的特征。近期的研究显示,表达Prx1基因的骨骼干细胞（Prx1+ skeletal stem cells, Prx1+SSCs）参与了骨骼的创伤愈合和对机械应力的应答反应。同时,牙周膜中Prx1+细胞在牙周组织正常发育和缺损修复中发挥的作用也受到关注。该文回顾Prx1基因和Prx1+细胞的特征和功能,总结Prx1+SSCs对骨骼改建或修复的作用,有助于SSCs在调控颅面骨生长、促进牙槽骨再生中的深入研究。