前哨淋巴结检测方法及其在肿瘤中的研究进展

前哨淋巴结(sentinel lymph node,SLN)是肿瘤淋巴结转移的第一站,SLN活检肿瘤阳性的患者需要做系统性淋巴结清扫;SLN活检阴性的患者,不需要做系统性淋巴结清扫,可以缩短手术时间,降低手术费用,减少手术并发症;目前识别SLN的方法包括生物活性染料示踪法,放射性核素示踪法,联合示踪法,纳米炭(carbon nanoparticles,CNP)标记前哨淋巴结活检技术以及吲哚菁绿(Indocyanine Green,ICG)荧光标记法。SLN活检技术在乳腺癌、甲状腺癌、胃癌、恶性黑色素瘤、宫颈癌、子宫内膜癌等肿瘤中皆有不同程度的研究。本文通过复习文献,对前哨淋巴结检测方法予以归纳及其在常见肿瘤中的研究进展予以综述,旨在为恶性肿瘤临床治疗提供参考。     

1.5T磁共振不同序列用于检出妇科肿瘤盆腔淋巴结转移的比较

目的:比较1.5T磁共振(MRI)不同序列条件下对妇科肿瘤盆腔淋巴结转移的检出情况,探讨最佳检出序列条件。方法:选取2015年5月-2017年5月初诊为卵巢癌、宫颈癌、子宫内膜癌的患者78例作为研究对象,均行盆腔淋巴结清扫术。所有患者术前均行T1加权序列(T1WI)、T2加权序列(T2WI)、增强扫描(T1WI+C)、弥散加权成像(DWI)检查,记录每个序列检查条件下检出的盆腔转移淋巴结个数及分布。以病理结果作为判断的"金标准"进行对比。结果:对比病理检查结果,应用DWI序列对妇科肿瘤盆腔淋巴结转移的检出率(95.8%)显著高于T2WI-MRI序列(85.8%)和T1WI-MRI序列(75.0%)(P0.05);DWI序列与T1WI+C序列(90.8%)相比差异无统计学意义(P0.05);DWI阈值法与DWI短径法相比,淋巴结的检出率差异无统计学意义(P0.05)。结论:应用1.5T磁共振检查妇科肿瘤盆腔淋巴节转移时,采用DWI序列扫描对于转移淋巴结的具有较高的检出率,显著优于其他序列扫描;在进行阳性淋巴结判断中,ADC阈值法和短径法均可选用。     

Spontaneous demonstration of counterclockwise right atrial activation following successful isthmus ablation

We describe an uncommon case of typical flutter with symptomatic sinus node dysfunction, in which a permanent junctional rhythm developed following ablation of the cavo-tricuspid isthmus. This rhythm activated the right atrium in counter clockwise manner thus providing spontaneous proof of unidirectional isthmus block, a phenomenon that is usually demonstrated by proximal coronary sinus pacing.     

Ex vivo imaging of T cells in murine lymph node slices with widefield and confocal microscopes

Naïve T cells continuously traffic to secondary lymphoid organs, including peripheral lymph nodes, to detect rare expressed antigens. The migration of T cells into lymph nodes is a complex process which involves both cellular and chemical factors including chemokines. Recently, the use of two-photon microscopy has permitted to track T cells in intact lymph nodes and to derive some quantitative information on their behavior and their interactions with other cells. While there are obvious advantages to an in vivo system, this approach requires a complex and expensive instrumentation and provides limited access to the tissue. To analyze the behavior of T cells within murine lymph nodes, we have developed a slice assay ¹, originally set up by neurobiologists and transposed recently to murine thymus ². In this technique, fluorescently labeled T cells are plated on top of an acutely prepared lymph node slice. In this video-article, the localization and migration of T cells into the tissue are analyzed in real-time with a widefield and a confocal microscope. The technique which complements in vivo two-photon microscopy offers an effective approach to image T cells in their natural environment and to elucidate mechanisms underlying T cell migration.     

Experimental manipulations of afferent immune responses influence efferent immune responses to brain tumors

Tumors grow more readily in the brain than in the periphery, in part due to immune privilege. Differences in both afferent and efferent components of the immune response contribute to this lower level of responsiveness. On the afferent side, despite the lack of lymphatic vessels in the brain, antigens from brain arrive in lymph nodes and spleen by several routes, and the route taken may influence the type of response generated. Work with viruses and soluble antigens in mice has shown that the intracerebral location and the volume of the inoculation influence the strength of the cytotoxic T cell response. We examined whether these factors influence the T cell response against experimental brain tumors in mice. Placement of tumor cells in the cerebral ventricles instead of the parenchyma generated an immune response sufficient to increase survival time. A large volume of an intraparenchymal infusion of tumor cells caused spread of cells to the ventricles, and resulted in longer survival time relative to a small volume infusion. Infusion of the same dose of radiolabeled tumor cells in either a small volume or a large volume allowed tracking of potential tumor antigens to the periphery. Both modes of infusion resulted in similar levels of radioactivity in blood, spleen and kidney. Unexpectedly, cells infused intraparenchymally in a small volume, compared to a large volume, resulted in (1) more radioactivity in cervical lymph nodes (parotid and deep cervical lymph nodes), (2) a greater number of CD11b+/Gr1+ myeloid suppressor cells in the tumors, and (3) fewer CD8+ cells within the tumor mass. Consistent with these observations, providing a stronger afferent stimulus by giving a concurrent subcutaneous injection of the same tumor cells infused into the brain increased CD8+ T cell infiltration of the tumor in the brain. These results suggest that the immune response elicited by antigens that drain predominantly to the cervical lymph nodes may be less effective than responses elicited at other lymph nodes, perhaps due to immunosuppressive cells. Directing therapies to the optimal peripheral sites may improve immune responses against brain tumors.     

硫化氢对家兔窦房结起搏细胞的电生理效应

本研究应用细胞内微电极技术,观察硫化氢(hydrogen sulfide,H2S)对家兔窦房结起搏细胞的电生理效应.结果表明:(1)NaHs(H2S供体)50、100、200 μmol/L浓度依赖地降低家兔窦房结起搏细胞4相去极化速率及起搏放电频率.(2)ATP敏感性钾(ATP-sensitive K ,KATP)通道阻断剂格列苯脲(glybenclamide,Gli,20 μmol/L)阻断NariS(100 μmol/L)的电生理效应.(3)预先应用起搏离子流(pacemaker currenL,If)通道阻断剂氯化铯(CsCl,2 mmol/L)对Naris(100μmol/L.)的电生理效应无影响.(4)胱硫醚-γ裂解酶(cystathionine γ-lyase,CSE)的不可逆抑制剂DL-propargylglycine (PPG,200 μmol/L)的家兔窦房结起搏细胞的动作电位参数无影响.以上结果提示,H2S对家兔窦房结起搏细胞有负性变时作用,这些效应可能与其开放KATP通道,增加K 外流有关,与If无关.本实验没有发现窦房结起搏细胞内有CSE催化产生的内源性H2S的合成.     

The vicissitudes of the pacemaker current <Emphasis Type="Italic">I</Emphasis><Subscript>Kdd</Subscript> of cardiac purkinje fibers

Summary The mechanisms underlying the pacemaker current in cardiac tissues is not agreed upon. The pacemaker potential in Purkinje fibers has been attributed to the decay of the potassium current I _Kdd. An alternative proposal is that the hyperpolarization-activated current I _f underlies the pacemaker potential in all cardiac pacemakers. The aim of this review is to retrace the experimental development related to the pacemaker mechanism in Purkinje fibers with reference to findings about the pacemaker mechanism in the SAN as warranted. Experimental data and their interpretation are critically reviewed. Major findings were attributed to K⁺ depletion in narrow extracellular spaces which would result in a time dependent decay of the inward rectifier current I _K1. In turn, this decay would be responsible for a “fake” reversal of the pacemaker current. In order to avoid such a postulated depletion, Ba²⁺ was used to block the decay of I _K1. In the presence of Ba²⁺ the time-dependent current no longer reversed and instead increased with time and more so at potentials as negative as −120 mV. In this regard, the distinct possibility needs to be considered that Ba²⁺ had blocked I _Kdd (and not only I _K1). That indeed this was the case was demonstrated by studying single Purkinje cells in the absence and in the presence of Ba²⁺. In the absence of Ba²⁺, I _Kdd was present in the pacemaker potential range and reversed at E _K. In the presence of Ba²⁺, I _Kdd was blocked and I _f appeared at potentials negative to the pacemaker range. The pacemaker potential behaves in a manner consistent with the underlying I _Kdd but not with I _f. The fact that I _f is activated on hyperpolarization at potential negative to the pacemaker range makes it suitable as a safety factor to prevent the inhibitory action of more negative potentials on pacemaker discharge. It is concluded that the large body of evidence reviewed proves the pacemaker role of I _Kdd (but not of I _f) in Purkinje fibers.     

病理分期在颌颈部淋巴结核治疗中的价值

目的:探讨病理分期在颌颈部淋巴结核治疗中的价值,以期寻找颌颈部淋巴结核的最佳治疗方案。方法:收集我科近5年的临床资料,对颌颈部淋巴结核患者的发病及治疗情况作一临床统计,并结合淋巴结核的病理分期对之加以分析,寻找治疗规律。结果:所有颌颈部淋巴结核患者按病理分期采取不同治疗方案,均达到较佳治疗效果,处于病理初期和中期的患者,临床治疗周期明显小于常规化疗。结论:遵从病理分期治疗颌颈部淋巴结核是一种较为科学合理的治疗思路和方法。     

Regeneration of zoysia grass (Zoysia matrella L. Merr.) cv. Konhee from young inflorescences and stem nodes

We have optimized conditions for efficient regeneration of the vegetatively propagated zoysia grass (Zoysia matrella L. Merr) cultivar “Konhee”. Two explants, young inflorescences, and stem nodes, were used and they displayed different responses to combinations and concentrations of plant growth regulators in callusing, embryogenic callus formation, and regeneration. The highest callus initiation rate from young inflorescences was obtained on medium supplemented with 4.5 to 9.0 μM 2,4-dicholorophenoxy acetic acid (2,4-D) and 0.44 μM 6-benzyl amino purine (BA). When the BA concentration was lowered to 0.044 μM, the highest percent embryogenic callus induction from young inflorescences was achieved. The highest callus initiation rate from stem nodes was obtained, when young inflorescences were cultured on MS medium supplemented with 4.5 to 9.0 μM 2,4-D, 0.44 μM BA, and 0.037 μM abscisic acid (ABA). But embryogenic callus formation from the stem node was highest in the presence of 4.5 to 9.0 μM 2,4-D, 0.044 μM BA, and 0.037 μM ABA. Addition of ABA significantly increased embryogenic callus formation from stem nodes, but not from young inflorescences. Regeneration percentage was variable in response to BA level, and inclusion of α-naphthalene acetic acid (NAA) and gibberellic acid (GA₃) further increased the regeneration percentage. The highest regeneration percentages obtained from the young inflorescences and stem nodes were 82% and 67%, respectively. This is the first report showing that plants can be regenerated from young inflorescences and stem nodes of vegetatively propagated zoysia grass.