阑尾为什么容易发炎?

问 :阑尾为什么容易发炎 ?答 :阑尾是附属于盲肠末端的一段肠管 ,位于盲肠和回肠交界处的后下方 ,一端开口于盲肠 ,另一端为盲端。阑尾外形细长 ,曲如蚯蚓 ,因此又叫蚓突。其大小因人身材的长短而有差异。平均约长 7～ 9cm,直径 0 .5～1.5cm。阑尾外面由腹膜包裹 ,并形成阑尾系膜 ,将阑尾悬挂于盲肠末端 ,系膜一般比阑尾短 ,因此 ,易造成阑尾曲折或扭转。以上结构特点导致阑尾引流不畅 ,使细菌容易停留壁内生长繁殖 ,人体肠道内本来就寄生有种类繁多的致病菌 ,这就构成阑尾易发炎的条件。另外 ,阑尾的血液供应仅为一条阑尾动脉 ,它是盲动脉…     

家犬下腹部及盆部淋巴系统解剖

用１０％普鲁士蓝氯仿溶液，对１６只家犬的腹、盆部器官做淋巴管间接注射。结果表明：在肠系膜上动脉的左右侧，有两个最大的淋巴结，分别为左、右肠系膜淋巴结。左肠系膜淋巴结接受空肠、大部回肠的淋巴管和胰十二指肠淋巴结及结肠淋巴结的输出管。右肠系膜淋巴结接受回肠末段的淋巴管。两肠系膜淋巴结的输出管与肝总淋巴结、胰脾淋巴结的输出管汇合，组成肠干，注入乳糜池的右侧。盆部髂内淋巴结最大，接受来自乙状结肠淋巴结和盆部器官淋巴结的输出管。两侧骼内淋巴结的输出管分别组成左、右腰干，向头侧走行，注入乳糜池的尾端。     

家犬下腹部及盆 淋巴系统解剖

用１０％普鲁士蓝氯仿溶液,对１６只家犬的腹,盆部器官做淋巴管间接注射。结果表明：在肠系膜上动脉的左右侧,有两个最大的淋巴结,分别为左、右肠系膜淋巴结。左肠系膜淋巴结接受空肠、大部回肠的淋巴管和胰十二指肠淋巴结及结肠淋巴结的输出管。右肠系膜淋巴结接受回肠末段的淋巴管。两肠系膜淋巴结的输出管与肝总淋巴结、胰脾淋巴结的输出管汇合,组成肠干,注入乳糜池的右侧。盆部髂内淋巴结最大,接受来自乙状结肠淋巴结和盆     

VEGF-D的表达与膀胱移行细胞癌LVD及淋巴结转移有关

目的观察血管内皮生长因子D(vascular endothelial growth factor D,VEGF-D)在人膀胱移行细胞癌组织内的表达,探讨VEGF-D在膀胱移行细胞癌组织淋巴管密度(lymphatic vessel density,LVD)及淋巴结转移之间的关系。方法取人膀胱移行细胞癌组织蜡块30例,免疫组化法观察VEGF-D在膀胱移行细胞癌组织内的表达情况。以淋巴管内皮特异性标记物D2-40标记淋巴管,计数癌组织内淋巴管密度。结果VEGF-D蛋白主要表达于癌细胞胞浆内,VEGF-D在淋巴结转移组膀胱移行细胞癌组织内的表达水平明显高于无淋巴结转移组(P0.05);淋巴结转移组膀胱移行细胞癌组织内的淋巴管密度明显高于无淋巴结转移组(P0.05)。VEGF-D表达与膀胱移行细胞癌淋巴管密度及淋巴结转移之间具有显著的相关性。结论VEGF-D表达在膀胱移行细胞癌组织内淋巴管生成及淋巴结转移中起重要作用。     

TGF-β1和Smad4在膀胱癌中的表达及其与淋巴结转移的关系

目的：观察转化生长因子β1（TGF-β1）和Smad4在膀胱癌组织内的表达情况,并分析其与膀胱癌淋巴管生成及淋巴结转移之间的关系。方法：选择在本院确诊的膀胱癌患者50例,根据淋巴结转移与否分为淋巴结转移组（30例）和无淋巴结转移组（20例1。应用免疫组化法检测膀胱癌组织内TGF-β1和Smad4的表达。以D2—40作为淋巴管内皮特异性标记物,检测膀胱癌组织内淋巴管生成情况并分析其与TGF-β1和Smad4的表达的关系。结果：TGF．B1主要表达于膀胱癌细胞胞浆内,在淋巴结转移组的表达率明显高于无淋巴结转移组（P=0．017）。Smad4表达于膀胱癌细胞胞浆和胞核内,在无淋巴结转移组的表达率明显高于有淋巴结转移组（P=0．005）。Smad4表达阳性组的淋巴管数密度（LVD）明显低于Smad4表达阴性组（P=0．037）。TGF-p1的表达与Smad4的表达呈显著的负相关性（P=0．001）。结论：TGF-β1的表达与膀胱癌淋巴管生成及淋巴结转移呈显著正相关,Smad4的表达与膀胱癌淋巴管生成及淋巴结转移呈显著负相关,TGF-β1／Smad4信号通路可能在膀胱癌淋巴管生成和淋巴结转移过程中起重要作用。     

肿瘤淋巴管入侵与无淋巴结转移膀胱癌复发及预后的相关性分析

目的:分析肿瘤淋巴管入侵与无淋巴结转移膀胱癌复发和预后之间的关系。方法:选取临床资料完整的膀胱癌病例72例,分为淋巴结转移组(32例)和无淋巴结转移组(40例)。采用Spearman相关分析探讨淋巴管入侵与膀胱癌复发和预后的相关性,应用Kaplan-Meier法描绘生存曲线,Cox比例危险度模型筛选影响膀胱癌患者预后的因素。结果:在72例膀胱癌组织中,淋巴管入侵的阳性率是48.6%(35/72),淋巴管入侵的阳性率随肿瘤分期和分级增加而显著升高(P0.05);淋巴结转移组的淋巴管入侵阳性率为68.8%(22/32),显著高于无淋巴结转移的32.5%(13/40)。淋巴管入侵与膀胱癌的临床分期、分级、淋巴结转移以及无淋巴结转移膀胱癌复发均显著相关(P0.05)。淋巴管入侵阴性的患者的五年总体生存率显著高于淋巴管入侵阳性者,淋巴管入侵是无淋巴结转移膀胱癌复发和预后不良的危险因素。结论:肿瘤淋巴管入侵与膀胱癌临床分期和淋巴结转移密切相关,并影响膀胱癌患者的总体生存率,可作为无淋巴结转移膀胱癌复发和预后的预测因素。     

血管内皮生长因子-C与乳腺癌淋巴管生成和淋巴结转移的关系

目的探讨血管内皮生长因子-C与乳腺癌淋巴管生成和淋巴结转移的关系。方法免疫组化法检测21例乳腺增生组和68例乳腺浸润性导管癌组病灶组织内VEGF-C蛋白的表达,并用淋巴管内皮细胞特异性标志物D2-40标记肿瘤新生淋巴管,计数肿瘤淋巴管的密度（LVD）。结果乳腺浸润性导管癌组VEGF-C的表达和淋巴管的密度（LVD）都明显高于乳腺增生组（P〈0．01）;乳腺浸润性导管癌中VEGF-C阳性组中淋巴管的密度（11．32±5．78）与VEGF-C阴性组中的淋巴管密度（8．75±3．53）,差别有统计学意义（P〈0．01）;乳腺浸润性导管癌中VEGF-C蛋白的表达和淋巴管密度（LVD）都与有无腋窝淋巴结转移及淋巴结转移个数有关（P〈0．05）。结论VEGF-C在乳腺浸润性导管癌淋巴管的生成中起着重要的作用;VEGF-C的高表达和淋巴管密度（LVD）的升高是促进乳腺导管癌淋巴结转移的重要的影响因素。     

大鼠小肠淋巴微循环及葡萄糖,右旋糖酐对淋巴流量和压力的影响

本实验采用淋巴管显示的方法观察大鼠小肠淋巴管分布走行及淋巴流的状态。肠壁淋巴管相互连接形成不规则的网格样分布,管径粗细不均,为１５─７３μｍ。肠壁淋巴管内未见淋巴瓣膜,淋巴液在管腔内流动。在肠壁交界处的淋巴管内有淋巴瓣膜和淋巴管的收缩运动,收缩频率４─３８次／ｍｉｎ。由静脉输注葡萄糖液、低分子右旋糖酐和生理盐水溶液,测量淋巴流量和压力的变化。小肠淋巴流量正常时为０．０５ｍｌ。用３５％葡萄糖液静脉注射后,淋巴流量和压力为０．７８±０．２８ｍｌ和０．９２±０．４６ｋＰａ,比输低分子右旋糖酐明显增加,生理盐水对淋巴流量改变作用不明显。表明葡萄糖液能促进淋巴液的生成,使淋巴流量增加,有利于血液和组织液的交换。     

MMP2和MMP9在粘膜内胃癌中表达及其临床病理意义

目的:观察基质金属蛋白酶(MMP)家族成员MMP2和MMP9在粘膜内胃癌中的表达及其与淋巴结转移的相关性。方法:研究病例为病理诊断为粘膜内胃癌的档案病例,应用免疫组织化学技术检测MMP2和MMP9在粘膜内胃癌中表达的临床病理意义,特别是与淋巴结转移的相关性。结果:临床病理分析结果显示有淋巴结转移的IMGC病例肿块直径要显著大于无淋巴结转移的IMGC。有淋巴结转移IMGC中低分化腺癌发生率要显著高于无淋巴结转移组。有淋巴结转移IMGC中淋巴管侵犯发生率要显著高于无淋巴结转移组。免疫组化结果显示,MMP2在正常胃粘膜上皮和粘膜内胃癌中的阳性表达率分别是7%和43.93%,有显著性差异(P0.01),MMP9在正常胃粘膜上皮和粘膜内胃癌中的阳性表达率分别为和23%和48.48%,无显著性差异(P0.05)。MMP9在淋巴结转移组中的阳性率(87.5%)显著高于无淋巴结转移组(36%),在有淋巴管侵犯病例中的表达率(83.3%)显著高于无淋巴管侵犯的病例(30%),差异均有统计意义(P0.05);而MMP2的表达与有无淋巴结转移及淋巴管侵犯均无显著相关性(P0.05)。结论:MMP9可能作为预测粘膜内胃癌是否有淋巴结转移的标志物,但需要结合组织分化、肿块大小和淋巴管侵犯等临床病理特点综合判断。MMP2可能与粘膜内胃癌的发生有关而作为早期诊断的指标。     

磁共振间质淋巴造影实验研究

目的:探讨间质MR淋巴造影对肢体淋巴水肿的诊断价值。方法:用改良的Danese手术方法在13只新西兰大白兔后肢一侧形成淋巴水肿模型,另一侧作为对照。在每只大白兔双侧后肢足背部趾蹼处注射0.2ml欧乃影,按摩注射部位30秒钟。分别于造影剂注射前后进行三维MR淋巴造影及延迟淋巴造影成像。结果:实验侧淋巴管阻塞早期为渗出性改变及淋巴管侧支开放,晚期出现淋巴管扩张、迂曲、皮肤逆流。引流远端淋巴结显影较对照侧明显延迟。对照侧欧乃影吸收迅速,引流区域各组淋巴结、淋巴管及胸导管显示清晰。结论:间质MR淋巴造影可以在解剖背景下很好地显示引流区域淋巴管、淋巴结的解剖形态、功能及其异常表现。     

Three-dimensional organization of lymphatics and its relationship to blood vessels in rat small intestine

Summary The lymphatic organization and its relationship to the vascular system in the rat small intestine was studied by scanning electron microscopy of corrosion casts and freeze-fractured tissues, and by light microscopy of injected preparations. The villus possessed 3–10 or more central lacteals depending upon the villous width. The lacteals in each villus possessed interconnections between adjacent ones and were surrounded externally by the villous capillary network. At the villous base, the lacteals fused and formed a wide sinus, from which 2 or 3 lymphatics descended and led into the submucosal ones. In the muscularis externa there was a coarse lymphatic network which, together with the submucosal one, drained into collecting lymphatics continuous with the mesenteric ones. The central lacteals and the sinus were lined with thin endothelial cells with cytoplasmic leaves interdigitating with those of adjacent ones. There were tissue channels in the villous interstitial space, which opened through the gaps between the lymphatic endothelial cells into the central lacteals.The voluminous lacteals in the villi suggest their great potential for lymph formation. The existence of collecting lymphatics with valves in the muscularis externa suggests that contraction of the layer is involved in transporting lymph towards the efferent lymphatics.     

胃良性病变不同部位粘膜肌形态改变及其意义

观察胃良性病变不同部位粘膜肌形态学改变及其意义。用目镜测微尺对不同部位的胃粘膜肌厚度进行测量,部分病例做网状纤维的VG染色。结果显示根据粘膜肌的形态学变化,把增厚之粘肌分作三个类型：即炎性增厚、肌性增厚和纤维性增厚,粘膜肌的改变与相应区的胃粘膜病变有关,结果表明粘膜肌的改变有三种类型,胃窦区的病变较体区重,粘膜的形态改变可能影响胃粘膜腺体的分泌,并有利于粘膜内癌向粘膜下侵犯。     

Evidence for a second valve system in lymphatics: endothelial microvalves.

The mechanism for interstitial fluid uptake into the lymphatics remains speculative and unresolved. A system of intralymphatic valves exists that prevents reflow along the length of the lymphatic channels. However, these valves are not sufficient to provide unidirectional flow at the level of the initial lymphatics. We investigate here the hypothesis that initial lymphatics have a second, separate valve system that permits fluid to enter from the interstitium into the initial lymph channels but prevents escape back out into the tissue. The transport of fluorescent microspheres (0.31 microm) across endothelium of initial lymphatics in rat cremaster muscle was investigated with micropipette manipulation techniques. The results indicate that microspheres can readily pass from the interstitium across the endothelium into the lumen of the initial lymphatics. Once inside the lymphatic lumen, the microspheres cannot be forced out of the lumen even after elevation of the lymphatic pressure by outflow obstruction. Reaspiration of the microspheres inside the lymphatic lumen with a micropipette is blocked by the lymphatic endothelium. This blockade exists whether the aspiration is carried out at the microsphere entry site or anywhere along the initial lymphatics. Nevertheless, puncture of the initial lymphatic endothelium with the micropipette leads to rapid aspiration of intralymphatic microspheres. Investigation of lymphatic endothelial sections fixed during lymph pumping shows open interendothelial junctions not found in resting initial lymphatics. These results suggest that initial lymphatics have a (primary) valve system at the level of the endothelium. In conjunction with the classical (secondary) intralymphatic valves, the primary valves provide the mechanism that facilitates the unidirectional flow during periodic compression and expansion of initial lymphatics.     

A Model for Fluid Drainage by the Lymphatic System

This study investigates the fluid flow through tissues where lymphatic drainage occurs. Lymphatic drainage requires the use of two valve systems, primary and secondary. Primary valves are located in the initial lymphatics. Overlapping endothelial cells around the circumferential lining of lymphatic capillaries are presumed to act as a unidirectional valve system. Secondary valves are located in the lumen of the collecting lymphatics and act as another unidirectional valve system; these are well studied in contrast to primary valves. We propose a model for the drainage of fluid by the lymphatic system that includes the primary valve system. The analysis in this work incorporates the mechanics of the primary lymphatic valves as well as the fluid flow through the interstitium and that through the walls of the blood capillaries. The model predicts a piecewise linear relation between the drainage flux and the pressure difference between the blood and lymphatic capillaries. The model describes a permeable membrane around a blood capillary, an elastic primary lymphatic valve and the interstitium lying between the two.     

PLANNED RESECTION OF THE REGIONAL LYMPH NODES IN PNEUMONECTOMY FOR CARCINOMA

Although there has been a reluctance to include the regional lymph nodes in pneumonectomy for cancer because of the supposed inaccessibility of the nodes, radical removal of the nodes within the thorax is a feasible procedure.Failure to include the regional nodes in pneumonectomy for cancer violates the accepted principle of inclusion of the regional lymphatics in operations for cancer. If pneumonectomy is indicated for removal of a malignant lesion, then removal of the regional nodes is also indicated. Injection of a dye helps the surgeon in identification of lymphatics to be excised.     

Peritoneal macrophages introduced into mouse foot pads enter the germinal center of regional lymph nodes nonspecifically.

Male mice were injected into their foot pads with sheep erythrocytes (SRBC) to form lymph follicles in the germinal centers in the popliteal lymph nodes. 4 weeks later, peritoneal macrophages labeled with carbon from syngeneic donors sensitized with SRBC or typhoid-paratyphoid bacilli (TAB) were separately injected into the foot pads as well. The popliteal lymph nodes were histologically examined at 6 h to 5 days after injection. Labeled macrophages appeared in the marginal sinus, migrated straight across the cortex from the marginal sinus to the lymph follicles and then entered the germinal centers. There was no difference in the mode of appearance, migration and localization of labeled macrophages in the regional lymph nodes between the mice given labeled macrophages from SRBC-sensitized donors and those given macrophages from TAB-sensitized donors. The entrance of lymph macrophages into the germinal centers of the regional lymph nodes would be immunologically nonspecific. After the injection of Pelikan ink into the foot pads, the macrophages which have taken up carbon in the peripheral tissue reached the regional lymph nodes via the afferent lymphatics and then entered the germinal centers, mainly through the medullary pole of the lymph follicles, after migrating along their immediate exterior from their marginal sinus to their medullary pole.     

Strongyloidiasis in an infant orangutan (Pongo pygmaeus)

Necropsy of a 15-month-old male orangutan (Pongo pygmaeus) showed multiple nodular elevations of the mucosa of the colon, petechial hemorrhages in both lungs, and mucosal ulcerations in the cecum, appendix, and proximal colon. Light microscopy revealed filariform larvae of Strongyloides in the lung, colon, and mesenteric lymph nodes. Rhabditiform larvae were also observed in sections of colon.     

Structure and carbohydrate histochemistry of the esophagus in ten teleostean species

The histology and carbohydrate histochemistry of ten teleostean esophagi were compared. Structurally, the four layers of a typical vertebrate digestive tract were consistently present. The epithelium was always stratified and in all but one species (Ictalurus nebulosus) contained taste buds. Esophageal mucous cells were not the typical goblet cells seen in other vertebrates but appeared to be of six different types, pairs of which were associated with particular families. In esocids, poorly developed mucous acini and serous monogranular cells were present. In all species, the subepithelial connective tissue was not divided into definitive lamina propriae and submucosae due to the absence of muscularis mucosae. Variably present in this connective tissue region were argentophilic fibers and in esocids only, randomly dispersed striated muscle fibers. The arrangement of the muscularis was reverse to that of the general vertebrate plan. In mucous cells, three general types of epithelial mucosubstances were identified and in broad terms were recognized as sulfomucins, sialomucins and neutral mucosubstances. Morphological differences were accompanied by differences in carbohydrate localization, each esophageal epithelium containing at least two different mucosubstances. However, the mucosubstances identified in each mucous cell had a profile of characteristics different in some respects from any other. Thus teleostean esophagi appear to perform an integrated diversity of functions as reflected by their complex morphology and carbohydrate histochemistry.     

Trypanosoma equiperdum: Movement from the dermis

Twelve dogs were injected intradermally with 352,770 to 14,391,660 Trypanosoma equiperdum and afferent and efferent lymph, lymph nodes, and blood examined by mouse inoculation at minute, hourly, and daily intervals following inoculation. The log dosage of trypanosomes given each dog was closely related to their body weight (P < 0.01). Afferent lymph contained trypanosomes as soon as 5 and 27 min after inoculation. Lymph nodes on the side of injection became positive within 5 min of injection, while those on the contralateral side remained negative for at least 120 min after injection. Blood contained trypanosomes as soon as 5 min after injection, although the average time for all dogs, before trypanosomes were demonstrated in the blood, was 40 min postinjection. Efferent lymph did not contain organisms until 25–76 hr after inoculation. We consider this sequence to indicate that T. equiperdum can leave the dermis in afferent lymphatics, reach the local lymph node, invade the blood stream from this site, and only after a day or longer do they leave the node via the efferent lymphatics.     

Bacterial infections of skin and soft tissues in filariasis

Adenolymphangitis is a common occurrence in filarial lymphedema. Damage to the lymphatics and lymph nodes by F. bancrofti is followed by obliteration of lymph vessels and lymph stasis. Obstruction of lymphatics prevents the bacteria penetrating skin to be evacuated with lymph stream to regional lymph nodes. Colonization of dermis, subcutis and lymphatics evokes clinical symptoms of adenolymphangitis. The question arises which strains of bacteria are responsible for the acute and chronic types of adenolymphangitis. The most probable strains responsible for this condition belong to the cocci and probably the bacillus strains.