腹腔镜术后联合GnRH-a治疗卵巢型内异症并不孕的疗效观察

目的:研究腹腔镜保守术后联合短期促性腺激素释放激素激动剂(GnRH-a)对卵巢型子宫内膜异位症合并不孕患者的治疗效果。方法:回顾性分析2008年5月-2011年5月在我院治疗内异症合并不孕的126例患者的临床资料,比较腹腔镜手术后联合GnRH-a治疗(用药组)和术后期待处理(对照组)的症状缓解率和妊娠情况。结果:用药组患者症状缓解率比对照组高,且差异有统计学意义(P0.05);用药组总妊娠率较对照组高,差异无统计学意义(P0.05),流产率比较无统计学差异(P0.05);治疗后患者1年内妊娠率最高,两组比较无统计学差异(P0.05),随访期间累积妊娠率比较,用药组高于对照组,无统计学意义(P0.05);用药组及对照组中Ⅰ-Ⅱ期及Ⅲ-Ⅳ期患者妊娠率均在50%以上,两组比较均无统计学差异(P0.05)。结论:此研究进一步明确腹腔镜术联合GnRH-a治疗卵巢子宫内膜异位症合并不孕患者能较好提高其症状缓解率和妊娠率,但妊娠率提高与期待治疗无差别。经手术或联合GnRH-a治疗后患者首次妊娠多发生在治疗后1年内,如果1年以上仍未妊娠,可根据实际情况选择其他助孕方法如辅助生育技术,以增加受孕机会。     

Development of Skewed Functionality of HIV-1-Specific Cytotoxic CD8+ T Cells from Primary to Early Chronic Phase of HIV Infection

In recent years, the prevalence of HIV-1 infection has been rapidly increasing among men who have sex with men (MSM). However, it remains unknown how the host immune system responds to the infection in this population. We assessed the quantity of HIV-specific CD8⁺ T-cell responses by using Elispot assay and their functionalities by measuring 5 CD8⁺ T-cell evaluations (IL-2, MIP-1β, CD107a, TNF-α, IFN-γ) with flow cytometry assays among 18 primarily and 37 early chronically HIV-infected MSM. Our results demonstrated that subjects at early chronic phase developed HIV-specific CD8⁺ T-cell responses with higher magnitudes and more diversified functionalities in comparison with those at primary infection. However, populations with IL-2⁺ CD107a⁺ or in combination with other functionality failed to develop in parallel. The multifunctional but not monofunctional HIV-specific CD8⁺ T cells were associated with higher CD4⁺ T -cell counts and lower viral loads. These data revealed that prolonged infection from primary to early chronic infection could selectively increase the functionalities of HIV-specific CD8⁺ T cells in HIV-infected MSM population, the failure to develop IL-2 and cytotoxic functionalities in parallel may explain why the increased HIV-specific CD8⁺ T cells were unable to enhance the containment of HIV-1 replication at the early chronic stage.     

Ultrasonic Elastography Research Based on a Multicenter Study: Adding Strain Ratio after 5-Point Scoring Evaluation or Not

Background

This study aimed to confirm whether strain ratio should be added after evaluation of lesions with 5-point elasticity scoring for differentiating benign and malignant breast lesions on ultrasonographic elastography(UE).

Materials and Methods

From June 2010 to March 2012, 1080 consecutive female patients with breast lesions were recruited into a multicenter retrospective study, which involved 8 centers across China. Each institutional ethic review board approved the study, and all the patients gave written informed consent. All the patients underwent the UE procedure and the strain ratios were calculated and the final diagnosis was made by histological findings. The sensitivity, specificity, accuracy, PPV and NPV were calculated for each of the two evaluation systems and the areas under the ROC curve were compared.

Results

The strain ratios of benign lesions (mean, 2.6±2.0) and malignant lesions (mean,7.9±5.8) were significantly different (p <0.01). When the cutoff point was 3.01, strain ratio method had 79.8% sensitivity, 82.8% specificity, and 81.3% accuracy, while the 5-point scoring method had 93.1% sensitivity, 73.0% specificity, and 76.8% accuracy. The areas under the ROC curve with the strain ratio method and 5-point scoring method were 0.863 and 0.865, respectively(p>0.05). The strain ratio method shows better a diagnosis performance of the lesions with elasticity score 3 and 4.

Conclusions

Although the two UE methods have similar diagnostic performance, separate calculation of the strain ratios seems compulsory, especially for the large solid breast lesions and the lesions with elasticity score 3 and 4.     

Novel matrine derivative MD-1 attenuates hepatic fibrosis by inhibiting EGFR activation of hepatic stellate cells

Matrine (MT), the effective component of Sophora flavescens Ait, has been shown to have anti-inflammation, immune-suppressive, anti-tumor, and anti-hepatic fibrosis activities. However, the pharmacological effects of MT still need to be strengthened due to its relatively low efficacy and short half-life. In the present study, we report a more effective thio derivative of MT, MD-1, and its inhibitory effects on the activation of hepatic stellate cells (HSCs) in both cell culture and animal models. Cytological experiments showed that MD-1 can inhibit the proliferation of HSC-T6 cells with a half-maximal inhibitory concentration (IC50) of 62 μmol/L. In addition, MD-1 more strongly inhibits the migration of HSC-T6 cells compared to MT and can more effectively induce G0/G1 arrest and apoptosis. Investigating the biological mechanisms underlying anti-hepatic fibrosis in the presence of MD-1, we found that MD-1 can bind the epidermal growth factor receptor (EGFR) on the surface of HSC-T6 cells, which can further inhibit the phosphorylation of EGFR and its downstream protein kinase B (Akt), resulting in decreased expression of cyclin D1 and eventual inhibition of the activation of HSC-T6 cells. Furthermore, in rats with dimethylnitrosamine (DMN)-induced hepatic fibrosis, MD-1 slowed the development and progression of hepatic fibrosis, protecting hepatic parenchymal cells and improving hepatic functions. Therefore, MD-1 is a potential drug for anti-hepatic fibrosis.     

不同品种小豆光合作用和生长发育对弱光的响应

为确定小豆作为林果行间套种作物的适宜性,通过田间试验和盆栽试验,测定全光和弱光处理(全光的48%)下3个小豆品种(阜南绿小豆、早熟黑小豆、晚熟黑小豆)在初花期的叶片光合特征参数、光合色素含量和RuBPCase活性,研究小豆生长发育对弱光的响应.结果表明: 弱光使3个品种小豆叶片的最大净光合速率、光饱和点、光补偿点等光合参数不同程度地向耐荫的方向变化,净光合速率、水分利用效率和RuBPCase活性也显著下降;遮阴后,阜南绿小豆的叶绿素a和b含量显著增加,Chl a/b和类胡萝卜素含量显著降低,其他小豆的叶绿素和类胡萝卜素含量无明显变化;弱光使3个品种小豆的生物量和干物质积累效率降低,根冠比降低,根瘤量减少,叶片数和叶面积指数减小;弱光胁迫下,阜南绿小豆提前开花、提前成熟,早熟黑小豆推迟开花、延迟成熟,而晚熟黑小豆只开花不结实.从遮阴后小豆的光合特性变化和生长发育差异等方面综合考虑,3个小豆品种的耐阴能力大小为:阜南绿小豆>早熟黑小豆>晚熟黑小豆.     

Narrowband Light Total Antireflection and Absorption in Metal Film–Array Structures by Plasmonic Near-Field Coupling

We study the cooperative effects between plasmon gap modes and optical cavity modes of a novel triple-layer structure consisting of double continuous gold films separated by a gold nanosphere array. Narrowband near-perfect antireflection of optical field is achieved for the first time due to the strong near-field light–matter interaction within the deep sub-wavelength gaps between adjacent nanospheres combined with the spatial field confinement effects of the optical cavity built by the double gold films. The coexistence cooperation of near-field dipole plasmon resonances and spatial optical field confinement presents more efficient light modification than that of the individual subsystem and may open a new approach to manage light flow. By varying the period of nanosphere array, the diameter of nanospheres, and the distance between the array and the film, optical behaviors of the proposed structure can be tuned in a wide range. High environmental sensitivity and large figure of merit factor are obtained using this structure as the detecting substrate. Furthermore, ultra-compact structure and high conduction suggest the proposed structure being a good candidate for potential applications in highly integrated optoelectronic devices, such as plasmonic filters and sensors.     

铁锈色小孢子菌引起Majocchi肉芽肿1例临床分析及分子鉴定

目的报道1例铁锈色小孢子菌感染引起的结节性肉芽肿及病理改变,探讨诊断和治疗。方法反复取感染部位分泌物进行细菌和真菌培养,对皮损进行病理检查,将培养菌落进行rDNAITS测序鉴定。结果分泌物PDA培养基中可见灰色菌落,表面呈绒毛状,37℃生长良好,镜下可见分隔菌丝未见分生孢子。分子生物学ITS测序结果显示：病原菌与铁锈色小孢子菌相似率为100%。确诊后用伊曲康唑治疗取得良好效果。结论在新疆特别是南疆地区头癣是很常见的皮肤病。对皮肤出现结节性损害且长期抗炎治疗不愈的患者,要考虑真菌感染的可能,及时诊断并早期进行抗真菌治疗。     

铁筷子(毛茛科)营养器官的结构及其系统学意义

应用解剖学方法,对铁筷子(Helleborus thibetanusFranch.)(毛茛科)营养器官的结构进行了研究。结果表明,铁筷子根的初生结构观察到三原型、四原型和六原型。营养器官中的维管束在横切面上木质部中的导管分子不呈“V”字形排列;根状茎的次生结构由外向内为表皮、皮层和维管柱,髓射线发达。茎的初生结构中多个维管束排列成环状,维管束鞘分化不明显,节部为单隙三迹,叶迹分别来自于3条维管束或同一条维管束。叶为两面叶,表皮细胞不规则;气孔器只分布于下表皮,为毛茛科典型的无规则型气孔。从铁筷子营养器官的解剖学特点来看,与毛茛科其它植物基本相同,但在营养器官中维管束木质部不呈“V”字形、维管束鞘分化不明显、节部具单叶隙等特征上与其它毛茛科植物不同。