Objective To investigate the correlation between imumnoglobulin A (IgA) of IgA nephropathy (I-gAN) in kidney tissues and hepatitis B virus antigens (HBVAg), and serum IgA, respectively. Methods The IgA pre-cipitation in glomerular of 66 different types of IgAN was determined by immunofluorescence double staining and laser confocal microscopy. The status of HBsAg and HBcAg were determined by two-step immunohistochemistry in 66 cases of IgAN tissues. The correlation between IgA precipitation and HBVAg infection and serum IgA was examined and compared, respectively. Results Immunofluorescence double staining showed that IgA was mainly in the glomerular mesangial area. A small amount of IgA granular deposition was found in the capillary loop. The precipita-tion of IgA in positive HBVAg kidney tissues was significantly higher than that in the negative HBVAg group ( P<0.05) and control group (P<0.05), which was correlated with the degree of renal lesions. There was no statistically significant difference between IgA precipitation and serum IgA in IgAN tissues. Conclusion The development of IgAN may be correlated with IgA precipitation in positive HBVAg kidney tissues with IgAN. The concentration of serum IgA may not be the decisive factor in the occurrence of IgAN.

Objective Through the studying and analyzing the etiology and clinical pathology characteristic of the events of autopsy in basic-level hospitals, it provides some references for the diagnosis and prevention of unexplained cases of the sudden death. Methods Collection 51 cases of pathological autopsy happened in Changzhi people's hospital of Shanxi Province (from 2004 to 2012), to conduct research and analysis the cause of death and the clinical pathology characteristic. Results 49 cases found the exact cause of death during the 51 cases of autopsy, accounting for 96%, of which the most common is the cardiovascular disease, accounting for 52.9%; the followed-by is the central nervous system diseases, accounting for 11.8%; the pulmonary embolism, ac-counting for 10%. Conclusions Through the autopsy cases of etiology and the clinical pathology characteristic analysis of scientific system, not only can clear the cause of death, also can help to improve the level of clinical diagnosis and treatment.

目的 探讨不同浓度染料木素对胰腺癌细胞作用及其抑癌基因表达的研究.方法 本实验共分实验组(80,120,160,200 μmol/L)的染料木素、空白对照组(PBS)和标准对照(吉西他滨).各组培养基处理细胞12,24,36,48,60 h后,细胞计数试剂盒(CCK-8)法检测人胰腺癌细胞株PANC-1在染料木素作用下的增殖活性;流式细胞术检测人胰腺癌细胞株PANC-1在染料木素木素作用下的凋亡细胞百分率;用逆转录-聚合酶连反应(RT-PCR)方法测定P53及P21抑癌基因的表达;Western-blot法检测抑癌基因P53和P21的蛋白表达水平.细胞凋亡与细胞基因mRNA采用的是LSD法,细胞增殖数据采用的是配对f检验.结果 流式细胞术显示,人胰腺癌细胞株PANC-1处理后60 h时在不同浓度(80,120,160,200 μmol/L)的染料木素作用下细胞凋亡率分别为(3.72±1.58)％、(35.98±3.76)％、(51.36±4.32)％和(64.10±2.09)％.吉西他滨(gemcitabine,GEM)组为(43.45±5.28)％,不同浓度染料木素组与标准对照组间比较差异有统计学意义(均P＜0.01);细胞增殖效果:160 μmol/L与200 mol/L、120 μmol/L与200 μmol/L、200 μmol/L与吉西他滨组之间比较,均有统计学意义(P＜0.01),而160 μmol/L与吉西他滨组比较无统计学意义(P＞ 0.05);Western-blot检测蛋白水平显示160 μmol/L和200 μmol/L染料木素相对于空白对照能够明显的增强抑癌基因P21和P53的蛋白水平的表达,相对于标准组没有明显的差异.结论 染料木素可以抑制人胰腺癌细胞株PANC-1增殖,并且初步探索了这种抑制作用表现出浓度及时间依赖性.

目的 综合性医院疾病分布广泛,呈现地区性、多样性,单一病种样本库相互封闭、欠规范、缺乏信息化与安全保障.探讨适合在综合性医院建立标准化、规范化重大疾病生物样本库模式的意义.方法 重大疾病生物样本数据库的建设,旨在建设符合国际标准的山西省重大疾病资源库,将基础研究成果转化,加强基础研究和临床应用的结合,解决临床上早期诊断和早期治疗的问题,将有助于开发针对这些疾病的早期预警、早期预防、早期治疗的新技术、新方法以及个体化治疗.作为山西省最大的综合性三甲医院之一——山西省医科大学第二医院针对山西省重大疾病分布如恶性肿瘤、骨关节病、慢性肾病、心脑血管病、风湿病、血液病等各系统疾病建立标准化、系统化、规范化的生物样本数据库,并逐步建立疾病对照正常人群生物样本数据库,实现资源整合与共享.结果 医院是生物样本库的主体,山西医科大学第二医院在院领导的支持下,由科技处和病理科牵头,成立重大疾病生物样本库,逐步形成一总多分,由科技处统一分层管理的样本库模式,按照中国医药生物技术协会组织生物样本库分会《中国医药生物技术协会生物样本库建设指南(试行)》要求,建立我院重大疾病生物样本库总库(病理科为基地、科技处统一管理).建立统一的SOP执行标准,信息管理体系,逐步完善生物样本库总分库的网络信息管理,将患者信息、随访信息等诸多信息实现院内网络化统一管理、资源共享.结论 综合性医院重大疾病生物样本库的建设是一个高度复杂、高度组织的系统化工程,需要多学科通力合作,行政管理和协调参与:标准化的信息化管理建立标准化生物样本库必要条件之一;高质量的样本和系统的临床随访资料;医学伦理、质量控制和安全保障;并充分发挥病理科及各合作科室在组织库建设中的作用。

BACKGROUND:Many studies have shown that matrix metal oproteinases 1, 3, 9 and 13 play an important role in articular cartilage degeneration and destruction, but there is less special research on the articular synovium. OBJECTIVE:To observe the effect of long-distance running on the expressions of matrix metal oproteinases 1, 3, 9 and 13 in the synovium. METHODS:Fifteen male Wistar rats were divided into three groups:control group, tablet group and uphil group. Rats in the control group received ordinary captivity;rats in the tablet group ran on the horizontal treadmil (0°) at the speed of 1 km/h for 1 hour daily, and lasted for 45 days;rats in the uphil group daily ran on the horizontal treadmil (0°) at the speed of 1 km/h for 1 hour, and lasted for 15 days, and then the rats ran on the uphil treadmil (+20°) at the speed of 1 km/h for 1 hour daily and lasted for 30 days. The knee joint synovium injury models with varying degrees were established. The dual hind knee joints were obtained after modeling for paraffin-embedded. Then the overal sagittal slices were obtained for hematoxylin-eosin staining and immunohistochemical staining, and the experimental results were observed and analyzed. RESULTS AND CONCLUSION:After long-distance running, the expression of matrix metal oproteinases 1 in synovium of the tablet group and uphil group was increased when compared with that of the control group (P<0.05), but there was no significant difference between tablet group and uphil group (P>0.05). There was no significant difference in matrix metal oproteinases 3 expression (P>0.05). The expressions of matrix metal oproteinase 9 and matrix metal oproteinase 13 in synovium were in gradient increasing state (P<0.05), which were lowest in the control group, increased in the tablet group and highest in the uphil group. The results indicate that long-distance running exercise can influence the normal physiological structure of rat knee joint synovium by changing the expression of matrix metal oproteinases.

在攻克恶性肿瘤的研究工作中,随着研究技术的不断进步,新方法的不断推出,分子机制研究进步很快,但实体瘤患者的长期生存率并未得到明显提高,生存率的提高还主要依赖于肿瘤的早诊和早治.转化医学是生物医学发展特别是基因组学和蛋白质组学以及生物信息学发展的时代产物,其实现的途径就是整合资源,建立平台,建立整合患者的危险因素、临床诊治、生存和预后等肿瘤生物样本数据库资料,以及具有完整的患者生物标本的、开放式的疾病转化研究平台.

Objective:To explore the relevance between macrophages and pathological changes of renal through observing macrophage specific antibody CD68 expression in renal tissue of patients with lupus nephritis(LN).Methods:CD68 expression in renal biopsy specimens of 48 patients with LN was detected by immunohistochemical techniques.Results:In normal kidney tissue,CD68 basically did not express or occasionally expressed.CD68 expression was significantly increased in the renal tissue of patients with LN(P<0.01),infiltration of macrophages in renal glomerulus and infiltration of macrophages in interstitium of renal tubules had a positive correlation(P<0.01).Conclusion:Macrophage may participate pathological changes of renal glomerulus and interstitium of renal tubules,and macrophage has ties with progression of pathogenetic condition of LN.

<正>神经肌肉疾病是临床表现为肌萎缩、肌无力、肌肥大、强直或肌肉疼痛等症状的一大组疾病,主要原因有:肌肉本身发生的病变,神经系统原发性损害或神经肌肉接头处传导障碍引起骨骼肌继发性病[1]

Objective To explore the changes and significance of the adhesion molecule P-selectin in IgA nephropathy.Methods The direct immunoluorescence technique detected 35 cases of IgA nephropathy in renal tissue P-selectin expression and distribution of.Results Normal renal tissue CD62P basic non-expression,while expression was 85.71% in patients with IgA nephropathy in renal tissue,mainly in the glomerular mesangial area,capillary and tubule interstitial site,and CD62P expression level of renal tubular interstitial lesions are positively correlated(P<0.05).Conclusion P-selectin may be play an important role in the pathogenesis of IgA nephropathy,may have some relationship with the occurrence and development of interstitial lesions in IgA nephropathy.

大鼠阿霉素肾病(adriamycin-induced nephropathy.AND)是通过阿霉素及其代谢产物诱发肾小球上皮细胞脂质过氧化,破坏肾小球滤过膜结构和功能,最终导致滤过屏障的通透性而引起蛋白尿[1].近年来研究证实Podocin是与足细胞裂孔隔膜(slit diaphragm,SD)结构功能相关的重要蛋白分子,对维持正常肾小球功能发挥着重要作用.除了裂孔隔膜之外肾小球基膜(glomerulus basement membrane.GBM)也是选择性滤过的主要屏障.层黏连蛋白(laminin,LN)是基膜(basement membrane,BM)的主要成分,参与基膜的构建及细胞黏附、增殖和分化,对肾脏的正常发育至关重要.

Objective To investigate the expression and significance of Caspase-3、Bcl-2 and PCNA in the various pathological type of IgA nephropathy(IgAN),and discuss the relationship between clinical index and Caspase-3、Bcl-2 and PCNA.Methods The expression of PCNA、Caspase-3 and Bcl-2 in 54 cases of renal setions was examined by immunohistochemistry.Collected the results of clinical indexes:serum creatinine(Scr)、urea nitrogen(BUN)、24 hour urine protein quant.Results(1)In IgA renal tissue the expression of PCNA from low to high were levelⅠ(0.09±0.03)、levelⅡ(0.12±0.02)、levelⅤ(0.13±0.01)、level Ⅲ(0.28±0.08)、level Ⅳ(0.54±0.03),between grade Ⅰ and grade Ⅱ、Ⅲ、Ⅳ、Ⅴ,the expression of PCNA were both significantly different(P 0.01).The expression of Caspase-3 and Bcl-2 were both gradely increased followed the level of IgAN.The expression of Caspase-3 in turn were 0.08±0.01、0.11±0.02、0.13±0.08、0.20±0.01、0.35±0.01,between level Ⅰand other levels which were both statistically significant(P 0.01).The expression of Bcl-2 in turn were 0.09±0.02、0.11±0.01、0.15±0.01、0.29±0.01、0.32±0.01,between grade Ⅰ、Ⅱand grade Ⅲ、Ⅳ、Ⅴ which were both statistically significant(P 0.01).(2)From grade Ⅰ to Ⅴ,Scr、 BUN、 24 hour urine protein quant were gradually increased,Scr levels were 65.08±14.11、81.53±21.71、133.86±69.36、147.56±52.69、280.03±137.81,its level between gradeⅤand other groups were significantly different(P 0.01);BUN levels were 4.77±1.39、6.16 ±2.48、6.97±3.60、9.44±2.80、13.30±6.32,its level between grade Ⅴ and grade Ⅰ、Ⅱ、Ⅲ were significantly different(P 0.01);24 hour urine protein quant levels were 0.84±0.33、2.50±1.08、3.35±0.82、3.54±0.77、4.66±1.42,its level between grade Ⅰ and other levels and between grade Ⅴ and gradeⅡ、Ⅲ were all significantly different(P 0.01).(3)The expression of PCNA、Caspase-3 and Bcl-2 were positively correlated with the level of Scr、BUN and 24 hour urine protein quant(P 0.01).The expression of PCNA was positively correlated with Caspase-3.Conclusion The expressions of PCNA、Caspase-3 and Bcl-2 are gradually increased with ⅠtoⅤIgA nephropathy.The progression of IgAN and the damage of renal function may be connected with the imbalance between proliferation and apoptosis.

Objective To investigate the expression of TGF-β1,p-JNK and α-SMA in tubulointerstitial of patients with IgA nephropathy(IgAN) and to analyze the effects of JNK on renal tubular epithelial cells transdifferentiation.Methods Refering classification of Haas type about pathomorphology of IgAN,thirty-nine renal biopsy specimen of patients with IgAN were divided into mild proliferation group(HaasⅠ,Ⅱtype),focal proliferation group(HaasⅢtype) and proliferation-sclerosis group(Haas Ⅳ,Ⅴtype).Renal tubulointerstitial lesion score was according to Katafuchi semiquantitative analyses.TGF-β1,p-JNK and α-SMA in renal tubulointerstitial were detected by immunohistochemistry staining.Results In the groups of IgAN,the score of tubulointerstitial lesion and the expression of TGF-β1,p-JNK and α-SMA were more abundant.The expression of p-JNK correlated closely to the expression of TGF-β1,α-SMA and the score of tubulointerstitial lesion.Conclusion It seems that JNK is a critical signal to regulate the TGF-β1-duced transdifferentiation of renal tubular epithelial cells in renal tissue of patients with IgAN.

Objective:To study the expression of various antigen in a variety of tumor tissue microarray,tissue microarray of tumor progression and tumor prognosis tissue microarray.To clear the application of tissue microarray technology in the study of tumor.Methods:Using tissue microarray and immunohistochemistry detect the expression of Estrogen Receptor(ER),Progesterone receptor PR in variety of tumor tissues,the expression of P53 in progress tissues of lung cancer,and the expression of P16 in squamous cell carcinoma of lung.Results:Hand-made tissue microarray arrays arranged in neat rows,only one organization was missed(1/625=0.16%),three organizations were folded(3/625=0.48%),the rest were all in good morphology.ER,PR in breast cancer,cervical cancer,endometrial cancer,ovarian cancer,lung cancer,esophageal cancer,gastric cancer and other tumors were all expressed,and the expression is different;The expression of P53 in lung cancer and atypical hyperplasia(70%,40%) was significantly higher than it in normal bronchial mucosa(0%)(P0.05);The lost pression rate of P16 protein in lung squamous cell carcinoma was 57.9%,in which metastasis group(8/13=61.5%) was significantly higher than those group without metastasis(7/17=41.2%)(P0.05).Conclusion:Tissue microarray technology can quickly and efficiently carry through various testing and analysis on a large number of tumor tissue samples,It is low-cost,strong comparability,hand-made is simple and economical,can be widely applied to various aspects of tumor pathology.Application of tissue microarray technology have detected ER,PR were expressed in a variety of tumors,suggesting that both those were related with a variety of tumors;proved P53 gene mutation is an early event in lung cancer,participated in the development of lung cancer;The certain loss of expression rate of P16 gene in squamous cell lung cancer indicated it related with tumor prognostic factors whether metastasis or not.

Objective To explore preoperative incidence, influencing factors of depression and nursing for the inpatients in the department of orthopedics. Methods A total of 107 cases in the department of orthopedics from March to May in 2010 were selected, the patients with unconsciousness and mental illness were ruled out, self-rating depression Scale (SDS] was used to assess the state of patients with depression. Results The incidence of depression was 26. 17%, univariate analysis showed: gender, education level and disease type were the risk factors of depression, multivariate analysis showed: gender, disease type, cure confidence and the worry of dragging the family were the risk factors of depression. Conclusions The inpatients in the department of orthopaedics has the depression psychology obviously.Nursing staffs should take the corresponding nursing strategy according to the factors of depression occurrence.

<正>肾脏疾病病理检查可以改变原来的临床推断25%～53%;改变治病方案20%～34%,更加准确地判断预后32%～57%[1]。所以临床医师如何运用肾脏病理提高临床工作水平是一个关键。

抢救物品及药品是为急救患者所备用的,有效有序的药品、物品管理直接关系着危重患者抢救的成功率,同时因为抢救车内的急救物品及药品种类繁多、数量大,对抢救车的管理造成了一定的难度.

Objective To explore the correlation of serum IgA concentration and kidney IgA deposition with severity of glomerular lesions in IgA nephropathy.Methods Sixty-six biopsy specimens of pathologically proven IgA nephropathy were divided into group A(mild mesangial proliferation),group B(moderate to severe mesangial proliferation) and group C(focal proliferative or proliferative/sclerotic IgA nephropathy).Twenty renal needle biopsy specimen of minimal glomerular changes were used as control.We retrieved the data on serum IgA in these cases.By using immune fluorescence techniques and laser confocal microscopy,the amount of IgA immune complex in the glomerulus was also measured.Results ① There was no correlation between serum IgA level and IgA immune complex deposition in IgA nephropathy(r=0.35,P>0.05).② IgA immune complex deposition was correlated in some degrees with IgA nephropathy lesions.Conclusion Serum IgA level may not be a determinant in occurrence of IgA nephropathy.On the other hand,IgA immune complex depositing in kidney tissues may lead to excessive accumulation in the glomerular extracellular matrix that plays an important role in the process of glomerular sclerosis.

骨折后恰当的护理能够极大地减少脂肪栓塞综合征(FES)的发生.即使发生FES,积极的治疗与护理也能够增加治愈率,减少死亡的发生.本文总结2009年1月以来120 例骨折患者,给予预防性治疗和护理,大大减少了FES的发生,现将护理体会总结如下.

Objective To observe the expression of nuclear factor-kappa B(NF-κ3)and monocyte chemnattractant protein-1(MCP-1),and the infiltration of mononuclear macrophage CD68 in lupus nephritis (LN).The association between NF-κB,MCP-1 and MΦ with kidney pathology and clinical manifestations is explored.MethodsNF-κB,MCP-1 and MΦ in renal biopsy specimens from 49 cases of LN were detected using immunohistochemical techeniques.Forty-nine cases of renal tissues were examined for NF-κB by in situ hybridization.The relationship between NF-κB,MCP-1 and MΦ with kidney pathology and clinical manifestations were analyzed.Results ①Compared with the control group ,the expression of NF-κB,MCP-1 and MΦ in LN was significantly higher(P＜0.01).The expression of MCP-1 positively correlated with MΦinfiltration and NF-κB(P＜0.01)in glomeruli and renal tubule and renal interstitium of LN.The expression of NF-κB,MCP-1 and the infiltration of MΦ in LN Ⅳ was significandy higher than non LN Ⅳ and the control group(P＜0.01,P＜0.05).There was no significant difference between renal NF-κB positive group and negative groups in the degree of the immunohistochemical and in situ hybridization examination(P＞0.05).②The histological activity index,urine protein volume(24 h)and serum creatinine in LN were significantly higher than the control group(P＜0.01),and the expression of NF-κB in LN was correlated with histological activity index,urine protein volume(24 h)and serum creatinine(P＜0.01,P＜0.01,P＜0.05).MCP-1 and CD68 expression in LN were correlated with histological activity index and urine protein volume(24 h),but not correlated with serum creatinine(P＞0.05).Conclusion NF-κB induced MΦ by activating MCP-1 may be one cause of kidney injury of LN.NF-κB signal pathway may act as a new therapeutic target for MΦinfiltration and proliferation inhibition in kidney.

Objective To detect the expression of mast cells(MC),macrophage(MΦ),T-cell,transforming growth factor(TGF)-β1 in kidneys of patients with lupus nephritis(LN),and to explore its correlation with the tubulointerstitial lesion(TIL)in LN.Methods The expression of MC,MΦ,T cells(CD4+,CD8+)and TGF-β1 in renal biopsy specimens from 51 cases with LN were detected by using immunohistochemical assay.Results The number of the infiltrated T cells(CD4+,CD8+)and CD68+ macrophage in cases with LN were significantly higher than that in the control group.There was a positive correlation between the expression of MC and renal interstitial fibrosis(P<0.05),and between the expression of CD68+ MΦ,T cells(CD4+,CD8+)and renal interstitial inflammation(P<0.05).Conclusion MC may be the major participant the in the renal interstitial fibrosis of LN,and TGF-β1 may be the important chemokines for the MC,MΦ and T cells.