马尔尼菲篮状菌(Talaromyces marneffei),旧称为马尔尼菲青霉菌(Penicillium marneffei),流行于东南亚和中国南部.法国Capponi等[1]在1956年从竹鼠体内分离的青霉菌属温控双相条件致病菌,室温25 ℃条件下表现为菌丝相, 37 ℃环境下表现为酵母相,酵母相菌体具有致病性.马尔尼菲篮状菌病主要集中于免疫力低下人群,尤其HIV患者,若得不到有效的治疗,病死率极高[2,3].近年来,感染T.marneffei发病率上升趋势明显[4],其传播途径最常见是经呼吸道吸入T. marneffei孢子导致感染.T.marneffei属胞内寄生真菌,其宿主细胞主要为巨噬细胞,易侵犯免疫系统受损患者的单核-巨噬细胞系统,但机体对其免疫机制尚不明确.本文就巨噬细胞对T. marneffei的识别机制,巨噬细胞抗T.marnef-fei机制及T.marneffei在巨噬细胞内的存活机制进行总结如下.

目的:分析利用实时定量PCR检测的方法检测胰岛素和高糖对巨噬细胞ACAT-1表达的影响.方法:将胰岛素和高糖共同作用于巨噬细胞A C A T-1,但是每次的时间不相同,分别为0小时、6小时、12小时、24小时及48小时,然后用实时定量PC R的方法进行检测,观察其产生的影响.结果:胰岛素和高糖共同作用于巨噬细胞ACAT-1不同的时间,12小时后的表达量要显著高于0、6、24及48小时的表达量(P<0.05);而48小时的表达量和0小时的表达量相比,无显著差异(P>0.05).结论:胰岛素和高糖共同作用于巨噬细胞ACAT-1将在12小时达到高峰,然后再逐渐下降,在48小时下降到0小时的水平.

Objective: To evaluate the safety and efficacy of transurethral enucleation of bladder tumor(TUEBT) in the treatment of non muscle-invasive bladder cancer (NMIBC). Methods: The clinical and pathological data of 82 NMIBC patients treated between No-vember 2015 and January 2018 in the First Affiliated Hospital of the Jinzhou Medical University were retrospectively analyzed. The 82 NMIBC patients were divided into a TUEBT group (38 cases) and a transurethral resection of bladder tumor (TURBT) group (44 cases). The differences in intraoperative indices, postoperative indices, and pathological staging between the two groups were compared. Re-sults: The bladder irrigation, indwelling catheter, and postoperative hospitalization times in the TUEBT group were (21.00 ± 3.55) h, (4.34±0.81) d, and (5.29±0.96) d, respectively, compared with (27.57±3.87) h, (5.32±0.83) d, and (6.32±0.86) d in the TURBT group, and the differences between groups were statistically significant (P<0.05). The operative time in the TUEBT group [(29.55±4.13) min] was longer than in the TURBT group [(25.30±4.01) min]. The hemoglobin decrease in the TUEBT group [(2.00±0.38) g/dL] was less than that in the TURBT group [(2.30±0.32) g/dL]. The incidence of obturator nerve reflex in the TUEBT group was 13.16% (5/38), compared to 34.09% (15/44) in the TURBT group. The recurrence rate in the TUEBT group was 10.53% (4/38), compared to 29.55% (13/44) in the TURBT group. The detrusor deletion rate in the TUEBT group was 0 (0/38), compared to 31.82% (14/44) in the TURBT group. The re-peat transurethral resection (ReTUR) standard was met in 22 cases in the TUEBT group and 33 in the TURBT group. ReTUR due to lack of a detrusor was required in 0 cases in the TUEBT group and 14 in the TURBT group. The differences in the above clinical characteris-tics were statistically significant (P<0.05). Conclusions: TUEBT can remove a tumor completely, while preserving the detrusor, improv-ing the accuracy of pathological staging, and reducing the probability of ReTUR. For NMIBC, TUEBT can obtain satisfactory clinical effi-cacy, with surgical safety and long-term efficacy superior to those of TURBT.