嗜酸粒细胞对支气管上皮细胞表达细胞间黏附分子1的诱导作用

目的探讨嗜酸粒细胞与支气管上皮细胞联合培养对支气管上皮细胞表达细胞间黏附分子(ICAM)-1的影响。方法人嗜酸粒细胞与支气管上皮细胞(BEAS-2B)联合培养4和12h,提取BEAS-2B细胞总RNA;通过逆转录聚合酶链反应(RT-PCR)方法分析与嗜酸粒细胞联合培养对BEAS-2B细胞中ICAM-1基因表达的影响;BEAS-2B细胞表面ICAM-1蛋白质的变化用荧光抗体流式细胞分析。结果经嗜酸粒细胞活化后,BEAS-2B细胞中ICAM-1基因表达上调;BEAS-2B细胞表面ICAM-1蛋白质量显著增加(34.23±4.19和57.60±7.62,P<0.05)。结论嗜酸粒细胞与支气管上皮细胞接触培养可诱导支气管上皮细胞表达ICAM-1。     

吸入小剂量皮质类固醇合并口服小剂量茶碱对哮喘患者的治疗及抗炎作用

目的探讨小剂量皮质类固醇合并小剂量茶碱对哮喘患者的疗效、抗炎作用及相互关系。方法对40例轻、中、重度的哮喘患者随机分成A,B两组。A组20例给予口服缓释茶碱每日200　mg+吸入二丙酸倍氯米松(BDP)每日300　μg;B组20例单纯吸入BDP每日600　μg+口服安慰剂。疗程共13周。观察A,B两组患者治疗前后症状、气道高反应性及炎症因子IL-8,TNF-α等变化。结果两组患者的症状计分及气道高反应性在治疗前、后差异均有显著意义(P＜0.01),而组间比较差异无显著意义(P＞0.05)。治疗前、后的炎症因子IL-8及TNF-αA组分别为(314.3±47.7)ng/L和(192.7±31.0)ng/L,(243.8±84.7)ng/L和(145.2±42.5)ng/L;B组分别为(308.5±50.6)ng/L和(237.3±54.7)ng/L,(244.7±81.1)ng/L和(144.5±45.6)ng/L,两组前、后比较差异有显著意义(P＜0.01);同时发现炎症因子IL-8,TNF-α均与症状计分及气道高反应性呈正相关。结论在哮喘抗炎治疗中,吸入小剂量皮质类固醇合并口服小剂量茶碱与较高剂量皮质类固醇具相同的作用;此外IL-8,TNF-α水平在一定程度可以作为哮喘气道炎症的血清学参考指标。     

慢性阻塞性肺疾病痰液白介素-8及肿瘤坏死因子-α的检测及临床意义

目的探讨 IL-8及 TNF-α在慢性阻塞性肺疾病 ( COPD)发病机理中的作用。方法收集 3 0例 COPD患者急性发作期及稳定期的痰液。应用 ELISA方法测定痰液中白介素 -8( IL-8)及肿瘤坏死因子 -α( TNF-α)水平。结果慢性阻塞性肺疾病患者急性发作期 ,IL-8及TNF-α水平分别为 ( 12 8.3± 44 .2 ) μg/L,( 164 9± 5 2 6) ng/L。稳定期 IL-8及 TNF-α水平分别为 ( 5 7.3± 3 3 .2 ) μg/L,( 4 2 6±2 0 0 ) ng/L ;IL-8及 TNF-α与 1秒钟用力呼气容积占预计值百分比 ( FEV1 占预计值 % ) ;1秒钟用力呼气容积 /用力肺活量 ( F EV1 /F Vc)呈显著相关。结论 IL-8、TNF -α共同参与 COPD气道炎症的形成 ,并与气道阻塞的程度密切相关。     

白介素-10对内毒素诱导肺泡巨噬细胞核因子-κB活化及肿瘤坏死因子释放的调节

目的 探讨白介素-10对内毒素(LPS)诱导肺泡巨噬细胞核因子-κB(NF-κB)活化及肿瘤坏死因子α(TNF-α)基因表达的调节,为临床运用白介素-10提供理论依据。方法 用支气管肺泡灌洗法收集肺泡巨噬细胞(PAM)进行培养,分正常对照组、LPS组、IL-10＋LPS组。用凝胶电泳迁移率改变分析(EMSA)法和ELISA法分别检测核提取物中NF-κB活性和细胞培养上清中TNF-α含量。结果 LPS组NF-κB活性和TNF-α含量在刺激后0.5～4h明显高于正常对照组;IL-10＋LPS组NF-κB活性和TNF-α含量均显著低于LPS组。结论 LPS诱导PAM的NF-κB活化,导致TNF-α基因表达增强;白介素-10可抑制NF-κB活化而减少TNF-α的释放。     

α-促黑色素细胞激素和KPV合成肽对烫伤大鼠血浆白介素-10水平的调节作用

目的观察烫伤大鼠血浆白介素-10(IL-10)水平的变化及α-促黑色素细胞激素(α -MSH)、合成肽KPV(Ac-Lys-L-ProD-Val)对其产生的调节作用.方法采用酶联免疫吸附法(ELISA)检测正常对照组、轻度烫伤组和重度烫伤组大鼠血浆IL-1 0的水平.采用体内注射肿瘤坏死因子-α(TNF-α)和IL1β中和抗体及α-MSH和合成肽KPV等措施调节其改变.收集大鼠腹腔巨噬细胞,体外观察α-MSH及KPV对其产生IL-10的影响.结果烫伤后12小时的血浆IL-10水平,轻度烫伤组[(83.97±16.08)ng/L]显著高于正常对照组[(6.70±3.93)ng/L,P<0.01] ,重度烫伤组大鼠血浆[(177.50±15.79)ng/L]又明显高于轻度烫伤组(P<0.01 );而抗TNF-α治疗组[(107.84±11.05)ng/L]、抗IL-1β治疗组[(105.22±23.01)ng/L]和α-MSH治疗组[(118.43±18.75) ng/L]及KPV治疗组[(124.69±24.27)ng/L]则均明显低于重度烫伤组(P均<0 .01).α-MSH和KPV可以刺激腹腔巨噬细胞分泌IL-10,分别为 (50.48±15.42)ng/L和(48.94±15.47)ng/L.结论不同程度的烫伤可使大鼠血浆IL-10水平升高,尤以重度烫伤升高更加明显.体内注射TNF-α和IL-1β中和抗体及αMSH和KPV均使重度烫伤大鼠血浆IL-10水平下降.α-MSH 和KPV可刺激大鼠腹腔巨噬细胞分泌IL-10.     

结核病患者细胞因子检测及其保护性免疫机制研究

目的探讨细胞因子及趋化性细胞因子在结核患者保护性免疫中的作用。方法用ELISA方法检测结核患者及正常人外周血单个核细胞(PBMC)经重组人白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)及脂多糖(LPS)刺激后培养上清液中调节激活正常T细胞表达及分泌因子(RANTES)和巨噬细胞炎性蛋白1-α(MIP1-α)的含量。结果结核患者PBMC用TNF-α或IFN-γ加LPS刺激组RANTES的分泌量[TNF-α组(1731．86±925．60)ng／L、IFN-γ组(2 120．78±1 120．72)ng／L]明显高于单用LPS刺激组[(1 102．56±873．44)ng／L,P<0．01)]。用重组人IL-4加LPS刺激,结核患者PBMC RANTES的分泌量[(1 333．90±621．82)ng／L]与单加LPS刺激组[(1 102．56±873．44)ng／L]相比两组的差异无统计学意义(P>0．05)。正常人及结核患者的PBMC经IL-4、TNF-α、IFN-γ及LPS刺激后MIP1-α分泌量无明显变化。结论TNF-α、IFN-γ及RANTES在结核患者的保护性免疫中可能起着重要的作用。     

生脉注射液对2型糖尿病肾病患者血液肿瘤坏死因子α和白细胞介素6的影响

目的:观察生脉注射液对2型糖尿病肾病患者血液细胞因子的影响,探讨生脉注射液治疗2型糖尿病肾病的机制。方法:2000-03/2003-06永州市人民医院内分泌科住院2型糖尿病肾病患者56例。按随机数字法将患者分为治疗组和对照组,各28例。选择30例本院健康体检自愿者作为对照组。治疗组给予生脉注射液治疗,对照组予常规西药治疗,于治疗前后检测患者血液中细胞因子白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平并与正常组进行比较。结果:生脉注射液治疗2型糖尿病肾病总有效率75%,而对照组总有效率为43%,两组比较,差异有显著性意义(χ2=5.976,P=0.028)。2型糖尿病肾病患者TNF-α和IL-6水平明显高于正常组(t=17.56,18.15,P<0.01)。治疗前生脉注射液治疗组血液中TNF-α犤(245.88±29.93)ng/L犦和IL-6犤(213.45±32.76)ng/L犦水平与对照组血液中TNF-α犤(257.43±27.65)ng/L〗和IL-6犤(203.87±34.15)ng/L犦比较,差异无显著性意义(P>0.05);治疗后生脉注射液治疗组血液中TNF-α犤(197.52±25.67)ng/L犦和IL-6犤(145.83±26.67)ng/L犦显著低于对照组血液中TNF-α犤(243.76±28.52)ng/L犦和IL-6犤(184.26±29.61)ng/L〗水平(t=6.377,5.103,P均<0.01)。生脉注射液治疗组治疗后尿蛋白量犤(1.15±0.58)g/24h犦显著低于对     

心力衰竭患者心功能与细胞因子及神经激素的关系

目的探讨慢性心力衰竭患者血浆细胞因子、神经激素的变化及其与心功能的关系。方法用酶联免疫双抗体夹心法测定122例慢性心力衰竭患者及30例健康人血浆中肿瘤坏死因子α(tumornecrosisfactoralpha,TNF-α)、白细胞介素-6(interleukine-6,IL-6)的浓度,放免法测定血浆肾素活性、血管紧张素Ⅱ(angiotensionⅡ,AngⅡ)浓度,荧光测定法测定血浆儿茶酚胺、去甲肾上腺素(norepinephrine,NE)的浓度。结果①慢性心力衰竭患者血浆中TNF-α水平明显高于对照组[对照组(13.09±2.47)ng/L],差异有显著性意义(P<0.05～0.01),且随着心力衰竭程度的加重,TNF-α水平呈进行性增高[Ⅱ级(18.85±2.82)ng/L,Ⅲ级(26.65±9.78)ng/L,Ⅳ级(38.01±19.21)ng/L];IL-6水平在心功能Ⅲ,Ⅳ级组中明显高于对照组[(18.72±8.28),(24.63±10.76)和(14.71±1.30)ng/L],差异有显著性意义(P<0.05～0.01),而心功能Ⅱ级组[(16.24±4.02)ng/L]与对照组相比差异无显著性。心功能Ⅲ、Ⅳ级组心力衰竭患者血中肾素活性、AngⅡ、儿茶酚胺、NE的浓度明显高于对照组(P<0.01)。②TNF-α与肾素活性、AngⅡ、儿茶酚胺、NE呈正相关(r=0.439,0.608,0.440,0.441,P<0.01),IL-6与肾素活性、儿茶酚胺、NE呈正相关(r=0.319,0.411,0.420,P<0.01)。结论神经激素-细胞     

慢性乙醇中毒患者血清IL-6,TNF-α水平与脑萎缩的相关性

背景乙醇中毒可致神经系统广泛、严重的损害,并可降低自然杀伤细胞应答而使细胞免疫发生变化.但有关乙醇中毒性免疫损伤和脑损伤关系的研究较少.目的探讨慢性乙醇中毒患者血清白细胞介素-6(Interleukin-6,IL-6)和肿瘤坏死因子α(Tumor necrosisfactor alpha,TNF-α)水平变化及其与乙醇中毒性脑萎缩的关系.设计对照实验研究.地点和对象地点为遵义医学院附属第一医院,对象为1999-02/2001-07门诊和住院的32例慢性乙醇中毒患者,均为男性,年龄24～64岁.发病年龄24～50岁,病程2个月～6年.30例对照系健康体检者,均为男性,年龄30～60岁.干预用双抗体夹心酶联免疫吸附试验测定血清中IL-6和TNF-α水平,并结合头颅CT扫描进行分析.主要观察指标以脑室指数、Huckman值、侧脑室体部指数及三脑室宽度判定脑萎缩程度.根据试剂盒的校正曲线计算血清中相应的IL-6和TNF-α浓度.结果①慢性乙醇中毒组脑萎缩发生率为50%.②慢性乙醇中毒组血清IL-6和TNF-α水平[分别为(286.31±104.79)ng/L,(413.34±66.87)ng/L]显著高于健康对照组[分别为(205.43±48.67)ng/L,(261.36±51.48)ng/L](P＜0.001).③慢性乙醇中毒有脑萎缩者血清IL-6和TNF-α水平[分别为(343.75±99.59)ng/L,(449.38±55.79)ng/L]高于无脑萎缩者[分别为(228.88±75.74)ng/L,(377.31±57.96)ng/L](P＜0.001);慢性乙醇中毒组无脑萎缩者血清TNF-α水平显著高于健康对照(P＜0.001).④慢性乙醇中毒者血清IL-6和TNF-α水平变化与脑萎缩程度相关与三脑室宽度及Huckman值呈正相关;与脑室指数及侧脑室体部指数呈负相关.结论慢性乙醇中毒患者存在免疫功能异常,血清IL-6和TNF-α水平增高与乙醇的萎缩性脑损害有相关性.     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Structure and function of "metalloantibiotics"

Although most antibiotics do not need metal ions for their biological activities, there are a number of antibiotics that require metal ions to function properly, such as bleomycin (BLM), streptonigrin (SN), and bacitracin. The coordinated metal ions in these antibiotics play an important role in maintaining proper structure and/or function of these antibiotics. Removal of the metal ions from these antibiotics can cause changes in structure and/or function of these antibiotics. Similar to the case of "metalloproteins," these antibiotics are dubbed "metalloantibiotics" which are the title subjects of this review. Metalloantibiotics can interact with several different kinds of biomolecules, including DNA, RNA, proteins, receptors, and lipids, rendering their unique and specific bioactivities. In addition to the microbial-originated metalloantibiotics, many metalloantibiotic derivatives and metal complexes of synthetic ligands also show antibacterial, antiviral, and anti-neoplastic activities which are also briefly discussed to provide a broad sense of the term "metalloantibiotics."