TNF-α对严重烫伤小鼠骨骼肌摄取葡萄糖作用的研究

目的　证实TNF α导致创伤胰岛素抵抗的机制。方法　以 40只用 3 0 %TBSAⅢ度严重烫伤小鼠为模型 ,分烫伤对照组和TNF α单克隆抗体注射组 ,观察骨骼肌用和不用胰岛素刺激的葡萄糖摄取水平的改变。结果　烫伤对照组基础葡萄糖摄取明显升高 ,但胰岛素依赖的葡萄糖摄取明显降低 ,TNF α单克隆抗体注射治疗组基础葡萄糖摄取能力明显下降 ,但胰岛素刺激的葡萄糖摄取明显升高。结论　TNF α能促进骨骼肌基础葡萄糖摄取 ,但抑制胰岛素刺激的葡萄摄取。TNF α在胰岛素抵抗中发挥重要作用     

Validation of Fatigue Impact Scale with various item sets – a Rasch analysis

Purpose: Fatigue is a symptom in patients with chronic gastrointestinal (GI) and liver diseases. Different instruments have been developed to assess the severity of fatigue and the 40-item Fatigue Impact Scale (FIS) is among the most widely used. Shorter versions of FIS include the 21-item Modified Fatigue Impact Scale (MFIS), and an eight-item version for everyday use. The study aimed to assess construct validity, reliability, and sufficiency of the raw score of the original FIS with 40 items, and examine the sufficiency of the 21 items from the Modified scale and the eight items of the Daily Fatigue Impact Scale (D-FIS), all of which are embedded in the 40-item scale.

Methods: Patients with chronic GI or liver disease (n?=?354) completed the FIS with 40 items. The majority (57%) was under the age of 55 years and approximately half were females (48%). Various item sets of FIS were derived which showed fit to the Rasch model.

Results: Local dependency and multidimensionality in FIS and the 21-item Modified scale were resolved with a testlet solution but the D-FIS showed local dependency and multidimensionality and differential item functioning (DIF) still remained. Two new item sets fulfilling unidimensionality and no DIF are suggested, one with 15 items and a six-item scale for daily use. The transformation table shows score-interval scale estimates for all these item sets.

Conclusions: Both the FIS and the Modified scale can be used to measure fatigue albeit requiring some adjustment for DIF. The eight-item D-FIS is more problematic, and its summed score is not valid. Alternative 15- and 6-item versions presented in this paper can offer valid summed scores, and the transformation table allows transformation of raw scores and comparisons across all versions.

• Implications for rehabilitation

• The Fatigue Impact Scale and the Modified Fatigue Impact Scale can be used to measure fatigue after adjustments for differential item functioning.

• Alternative 15- and 6-item versions of Fatigue Impact Scale offer valid summed scores. The summed score for the Daily Fatigue Impact Scale is not valid.

• A transformation table with raw scores and Rasch transformed interval scale metric makes it possible to compare scores derived from the Fatigue Impact Scale, the Modified Fatigue Impact Scale and the proposed 15- and 6-item versions of Fatigue Impact Scale for research and/or clinical use.

     

Overexpression of heat shock protein Hsp27 protects against cerulein-induced pancreatitis

BACKGROUND & AIMS: Heat shock protein (Hsp) 27 regulates actin cytoskeletal dynamics, and overexpression of Hsp27 in fibroblasts protects against stress in a phosphorylation-dependent manner. Induction of Hsps occurs in acute pancreatitis, but Hsp27 has not been ascribed a specific role. To examine whether Hsp27 would ameliorate acute pancreatitis, we generated transgenic mice overexpressing human Hsp27 (huHsp27) or Hsp27 with the phosphorylatable residues Ser(15,78,82) mutated to aspartic acid (huHsp27-3D) to mimic phosphorylation or to alanine (huHsp27-3A), which is nonphosphorylatable. METHODS: huHsp27 was expressed at high levels in the exocrine pancreas by use of a cytomegalovirus promoter. Protein expression was analyzed by Western blotting and immunofluorescence. Acute pancreatitis was induced with 6 or 12 hourly cerulein injections (50 microg/kg intraperitoneally) and its severity assessed by measuring serum amylase and lipase levels, pancreatic trypsin activity, edema, and morphologic changes by quantitative scoring of multiple histologic sections and visualization of filamentous actin. Systemic inflammatory effects were monitored by measuring lung myeloperoxidase activity (a marker of neutrophil infiltration). RESULTS: huHsp27 protein was overexpressed in the pancreas and localized to pancreatic acini. Acute pancreatitis was ameliorated by overexpression of huHsp27 and the huHsp27-3D mutant, which were associated with suppression of pancreatic trypsin activity and acinar cell injury and preservation of the actin cytoskeleton. In contrast, these changes were unaffected by overexpression of the nonphosphorylatable huHsp27-3A mutant. CONCLUSIONS: Pancreatic overexpression of huHsp27 protects against cerulein-induced acute pancreatitis in a specific phosphorylation-dependent manner and is associated with preservation of the actin cytoskeleton.     

Tα1对食管癌细胞RNA转染的脐血树突状细胞功能的影响

目的 探讨食管癌T.Tn细胞RNA转染脐血树突状细胞(DCs)对T细胞增殖和细胞毒性T淋巴细胞(CTL)特异性抗肿瘤作用的影响,以及胸腺肽α1(Tα1)对脐血DCs疫苗的免疫佐剂作用.方法 分离脐血单个核细胞,经重组人粒细胞巨噬细胞集落刺激因子(rhGM-CSF)、重组人干细胞因子(rhSCF)、重组人IL-4(rhIL-4)诱导和T.Tn细胞RNA转染形成成熟DCs,加入Tα1制备肿瘤疫苗.检测RNA转染后DCs表型变化;MTT法检测各组脐血DCs诱导T细胞增殖和CTL细胞毒活性.结果 与转染前比较,T.Tn细胞RNA转染后脐血DCs表面MHC-Ⅰ、MHC-Ⅱ和CD54、CD80和CD86分子水平明显升高(P均<0.05);可显著促进T细胞增殖,有效诱导CTL的特异性杀瘤活性(P<0.05).而Tα1能显著促进RNA致敏脐血DCs的表面分子表达和T细胞功能(P<0.05).结论 Tα1联合食管癌细胞RNA转染脐血DCs可制备高效、特异的肿瘤疫苗,有望成为食管癌生物治疗的新途径.     

Echocardiographic Assessment of Regional and Global Left Ventricular Function Wall-Motion Scoring in Parasternal and Apical Views Versus Apical Views Alone

The aim of the study was to examine the value of echocardiographic wall-motion scoring in apical views as compared to a conventional combination of apical and parasternal views. In 50 consecutive patients referred to coronary arteriography for potential revascularization, echocardiographic digital image loops of the left ventricle (LV) were recorded in parasternal long- and short-axis views and in apical long-axis, two-, and four-chamber views. Eight of 16 standardized LV segments appear both in the apical and in the parasternal views (group 1 segments). The remaining eight segments are visualized in the apical views only (group 2). Using a cross-over design, two cardiologists independently performed regional wall-motion scoring based on apical views, respectively, based on the combination of parasternal and apical views. Using the conventional approach (parasternal and apical views) 98% of the total 800 segments were scored as compared to 95% when using the mere apical approach (P < 0.05); 94% of the 800 segments were scored from both approaches. The regional wall-motion score was identical in 76% of group 1 segments and in 77% of group 2 segments. It diverged, at most, one score in 94% of group 1 segments and in 91% of group 2 segments (P > 0.05). LV ejection fraction (EF) calculated on the basis of average wall-motion score exclusively assessed from the apex differed little from angiographic EF (mean difference 2.0%, 95% confidence limits ± 6.6%). Intraobserver variability of wall-motion scores (n = 25 patients) was small and almost identical for the two cardiologists. Similarly, interobserver variability was small and identical for apical views and conventional views. We conclude that there is no substantial loss of information when echocardiographic evaluation of regional and global left ventricular function is performed solely from the apical approach.     

Carbachol priming increases glucose- and glucagon-like peptide-1 (7-36)amide-, but not arginine-induced insulin secretion from the isolated perfused rat pancreas

The priming effect of carbachol on glucose-, arginine- and glucose plus GLP-1 (7-36)amide induced insulin secretion was investigated. The isolated rat pancreas was perfused in vitro during a basal period of 10 min with Krebs-Ringer-bicarbonate buffer containing 2.8 mmol/l glucose. This medium was then supplemented with carbachol (10,1.0.1 mumol/l, respectively). After an additional 10 min period at 2.8 mmol/l glucose insulin secretion was stimulated for 44 min with 10 mmol/l glucose, or glucose plus GLP-1 (7-36)amide (0.5 nmol/l), or arginine (10 mmol/l). Pretreatment with carbachol resulted in a concentration dependent sensitization of B-cells to a consecutive glucose load (10 mmol/l). Both phases of the biphasic insulin secretory response were significantly enhanced. Priming experiments followed by a subsequent combined glucose / GLP-1 (7-36)amide or arginine stimulation were performed with 10 mumol/l carbachol. Prior exposure of the pancrease to carbachol enhanced the glucose / GLP-1 (7-36)amide induced insulin release, but left the arginine stimulated secretion unaltered. Our data suggest that in the regulation of postprandial insulin release cholinergic sensitizing effects might be involved which are mediated by muscarinic receptors.     

易化技术配合针刺治疗脑卒中偏瘫的临床研究

目的：探讨易化技术配合针刺对脑卒中偏瘫患者运动功能、日常生活活动能力的影响。方法：将200例脑卒中偏瘫患者随机分为易化技术配合针刺组（A组）、易化技术组（B组）、针刺组（C组）和对照组（D组），每组各50例，采用Brunnstrom偏瘫分期、功能独立性评定（FIM）评定患者治疗前后的运动功能和日常生活活动能力。结果：A、B、C各组治疗后患肢恢复至Brunnstrom Ⅳ级以上的患者数和FIM评分均明显高于D组（P＜0．05）；B组治疗后Brunnstrom Ⅳ级以上和FIM评分与C组无差异（P＞0．05）；A组治疗后Brunnstrom Ⅳ级以上和FIM评分均明显高于B组和C组（P＜0．05）。结论：易化技术配合针刺可以促进脑卒中偏瘫患者的运动功能和日常生活活动能力的恢复。