人脐带间充质干细胞联用神经节苷酯GM1治疗新生大鼠缺氧缺血性脑损伤

目的 观察人脐带间充质干细胞(human umbilical cord mesenchymal stem cells, hUCMSCs)移植及联用神经节苷酯GM1治疗新生大鼠缺氧缺血性脑损伤(hypoxic-ischemic brain damage, HIBD)的效果。方法 RICE法制备七日龄新生大鼠HIBD模型, 随机分为hUCMSCs移植组(n=15)、hUCMSCs+GM1组(n=15), 72 h后经颈静脉移植等量的hUCMSCs, hUCMSCs+GM1组再腹腔注射GM1, 两组均在移植后第31、32、33、34、35天用Morris水迷宫对两组大鼠行为学测试, 比较两组大鼠脑功能恢复情况。免疫荧光染色观察DiI标记的hUCMSCs移植后在两组大鼠脑中的分布情况;神经元前体细胞标记DCX特异性染色观察hUCMSCs移植后分化成神经元前体细胞的情况。结果 Morris水迷宫测试:hUCMSCs+GM1组逃避潜伏期明显短于hUCMSCs移植组, 差异具有统计学意义(P＜0.05)。移植后hUCMSCs能迁徙到脑组织中, 并分布于缺血区的小血管旁, 能分化成神经元前体细胞。hUCMSCs+GM1组大鼠脑片干细胞分布明显多于hUCMSCs移植组(P＜0.05)。结论 hUCMSCs移植对HIBD新生大鼠脑功能有修复作用, 联用GM1, 有协同作用。     

A systematic review of air pollution as a risk factor for cardiovascular disease in South Asia: Limited evidence from India and Pakistan

Cardiovascular diseases (CVD) are major contributors to mortality and morbidity in South Asia. Chronic exposure to air pollution is an important risk factor for cardiovascular diseases, although the majority of studies to date have been conducted in developed countries. Both indoor and outdoor air pollution are growing problems in developing countries in South Asia yet the impact on rising rates of CVD in these regions has largely been ignored. We aimed to assess the evidence available regarding air pollution effects on CVD and CVD risk factors in lower income countries in South Asia. A literature search was conducted in PubMed and Web of Science. Our inclusion criteria included peer-reviewed, original, empirical articles published in English between the years 1990 and 2012, conducted in the World Bank South Asia region (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka). This resulted in 30 articles. Nine articles met our inclusion criteria and were assessed for this systematic review. Most of the studies were cross-sectional and examined measured particulate matter effects on CVD outcomes and indicators. We observed a bias as nearly all of the studies were from India. Hypertension and CVD deaths were positively associated with higher particulate matter levels. Biomarkers of oxidative stress such as increased levels of P-selection expressing platelets, depleted superoxide dismutase and reactive oxygen species generation as well as elevated levels of inflammatory-related C-reactive protein, interleukin-6 and interleukin-8 were also positively associated with biomass use or elevated particulate matter levels. An important outcome of this investigation was the evidence suggesting important air pollution effects regarding CVD risk in South Asia. However, too few studies have been conducted. There is as an urgent need for longer term investigations using robust measures of air pollution with different population groups that include a wider range of air pollutants and outcomes, including early indicators of CVD. These regions are facing burdens from increasing urbanization, air pollution and populations, generally weaker health infrastructure, aging populations and increased incidence of non-communicable diseases, included CVD. The extent to which the problem of air pollution and CVD will impact these countries will depend largely on the information available to inform policy and programs, which are still lacking, political will as well as social and economic development.     

Oxidative DNA damage and inflammatory responses in cultured human cells and in humans exposed to traffic-related particles

Particulate pollution is a major public health concern because epidemiological studies have demonstrated that exposure to particles is associated with respiratory diseases and lung cancer. Diesel exhaust particles (DEP), which is classified as a human carcinogen (IARC, 2012), are considered a major contributor to traffic-related particulate matter (PM) in urban areas. DEP consists of various compounds, including PAHs and metals which are the principal components that contribute to the toxicity of PM. The present study aimed to investigate effects of PM on induction of oxidative DNA damage and inflammation by using lymphocytes in vitro and in human exposed to PM in the environment. Human lymphoblasts (RPMI 1788) were treated with DEP (SRM 2975) at various concentrations (25–100 μg/ml) to compare the extent of responses with alveolar epithelial cells (A549). ROS generation was determined in each cell cycle phase of DEP-treated cells in order to investigate the influence of the cell cycle stage on induction of oxidative stress. The oxidative DNA damage was determined by measurement of 8-hydroxy-deoxyguanosine (8-OHdG) whereas the inflammatory responses were determined by mRNA expression of interleukin-6 and -8 (IL-6 and IL-8), Clara cell protein (CC16), and lung surfactant protein-A (SP-A). The results showed that RPMI 1788 and A549 cells had a similar pattern of dose-dependent responses to DEP in terms of particle uptake, ROS generation with highest level found in G2/M phase, 8-OHdG formation, and induction of IL-6 and IL-8 expression. The human study was conducted in 51 healthy subjects residing in traffic-congested areas. The effects of exposure to PM_2.5 and particle-bound PAHs and toxic metals on the levels of 8-OHdG in lymphocyte DNA, IL-8 expression in lymphocytes, and serum CC16 were evaluated. 8-OHdG levels correlated with the exposure levels of PM_2.5 (P < 0.01) and PAHs (P < 0.05), but this was not the case with IL-8. Serum CC16 showed significantly negative correlations with B[a]P equivalent (P < 0.05) levels, but positive correlation with Pb (P < 0.05). In conclusion, a similar pattern of the dose-dependent responses to DEP in the lymphoblasts and lung cells suggests that circulating lymphocytes could be used as a surrogate for assessing PM-induced oxidative DNA damage and inflammatory responses in the lung. Human exposure to PM leads to oxidative DNA damage whereas PM-induced inflammation was not conclusive and should be further investigated.     

新生儿窒息心肌损害应用磷酸肌酸钠治疗的临床观察

目的探讨新生儿窒息心肌损害患者应用磷酸肌酸钠治疗的临床效果。方法以2012年7月²014年6月间收治的84例新生儿窒息继发心肌损伤的患儿为研究对象,随机分为观察组及对照组各42例,对照组进行常规治疗,观察组在此基础上增加使用磷酸肌酸钠,比较两组临床疗效及实验室指标的变化。结果观察组临床治疗显效率高于对照组,其血清磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)和α-羟丁酸酶(HBDH)三项均低于对照组,其差异皆有统计学意义(p<0.05)。结论在常规基础上增加使用磷酸肌酸钠可以有效提高临床治疗新生儿心肌损伤的效果。     

急性脑梗死患者应用磁共振弥散张量白质纤维束示踪成像评估预后的临床研究

目的：探讨分析磁共振弥散张量白质纤维束示踪成像对急性脑梗死患者康复的评估价值。方法：回顾性分析2010年10月-2012年12月郑州市第二人民医院神经内科明确诊断为脑梗死的75例患者的临床资料,利用磁共振扫描仪,对脑梗死患者进行常规磁共振（magnetic resonance imaging, MRI）,依照皮质脊髓束受累情况将患者分成三组,在患者起病后的不同时期,发病后3 d内（急性期）、发病后8-14 d（慢性早期）、发病后30~60 d（慢性期）依照美国国立卫生院卒中量表（Nation Institutes of Health Stroke Scale, NIHSS）对患者进行神经功能评分,利用统计学方法对不同级别皮质脊髓束损伤组患者不同时期的神经功能评分分别进行比较,评价该神经束的受累情况与脑梗死患者预后变化的关系。结果：随着发病时间的不断延长,三组患者的NIHSS评分均呈现明显降低的趋势,差异有统计学意义（P〈0.05）。组间比较发现,在不同时期,B、C组患者的NIHSS评分均显著高于A组,组间比较差异均有统计学意义（P〈0.05）;C患者的NIHSS评分均显著高于B组,两组比较差异均有统计学意义（P〈0.05）。结论：磁共振弥散张量白质纤维束示踪成像可准确定位梗死灶,有助于预测急性脑梗死患者运动功能的恢复,值得在临床上推广应用。     

紫癜性肾炎患者血清金属蛋白酶组织抑制物-1水平变化和临床意义

目的：观察不同分期过敏性紫癜性肾炎（Henoch-Schonlein purpura nephritis,HSPN）患者和健康人血清中金属蛋白酶组织抑制物-1（tissue inhibitors of metalloproteinase-1,TIMP-1）水平的变化,初步探讨TIMP-1在HSPN不同阶段中的作用及其与肾损害程度的关系,通过相关药物阻断TIMP-1的表达或抑制其活性,可能为预防、治疗肾脏纤维化提供一个新方法,以期达到理想治疗效果。方法：将过敏性紫癜性肾炎患者42例（试验组）按病理类型分组,并设立健康对照组。抽取两组的外周静脉血5 mL,分离血清,应用ELISA双抗体夹心法分别对其进行检测,观察各组TIMP-1水平的表达情况。结果：试验组Ⅱ～Ⅵ级组血清中TIMP-1水平较健康对照组显著增高（P〈0.05）,Ⅲ～Ⅵ级组血清中TIMP-1水平较Ⅱ级组显著增高（P〈0.01）,Ⅰ级组血清中TIMP-1水平与健康对照组比较差异无统计学意义（P＆gt;0.05）。结论：通过检测TIMP-1水平,再结合其他化验指标和临床表现,有助于对该疾病的治疗效果或者预后给予判断,对减少肾功能衰竭发生率具有指导意义。     

胱抑素联合尿微量白蛋白肌酐比值在60例糖尿病早期肾损害中的应用

目的：分析血清胱抑素C（Cys-C）、尿微量白蛋白/肌酐比值（mAlb/Cr）联合检测在糖尿病患者早期肾损伤的诊断中的应用。方法：选取60例糖尿病患者（研究组）与60例健康体检者（对照组）,分别使用免疫透射比浊法、散射比浊法、苦味酸动力学法测定两组的Cys-C、尿微量白蛋白、肌酐水平。结果：研究组Cys-C、mAlb/Cr值分别是（1.43±0.43）mg/L、（12.57±8.13）mg/mmol,均明显高于对照组（P〈0.05）;研究组Cys-C水平〉1.4 mg/L者16例,阳性率为26.7%,mAlb/Cr水平〉3 mg/mmol者19例,阳性率为31.7%;两项指标联合检测结果高于正常范围共22例,联合检测阳性率为36.7%,高于两项指标单独检测（P〈0.05）;本组实际肾损伤22例,联合检测准确率100%。结论：Cys-C、mAlb/Cr比值联合检测可明显提升糖尿病早期肾损伤诊断准确度与敏感度。     

抗结核药物致肝损害的相关因素分析

目的：探讨抗结核药物致肝损害的相关因素。方法：回顾性分析本院自2010年1月-2013年8月收治的1538例结核病患者的临床资料,分析抗结核药物致肝损害的因素,其中包括患者的性别、年龄、种族、糖尿病史、饮酒史、HBsAg、结核类型以及肝炎史等方面。结果：本组1538例患者中,发生轻度肝损伤154例（10．01％）,中度肝损伤45例（2．93％）,重度肝损伤25例（1．63％）,总损伤224例（14．56％）。HBsAg呈现阳性的患者发生肝损伤的几率明显高于阴性者,有糖尿病史和肝炎史患者发生肝损伤几率明显高于无糖尿病史和肝炎史,有饮酒史的患者发生药物性肝损伤的几率要明显高于无饮酒史患者,进行过预防性保肝治疗的患者其患病率明显低于没有进行过治疗的患者,营养状况的好坏也与患者患病的几率有关,差异有统计学意义（P〈0．05）。结论：在进行抗结核药物治疗时,应充分了解患者的病情、病史等,选择对患者危害性较小的抗结核药物,并采取适当的护肝措施,以尽可能减少药物性肝损害的发生,保证抗结核治疗的顺利进行。     

单壁碳纳米管对小鼠N2a神经瘤细胞潜在毒性的探讨

目的探究单壁碳纳米管（single—wailed carbon nanotubes,SWCNTs）对小鼠成神经瘤细胞（N2a）的细胞毒性作用。方法采用不同浓度的SWCNTs悬液（0、12．5、25、50ug·ml-1）对N2a细胞进行24h染毒处理后,检测细胞活力,细胞活性氧（reactive oxygen species,ROS）、还原型谷胱甘肽（GSH）水平。结果随着N2a染毒浓度的增加,N2a细胞活力下降,ROS含量增加,GSH含量下降。在维生素C（Vitc）存在的情况下,最高浓度组（50ug·ml-1）产生的细胞损伤最大程度上得到缓解。结论SWCNTs的暴露在某种程度上可对N2a细胞产生一定的细胞毒性,并且VitC可以通过降低氧化损伤对N2a细胞起到一定的保护作用。     

血清胱抑素C在妊娠糖尿病早期肾损害诊断中的应用价值

目的 探讨血清胱抑素C （Cys C）在妊娠糖尿病（GDM）患者早期肾损害诊断中的应用价值.方法 选取GDM患者67例,正常孕妇66例,未孕妇女57例,运用免疫透射比浊法检测Cys C浓度,用酶法检测血清尿素氮（BUN）和肌酐（Cr）浓度.结果 GDM组Cys C浓度显著高于正常未孕组和正常孕妇组（P＜0.05）;GDM晚孕组Cys C浓度和Cr浓度显著高于GDM中孕组（P＜0.05）;GDM晚孕组血清BUN浓度显著高于正常晚孕组（P＜0.05）;GDM晚孕组血清Cr浓度显著高于正常未孕组与正常晚孕组（P＜0.05）.结论 与BUN和Cr比较,Cys C是特异性强和敏感度高的肾功能评价指标.检测Cys C能早期发现GDM导致的肾功能损害,降低母婴并发症或围产期死亡率,具有重要的应用价值.