免疫组化联合基因重排检测对发热待查伴骨髓分类不明细胞的诊断价值

目的:探讨发热待查伴有骨髓中发现分类不明细胞免疫组化联合基因重排检测的诊断价值。方法:对23例长期发热并骨髓或外周血中有分类不明细胞浸润的患者分离骨髓或外周血的单个核细胞进行免疫组化染色和基因重排检测。结果:23例患者中,诊断为非霍奇金淋巴瘤12例,其中滤泡性淋巴瘤(FL)3例、套细胞淋巴瘤(MCL)1例、弥漫性大B细胞淋巴瘤(DLBCL)2例、间变性大细胞淋巴瘤-T(ALCL)3例、血管免疫母细胞性T细胞淋巴瘤(AITCL)1例,侵袭性NK细胞白血病/淋巴瘤(ANKCL)1例,恶性组织细胞病1例;2例结合脾脏病理学诊断SLE;诊断为骨髓转移癌5例;4例未能确诊。结论:联合运用免疫组化和基因重排技术对长期发热并骨髓分类不明细胞浸润患者有一定的诊断价值。     

Food groups and bone health

Studies aimed at determining the relationship between key nutrients (especially calcium) and bone health have examined directly the effect of a specific nutrient (or, in some cases, various nutrients) commonly consumed in the human diet. Consideration of the foods man actually consumes rather than the nutrients contained within them is an alternative strategy that has been adopted in other disciplines examining the relationship between diet and disease. Two studies indicate that a high fruit and vegetable, intake is protective for the skeleton, whereas high candy consumption is associated with lower bone mass, irrespective of gender. These data also suggest that a high intake of fatty, sugary foods is detrimental to bone health around the time of menopause. Because milk and milk products provide greater than 50% of the total calcium in the Western diet as well as a number of other key nutrients including phosphorus, magnesium, and zinc, they have a fundamental role in bone health determination. Milk supplementation also improves the nutritional quality of postmenopausal women's diets to a greater extent than calcium. Data for alcohol consumption are also intriguing. Recently, a positive association was noted between tea drinking and bone mass in postmenopausal women and may point to the influence of flavonoids contained in tea on bone health.     

抗生素诱导SPF级BALB/c小鼠胃肠道白念珠菌定植模型

目的:建立抗生素诱导SPF级BALB/c小鼠胃肠道白念珠菌定植模型.方法:SPF级♀Balb/c小鼠随机饮用抗生素头孢曲松水溶液5d(120h)后,单次口服灌胃107CFU(50μL)白念珠菌以诱导其定植.并运用平板计数和基于细菌16SrDNA的PCR-DGGE技术分析小鼠胃肠道的白色念珠菌定植与微生物区系变化.结果:抗生素处理5d后,减少了胃肠道99.99%以上的可培养厌氧菌和肠杆菌,与处理前相比,有极显著差异(厌氧菌:8.53±0.31Log10CFU/gvs4.18±0.90Log10CFU/g,P<0.01;肠杆菌:3.67±0.14Log10CFU/gvs0,P<0.01),而且DGGE图谱分析显示,抗生素处理后小鼠细菌微生物区系的多样性明显减少(条带数由27-32条减少到2-7条).对抗生素处理小鼠单次口服灌胃107CFU白念珠菌2d后,在小鼠胃、小肠、盲肠和大肠检测到大量的C.albicans,数量分别为4.44±0.02Log10CFU/tissue,5.05±0.19Log10CFU/tissue,5.62±0.06Log10CFU/tissue,4.95±0.14Log10CFU/tissue,并且单次口服灌胃白念珠菌1wk后,小鼠胃肠道内仍维持有4.01±0.06Log10CFU/g的白念珠菌定植.与正常Control组和Antibioticonly组相比,Antibiotic Candida模型组小鼠肠杆菌增殖了10到100倍(3.65±0.16Log10CFU/g,3.21±0.18Log10CFU/gvs5.42±0.33Log10CFU/g,P<0.05);同时DGGE图谱分析显示,Antibiotic Candida模型组小鼠细菌微生物区系多样性较低(条带数Antibiotic Candida/22-24条,Control/28-34条和Antibioticonly/27-34条),各小鼠细菌微生物区系之间的相似性为63.8%-67.0%.结论:抗生素处理诱导了胃肠道微生物区系紊乱,导致了白念珠菌在SPF级Balb/c小鼠胃肠道定植成模.     

Osteoporosis in children and young adults

Osteoporosis is a major public health problem with serious long-term complications. In children, the definition of osteoporosis is not only based on densitometric criteria but also takes into account vertebral and long bone fragility fractures. Several factors, such as long-term high-dose steroids, chronic inflammation, malnutrition, immobility, lack of sex steroids, and medication can reduce bone density and increase the risk for fragility fractures when left untreated. Also, genetic conditions can predispose to primary bone fragility disorders, with osteogenesis imperfecta being the most common. Furthermore, since the growing skeleton is at an increased rate of bone remodeling, the ability to heal long bone fractures and reshape vertebral fractures differentiates children from adults. The scope of this chapter is to review the risk factors of osteoporosis and fragility fractures and describe the commonest causes of primary and secondary osteoporosis and their management in children and young adults.     

自体骨髓干细胞动员治疗大鼠实验性心肌梗死

目的研究应用粒细胞集落刺激因子(GCSF)动员自体骨髓干细胞对大鼠实验性心肌梗死的治疗作用。方法应用冠状动脉结扎的大鼠心肌梗死模型,给予GCSF动员自体骨髓干细胞,于大鼠心肌梗死后1周测外周血CD34 细胞含量,并用免疫组化染色观察心肌梗死区的CD34 细胞浸润情况。于梗死后4周用HE和免疫组化染色及血流动力学监测评价实验大鼠的心肌梗死面积,血管密度和心功能。结果心肌梗死后1周,GCSF组大鼠外周血CD34 细胞含量明显高于对照组,心肌梗死交界处见CD34 细胞浸润。4周后,与对照组相比,GCSF组心肌梗死范围减小,新生血管增多,心功能改善。结论应用GCSF动员自体骨髓干细胞对大鼠实验性心肌梗死有明确的治疗作用。     

Low bone mineral density in professional scuba divers

Scuba diving is associated with a 90% reduction in effective weight and with the loss of a weight-bearing effect on joints. These conditions are very similar to the continuous weightlessness that occurs in spaceflight and bed-rest, which are clearly associated with significant bone mass loss. Here, we studied the bone mineral density (BMD) of 66 professional scuba divers using a dual-photon densitometer, and have depicted a reduction in the BMD in comparison to a matched control group of non-divers. Our results suggest that diving is also an activity where the unloading effect alters bone metabolism, leading to a reduction in BMD.Abbreviations BMD Bone mineral density     

自体骨髓单个核细胞移植治疗扩张型心肌病的临床研究

目的研究自体骨髓单个核细胞(ABMMNCs)经冠状动脉(冠脉)移植对扩张型心肌病(DCM)患者心功能的影响及其安全性。方法16例扩张型心肌病患者,按患者的意愿分成两组移植组(n=10)在药物治疗的同时,通过冠脉转运将ABMMNCs移植入心肌组织内;对照组(n=6)只进行相关的药物治疗;两组在术前和术后6个月分别行超声心动图及动态心电图检查。结果超声心动图检查显示移植组的左心室射血分数(LVEF)较术前明显增高,左心室舒张末期内径(LVDd)、左心室收缩末期内径(LVSd)较术前明显降低,左心房内径(LAD)也较术前明显降低。而对照组的LVEF,LVDd及LVSd虽然较6个月前有所改善,但差异无统计学意义(P>0.05)。术中及术后随访6~12个月均无恶性心律失常和其他合并症发生。结论ABMMNCs经冠脉移植,可以治疗扩张型心肌病,改善心脏功能,而且较为安全。     

经冠状动脉注射骨髓单个核细胞影响心肌细胞凋亡的实验研究

目的观察经冠状动脉注射方式移植骨髓单个核细胞对心脏功能的改善和心肌细胞凋亡的影响。方法结扎小型猪冠状动脉制备心肌梗死模型，然后经冠状动脉注射骨髓单个核细胞，术后3周用超声心动图以及左心室造影检测心功能．核素心肌显像观察心肌灌注，冠状动脉造影观察侧支循环形成．用TUNEL检测心肌细胞凋亡。结果把骨髓单个核细胞通过冠状动脉注射到猪心肌梗死模型，显示左心室dp／dtmax较对照组增高，心肌灌注显著改善。冠状动脉有侧支循环形成，缺血心肌细胞；较对照组减少了53．6％结论骨髓单个核细胞心肌内移植可改善心脏收缩功能，可能与移植细胞抑制心肌细胞凋亡有关。     

骨质疏松症大鼠骨诱导能力改变的研究

目的　探讨骨质疏松性骨折愈合困难的原因 ,为临床治疗骨质疏松性骨折寻找可行性途径和方法。　方法　雌性SD大鼠 4 0只作为供体大鼠 ,随机分为卵巢切除组和对照组 ,每组 2 0只 ,卵巢切除组切除双侧卵巢以复制骨质疏松模型 ,对照组行假手术。 4个月后处死大鼠 ,取肢体长骨按Urist方法分别制备骨基质明胶。雌性SD大鼠 17只 ,双侧股部切开 ,左、右侧肌袋内分别植入卵巢切除大鼠及对照大鼠骨基质明胶。大鼠饲养 14d处死 ,分别取出肌袋植入物组织行组织学检查及骨碱性磷酸酶 (ALP)活性、Ca含量测定。　结果　卵巢切除组的和对照组的植入物组织ALP活性单位分别为 (7 2 2± 2 5 9)IU/ g和 (12 0 1± 6 18)IU/g ,两者差异有显著性 (P <0 0 1)。卵巢切除组的和对照组的植入物组织Ca含量分别为 (5 10± 0 84 ) μg/ g和 (5 73± 0 79) μg/ g ,两者差异有显著性 (P <0 0 5 )。　结论　雌激素缺失所致骨质疏松骨的骨诱导能力较正常骨明显降低 ,骨质疏松性骨折愈合困难与骨骼中骨诱导生长因子的缺乏有关。对于骨质疏松性骨折的治疗要改进骨折固定方法 ,外源补充或促进内源性骨诱导生长因子的表达 ,对于促进骨折愈合具有重要作用。     

Radiographic damage associated with low bone mineral density and vertebral deformities in rheumatoid arthritis: The Oslo‐Truro‐Amsterdam (OSTRA) collaborative study

Objective

To examine variables associated with bone mineral density (BMD) and vertebral deformities in women with rheumatoid arthritis (RA) from 3 northwest European countries.

Methods

Female patients were recruited from rheumatology clinics in Oslo, Norway; Truro, UK; and Amsterdam, The Netherlands (150 total, 50 per center, age 50–70 years, disease duration ≥5 years). Demographic and clinical data were collected and BMD was measured by means of dual energy x‐ray absorptiometry. Associations between demographic and clinical measures on the one hand and BMD and vertebral deformities on the other were investigated by single and multiple regression analyses.

Results

Body mass index (BMI), medication use, RA damage measures, and BMD differed significantly between the 3 centers. Overall, Norwegian patients had the lowest BMI, used more corticosteroids and antiosteoporotic drugs, had lower joint damage measured by Larsen score, and lower BMD at both spine and hip. High age, low BMI, and high cumulative dose of corticosteroids (last 2 years) are related to low BMD. A high Larsen score was associated with low BMD at the hip. Larsen score was the independent determinant of vertebral deformities after correction for center, age, BMI, and BMD.

Conclusion

Data from 3 countries on BMD and vertebral deformities in female patients aged 50–70 years with longstanding RA are presented, demonstrating an association between radiographic RA damage and low BMD and between radiographic RA damage and vertebral deformities.