五味消毒饮灌肠治疗慢性盆腔炎的临床疗效观察

目的：观察五味消毒饮灌肠治疗慢性盆腔炎的临床疗效及部分机制。方法：将本院70例慢性盆腔炎随机分为对照组和治疗组,各35例,其中对照组患者口服甲硝唑片及司帕沙星片,连续服用7 d。治疗组在对照组治疗方案基础上加用五味消毒饮灌肠,连续灌肠7 d。比较2组临床疗效、治疗前后简易McGill疼痛评分变化及外周血清TNF-α的浓度变化。结果：1）经过治疗后对照组临床总有效率为80%,治疗组为91.43%,2组比较具有统计学意义（P<0.05）;2）治疗前对照McGill疼痛评分比较差异无统计学意义（P>0.05）,治疗7 d后分别与各自治疗前比较,对照组和治疗组P均<0.05,组间比较,2组比较P<0.05治疗组改善较对照组明显。3）2组治疗前TNF-α蛋白表达无明显统计学意义（P>0.05）;治疗7 d后,治疗组的TNF-α蛋白浓度低于对照组;4）McGill疼痛评分与TNF-α存在相关关系（P<0.05）。结论：五味消毒饮灌肠可明显改善慢性盆腔炎的临床症状,其治疗机制可能与下调TNF-α有关。     

Increased arterial stiffness in inflammatory bowel diseases is dependent upon inflammation and reduced by immunomodulatory drugs

Background

Inflammatory bowel diseases (IBD) are associated with an increased cardiovascular risk that is not fully explained by traditional cardiovascular risk factors but may be due to inflammation and mediated by an increased arterial stiffness. Aims: Study 1, to investigate the relationship between inflammation and arterial stiffening; Study 2, to look whether aortic stiffening is reduced by immunomodulatory therapy in IBD.

Methods

Study 1 (Cross-sectional study): pulse wave velocity (PWV) was measured in 74 IBD subjects (40 ulcerative colitis and 34 Crohn's disease) and 80 matched controls. Study 2 (Longitudinal study): the effect of therapy on PWV was measured at baseline and 3.4 ± 0.5 years later in 14 IBD subjects treated only with salicylates, 11 subjects treated with steroids and azathioprine, 7 subjects treated with anti TNF-alpha and 30 matched controls.

Results

Study 1: All parameters were comparable between subjects with ulcerative colitis and Crohn's disease. Compared to controls, subjects with ulcerative colitis and those with Crohn's disease have both higher carotid-femoral PWV (7.0 ± 1.1, 7.8 ± 1.7 and 8.0 ± 1.6 m/s, respectively; P < 0.001) and carotid-radial PWV (7.2 ± 0.9, 8.8 ± 1.4 and 8.8 ± 1.3 m/s, respectively; P < 0.001). In fully adjusted models carotid-femoral PWV was positively associated with disease duration whereas carotid-radial PWV was associated with C-reactive protein and history of relapse. Study 2: in fully adjusted model carotid-femoral PWV increased significantly at follow-up in IBD subjects treated with salicylates but not in those treated with steroids and azathioprine or anti TNF-alpha.

Conclusion

Increased arterial stiffness in IBD is dependent upon inflammation and reduced by immunomodulatory drugs.     

电点燃致癎大鼠海马TNF-α mRNA表达和细胞凋亡观察

目的测定杏仁基底外侧核电点燃癫痫大鼠海马TNF—α mRNA表达和细胞凋亡情况，探讨TNF—α／TNF-R1介导的死亡信号途经在癫痫中的作用。方法建立大鼠杏仁核点燃癫痫模型，采用半定量RT-PCR法检测电点燃大鼠海马组织的TNF-α mRNA表达，用原位末端标记法（TUNEL）检测该部位细胞凋亡变化。结果电点燃大鼠海马TNF-α mRNA表达升高，点燃大鼠海马细胞凋亡明显增多。结论在电点燃癫痫大鼠模型中，TNF-α可能参与了点燃过程，海马细胞凋亡增加，这些与癫痫发作密切相关。     

Establishment and characterization of a novel CD34-positive human myeloid leukemia cell line: MHH225 growing in serum-free culture

A new human multilineage myeloid leukemia cell line, MHH225, has been established in our laboratory from the bone marrow of a 60-year-old patient suffering from acute megakaryoblastic leukemia (M7); it provides a unique model for studying the effect of biologic and chemical agents on the lineage specificity of a multipotent myeloid leukemia clone containing a mixed population of megakaryoblast, erythroblast, and myeloblast cells in a serum-free culture. Morphologically, all 225 cells are large blast cells with basophilic cytoplasm containing no granules, large round nucleus containing 2–3 prominent nucleoli, and fine chromatin structure and a large nuclear/cytoplasm ratio. The MHH225 cells are CD34⁺HLA-DR⁺CD33⁺CD13⁺ with 57.6%, 28.3%, and 7.8% of them being CD41⁺, glycophorin A⁺, and CD15⁺, respectively, and all lymphoid-specific antigens are negative. The karyotype analysis of MHH225 cells revealed a deletion of the short arm of chromosome 7: del(7)(p13)-, a whole-arm translocation between the long arms of chromosomes 9 and 21: t(9;21)(q10;q10), and a chromosome 11 with an elongated long arm due to duplication of chromosome 11 material as well as to translocation of part of chromosome 9 onto 11q+. Also, chromosome 21 was deleted in some metaphases or showed a ring formation in other metaphases. Utrastructurally, MHH25 cells display a strong platelet peroxidase activity in the nuclear envelope and the endoplasmic reticulum. The MHH25 cells have been grown exponentially without growth factors or conditioned media or serum only in RPMI1640 culture medium. None of the myelopoietic growth factors, i.e., interleukin-3, GM-CSF, G-CSF, erythropoietin, or interleukin-6, has any effect on the proliferation and differentiation of MHH25 cells. The two, hematopoietic inhibitory cytokines, interferon-alpha and tumor necrosis factor-alpha, have only minimal growth inhibitory effect. Stem cell factor showed only weak growth-stimulatory effect on MHH225 cells but significantly inhibited chemotherapy-induced apoptosis in these cells. The new cell line MHH225 should constitute a useful model for studying stem cell antigen (CD34)-positive human multilineage myeloid leukemia cells carrying a deletion in the short arm of chromosome 7 and an aberration in chromosome 11 and provide a unique tool for investigating human hematopoietic stem cell biology and its cytokine regulation in serum-free cultures. To our knowledge, the MHH225 cell line is the first human CD34-positive leukemia cell line growing in serum-free cultures to be established.     

IL-6、IL-8、TNF-α在慢性胃炎患儿血清变化意义研究

目的探讨白介素-6 (IL-6)、白介素-8 (IL-8)、肿瘤坏死因子-α(TNF-α)在慢性胃炎患儿血清变化中的意义。方法选取2014年9月至2018年11月于郑州大学附属儿童医院进行慢性胃炎治疗的患儿120例临床资料进行分析,同时选取115例正常健康体检儿童的临床资料作为对照组。检测各组患儿血清中IL-6、IL-8、TNF-α水平和各个指标的特异度、灵敏度情况。结果慢性胃炎患儿血清中IL-6、IL-8、TNF-α表达水平明显高于健康组(P<0.05)。同时检测表明IL-6、IL-8、TNF-α三者联合诊断的特异度、灵敏度高于单一检测(P<0.05)。随着治疗时间的增加,慢性胃炎患儿血清中的IL-6、IL-8、TNF-α水平逐渐下降(P<0.05)。结论 IL-6、IL-8、TNF-α水平在慢性胃炎的发生发展中不断变化,为精准诊断慢性胃炎提供了新的思路。     

Cortistatin is endogenous to the human intervertebral disc and exerts in vitro mitogenic effects on annulus cells and a downregulatory effect on TNF-α expression

Background contextCortistatin (CST) is a recently discovered cyclic neuropeptide with biologic anti-inflammatory properties relevant to disc degeneration.PurposeTo test whether CST is present in the disc tissue, whether its expression is influenced by tumor necrosis factor-α (TNF-α), and whether it influences cell proliferation.Study designInstitutional review board–approved study using immunohistochemistry on human disc tissue, in vitro annulus cultures to determine the effect of CST on cell proliferation, and the effect of TNF-α on CST gene expression.Patient sampleDiscs from 12 subjects used for immunohistochemistry, four annulus specimens used for cell culture with proinflammatory cytokines, and 11 used for cell proliferation analyses.Outcome measuresImmunohistochemical localization of CST, gene expression of CST, and cell proliferation analyses.MethodsImmunohistochemistry localized CST in disc tissue. Microarray analysis measured CST gene expression. Human annulus cells were exposed to CST for proliferation tests or cultured for the effect of TNF-α on CST expression. Standard statistical analyses were performed.ResultsImmunohistochemistry identified CST in outer annulus, inner annulus, and nucleus tissue. Annulus cells exposed to TNF-α revealed significantly lower CST expression (p=.013). Exposure to CST significantly increased proliferation. Quantitative real-time polymerase chain reaction also confirmed expression of CST in vitro.ConclusionsData provide the first evidence that CST is present in the human disc. Addition of CST significantly increased cell proliferation. Cortistatin expression was significantly downregulated by TNF-α exposure in vitro. Findings suggest possible in vivo reduction of the anti-inflammatory actions of CST because of elevated proinflammatory cytokines during degenerating disc.     

Aerobic and resistance training effects compared to aerobic training alone in obese type 2 diabetic patients on diet treatment

Aims

The study was designed to compare a combined aerobic and resistance training (ART) with an aerobic training (AT) over hemodynamic, glucose metabolism and endothelial factors, adipokines and pro-inflammatory marker release in a population of obese type 2 diabetic patients.

Methods

Forty-seven patients were randomly assigned to aerobic (27 patients) or aerobic plus resistance (20 patients) exercise trainings, on the top of a diet regime. Anthropometric, metabolic, hormonal and inflammatory variables were measured at hospitalization and discharge.

Results

Both exercise programs equally improved body weight and fructosamine levels however ART only partially decreased HOMA index compared with AT (ART: −25% vs AT: −54%, p < 0.01). Mean blood pressure (AT: −3.6 mmHg vs ART: +0.6 mmHg, p < 0.05) and endothelin-1 (ET-1) incremental areas during walking test (AT: −11% vs ART: +30%, p < 0.001) decreased after AT while increased after ART. Adiponectin levels increased by 54% after AT while decreased by 13% after ART (p < 0.0001) and matrix metalloproteinase-2 (MMP-2), tumor necrosis factor-alpha (TNF-alpha) and monocyte chemoattractan protein-1 (MCP-1) levels significantly decreased in AT while increased in ART group.

Conclusions

Compared with AT, ART similarly enhanced body weight loss but exerted less positive effects on insulin sensitivity and endothelial factors, adipokines and pro-inflammatory marker release.     

Tumor necrosis factor-α levels correlate with postoperative pain severity in lumbar disc hernia patients: opposite clinical effects between tumor necrosis factor receptor 1 and 2

Lumbar disc hernia (LDH) is a leading cause of chronic pain in adults. The underlying pathology of chronic pain after discectomy remains unclear. Chronic local inflammation is considered to underlie painful symptomatology. In this context, we investigated tumor necrosis factor (TNF)-α, TNF receptor 1 (TNFR1), and TNF receptor 2 (TNFR2) expression at the time of surgery in LDH patients and correlated it with the severity of postoperative pain. We analyzed protein and mRNA levels from muscle, ligamentum flavum (LF), annulus fibrosus (AF), and nucleus pulposus (NP) in LDH patients and scoliosis patients (SP), who served as controls. Pain assessment with the visual analogue scale (VAS) was performed 1 day before surgery and 6 weeks and 12 months postoperatively. TNF-α protein levels were detected in AF, LF, and NP in all LDH patients, but not in SP. TNF-α mRNA was significantly greater in LDH patients than in SP; ie, 5-fold in AF, 3-fold in NP, and 2-fold in LF. For NP, TNF-α protein levels correlated with VAS scores (r = 0.54 at 6-week and r = 0.65 at 12-month follow-up). Also, TNFR1 protein levels in NP positively correlated with VAS scores (r = 0.75 at 6-week and r = 0.80 at 12-month follow-up). However, TNFR2 protein levels in AF negatively correlated with VAS scores (r = −0.60 at 6 weeks and r = −0.60 at 12 months follow-up). These data indicate that TNF-α levels could determine the clinical outcome in LDH patients after discectomy. Moreover, the opposite correlation of TNF receptors with pain sensation suggests that an unbalanced expression plays a role in the generation of pain.     

TNF-α in CRPS and 'normal' trauma--significant differences between tissue and serum

Posttraumatic TNF-alpha signaling may be one of the factors responsible for pain and hyperalgesia in complex regional pain syndromes (CRPS). In order to further specify the role of TNF-alpha we investigated tissue (skin) and serum concentrations in three different patient groups: patients with osteoarthritis and planned surgery, with acute traumatic upper limb bone fracture waiting for surgery, and with CRPS I. Thirty patients (10 in each group) were recruited. Mean CRPS duration was 36.1 ± 8.1 weeks (range 8-90 weeks). Skin punch biopsies were taken at the beginning of the surgery in osteoarthritis and fracture patients and from the affected side in CRPS patients. Blood samples were taken before the respective procedures. Skin and serum TNF-alpha levels were quantified by ELISA. Compared to patients with osteoarthritis, skin TNF-alpha was significantly elevated in CRPS (p < 0.001) and fracture patients (p < 0.04). Skin TNF-alpha in CRPS patients was higher than in patients with acute bone fracture (p < 0.02). In contrast, serum TNF-alpha values were the same in osteoarthritis and CRPS, and lower in fracture patients (p < 0.03). Our results indicate a local but not systemic increase of TNF-alpha in CRPS patients. This increase persists for months after limb trauma and may offer the opportunity for targeted treatment.