Accuracy of dual-energy radiographic absorptiometry of the lumbar spine: cadaver study

Dual-energy radiographic absorptiometry (DRA) was used to measure the bone mineral content and area density of lumbar vertebrae (L2-L3) in 11 cadavers. These data were subsequently compared with measured ash content and density. Excellent correlation was obtained between bone mineral content measured with DRA and ash weight (r = .963, P less than .0001). The accuracy error in determining mineral content in lumbar vertebrae with DRA was about 9%. In addition, strong correlation was observed between bone mineral density measured with DRA and ash density (r = .881, P less than .0001).     

蜂胶乔松素对脂多糖诱导人脐静脉内皮细胞的保护作用

目的:观察蜂胶乔松素对脂多糖诱导人脐静脉内皮细胞的影响,探讨其对人脐静脉内皮细胞可能的保护作用。方法:实验于2006-03/10在泰山医学院生命科学研究所(省重点实验室)完成。①实验材料:取出生1h内新生儿脐带,患者知情同意。②实验分组及方法:培养人脐静脉内皮细胞,建立脂多糖损伤模型(以10mg/L的脂多糖培养液培养细胞12h),实验分为空白对照组(加等量D-Hank’s液)、脂多糖组(10mg/L)、乔松素组(加10mg/L脂多糖预孵育12h后,按50,100,200mg/L分别加入乔松素),各组设8个复孔,共同孵育24h。③实验评估:光镜下观察细胞形态,MTT法观察乔松素对人脐静脉内皮细胞活性的影响,ELISA方法检测培养上清中血管假血友病因子的含量,TUNEL检测细胞凋亡率。结果:①细胞形态:空白对照组细胞紧密贴壁,呈铺路石状生长。脂多糖组可见多数细胞呈圆形;乔松素组见上述细胞较脂多糖组明显减少。②乔松素对人脐静脉内皮细胞活性、凋亡及血管假血友病因子含量的影响:与对照组比较,脂多糖组能明显诱导人脐静脉内皮细胞的凋亡(P<0.01),不同浓度乔松素组可改善内皮细胞形态,组织活性明显升高(P<0.05),同时抑制内皮细胞血管假血友病因子的释放(P<0.05),使脂多糖诱导的人脐静脉内皮细胞凋亡细胞数明显减少(P<0.05)。结论:乔松素能增强人脐静脉内皮细胞活性,抑制脂多糖诱导人脐静脉内皮细胞的凋亡,从而发挥可能的内皮细胞保护功能。     

Non-invasive trigeminal evoked potentials: normative aging data

A mild electric shock applied to the lower lip was used to elicit reliable evoked potentials from the trigeminal nerve in 50 normal adults who ranged in age from 20 to 69 years. The waveforms were morphologically similar to those observed with invasive procedures. No substantial effects for subject age, side of stimulation, or recording electrode were obtained for any of the individual trigeminal evoked potential amplitudes or latencies. Female subjects tended to have somewhat larger amplitudes and shorter latencies than male subjects. The results suggest that non-invasive procedures produce reliable evoked potential measures of trigeminal nerve function for patients of all ages.     

自体造血干细胞的体外净化

目的:综合分析自体造血干细胞体外净化的方法。资料来源:应用计算机检索Medline 1991-01/2003-12有关自体造血干细胞体外净化方法的文章,检索词“purging,HSCT”,并限定文章语言种类为English。同时计算机检索CNKI数据库1991-01/2003-12有关自体造血干细胞体外净化方法的文章,检索词“体外净化,PUVA”,并限定文章语言种类为中文。资料选择:对相关资料进行整理,选取同一领域、不同方面的文献,以近期发表或权威杂志的文章优先。资料提炼:共检索到42篇有关自体造血干细胞体外净化方法的文献,其中24篇文章符合要求。排除18篇,其中15篇系重复同一研究,3篇为Meta分析。资料综合:自体造血干细胞的体外净化方法很多,如物理方法、生物学方法、药物方法、免疫净化、基因净化等。每种净化方法都有其各自的优势和不足,如淋巴系统疾病可以采用免疫净化;慢性粒细胞白血病患者可考虑反义技术;大多数患者则均可以考虑药物净化的方法。结论:针对不同的疾病,可以选择不同的净化方法,还可以将几种净化方法联合起来,其效果和方法的改进也在不断的研究探索中。     

氟尼辛葡甲铵的解热镇痛效应

目的:通过小白鼠醋酸扭体法、家兔蛋白胨致热法观察氟尼辛葡甲铵的解热、镇痛作用。方法:实验于2004-03/06在南京农业大学药理及毒理教研室实验室完成。①小鼠扭体实验:取清洁级KM小鼠80只按随机数字表法分为8组,每组10只:双氯芬酸钠16.25mg/kg组、安乃近32.5mg/kg组、氟尼辛葡甲铵10,5,2.5,1.25,0.625mg/kg组、生理盐水对照组。除双氯芬酸钠采取口服外,其余各组分别肌肉注射相应剂量的药品,生理盐水对照组给予等体积量的生理盐水。给药30min后立即给各组小鼠腹腔注射1.2%的冰醋酸溶液0.2mL/只,观察记录15min内出现扭体反应的次数。②蛋白胨致热实验:健康家兔36只,按随机数字表法分成6组,每组6只:空白对照组(生理盐水1mL/kg)、氟尼辛葡甲铵1,2,4mg/kg组、安乃近0.2g/kg组和氨基比林0.2g/kg组。实验前测定各组兔子的直肠体温。在家兔大腿肌肉注射40%蛋白胨,剂量为2mL/kg,然后按上述分组分别给予相应的药物。给药后8h内每小时各测体温1次。结果:80只小鼠和36只家兔均进入结果分析,中途无脱落。①与生理盐水对照组相比,安乃近32.5mg/kg组、氟尼辛葡甲铵10,5,2.5,1.25mg/kg组和双氯芬酸钠16.25mg/kg组对醋酸所致小鼠的扭体反应有显著的镇痛作用[(4.3±4.1),(10.4±5.7),(0.0±0.0),(0.9±1.9),(1.8±2.4),(3.2±4.2),(3.6±3.9)次/15min;P<0.05,P<0.01]。②与空白对照组比较,氟尼辛葡甲铵高、中剂量组及安乃近0.2g/kg组、氨基比林0.2g/kg组对由蛋白胨引起的家兔发热,在给药后4～8h均有显著的抑制作用(P<0.05),氟尼辛葡甲铵高、中剂量和安乃近0.2g/kg组在给药后6～8h作用极显著(P<0.01)。氟尼辛葡甲铵高剂量组在给药后5～7h显著强于安乃近0.2g/kg组(P<0.05),与氨基比林0.2g/kg组相比,差异极显著(P<0.01)。氟尼辛葡甲铵中剂量组作用稍逊于安乃近0.2g/kg组,差异不显著。氟尼辛葡甲铵低剂量组与氨基比林0.2g/kg组相当。结论:氟尼辛葡甲铵具有明显的解热、镇痛作用。     

Demographic characteristics and prevalence of serologic markers among donors who use the confidential unit exclusion process: the Retrovirus Epidemiology Donor Study

BACKGROUND: Most blood centers utilize a confidential unit exclusion (CUE) process, intended to reduce the risk of transfusion-associated infectious diseases by allowing high-risk donors confidentially to exclude their blood from use for transfusion. The effectiveness of this method remains controversial. STUDY DESIGN AND METHODS: Confirmatory or supplemental test results for antibodies to human immunodeficiency virus, human T-lymphotropic virus type I, and hepatitis C virus, as well as hepatitis B surface antigen and syphilis and screening test results for antibodies to hepatitis B core (antigen) and alanine aminotransferase levels were obtained for approximately 1.8 million units donated during 1991 and 1992 at five blood centers within the United States. The prevalences of these infectious disease markers in units that the donors confidentially excluded (CUE+) and units that the donors did not exclude (CUE-) were calculated and examined within demographic subgroups. RESULTS: Units that were CUE+ were 8 to 41 times more likely to be seropositive for antibodies to human immunodeficiency virus and hepatitis C virus, hepatitis B surface antigen, and syphilis and three to four times more likely to react for antibody to hepatitis B core (antigen) or to have elevated alanine aminotransferase levels than units that were CUE- (p < 0.001). The positive predictive value of CUE (the percentage of CUE+ units that were confirmed seropositive for any marker) was 3.5 percent, and the sensitivity of CUE (the percentage of confirmed-seropositive units that were CUE+) was 2.3 percent. CONCLUSION: The current CUE process has low sensitivity and apparently low positive predictive value, and in many cases, it appeared that donors misunderstood it. Yet, CUE was not a “random process,” as CUE+ units were more likely to be seropositive for any infectious disease marker than CUE- units. This suggests that efforts to improve the CUE system may be warranted. As risk factors for transfusion-transmitted infection become more difficult to identify by history-based screening, however, such efforts may have limited effect.     

Plasmodium vivax: a cause of malnutrition in young children

We studied the aetiology of malnutrition in a cohort of 1511 children < 10 years old in Espiritu Santo, Vanuatu. Malnutrition was categorized using standard anthropometric criteria as: underweight [weight-for-age (WA) Z score < -2], wasting [weight-for-height (WH) Z < -2], or stunting [height-for-age (HA) Z < -2]. On multiple logistic regression analysis, the only factors significantly associated with wasting were age < 5 years [OR (95% CI) 1.8 (1.2-2.9), p = 0.01] and having suffered one or more episodes of clinical P. vivax malaria in the 6 months preceding nutritional assessment [OR 2.4 (1.3-4.4), p = 0.006]. The incidence of P. vivax infection was significantly higher during the 6 months preceding assessment in underweight vs. non-underweight children [incidence rate ratio (IRR) 2.6 (1.5-4.4), p < or = 0.0001). These groups had similar incidences of clinical P. falciparum infection during the same period [IRR 1.1 (0.57-2.1) p = 0.8] and of either species during the 6 months following assessment [IRR P. vivax 1.3 (0.9- 2.0) p = 0.2; IRR P. falciparum 1.3 (0.9-1.9) p = 0.2]. In these children, P. vivax malaria was a major predictor of acute malnutrition; P. falciparum was not. Wasting neither predisposed to nor protected against malaria of either species. Although P. vivax malaria is generally regarded as benign, it may produce considerable global mortality through malnutrition.      

人表皮细胞与角膜上皮细胞蛋白质组的差异表达初步研究

目的：应用蛋白质组技术比较人表皮细胞与角膜上皮细胞之间的蛋白质表达差异。方法：实验于2005-11，2006-10在中山大学中山眼科中心国家眼科学重点实验室完成。分别培养人表皮细胞与角膜上皮细胞，裂解原代细胞抽提总蛋白，精确定量后进行双向电泳，扫描电泳凝胶获得二维总蛋白图谱。图谱使用软件辅助比较分析，找出差异表达点，从凝胶中抠取差异点，胶内酶解后用基质辅助激光解吸附，电离飞行时间串级质谱法鉴定差异蛋白。结果：人表皮细胞与角膜上皮细胞蛋白质凝胶分析获得600余个清晰的蛋白质斑点，在比较分析出的26个差异点中初步鉴定出4个差异表达蛋白，分别是细胞内氯离子通道1、Psodasin、乳酸脱氢酶B和丝氨酸蛋白酶抑制因子。结论：人表皮细胞与角膜上皮细胞在蛋白质表达上有较高的相似性以及较好的可比性，为探索表皮细胞横向分化成角膜上皮细胞的分子机制做出了有益的尝试，并提供了具有一定可操作性的实验方法。     

腰椎定点牵压与硬膜外隙注药疗法单独或联合应用治疗腰椎间盘突出症

目的:对比观察硬膜外隙注药与腰椎定点牵压疗法及其联合应用治疗腰椎间盘突出症的疗效。方法:①选择2004-01/2006-01解放军总医院康复医学科门诊诊治的腰椎间盘突出症患者180例,男125例,女55例,年龄20～65岁。患者对治疗方案知情同意。按随机数字表法将患者分为3组:硬膜外隙注药组、腰椎定点牵压疗法组、联合治疗组,每组60例。硬膜外隙注药组:骶管注射利多卡因注射液、胞二磷胆碱、维生素B12、地塞米松混合液,每5d注射1次,共4次。腰椎定点牵压疗法组:采用胸带与下肢固定带牵引,待牵引床启动逐渐使患者腰脊柱拉伸时,术者双手拇指关节突关节连线,由上腰段向腰骶段滑行推压,当拇指推压到病变间隙时,牵引力须达到患者体质量1.5倍左右,迅速向脊柱前方施压。共2次。联合治疗组为两种疗法联合应用。每2次硬膜外隙注药后施行腰椎定点牵压疗法疗法1次,共2次。②于治疗前和治疗后3,6个月采用疼痛强度评分评估疼痛程度(0～10分,0分为无痛,10分为最痛),治疗前和治疗后3个月观察临床体征和评估疗效,疗效评估依据胡有谷的腰椎间盘突出症和国家中医药管理局(1994年)制定的中医病症诊断疗效标准。③计量和计数资料差异比较分别采用t检验和χ2检验。结果:腰椎间盘突出症患者180例均进入结果分析。①疼痛强度变化:治疗后3个月3组疼痛强度评分均较治疗前降低,其中联合治疗组与治疗前比较,差异明显(χ2=2.13,P<0.01)。治疗后6个月,各组病例的疼痛症状大多数获得控制,其中联合治疗组疼痛强度评分与治疗前比较,差异明显(χ2=4.03,P<0.01),联合治疗组和硬膜外隙注药组疼痛强度评分明显低于腰椎定点牵压疗法组(χ2=5.62,6.16,P<0.05)。②临床体征变化:各组治疗后3个月4项体征均较治疗前改善,其中联合治疗组直腿抬高试验阳性患者数明显少于硬膜外隙注药组和腰椎定点牵压疗法组(7,19,14例,χ2=9.24,9.14,P<0.01)。③疗效:联合治疗组治疗有效率明显高于其他硬膜外隙注药组和腰椎定点牵压疗法组[100%(60/60),88%(53/60),92%(55/60),χ2=6.26,6.04,P<0.01],而其他2组间比较,差异不明显(χ2=8.63,P>0.05)。结论:硬脊膜外注药及腰椎定点牵压疗法均是治疗腰椎间盘突出症的有效疗法,联合应用疗效更好。     

Blood usage in lung transplantation

BACKGROUND: Few published data are available regarding perioperative blood usage in lung transplantation. STUDY DESIGN AND METHODS: The medical records of all patients undergoing lung transplantation at a university medical center in 1994 and 1995 were reviewed. RESULTS: Ninety patients underwent lung transplantation during this period. Six patients were excluded: two received a living related-donor lung, three underwent retransplantation and one underwent concomitant repair of a tetralogy of Fallot. Of the 84 evaluable patients, 59 underwent single lung transplantation and 25 double lung transplantation. Double-lung recipients used more red cells (6.4 vs. 1.7 units, p = 0.0002) and were more likely to receive red cells, platelets, plasma, or any component (92 vs. 32%, p< or =0.0001) than were single-lung recipients. Double- lung recipients were more likely to require cardiopulmonary bypass (40 vs. 12%, p = 0.003), and cardiopulmonary bypass was associated with greater transfusion requirements (p< or =0.0001). However, among patients requiring cardiopulmonary bypass, blood use did not differ between those undergoing double lung transplantation and those undergoing single lung transplantation. In the subset of patients not requiring cardiopulmonary bypass, double-lung recipients received more red cells (4.5 vs. 0.7 units, p< or =0.0001) and more plasma (2.0 vs. 0.2 units, p = 0.006). CONCLUSION: Double-lung recipients require more perioperative transfusions than single-lung recipients. The greater transfusion requirement is due to the more frequent need for cardiopulmonary bypass as well as the greater complexity of the procedure. These data are useful for developing surgical blood ordering guidelines for lung transplantation.