Autologous protein solution prepared from the blood of osteoarthritic patients contains an enhanced profile of anti‐inflammatory cytokines and anabolic growth factors

The objective of this clinical study was to test if blood from osteoarthritis (OA) patients (n = 105) could be processed by a device system to form an autologous protein solution (APS) with preferentially increased concentrations of anti‐inflammatory cytokines compared to inflammatory cytokines. To address this objective, APS was prepared from patients exhibiting radiographic evidence of knee OA. Patient metrics were collected including: demographic information, medical history, medication records, and Knee Injury and Osteoarthritis Outcome Score (KOOS) surveys. Cytokine and growth factor concentrations in whole blood and APS were measured using enzyme‐linked immunosorbent assays. Statistical analyses were used to identify relationships between OA patient metrics and cytokines. The results of this study indicated that anti‐inflammatory cytokines were preferentially increased compared to inflammatory cytokines in APS from 98% of OA patients. APS contained high concentrations of anti‐inflammatory proteins including 39,000 ± 20,000 pg/ml IL‐1ra, 21,000 ± 5,000 pg/ml sIL‐1RII, 2,100 ± 570 pg/ml sTNF‐RI, and 4,200 ± 1,500 pg/ml sTNF‐RII. Analysis of the 82 patient metrics indicated that no single patient metric was strongly correlated (R² > 0.7) with the key cytokine concentrations in APS. Therefore, APS can be prepared from a broad range of OA patients. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 32:1349–1355, 2014.     

血小板活化因子反相高效液相色谱法测定及其在老年性疾病中的应用

目的 建立血小板活化因子(PAF)的反相高效液相色谱(rHPLC)检测法,与生物学检测法比较,探讨其在老年脑梗死、高血压、冠心病等疾病中的意义。方法 采用rHPLC对100例健康对照者、23例脑梗死、28例高血压病、65例冠心痛患者血PAF进行分析。结果 rHPLC法与生物学法相关性较好,操作简便,重复性好,灵敏度高,干扰因素少。脑梗死、冠心痛患者血PAF值显著高于参考值（P＜0．01);高血压病组与对照组比较,无显著性差异(P＞0．05)。结论 rHPLC法测定PAF更具可靠性,更能正确地反映血中PAF水平;有助于进一步推动PAF的临床与基础研究。     

Does decreased mean platelet volume predict inflammation in chronic renal failure,dialysis, and transplanted patients?

Objectives: Increased platelet activation contributes to cardiovascular mortality in chronic kidney disease patients (CKD). Larger platelets are more active and this increased activity had been suggested as a predictive biomarker for cardiovascular disease. In this study, we aimed to evaluate mean platelet volume (MPV) as an inflammatory marker in a broadened group of CKD patients. Our study is unique in literature as it covers all types of CKD including renal replacement therapies. Materials and methods: 200 patients (50 renal transplanted, 50 hemodialysis, 50 peritoneal dialysis, 50 chronic renal failure stages 3–4) were investigated who were between 18 and 76 years of age. The collected data included demographic properties, platelet count, MPV, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and hemoglobin. All of the patients had at least 12 month of therapy of either renal replacement modality. Results: The mean CRP value was detected statistically significantly higher in hemodialysis (HD) patients compared to the resting three groups of patients (p?p?p?>?0.05). Conclusions: ESR and CRP were significantly increased in hemodialysis patients compared to the other groups. We did not detect a significant difference among MPV between the groups. ESR was detected lowest in transplanted patients. Transplantation is coming forward as the favorable choice of renal replacement therapy which decreases inflammation.     

低强度脉冲超声治疗关节软骨缺损的超微结构研究

目的：观察低强度脉冲超声治疗兔关节软骨缺损的效果。方法：在21只兔股骨内侧髁软骨面处钻孔，作为动物模型。术后左后肢膝关节缺损处以低强度脉冲超声辐射作为治疗侧，右后肢予以假辐射作为对照侧。分别于术后2周、4周和8周全部处死取材，作透射电镜检查。结果：治疗侧软骨缺损修复速度及修复组织质量均比对照侧高。结论：低强度脉冲超声能有效地治疗关节软骨缺损。     

自体富血小板血浆与人工骨混合物治疗胫骨平台骨折合并骨缺损的临床应用

背景：骨缺损修复一直是骨科临床面临的难题之一。近年来,骨组织工程学的发展为骨缺损修复开辟了新的途径,但骨髓基质细胞体外培养回植入体内修复骨缺损还仅限于实验研究。目的：评价临床上应用自体富血小板血浆（PRP）与人工骨混合物治疗胫骨平台骨折合并骨缺损的临床疗效。方法：2006年7月至2010年7月收治胫骨平台骨折合并骨缺损患者（SchatzkerⅡ~Ⅴ型）36例。随机分成：A组（17例）采用自体PRP与人工骨复合物填充骨缺损;B组（19例）采用自体髂骨填充。所有患者于术后1.5、3、6、12个月复查植骨部位的X线片观察骨折愈合时间,采用Rasmussen评分标准评价胫骨平台骨折复位及固定效果,Hss评分评价膝关节术后功能恢复情况,NRS分级法对疼痛进行量化评分,配对T检验对两组数据进行比较。结果：36例全部获得随访,随访时间11-36个月,平均16个月。A组患者平均手术时间、术中出血量及术后疼痛评分（不包括供骨区）明显低于B组（P〈0.05）,而Rasmussen评分、HSS评分及骨折平均愈合时间与B组无明显差异（P〉0.05）。结论：自体PRP与人工骨混合物填充治疗胫骨平台骨折合并骨缺损较传统自体髂骨填充显著缩短手术时间,减少术中出血,减轻术后疼痛,避免供骨区并发症,修复效果理想,为胫骨平台骨折合并骨缺损的治疗提供了一个新的方法。     

脓毒症患者血小板下降与感染性休克发生的相关性

目的：分析脓毒症患者血小板下降情况及其与感染性休克发生的相关性。方法回顾性分析45例脓毒症患者血小板正常范围内下降（同时测同一时间点的TPO水平）与感染性休克发生前后的变化,以及发生感染性休克与未发生休克的脓毒症患者血小板计数变化（同一时间TPO水平）并同APACHEⅢ（急性生理学及慢性健康状况评分系统Ⅲ）评分对比分析得出。结果脓毒症患者诊断前PLT水平为（187.7＆#177;51.73）＆#215;109/L;脓毒症诊断后PLT水平为（126.1＆#177;38.71）＆#215;109/L,二者差异具有统计学意义（t=5.743,P＜0.001）;24例脓毒症未发生休克患者PLT下降,为（49.44＆#177;49.50）＆#215;109/L;21例感染休克患者PLT水平下降,为（90.19＆#177;44.86）＆#215;109/L;二者差异具有统计学意义（t=-2.896,P＜0.001）。脓毒症患者诊断前后血小板计数下降和感染休克发生后血小板计数下降与APACHEⅢ评分均呈正相关关系（r=0.449、0.978,P＜0.001）。结论血小板计数下降作为脓毒症患者病情变化的单独风险依据,可观察抗炎与促炎平衡状态的指标,无论血小板计数在否正常范围,下降的趋势更为重要。     

葛根素对心房纤颤患者血小板活化和内皮功能的影响

目的 :观察葛根素对心房纤颤患者血小板活化和内皮功能的影响。方法 :选择 42例心房纤颤患者 ,随机分为葛根素组和阿斯匹林组两组。另选 2 1例体检健康者作为正常对照组。在常规治疗基础上 ,葛根素组用 5 %葡萄糖注射液 葛根素 5 0 0mg静脉滴注 ,1次 /d ,连续 2周 ;阿斯匹林组用阿斯匹林 15 0mg ,1次 /d ,连续口服 2周。观察治疗前后血小板活性标志物P选择素和内皮功能受损标志物血浆血管性假性血友病因子的变化。结果 :治疗前 ,心房纤颤患者血小板P选择素、血浆血管性假性血友病因子显著增高。经葛根素与阿斯匹林治疗均可降低P选择素、血浆血管性假性血友病因子水平。且葛根素和阿斯匹林组疗效无明显差异。结论 :心房纤颤患者存在血小板活性增强和内皮功能受损 ,葛根素可显著改善血小板活化状态和内皮细胞功能 ,且能与阿斯匹林相媲美     

Platelet count and erythrocyte sedimentation rate are good predictors of Kawasaki disease: ROC analysis

Background and Aims: Kawasaki disease (KD) is the leading cause of acquired pediatric cardiac disease and requires a timely diagnosis. Available effective therapy is ideally administered within 10 days of illness diagnosis. Recent reports of several laboratory tests in KD have been published. In this study, we aimed to evaluate the sensitivity and specificity of several laboratory tests. Methods: We performed a retrospective study of consecutive patients diagnosed with KD from January to December 2008. We studied the sensitivity and specificity of several different tests [T‐cell subgroups, platelet count, erythrocyte sedimentation rate (ESR), and C‐reactive protein (CRP)] to predict KD using receiveroperator characteristic curve analysis. Results: No significant difference was demonstrated in T‐cell subgroups between patients with KD and referent patients (P>0.05). However, platelet count, ESR, and CRP were significantly higher in patients with KD than in referent patients (P<0.05). ESR showed a sensitivity of 93.9% and specificity of 83.3% with a cut‐off of 15 mm/hr (area under the curve [AUC], 89.1%; P=0.03). Platelet count showed a sensitivity of 70.6% and specificity of 75% with a cut‐off of 336.5×10⁹/l (AUC, 71.2%; P=0.03). Conclusions: These results indicate that platelet count and ESR are good predictors of KD. J. Clin. Lab. Anal. 24:385–388, 2010. © 2010 Wiley‐Liss, Inc.