六种氟喹诺酮类药物体外对人型支原体的抗微生物作用

目的：检测氟喹诺酮类药物对人型支原体（Mh）临床株的抗微生物作用，指导临床合理用药。方法：以微量肉汤释释法检测103株Mh对6种氟喹诺酮类药物的敏感性。结果：在6种药物中司帕沙星和加替沙星抗Mh活性最强，MIC50分别为0.031 25mg/L和0.25mg/L，MIC50均为1mg/L。其次为左氧氟沙星MIC50和MIC90分别为1mg/L和4mg/L，氧氟沙星和环丙沙星的MIC50和MIC90均分别为2mg/L和8mg/L。诺氟沙星的抗Mh活性最差，其MIC50和MIC90分别达到32mg/L和64mg/L。结论：氟喹诺酮类抗菌药新品种司帕沙星和加替沙星的抗Mh活性较临床沿用的品种强；Mh对临床沿用的氟喹诺酮类药物有不同程度的耐药性。     

6种氟喹诺酮类药物的体外抗解脲脲原体作用

目的；研究检测解脲脲原体（Uu)临床株对氟喹诺酮类药物的敏感性，为临床治疗提供参考依据。方法：应用微量肉汤稀释法检测了88株Uu对6种氟喹诺酮类药物的敏感性。结果：在6种药物中司帕沙星和加替沙星抗Uu活性最强，MIC50分别为0.25μg/ml和0.5μg/ml，MIC90均为4μg/ml。其次为左氧氟沙星和氧氟沙星，MIC50分别为1μg/ml和2μg/ml，MIC90分别为4μg/ml和8μg/ml。诺氟沙星和环丙沙星的抗Uu活性最差。结论：氟喹诺酮类抗菌药新品种司帕沙星，左氧氟沙星和加替沙量的抗Uu活性较老一代药物更强；Uu对老一代氟喹诺酮类药物存在不同程度的耐药。     

Effect of linezolid on cytokine production capacity and plasma endotoxin levels in response to lipopolysaccharide stimulation of whole blood

The purpose of this study was to assess lipopolysaccharide (LPS)-stimulated cytokine production in the presence of linezolid (LZD) in comparison with the drug effect on the plasma endotoxin level. Peripheral venous whole-blood samples collected from five healthy subjects were stimulated with 10 μg/ml of LPS. LZD was then added to the LPS-stimulated blood samples at concentrations of 0, 2, 4, and 15 μg/ml, followed by incubation for 24 h at 37°C in a 5% CO₂–95% air atmosphere. Supernatants of the resultant cultures were assayed to determine the levels of tumor necrosis factor (TNF)-α, interferon (IFN)-γ, interleukin (IL)-10, monocyte chemoattractant protein (MCP)-1, and endotoxin. Significant decreases in the levels of TNF-α and IFN-γ were observed in the LZD 2, 4, and 15 μg/ml groups as compared with that in the 0 μg/ml group (Dunnett’s procedure; P < 0.05). The level of IL-10 tended to increase irrespective of the LZD concentration; however, no significant intergroup differences were observed [analysis of variance (ANOVA); P = 0.68]. No significant decrease of the endotoxin level was observed in the LZD 2, 4, or 15 μg/ml groups as compared with that in the 0 μg/ml group, with no significant intergroup differences (ANOVA; P = 0.83). No change in the MCP-1 levels was observed irrespective of the LZD concentration (ANOVA; P = 0.82). To conclude: (1) it appears possible that LZD inhibits the production of INF-γ and TNF-α to a limited extent; (2) LZD did not exert any inhibitory effect on endotoxin production by bacteria, while suppressing cytokine production. The results indicate that LZD may have a significant role in saving the lives of patients with sepsis.     

In vitro and in vivo activities of fluoroquinolones against Aeromonas hydrophila

Aeromonas hydrophila, an uncommon human pathogen, can cause invasive infections in immunocompromised individuals. As the fluoroquinolones have been shown to be active in vitro against mesophilic aeromonads and clinical experience with the use of fluoroquinolones to treat aeromonads infections is limited, the antimicrobial activities of five selected drugs (ciprofloxacin, gatifloxacin, levofloxacin, lomefloxacin, and moxifloxacin) against A. hydrophila were studied in vitro and in mice. The MICs of the fluoroquinolones (except lomefloxacin), cefotaxime, and minocycline for 90% of 64 clinical isolates of A. hydrophila tested by the agar dilution method were 相似文献   

In vitro and in vivo activities of newer fluoroquinolones against Vibrio vulnificus

The MICs of six fluoroquinolones as well as minocycline and cefotaxime for 46 clinical isolates of Vibrio vulnificus were determined by the agar dilution method. All the drugs tested had good activities against all isolates, with the MICs at which 90% of the isolates tested were inhibited (MIC(90)s) by five of the fluoroquinolones ranging between 0.03 and 0.06 micro g/ml. The MIC(90) of lomefloxacin, on the other hand, was 0.12 micro g/ml. Time-kill studies were conducted with these agents and a clinical strain of V. vulnificus, VV5823. When approximately 5 x 10(5) CFU of V. vulnificus/ml was incubated with any one of the above-mentioned six fluoroquinolones at concentrations of two times the MIC, there was an inhibitory effect on V. vulnificus that persisted for more than 48 h with no noted regrowth. The efficacies of the fluoroquinolones were further evaluated in vivo in the mouse model of experimental V. vulnificus infection and compared to the efficacy of a combination therapy using cefotaxime plus minocycline. With an inoculum of 1.5 x 10(7) CFU, 28 (87.5%) of 32 mice in the cefotaxime-minocycline-treated group survived and 29 (91%) of the 32 mice in the moxifloxacin-treated group survived while none of the 32 mice in the control group did. With an inoculum of 3.5 x 10(7) CFU, the difference in survival rates among groups of 15 mice treated with levofloxacin (13 of 15), moxifloxacin (10 of 15), gatifloxacin (10 of 15), sparfloxacin (11 of 15), ciprofloxacin (12 of 15), or lomefloxacin (10 of 15) was not statistically significant while none of the 15 mice treated with saline survived. We concluded that the newer fluoroquinolones as single agents are as effective as the cefotaxime-minocycline combination in inhibiting V. vulnificus both in vitro and in vivo.     

谷氨酰胺在体内/外对巨噬细胞炎症因子分泌的影响

目的 观察谷氨酰胺(Gln)在体内/外条件下对巨噬细胞炎症反应及热休克蛋白(HSP)表达的影响,探讨Gin在脓毒症时抑制体内炎症反应的机制.方法 实验 1:将培养的腹腔巨噬细胞株RAW264.7分为Gln 0、0.5和8 mmol/L 3组,分别于内毒素脂多糖(LPS)刺激后0、1、4、12和24 h收集细胞及上清液.实验2:45只昆明小鼠被随机均分为假手术(Sham)组、模型组、Gin组;采用盲肠结扎穿孔术(CLP)制备小鼠脓毒症模型,术后即刻从尾静脉注射Gin 0.75 g/kg(Gln组)或等量生理盐水(Sham组和模型组).6 h后采血,腹腔灌洗分离巨噬细胞.用酶联免疫吸附法(ELISA)检测细胞上清液、血清、巨噬细胞裂解液中肿瘤坏死因子-a(TNF-a)、白细胞介素-6(IL-6)、IL-10浓度;用蛋白质免疫印迹法检测巨噬细胞HSP72蛋白表达.结果 体外条件下Gin可显著促进RAW264.7细胞释放TNF-a,IL-6和IL-10,呈剂量和时间依赖性(P＜0.05或P＜0.01),LPS刺激4 h后,Gln 8 mmol/L组RAW264.7细胞HSP72表达显著增加(P均＜0.01).体内条件下,Gin组腹腔巨噬细胞TNF-a、IL-6含量均明显低于模型组(P＜0.01和P＜0.05),3组间IL-10含量比较差异无统计学意义;Gln组血清TNF-a浓度明显低于模型组(P＜0.05),两组血清IL-6、IL-10浓度差异无统计学意义;Gin组巨噬细胞HSP72表达较模型组和Sham组均显著升高(P均＜0.01).结论 Gin体外作用时可显著促进巨噬细胞释放TNF-a和IL-6,且该作用不能被HSP72表达所抑制.体内作用条件下Gln抑制腹腔巨噬细胞合成TNF-a和IL-6.体外和体内条件下Gln都可诱导巨噬细胞表达HSP72,提示HSP72表达可能不是Gln在脓毒症时抑制机体炎症反应的主要机制.     

In vivo efficacy of telithromycin on cytokine and nitric oxide formation in lipopolysaccharide-induced acute systemic inflammation in mice

OBJECTIVES: The ketolide telithromycin represents a new subclass of 14-membered semisynthetic macrolides. Because there is evidence that traditional macrolides such as roxithromycin exert anti-inflammatory activity, we investigated the anti-inflammatory action of telithromycin against lipopolysaccharide (LPS)-induced acute systemic inflammation in mice in comparison with roxithromycin. METHODS: CD-1 mice were injected intraperitoneally with LPS (1 mg/kg), and the effects of pretreatment with a single intraperitoneal dose of telithromycin (150 mg/kg) or roxithromycin (50 mg/kg) for 2 h on the expression and formation of tumour necrosis factor alpha (TNFalpha), interleukin-1 beta (IL-1beta), interferon gamma (IFNgamma) and inducible nitric oxide synthase (NOS-II) as well as nitric oxide (NO) were analysed at different time points after LPS-treatment. Cytokine and NOS-II mRNA abundance was examined using real-time RT-PCR. Tissue cytokine levels were determined by enzyme-linked immunosorbent assay kits (ELISA); NO levels were measured by colorimetric assay kits. RESULTS: Pretreatment of mice with telithromycin as well as roxithromycin similarly attenuated the LPS-induced expression and formation of TNFalpha, IL-1beta and IFNgamma. Furthermore, the LPS-induced increase of NOS-II mRNA and the formation of NO were clearly diminished. CONCLUSION: These results suggest that the ketolide telithromycin has anti-inflammatory properties like conventional macrolides due to inhibition of the production of proinflammatory cytokines, which leads to a decreased formation of NO in LPS-treated mice. Our data indicate that ketolides may have beneficial therapeutic effects independent of their antibacterial activity.     

脂多糖对大鼠腹膜间皮细胞白细胞介素15、6及丙二醛表达的影响

目的研究脂多糖(lipopolysaccharide,LPS)对大鼠腹膜间皮细胞(rat peritoneal me-sothelial cells,RPMC)白细胞介素15(interleukin-15,IL-15)、IL-6及丙二醛(malondialdehyde,MDA)的影响。方法胰蛋白酶法行RPMC的原代培养和传代,经鉴定第3代用于试验。分组:①正常对照组;②LPS组:不同浓度LPS组(1、10、100mg/L)分别作用6h和12h;③不同时间组:10mg/L LPS分别作用于RPMC3、6、12、24h。实时定量PCR法测IL-15mRNA的表达;ELISA法检测细胞培养上清液中IL-15和IL-6的表达;硫代巴比妥法测MDA。结果 LPS可刺激RPMC的IL-15mRNA及蛋白的表达增高且在12h内呈时间剂量依赖性(P<0.05);LPS诱导RPMC IL-6的蛋白表达增高(P<0.05);LPS诱导RPMC MDA的含量表达增高且呈浓度依赖(P<0.05)。结论 IL-15作为炎症因子参与了腹膜透析相关性腹膜炎的病理过程。LPS可上调RPMC IL-15、IL-6和MDA的表达,导致腹膜炎症及氧化应激。     

抗体芯片分析炎性细胞因子在严重脓毒症中的表达

目的应用抗体芯片分析严重脓毒症患者血清中炎性细胞因子的表达。方法12例符合严重脓毒症诊断标准的患者和10例年龄、性别匹配的对照组患者入选。用生物素标记从两组患者血清中提取的总蛋白,然后与预先点有40个主要炎症相关细胞因子的特异抗体的抗体芯片膜反应,目标蛋白与辣根过氧化物酶(HRP)标记的抗链霉生物素抗体结合并曝光显示反应信号,最后用激光扫描仪将其转化为图像文件进行分析。结果与对照组相比,脓毒症患者组血清中多种炎性细胞因子包括促炎因子、抗炎因子、趋化因子、某些细胞因子受体等的表达水平大幅度提高,但抗炎因子白介素(IL)-2、-4、-13、-15表达明显下降。结论严重脓毒症病程中存在炎症反应过度、抗炎因子与促炎因子失衡。     

In vitro and in vivo anti- Helicobacter pylori activity of Y-904, a new fluoroquinolone

 Y-904 is a new fluoroquinolone with a broad antimicrobial spectrum. In particular, it has anti-Helicobacter pylori activity superior to that of existing fluoroquinolones. In the present study it was examined for its in vitro antibacterial activity against 51 clinical isolates of H. pylori, including clarithromycin- and metronidazole-resistant strains. The minimum inhibitory concentration of Y-904 at which 90% of isolates were inhibited was close to that of amoxicillin and clarithromycin and lower than that of levofloxacin and metronidazole (0.1, 0.1, 0.2, 3.13, and 12.5 μg/ml, respectively). Y-904 showed equally strong activity at pH 5.5 as at pH 7.0. At 10 times the minimum inhibitory concentration, Y-904 decreased the viable count of H. pylori to below 10⁻⁵ within 2 h after exposure. No significant change in the minimum inhibitory concentration was observed when H. pylori, Staphylococcus aureus, and Escherichia coli were successively subcultured in medium containing subinhibitory concentrations of Y-904. Y-904 also strongly inhibited the supercoiling activity of DNA gyrase from H. pylori ATCC43504 (IC₅₀, 1.48 μg/ml). A study of Y-904 treatment in H. pylori-infected Mongolian gerbils using twice-daily oral administration for 7 days demonstrated that the complete clearance dose of Y-904 was 1 mg/kg and that its potency was around 10, 30, and 30 times that of amoxicillin, clarithromycin, and levofloxacin, respectively. These results indicate that Y-904 is a promising candidate for the eradication of H. pylori infection. Received: November 8, 2002 / Accepted: March 10, 2003 Acknowledgments We thank Dr. T. Sugiyama, Dr. M. Kato (Hokkaido University, Sapporo, Japan), and Dr. K. Sakurai (Showa University, Yokohama, Japan) for graciously providing the clinical isolates of H. pylori. We are also grateful to Mr. K. Honjo for assistance in the in vitro antibacterial studies and to Mr. S. Miyoshi for pharmacokinetic data.     

In vitro and in vivo effects of doxycycline on Toxoplasma gondii.

We investigated the effects of doxycycline on Toxoplasma gondii infections in vitro and in vivo. Resident peritoneal macrophages were infected with the virulent RH strain of T. gondii and exposed to doxycycline at different concentrations. The antitoxoplasmic activity of doxycycline was first assessed with [3H]uracil, which is incorporated by the parasite but not the host cell. The concentration of doxycycline that inhibited 50% of the radioactive uptake was calculated to be 6.4 micrograms/ml (95% confidence limits, 5.07 to 8.06 micrograms/ml); the concentration of doxycycline that inhibited 90% of the radioactive uptake was 14 micrograms/ml. Tetracycline was ineffective up to 40 micrograms/ml. Furthermore, microscopic examination of the infected macrophages after treatment with doxycycline confirmed the inhibition of intracellular growth of T. gondii. Mice acutely infected by the intraperitoneal route with 5 x 10(3) tachyzoites of T. gondii were protected against death with a dose of 300 mg of doxycycline per kg (body weight) administered by the oral route for 10 days, starting 24 h after challenge. When mice were infected with 10(5) tachyzoites of T. gondii and treated 12 days starting 2 h after challenge, the protection and the cure rates were, respectively, 100 and 0% after doxycycline alone (300 mg/kg per day), 0 and 0% after pyrimethamine alone (12.5 mg/kg per day), and 100 and 60% after the combination of these two drugs at the same dosages given above. These results suggest that doxycycline may prove to be useful in the treatment of toxoplasmic infections.     

槲皮素对内毒素急性肺损伤的保护作用

目的　探讨槲皮素 (quercetin)对内毒素急性肺损伤 (ALI)的保护作用。方法　 2 4只SD大鼠 ,随机分成ALI模型组、槲皮素干预组、正常对照组 (n =8只 )。各组大鼠均于注射LPS或生理盐水 6h后测定PaO2 、pH值、PaCO2 ,血清TNF α、IL 8、P 选择素浓度和肺组织匀浆髓过氧化物酶 (MPO)含量及TNF α、IL 8、P 选择素浓度 ;观察肺病理改变、肺湿 /干重比 (W /D)。结果　与ALI模型组比较 ,槲皮素干预组的肺水肿病理改变明显减轻 ,PaO2 改善 ,MPO、P 选择素及TNF α、IL 8降低 (P <0 0 1)。结论　槲皮素能改善ALI大鼠的气体交换功能 ,抑制炎性介质的释放 ,对内毒素诱导的ALI有保护作用     

丙戊酸钠对脂多糖诱导大鼠急性肺损伤的保护作用

目的 研究丙戊酸钠(valproic acid,VPA)对脂多糖(lipopolysaccharide,LPS)诱导的大鼠急性肺损伤的影响.方法 实验地点在武汉协和医院中心实验室,通过股静脉注射LPS复制大鼠急性肺损伤模型,观察光镜下肺组织病理学改变、血清炎性因子和肺部炎性反应判定模型是否成功.依据干预药物的不同确定实验分组:股静脉给予5mL/kg生理盐水为对照组(NS组),股静脉给予LPS 10 mg/kg为模型组(LPS组),模型成功后股静脉给予VPA 300mg/kg治疗为治疗组(LPS+VPA组).注射LPS或NS后6 h处死动物,血气分析观察动脉血氧分压(PaO2)、肺泡气-动脉血氧分压差(A-aDO2)、乳酸(Lac),检测肺组织干湿重比(W/D),髓过氧化物酶(MPO)活性,肺泡灌洗液(BALF)中白蛋白质量浓度,用ELISA法检测6 h血清中TNF-α和IL-1β的含量,HE染色光镜下观察肺组织病理学变化.计量资料以均数±标准差(-x±s)表示,应用SPSS 13.0统计软件行单因素方差分析.结果 LPS组PaO2(mmHg)(81.50±3.24)较NS组(106.40±4.50)降低,A-aDO2(mmHg),Lac[(19.70±2.21),(3.63±0.22)]较NS组[(6.30±1.70),(1.21±0.19)]升高,W/D,MPO活性(μ/g),BALF中白蛋白质量浓度(pg/mL)分别为[(6.52±0.30),(7.25±0.49),(2.940±0.047)]较NS组[(4.38±0.17),(1.76±0.31),(0.099±0.077)]升高,血清中TNF-α和IL-1β的质量浓度(pg/ml)分别为(3325±284),(1950±222)较NS组(90±12),(50±11)显著升高,差异具有统计学意义(P＜0.05),LPS组肺组织出现病理学改变;与LPS组比较,LPS+VPA组上述指标除PaO2(mmHg)(94.50±4.38)上升外,其余指标均降至[(13.50±4.77),(2.13±1.02),(5.33±0.12),(4.38±0.42),(1.260±0.039),(2410±320),(1220±162)],差异具有统计学意义(P＜0.05),LPS+VPA组肺组织病理学改变明显减轻.结论 丙戊酸钠对脂多糖诱导的大鼠急性肺损伤有一定保护作用.

Abstract：

Objective To investigate the effects of valproic acid (VPA) on acute lung injury induced by Lipopolysaccharide in rats. Method The rat model of acute lung injury was made by intravenous injection of lipopolysaccharide (LPS). The pathological changes of lung were observed under light microscope and inflammatory cytokines in serum detected by using ELISA to judge whether the model was successfully done or not. All rats were divided into three groups as per the different intervention agents employed. Rats in control group were treated with intravenous injection of NS in dose of 5 ml/kg, rats in LPS group were exposed to LPS with dosage of 10 mg/kg and model rats in LPS + VPA group were treated with VPA in dose of 300 mg/kg. The rats were sacrificed 6 h after LPS or NS administration. The blood PaO2 ,A-aDO2 and blood lactic acid (Lac) were measured, the lungs were removed for observing the histopathological changes and determination of wet/dry lung weight (W/D) ratio and myeloperoxidase (MPO) activity as well as albumin concentration in broncho-alveolar lavage fluid (BALF) . Seurm was collected to determine the concentrations of tumor necrosis factor-a (TNF-α) and interleukin-1β( IL-1 β) by using LISA 6 h later. All data were presented in ((x)±s). One-way ANOVA was used for comparing differences between groups. Results Compared with acute lung injury group, the blood PaO2 (94. 50 ± 4.38 ) in rats of LPS + VPA group was higher, whereas A-aDO2 ( 13.50 ± 4.77 ) and blood lac( 2.13 ± 1. 02 ) in LPS + VPA group were lower. VPA significantly lowered W/D (5.33 ±0. 12) ratio and MPO activity (4.38 ±0. 42) in the lung. Albumin concentration ( 1. 260 ± 0. 039 ) in BALF, and the levels of TN F-α( 2 410 ±320 )and IL-1β( 1 220 ± 162 )in serum were lower in LPS + VPA group. The histological changes of lung injury were lessened by VPA. Conclusions Valproic acid has protective effects against lipopolysaccharide-induced acute lung injury in rats.     

二甲亚砜对外周血单个核细胞增殖能力和细胞因子分泌功能的影响

目的：探讨二甲亚砜（DMSO）对外周血单个核细胞（PBMCs）增殖能力和细胞因子分泌能力的影响。方法分别设置含不同终体积分数 DMSO 的细胞培养体系及空白对照,采用羟基荧光素二醋酸盐琥珀酰亚胺脂（CFSE）示踪技术和酶联免疫斑点（ELISPOT）技术分别检测 PBMCs 的增殖能力和细胞因子分泌功能,分析 DMSO 对 PBMCs功能的影响。结果当培养体系中 DMSO 的体积分数为2％时,PBMCs 的增殖功能开始受到明显抑制,与对照组相比差异有统计学意义（P ＜0．01）;当 DMSO 的浓度为4％时,PBMCs 分泌细胞因子的功能开始受到明显抑制,与对照组相比差异有统计学意义（P ＜0．05）;并且,DMSO 对 PBMCs 增殖和细胞因子分泌功能的影响存在浓度依赖趋势。结论DMSO 浓度大于2％的培养体系会对 PBMC 产生明显的细胞毒性作用,应采取适当措施减小或规避 DMSO 对实验结果的影响。     

In vitro and in vivo effects of quinupristin-dalfopristin against Pneumocystis carinii

Quinupristin-dalfopristin (Q-D), which is active against bacteria and Toxoplasma gondii, was examined for its activity against Pneumocystis carinii. After 72 h of incubation with rat P. carinii in an ATP cytotoxicity assay, the 50% inhibitory concentration of Q-D was 10.6 microg/ml, a level that can be achieved in serum with high-dose administration. Q-D administered intraperitoneally at doses of 50 to 200 mg per kg of body weight per day in the treatment and 100 mg/kg/day three times per week in the prophylaxis of pneumocystosis in immunosuppressed mice reduced the organism burden up to 15- and 302-fold, respectively. We conclude that Q-D has activity against P. carinii in vitro and in vivo.     

In vitro and in vivo effects of clindamycin on polymorphonuclear leukocyte function.

The effects of clindamycin on polymorphonuclear leukocytes (PMNLs) were evaluated in vitro and in vivo in an experimental model and in immunocompromised patients with and without infection. Chemotaxis, chemiluminescence, and bactericidal capacity were evaluated using PMNLs preincubated with clindamycin in different concentrations. In the three phases of the study, clindamycin at a concentration of 2 mg/L significantly increased PMNL function. In contrast, when higher concentrations were used, PMNL function was not modified and in some cases it was decreased. Our findings suggest that clindamycin, in concentrations of 2 mg/L, positively modifies PMNL function.     

In vitro and in vivo effects of prestorage filtration of apheresis platelets

BACKGROUND: The effect of prestorage filtration on the quality of apheresis platelet concentrates stored for transfusion is undetermined. STUDY DESIGN AND METHODS: Investigation of 11 plateletpheresis components used a concurrent paired-study design. On the day of collection, each component was equally divided into two suspensions; one half was filtered, and the other half was not. Each suspension was stored for 5 days. In vitro testing was performed on the day of collection (Day 0) for cell counts and on Day 5 for measurements of lactate, glucose, blood gases, pH, platelet ATP, hypotonic stress ratio, extent of shape change in response to ADP, tissue necrosis factor alpha, interleukin 8, interleukin 1 alpha, interleukin 1 beta, interleukin 6, and platelet surface glycoproteins by flow cytometry. At the end of the 5-day period, a sample was taken from each of the two suspensions, radiolabeled with either 51Cr or 111In, and transfused concurrently. Posttransfusion samples were drawn for measurements of recovery and platelet survival and for functional assessment of the ex vivo ability of the circulating radiolabeled platelets to aggregate in response to ADP. RESULTS: The apheresis component had a mean platelet yield of 3.2 +/? 0.4 × 10(11) and a white cell yield ranging from 1 × 10(5) to 1 × 10(8), with a median of 2 × 10(7). Filtration resulted in a platelet loss of approximately 10 percent and a variable 2 to 3 log10 reduction in white cell content. No significant differences between filtered and unfiltered suspensions in paired t tests that would likely have an impact on platelet quality were observed in the in vitro tests. The in vivo recovery and survival were highly similar and not statistically different in filtered and unfiltered paired suspensions: the mean difference was 1.2 +/? 4.0 percent for recovery and 7.0 +/? 15 hours for survival. The functional assessment by aggregation to ADP showed no difference between filtered and unfiltered suspensions. A small decrease in tumor necrosis factor alpha and interleukin 8 was evident in the filtered suspension as compared to levels in the unfiltered suspensions. CONCLUSION: Prestorage white cell reduction in apheresis components resulted in WBC reduction by several log10 with no evident adverse effect on platelet viability or function.     

合并症与腹膜透析患者炎症营养状况及预后关系的探讨

目的 探讨合并症与腹膜透析患者炎症、营养状况以及预后的关系.方法 腹膜透析患者202例人,记录患者进入腹膜透析时和腹膜透析后合并症发生状况以及截止至2010年8月31日前的转归.使用Charlson合并症指数(charlson comorbidity index,CCI)并把患者分为无合并症组、低合并症组和高合并症组,分析比较3组患者的炎症状况、营养水平以及转归情况.结果 低合并症组和高合并症组与无合并症组相比主观综合性营养评估法(SGA)评估的营养不良发生率、血超敏C反应蛋白 (hsCRP)水平均显著增加(χ2=17.196,50.230,均 P＜0.05),血白蛋白、瘦体质量(LBM)、瘦体质量百分比(%LBM)、标准化蛋白质相当总氮表现率(nPNA)均显著降低( F=12.034,6.325,12.505,6.230,均P＜0.05).Kaplan-Meier分析显示,高合并症组和低合并症组患者的死亡率显著高于无合并症组(χ2=37.048 P＜0.05).Cox多元回归分析显示,CCI、年龄、SGA、%LBM是影响患者预后的独立危险因素(χ2=9.872,5.836,7.816,15.051,均 P＜0.05).结论 存在合并症的腹膜透析患者在透析过程中可能伴有更多的炎症状态和营养不良,且预后较差;合并症指数可以预测腹膜透析患者的预后.