羟基喜树碱诱导大鼠心脏移植免疫耐受机制的探讨

以纯系SD大鼠为供者,Wistar大鼠为受者行异体颈部心脏移植,移植后受者大鼠接受不同剂量羟基喜树碱（HCPT）、环孢素A（CsA）治疗或二者联合应用。应用RT-PCR方法检测移植物内及受者脾内细胞因子mRNA表达情况,观察HCPT和CsA在诱导异基因大鼠心脏移植免疫耐受中的作用,并探讨免疫耐受的形成机制。结果显示,与对照组比较,各用药组移植心脏存活时间显著延长。[HCPT2.0mg/（kg·d）]组中3/10和[HCPT1.0mg/（kg·d）+CsA10mg/（kg·d）]组中5/10受者大鼠形成特异性免疫耐受。耐受组IL-4、IL-10mRNA表达明显高于排斥组,而IL-2、IFN-γ明显低于排斥组。受者脾内细胞因子表达量近似于移植物内。提示大剂量NCPT或小剂量HCPT与CsA合用可诱导异基因大鼠心脏移植免疫耐受;细胞因子偏向Th2亚类是免疫耐受形成机制之一。     

蒺藜总皂甙对TNF-α及IL-1β诱导内皮细胞粘附的抑制作用

目的：观察蒺藜总皂甙（ｇｒｏｓｓｓａｐｏｎｉｎｓｆｒｏｍ ＴｒｉｂｕｌｕｓｔｅｒｒｅｓｔｒｉｓＬ,ＧＳＴＴ） 对肿瘤坏死因子－ α（ＴＮＦ－ α） 、白细胞介素－１β（ＩＬ－１β） 诱导的培养新生牛脑微血管内皮细胞（ＣＭＥＣ） 粘附大鼠血单核细胞（ＭＮＣ） 及中性粒细胞（ＰＭＮ） 的影响。方法：用ＴＮＦ－α和ＩＬ－１β分别诱导传代的ＣＭＥＣ,计粘附ＭＮＣ及ＰＭＮ的细胞数,并计算粘附率。结果：ＣＭＥＣ 经ＴＮＦ－ α处理４ｈ 后,ＣＭＥＣ与ＭＮＣ及ＰＭＮ的粘附率,分别增加到３１．３±０．５％ 和３２．１±０．５％ （对照组分别为１２ ．５±０ ．２％ 和１３ ．８±０ ．４ ％） ,经ＩＬ－１β处理２ｈ 后,则分别为４４．５ ±１．０ ％ 和４４．８ ±０．７ ％ （ 对照组分别为１２ ．９ ±０．６ ％ 和１４．７ ±０．６％ ）。在ＴＮＦ－ α（ＩＬ－ １β） 处理前,用ＧＳＴＴ与ＣＭＥＣ共孵育,预处理２ｈ,则ＧＳＴＴ可剂量依赖性地抑制ＴＮＦ－ α和ＩＬ－ １β的作用。结论：ＧＳＴＴ可抑制ＣＭＥＣ 与ＰＭＮ及ＭＮＣ的粘附。     

T细胞疫苗接种抗异种角膜移植排斥的实验研究

本实验研究体外证实：豚鼠组织抗原可诱导经其免疫Ｗｉｓｔａｒ大鼠Ｔ淋巴细胞特异性增殖，Ｔ细胞疫苗能诱导经此疫苗接种鼠产生抗其个体型淋巴细胞增殖。这些淋巴细胞包括ＣＤ４＾＋和ＣＤ８＾＋两类表型。经Ｔ细胞疫苗接后，Ｗｉｓｔａｒ大鼠淋巴细胞表现出对豚鼠组织抗原的特异性转化率降低。体内研究表明：Ｔ细胞疫苗接种能显著延长异种角膜植片在Ｗｉｓｔａｒ大鼠眼中的存活期，其疗效优于雷公藤甲素，接近ＣｓＡ。     

高压氧对实验兔海水型呼吸窘迫综合征的预防作用

目的　观察高压氧（ＨＢＯ）对海水淹溺肺水肿（ＰＥ－ＳＷＤ）的预防作用。方法　复制ＰＥ－ＳＷＤ动物模型后,３２ 只兔随机分为ＰＥ－ＳＷＤ对照组、药物治疗组和ＨＢＯ组。对３ 组兔的动脉血气酸碱指标、Ｃａ２＋ 沉淀反应颗粒、ｃ－ｆｏｓ ｍ ＲＮＡ和ｃ－ｊｕｎ ｍ ＲＮＡ 等进行自动检测和定量分析比较,并观察分析３组兔的存活时间和海水型呼吸窘迫综合征（ｓｅａｗ ａｔｅｒ－ｒｅｓｐｉｒａｔｏｒｙ ｄｉｓｔｒｅｓｓ ｓｙｎｄｒｏｍ ｅ,ＳＷ－ＲＤＳ）发生率。结果　ＨＢＯ组兔ＰａＯ２ ,ＳａＯ２ 和ｐＨ ３ 项指标比药物组显著升高（Ｐ＜ ０．０１）,动物存活时间［（４３．０３±７．１９）小时］比药物组［（２３．５８±１．４９）小时］明显延长,Ｃａ２＋ 沉淀反应颗粒,ｃ－ｆｏｓ ｍ ＲＮＡ,ｃ－ｊｕｎ ｍ ＲＮＡ和ＳＷ－ＲＤＳ发生率ＨＢＯ组则明显低于药物组（Ｐ＜ ０．０１）。结论　ＨＢＯ可明显提高ＰａＯ２ 和ＳａＯ２,有效改善低氧血症和代谢性酸中毒,减轻ＰＥ－ＳＷＤ时肺组织的损伤,从而可防止ＰＥ－ＳＷＤ向ＳＷ－ＲＤＳ转化。     

高压氧治疗重型颅脑损伤后临床、脑电地形图、血浆内皮素、经颅多普勒超声的研究

目的研究高压氧（ＨＢＯ）治疗重型颅脑损伤（ＳＥＩ）的疗效及机制。方法治疗组３５例,对照组２０例,观察ＨＢＯ前后脑电地形图（ＢＥＡＭ）血浆内皮素（ＥＴ）及经颅多普勒超声（ＴＣＤ）查大脑中动脉收缩期流速,平均流速及搏动指数（ＭＣＡ－Ｖｓ,Ｖｍ,ＰＩ）等７项参数。结果治疗组的临床（ＧＣＳ）,ＢＥＡＭ,预后（ＧＯＳ）均明显迅速改善,与对照组有显著性差异。治疗组在ＨＢＯ１疗程后的ＥＴ值从（９１．２４±１２．１８）ｎｇ／Ｌ降到（６８．８８±１４．３７）ｎｇ／Ｌ（Ｐ＜０．０１）,与对照组相应时相比较,ＥＴ降至（８３．１２±１２．２２）ｎｇ／Ｌ,也有显著性差异（Ｐ＜０．０５）。相应的ＴＣＤ的ＭＣＡ－Ｖｍ从（６４．２±４．８）ｃｍ／ｓ降至（５１．６±４．２）ｃｍ／ｓ（Ｐ＜０．０１）,ＭＣＡ－Ｖｓ,ＰＩ的下降同样有极显著性差异（Ｐ＜０．０１）。结论ＨＢＯ能迅速改善重型颅脑损伤者的意识状态、ＢＥＡＭ异常率及生存质量。研究表明与急性期血浆ＥＴ下降和ＭＣＡ血管痉挛缓解有关,表现在ＭＣＡ血流速度和血管阻力的改善,从而减轻脑缺血缺氧,降低颅压,这是ＨＢＯ改善预后的重要机制之一。     

口服抗原对同种异体移植免疫反应的影响

将Wistar大鼠预先喂养同种异基因SD大鼠脾细胞7天，然后接受SD大鼠的皮肤移植，7天后，再接近SD大鼠的心脏移植，观察口服抗原后体外混合淋巴细胞培养（MLC）、体内迟发型超敏反应（DTH）以及心脏存活时间。口服抗原后，体外MLC及体内DTH反应均出现明显的抗原特异性降低，口服抗原组大鼠并接近供者皮肤致敏后的心脏移植存活时间达到7天，与对照组未致敏鼠的心脏移植存活时间一致；而未口服抗原组接受皮肤致敏后的心脏移植存活时间不超过2天。提示口服抗原可以使异基因抗原的特异性免疫应答降低，延长移植存活时间，阻皮肤移植物的事先致敏反应的发生，并使加速排斥反应时间明显延迟。     

正常肺动脉分支直径CT测量

目的：在 Ｃ Ｔ 像上测量正常肺动脉分支直径并探讨其准确测量的可能性。方法：选１ ０１ 例正常成人, 在常规静脉注射碘造影剂后１０ ｓ 立即自隆突层面开始以５ ｍ ｍ 层厚连续动态扫描至下肺静脉水平; 分别在各持有特定参考标志的 Ｃ Ｔ 层面测量肺动脉大分支直径。结果：左、右肺动脉及左、右叶间动脉直径依次为１７ ．７ ±１ ．９ ｍ ｍ ,１６ ．７ ±２ ．０ ｍ ｍ ,１３ ．５ ±１ ．６ ｍ ｍ ,１１ ．９ ±１ ．５ ｍ ｍ ,左、右肺动脉直径与年龄呈非常显著正相关（ Ｐ ＜ ０ ．０１） 。结论： Ｃ Ｔ 是测量肺动脉分支直径的可靠方法。     

门静脉高压病人部分脾栓塞术对门静脉及其分支压力的影响

目的　研究门脉高压,脾功能亢进病人部分脾栓塞（ＰＳＥ） 前后门脉压力改变,以期得到ＰＳＥ对门脉压力改变的影响。方法　采用脾动脉插管及经皮经肝门脉置管在ＰＳＥ前后分别测量门脉主干,脾静脉及肠系膜上静脉压力,通过自身对照ｔ 检验进行统计学研究。结果　ＰＳＥ前门脉主干（ＰＶ）压力为（５１ ．４±１３．７）ｃｍ Ｈ２Ｏ,脾静脉（ＳＶ）为（５５ ．５±２３ ．２）ｃｍ Ｈ２Ｏ,肠系膜上静脉（ＳＭＶ）为（５１．８±１７ ．２）ｃｍ Ｈ２Ｏ,ＰＳＥ后ＰＶ 为（４２．４ ±８．７）ｃｍ Ｈ２Ｏ,ＳＶ 为（４２．３±１１ ．８）ｃｍ Ｈ２Ｏ,ＳＭＶ 为（４３ ．４ ±１３．１）ｃｍＨ２Ｏ,通过自身对照“ｔ”检验,ＰＶ,ＳＶ 为Ｐ＜ ０ ．０５ ,ＳＭＶ 为Ｐ＜ ０ ．００１ 。结论　ＰＳＥ前后门脉主干及其分支压力改变经检验差别有统计学意义。ＰＳＥ术后短期内门脉及其分支压力可明显降低     

红细胞乙酰胆碱酯酶动力学法自动化测定

目的：建立适用于测定实验动物红细胞乙酰胆碱酯酶（ＡＣｈＥ）活性的自动化动力学法。方法：根据Ｗｈｉｔａｋｅｒ法稍加修改，编制适用于自动生化仪的ＡＣｈＥ动力学法分析程序，并作方法学性能评价。结果：在本法条件下，酶反应吸光度和时间之间的线性可达≥５ｍｉｎ；ＡＣｈＥ活性在２１０Ｕ／Ｌ范围内，呈线性关系，最低检测限为≤１．５Ｕ／Ｌ；批内和批间ＣＶ分别为１．１％～１．７％和３．０％～４．５％；正常参考值（ｘ±ｓ，ｋＵ／ＬＲＢＣ）：恒河猴１１．９０±１．７４（ｎ＝１９），比格狗１．８１±０．４７（ｎ＝４５），ＳＤ大鼠０．９７±０．２０（ｎ＝３０）。结论：自动化动力学法测定红细胞ＡＣｈＥ简便，精密度高，尤其适用于大鼠和狗等动物红细胞低活性ＡＣｈＥ测定。     

EPI在上腹部MR成像中的应用:结果与屏气FSE T_2加权像比较

目的：比较８个发射的平面回波成像（ＥＰＩ）与屏气快速自旋回波（ＦＳＥ）对上腹部的Ｔ２ 加权ＭＲ成像。方法：对１７名志愿者,进行了上腹部８ 个发射的ＥＰＩ（１８ｓ）,结果与屏气ＦＳＥＴ２ 加权像（２４ｓ）比较。脂肪抑制技术被应用于每个序列。对肝脏、脾、胰腺和肾脏的信噪比（ＳＮＲ）和脾－ 肝信号强度差别与噪音比率（ＳＤ／Ｎｓ）,以及对显示上腹部器官能力和图像质量进行质量评定。结果：８ 个发射的ＥＰＩ比屏气的ＦＳＥＴ２ 加权像在肝脏（４．６５±１．７５ Ｖｓ ３．１２±１．１５,ｐ＜ ０．０１）,脾脏（８．８６±３．１２ Ｖｓ ６．９１±１．９８,ｐ＜０．０５）和胰腺（５．３９±１．９５Ｖｓ３．３６±１．１９,ｐ＜ ０．００５）ＳＮＲ均有显著增加,但对肾脏ＳＮＲ的增加（８．１４±３．００ Ｖｓ７．３１±２．４３,ｐ＝ ０．３９６５）不明显。两者显示的脾－ 肝ＳＤ／Ｎｓ基本相似（４．２１±１．９７ Ｖｓ３．７９±１．０７,ｐ＝ ０．４６１９）。对显示上腹部器官影像的质量,８个发射的ＥＰＩ比屏气ＦＳＥＴ２ 加权像好,且没有明显的呼吸运动伪影,但前者比后者具有更多的来自于胃肠气体的磁敏感性伪影。结论：上腹部的ＭＲ成像,８ 个发射的ＥＰＩ能     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.