造血因子动员后自体外周血干细胞移植对急性放射病猴的治疗作用

目的　观察重组人粒细胞集落刺激因子 (rhG CSF)或rhG CSF +重组人干细胞因子 (rhSCF)动员后外周血干细胞 (PBSC)自身移植对 7 0Gyγ射线照射猴的治疗效果。方法　 15只正常成年猕猴分成照射对照、rhG CSF和rhG CSF +rhSCF 3组。rhG CSF 10 μg/(kg·d) (μKD)连续 5天皮下注射 ,rhSCF 2 0 μKD连续 8天皮下注射 ,后 5天与rhG CSF联用。照射对照组注射等体积的生理盐水。照射当天收集PBSC ,7 0Gyγ射线照射后 3～4h做自体PBSC移植 ,观察其造血恢复情况。结果　在移植后恢复期rhG CSF +rhSCF组白细胞数明显高于对照组和rhG CSF组。rhG CSF+rhSCF和rhG CSF组外周血小板数的恢复优于照射对照组 ,骨髓CFU数明显高于对照组。病理组织学检查表明 ,rhG CSF组骨髓腔内造血细胞数量超过照射对照组 ,但比rhG CSF +rhSCF组少。结论　rhG CSF或rhG CSF +rhSCF组动员后自体PBSC移植可明显促进急性放射病猴的造血功能恢复 ,两因子联用组的效果优于单因子组。     

rhIL-11+rhG-CSF对中子急性放射病狗的治疗作用

目的　探讨rhIL-11与rhG-CSF联用对中子急性放射病(ARS)的治疗作用。方法　18只雄性成年比格狗,随机分为照 射对照组、对症治疗组和两因子+对症联合治疗组。所有动物均接受90%中子照射,吸收剂量为2.0Gy。联合治疗组动物于照射后 即刻开始皮下注射rhG-CSF10μg/(kg·d)和rhIL-1150μg/(kg·d),给药时间分别为14天和21天,观察照射后动物外周血象及骨髓 有核细胞形成CFU-GM能力的变化。结果　对症治疗组和联合治疗组动物全部存活,而照射对照组动物30天存活率为57.1%。照 射后联合治疗组各检测点外周血白细胞数及恢复期血小板和红细胞数均明显高于照射对照组及对症治疗组。照射后1天,联合治疗 组骨髓CFU-GM数量是两个对照组的6倍(P<0.01),33天分别是照射对照组、对症治疗组的1.75和1.46倍(P<0.01)。结论　 rhIL-11与rhG-CSF联合给药可以升高2.0Gy裂变中子照射狗的外周血白细胞、血小板数的最低值,缩短白细胞最低值持续的时间, 加速骨髓造血功能的恢复,对2.0Gy中子照射狗有明显的治疗作用。     

rhSCF动员的外周血干细胞对7.0 Gy照射猴造血功能的影响

目的　观察经重组人干细胞因子 (rhSCF)或rhSCF 重组人粒细胞集落刺激因子(rhG CSF)动员后外周血干细胞移植对 7 0Gyγ射线照射猴的治疗效果。方法　 15只猕猴分成照射对照、rhSCF和rhSCF rhG CSF 3组。rhSCF 5 0 μg·kg- 1 ·d- 1 每天 1次 ,连续 8d皮下注射 ;单独注射rhSCF 3d后每天 1次皮下注射rhG CSF 10 μg·kg- 1 ·d- 1 ,给药 5d ;照射对照组同时给予等体积的生理盐水。照射前 4h收集外周血干细胞 (PBSC) ,7 0Gyγ射线照射后 2～ 3h回输PBSC ,观察其造血恢复情况。结果　单纯rhSCF动员的PBSC可促进照射猴外周血白细胞和血小板数的恢复 ,但不如rhSCF rhG CSF联合动员组。单用rhSCF动员组各系集落数与照射对照组无明显差异 ,rhSCF rhG CSF组的照后 30d的CFU GM、CFU Mix和CFU MK数明显高于照射对照组。照射对照组骨髓病理切片主要为脂肪细胞 ,而另两组骨髓腔内都可见到丰富的造血细胞 ,三系造血活跃。结论　rhSCF和rhSCF rhG CSF动员的PBSC可促进 7 0Gyγ射线照射猴的造血功能恢复 ,两因子联用组的效果优于单因子组。     

rhIL-11联合rhG-CSF和CTX动员小鼠外周造血干/祖细胞的实验研究

为研究rhIL 11联合rhG CSF和CTX对C5 7BL/ 6小鼠外周造血干细胞的动员作用 ,将 48只C5 7BL/ 6小鼠随机分为 4组 ,3组d0给予一次腹腔注射 2 0 0mg/kg的CTX ,其中 2组d1d15分别皮下注射rhIL 11、rhIL 11加rhG CSF ,观察不同时间外周血白细胞、血小板计数、CD34 细胞比例、CFU GM、CFU MK及CFU E的数量变化。结果发现 ,rhIL 11或联合rhG CSF可明显促进CTX骨髓抑制小鼠外周血血小板和白细胞的恢复、提高外周血CD34 细胞比例及三系造血细胞集落数量。证明rhIL 11具有外周血造血干细胞动员作用 ,而与rhG CSF和CTX联合动员效果更佳。     

细胞因子联合对4.5 Gy γ射线照射 比格犬的实验治疗作用

目的 观察细胞因子新的组合(rhG-CSF+rhIL-11+rhIL-2)对骨髓型急性放射病(ARS)比格犬的治疗作用。方法 以4.5 Gy  ⁶⁰Co γ射线照射比格犬制备骨髓型ARS动物模型,动物分为照射对照(5只)、综合对症(5只)和综合对症加细胞因子治疗3组(6只),通过观察动物体征、存活时间、存活数以及动物造血及胃肠道等脏器的恢复情况,分析细胞因子联合治疗效果。结果 4.5 Gy  ⁶⁰Co γ射线照射后,比格犬出现食欲下降、发热、精神状态差和柏油便等症状,照射对照组动物于照射后2周内全部死亡,平均存活(12.7±1.4)d;综合对症组呈现明显的急性放射病症状,并于照射后第33天死亡1只;而综合对症加细胞因子组动物在45 d观察期内不仅全部存活,临床症状明显改善,且其造血功能及胃、肠道等受损组织基本恢复。结论 在综合对症基础上给予rhG-CSF+rhIL-11+rhIL-2组合治疗可以有效地促进4.5 Gy ⁶⁰Co γ射线照射比格犬造血系统功能和胃肠道等重要脏器的恢复,提高受照动物存活数,并改善动物生存质量。     

rhIL-11对急性放射病小鼠骨髓细胞凋亡的影响

目的　研究rhIL 11对急性辐射损伤后骨髓造血细胞凋亡的影响。方法　应用原位末端标记、流式细胞术及琼脂糖凝胶电泳法分别在照射后不同时间观察了rhIL 11对 5 5Gy6 0 Coγ射线全身照射小鼠骨髓造血细胞凋亡的影响。应用免疫组织化学法观察了各组小鼠骨髓细胞Bcl 2和P5 3蛋白的表达变化。结果　①照射前应用rhIL 11可使照射后 6h小鼠骨髓造血细胞凋亡率下降 ,而照射后给药组照射后 12h凋亡率下降更加明显。②照射后 3d给药组P5 3蛋白表达均较照射对照组明显降低 (P <0 0 1) ,Bcl 2蛋白表达则明显升高 ;照射后 7d给药组Bcl 2升高仍明显。结论应用rhIL 11可有效抑制照射后小鼠骨髓造血细胞凋亡 ,有利于造血功能的恢复。rhIL 11对细胞凋亡的影响可能与Bcl 2和P5 3等蛋白的调节密切相关。     

造血因子治疗中子急性放射病的实验研究

目的通过观察造血生长因子-重组人白细胞介素-11(rhIL-11)和重组人粒细胞集落刺激因子(rhG-CSF)联合应用的方法对中子急性放射病狗的治疗效果,探讨中子损伤治疗的救治方法。方法14只雄性成年比格狗随机分为照射对照和rhIL-11+rhG-CSF治疗组。所有动物均接受90%裂变中子照射,治疗组于照后当天开始每天1次皮下注射rhG-CSF10μg·kg-1·d-1和rhIL-1150μg·kg-1·d-1,给药时间分别为14和21d。照射后观察动物的外周血象、外周血CD4+/CD8+比值变化、骨髓CFU-E及组织病理学改变。结果照射后早期对照组动物全部发生不同程度的呕吐,治疗组仅1只动物呕吐。照射后30d照射对照组死亡3只,治疗组动物全部存活。照后治疗组外周血白细胞数和恢复期血小板数明显高于照射对照组。照射后1、21和33d治疗组外周血CD4+/CD8+比值分别为照射对照组1·24、1·55和2·15倍。照射后1和33d治疗组动物骨髓CFU-E分别为照射对照组的5·25和2·34倍(P<0·01)。结论rhIL-11+rhG-CSF联合给药可明显促进中子照射所致骨髓型急性放射病狗的造血和免疫功能恢复,为细胞因子应用于中子急性放射病的临床治疗提供了实验依据。     

Toll样受体5激动剂CBLB502对7.0Gy60Coγ射线照射恒河猴的辐射防护作用观察

目的 观察Toll样受体5激动剂CBLB502对7.0Gy 60Coγ射线全身照射恒河猴的辐射防护作用.方法 30只健康成年恒河猴分为对症治疗组、WR-2721(辐射防护剂氨磷汀)组和CBLB502 2.5、10、40μg/kg组,每组6只.所有动物均用60C0 γ射线放射源一次全身双侧照射7.0Gy(剂量率13.00～13.52cGy/min).CBLB502给药剂量为2.5、10和40μg/kg,阳性对照药WR-2721剂量为30mg/kg,对症治疗组注射生理盐水0.3ml/kg,均为照射前0.5h一次肌肉注射.所有动物照射后在同一原则下给予对症治疗.观察各组动物一般体征、外周血象、造血祖细胞集落培养情况及组织病理学检查结果.结果 照射后40d时CBLB502 10、40μg/kg组动物存活率均为100％,而对症治疗组存活率仅为33％(2/6);WR-2721组各系造血恢复稍快于对症治疗组,但差异无统计学意义;与对症治疗组比较,CBLB502 40μg/kg组外周血白细胞和血小板最低值显著增高,血小板低值持续时间缩短,开始恢复时间提前,输血量明显减少(P＜0.05),骨髓、肠道等组织损伤明显减轻.结论 7.0Gy 60Coγ射线全身照射猴均发生了重度骨髓型急性放射病.照前30min一次性给予40μg/kg CBLB502对7.0Gy 60Coγ射线照射猴有明显的辐射防护作用,其效果优于目前常用的辐射防护剂WR-2721.     

rhIL-11不同时间给药对急性放射病猕猴造血系统的影响

目的 观察rhIL-11不同时间约药对^60Coγ射线照射猕猴造血系统的影响。方法 正常成年猕猴用^60Coγ射线一次全身照射3．0Gy ,吸引剂量率154．96cGy/min,分照射对照、早期给药和后给药3组,后两组分别在照射后当天和第13天开始皮下注射rhIL-1160μg.kg^-1.d^-1(μKD),每日1次,连续14d。结果 照射后应用rhIL-11可明显短照射猴外周血小板数和白细胞数量低值的持续时间,早期给药还可明显升高照射猴外周血小板数的最低值。给药后1周内,早期给药组外周血红细胞数较照射对照组有一定程度的降低,从给药后第19天开始则明显高于照射对照组。照射后45d骨髓细胞培养结果表明,rhIL-11可明显刺激照射猴骨髓有核细胞体外形成CFU－MK和CFU－Mix的能力。病理组织学观察结果同样表明 IL-11治疗组骨髓粒系和巨核系细胞明显增殖。结论 rhIL-11可明显促进急性放射病猴骨髓造血功能的恢复,照射后早期给药的效果优于第13天开始给药。     

复方萘酚喹对比格犬的长期毒性

目的 :观察犬连续口服复方萘酚喹的毒性剂量、损伤的靶器官、可逆性及安全剂量范围。方法 :给比格犬口服复方萘酚喹 1 7.5 ,87.5或 1 4 0mg/(kg·d) ,每天 1次 ,连服 1 4d。给药结束后 ,各组活杀 2 /3,留 1 /3继续观察2 8d。观测了临床症状和生理指标 ,血液学 8项、血生化 1 3项、尿 8项、心电图、眼底、骨髓和组织病理学。结果 :主要毒性反应见于 1 4 0mg/(kg·d)组 ,给药后 5 /6只犬出现恶心、呕吐等消化系统症状 ,部分动物出现阵发性抽搐 ,几分钟后自行缓解。该组给药后GOT ,GPT明显升高 ,心电图Q_T间期延长 ,骨髓红系受到抑制 ,组织学检查可见肝细胞损伤明显。 87.5mg/(kg·d)组各种毒性反应均较大剂量组轻 ,所有毒性反应于停药后自行恢复。 1 7.5mg/(kg·d)组未见明显毒副作用。结论 :1 4 0mg/(kg·d)为重度中毒剂量 ,87.5mg/(kg·d)为中度中毒剂量 ,1 7.5mg/(kg·d)为安全剂量。毒性靶器官是肝脏和骨髓 ,损伤是可逆的     

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.     

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).     

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.     

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.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）