低剂量辐射对脐血免疫细胞功能影响的初步研究

目的 观察低剂量辐射对脐血淋巴细胞增殖，CD25分子表达，IL－2水平和NK细胞活性的影响。方法：（1）采用^3H-TdR掺入法和^3H-TdR释放法检测62mGy,124mGy,186mGy 射线照射新鲜分离的脐血淋巴细胞增殖和NK细胞活性。（2）采用单克隆抗体直接免疫荧光标记流式细胞术和酶联免疫吸附实验检测62mGy γ射线照射新鲜分离的脐血淋巴细胞在不同时间（12h,24h,48h）CD25分子表达和培养上清液的IL－2水平。结果 在一定剂量范围内的低剂量辐射显著促进脐血淋巴细胞增殖和增强NK细胞活性。62mGy γ射线照射后脐血淋巴细胞CD25表达和IL－12水平显著上调，CD25表达和IL－2的水平随时间推移逐步增高。结论 在一定剂量范围内的低剂量辐射能促进淋巴细胞的增殖，活化和成熟，增强NK细胞活性。低剂量辐射对脐血免疫细胞存在兴奋效应。可能加速脐血移植时造血功能和免疫功能的重建，这可能增加移植物抗白血病效应，降低其复发，显示出临床应用前景。     

~(60)Coγ射线照射抑制平滑肌细胞增殖的MAPK及PKC途径

目的　探讨γ射线照射抑制平滑肌细胞 (SMC)增殖的信号传递途径。方法　培养的动脉平滑肌细胞分别接受吸收剂量为 3 5、7 0、14Gy60 Coγ射线照射后 ,以3 H TdR掺入法测定平滑肌细胞增殖程度 ,放射活性法测定蛋白激酶C(PKC)及丝裂素活化蛋白激酶 (MAPK)活性。结果7 0、14Gy60 Coγ射线能明显抑制平滑肌细胞增殖 ,同时有MAPK、PKC活性明显降低。结论　 7 0、14Gy60 Coγ射线抑制血管平滑肌细胞增殖可能是通过降低MAPK、PKC活性途径实现的。     

野生型p53基因转染卵巢癌SKOV-3细胞对放疗敏感性的影响

目的 探讨γ射线照射抑制平滑肌细胞（SMC）增殖的信号传递途径。方法 培养的动脉平滑肌细胞分别接受吸收剂量为3.5、7．0、14Gy^60Coγ射线照射后，以^3H-TdR掺入法测定平滑肌细胞增殖程度，放射活性法测定蛋白激酶C（PKC）及丝裂素活化蛋白激酶（MAPK）活性。结果 7．0、14Gy^60Coγ射线能明显抑制平滑肌细胞增殖，同时有MAPK、PKC活性明显降低。结论 7．0、14Gy^60Coγ射线抑制血管平滑肌细胞增殖可能是通过降低MAPK、PKC活性途径实现的。     

用^3H—TdR释放法测定小鼠NK细胞的辐射敏感性

用~3H—TdR释放法测定C_(57)BL/6小鼠脾细胞对YAC-1细胞林的NK活性,首次将该法应用于研究NK细胞对γ线的辐射敏感性,得出如下结论:(1)小鼠整体照射后24h脾脏NK活性的D_(37)约为17Gy,D_0约为11Gy;在24～32Gy范围内仍保留着30%的NK活性,存活曲线为反“S”形,验证了NK细胞总体对辐射的相对耐受性。(2)脾细胞离体或整体照射1～2Gy后即刻NK活性均迅速下降,在2～24Gy内,离体和整体照射组的NK活性分别维持在40%～80%和50%,前者高于后者,说明NK细胞对离体照射比对整体照射更不敏感。(3)小鼠整体照射后24h,全脾细胞数在较小剂量(<4Gy)内急剧下降,然后随剂量增大变化平缓。可以推测NK活性的变化与脾细胞总数的改变有一定关系。(4)综合分析本实验结果,可以设想NK细胞本身可能存在着辐射敏感性不同的亚群。(5)用~3H—TdR释放法测定NK细胞的辐射敏感性,自然释放率低,重复性好,可靠易行。     

脐血基础与临床研究

目的 对脐血进行系列研究，以期为临床应用提供实验依据。方法 采用分离新鲜脐血单个核细胞，未行或行低剂量^60Co γ射线62mCy照射，并用^3H-TdR掺入和释放法、ELISA分析、流式细胞仪、MTT和粒巨噬细胞集落形成单位测定等方法对脐血量、单个核细胞（MNC）数量、活性MNC百分率、CD34^＋细胞数及其与新生儿月龄、性别、脐血血象及产妇年龄关系、脐血T淋巴细胞、NK细胞活性、低剂量照射脐血后T淋巴细胞和NK细胞活性变化、脐血清集落刺激活性物质和临床用于白细胞减少症疗效进行了实验和临床研究。结果 每份脐血在100～150ml范围内占95．4％，其量与MNC无相关性，存放在6℃冰箱3d以内较适宜，活性MNC在91．2％以上；脐血中CD34^＋细胞数除与性别相关外，与其他因素无相关性；脐血T淋巴细胞和NK细胞活性偏低，低剂量照射能提高其活性；脐血清富含细胞集落刺激活性物质，以IL-3为主；白细胞减少症患者输注脐血可提升外周血白细胞总数水平。结论 由于以上诸多优势，故脐带血具有临床应用的广阔前景。     

不同LET射线及其联合照射下淋巴母细胞微核率的剂量效应

目的 探讨在α粒子、γ射线以及联合照射下淋巴母细胞微核率的剂量效应.方法 以HMy2.CIR淋巴母细胞为对象,分别以不同剂量的α粒子和γ射线进行照射,以及先以0.025 ～0.500 Gy的α粒子照射后即刻以不同剂量的γ射线进行照射,用胞质分裂阻断法检测淋巴细胞微核,建立不同照射条件下淋巴母细胞微核率的剂量-效应曲线.结果 对于γ射线照射,微核率剂量-效应符合线性平方模型Y=c+αD+ βD2.对于α粒子照射,当照射剂量＜0.250 Gy时,细胞微核率随剂量的增加呈线性增加,当其剂量进一步增加时,微核率剂量-效应曲线呈现下弓型,可以采用反映辐射旁效应的BaD模型Y=c +αD +σ[1 -exp(-δD)]exp(-βD)进行很好地拟合.对于联合照射,当α粒子剂量较低时,微核率的剂量效应与γ射线照射时的相似;但当α粒子剂量较大时,微核率的剂量-效应更接近于α粒子照射.同时,0.2、0.5 Gyα粒子联合γ射线照射引起的微核率显著高于它们单独照射时的微核率之和(=5.22 ～ 11.86,P＜0.05).结论 α粒子照射具有与γ射线不同的辐射损伤规律,辐射旁效应可能在其中发挥了重要作用,而联合照射则可以引起细胞损伤的协同增强.     

低剂量辐射对脐血的免疫刺激作用

目的：探讨低剂量辐射对脐血T淋巴细胞膜分子表达，IL－2分泌及LAK细胞体外抗肿瘤活性的影响。方法：新鲜分离的脐血淋巴细胞及LAK前体细胞接受低剂量γ射线照射，分别用直接免疫荧光标记流式细胞术，MTT法及3H-TdR释放实验检测T淋巴细胞膜分子的表达，IL－2分泌的LAK体外杀伤肿瘤靶细胞（K562，HL－60）活性。结果：（1）62mGyγ射线照射后，脐血淋巴细胞CD3，TCR／CD3复合物，CD4，CD8分子表达显著上调，且均在4－24h，人随时间推移而逐步增强，CD4／CD8比值无显著性变化；（2）62mGy γ射线照射后，脐血单个核细胞上清IL－2活性随培养时间推多逐渐增强，不同时间点比较差异均有显著性（P＜0．05）；（3）脐血LAK细胞对K562和HL－60的杀伤活性与成人外周血相比差异无显著性（P＞0．05），接受低剂量辐射的脐血LAK细胞对K562和HL－60的细胞毒性显著高于非照射组（P＜0．01），结论：低剂量辐射可促进脐血T淋巴细胞的成熟，活化和信号的转导及IL－2的分泌，增强脐血LAK杀伤肿瘤靶细胞的细胞毒活性，从而可能在脐血移植中加速免疫功能重建，增强移植物抗白血病效应。     

β和γ射线照射肿瘤细胞的生物效应比较

目的 比较低剂量率β射线和高剂量率γ射线照射诱发肿瘤细胞生物效应特点。方法采用^32Pβ射线和^60Coγ射线照射人宫颈癌HeLa细胞系，用台盼蓝排除法和X-gal衰老细胞染色法比较两种照射肿瘤细胞死亡方式的差异。结果 ^32Pβ射线(0．375cGy/min)和^60Coγ射线(206cGy/min)照射HeLa细胞后72h的结果表明，低剂量率β射线抑制细胞增殖为渐进性，使多数的细胞在一个或几个细胞倍增周期后死亡，以增殖性死亡为主；高剂量率γ射线对细胞的抑制作用直接、迅速，细胞坏死比例高，增殖性死亡(衰老)比例低于持续低剂量照射方式。结论 不同的辐射方式对细胞的杀伤方式不同，了解其放射生物学机理有助于临床治疗方案的选择。     

γ射线致旁效应细胞脆性组氨酸三联体的表达

目的 研究⁶⁰Coγ射线照射后人淋巴母细胞(AHH-1)及其旁效应细胞中脆性组氨酸三联体(FHIT)基因的表达情况,探讨FHIT基因在电离辐射旁效应中的作用。方法 旁效应细胞模型的制备:分别用不同剂量(0、2和5 Gy) ⁶⁰Coγ射线照射AHH-1细胞后,立即离心,将直接受照细胞与未受照细胞共同培养于Transwell中,此未受照细胞为旁效应1组;另将直接受照细胞培养液转移至未受照细胞培养瓶中形成旁效应2组。于照后0、6、12和24 h收集细胞,抽提细胞总RNA及总蛋白,分别应用RT-PCR和Western blot方法检测 FHIT mRNA及蛋白表达水平;并在照后即刻和24 h收集细胞,应用流式细胞仪检测细胞周期,并应用细胞计数法观察细胞增殖变化。结果 对照细胞、直接受照细胞、旁效应细胞中FHIT基因 mRNA水平变化不明显,而FHIT蛋白表达在直接受照细胞及旁效应细胞中显著下调(F=102.45.P<0.001)。细胞周期分析结果显示直接受照细胞及旁效应细胞G₂期阻滞明显,且增殖能力明显下降。结论 2、5 Gy⁶⁰Coγ射线照射能导致直接照射AHH-1细胞及其旁效应细胞FHIT蛋白表达明显下调,提示FHIT基因在电离辐射旁效应中发挥一定作用。     

AT细胞系辐射敏感性与细胞凋亡的相关研究

目的 探讨AT细胞高辐射敏感性与细胞凋亡之间的联系。方法 以液体闪烁测量法测3H-TdR掺入百分率来观察^60Co γ射线照射对AT5BIVA（AT）和GM0639（GM）细胞增殖的影响;实验于照射后0、24、48和72 h,用细胞流式术动态检测AT和GM细胞的自发凋亡率及^60Co γ射线照射诱发的凋亡率。结果 ^60Co γ射线0～6 Gy照射后,AT和GM两种细胞3H-TdR掺入百分率均呈剂量依赖性降低,且AT细胞降低得比GM细胞快,两种细胞3H-TdR掺入百分率与受照射剂量间可拟合成指数方程：SAT=0.9718e^-0.6855D（R^2=0.9950）、SGM=1.0928e^-0.3731D（R^2=0.9777）;AT细胞的自发凋亡率高于GM细胞;2～6 Gy照后24 h,两种细胞由辐射诱发的凋亡率均随照射剂量增大而升高,且在同一剂量点,前者凋亡率高于后者;2 Gy照射后0～72 h,AT和GM细胞的凋亡率均呈时间依赖性增加,且随照后时间延长两者间差异逐步增大,在72 h达到显著水平。结论 AT细胞高辐射敏感性与其较高的自发及辐射诱发的凋亡密切相关。     

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.     

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）     

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.