TNF-α对小鼠腹腔渗出细胞抗真菌活性的影响

目的：研究TNF—α对小鼠腹腔渗出细胞的激活和杀菌活性的效应。方法：以IL-12、IL-18、IFN—γ、TNF-α及抗体诱导小鼠腹腔渗出细胞和巨噬细胞，应用ELISA法测定细胞因子变化，Griess反应法测定培养上清液中NO的含量，检测巨噬细胞内新型隐球菌菌落数。结果：IL-12和IL-18联合应用协同诱导腹腔渗出细胞产生TNF—α，且能被IFN—γ抗体所抑制。IFN—γ、TNF-α协同诱导巨噬细胞产生NO和增强其杀伤新型隐球菌活性。结论：TNF—α在细胞因子相互调节诱导增强巨噬细胞杀真菌活性中起重要作用。     

红色奴卡放线菌细胞壁骨架制剂对小鼠腹腔渗出细胞及细胞内环核苷酸含量影响

本实验表明，红色奴卡放线菌细胞壁骨架（Nr-CWS)制剂小鼠腹腔内注射，使腹腔渗出细胞（PEC）明显增加。第1天以多形核粒细胞增加为主很快恢复，4天以后巨噬细胞和淋巴细胞增加显著，吞噬细胞吞噬功能也明显增强，在巨噬细胞吞噬功能增强的同时，PEC中cGMP含量亦显著增加，两者呈平行关系，PEC中cAMP含量在注射Nr-CWS制剂后第2天即显著增加，第6天达高峰，然后逐渐下降至正常水平。     

分娩后小鼠腹腔巨噬细胞的吞噬功能

本文证明分娩后4天小鼠腹腔巨噬细胞和注射葡聚糖后的小鼠腹腔巨噬细胞,以及正常未妊娠小鼠腹腔巨噬细胞吞噬鸡红细胞和酵母菌的功力明显不同。其中。分娩后4天和注射葡聚糖腹腔巨噬细胞,其吞噬率和吞噬指数都明显高于对照组。该结果表明分娩后小鼠体内单核——吞噬细胞系统活性增强,吞噬活性增高。     

小鼠腹腔细胞作为人杂交瘤细胞饲养细胞的实验研究

小鼠腹腔细胞作为人杂交瘤细胞饲养细胞的实验研究聂晶范永星赵洪礼（沈阳军区军事医学研究所，沈阳１１００３４）在人杂交瘤细胞克隆化的过程中，常规采用人外周血淋巴细胞（ＰＢＬ）作为饲养细胞，但因ＰＢＬ制备比较烦琐，来源有限，给实际工作带来不便。我们在制备...     

巨噬细胞对凋亡细胞的吞噬与免疫调节

巨噬细胞,作为机体的专职高效吞噬细胞,在凋亡细胞的清除方面起着非常重要的作用,进而对凋亡细胞诱导的免疫反应也产生了举足轻重的影响。机体产生的自身抗原由巨噬细胞吞噬后向抗原特异性T细胞的提呈在免疫应答或维持自身免疫耐受中起着至关重要的作用。相反,凋亡细胞的吞噬通路异常则有可能导致系统性或器官特异性自身免疫性疾病的发生。本文综述了巨噬细胞吞噬凋亡细胞之后对机体免疫调节的影响,特别是凋亡细胞被吞噬之后在自身免疫性疾病与免疫耐受方面的影响。     

改良的人嗜碱细胞脱颗粒试验在花粉变态反应研究中的应用

改良的人嗜碱细胞脱颗粒试验是一种观察人嗜碱细胞对特异性变应原脱颗粒反应的简易方法。其步骤包括聚蔗糖——泛影葡胺浓缩嗜碱细胞,用阿尔新蓝特异性染色细胞浆内肝素颗粒,借助于血球计数板计数未脱粒细胞,以加入特异性变应原后染色细胞减少30％以上判定为阳性。本文以蒿属花粉作为特异性变应原,对50例由蒿属花粉过敏所致的典型秋季花粉症患者作嗜碱细胞脱颗粒试验。结果发现,在花粉症缓解期阳性率为72％,且其阳性率随蒿属花粉皮试反应强度的增加而升高,而在花粉症急性发作期阳性率为34％,明显低于缓解期。由此对“嗜碱细胞释放能力”这一重要参数进行了初步探讨,认为在花粉症急性发作期嗜碱细胞在体内已经或正在和特异性变应原发生作用,此时如果嗜碱细胞在体外再和变应原接触时,由于其释放能力的限制,将处于相对的低反应状态。30例正常人的阴性反应结果则排除了蒿属花粉变应原的非特异性脱颗粒作用。本研究表明该方法在花粉变态反应研究中应用的敏感性和稳定性。     

猪苓及猪苓多糖对膀胱癌模型大鼠腹腔巨噬细胞吞噬和表面免疫相关分子表达的影响

目的:观察猪苓及猪苓多糖(PPS)对BBN加糖精诱导的膀胱癌大鼠腹腔巨噬细胞的吞噬功能、体外NO释放及共刺激分子和表面分子表达的影响。方法:实验分为空白对照组、模型组、PPS组和猪苓高中低剂量共6组。用流式细胞术检测膀胱癌大鼠腹腔巨噬细胞的荧光微球吞噬率、TLR4/CD14、CD86、CD40的表达。Griess试剂盒检测并分析猪苓及PPS对腹腔巨噬细胞体外NO释放的影响。结果:PPS组与模型组比较,PPS显著促进巨噬细胞吞噬率的增加、NO释放的比值均降低、巨噬细胞表面分子TLR4/CD14、CD86、CD40的表达均显著升高(P<0.05)。不同浓度猪苓组与模型组比较巨噬细胞吞噬率增加、NO释放的比值均降低(P<0.05),巨噬细胞表面分子CD86表达增加。低浓度猪苓组巨噬细胞CD40表达百分率显著升高(P<0.05);但TLR4/CD14的表达无明显变化;中、高剂量猪苓组TLR4/CD14的表达百分率与模型组比较则降低(P<0.05),CD40的表达无统计学差异。结论:PPS可显著促进膀胱癌大鼠腹腔巨噬细胞的吞噬功能和表面免疫相关分子的表达,但猪苓组对巨噬细胞功能的影响因剂量不同而表现出不同结果,可能与猪苓诸多成分同时作用或各成分作用的靶点不同有关。     

多抗甲素增强大鼠腹腔巨噬细胞抗癌免疫功能的研究

目的 本实验探讨腹腔内注射多抗甲素增强大鼠腹腔免疫功能的机制。方法 大鼠腹腔内分别注射0．5、1．0和1．5mg的多抗甲素。2d后处死大鼠分离巨噬细胞。计数并测定乳酸脱氢酶（LDH）和酸性磷酸酶（AcP）的活性，巨噬细胞吞噬活力，一氧化氮（NO）的分泌以及对人K562细胞的细胞毒性进行分析。同时采集大网膜，对大网膜乳斑的数量和面积进行了观察分析。结果 大鼠腹腔巨噬细胞数量、LDH和ACP的活性、吞噬活力、NO的分泌以及细胞毒性随着多抗甲素剂量的增加而增加。并且多抗甲素也显著增加了大网膜乳斑的数量和面积。结论 腹腔内注射多抗甲素可显著增加大鼠大网膜乳斑的数量和面积，并因此增加PMφ的数量，增强PMφ的活性。因而增强了腹腔巨噬细胞的免疫功能。     

薄盖灵芝对小鼠腹腔巨噬细胞的作用

<正> 薄盖灵芝是祖国医学中常用的补益药之一,从薄盖灵芝菌丝体提取制成的注射液(简称薄芝液)的免疫药理我们已作过报道,但目前有关薄芝液对小鼠腹腔巨噬细胞的作用研究较少。薄芝液可促进小鼠巨噬细胞吞噬功能虽有所报道,但由于巨噬细胞是一种具有多种功能的免疫细胞,吞噬功能是巨噬细胞的基本功能之一。因此,我们采用多种测定巨噬细胞功能的方法,以分析薄芝液对巨噬细胞活性的影响。     

Continuous Ambulatory Peritoneal Dialysis Peritonitis: Microbiology and Outcomes

Context: Continuous ambulatory peritoneal dialysis (CAPD) is now a preferred mode of the treatment in patients with end-stage renal disease, but peritonitis remains to be a shortcoming of CAPD. High-culture negativity, emerging drug resistance and peritoneal dialysis (PD)-related morbidity and mortality have been a challenge to tackle. Aims: The present study was taken up to compare the the various culture methods and to identify the spectrum of organisms causing CAPD peritonitis and their outcome. Settings and Design: A prospective, observational, cross-sectional study was conducted at a tertiary care teaching hospital in Hyderabad over a period of 1 year. Subjects and Methods: Dialysate fluid from 100 episodes of clinically suspected peritonitis in 75 patients was processed by conventional centrifuging, water lysis, direct inoculation and addition of centrifuged pellet into brain–heart infusion broth and by automated blood culture system. Identification and antibiotic susceptibility of organisms was done, and the outcome of PD-related peritonitis was analysed. Statistical Analysis Used: The categorical data and continuous data were analysed using the Chi-square test and Student’s t-test, respectively. P < 0.05 was considered statistically significant. Results: Of the 100 PD fluids, 87 were culture positive. Automated blood culture systems detected 87 episodes, whereas conventional centrifuge method detected only 53 episodes (P = 0.00001). Peritonitis due to Gram-negative organisms (62.3%) was higher than that of Gram-positive peritonitis (31.1%) and fungi (6.4%). Nineteen per cent episodes were constituted by relapse (9), refractory (4), recurrent (4) and repeat (2) peritonitis. Outcomes were analysed as recovery (77%), catheter removal (15%) and death (2.6%). Conclusions: Direct inoculation of peritoneal fluid into automated blood culture bottles increases the positivity rate and also aids in the early detection of CAPD peritonitis, helping reduce morbidity and mortality of PD patients.     

腹膜透析患者抑郁症状的影响因素

目的:探讨腹膜透析病人抑郁及影响因素。方法:用汉密顿抑郁量表(HAMD)17项版本评估99例透析大于3个月,临床状况稳定的门诊腹膜透析病人的抑郁症状,用Charlson合并症指数评估病人合并症情况,同时调查睡眠质量、躯体症状、社会支持等因素和有关的生化指标。结果:抑郁评分均值7.37±5.38,其中10~13分11例(11.2%),14~17分9例(9%),大于17分5例(5.1%)。抑郁评分与合并症指数正相关,与躯体症状负相关,与睡眠质量负相关。抑郁评分与血清白蛋白(ALB)、血红蛋白(Hb)、尿素清除指数(Kt/Vurea)相关性无统计学意义。抑郁评分与经济收入、社会支持等呈负相关,多元线性回归分析结果表明,躯体症状、睡眠质量、肾脏疾病所致负担是抑郁的预测因子。结论:腹膜透析病人中抑郁情绪多见,躯体症状、睡眠质量、疾病所致负担等是抑郁情绪的影响因素。     

Predicting One-Year Mortality in Peritoneal Dialysis Patients: An Analysis of the China Peritoneal Dialysis Registry

This study aims to investigate basic clinical features of peritoneal dialysis (PD) patients, their prognostic risk factors, and to establish a prognostic model for predicting their one-year mortality. A national multi-center cohort study was performed. A total of 5,405 new PD cases from China Peritoneal Dialysis Registry in 2012 were enrolled in model group. All these patients had complete baseline data and were followed for one year. Demographic and clinical features of these patients were collected. Cox proportional hazards regression model was used to analyze prognostic risk factors and establish prognostic model. A validation group was established using 1,764 new PD cases between January 1, 2013 and July 1, 2013, and to verify accuracy of prognostic model. Results indicated that model group included 4,453 live PD cases and 371 dead cases. Multivariate survival analysis showed that diabetes mellitus (DM), residual glomerular filtration rate (rGFR), , SBP, Kt/V, high PET type and Alb were independently associated with one-year mortality. Model was statistically significant in both within-group verification and outside-group verification. In conclusion, DM, rGFR, SBP, Kt/V, high PET type and Alb were independent risk factors for short-term mortality in PD patients. Prognostic model established in this study accurately predicted risk of short-term death in PD patients.     

腹膜透析病人的焦虑和抑郁水平与其病情变化的相关分析

目的:探讨腹膜透析病人情绪障碍,即焦虑症状和抑郁症状的发生情况,以及与透析相关因素的关系.方法:88例腹膜透析病人,使用Hamilton焦虑量表和Hamilton抑郁量表评估其情绪状况,同时测定其营养状况、残余肾功能和透析充分性、以及炎症水平,记录心脑血管事件发生情况等.结果:本组腹膜透析病人焦虑症状的发生率为44.3%,抑郁症状的发生率为56.8%.具有糖尿病和心脑血管病史者的Hamilton焦虑评分和抑郁评分高于无此类病史者(P<0.05).SGA评分较高的病人Hamilton焦虑评分和抑郁评分也较高;焦虑评分和抑郁评分较高的病人,其血清白蛋白水平、蛋白质摄入水平、体重指数、上臂中段肌肉面积和脂肪面积均较低(r=0.22～0.60,P<0.05或P<0.01).结论:腹膜透析病人焦虑症状和抑郁症状的发生率较高,焦虑症状和抑郁症状与心脑血管系统疾病和糖尿病相关,并可能与营养不良的发生存在一定的关系.     

Effect of Peritoneal Dialysis Modality on the 1-Year Rate of Decline of Residual Renal Function

Purpose

The effect of different peritoneal dialysis (PD) modalities on the decline in residual renal function (RRF) is unclear due to inconsistencies among studies. In particular, the effect of automated peritoneal dialysis (APD) modalities [continuous cyclic peritoneal dialysis (CCPD) and nightly intermittent peritoneal dialysis (NIPD)] on RRF has not been examined in a large cohort.

Materials and Methods

We conducted a single-center retrospective study to investigate the association between PD modalities and decline in RRF in 142 incident PD patients [34 on CCPD, 36 on NIPD, and 72 on continuous ambulatory peritoneal dialysis (CAPD)]. RRF was measured within 2 months from PD start and at 1 year after PD initiation.

Results

The RRF at 1 year after PD initiation was 1.98±2.20 mL/min/1.73 m² in CCPD patients and 3.63±3.67 mL/min/1.73 m² in NIPD patients, which were moderately lower than 4.23±3.51 mL/min/1.73 m² in CAPD patients (p=0.064). Moreover, there was no significant difference in the 1-year rate of decline of RRF between CCPD and NIPD patients, although APD patients had a faster 1-year RRF decline rate than CAPD patients (CCPD and NIPD vs. CAPD: -45.68 and -36.69 vs. 1.17%/year, p=0.045). APD was associated with a more rapid decline in RRF in patients with end-stage renal disease undergoing PD, although multivariate analysis attenuated the significance of this finding (β=-31.50; 95% CI, -63.61 to 0.62; p=0.052).

Conclusion

Our results suggest that CAPD might be more helpful than APD for preserving RRF during the first year of dialysis therapy, although there was no significant difference in the 1-year rate of decline of RRF between the two APD modalities.     

Involvement of Leptin in the Progression of Experimentally Induced Peritoneal Fibrosis in Mice

Leptin is a hormone mainly produced by white adipose cells, and regulates body fat and food intake by acting on hypothalamus. Leptin receptor is expressed not only in the hypothalamus but in a variety of peripheral tissues, suggesting that leptin has pleiotropic functions. In this study, we investigated the effect of leptin on the progression of peritoneal fibrosis induced by intraperitoneal injection of chlorhexidine gluconate (CG) every other day for 2 or 3 weeks in mice. This study was conducted in male C57BL/6 mice and leptin-deficient ob/ob mice. Peritoneal fluid, blood, and peritoneal tissues were collected 15 or 22 days after CG injection. CG injection increased the level of leptin in serum and peritoneal fluid with thickening of submesothelial compact zone in wild type mice, but CG-injected ob/ob mice attenuate peritoneal fibrosis, and markedly reduced the number of myofibroblasts, infiltrating macrophages, and blood vessels in the thickened submesothelial area. The 2-week leptin administration induced a more thickened peritoneum in the CG-injected C57BL/6 mice than in the PBS group. Our results indicate that an upregulation of leptin appears to play a role in fibrosis and inflammation during peritoneal injury, and reducing leptin may be a therapeutically potential for peritoneal fibrosis.     

An Unusual Case of Unresolving Tunnel Infection in a Patient on Continuous Ambulatory Peritoneal Dialysis

Atypical mycobacteria remain a rare cause of peritoneal dialysis catheter-related tunnel infection (TI) and poses serious risk because of the resistant nature to most antibiotic therapy. Non-tubercular mycobacterial infections lead to chronicity requiring peritoneal dialysis catheter removal. We report an 82-year-old male, with diabetic nephropathy who had a coinfection with Staphylococcus hominis and Mycobacterium abscessus who presented with pus discharge at exit site and TI. He was treated with relocation of the extraperitoneal part of the catheter with a new exit site without catheter removal and multidrug mycobacterial therapy.     

非卧床持续性腹膜透析方法治疗尿毒症56例临床分析

目的探究分析非卧床性持续性腹膜透析(CAPD)的方法用于治疗尿毒症的临床效果。方法对我院2012年6月~2013年6月行非卧床持续性腹膜透治疗的56例尿毒症患者观察其治疗前后生化指标、生存率、并发症及生活质量的变化。结果接受CAPD后BUG、CR、SCR指标下降,感染及心血管疾病并发症降低,临床症状改善率增加,生活质量有所提高。结论CAPD治疗尿毒症简易、安全、有效,价格低廉,患者的生活质量也有明显的提高。     

肾衰竭持续性自动腹膜透析充分性的智能评价方法

透析充分性是肾衰竭腹膜透析治疗过程中的重要评价依据。首先详细分析了临床症状、KT／V（尿素清除率）、Ccr（肌酐清除率）、营养状态等主要因素对透析充分性的影响，然后建立了一种基于模糊逻辑的综合评价数学模型，并根据各种相关因素对持续性自动腹膜透析（CAPD）治疗过程中透析充分性的影响程度进行模糊化后再做出综合评价。临床实例分析表明，该模糊综合评价方法比单纯利用KT／V和Ccr两种指标来评价的准确率更高，实用性更好。     

Overhydration Negatively Affects Quality of Life in Peritoneal Dialysis Patients: Evidence from a Prospective Observational Study

Backgound: This study evaluated whether the hydration status affected health-related quality of life (HRQOL) during 12 months in peritoneal dialysis (PD) patients.Methods: The hydration status and the HRQOL were examined at baseline and after 12 months using a bioimpedance spectroscopy and Kidney Disease Quality of Life-Short Form, respectively in PD patients. Four hundred eighty-one patients were included and divided according to the baseline overhydration (OH) value; normohydration group (NH group, -2L≤ OH ≤+2L, n=266) and overhydration group (OH group, OH >+2L, n=215). Baseline HRQOL scores were compared between the two groups. The subjects were re-stratified into quartiles according to the OH difference (OH value at baseline - OH value at 12 months; <-1, -1 - -0.1, -0.1 - +1, and ≥+1L). The relations of OH difference with HRQOL scores at 12 months and the association of OH difference with the HRQOL score difference (HRQOL score at baseline - HRQOL score at 12 months) were assessed.Results: The OH group showed significantly lower baseline physical and mental health scores (PCS and MCS), and kidney disease component scores (KDCS) compared with the NH group (all, P<0.01). At 12 months, the adjusted PCS, MCS, and KDCS significantly increased as the OH difference quartiles increased (P<0.001, P=0.002, P<0.001, respectively). In multivariate analysis, the OH difference was independently associated with higher PCS (β = 2.04, P< .001), MCS (β=1.02, P=0.002), and KDCS (β=1.06, P<0.001) at 12 months. The OH difference was independently associated with the PCS difference (β = -1.81, P<0.001), MCS difference (β=-0.92, P=0.01), and KDCS difference (β=-0.90, P=0.001).Conclusion: The hydration status was associated with HRQOL and increased hydration status negatively affected HRQOL after 12 months in PD patients.