脑源性神经生长因子促进成年大鼠脑海马神经干细胞定向分化的浓度选择

目的：探讨培养基中表皮生长因子与血清两者浓度一定的条件下，不同浓度的脑源性神经生长因子对成年大鼠脑海马神经干细胞向神经元分化的影响。 方法：实验于2007—08在中国医科大学神经解剖研究室完成。①材料：清洁级雄性成年SD大鼠1只，由中国医科大学实验动物部提供，实验过程中对动物的处置符合动物伦理学标准。实验过程中应用的表皮生长因子、脑源性神经生长因子均由R＆D公司提供：（多实验方法：无菌条件下分离大鼠脑海马组织，剪碎后胰蛋白酶消化，过滤、离心、弃上清，加入含2％B27、20μg／L表皮生长因子、20μg／L碱性成纤维生长因子的DMEM／F12无血清条件培养基体外培养神经干细胞，传至第4代时利用有限稀释法进行单克隆培养，100倍镜下克隆球直径约为200μm时制备单细胞悬液，稀释后滴加于96孔板内，设立两组，全量新鲜培养基组加入刚配置未使用过的DMEM／F12无血清培养基100μL，半量条件培养基组加入上述曾用于神经干细胞培养且含有其代谢产物的1／2DMEM／F12无血清培养基100斗L。（劲实验评估：观察神经干细胞的单克隆培养增殖情况。对克隆球行巢蛋白、神经元特异性烯醇化酶、胶质原纤维酸性蛋白免疫细胞化学染色。按培养基中脑源性神经生长因子终浓度的不同将所培养细胞设立0，50，100，150，200μg／L组，各组均加入20μg／L表皮生长因子和体积分数为0．1的胎牛血清，1周后行神经元特异性烯醇化酶免疫细胞化学染色，检测神经干细胞向神经元分化情况。 结果：①神经干细胞单克隆培养结果：单克隆培养开始时神经干细胞增殖缓慢，半量条件培养基组细胞增殖速度快于全量新鲜培养基组，随着细胞数的增多，两组细胞增殖速度也相应加快，分别在培养后第12天、第15天形成直径为200μm的克隆球。②神经干细胞免疫细胞化学染色结果：单克隆培养后克隆球表达巢蛋白，诱导分化后神经元特异性烯醇化酶、胶质原纤维酸性蛋白均呈阳性表达：③各组神经干细胞分化为神经元的比例：与0μg／L脑源性神经生长因子组比较，50，100μg／L脑源性神经生长因子组的神经干细胞分化为神经元比例均明显增高（t=2．502～5．025，P〈0．05）；而浓度为150，200μg／L时均无明显变化（t=0．420～1．857，P〉0．05）。 结论：向含有B27、表皮生长因子、碱·性成纤维生长因子的DMEM／F12条件培养基中加入20μg／L表皮生长因子和体积分数为0．1胎牛血清的情况下，脑源性神经生长因子促使神经干细胞向神经元分化的较佳浓度为50μg／L。     

The effect of solvent/detergent-treated plasma on red cells stored in vitro

BACKGROUND: The potential use of solvent/detergent-treated plasma (S/D plasma) in transfusion practice raises concerns about the cytolytic effects that any residual solvent and detergent in the virally inactivated blood component might have on units of red cells in vitro, if the two components are mixed during preparation. STUDY DESIGN AND METHODS: S/D plasma was mixed with variously processed units of stored red cells, in vitro, to evaluate the effect the residual solvent and detergent would have on cell membrane integrity. A paired protocol design was used in which half-units of red cells were exposed to S/D plasma (test), and the matched half-units were exposed to either the supernatant additive solution from the original red cell unit or standard fresh-frozen plasma (FFP) (control). After incubation for up to 5 days, the units were evaluated for evidence of hemolysis or changes in other red cell storage assays. RESULTS: This study showed that, for fresh additive solution red cells (AS-1), the 5-day storage plasma hemoglobin levels were comparable in the red cells exposed to S/D plasma (21 mg/dL) and in the paired half-units stored in the original AS-1 supernatant (31 mg/dL) (p > 0.05). Similar findings were recorded for stored AS-1 red cells (S/D plasma; 111 mg/dL vs. AS-1 supernatant, 147 mg/dL; p > 0.05); stored CPDA-1 red cells (S/D plasma, 133 mg/dL vs. FFP, 103 mg/dL; p > 0.05); frozen red cells (S/D plasma, 28 mg/dL vs. FFP, 18 mg/dL; p > 0.017); and stored irradiated AS-1 red cells (S/D plasma, 608 mg/dL vs. AS-1 supernatant, 726 mg/dL; p > 0.05). Comparable results were found for other assays, including levels of plasma potassium, osmotic fragility, and red cell antigen titer. CONCLUSION: These data show that S/D plasma does not induce red cell lysis even after 5 days of in vitro storage. These results are consistent with previous findings by this laboratory that platelets are not harmed by storage in S/D plasma. Red cells resuspended in S/D plasma and stored for up to 5 days maintain in vitro storage characteristics that are acceptable for the use of the cells in clinical transfusion practice.     

Prenatal cocaine exposure and childhood obesity at nine years

Little is known about the association between prenatal cocaine exposure and obesity. We tested whether prenatal cocaine exposure increases the likelihood of obesity in 561 9-year-old term children from the Maternal Lifestyle Study (MLS). Overall, 21.6% of children met criterion for obesity (body mass index [BMI] ≥ 95th percentile, age and sex-specific). While there was no overall cocaine effect on obesity, multivariate logistic analysis revealed that children exposed to cocaine but not alcohol were 4 times more likely to be obese (OR 4.11, CI 2.04-9.76) than children not exposed to either drug. No increase in obesity prevalence was found in children exposed to alcohol but not cocaine (OR 1.08, CI .59-1.93) or both (OR 1.21, CI 0.66-2.22). Alcohol exposure may attenuate the effect of cocaine exposure on obesity. Increased obesity associated with cocaine but not alcohol exposure was first observed at 7 years. BMI was also elevated from 3 to 9 years in children exposed to cocaine but not alcohol, due to increasing weight but normal height. Prenatal exposure to cocaine may alter the neuroendocrine system and metabolic processes resulting in increased weight gain and childhood obesity.     

瑞芬太尼在产科麻醉镇痛中的应用

瑞芬太尼是一种新型的超短效阿片药物,它的出现使得麻醉可控性和预见性得到了优化。最近有更多的研究将它用于产科的麻醉与镇痛,为产科麻醉用药带来了新的选择。本文将就瑞芬太尼近年来在产科麻醉与镇痛方面的临床研究进展进行探讨。     

The Effect of Parenting Stress on Child Behavior Problems in High-Risk Children with Prenatal Drug Exposure

Objective To examine the relationship between early parenting stress and later child behavior in a high-risk sample and measure the effect of drug exposure on the relationship between parenting stress and child behavior. Methods A subset of child-caregiver dyads (n = 607) were selected from the Maternal Lifestyle Study (MLS), which is a large sample of children (n = 1,388) with prenatal cocaine exposure and a comparison sample unexposed to cocaine. Of the 607 dyads, 221 were prenatally exposed to cocaine and 386 were unexposed to cocaine. Selection was based on the presence of a stable caregiver at 4 and 36 months with no evidence of change in caregiver between those time points. Results Parenting stress at 4 months significantly predicted child externalizing behavior at 36 months. These relations were unaffected by cocaine exposure suggesting the relationship between parenting stress and behavioral outcome exists for high-risk children regardless of drug exposure history. Conclusions These results extend the findings of the relationship between parenting stress and child behavior to a sample of high-risk children with prenatal drug exposure. Implications for outcome and treatment are discussed. Portions of the data were previously presented at the 11th Annual Research Symposium on Mental Health Sciences, The Warren Alpert Medical School of Brown University, Providence, RI and at the 25th Annual Society for Developmental and Behavior Pediatrics Meeting in Providence, RI.     

2010年《药品评价》内容及形式创意征集

《药品评价》糖尿病专辑在2009年已经陆续出刊11期,得到了众多临床医生的关注,很多医生写信或发邮件向我们咨询问题并提出宝贵意见和建议,这些对我刊的内容建设很有帮助,读者对杂志的评价也给我们很大的鼓励和信心。新的一年即将到来,为了给各位读者提供更实用、更受欢迎的内容,我刊诚邀各位读者就我刊2009年内容和形式以及对2010年的期望提出您的意见和想法,这对我们明年的内容组织和展现形式将提供很大的帮助。     

Do women with epilepsy have increased frequency of menstrual disturbances?

PROBLEM: Menstrual disorders, reduced fertility and sexual problems seem to be more frequent in women with epilepsy than in the general population. Most investigations concerning menstrual disturbances in epilepsy patients, however, are small and based on selected materials. We therefore wanted to investigate the frequency of menstrual disturbances in a large, unselected population of epilepsy patients. METHODS: A retrospective, questionnaire study of a cohort of female outpatients, aged 18-45 was conducted. Each patient chose a close female friend who served as control, to optimise matching regarding age and lifestyle. RESULTS: Answers were received from 265 patients and 142 controls. Menstrual disturbances were more frequent in patients with epilepsy (48.0%) than in controls (30.7%) (P=0.004). Menstrual disturbances were more frequent in patients on polytherapy versus monotherapy (P=0.049) and more frequent in patients with high seizure frequency (>5seizures/year) compared to patients with a lower seizure frequency or those seizure free (P=0.006). The frequency of menstrual disturbances was higher in patients on valproate compared to carbamazepine monotherapy (P=0.045). CONCLUSION: This investigation confirms that women with epilepsy have an increased frequency of menstrual disturbances compared to women without epilepsy. In women with high seizure frequency and in those on polytherapy, the frequency of menstrual disturbances are further increased. The highest frequency of menstrual disturbances occurred in women using valproate.     

Arthroscopic chondrectomy as a treatment of cartilage lesions

Although favorable effects of débridement with chondrectomy and drilling or abrasion have been reported in treating of cartilage lesions in the knee joint; however, in most cases an additional intervention is generally performed during arthroscopy. We studied 53 consecutive patients with solitary chondral lesions in the weight-bearing part of the knee and treated 86 cartilage lesions by arthroscopic débridement, including a detailed removal of damaged or undermined cartilage. We evaluated the postoperative course by questionnaire (mean follow-up 6.5 years, response rate 83%). All patients reported a positive effect of chondrectomy: 69% considered the knee considerably better or cured and 77% regarded the effect as permanent. There was no complication of the arthroscopies performed, and no patient noted any deterioration in the condition. We therefore recommend routine chondrectomy of cartilage lesions when these are found during an arthroscopy.