沙土鼠脑缺血后再灌注神经细胞凋亡与参附注射液联合尼卡地平预处理的影响

目的:检测经参附注射液和尼卡地平联合预处理后的沙土鼠脑组织中抑凋亡基因bcl-2的表达,探讨参附注射液联合尼卡地平预处理对脑缺血后再灌注神经细胞凋亡的影响。方法:实验于2005-07/09在河南大学麻醉与危重病医学研究所完成。50只健康成年沙土鼠随机分成5组,每组10只。①假手术对照组:只进行分离颈部血管,不夹闭双侧颈总动脉。②脑缺血对照组:夹闭沙土鼠双侧颈总动脉造成脑缺血模型。全脑缺血5min后再灌注72h。③尼卡地平预处理组:缺血前30min静脉给予尼卡地平0.2mg/kg。④参附注射液预处理组:缺血前30min腹腔注射参附注射液10mL/kg。参附注射液主要成份为人参皂甙和乌头碱,分别为红参和黑附片的提取物。⑤参附注射液联合尼卡地平预处理组:缺血前30min腹腔注射参附注射液10mL/kg,同时静脉给予尼卡地平0.2mg/kg。后3组缺血5min后分别再灌注72h。实验结束后快速断头取脑,石蜡切片,采用DNA末端标记技术(TUNEL法)观察各组脑细胞凋亡的变化情况并采用免疫组化染色评定bcl-2蛋白反应强度。结果:实验沙土鼠50只全部进入结果分析。①凋亡细胞所占比例:参附注射液联合尼卡地平组低于参附注射液组、尼卡地平组和脑缺血对照组,差异有显著性意义[(18.7±3.1)%,(42.4±3.6)%,(38.0±1.9)%,(72.4±2.2)%,P<0.05],参附注射液组和尼卡地平组相比差异无显著性意义(P>0.05)。②皮层细胞bcl-2蛋白免疫反应强度:参附注射液联合尼卡地平预处理组高于参附注射液预处理组、尼卡地平预处理组和脑缺血对照组,差异有显著性意义(2.70±0.39,1.30±0.78,1.70±0.33,0.90±0.54,P<0.05),参附注射液预处理组与尼卡地平预处理组相比,差异无显著性意义(P>0.05)。结论:脑缺血前经参附注射液联合尼卡地平预处理后,能明显减少细胞凋亡的发生,可能与bcl-2蛋白表达增强有关。     

老年糖尿病患者强化糖尿病教育的效果与评价

目的:观察强化糖尿病教育对老年2型糖尿病患者血糖控制的影响,并对教育的方法模式及患者的顺应性作出评价。方法:①随机选取老年2型糖尿病患者156例,均为2004-03/07青岛大学医学院附属医院门诊就诊患者,年龄(64.7±6.6)岁,病程(10.54±7.06)年。②入选患者在原有糖尿病治疗方案的基础上进行强化糖尿病教育:入选后半年之内每月进行一次糖尿病教育,半年后每3个月一次教育,教育以糖尿病有关知识专题集体讲座为主,辅以答疑。专人负责电话通知患者教育讲座的具体的时间、地点和内容。每次讲座时监测空腹血糖、餐后2h血糖,入选时、教育后第6,12个月测定糖化血红蛋白;同时记录患者接受教育频率,计算依从率。③采用随机区组设计的方差分析(广义线性模型)分析数据完整的患者的空腹血糖、餐后2h血糖及糖化血红蛋白随时间变化情况(入选时、第6,12个月时)。结果:①依从率:入选时156例,第2次教育时为125例,依从率74.8%,随着时间的延长,接受强化教育的患者逐渐减少,至第6个月时依从率28.1%,至1年时仅有33例接受教育,依从率为21.2%。②完成全程教育的33例患者的资料:教育第6,12个月时的空腹血糖、餐后2h血糖较入选时下降[空腹血糖:(7.9±2.1),(7.8±1.4),(9.7±2.1)mmol/L,F=31.05,P<0.01;餐后2h血糖:(12.0±4.0),(12.2±3.3),(17.8±3.8)mmol/L,F=56.61,P<0.01];糖化血红蛋白在教育第6,12个月也较入选时下降,但无统计学意义[(7.0±1.1)%,(6.9±1.1)%,(7.6±1.7)%,F=2.97,P=0.06]。结论:强化糖尿病教育可使老年2型糖尿病患者血糖有效持续稳定地控制,但患者接受强化教育的依从性差。     

骨髓间充质干细胞移植治疗脑梗死的作用及近况

目的:文章就骨髓间充质干细胞治疗脑梗死的应用研究进展及其治疗作用机制进行综述。资料来源:应用汁算机检索Medline1999-01/2006-11骨髓间充质干细胞相关细胞修复的文献,检索词"mesenchymal stemcells,cerebral ischemia,stroke"并限定文献语言种类为English。资料选择:对资料进行初审,选择包含骨髓间充质干细胞治疗脑缺血的基础研究文章,排除重复研究、综述类文献。资料提炼:纳人35篇符合标准的文献,对骨髓间质干细胞在脑梗死中的应用及其修复机制进行归纳。资料综合:①骨髓间充质干细胞具有高度的自我复制能力和多向分化潜能,可分化成多种细胞。骨髓间充质干细胞移植是近年来医学领域的研究热点,被用于脑梗死动物模型的治疗。②骨髓间充质干细胞对脑梗死动物模型具有较好的治疗作用。③骨髓间充质干细胞能够激活内源性的修复机制。④骨髓间充质干细胞移植后能够分泌大量营养因子从而发挥其神经保护和营养支持作用。结论:骨髓间充质干细胞对脑梗死具有较好的治疗作用,主要通过其移植后分泌大量营养因子从而发挥对脑梗死的治疗作用。     

颈椎椎后肌肉组织Ca^（2＋）-ATP酶与颈椎病及颈部软组织病理变化的相关性

目的:通过分析Ca2 与骨骼肌的关系,进一步阐述颈椎椎后肌肉组织内Ca2 -ATP酶与颈椎病的关系,及颈部软组织的病理变化。方法:应用计算机检索PubMed 1985-01/2006-12相关骨骼肌损伤与肌组织Ca2 -ATP酶关系方面的文献,检索词“Ca2 pump,Ca2 -ATPase,skeletal muscle”。限定文献语言种类为English。同时计算机检索CNKI与万方数据库1990-01/2006-12相关钙ATP酶与骨骼肌损伤的关系,及颈椎病发病病因的文献。检索词“钙ATP酶(Ca2 -ATP酶),骨骼肌,颈椎病病因”,限定文献语言种类为中文。对资料进行初审,选取包括Ca2 -ATP酶与肌组织损伤相关的文献,开始查找全文。纳入标准:Ca2 -ATP酶活性变化与骨骼肌损伤密切相关的文献研究。排除标准:重复研究,Meta分析类文章。共检索到4050篇关于Ca2 -ATP酶活性变化,骨骼肌损伤及颈椎病发病原因等方面的文献,最终纳入24篇符合标准的文献。结果:目前对酶活性变化与骨骼肌损伤的关系研究已较为广泛。而骨骼肌损伤作为颈椎病发病的一个因素,以酶活性变化作为指标来观察颈椎病发病时颈部软组织病理变化情况,及治疗后软组织病理变化情况的研究则较为少见。众多研究表明Ca2 是参与骨骼肌收缩的重要离子之一,与骨骼肌的生理病理有密切关系,而肌细胞内质网膜上的Ca2 -ATP酶是调节细胞内Ca2 浓度的重要蛋白质之一。骨骼肌慢性劳损易导致ATP酶活性下降,而酶活性的下降加重骨骼肌损伤,而引发系列疾病。强迫屈颈体位作为颈椎病发病的危险因素之一,可使颈椎椎后肌肉Ca2 -ATP酶活性降低,酶活性降低致使肌细胞损伤,并最终导致骨骼肌损伤而发病。结论:Ca2 -ATP酶活性变化是颈部软组织病理变化的一个重要指标之一。同时,该酶的活性变化也与颈椎病发病有着密切的关系。     

T cell clones specific for hybrid I-A molecules. Discrimination with monoclonal anti-I-A (k) antibodies

Alloreactive and soluble antigen-reactive, I-A-restricted T cell clones were examined for their ability to recognize hybrid I-A antigens. Several clones that recognized hybrid I-A(b)/I-A(k) molecules on (C57BL/6 x A/J)F(1) [(B6A)F(1)] spleen cells were studied. We were able to distinguish clones that recognized hybrid I-A molecules of the A(b)(a)A(k)(β) type from those that recognized A(k)(a)A(b)(β) molecules. We reached this conclusion by considering data from three independent types of experiments. (a) Monoclonal antibodies were used to inhibit T cell stimulation. Antibodies 10.2.16 and H116.32 distinguished two mutually exclusive “families” of T cell clones. One group of clones was inhibited by 10-2.16 and not H116.32, the other group exhibited reciprocal inhibition. (b) T cell proliferation was assayed using antigen-presenting cells from B6.C-H-2(bml2) (bml2) and [bml2 × B10.A(4R)]F(1) mice. Because the bml2 strain has a mutation that results in an altered A(b)(β) polypeptide chain (A(bm12)(β)), we reasoned that clones that could recognize the [bm12 × B 10.A(4R)]F(1) cells were recognizing A(b)(a)A(k)(β) molecules. Alternatively, clones not recognizing [bml2 × B10.A(4R)]F(1) cells had specificity for A(k)(a)A(b)(β) molecules. (c) I-A molecules immunoprecipitated from radiolabeled (B6A)F(1) splenocyte extracts were analyzed by two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis. These experiments confirmed an earlier report that antibody 10.2.16 recognized determinants on the A(k)(β) chain (12). Antibody H116.32 immunoprecipitated products consistent with recognition of A(k)(a) determinants. Taken together, these three types of results offer conclusive evidence that T cell clones recognizing “hybrid” I-A molecules use either A(b(k)A(k)(β) or A(k)(a)A(b)(β) molecules as recognition or restriction sites. Clones whose proliferation was supported by [bm 12 x B10.A(4R)]F(1) cells and blocked by anti-I-A(k) antibody 10-2.16 recognized A(b)(a)A(k)(β) B molecules. Clones that were blocked by antibody H116.32 and did not recognize [bml2 X B10.A(4R)]F(1) cells use a recognition site(s) on A(b)(a)A(k)(β) molecules. Thus, we can demonstrate both functionally and biochemically that hybrid F(1) I-A molecules of the structure A(k)(a)A(b)(β) and A(b)(a)A(k)(β) both exist on (B6A)F(1) splenocytes and that both configurations are used in immune recognition phenomena.     

Thalassemia Bone Disease: A 19‐Year Longitudinal Analysis

Thalassemia is an inherited disorder of alpha or beta globin chain synthesis leading to ineffective erythropoiesis requiring chronic transfusion therapy in its most severe form. This leads to iron overload, marrow expansion, and hormonal complications, which are implicated in bone deformity and loss of bone mineral density (BMD). In this 19‐year retrospective longitudinal study, the relationships between BMD (determined by dual‐energy X‐ray absorptiometry) and risk factors for osteoporosis in 277 subjects with transfusion‐dependent thalassemia were examined. The mean age at first review was 23.2 ± 11.9 years and 43.7% were male. Hypogonadism was present in 28.9%. Fractures were confirmed in 11.6% of subjects and were more frequent in males (16.5%) compared with females (7.7%). Lumbar spine (LS), femoral neck (FN), and total body (TB) Z‐scores were derived. Patients with transfusion‐dependent thalassemia had a significant longitudinal decline in BMD at the FN and TB. In the linear mixed‐model analysis of BMD and risk factors for bone loss, FN Z‐score was more significantly associated with risk factors compared with the LS and TB. The rate of decline at the FN was 0.02 Z‐score per year and was 3.85‐fold greater in males. The decline in FN Z‐score over the last 5 years (years 15 to 19) was 2.5‐fold that of the previous 7 years (years 8 to 14) and coincided with a change in iron chelator therapy from desferrioxamine to deferasirox. Hemoglobin (Hb) levels positively correlated with higher TB and LS Z‐scores. In conclusion, the FN is the preferred site for follow‐up of BMD. Male patients with β‐thalassemia experienced a greater loss of BMD and had a higher prevalence of fractures compared with females. Transfusing patients (particularly males) to a higher Hb target may reduce the decline in BMD. Whether deferasirox is implicated in bone loss warrants further study. © 2014 American Society for Bone and Mineral Research.     

The influence of oral health conditions,socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life

Background  

The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL).     

Cannabidiolic acid prevents vomiting in Suncus murinus and nausea-induced behaviour in rats by enhancing 5-HT1A receptor activation

Background and Purpose

To evaluate the ability of cannabidiolic acid (CBDA) to reduce nausea and vomiting and enhance 5-HT_1A receptor activation in animal models.

Experimental Approach

We investigated the effect of CBDA on (i) lithium chloride (LiCl)-induced conditioned gaping to a flavour (nausea-induced behaviour) or a context (model of anticipatory nausea) in rats; (ii) saccharin palatability in rats; (iii) motion-, LiCl- or cisplatin-induced vomiting in house musk shrews (Suncus murinus); and (iv) rat brainstem 5-HT_1A receptor activation by 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) and mouse whole brain CB₁ receptor activation by CP55940, using [³⁵S]GTPγS-binding assays.

Key Results

In shrews, CBDA (0.1 and/or 0.5 mg·kg⁻¹ i.p.) reduced toxin- and motion-induced vomiting, and increased the onset latency of the first motion-induced emetic episode. In rats, CBDA (0.01 and 0.1 mg·kg⁻¹ i.p.) suppressed LiCl- and context-induced conditioned gaping, effects that were blocked by the 5-HT_1A receptor antagonist, WAY100635 (0.1 mg·kg⁻¹ i.p.), and, at 0.01 mg·kg⁻¹ i.p., enhanced saccharin palatability. CBDA-induced suppression of LiCl-induced conditioned gaping was unaffected by the CB₁ receptor antagonist, SR141716A (1 mg·kg⁻¹ i.p.). In vitro, CBDA (0.1–100 nM) increased the E_max of 8-OH-DPAT.

Conclusions and Implications

Compared with cannabidiol, CBDA displays significantly greater potency at inhibiting vomiting in shrews and nausea in rats, and at enhancing 5-HT_1A receptor activation, an action that accounts for its ability to attenuate conditioned gaping in rats. Consequently, CBDA shows promise as a treatment for nausea and vomiting, including anticipatory nausea for which no specific therapy is currently available.     

The International Infections in Pregnancy Study: group B streptococcal colonization in pregnant women

Background: Heavy colonization with group B streptococcus (GBS) has been associated with increased risk of preterm birth and neonatal sepsis; the burden of neonatal GBS disease varies geographically. To determine whether variation in heavy colonization and GBS serotypes could contribute to geographic differences in disease burden, we assessed the prevalence of heavy colonization and the distribution of serotypes in asymptomatic pregnant women in multiple countries.

Methods: Cervical, lower vaginal and urine samples were collected from women attending seven prenatal clinics in six countries. Light colonization was defined as GBS isolation from Lim broth only; heavy colonization was isolation from urine or sheep blood agar plates. Isolates were serotyped using capillary precipitation.

Results: GBS was present in 11.3% of 1308 participants (range 7.1–21.7%); 5.0% were heavily colonized (0.4–18.8%) and 6.4% were lightly colonized (2.9–8.0%). Serotypes III and V were most common (both 17.2%). Serotypes VII and VIII were found in one study center.

Conclusions: The prevalence of heavy colonization and GBS serotypes varied significantly among our study centers. Whether this variation could in part explain geographic differences in neonatal morbidity and mortality is a hypothesis that needs further study.