Effect of cisapride on functional dyspepsia in patients with and without histological gastritis: A double-blind placebo-controlled trial

In the present double-blind placebo-controlled study the effect of cisapride on functional dyspepsia was evaluated in patients with and without histological gastritis. Patients with functional dyspepsia and whose symptoms persisted after a 2 week run-in period with antacid treatment were randomized to receive cisapride (10 mg) or matching placebo three times daily for 4 weeks. Symptoms of epigastric pain, bloating, nausea, belching, early satiety and heartburn were graded on a four-point scale based on patients’ feedback and diary card recording. A global response was also formulated by the investigators. One hundred and four patients entered the study and 76 completed the trial, comprising 36 patients with histological gastritis and 40 patients without gastritis. Symptom scores in both gastritis and non-gastritis groups were significantly improved by both cisapride and placebo; however, the improvement was not statistically different between the two treatment groups. Cisapride produced a good or better global response in 58% of subjects with histological gastritis and in 53% of subjects without gastritis compared with 47% and 52%, respectively, of patients on placebo; this difference was not statistically significant. Gastric histology did not influence the effect of cisapride on the symptoms of functional dyspepsia.     

Variation in fetal hemoglobin parameters and predicted hemoglobin S polymerization in sickle cell children in the first two years of life: Parisian Prospective Study on Sickle Cell Disease

Intracellular hemoglobin S (HbS) polymerization is most likely to be the primary determinant of the clinical and biologic manifestations of sickle cell disease (SCD). Fetal hemoglobin (HbF) does not enter the HbS polymer and its intracellular expression in sickle erythrocytes inhibits polymerization. HbF levels, high at birth but decreasing thereafter, protect the newborn from the clinical manifestations of this hemoglobinopathy. We have measured the sequential changes in HbF, F reticulocytes, and F cells in the first 2 years of life in 25 children with SCD and compared the results with those obtained in 30 normal children (AA). We have also calculated HbF per F cell (F/F cell), the preferential survival of F cells versus non-F cells, as measured by the ratio F cells versus F reticulocytes (FC/FR) and polymer tendency at 40% and 70% oxygen saturation. HbF levels decreased from about 80.4% +/- 4.0% at birth to 9.2% +/- 2.9% at 24 months. During this time, we observed a regular decrease of the F reticulocytes and the F cells. The kinetics of the decline of F/F cell was comparable with the decline of HbF, rapid from birth (mean, 27.0 +/- 3.6 pg) to 12 months of age (mean, 8.5 +/- 1.5 pg) and then slower from 12 to 24 months of age (mean, 6.2 +/- 1.0 pg) in the SCD children. In the AA children, the decrease in HbF, due to changes in both numbers of F cells and F/F cell, was more precipitous, reaching steady-state levels by 10 months of age. Calculated values for mean polymer tendency in the F-cell population showed that polymerization should begin to occur at 40% oxygen saturation at about 3 months and increase progressively with age, whereas polymerization at 70% oxygen saturation would not occur until about 24 months. These values correspond to HbF levels of 50.8% +/- 10.8% and 9.2% +/- 2.9%, respectively, and F/F cell levels of 15.6 +/- 4.5 pg and 6.2 +/- 1.0 pg, respectively. In the non--F-cell population, polymerization was expected at birth at both oxygen saturation values. Three individuals had significantly greater predicted polymerization tendency than the remainder of the group because of early decreases in HbF. These individuals in particular, the remainder of the cohort, as well as other recruited newborns, will be studied prospectively to ascertain the relationship among hematologic parameters, which determine polymerization tendency and the various clinical manifestations of SCD.     

BCR-ABL protein expression in peripheral blood cells of chronic myelogenous leukemia patients undergoing therapy

Chronic myelogenous leukemia (CML) is a myeloproliferative disorder associated with the Philadelphia chromosome (Ph1) in more than 95% of these patients. The Ph1 and the resulting BCR-ABL fused genes are markers for this type of leukemia. In CML, the product of the fused BCR- ABL gene is typically a protein of approximately 2,000 amino acids termed P210 BCR-ABL. We have developed an assay for the BCR-ABL protein involving Western blotting of circulating white blood cells (WBC) with an anti-ABL monoclonal antibody that can detect P210 BCR-ABL and P145 ABL in peripheral blood cells from chronic phase Ph1-positive leukemia patients. This assay was used to analyze the BCR-ABL protein content of circulating WBC from CML patients before and after various treatments. In parallel to changes in percentages of Ph1-positive blood cells as determined by cytogenetic analyses of bone marrow samples, BCR-ABL protein expression in blood cells decreased or increased as patients entered remission or underwent relapse. Of interest, six Ph1-negative CML patients were BCR-ABL protein-positive. All except one had a rearrangement in the major breakpoint cluster region and that patient expressed P185 BCR-ABL and not P210. Our results indicate that the BCR- ABL Western blotting assay has clinical applications for both diagnosis and prospective evaluation of Ph1-positive and Ph1-negative CML patients.     

胶原-生物衍生骨材料与兔成骨细胞的相容性及其体外附着特点

目的:观察胶原-生物衍生骨复合材料与兔成骨细胞的相容性及体外附着规律,为进一步的体内实验提供参考数据。方法:实验于2003-10/2005-02在华西医科大学组织工程实验室进行。①材料制备:新鲜捐献骨(人),经脱脂、脱蛋白等工艺制成单纯生物衍生骨材料,以Ⅰ型胶原通过真空吸附法修饰单纯生物衍生骨材料表面,构建出胶原生物衍生骨材料。②实验方法:将体外培养的兔骨膜成骨细胞分别复合于单纯生物衍生骨材料和胶原生物衍生骨材料,共同培养7d。③观察指标:分别于培养第1,3,5和7天取材,扫描电镜观察成骨细胞形态及附着情况;用紫外/荧光/可见光高效分析仪测定成骨细胞产生的碱性磷酸酶活性;MTT检测成骨细胞增殖情况;用流式细胞仪检测兔成骨细胞的细胞周期、DNA含量及倍体水平。结果:①扫描电镜结果:胶原生物衍生骨材料组成骨细胞黏附和增殖优于生物衍生骨材料组。②碱性磷酸酶活性:生物衍生骨材料组低于胶原生物衍生骨材料组(0.019±0.003,0.038±0.004,P<0.05)。③细胞增殖情况:在培养第1,3,5,7天胶原生物衍生骨材料组成骨细胞A值均高于生物衍生骨材料组(P<0.05)。④流式细胞检测生物衍生骨材料、胶原生物衍生骨材料对兔成骨细胞的细胞周期影响不大,各组细胞皆为正常的二倍体细胞,未见异倍体细胞形成,胶原修饰后无细胞毒性。结论:以单纯生物衍生骨作为载体,其表面经胶原修饰后的复合材料与成骨细胞有良好的细胞相容性,无细胞毒性。     

生理载荷条件下髋臼假体的疲劳破坏机制(上)

本文对生理载荷条件下(正常步态、爬楼梯和日常活动的混态载倚)骨水泥髋臼假体(牛髋骨试件)的失效机制进行研究.试验中利用髋关节仿真试验机施加生理载倚,利用人工仿真关节液来模拟体内生理环境,以测试髋臼假体的生命周期.在试验中通过微CT扫描仪观测并记载破坏的进程,并在试验结束后使用显微镜进行验证.结果表明,在所有载荷条件下,骨水泥-骨的界面松解是导致假体失效的原因,在体外环境条件下界面松解发生在髋臼窝中心的后上部区域,在体内生理环境下界面松解则发生在髋臼窝的所有区域.因此.模拟人体内部生理条件的试验环境是必需的,同时也确定髋臼假体的失效来自于力学和生物学因素的共同作用.     

Automated anatomical demarcation using an active shape model for videofluoroscopic analysis in swallowing

The current gold standard method in the clinical assessment of swallowing is the visual inspection of videofluoroscopic frames. Specific clinical measurements are estimated based on various anatomical and bolus positional information with respect to time (or frame number). However, due to the subjective nature of visual inspection clinicians face intra- and inter-observer repeatability issues and bias when making these estimations. The correct demarcations of reference lines highlighting the positions of important anatomical landmarks would serve as a visual aid and could also be used in conjunction with bolus detection methods to objectively determine these desirable measurements. In this paper, we introduce and test the reliability of applying a 16-point Active Shape Model as a deformable template to demarcate the boundaries of salient anatomical boundaries with minimal user input. A robust end and corner point detection algorithm is also used to provide image information for the suggested movement of the template during the fitting stage. Results show the model deformation constraints calculated from a training set of images are clinically coherent. The Euclidean distances between the fitted model points against their corresponding target points were measured. Test images were taken from two different data sets from frames acquired using two different videofluoroscopy units. Overall, fitting was found to be more reliable on the vertebrae and inferior points of the larynx compared to the superior laryngeal points and hyoid bone, with the model always fitting the C7 vertebra with discrepancies no higher than a distance of 23 pixels (3.2% of the image width, approximately 7.6 mm).     

卟啉化合物的研究:取代四苯基卟啉与5-氟脲嘧啶共价相连化合物的合成及其抗癌活性

合成了3个取代四苯基卟啉与5-氟脲嘧啶以共价相连的化合物。通过用它们加光照对小鼠移植瘤生长的抑制作用、对小鼠癌细胞的杀伤效果及对小鼠耳指数的测定,初步结果显示,化合物1,2,3对癌细胞都有光敏毒杀效应,但1远较2和3显著。