Electron microscopy study of genesis and dynamics of immunodeposition in IgMk-IgG cryoglobulin-induced glomerulonephritis in mice

Cryoglobulinemic glomerulonephritis is particularly frequent in type II mixed IgMk-IgG cryoglobulinemia. The typical form is a membranoproliferative glomerulonephritis with a particular monocyte infiltration. In the most severe cases, there is occlusion of the capillary lumina by the same immunoglobulin constituents of the cryoprecipitate. While it is generally accepted that the "hyaline thrombi" are endoluminal aggregates of IgG-IgM immune complexes, probably favored by high endocapillary concentration of cryoglobulins, the modality of generation has not been studied. To study the dynamic formation of such "thrombi," we reproduced an experimental model of cryoglobulinemic glomerulonephritis in mice by injecting them twice a day for 3 days with 4 mg human IgMk-IgG cryoglobulins previously solubilized at 37 degrees C. The dynamic formation of immunodeposits was studied by immunofluorescence and electron microscopy. After 1 day, only mesangial deposits were found; after 3 days, in addition to mesangial deposition, all the capillary lumina were occluded by huge electron-dense bodies. To look for and quantify the contacts between such "thrombi" and mesangial or subendothelial deposits, we obtained serial, ultrathin, 0.5-microm sections that allowed us to reconstruct the whole glomerular tuft. Within each serial section, there was continuity between hyaline thrombi and mesangial or subendothelial deposits ranging from 80% to 85% of the capillary loops. The percentage was 100% for two adjacent serial sections. In conclusion, our data demonstrate directly for the first time that hyaline thrombi follow mesangial deposits. The high percentage of contacts between thrombi and mesangial or subendothelial deposits suggests that they result from in situ build-up of true huge endoluminal immunodeposits after saturation of the clearance capacity of the mesangium.     

蒙医诊断学教学探讨

蒙医诊断学是具有较强理论性和实践性的学科，这一特点要求我们在蒙医诊断学的教学方法上，既要重视理论教学，又要重视临床教学；既要传授知识，又要培养实际动手能力。     

Prevalence of HLA sensitization in female apheresis donors

BACKGROUND: Transfusion-related acute lung injury (TRALI) is a serious complication of plasma-containing blood components. Studies have implicated HLA antibodies along with biologically active lipids in stored blood in the pathogenesis of TRALI. It has been proposed that the exclusion of HLA-untested, multiparous donors of plasma-rich components, including plasma and single-donor apheresis platelets, would substantially reduce the risk of TRALI. STUDY DESIGN AND METHODS: To investigate the feasibility of such an exclusion, 332 female plateletpheresis donors with a record of over 9000 donations, none of which were associated with TRALI, were studied. RESULTS: Seventeen percent of female donors demonstrated HLA sensitization. Parity and HLA sensitization were significantly correlated (p<0.0001), with sensitized donors having an average of 2.9 (+/− 0.6 95% CI) prior pregnancies and unsensitized donors having an average of 1.8 (+/− 0.2 95% CI) prior pregnancies. The percentage of HLA-sensitized women with 0, 1 to 2, and > or = 3 pregnancies was 7.8, 14.6, and 26.3, respectively. CONCLUSION: These findings confirm the hypothesis that multiparous women (> or = 3 pregnancies) represent an increased potential risk for TRALI. However, the exclusion of multiparous plateletpheresis donors would eliminate one-third of our female donor pool. Screening such donors for HLA sensitization may represent the optimal approach for identifying donors at risk for causing TRALI, but this still would result in the deferral of 8 percent of female plateletpheresis donors. At present, prospective screening to identify donors at risk for causing TRALI is not justified.     

新型无机微粒栓塞材料BaFe12O19的血液相容性实验

目的:评价BaFe12O19微粒作为一种新开发的具有潜在应用前景的新型血管内栓塞材料的血液相容性,并观察其对机体的出血时间、凝血时间及凝血酶原时间、纤维蛋白原测定、活化部分凝血活酶时间、凝血酶时间的影响。方法:BaFe12O19微粒材料于2005-07/2006-05在武汉理工大学生物材料与工程研究中心实验室完成,血液相容性实验于2006-05/09在解放军广州军区武汉总医院中心实验室完成。①溶血实验:取人新鲜全血,分别加入生理盐水(阴性对照组)、蒸馏水(阳性对照组)、无机微粒浸提液(实验组),观察溶血情况,计算溶血率。②出血、凝血时间测定:健康NIH小鼠随机分为实验组和对照组,分别腹腔注射无机微粒混悬液或生理盐水1 mL,7 d后测定出血、凝血时间。③凝血功能实验:取健康Wistar大鼠静脉血,随机分为实验组及对照组,分别注入1 g/L微粒混悬液或生理盐水1 mL,30 min后测量凝血功能。结果:①溶血实验结果:实验组和阴性对照组均无溶血现象,阳性对照组全部溶血,实验组的溶血率为2.08%,符合ISO规定的不大于5%的标准。②出血、凝血时间测定结果:实验组和对照组小鼠的出血、凝血时间比较差异无显著性意义(P>0.05)。③凝血功能实验结果:实验组和对照组凝血酶原时间、纤维蛋白原、活化部分凝血活酶时间、凝血酶时间比较均无显著差别(P>0.05)。结论:BaFe12O19微粒符合血液相容性标准,具有良好的血液相容性能。     

马缨丹叶的化学成分研究

自马缨丹(Lantana camara L.)叶中分离到六个化合物。经光谱(UV,IR,MS,¹HNMR,¹³CNMR)和化学分析,分别鉴定为齐墩果酮酸(oleanonic acid,Ⅰ),马缨丹甲素(lantadene A,Ⅱ),马缨丹乙素(lantadene B,Ⅲ),lantanilic acid(Ⅳ),icterogenin(Ⅴ)和4′,5-二羟基-3,7-二甲氧基黄酮-4′-O-β-D-吡喃葡萄糖甙(4′,5-dihydroxy-3,7-dimethoxyflavone-4′-O-β-D-glucopyranoside,Ⅵ)。Ⅵ是新化合物,命名为马缨丹黄酮甙(camaroside)。     

Incidence of metastatic lesion of different groups of the intrathoracic lymph nodes in lung cancer (based on research data on surgical preparations)

The study was concerned with the frequency of metastatic spread of lung cancer to intrathoracic lymph nodes versus lung lobe distribution of malignancy in 299 cases of surgical treatment. In cases of primary tumor in any lobe of both lungs, metastases were detected primarily in the pulmonary and bronchopulmonary lymph nodes. A decreasing frequency of metastases was observed from the intrapulmonary lymph nodes to those of the root of the lung and mediastinum.     

Simulated pulmonary nodules: detection with dual-energy digital versus conventional radiography

Performance of a prototype dual-energy digital chest radiography unit in detecting calcified and noncalcified simulated pulmonary nodules was compared with that of a highly optimized, conventional system. Nodules ranging in size (0.5, 1.0, and 1.6 cm), in number (five to 11), and in calcium content (0-25 mg) were superimposed over the lungs of a frozen, unembalmed, human chest phantom. For each technique, six observers examined 50 posteroanterior projections with different randomized nodule locations. Detection consisted of locating and assigning a level of confidence to each perceived nodular opacity. The resulting plots of the true-positive fraction versus the mean number of false-positive calls per projection indicate that for both calcified and noncalcified nodules, the digital unit performed significantly better (P less than .01).     

Suppression of peroxisomal membrane protein defects by peroxisomal ATP binding cassette (ABC) proteins

X-Linked adrenoleukodystrophy (X-ALD) is a neurodegenerative disorder characterized by reduced peroxisomal very long chain fatty acid (VLCFA) beta-oxidation. The X - ALD gene product (ALDP) is a peroxisomal transmembrane protein with an ATP binding cassette (ABC). ALDP and three other ABC proteins (PMP70, ALDR, P70R) localize to the peroxisomal membrane. The function of this family of peroxisomal membrane proteins is unknown. We used complementation studies to begin analysis of their role in VLCFA beta-oxidation and on the peroxisomal membrane. Expression of either ALDP or PMP70 restores VLCFA beta- oxidation in X-ALD fibroblasts, indicating overlapping functions. Their expression also restores peroxisome biogenesis in cells that are deficient in the peroxisomal membrane protein Pex2p. Thus it is likely that complex protein interactions are involved in the function and biogenesis of peroxisomal membranes that may contribute to disease heterogeneity.      

Utilization of Primary Care versus Specialized Care in Children with and without Chronic Illness: A Population-Based Study

ABSTRACT. Children's utilization of curative care was studied to analyse the division of responsibilities between undifferentiated primary care and specialized care. All chronically ill ( n = 510), a control group ( n = 287) and the total population 0–15 years of age ( n = 6080) in a primary care district were studied using register data. Chronically ill children comprised 8.4% of the total child population and were registered for 1/10 of the primary health care visits, 1/3 of the specialized visits, 1/3 of the hospitalizations and 112 of the in-patient days of all children. The yearly ambulatory visits were 3.7/child in the chronically ill and 1.5/child in the control group, of which 1/3 and 2/3, respectively, were to primary care. Utilization of specialized care increased with disability. Chronically ill children visited primary care mainly for acute respiratory infections but seldom for allergic or other chronic conditions.