Do positive or negative experiences of social support relate to current and future health? Results from the Doetinchem Cohort Study

Background  

Cross-sectional studies have reported associations between social support and health, but prospective evidence is less conclusive. This study aims to investigate the associations of positive and negative experiences of social support with current and future lifestyle factors, biological risk factors, self-perceived health and mental health over a 10-year period.     

Review: Understanding sorbent dialysis systems

Although maintenance haemodialysis once had the benefit of two distinctly different dialysate preparation and delivery systems – (1) a pre‐filtration and reverse osmosis water preparation plant linked to a single pass proportioning system and (2) a sorbent column dependent dialysate regeneration and recirculation system known as the REDY system – the first came to dominate the market and the second waned. By the early 1990s, the REDY had disappeared from clinical use. The REDY system had strengths. It was a small, mobile, portable and water‐efficient, only 6 L of untreated water being required for each dialysis. In comparison, single pass systems are bulky, immobile and water (and power) voracious, typically needing 400–600 L/treatment of expensively pretreated water. A resurgence of interest in home haemodialysis – short and long, intermittent and daily – has provided impetus to redirect technological research into cost‐competitive systems. Miniaturization, portability, flexibility, water‐use efficiency and ‘wearability’ are ultimate goals. Sorbent systems are proving an integral component of this effort. In sorbent dialysate regeneration, rather than draining solute‐rich dialyser effluent to waste – as do current systems – the effluent repetitively recirculates across a sorbent column capable of adsorption, ion exchange or catalytic conversion of all solute such that, at exit from the column, an ultra‐pure water solution emerges. This then remixes with a known electrolyte concentrate for representation to the dialyser. As the same small water volume can recirculate, at least until column exhaustion, water source independence is assured. Many current technological developments in dialysis equipment are now focusing on sorbent‐based dialysate circuitry. Although possibly déjà vu for some, it is timely for a brief review of sorbent chemistry and its application to dialysis systems.     

ATG16L1 and NOD2 polymorphisms enhance phagocytosis in monocytes of Crohn’s disease patients

AIM:To investigate if the presence of relevant genetic polymorphisms has effect on the effectual clearance of bacteria by monocytes and granulocytes in patients with Crohn’s disease(CD).METHODS:In this study,we assessed the differential responses in phagocytosis by measuring the phagocytic activity and the percentage of active phagocytic monocytes and granulocytes in inflammatory bowel disease patients as well as healthy controls.As both autophagy related like 1(ATG16L1)and immunityrelated guanosine triphosphatase gene are autophagy genes associated with CD and more recently nucleo-tide-binding ligomerization domain-containing protein2(NOD2)has been identified as a potent inducer of autophagy we genotyped the patients for these variants and correlated this to the phagocytic reaction.The genotyping was done with restriction fragment length polymorphisms analysis and the phagocytosis was determined with the pHrodo?Escherichia coli Bioparticles Phagocytosis kit for flowcytometry.RESULTS:In this study,we demonstrate that analysis of the monocyte and granulocyte populations of patients with CD and ulcerative colitis showed a comparable phagocytic activity(ratio of mean fluorescence intensity)between the patient groups and the healthy controls.CD patients show a significantly higher phagocytic capacity(ratio mean percentage of phagocytic cells)compared to healthy controls(51.91%±2.85%vs 37.67%±7.06%,P=0.05).The extend of disease was not of influence.However,variants of ATG16L1(WT:2.03±0.19 vs homozygoot variant:4.38±0.37,P<0.009)as well as NOD2(C-ins)(heterozygous variant:42.08±2.94 vs homozygous variant:75.58±4.34(P=0.05)are associated with the phagocytic activity in patients with CD.CONCLUSION:Monocytes of CD patients show enhanced phagocytosis associated with the presence of ATG16L1 and NOD2 variants.This could be part of the pathophysiological mechanism resulting in the disease.     

COX-2-dependent cardiac failure in Gh/tTG transgenic mice

Gh is a GTP binding protein that couples to the thromboxane receptor (TP), but also functions as tissue transglutaminase II (tTG). A transgenic mouse model was generated in which Gh was overexpressed (GhOE) in ventricular myocytes under the control of the alpha-myosin heavy chain promoter. Heart rate was elevated and both blood pressure and left ventricular ejection fraction were depressed in GhOEs. Left ventricular mass was increased, consistent with genetic and ultrastructural evidence of hypertrophy. Fibrosis and apoptosis were also augmented. Survival declined disproportionately in older GhOEs. Cardiomyocyte expression of COX-2, thromboxane synthase (TxS), and the receptors for TxA2 (the TP), PGF2alpha (the FP), and PGI2 (the IP) were upregulated and urinary 8,12-iso-iPF2alpha-VI,2,3-dinor-6-keto-PGF1alpha and 2,3-dinor-thromboxane B2 were increased in GhOEs, reflecting increased lipid peroxidation and cyclooxygenase (COX) activation. Selective COX-2 inhibition, TP antagonism, and suppression of lipid peroxidation each rescued the cardiac phenotype. Infusion of an FP agonist exacerbated the phenotype, whereas administration of an IP agonist improved cardiac function. Directed cardiac overexpression of Gh/tTG causes both TG activation and increased TP/Gh-dependent signaling. The COX-2-dependent increase in TxA2 generation augments cardiac hypertrophy, whereas formation of PGI2 by the same isozyme ameliorates the phenotype. Oxidant stress may contribute, via regulation of COX-2 expression and/or ligation of the TP and the FP by isoprostanes. Gh/tTG activation regulates expression of COX-2 and its products may differentially modulate cardiomyocyte commitment to cell death or survival.     

骨髓基质干细胞移植对正常和心肌梗死大鼠心电图及心功能的影响

目的:骨髓基质干细胞移植到心肌梗死的瘢痕心肌组织中可以改善心功能,但以心电图为观察指标的研究不多。实验观察骨髓基质干细胞移植对正常和心肌梗死大鼠心电图及心功能的影响。方法:实验于2004-01/2005-03在哈尔滨医科大学完成。①实验动物:选取4周龄雄性Wistar大鼠80只,随机数字表法分为梗死移植组、正常移植组、梗死非移植组、正常非移植组,20只/组。另选取7d龄Wistar雄鼠30只作为骨髓基质干细胞的来源。②实验方法:采用密度梯度离心法获取鼠骨髓基质干细胞,配成1×109L-1的细胞悬液,使用5-氮胞苷体外诱导培养3～4周,移植前24～48h行Brdu标记。取载有细胞的盖玻片,测定钙释放时将20mmol/L的caffeine快速加在细胞表面。梗死移植组、梗死非移植组大鼠建立心肌梗死模型。造模4周后,梗死移植组将0.25mL诱导的骨髓基质干细胞悬液注射至大鼠心肌梗死后的瘢痕组织,正常移植组同法将骨髓基质干细胞悬液注射至正常心肌组织,梗死非移植组、正常非移植组注射等量不含骨髓基质干细胞的培养液基质。③实验评估:观察骨髓基质干细胞的诱导分化情况及其植入后在瘢痕心肌组织中的生存状态。测定细胞内钙离子浓度。记录术前、冠脉结扎后即刻/细胞移植即刻、术后4周的心电图变化。检测术后4周的超声和血流动力学指标变化。结果:80只大鼠均进入结果分析。①骨髓基质干细胞的诱导分化及其植入后的生存状态:5-氮胞苷诱导3周后,骨髓基质干细胞表达肌钙蛋白Ⅰ和肌凝蛋白重链,细胞内有丰富的肌丝和Z线,细胞器较多。植入4周后在心肌瘢痕组织中分化为心肌细胞。②细胞内钙离子浓度:两组细胞在caffeine刺激下钙离子的释放均呈波峰状,但诱导组应用caffeine后钙离子浓度降低且低于基础状态,钙释放受到抑制,未诱导组不受影响。③心电图观察:与术前比较,梗死移植组QRS波变窄,R波降支出现正常顿挫波,未见显著心律失常。④超声检测及血流动力学分析:术后4周,与梗死非移植组比较,梗死移植组左室收缩末压、左室射血分数和压力变化速率最大值均显著升高(P<0.05或0.01)。结论:骨髓基质干细胞体外诱导后能分化为心肌样细胞,植入到瘢痕心肌组织中生存、增殖良好,可改善心电图及心肌弹性,从而改善心肌梗死大鼠的心功能。     

灰色数列预测模型在成骨细胞体外培养中的应用

目的：灰色模型是运用一定的数学方法使信息不完全明确的系统经数据处理后能得到较明确结果的一种数学预测模型，体外细胞培养的影响因素较多，属于信息不完全明确的灰色系统，故运用灰色GM（1，1）模型对成骨细胞增殖、分化的变化规律进行预测，验证模型在体外细胞培养中的可应用性。方法：实验于2005—11／2006—03在广东医学院药理教研室完成。①实验过程：应用酶序列消化分离培养法培养新生大鼠颅骨成骨细胞；用MTT法测定体外培养成骨细胞在不含血清培养液A值，以了解成骨细胞的增殖情况；对硝基苯磷酸盐法观察体积分数为0．01的胎牛血清培养液对体外培养成骨细胞分泌碱性磷酸酶活性的影响，代表成骨细胞的分化情况。②灰色GM（1，1）模型建立：运用灰色系统理论，通过SAS8．1软件对体外培养成骨细胞MTT值和碱性磷酸酶OT值进行分析和预测。结果：运用灰色系统理论的后验差检验方法对模型进行检验，MTT这一指标的平均相对误差为4．4％，碱性磷酸酶这一指标的平均相对误差为7．04％，后验差比值为0．048和0．315，综合评定该模型为“好”。结论：灰色GM（1，1）模型对体外培养成骨细胞MTT值和碱性磷酸酶的OT值变化的预测精度高，结果可靠。体外培养成骨细胞MTT值和碱性磷酸酶的OT值的变化可用灰色GM（1，1）模型进行预测。     

工程化视知觉感知学习系统治疗儿童弱视的效果评价

目的:传统治疗弱视的方法(如遮盖治疗,精细训练等)起效慢,疗效欠佳;视知觉感知学习系统作为一种针对性很强的儿童弱视治疗方法,其疗效需进一步观察。方法:①收集2006-09/2007-02于广西壮族自治区人民医院视光中心就诊的弱视儿童125例250眼,女73例,男52例,年龄(6±2)岁。患儿家长知情同意并签署知情同意书;实验经医院伦理委员会批准。②根据视功能检查结果,采用视知觉感知学习系统对弱视患儿进行针对性的治疗,如双眼视力相差两行以上,辅助遮盖优势眼治疗。1个月为1个疗程,每天训练2次,每次2个训练内容(程序),每个训练内容10min,40min/d,训练内容之间要求有10min左右的休息间隙。训练需在安静和黯淡环境下进行。每月定期复查双眼视力及其各项视功能的恢复情况,并根据复查结果继续原程序治疗或调整治疗程序。结果:弱视患儿125例均进入结果分析。①视力:视知觉感知学习系统治疗儿童弱视的总有效率为75.2%,视力提高行数从治疗第3个月起有大幅增加(P<0.05),最佳矫正视力由治疗前的0.60±0.23提高至治疗后的0.86±0.26,差异有显著性意义(P<0.05)。②治疗时间与疗效:疗效达到进步的平均时间为(2.82±1.30)个月,达到基本治愈为(2.87±1.40)个月。治疗3个月的患者视力疗效达进步率最高[98%(39/40)],治疗1个月的患者视力进步率最低[55%(31/56),P<0.05]。基本治愈率随治疗时间的增加递增,治疗4个月组基本治愈率最高[67%(31/46),P<0.05]。结论:视知觉感知学习系统治疗儿童弱视疗效快,达到有效的时间为治疗两三个月。     

不同孔径纳米羟基磷灰石人工骨修复兔桡骨缺损效果比较

目的:纳米级的羟基磷灰石材料与人体内组织成分更为相似,具有更佳的生物性能。评价不同孔径的多孔纳米羟基磷灰石人工骨的骨缺损修复能力,从而筛选出适合的孔径以达到骨传导功能与生物力学性能的良好统一。方法:实验于2005-10/2006-10在深圳市第二人民医院中心实验室完成。①实验材料:纳米羟基磷灰石人工骨以硝酸钙和磷酸二氢铵为原料,采用溶胶-絮凝法制备粉体,运用压力成型、木模成型和浸渍成型分别制得孔隙分布均匀的孔径分别为50～150μm、100～250μm和300～500μm的多孔纳米羟基磷灰石人工骨。②实验动物:雄性新西兰大白兔60只随机分为植入50～150μm孔径材料组、植入100～250μm孔径材料组、植入300～500μm孔径材料组、空白对照组,每组15只。实验过程中对动物处置符合动物伦理学要求。③实验方法:制备双侧桡骨骨缺损动物模型,然后用3种不同孔径的纳米羟基磷灰石人工骨材料植入骨缺损处进行修复,空白对照组不植入任何材料。④实验评估:术后4,8和12周分别行大体标本观察、X射线片观察、扫描电镜观察及生物力学测试,比较各组材料修复骨缺损的能力。结果:实验动物均进入结果分析。①X射线片检查结果:术后4周、8周、12周,植入100～250μm孔径材料组X射线评分高于植入50～150μm,300～500μm孔径材料组,差异有显著性意义(P<0.05)。②生物力学检测结果:术后4周、8周、12周,植入100～250μm孔径材料组生物力学强度高于植入50～150μm,300～500μm孔径材料组,差异有显著性意义(P<0.05)。③扫描电镜观察结果:植入100～250μm孔径材料组成骨效果明显优于植入50～150μm,300～500μm孔径材料组和空白对照组。结论:纳米羟基磷灰石人工骨具有良好的成骨能力,但其骨修复能力受孔径因素的影响,孔径100～250μm的纳米羟基磷灰石人工骨材料成骨能力较好。     

颈动脉内中膜厚度与初诊2型糖尿病视网膜病变的关系

目的:研究发现,糖尿病视网膜病变和动脉粥样硬化终点事件相关。试验拟验证颈动脉内中膜厚度与初诊汉族2型糖尿病患者糖尿病视网膜病变相关危险因素的关系。方法:①试验对象:选择2006-06/2007-06本院住院的初诊2型糖尿病患者187例,男114例,女73例;平均年龄(51±14)岁;平均体质量指数(24.7±4.7)kg/m2。均符合1997年美国糖尿病协会的2型糖尿病诊断标准,排除既往已存在心血管疾病者。患者对治疗及试验均知情同意。根据眼底照相检查结果,将所有受检者分为糖尿病视网膜病变组及非糖尿病视网膜病变组进行统计分析。②试验方法及评估:所有患者询问一般情况,测量颈动脉内中膜厚度以及相关生化指标,对糖尿病视网膜病变相关因素进行单因素及多因素Logistic回归分析。结果:纳入2型糖尿病患者187例,均进入结果分析。单因素Logistic回归分析显示,高血压、糖尿病家族史、颈动脉内中膜厚度、尿白蛋白、低密度脂蛋白胆固醇与糖尿病视网膜病变发生呈显著正相关,多因素Logistic回归分析未见显效因素。结论:单因素回归分析中颈动脉内中膜厚度及其他4项指标与糖尿病视网膜病变相关,而多因素回归分析这些因素未进入主效基因模型。