Expression of NLRP3 inflammasome in the BSA-overloaded rats kidney

Objective To observe NLRP3 inflammasome expression and inflammatory cells infiltration in the BSA-overloaded rats kidney, and to investigate the potential mechanism of renal injury induced by proteinuria. Methods After unilateral right nephrectomy, eighteen healthy male Wistar rats were randomly divided into two groups: protein overload nephropathy model group (n=10), treated with intraperitoneal injections of bovine serum albumin (BSA); control group (n=8), treated with intraperitoneal injections of 0.9% saline for 9 weeks. Body weigh were measured every week and 24 h urine were collected in 0, 2, 5, 7, 9 week. The plasma levels of blood total protein (TP), albumin (Alb), serum creatinine (Scr) and blood urea nitrogen (BUN) were determined by automatic analyzers. Renal pathological changes were evaluated by PAS and Masson stains. Immunohistochemical staining was used to detect the expression of NLRP3, caspase-1, IL-1β, and IL-18, as well as the types of inflammatory cells. The NLRP3, caspase-1, IL-1β, and IL-18 protein and mRNA levels were also analyzed by Western blot and real-time PCR in two groups. Results It was found that there was a significant increase of proteinuria and BUN in model group compare to that in control group (all P＜0.05). However, there were no significant changes in body weight, TP, Alb and Scr between the two groups. Morphological study demonstrated that renal tubular epithelial cell injury, proteinaceous casts in tubular lumen, accompanying with the dominant macrophages and lymphocytes infiltration in interstitium in model group. The immunohistochemistry showed that there were more T (CD3+), B cells (CD20+) and macrophages (CD68+) in renal interstitium in model group than that in control group (P＜0.05). Tubulointerstitial injury score was higher than that of the control group (P＜0.05). Immunohistochemistry, Western blot and real-time PCR all showed that the expression of NLRP3, caspase-1, IL-18 and IL-1 β were significantly increased compared to those in control group (P＜0.05). Furthermore, there were significant correlations between proteinuria and IL-1β/IL-18 expression (P＜0.05). Conclusion NLRP3 inflammasome activation is involved in tubulointerstitial inflammation caused by proteinuria.     

生物可降解聚氨酯的合成及应用

生物可降解聚氨酯材料具有优异的机械性能,良好的血液相容性、组织相容性和生物可降解性,因而在生物医学上得到了广泛的应用.聚氨酯的设计自由度很大,可以通过选择不同嵌段和调节软硬段间的比例,从而合成出具有不同化学结构、机械性能和热性能的聚氨酯以满足不同的应用要求.生物可降解聚氨酯在医学上的应用主要集中在药物缓释载体材料、手术缝合线、人造皮肤、伤口敷料、医用粘合剂、组织工程修复及细胞培养支架等.     

心理干预对冠状动脉搭桥术病人抑郁心理影响的研究进展

从对手术的不了解、既往手术体验及情绪障碍、人格特征的差异、医护人员及医疗环境 4方面阐述了手术产生抑郁心理的相关因素。提出了针对性的术前、术后心理干预措施。     

推拿加鹿衔草为主组方干预老年性膝骨关节炎

目的:观察推拿和鹿衔草为主组方治疗老年性膝关节骨关节炎的干预效果。方法:选择2002-03/2004-06在上海交通大学附属第一人民医院推拿科、中医科门诊就诊的老年性膝关节骨关节炎患者86例,均自愿参加观察。按随机分组表分成4组,即推拿 鹿衔草组、推拿组、鹿衔草组及自我锻炼组,分别为22,22,22及20例。①推拿组患者取俯卧位,以滚法作用于患肢后侧5min,重点在部委中(、委阳(;取仰卧位,用滚法作用于患者患侧大腿股四头肌,着重于膝关节髌骨上部5min;继而以按揉与弹拨法交替作用于患肢,配合点按犊鼻、内外膝眼、阳陵泉、鹤顶、膝阳关、梁丘等(位;作屈膝法,配合膝关节伸屈、旋内、旋外被动运动;最后以擦法擦热患膝。3次/周,共治疗4周。②鹿衔草组患者服用汤药(鹿衔草为主的基础方),辩证加减。1剂/d,分2次口服,共服用4周。③推拿 鹿衔草组治疗方法:在推拿治疗同时服用鹿衔草为主组方的汤药,共治疗4周,方法同上。④自我锻炼组:进行知识教育,并嘱患者自行进行功能锻炼,包括牵张训练、主动和被动活动度训练及增力训练等,锻炼时间为4周。采用WOMAC评分(包括疼痛、僵硬、日常生活3大类,用0～100mm视觉量表评分法,分数越高患者的机体功能越差,对生活的影响程度也越大)和20m步行时间对治疗前及治疗4周后的膝关节功能进行评估,并在治疗4周后评估疗效,疗效评定标准:①有效:关节疼痛、肿胀消失,活动功能恢复正常,理化检查正常。②好转:关节疼痛、肿胀减退,活动功能好转。结果:86例患者均进入结果分析,无脱落。①各组患者治疗4周后的WOMAC评分和20m步行时间均较治疗前显著降低(P<0.05)。治疗4周后推拿 鹿衔草组的WOMAC评分显著低于自我锻炼组(P<0.05);推拿 鹿衔草组和推拿组的20m步行时间显著短于自我锻炼组(P<0.05)。②经过4周的治疗和锻炼,推拿 鹿衔草组、推拿组、鹿衔草组及自我锻炼组患者的治疗有效率分别为86%,82%,82%和60%,各组比较差异均无显著性意义(P>0.05)。结论:单纯推拿、单纯服用鹿衔草及自我功能锻炼均能有效治疗老年性膝关节骨关节炎,明显改善患者膝关节运动功能,但推拿加鹿衔草综合治疗的疗效更优。     

Accumulation of methotrexate polyglutamates in lymphoblasts is a determinant of antileukemic effects in vivo. A rationale for high-dose methotrexate.

Methotrexate (MTX) is one of the most widely used drugs for the treatment of childhood acute lymphoblastic leukemia (ALL) and is commonly given in high doses. However, the rationale for high-dose MTX (HDMTX) has been challenged recently. To determine whether higher MTX polyglutamate (MTXPG) concentrations in ALL blasts translate into greater antileukemic effects, 150 children with newly diagnosed ALL were randomized to initial treatment with either HDMTX (1,000 mg/m2 intravenously over 24 h) or lower-dose MTX (30 mg/m2 by mouth every 6 h x 6). ALL blasts accumulated higher concentrations of MTXPG and long-chain MTXPG (MTXPGLC) after HDMTX (P < 0.00001). Of 101 patients evaluable for peripheral blast cytoreduction, MTXPG concentrations were higher in patients whose blast count decreased within 24 h (P = 0.005) and in those who had no detectable circulating blasts within 4 days (P = 0.004). The extent of inhibition of de novo purine synthesis in ALL blasts was significantly related to the blast concentration of MTXPGLC (IC95% = 483 pmol/10(9) blasts). The percentage of patients with 44-h MTXPGLC exceeding the IC95% was greater after HDMTX (81%) than LDMTX (46%, P < 0.0001). These data indicate that higher blast concentrations of MTXPG are associated with greater antileukemic effects, establishing a strong rationale for HD-MTX in the treatment of childhood ALL.     

Ondansetron attenuates hepatic injury via p38 MAPK-dependent pathway in a rat haemorrhagic shock model

Background

Ondansetron is a 5-HT3 receptor antagonist with potent antiemetic, analgesic, and antiphlogistic effects. Recent evidence suggests that the co-existence of 5-HT3 receptors in various cell types is involved in inflammation. However, the effects that 5-HT3 antagonists produce in haemorrhagic shock and resuscitation remain unknown. In this study, we hypothesized that ondansetron administration in male rats, after haemorrhagic shock, decreases cytokine production and protects against hepatic injury through a p38 mitogen-activated protein kinase (MAPK) pathway.

Methods

Male Sprague-Dawley rats underwent haemorrhagic shock (mean arterial blood pressure 40 mmHg for 90 min), followed by resuscitation. Various doses of ondansetron (0.1, 0.3, 1, 3 mg kg⁻¹) or a single dose of ondansetron (1 mg kg⁻¹) with or without a p38 MAPK inhibitor (SB-203580, 2 mg kg⁻¹) or vehicle were administered intravenously during resuscitation. Plasma aspartate aminotransferase (AST) and alanine aminotransferase (ALT) concentrations and various liver proinflammatory parameters were measured at 24 h after resuscitation.

Results

Results show that haemorrhagic shock increases plasma AST and ALT concentrations, hepatic myeloperoxidase activity, cytokine-induced neutrophil chemoattractant (CINC)-1, CINC-3, intercellular adhesion molecule-1 (ICAM-1), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) levels. These parameters were significantly improved in the ondansetron-treated rats subjected to haemorrhagic shock. Ondansetron treatment restored phos-p38 MAPK expression as compared with vehicle-treated haemorrhaged rats. Coadministration of SB-203580 prevented the beneficial effects of ondansetron on postresuscitation proinflammatory responses and hepatic injury.

Conclusion

Ondansetron attenuates hepatic injury following haemorrhagic shock, which is, at least in part, to be due to its anti-inflammatory effect via p38 MAPK signal pathway.     

超声引导下深度冷冻治疗原发性肝癌

应用超声引导对３２例原发性肝癌进行了插入式深低温冷冻治疗。全部病例术后恢复均顺利，无手术死亡及严重并发症。其中２５例冷冻后肿瘤均有不同程度缩小，１３例肿瘤缩小≥５０％。认为深度低温冷冻治疗肝癌不仅能有效地杀灭冷冻区所有的肿瘤细胞，还能最大限度地保存正常肝组织；而且在术中Ｂ超的监测下能对冷冻的范围进行准确的控制，避免损伤肝内重要的管道系统。因此深度低温冷冻治疗对某些无法手术切除的肝癌是一种安全有效的治疗方法。     

宾州忧虑问卷在中国大学生人群中的初步修订

目的:考察宾州忧虑问卷在中国非临床样本中的因素结构,并检验宾州忧虑问卷的总分和各素分的性别差异。方法:于2005-11选择北京大学2002～2005级的本科生677人为量表结构分析和一致性信度检验的测试样本。第一次施测8周后选择2004级本科生40人作为重测样本。调查问卷包括宾州忧虑问卷(16个项目,各项目均采取5点程度评估);Padua问卷(包括60个项目,各项目均采取5点程度评估,包含4个因素,因素Ⅰ:思维失控与怀疑感。因素Ⅱ:污染。因素Ⅲ:检查。因素Ⅳ:受驱使与行为失控感);状态特质焦虑问卷(状态焦虑量表和特质焦虑量表两个分量表共40个描述题组成,用来测量个体作为人格特质的焦虑倾向);贝克抑郁问卷(评价抑郁的严重程度,4级评分,总分范围为0～39分)。采用集体测试采集数据。结果:发放问卷677份,全部收回且合格,均进入结果分析。①探索性因素分析获得宾州忧虑问卷的2个因素:一般焦虑和焦虑缺失。②宾州忧虑问卷信度检验:总分的α系数为0.89,一般焦虑和焦虑缺失的α系数分别为0.91,0.69,重测信度分别为0.72,0.55。③宾州忧虑问卷的总分及一般焦虑和焦虑缺失因素的得分与状态特质焦虑问卷总分,贝克抑郁量表总分,Padua强迫问卷的因素1(思维失控与怀疑感)得分有较高的相关,说明有良好的汇聚效度。④男女被试在宾州忧虑问卷总分及一般焦虑和焦虑缺失因素得分差异无显著性意义。结论:宾州忧虑问卷在中国大学生人群中具备合格的信度和汇聚效度,需进一步研究其区分效度。     

自发性细菌性腹膜炎易感因素分析

目的分析自发性细菌性腹膜炎 (SBP)的易感因素 ,选择预防性抗菌治疗对象。方法将 30 7例肝硬变腹水患者按有无胃镜检查、嗜酒、Child Pugh分级、消化道出血、SBP病史等因素 5次分组 ,比较各组SBP发生率。 结果嗜酒者SBP发生率 2 5 .0 % ,非嗜酒者为 1 4 .6 % ;Child PughC级SBP发生率为 2 4 .0 % ,Child PughB级为 1 2 .4% ;消化道出血者SBP发生率为 2 7.5 % ,无消化道出血者为7.9% ;有SBP病史者发生率 66 .7% ,无SBP病史者为 1 0 .9%。其发生率均具有显著性差异。而有或无胃镜检查 ,其SBP发生率无显著差异。结论嗜酒、消化道出血、SBP病史以及Child Pugh分级作为SBP易感因素可以预测SBP的发生 ,采用选择性肠道去污染等办法可以降低SBP的发生率 ,改善预后。