体外诱导骨髓间充质干细胞向肾小管上皮样细胞分化

Objective To investigate the differentiation of rat bone marrow mesenchymal stem cells (MSCs) to renal tubular epithelial-like cells under different conditions. Methods MSCs were obtained from rat marrow. MSCs were isolated by gradient density centrifugation and plastic adherence and then purified. Surface markers were identified with flow cytometry after amplification in vitro. The purified MSCs of the third passage were cultured respectively as follows: (1) control group: DMEM medium with fetal bovine serum(FBS). (2) all-trans retinoic acid (ATRA) group: DMEM medium with FBS, ATRA and ischemic reperfusion-injured kidney tissue homogenate. (3)combination group: DMEM medium with FBS, ATRA, ischemic reperfusion-injured kidney tissue homogenate, epidermal growth factor (EGF) and bone morphogenetic protein 7 (BMP-7). After 7 days, the MSCs were collected for alkaline phosphatase (AKP) staining, cytokeratin-18 and E-cadherin immunocytochemical analysis. Results The positive rates of the third passage MSCs in CD44, CD90 and CD29 were 97.8%±0.9%, 96.8%±1.4% and 97.6%±2.4%,respectively, but in CD11b/c and CD34 were only 13.2%±0.6% and 1.2%±0.5%. The MSCs in control group were spindle. The MSCs in ATRA group were round and elliptic. The MSCs in combination group became cobblestone-like cells after 7 days. AKP staining showed that tubular epithelial-like cells from MSCs in control group were negative, some above cells in ATRA group were positive and number of above cells increased in combination group. Compared with negative control group, the ratios of cytokeratin-18 positive cells in ATRA group and combination group were respectively increassed by 29.47%±1.08% and 47.52%±2.13% (all P<0.05), the ratios of E-cadherin positive cells in ATRA group and combination group were respectively increased by 14.88%±2.46% and 36.15%±1.13% (all P<0.05). Conclusion MSCs may differentiate by renal tubular epithelial-like cells under the induction of ischemic reperfusion-injured kidney tissue homogenate and ATRA in vitro, which are further differentiated under the combined induction of EGF and BMP-7.     

Sonographic biometry of spleen among school age children in Nsukka,Southeast, Nigeria

Background

Normative value of spleen size among school age children is important for objective assessment of the spleen.

Objectives

This study was aimed at determining sonographically the normal limits of the spleen size according to age, sex, and somatometric parameters among school age children.

Methods

A cross sectional study was done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6 – 17 years. The subjects were recruited from some primary and secondary schools within Nsukka metropolis and also from out patients in the study centre. A pilot study was done to determine the intra- and inter rater reliability of sonographic measurements of the spleen. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen sizes were obtained with the subject in a right lateral decubitus position.

Results

Measurement of spleen length was reliable while measurement of spleen width was less reliable within and between sonographers. Dimensions of the spleen were not statistically different in boys and girls (p > 0.05). Height correlated best with spleen dimensions.

Conclusions

Normogram of the spleen size with respect to height is important in the determination of some pathology associated with changes in its size.     

D-penicillamine in the treatment of eosinophilic fasciitis: case reports and review of the literature

Eosinophilic fasciitis (EF) is a rare disease characterized by symmetrical thickness and hardening of the skin, especially localized to forearms and thorax, with eosinophilia. Corticosteroids represent the first-line therapy, even if some patients are scarcely responsive and/or may develop important side effects due to long-term treatment. Here, we describe three cases of EF, two of them refractory to previous steroid therapy, successfully treated with D-penicillamine. The present clinical observations together with the updated review of the literature suggest usefulness of D-penicillamine in EF patients, as well as its potential steroid-sparing value.     

运用中医理论探讨冠心病的发作时间与护理

目的运用子午流注学说,针对冠心病病例的病情变化与时辰的关系实施择时护理,并观察其疗效。方法将90例冠心痛住院患者随机分为观察组（择时护理）和对照组（随机护理）,对2种护理方式的效果进行比较分析。结果冠心病的反复率方面,观察组低于对照组,且并发症发生率降低（P〈0．01）,有显著性差异。结论在中医理论指导下的冠心病调护,对提高治疗的有效率起到了一定的作用。     

肝动脉栓塞致胃粘膜损伤的实验研究

目的研究肝动脉栓塞致胃粘膜损伤的机制．方法日本大耳白兔３２只，随机分为３组：正常组８只，假手术对照组８只，肝动脉栓塞组１６只．用超液态碘油制兔部分肝动脉栓塞模型．在手术前后，用放免法测定其血浆中内皮素（ＥＴ）水平，直接穿刺门静脉测压，激光多谱勒血流仪测定其胃粘膜血流量（以电压Ｖ表示），并观察胃粘膜组织形态学改变．结果肝动脉栓塞术后３ｄ和６ｄ兔血浆ＥＴ（ｎｇ／Ｌ，２１５±３５，２１５±４７）显著高于假手术对照组（１５５±２８，１４６±２８，Ｐ＜００１）．肝动脉栓塞术后６ｄ，其门静脉压力（ｋＰａ，１０９±０１０）明显高于对照组（０８５±００７，Ｐ＜００５）．胃粘膜血流量（３６４Ｖ±０７７Ｖ）显著低于正常组（４８１Ｖ±０４２Ｖ，Ｐ＜００５）和假手术对照组（４６５Ｖ±０３２Ｖ，Ｐ＜００５）．胃粘膜损害发生率（６８８％）显著高于对照组（２５０％，Ｐ＜００５）．结论肝动脉栓塞可使其血浆ＥＴ水平明显升高，门静脉压力增加，胃粘膜血流量下降，从而导致胃粘膜损伤     

中老年2型糖尿病患者认知功能的影响因素分析

目的:评估中老年2型糖尿病患者的认知功能并了解其相关的影响因素。方法:选择中老年有2型糖尿病病史患者(年龄40~69岁)199例。调查患者既往病史、糖尿病病程、家族史,检测并比较所有入组患者的体质量指数(BMI)、腰臀比(WHR)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂、血压及颈动脉彩色超声。选用蒙特利尔认知评估(MoCA)量表北京版进行认知功能的评估。结果:糖尿病病程5年以上的患者MoCA评分较5年以内者降低(P<0.05)。认知功能与受教育年限、高血压病史、WHR、FPG、HbA1c、颈动脉内膜中层厚度(IMT)、颈动脉阻力指数(RI)显著相关(P<0.05)。多元回归分析显示,受教育年限、高血压病史、颈动脉RI、HbA1c是影响糖尿病患者MoCA评分水平的关键因素。结论:中老年2型糖尿病患者的认知功能与其受教育程度、高血压病史、颈动脉血管阻力及血糖控制情况密切相关。     

Sonographic determination of spleen to left kidney ratio among Igbo school age children of south east Nigeria

Background

Clinical determination of mild splenomegaly is notoriously inaccurate.

Objectives

To determine sonographically the spleen to left kidney ratio according to age and somatometric parameters among school age children in a tropical environment.

Methods

A cross sectional study and convenience sampling were done on 947 apparently healthy subjects (496 boys and 451 girls) aged 6–17 years at the University of Nigeria Medical Centre, Nsukka. The sonographic examination was performed on Shenzhen DP-1100 machine with 3.5 and 5 MHz convex transducers. Spleen and left kidney lengths were obtained using appropriate techniques. The weight and height of the subjects were obtained with the participants wearing light weight street clothes without shoes.

Results

Measurement of spleen and left kidney lengths were reliable within and between sonographers. The spleen and left kidney lengths were not statistically different in boys and girls (p > 0.05). The spleen to left kidney ratio according to age and somatometric parameters is constant at about 1.13 with 1.3 as the upper limit of normal in the studied population.

Conclusion

Sonography can be used to detect mild splenomegaly if the spleen to left kidney ratio is greater than 1.3 in the absence of renal disease among school age children.     

胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

胰岛素强化治疗在2型糖尿病骨折患者围手术期的应用

Objective To investigate the best way to control the blood sugar level during the perioperation of bone fracture patients with type 2 diabetes(T2DM).Methods Bone fracture patients with T2DM were randomly divided into three groups:continuous subcutaneous insulin infusion group(insulin aspart,group CSII,n=20),glargine treatment group(insulin aspart+insulin glargine,group GA,n=20),and NPH treatment(insulin aspart+rh-insulin,group NA,n=20).The levels of fasting plasma glucose(FPG)and the 2 hours postprandial glucose(2h PG),blood glucose fluctuation(BGF),insulin dosage(ID),good effective time(GET),incidence of hypoglycemia,dawn phenomenon and infection,average time of stitches removal(ATSR),average hospitalized length(AHL)of three groups were compared.Results FPG and 2hPG,ID in group CSII[(6.32±1.18)mmol/L,(7.72±1.53)mmol/L,(35.40±1.60)IU]and group GA [(6.25±0.88)mmol/L,(7.32±1.17)mmol/L,(36.20±0.80)IU]were significantly lower than those of group NA [(7.44±1.36)mmol/L,(8.52±0.76)mmol/L,(40.50±2.40)IU,all P<0.05],simulaneously,BGF,GET incidence of complications,ATSR,AHL of group CSII and GA were significantly lower than those of group NA(all P<0.05).There were not significant difference between group CSII and group GA.Compared with group CSII,group GA had less costs in-hospital and better practicability.Conclusion Both CSII and insulin glargine combined with insulin aspart can effectively,safely,rapidly and stablely control hyperglycemia.and might be the first choice to control blood sugar for bone fracture patients with T2DM in perioperation.     

HPV18 L1基因重组DNA构建及其免疫小鼠体内特异抗体的测定

目的：人类乳头瘤病毒１８型（ＬＰＶ１８）感染与宫颈癌的发生高度相关。其晚期基因Ｌ１编码的Ｌ１结构蛋白是刺激机体产生中和抗体的主要抗原。利用ＨＰＶ Ｌ１基因重组质粒进行ＤＮＡ疫苗的初步免疫学实验研究。方法：从ＨＰＶ１８－ｐＢＲ３２２质粒中扩增ＨＰＶ１８ Ｌ１基因,测序证明扩增片段的可靠性,构建了两个真核表达重组质粒ＨＰＶ１８ Ｌ１－ｐｃＤＮＡ３和ＨＰＶ１８Ｌ１－ｐｃＥＰ４。将提纯的质粒ＤＮＡ直接免疫