不同分离方法与培养条件下大鼠骨髓间充质干细胞生长增殖情况比较

目的:应用贴壁分离法和密度梯度离心法以不同培养条件观察纯化过程中对获得的骨髓间充质干细胞的影响,试图寻找获得高质量、高活性的骨髓间充质干细胞的培养条件。方法:实验于2005-09/2006-01在解放军第四军医大学实验动物中心实验部进行。①SPF级雄性Wistar大鼠18只,贴壁分离培养取12只,根据血清和培养基的不同分为4组:进口血清 DMEM组、进口血清 F12-DMEM组、国产血清 DMEM组、国产血清 F12-DMEM组,3只/组。密度梯度离心培养实验取剩余6只,以分离液的不同分为Ficoll分离液组、Percoll分离液组,3只/组。②骨髓取材:各组大鼠断颈处死后,无菌取双下肢,剔除股骨、胫骨周围肌肉组织,剪去骨干的两端,暴露骨髓腔,穿刺两侧骨端取出骨髓。③贴壁分离法:进口血清 DMEM组、进口血清 F12-DMEM组、国产血清 DMEM组、国产血清 F12-DMEM组大鼠分别采用相应的血清和培养基冲洗骨髓,制备单细胞悬液,接种于培养瓶中,5d后首次更换培养液,弃去未贴壁细胞,此后每3～4d换液1次。④密度梯度离心法:Ficoll分离液组选用的Ficoll分离液密度为1.077;Percoll分离液组将Percoll分离液与0.1mol/L磷酸盐缓冲液按9∶1比例混匀,密度为1.073。将两组大鼠骨髓置入离心管,离心弃上清,轻轻叠加到相同体积的各自对应分离液上,再次离心收集界面层白色混浊液,采用F12-DMEM培养液重悬细胞,按1×109L-1的密度接种于培养瓶中,培养条件与贴壁分离法相同。⑤指标检测:倒置显微镜下,每天观察贴壁分离、密度梯度离心不同培养条件下细胞的生长情况和活体形态特征。进行锥虫蓝排斥试验,蓝染细胞为死亡细胞,在3min内用计数板分别计数活细胞和死细胞,未被蓝染细胞所占细胞总数的百分比即为初步得到细胞活性的数据。两种分离方法均取生长良好的第3代细胞,以时间为横坐标,细胞数为纵坐标,绘制生长曲线。结果:18只大鼠均进入结果分析。①细胞形态观察结果:贴壁分离法:采用进口血清培养的两组细胞形态学上都表现为长梭形,细胞活性较高,且给予F12-DMEM培养基的细胞增殖较快,集落融合较早,传代所需时间短;采用国产血清培养的两组细胞中,给予F12-DMEM培养基可以获得梭形细胞,而给予DMEM培养基后则多为类圆形骨髓样细胞,仅见极少梭形细胞。密度梯度离心法:Ficoll分离液组和Percoll分离液组均可培养出梭形骨髓间充质干细胞,细胞活性均高,但集落融合、传代所需的时间均较贴壁分离法长。②细胞活性检测结果:贴壁分离法:进口血清 DMEM组、进口血清 F12-DMEM组、国产血清 DMEM组、国产血清 F12-DMEM组的活细胞率分别为98.3%,98.7%,97.1%,97.7%,组间比较差异无显著性意义(χ2=0.054～0.620,P均>0.05)。密度梯度离心法:Ficoll分离液组活细胞率与Percoll分离液组相似(96.9%,97.1%,t=1.066,P>0.05)。③第3代细胞生长曲线测定结果:不同培养条件下各组第3代细胞生长曲线基本相似,在培养1d时,细胞量稍有减少;4d后细胞数均迅速增长;8d进入平台期,细胞增殖减慢。结论:采用全骨髓贴壁分离法和密度梯度离心法,只要选择合适的培养条件均可获得骨髓间充质干细胞,但选用进口胎牛血清、F12-DMEM培养基效果较好。     

Second‐look endoscopy with thermal coagulation or injections for peptic ulcer bleeding: A meta‐analysis

Background and Aims: In the management of peptic ulcer bleeding, the benefits of second‐look endoscopic treatment with thermal coagulation or injections in controlling recurrent bleeding is unsure. This study set out to compare efficacy of routine second‐look endoscopy with treatment using either thermal coagulation or injections versus single endoscopy by pooling data from published work. Methods: Full publications in the English‐language published work as well as abstracts in major international conferences were searched over the past 10 years, and six trials fulfilling the search criteria were found. Outcome measurements included: (i) recurrent bleeding; (ii) requirement of surgical intervention; and (iii) mortality. We examined heterogeneity of trials and pooled the effects by meta‐analysis. The quality of studies was graded according to the prospective randomization, methods of patient allocation, the list of exclusion criteria, outcome definitions and the predefined salvage procedures for uncontrolled bleeding. Results: Among 998 patients recruited in these five randomized trials, 119 received routine second‐look endoscopy with thermal coagulation, and 374 received second‐look with endoscopic injection and 505 had single endoscopic therapy. Less recurrent bleeding was reported after thermal coagulation (4.2%) than single endoscopy (15.7%) (relative risk [RR] = 0.29; 95% confidence interval [CI] = 0.11–0.73), but no reduction was reported for the requirement of surgical intervention and all‐cause mortality. Injection therapy did not reduce re‐bleeding (17.6%) when compared to single endoscopy (20.8%; RR = 0.85; 95% CI = 0.63–1.14), requirement for surgery and mortality. Conclusion: Routine second‐look endoscopy with thermal coagulation, but not injection therapy, reduced recurrent peptic ulcer bleeding. There is no proven benefit in reducing surgical intervention and overall mortality.     

穴位注射治疗尖锐湿疣及对免疫功能的影响

目的：探讨穴位注射治疗CA的临床疗效及对CA患者免疫功能的影响。方法：149例患者随机分为治疗组（A组）、药物对照组（B组）和空白对照组（C组）。运用激光治疗消除疣体后，A组用卡介菌多糖核酸穴位注射，B组用卡介菌多糖核酸肌肉注射，C组仅行激光消除疣体治疗。分别于治疗前及6个月以后检测患者细胞免疫功能。另设健康人对照组40例，检测项目同上。结果：治疗前与健康人相比，CA患者CD4^＋百分率降低，CD8^＋百分率升高，CD4^＋／CD8^＋比值降低，NK细胞活性降低（P〈0．05或P〈0．01）。运用穴位注射卡介菌多糖核酸治疗后，治疗组CD4^＋百分率升高，CD8^＋百分率降低，CD4^＋／CD8^＋比值升高，NK细胞活性升高（P〈0．05或P〈0．01）。结论：穴位注射卡介菌多糖核酸疗法对CA的T淋巴细胞亚群、自然杀伤（NK）细胞有良性调节作用；可明显降低尖锐湿疣复发率，提高细胞免疫调节作用，是防止尖锐湿疣复发的机制之一。     

Anti-neutrophil cytoplasmic antibodies in Japanese children with ulcerative colitis

Objective: To investigate the diagnostic value of anti-neutrophil cytoplasmic antibodies (ANCA) in the diagnosis of ulcerative colitis (UC) in Japanese children.
Methodology Serum samples from 23 children with UC (17 Japanese, 6 non-Japanese), 27 children with Crohn's disease (CD) (10 Japanese, 17 non-Japanese), 10 children with other diarrhoeal diseases, and 33 normal, healthy adult volunteers were assayed for ANCA using an indirect immunofluorescence technique.
Results ANCA were detected in 6/17 (35%) UC patients and 0/10 (0%) CD patients in Japanese children, and in 3/6 (50%) UC patients and 3/17 (18%) CD patients in non-Japanese children. The difference in prevalence between Japanese and non-Japanese children with UC was not statistically significant ( P >0.05). ANCA were not found in other diarrhoeal patients and volunteers.
Conclusions Although ANCA have been reported to be useful in the diagnosis of UC in adults, they may be of limited use in Japanese children. This might reflect the heterogeneity of UC.     

Effect of exercise-induced arterial O2 desaturation on VO2max in women

PURPOSE: We have recently reported that many healthy habitually active women experience exercise induced arterial hypoxemia (EIAH). We questioned whether EIAH affected VO2max in this population and whether the effect was similar to that reported in men. METHODS: Twenty-five healthy young women with widely varying fitness levels (VO2max, 56.7 +/- 1.5 mL x kg(-1) x min(-1); range: 41-70 mL x kg(-1) x min(-1)) and normal resting lung function performed two randomized incremental treadmill tests to VO2max (FIO2: 0.21 or 0.26) during the follicular phase of their menstrual cycle. Arterial blood samples were taken at rest and near the end of each workload during the normoxic test. RESULTS: During room air breathing at VO2max, SaO2 decreased to 91.8 +/- 0.4% (range 87-95%). With 0.26 FIO2, SaO2, at VO2max remained near resting levels and averaged 96.8 +/- 0.1% (range 96-98%). When arterial O2 desaturation was prevented via increased FIO2, VO2max increased in 22 of the 25 subjects and in proportion to the degree of arterial O2 desaturation experienced in normoxia (r = 0.88). The improvement in VO2max when systemic normoxia was maintained averaged 6.3 +/- 0.3% (range 0 to +15%) and the slope of the relationship was approximately 2% increase in VO2max for every 1% decrement in the arterial oxygen saturation below resting values. About 75% of the increase in VO2max resulted from an increase in VO2 at a fixed maximal work rate and exercise duration, and the remainder resulted from an increase in maximal work rate. CONCLUSIONS: These data demonstrate that even small amounts of EIAH (i.e., >3% delta SaO2 below rest) have a significant detrimental effect on VO2max in habitually active women with a wide range of VO2max. In combination with our previous findings documenting EIAH in females, we propose that inadequate pulmonary structure/function in many habitually active women serves as a primary limiting factor in maximal O2 transport and utilization during maximal exercise.     

Tonsillectomy, adenoidectomy, and myringotomy in sickle cell disease: perioperative morbidity. Preoperative Transfusion in Sickle Cell Disease Study Group

PURPOSE: To compare the rates of perioperative morbidity of patients with sickle cell anemia who were randomly assigned to 2 preoperative transfusion regimens and to identify predisposing factors for perioperative complications. PATIENTS AND METHODS: Investigators at 36 centers enrolled 118 patients who were scheduled to have elective surgery and agreed to randomization between 2 preoperative transfusion regimens. Forty-seven subjects were enrolled but not randomized, including 20 who were not transfused before surgery. Perioperative management was based on a prescribed care plan. RESULTS: Tonsillectomy and/or adenoidectomy (TA) were performed on 136 persons, and 29 had myringotomy as their primary procedure. There were no differences in the frequency of complications between the randomized groups. The serious, non-transfusion complication rates for randomized patients were 32% (34 of 107) for TA and 36% (4 of 11) for myringotomy. A history of pulmonary disease was a predictor of postoperative sickle cell-related events for patients undergoing TA surgery. CONCLUSIONS: The more intensive transfusion regimen did not result in fewer perioperative complications. The high frequency of complications emphasizes the need for anticipatory management of persons undergoing TA. A history of pulmonary disease identifies patients at increased risk for sickle cell-related events after TA surgery. Patients undergoing myringotomy have a low frequency of sickle cell-related events but a significant frequency of other serious perioperative complications.     

Elephantiasis nostras verrucosa: beneficial effect of oral etretinate therapy

Elephantiasis nostras verrucosa is characterized by chronic secondary, non-filarial lymphoedema due to recurrent lymphangitis, dermal fibrosis, and epidermal changes consisting of hyperkeratotic, verrucous and papillomatous lesions. Histologically, there is pseudoepitheliomatous hyperplasia. Therapeutic efforts should aim to reduce lymph stasis, which will also lead to improvement of the cutaneous changes. In this study, rapid disappearance of the hyperkeratotic and verrucous lesions, remarkable flattening of the papillomatous nodules and improvement of lymphoedema occurred in three obese patients treated with etretinate in an initial dose of 0.6-0.75 mg/kg/day for 4-6 weeks. Monitoring of plasma concentrations of etretinate, acitretin and 13-cis-acitretin by HPLC revealed sufficient short-time absorption (4 h) and bioavailability of the drug (30 days; two out of three patients). Long-term maintenance therapy in one patient produced a remarkable improvement in the lymphoedema; another patient relapsed after discontinuation of the etretinate and responded again after this was reintroduced. In the third patient treatment was withdrawn because of an increase in triglycerides, but improvement persisted 6 months later. The clinical side-effects of oral retinoid therapy were moderate and well tolerated.     

Effect of chronic intoxication with (+)-amphetamine on its concentration in liver and brain and on (14C) leucine incorporation into microsomal and cytoplasmic proteins of rat liver

Rats were treated with increasing concentrations of (+)-amphetamine sulphate in drinking water for 90 days. The ingested dose of amphetamine was found to increase from 16 mg kg^?1 on the first day up to 90 mg kg^?1 on the 32nd day of treatment. The rats were maintained on the highest dose regime for a further 58 days without any deaths, which showed that tolerance to the overall toxicity of the drug developed. The concentrations of [³H]amphetamine in liver and brain of chronically treated rats were significantly higher than those of controls. Chronic treatment with amphetamine significantly reduced body and liver weight of rats, but did not influence the relative liver to body weight. A marked inhibition of [¹⁴C]leucine incorporation into liver microsomal and cytoplasmic proteins was observed after 90 days of treatment with amphetamine. The relation between inhibition of microsomal protein synthesis and the increase of amphetamine concentrations in liver and brain is discussed.