牛骨形态发生蛋白对骨质疏松性椎体骨折愈合过程中局部血管内皮生长因子表达的作用

目的:观察骨质疏松性椎体骨折愈合过程中,局部血管内皮生长因子动态表达,探讨牛骨形态发生蛋白促进SD大鼠骨质疏松性椎体骨折愈合的作用机制。方法:实验于2005-07/2006-07在解放军兰州军区总医院骨研所完成。①牛骨形态发生蛋白的制备:青海小牦牛大腿骨,-4℃条件下,粉碎,按Urist改良方法提取。②选择雌性SPF级8个月龄SD大鼠96只,去除双侧卵巢建立骨质疏松模型。随机分为2组:实验组和对照组,每组48只。③术后3个月行L5椎体开窗建立人工骨折模型,实验组置牛骨形态发生蛋白10mg 纤维蛋白复合体;对照组注入等量无血清培养液。④于手术后3,7,10,14,21,28,56,84d每组麻醉状态处死6只,用苏木精-伊红染色、免疫组织化学及定量聚合酶链反应检测骨折愈合不同时间的标本血管内皮生长因子及血管内皮生长因子mRNA的动态表达,阳性信号为胞浆内棕色颗粒。结果:96只SD大鼠全部进入结果分析。①骨折愈合不同时间组织学观察:实验组术后7d纤维骨痂形成,21d新生骨组织与旧骨组织出现融合,56～84d软骨性骨痂已逐渐被骨性骨痂取代,骨折部位髓腔再通,出现成熟板层骨,骨折基本愈合。对照组术后7d未见典型纤维性骨痂;21d新生骨组织大都游离与孤立存在,术后28d骨小梁仅有少部分连结成网状,56～84d部分骨缺损存在,不见成熟板层骨,大部分髓腔不通,骨折愈合延迟。②骨折不同时间血管内皮生长因子免疫组织化学结果:实验组血管内皮生长因子在7d左右可见有阳性表达的细胞,14d有分泌高峰,对应循环数(CT值)最小,两组比值最大。而对照组未见明显分泌高峰。③实时荧光定量聚合酶链反应检测结果:对照组在造模后1,2,4,6,8周时,椎体内的血管内皮生长因子mRNA的表达量明显低于实验组(P<0.01)。结论:牛骨形态发生蛋白可促进大鼠骨质疏松性椎体骨折部位血管内皮生长因子的动态表达,可在受体骨折部位局部促进骨折生长。     

人脂肪干细胞体外培养特性及成脂成软骨分化

目的:观察人脂肪组织间充质干细胞体外分离培养及成脂、成软骨诱导分化的生物学性状,探讨其作为软骨组织工程种子细胞的可行性。方法:实验于2006-08/2007-03在吉林大学中日联谊医院前列腺疾病防治研究中心完成主要工作。实验方法:①人脂肪组织来源于健康成年女性腹部吸脂术,酶消化法分离出脂肪间充质干细胞,接种于含体积分数为0.10胎牛血清的高糖DMEM培养基进行原代培养。②取第3代脂肪间充质干细胞,采用细胞计数法测定细胞生长曲线,流式细胞仪测定CD13、CD34抗原的表达,免疫荧光法测定CD34抗原的表达。③取第3代脂肪间充质干细胞,用含体积分数为0.10胎牛血清、0.5mmol/LIBMX、1μmol/L地塞米松、10μmol/L胰岛素的成脂诱导培养基和含体积分数为0.01胎牛血清、10μg/L转化生长因子β1、50nmol/L抗坏血酸、6.25mg/L胰岛素的成软骨诱导培养基分别诱导分化。④每天用倒置显微镜观察细胞形态及增殖变化,油红"O"、AB-PSA染色和Ⅱ型胶原免疫细胞化学染色检测成脂、成软骨分化情况。结果:①体外培养的脂肪间充质干细胞呈扁平的长梭形,细胞形态均一,传代稳定。间质细胞相关标志CD13和干细胞相关标志CD34表达阳性。②定向诱导后表现出脂肪细胞和软骨细胞特性。经成脂诱导,细胞内出现空泡,油红"O"染色呈红色;经成软骨染色,AB-PSA染色呈紫红色,Ⅱ型胶原免疫细胞化学染色胞浆呈棕黄色。结论:脂肪干细胞能向软骨细胞方向诱导分化,可作为软骨组织工程种子细胞。     

Visual development of human milk-fed preterm infants provided with extra energy and nutrients after hospital discharge

Background: Human milk (HM) is the optimal way to nourish preterm low birth weight (LBW) infants after hospital discharge. However, there are few data on which to assess whether HM alone is sufficient to address hospital‐acquired nutrition deficits, and no adequately powered studies have examined this question using neurodevelopment as an outcome. The purpose of this work was to determine whether adding extra energy and nutrients to the feedings of predominantly HM‐fed LBW infants early after discharge improves their visual development. Visual development was used in this study as a surrogate marker for neurodevelopment. Methods: At discharge, 39 predominantly HM‐fed LBW infants (750–1800 g, 1288 ± 288 g) were randomized to receive human milk alone (control) or around half of the HM received daily mixed with a multinutrient fortifier (intervention) for 12 weeks. Grating acuity (ie, visual acuity) and contrast sensitivity were assessed using sweep visual‐evoked potential tests at 4 and 6 months corrected age. Results: At 4 and 6 months corrected age, intervention infants demonstrated higher grating acuity compared to those in the control group (intervention: 7.8 ± 1.3 and 9.7 ± 1.2 [cycles/degree] vs control 6.9 ± 1.2 and 8.2 ± 1.3, P = .02). Differences in contrast sensitivity did not reach statistical significance (P = .11). Conclusion: Adding a multinutrient fortifier to a portion of the expressed breast milk provided to predominantly HM‐fed LBW infants early after discharge improves their early visual development. Whether these subtle differences in visual development apply to other aspects of development or longer term neurodevelopment are worthy of future investigation.     

Respiratory consequences of red sludge dust inhalation in rats

The environmental disaster following flooding by red sludge in the Ajka region in Hungary poses a serious public health threat with particular concern regarding the potentially adverse respiratory effects of the inhalation of red sludge dust (RSD). The respiratory consequences of the inhalation of RSD obtained from field samples were investigated in rats. Rats were either exposed to RSD at a high concentration (2 weeks, 8 h/day), or kept in room air. After the exposures, the airway resistance (R_aw) and the respiratory tissues mechanics were measured under baseline condition, and following methacholine (MCh) challenges with the aim of establishing airway hyper-responsiveness (AH). Histopathology was performed to assess lung morphologic alterations. The physical properties and the chemical composition of the RSD were also characterized. The size distribution, chemical composition and topology of the RSD particles applied in our experiments were similar to those observed at the site of the disaster. The inhalation of RSD did not alter the basal respiratory mechanics, whereas it led to greater MCh-induced responses in R_aw, demonstrating the progression of mild AH. Histopathological investigations revealed fine, granular particles in the alveolar macrophages, as evidence that RSD had reached the lower respiratory tract and induced mild inflammation around the alveoli and the pulmonary vasculature. The mild respiratory symptoms that developed following short-term exposure of healthy individuals to high concentrations of airborne RSD do not appear to pose a greater respiratory hazard than the inhalation of urban dust at a comparable concentration.     

Prevalence of WU and KI polyomaviruses in plasma, urine, and respiratory samples from renal transplant patients

WU and KI polyomaviruses (WUPyV, KIPyV) have been detected in respiratory, blood, stool, and lymphoid tissue, but not in urine samples. PCR based detection revealed higher frequency in immunocompromised individuals. In this study the prevalence of WUPyV and KIPyV was analyzed in respiratory, urine, and blood samples from renal transplant patients compared with healthy individuals. WUPyV and KIPyV were detected by nested PCR. The PCR products were sequenced and viral DNA loads were determined by quantitative real-time PCR. WUPyV and KIPyV were found in plasma (3.6%; 7/195), urine (14%; 7/50), and respiratory samples (10%; 9/90) of renal transplant patients, but not in plasma (0/200) and urine (0/36) specimens from healthy blood donors. WUPyV and KIPyV were detected mainly early after renal transplantation and the viral loads were low. A higher prevalence of WUPyV was found in plasma and urine samples, KIPyV was found more frequently in respiratory samples from renal transplant patients. It is hypothesized that immunosuppression due to the transplantation may result in reactivation of these viruses or may establish greater susceptibility to infection with KIPyV and WUPyV.     

Six-minute walk test in adults with cerebral palsy. A study of reliability

OBJECTIVE: To determine the reliability of a six-minute walk test in adults with cerebral palsy. DESIGN: Four repeated walk tests during two weeks. SETTING: The tests were conducted in a 40-m-long corridor at a rehabilitation centre for outpatients. SUBJECTS: Twenty-five adults (9 women and 16 men) with CP. Mean age 36 (26-58) years. Twelve subjects walked with walking aids and 13 without. Interventions: No intervention. MEASURES: The subjects were instructed to walk as far as possible for 6 min. The distance walked, heart rate and perceived exertion were assessed. RESULTS: Mean distances walked by the subjects in the four tests were 316, 336, 341 and 345 m. The repeatability between test 1 and the other tests was 66 m, and when the first walk test was excluded 40 m. The coefficient of variation (CV) between test 1 and the other tests varied between 7.1 and 8.7%, and when the first walk test was excluded between 3.7 and 4.5%. Intraclass correlation (ICC 1.1) was 0.97 in the four tests, and when the first walk test was excluded 0.99. Walking distance was longer (P<0.01) and varied less in subjects walking without walking aids (n = 13) compared with subjects using walking aids (n = 12). CONCLUSIONS: Six-minute walk test showed high reliability, with a repeatability of 40 m. One practice test is recommended, as the walking distance in the first test was significantly shorter (P<0.01) than the other three tests.