角膜移植260例病因分析并与国外数据比较

目的:总结进行角膜移植手术患者的病因学资料,并与国外相应统计资料比较。方法:收集2001-12/2005-12在南昌大学医学院第一附属医院眼科接受角膜移植手术的260例患者(260眼)的临床资料做以统计,内容包括性别、年龄,与角膜移植相关的临床诊断、手术方法等,患者均知情同意。患者的病种统计以出院时第一诊断为基准。260例患者中行单纯板层角膜移植125例,单纯穿透性角膜移植63例,联合羊膜覆盖33例,联合角膜缘干细胞移植术20例,联合结膜瓣遮盖术19例。术后半年进行视力评估,视力<3.7为盲。结果:260例角膜移植患者全部进入结果分析,无脱落。①260例患者中男162例,女98例,年龄(24±19)岁。角膜移植的病因按病例数由多至少排列,首位为角膜炎后角膜白斑,计86例(占3.08%),尤以病毒性角膜炎为主;外伤后角膜疤痕病变居第2位,计78例(占30%),随后为角膜溃疡并穿孔、蚕食性角膜溃疡、圆锥角膜、角膜皮样瘤、角膜营养不良、角膜失代偿、角膜葡萄肿以及角膜原位癌。角膜炎后角膜白斑病毒性角膜炎后最为多见,而国外类似的统计表明大泡性角膜病变占据首位。②术后半年260例角膜移植患者的脱盲率达94%。结论:与发达国家角膜移植最常见病因为大泡性角膜病变不同,角膜炎后角膜白斑、外伤后角膜疤痕、角膜溃疡并穿孔依次是国内角膜移植最常见的原因。     

Characterization of the neutrophil molecules identified by quinine- dependent antibodies from two patients

BACKGROUND: Two patients with episodic pancytopenia and renal failure associated with quinine (Qn) ingestion were previously found to have Qn- dependent antibodies that reacted with red cells, platelets, and neutrophils. The purpose of these studies was to characterize the neutrophil antigens recognized by Qn-dependent antibodies from these two patients. STUDY DESIGN AND METHODS: The neutrophil molecules recognized by the Qn-dependent antibodies in the sera from the two patients were analyzed by immunoprecipitation using 125I-labeled neutrophils. Neutrophils from 13 different donors were tested. RESULTS: The Qn-dependent antibodies from Patient 1 immunoprecipitated a 60-kDa molecule on neutrophils from seven donors and an 85-kDa molecule on neutrophils from three donors. The Qn-dependent antibodies from Patient 2 reacted with a 32-kDa molecule on neutrophils from 5 donors, a 60-kDa molecule on neutrophils from 9 donors, and an 85-kDa molecule on neutrophils from 10 donors. Neutrophil-specific antigen NB1 is also located on a 60-kDa glycoprotein (GP). While the antibody in serum from Patient 1 did not show specificity for NB1, the antibody from Patient 2 detected the 60-kDa molecule on NB1-positive neutrophils from 9 of 11 donors tested and did not detect the 60-kDa molecule on NB1-negative neutrophils from 2 donors. In a monoclonal antibody immobilization of granulocyte antigens assay, the Qn-dependent antibody from both patients reacted with the 60-kDa molecule carrying NB1. The Qn- dependent antibody from a third patient, Patient 3, was previously found to react with an 85-kDa GP and the 60-kDa NB1 GP. To determine if the Qn-dependent antibodies from Patients 2 and 3 recognized the same 85-kDa GP, neutrophils were treated with serum from Patient 3 plus Qn to remove the 85-kDa GP. Then, serum from Patient 2 plus Qn no longer immunoprecipitated the 85-kDa GP. CONCLUSION: The antigens recognized by Qn-dependent neutrophil antibodies were located on molecules of 85, 60, and 32 kDa. Qn-dependent antibodies from two patients reacted with the same 85-kDa GP and those from three patients reacted with the same 60-kDa GP. The 60-kDa molecule recognized by the Qn-dependent antibodies carried the NB1 antigen.     

同型半胱氨酸对大鼠血管平滑肌细胞增殖及胶原生成的影响

目的:观察同型半胱氨酸的浓度对Ⅰ,Ⅲ,Ⅳ和Ⅵ型胶原的产生以及大鼠血管平滑肌细胞增殖效应的影响。方法:实验于2005-02/2006-04在瑞金医院心内科实验室完成。①采用组织块贴壁法原代培养大鼠胸主动脉平滑肌细胞,用不同浓度的同型半胱氨酸(0.025,0.05,0.1,0.2,0.5,1.0,1.5,2.0,3.0,5.0 mmol/L)刺激大鼠血管平滑肌细胞,并设对照孔(未加同型半胱氨酸)和空白孔(未加细胞)作对照。②分别作用12,24,48,72h,以四甲基偶氮唑盐法检测同型半胱氨酸对平滑肌细胞的活性细胞数量及细胞增殖情况;以5溴-2脱氧尿苷法检测同型半胱氨酸对大鼠血管平滑肌细胞DNA合成的作用;流式细胞仪观察细胞周期的变化;酶联免疫法测定胶原的含量。结果:①细胞增殖情况:在0.025,0.05 mmol/L的同型半胱氨酸浓度刺激下,12～48h血管平滑肌细胞增殖增加明显。②细胞DNA合成:与四甲基偶氮唑盐结果类似,24～48h时,在浓度为0.025,0.05 mmol/L的同型半胱氨酸刺激下细胞合成DNA增加(24h:432±33,774±52;48h:582±32,816±62),其促增殖作用增强(P<0.05);随着浓度的增加,大鼠血管平滑肌细胞合成DNA开始下降,至5 mmol/L浓度时最低。③细胞周期的变化:24h时在浓度为0.025,0.05 mmol/L的同型半胱氨酸刺激下增殖的细胞S期的百分含量较对照组和同型半胱氨酸其他浓度组明显增加。④胶原的含量:细胞的Ⅰ型和Ⅳ型胶原分泌随着同型半胱氨酸浓度的升高呈现剂量依赖性的增高模式。Ⅲ型胶原有轻度的升高,无统计学上意义。高浓度的同型半胱氨酸会减少Ⅵ型胶原的分泌,并呈剂量依赖性(r2=0.41;P<0.001)。结论:较低浓度的同型半胱氨酸刺激大鼠血管平滑肌细胞的增殖加速;并可能通过改变纤维斑块中的胶原构成类型导致了斑块的不稳定性和易损性,最终加速了粥样斑块的发生和发展。     

木通马兜铃化学成分研究

从木通马兜铃(Aristolochia manshuriensis Kom)茎皮中分得一个新化合物(5),经光谱(IR,UV,HRMS,^{1HNMR,NOEDS)鉴定为3,4-二甲氧基-10-硝基菲-1-羧酸甲酯,命名为马兜铃酸BII甲酯。另11个已知化合物是马兜铃酸Ⅰ,Ⅱ,Ⅲa,Ⅳ,Ⅳa,对羟基桂皮酸,β-谷甾醇,豆甾烷-3,6-二酮,6-羟基-豆甾-4-烯-3-酮,胡萝卜甙,二十八酸甘油单酯;其中二十八酸甘油单酯为首次从该属植物中分得。}