Recipient Myd88 Deficiency Promotes Spontaneous Resolution of Kidney Allograft Rejection

The myeloid differentiation protein 88 (MyD88) adapter protein is an important mediator of kidney allograft rejection, yet the precise role of MyD88 signaling in directing the host immune response toward the development of kidney allograft rejection remains unclear. Using a stringent mouse model of allogeneic kidney transplantation, we demonstrated that acute allograft rejection occurred equally in MyD88-sufficient (wild-type [WT]) and MyD88^−/− recipients. However, MyD88 deficiency resulted in spontaneous diminution of graft infiltrating effector cells, including CD11b⁻Gr-1⁺ cells and activated CD8 T cells, as well as subsequent restoration of near-normal renal graft function, leading to long-term kidney allograft acceptance. Compared with T cells from WT recipients, T cells from MyD88^−/− recipients failed to mount a robust recall response upon donor antigen restimulation in mixed lymphocyte cultures ex vivo. Notably, exogenous IL-6 restored the proliferation rate of T cells, particularly CD8 T cells, from MyD88^−/− recipients to the proliferation rate of cells from WT recipients. Furthermore, MyD88^−/− T cells exhibited diminished expression of chemokine receptors, specifically CCR4 and CXCR3, and the impaired ability to accumulate in the kidney allografts despite an otherwise MyD88-sufficient environment. These results provide a mechanism linking the lack of intrinsic MyD88 signaling in T cells to the effective control of the rejection response that results in spontaneous resolution of acute rejection and long-term graft protection.     

三种膳食结构对去卵巢大鼠骨量和骨结构的影响

目的 比较不同膳食结构对去卵巢大鼠（OVX）骨量和骨结构的影响。方法 30只去卵巢大鼠随机分为3组,分别以基础、高脂和黄豆饲料喂养3个月。每周称体重一次,结算各组大鼠每天的摄食量。3个月后,采血测血清血脂水平、血钙、血磷和雌二醇;双能X线骨密度仪测定实验前、后大鼠全身、脊柱和股骨骨密度;取一侧股骨制备脱钙骨切片,进行骨形态学观察和骨计量学测定。结果 1、各组大鼠每天食物摄入量、血钙和血磷无统计学差异。2、黄豆饲料组大鼠体重最小(P<0.05);血清E2水平最高(P<0.05);全身、股骨和脊柱BMD均最高(P<0.05);骨小梁数量最多、骨小梁面积和厚度均最大(P<0.05)。而高脂饲料组大鼠体重最大(P<0.05);TG和LDL水平最高,HDL最低 (P<0.05);全身、股骨和脊柱BMD均最低(P<0.05),高脂饲料与基础饲料相比,骨小梁数量无差异,但骨小梁面积和厚度较大(P<0.05)。结论 从绝经后骨质疏松预防角度来说,富含黄豆的饮食较高脂饮食是一种较好的膳食结构;后者可能加速了女性的骨丢失。     

维持性血液透析患者血红蛋白波动的临床研究

目的了解维持性血液透析患者血红蛋白(Hb)波动情况,初步探讨Hb波动的影响因素。 方法选取复旦大学附属中山医院血液透析中心透析龄超过12个月的患者。以Hb110～120 g/L为靶目标值,根据前后两个月的Hb变化值是否达到10 g/L分为波动组和非波动组。应用多因素Logistic回归分析Hb波动的影响因素。 结果共163例患者,基线Hb值为(107.52±15.47)g/L,随访期平均Hb值为(106.57±15.22)g/L。基线及随访期Hb达标情况大致相似,46.6%～56.4%患者Hb未达标(Hb<110 g/L)。随访期中仅有1.2%患者Hb始终达标。患者平均Hb波动值为8.15±5.01 g/L,Hb波动率为27.0%,短期波动在大多数血液透析患者中较常见,少数患者Hb长期处于不稳定状态。非波动组患者的透析龄和基础Hb值显著高于波动组(t＝－5.602, P＝0.048; t＝－1.731, P＝0.010),促红细胞生成素(EPO)剂量显著低于波动组(t＝6.218, P<0.001)。多因素Logistic回归分析显示,经过透析龄<24个月、基础Hb<100 g/L等因素校正后,EPO剂量≥200 U/(kg·w)与Hb波动显著独立相关(OR＝4.7,95%CI 3.2～9.3,P＝0.030)。 结论Hb波动在维持性血液透析患者中普遍存在,少数患者Hb长期处于不稳定状态。Hb波动较大的维持性血液透析患者EPO剂量应用也较大。     

不同钙浓度腹膜透析液对长期CAPD患者矿物质和骨代谢影响的分析

目的观察腹膜透析液钙离子浓度对持续性不卧床腹膜透析(CAPD)患者矿物质和骨代谢的影响。 方法回顾性分析我院腹膜透析中心行CAPD治疗2年以上的123例患者,根据腹膜透析液钙离子浓度分为低钙腹膜透析液组(LCD组,钙离子浓度为1.25 mmol/L)和标准钙腹膜透析液组(SCD组,钙离子浓度为1.75 mmol/L),观察不同钙浓度腹膜透析液对患者血清钙、磷、全段甲状旁腺激素(iPTH)、颈动脉厚度、心脏瓣膜钙化及骨痛、皮肤瘙痒等情况的影响。使用SPSS 18.0统计软件包进行数据处理。 结果2组患者治疗前人口学特征、腹膜转运特性、钙磷代谢等指标的基线水平差异无统计学意义(P>0.05)。治疗2年后,2组患者血钙浓度及达标率较治疗前均显著增高(P<0.05),SCD组血钙浓度增幅高于LCD组,但差异无统计学意义(0.26±0.31 mmol/L与0.17±0.29 mmol/L, t＝1.621,P＝0.108);2组间治疗后血清钙、磷、iPTH平均水平及其达标率、颈动脉厚度、心脏瓣膜钙化比例、骨痛及皮肤瘙痒累计发生率差异均无统计学意义(P>0.05);LCD组活性维生素D使用比例显著高于SCD组(χ² ＝6.373,P<0.05)。 结论采用低钙与标准钙腹透液治疗2年,对CAPD患者矿物质和骨代谢的影响无显著性差异。     

利用PDMS微孔阵列微型反应器设计hADSCs空间堆叠模型

目的 利用微尺度技术(Micro-scale technologies)建立人脂肪干细胞(h ADSCs)体外三维培养平台,观察空间堆叠状态对种植后的h ADSCs增殖和凋亡的影响。方法 利用光刻技术在硅晶元表面生成直径60μm、80μm、100μm和150μm的微柱状结构,经聚二甲基硅氧烷(PDMS)倒模、固化生成同规格的微孔阵列(Micro-well arrays),加装PDMS环形外壁后组成微型反应器,测量、分析此实验平台的加工误差率;第3代h ADSCs配制成1×105cells/m L、6×104cells/m L、3×104cells/m L三种浓度单细胞悬液,并各取200μL分别接种于纯平PDMS微型反应器及直径60μm、80μm、100μm和150μm微孔微型反应器内,选择种植后24 h、72 h、120 h和168 h为采样点,对各观察组细胞分布状况进行形态学描述、细胞计数及活/死细胞检测。结果 各孔径PDMS微孔阵列的微孔口径精度误差率均不超过0.2%;档h ADSCs以6×104cells/m L浓度接种时,细胞基本可以实现在150μm微孔内呈单层平铺、100μm微孔内呈2层堆叠、80μm微孔内呈3层堆叠;各微孔内细胞数在7 d内均无明显的数量变化,60μm组微孔内细胞数最少且微孔外平面残留细胞最多(P<0.05);60μm组微孔内凋亡细胞比例高于其他组(P<0.05)。结论 微加工倒模制作的PDMS微孔阵列培养平台误差率低,可满足高精度设计需要;h ADSCs短时间(7 d)接种于微孔内处于增殖静止状态,能够保持三维堆叠状态稳定,便于进行堆叠状态下的细胞学早期研究;h ADSCs在不同口径微孔内可以实现不同的堆叠层数,其凋亡比率与堆叠层数有关,堆叠层数少的细胞凋亡比例低于堆叠层数多者。     

隆鼻术中扁圆形前鼻孔的联合治疗

目的 探讨隆鼻术中扁圆形前鼻孔塑形的手术方式。方法 2014年12月至2015年5月,对57例先天性鼻孔扁圆横向者,采集术前术后数字图像并测量数据。从鼻外切口入路,通过采用两侧大翼软骨拉拢缝合、鼻小柱-上唇皮瓣推进法、自体软骨/假体植入等,达到全鼻形态的综合塑形。结果 所有患者切口一期愈合,鼻孔方向和角度明显改善,术后效果满意。术后随访6~12个月,可见切口瘢痕隐蔽,鼻孔形态无复发,无并发症出现。结论 通过两侧大翼软骨拉拢缝合、鼻小柱-上唇皮瓣推进,可有效调整鼻孔形态。     

Low expression of HIV genes in podocytes accelerates the progression of diabetic kidney disease in mice

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Investigating the effects of walnut ointment on non-healing burn wounds

Effective treatments for non-healing burn wounds are an unmet need for 95% of burn sufferers. Approaches currently available to treat non-healing burn wounds are not satisfactory due to undesirable side-effects or expense. The anti-oxidation and antibacterial activities of walnuts are recommended for treating chronic diseases. Walnut ointment has been developed and successfully applied to treat non-healing burn wounds in our hospital for decades. We report herein a detailed retrospective case review examining patients’ response to the walnut ointment. The walnut ointment has shortened healing time of non-healing burn wounds and improved clinical outcomes. In order to investigate the mechanism of action, walnut ointment has been applied on wounds of porcine full-thickness burn wound models. Histological and immunohistochemical analysis indicated our walnut ointment supports wound healing through promoting keratinocyte proliferation and differentiation. Taken together, we recommend the walnut ointment offers an effective and economical treatment for patients presenting with non-healing burn wounds.