Effect of storage and ultraviolet B irradiation on CD14-bearing antigen- presenting cells (monocytes) in platelet concentrates

BACKGROUND: Ultraviolet B (UVB) irradiation of platelet concentrate (PCs) reduces platelet alloimmunization, but the mechanism of the effect is unclear. Evidence suggests that UVB may downregulate the expression of surface adhesion molecules on passenger antigen- presenting cells in PCs. STUDY DESIGN AND METHODS: The effect of blood bank storage, platelet preparation from whole blood, and UVB irradiation on the quantitative expression of intercellular adhesion molecule-1 (ICAM-1, or CD54), HLA-DR, CD45, and CD11c on CD14-positive antigen-presenting cells (monocytes) was studied by using two-color flow cytometry. RESULTS: Blood bank storage for 4 days resulted in upregulation of ICAM-1 and HLA-DR and downregulation of CD14 but left the expression of CD11c and CD45 unchanged. Preparation of PCs from fresh whole blood was associated with a rapid increase in CD11c without upregulation of ICAM-1 and HLA-DR. UVB irradiation before storage inhibited the upregulation of ICAM-1 and HLA-DR, resulted in accelerated downregulation of CD14, and was associated with increased loss of monocytes. Agitation of the PC bag during irradiation was of critical importance, since omission of agitation resulted in largely uninhibited upregulation of ICAM-1 but was still associated with significantly higher cell loss than that seen in unirradiated controls. CONCLUSION: UVB exposure nonspecifically affects monocytes in PCs, resulting in downregulation of surface molecules that are important for antigen presentation, as well as in significant cell loss.     

术前预防性使用抗生素对剖宫产切口感染的影响

目的探讨术前预防性使用抗生素对剖宫产术后切口感染的影响。方法以2012年1月至2014年1月间我院收治的106例剖宫产孕妇为研究对象,随机分为术前应用抗生素组(观察组)及术后应用抗生素组(对照组)各53例。比较两组患者术中出血量、术后体温及血液学检查结果,观察患者术后感染情况。结果观察组术中出血量为165.4 mL,对照组为159.2 mL,两组之间差异无统计学意义(P>0.05);观察组甲级愈合率为96.2%,对照组甲级愈合率为90.6%,两组之间差异有统计学意义(P<0.05);观察组术后最高体温>38℃者4例、对照组术后最高体温>38℃者7例,两组之间差异无统计学意义(P>0.05);观察组C反应蛋白异常升高者2例,对照组术后C反应蛋白异常升高者9例,两组之间差异有统计学意义(P<0.05);观察组术后腹部切口感染、产褥感染例数分别为1例和1例,对照组术后腹部切口感染、产褥感染例数分别为5例和3例,两组之间差异有统计学意义(P<0.05);两组术后各有1例泌尿系统感染病例,差异无统计学意义(P>0.05)。结论术前预防性使用抗生素降低患者术后切口感染的发生,有利于切口愈合。     

G-CSF及与辛伐他汀联合应用对大鼠急性心肌梗死后细胞凋亡的影响

随着凋亡相关研究的进展,心肌细胞凋亡与心肌梗死(acute myocardial infarction,AMI)的关系逐渐受到重视.本实验联合应用粒细胞集落刺激因子(granulocyte-colony stimu-lating factor,G-CSF)和辛伐他汀动员干细胞修复AMI后的梗死心肌,通过流式及免疫组化法检测细胞凋亡率和BCL-2/BAX比值,评价其干细胞动员作用对梗死后心肌细胞凋亡的影响.     

Effect of climate therapy at Gran Canaria on vitamin D production, blood glucose and lipids in patients with psoriasis

Background Climate therapy (heliotherapy) of psoriasis is an effective and natural treatment. Ultraviolet radiation (UVB) from the sun improves psoriasis and induces vitamin D₃ synthesis. Objective The aim of the study was to investigate the effect of climate therapy on vitamin D₃ synthesis, blood glucose, lipids and vitamin B12 in psoriasis patients. Methods Twenty Caucasian patients (6 women and 14 men; mean age, 47.2 years; range, 24–65) with moderate to severe psoriasis [mean Psoriasis Area and Severity Index (PASI) score 9.8; range, 3.8–18.8] received climate therapy at the Gran Canarias for 3 weeks. Blood samples were drawn before and after 15 days of sun exposure. In addition, the patients’ individual skin UV doses based on UV measurements were estimated. Results Sun exposure for 15 days lead to a 72.8% (± 18.0 SD) reduction in the PASI score in psoriasis patients. Although no direct correlation was observed between PASI score improvement and UVB dose, the sun exposure improved the vitamin D, lipid and carbohydrate status of the patients. The serum concentrations of 25‐hydroxyvitamin D [25(OH)D] increased from 57.2 ± 14.9 nmol/L before therapy to 104.5 ± 15.8 nmol/L (P < 0.0001) after 15 days of sun exposure; the serum levels of 1,25‐dihydroxyvitamin D [1,25(OH)₂D] increased from 146.5 ± 42.0 to 182.7 ± 59.1 pmol/L (P = 0.01); the ratio of low‐density lipoprotein cholesterol and high‐density lipoprotein cholesterol decreased from 2.4 to 1.9 (P < 0.001); and the haemoglobin A₁c (HbA₁c) levels decreased from 5.6 ± 1.7% to 5.1 ± 0.3% (P < 0.0001). Conclusion Climate therapy with sun exposure had a positive effect on psoriasis, vitamin D production, lipid and carbohydrate status.     

The effect of recombinant GM-CSF on the recovery of monkeys transplanted with autologous bone marrow

The regulatory function of recombinant human granulocyte-macrophage colony stimulating factor (rhGM-CSF) on granulocyte production in vivo was evaluated in an autologous bone marrow transplantation model using rhesus monkeys. Monkeys were exposed to 9.0 Gy total body irradiation and then transplanted with 5.0 x 10(7) low-density bone marrow cells/kg. Alzet miniosmotic pumps were subcutaneously implanted to deliver rhGM-CSF at a rate of 50,400 U/kg/d. Minipumps, containing either rhGM-CSF or saline, were implanted between zero and five days after transplantation for seven days. Kinetic recoveries of peripheral blood cells after either saline or rhGM-CSF treatment were compared. Treatment with rhGM-CSF accelerated the recovery of neutrophils. Neutrophils in rhGM-CSF-treated animals recovered to 80% (3.4 x 10(3)/mm3) pre-irradiation control levels by day 20, in comparison with only 33% (0.9 x 10(3)/mm3) recovery for saline control monkeys. In addition, the recovery of neutrophils was enhanced over that of the controls, reaching 140% v 70% on day 30. Another prominent feature of rhGM-CSF-treated monkeys was the accelerated recovery of platelets, reaching near 50% normal levels by day 24 in comparison with 20% of normal levels for controls. The infusion of rhGM-CSF was shown to be an effective regulator of early hematopoietic regeneration, leading to the accelerated recovery of both neutrophils and platelets and then providing a consistent sustained increase of neutrophils even in the absence of rhGM-CSF.     

耳后进路夹层法与内植法鼓膜修补术疗效比较

【目的】探讨并比较耳后进路夹层法与内植法鼓膜修补术疗效。【方法】收集需行鼓膜修补术患者80例（92耳）,按手术方法分为夹层法组42例（46耳）与内植法组38例（46耳）。分别观察两组术后听力恢复情况、术前术后言语频率平均听阈、术后3个月鼓膜情况、术后6个月愈合率。【结果】术后听力恢复情况夹层法优于内植法（P ＜0．05）;夹层法术后言语频率平均听阈明显高于内植法（P ＜0．01）;术后随访3个月后两组引起再穿孔、鼓膜内陷的发生有统计学差异（ P ＜0．05）;术后6个月愈合率比较,夹层法优于内植法,两组有统计学差异（ P ＜0．05）。【结论】耳后进路夹层法与内植法鼓膜修补术短期疗效相当,但前者更有利于听力恢复,是治疗鼓膜穿孔的较为理想的方法。     

甲氧西林耐药／敏感金黄色葡萄球菌基因分型和毒力基因检测

目的：分析耐甲氧西林金黄色葡萄球菌（金葡菌）（MRSA）和甲氧西林敏感金葡菌（MSSA）临床分离株基因分型及毒力基因分布特征是否存在差异,了解金葡菌耐药性演变与毒力变迁之间的相关性。方法采用脉冲场凝胶电泳（PFGE）方法和多位点序列分型（MLST）方法对呼和浩特地区住院患者中分离的30株 MRSA 和30株 MSSA 进行分子分型,同步采用聚合酶链反应（PCR）方法检测菌株毒力基因。结果60株金葡菌 PFGE 分型共分19个型,MSSA 菌株分布在 I 和 H 型等16个基因型中,而 MRSA 株主要集中分布在 K 和 M 2个基因型中。20株不同 PFGE 型菌株 MLST 分型结果显示,MRSA 株主要为 ST-239型;MSSA 株呈多样性分布特征,主要以 ST-5型、ST-7型、ST-15型为主。毒力基因在 MRSA 和 MSSA 中分布差异显著。MSSA 毒力基因整体携带率明显高于 MRSA（53．9％对40．0％,χ2＝32．7,P ＜0．01）。MRSA 株 sea、cna 和 cap 8基因携带率明显高于 MSSA 携带率（P ＜0．01）,而 sec、seg 、sei、sem、sen、seo、fnbB、ebpS、cap5基因携带率明显低于 MSSA（P＜0．05）。结论呼和浩特地区金葡菌临床分离株基因型呈现多样化分布特点,MRSA 主要以 ST-239型为主。MSSA 毒力基因携带率高,特定毒力因子在 MRSA 和 MSSA 株中呈现一定聚集分布特征,金葡菌特定耐药性的获得可能伴随特定毒力特征的变化。     

糖尿病人群中胰岛素和游离脂肪酸水平的相关性研究

目的探讨糖尿病人群中胰岛素和游离脂肪酸水平的相关性。方法选取2009年1月至2014年8月成都市第四人民医院就诊的2型糖尿病患者及同期门诊体检的健康人群,观察比较各人群各项生化指标。结果 2组人群生化特征比较,其中体质量指数、空腹血糖、餐后2h血糖、空腹血清胰岛素(FINS)、三酰甘油、高密度脂蛋白胆固醇、游离脂肪酸(FFA)、胰岛素敏感指数(IAI)差异有统计学意义(P0.05);糖尿病组中FINS与FFA呈正相关(r=0.678,P0.05),IAI与FFA呈负相关(r=-0.654,P0.05)。健康组FINS与FFA呈正相关,相关系数为0.447(P0.05)。结论糖尿病人群血清FFA升高,胰岛素分泌增加,IAI下降,而健康人群血清FFA升高与胰岛素分泌增加有关。