体外培养脂肪组织来源干细胞与胶原/壳聚糖复合支架的亲和性

目的：制备适合脂肪组织来源的干细胞生长的支架,观察复合支架各组成的体积比率与细胞培养的亲和性. 方法：实验于2006-09/2007-01在大连理工大学干细胞与组织工程研发中心完成.①实验方法：将3.55 g/L Ⅰ型胶原和20 g/L壳聚糖分别以9∶1,7∶3,5∶5,3∶7,1∶9的体积比混合冻干,碳化二亚胺/N-羟基琥珀酰亚胺交联后再次冻干并进行分析.②实验评估：扫描电镜观察不同材料交联前后的微观结构;IPP软件分析计算支架的平均孔径;测量支架的吸水性和孔隙率;通过胶原酶检测支架的体外生物可降解性;扫描电镜和苏木精-伊红染色观察脂肪组织来源的干细胞在复合支架上的生长情况. 结果：①交联前后的微观结构：冻干后的各种支架材料呈白色,表面粗糙,材料内部呈海绵状多孔隙结构,其中以胶原/壳聚糖体积比为9∶1的复合支架最为疏松,1∶9的支架最致密.扫描电镜下支架的胶原含量越高,支架内的胶原丝越多,支架的孔与孔之间相互连通构成了通孔.交联前后支架的形态结构无明显改变.②支架的平均孔径∶交联后体积比为9∶1,7∶3和5∶5的复合支架孔径50～200 μm,可用于细胞的三维培养.③支架的吸水性和孔隙率∶体积比为5∶5的复合支架的吸水性和含水量最高,而7∶3次之;多孔支架在水中未发生明显的溶胀现象;支架的孔隙率均在90%以上.④支架的体外生物可降解性：未交联的支架随着胶原含量的减少,支架的降解速率增加.而交联后随着胶原含量的减少,降解速率减慢,交联后的复合支架降解速度较未交联慢.⑤脂肪组织来源的干细胞在复合支架上的生长情况：脂肪组织来源的干细胞在支架上培养5 d后扫描电镜观察细胞在7∶3的支架上爬行生长并融合成片,苏木精-伊红染色观察支架孔内及表面出现大量的细胞团,并融合成片状,而5∶5支架上黏附生长的细胞较少. 结论：结合支架的孔径、吸水性、孔隙率、体外生物可降解性和细胞与支架的生物相容性,可知体积比为7∶3的复合支架对脂肪组织来源的干细胞的亲和性较好,适于脂肪组织来源的干细胞的三维培养.     

Direct medical costs of liquid intravenous immunoglobulins in children, adolescents, and adults in Spain

The aim of this study was to determine health care resource utilization and direct medical costs in Spanish patients treated with intravenous immunoglobulins (IVIGs) in 2009. Cost-of-illness analyses were performed to estimate direct medical costs of patients treated with IVIGs. Prevalence data were obtained from the Spanish Primary Immunodeficiency registry. A semi-structured questionnaire was used to collect data on health care resource utilization and patient distribution. Drug, administration, and premedication costs were considered from the payer's perspective. Separate analyses were conducted for children and adolescents versus adults. The numbers of children and adolescents with replacement therapy were 724, with immunomodulation 243, and with allogeneic bone marrow transplantation 30. The numbers of adult patients were, respectively, 3450, 1134, and 172. Mean annual costs for children and adolescents were 6293 € with Privigen, 6292 € with Kiovig, 6939 € with Flebogamma, and 6559 € with Octagamocta. For adults, estimations were 17 106 € with Privigen, 17 103 € with Kiovig, 18 077 € with Flebogamma, and 17 423 € with Octagamocta. Direct medical costs for IVIGs were approximately 91.8 million €. Drug costs represented 94% of total costs. The choice for a certain IVIG treatment depends on individual patient characteristics and cost considerations.     

胶原肽联合钙尔奇D治疗绝经后骨质疏松患者疗效分析

目的 研究胶原肽联合钙尔奇D对绝经后骨质疏松患者的疗效分析。方法 202例绝经后骨质疏松症患者随机分为试验组(每天口服胶原肽10 g联合钙尔奇D 600 mg)和对照组（口服钙尔奇D 600 mg）,进行为期6个月的治疗。利用化学发光法检测血清总骨1型前胶原N端肽(N-propeptide of type 1 collagen,PINP）、β-I型胶原交联羧基末端肽（C-terminal crosslinked telopeptides of type 1 collagen,β-CTX）、血清骨钙素（osteocalcin,OC）、25-羟维生素D3[25 hydroxy vitamine D3,25(OH)D3]、甲状旁腺素(parathyroid hormone,PTH)。利用双能X线(dual energy X-ray absorptiometry,DXA)吸收法进行腰椎、股骨骨密度(bone mineral density,BMD)检测。结果 治疗6个月后,口服胶原肽联合钙尔奇D能够更有效地缓解骨质疏松导致的骨痛。试验组患者血清PTH、25(OH)D3及OC水平明显高于治疗前(P＜0.01)及对照组（P＜0.01）。对照组患者治疗后血清PINP水平明显低于治疗前(P＜0.01）,而PTH、25(OH)D3、β-CTX水平明显高于治疗前(P＜0.01)。试验组患者治疗后血清PINP水平明显高于对照组（P＜0.01）,而β-CTX水平低于对照组（P＜0.05）。试验组患者腰椎L2、L4及股骨颈、粗隆间BMD明显高于治疗前(P＜0.01）及对照组(P＜0.05）。试验组患者各部位BMD均显著高于治疗前(P＜0.01）;而对照组患者治疗后上述各指标差异无统计学意义(P＞0.05)。结论 口服胶原肽联合钙尔奇D既能促进骨形成,又能抑制骨吸收,进一步增加BMD,并且可以缓解骨质疏松引起的疼痛。     

用改良消减法克隆类风湿性关节炎滑膜细胞中的高表达基因

0　引言　在类风湿性关节炎 (rheumatoid arthritis,RA)中 ,关节内滑膜细胞 (fibroblast- like synovial cells,FL S)的过度增生是造成关节软骨破坏和关节畸形的关键环节 ,为了研究滑膜细胞发生增殖的机制 ,我们采用赵忠良等人设计的改良消减杂交法[1 ] ,并以骨性关节炎 (osteoarthritis,OA)滑膜细胞为对照筛选 RA滑膜细胞中的高表达基因 .1　方法　将 RA滑膜细胞和 OA滑膜细胞分别设定为实验组和扣除组 ,用扣除组的 c DNAs杂交扣除掉实验组中与前者相同的 c DNAs,得到的就是目的产物 :实验组中高拷贝数的或独有的 c DNAs,也就是 …     

一测多评法同时测定蒙药吉如合-6中6种成分含量

目的 利用一测多评法同时测定蒙药吉如合-6中鞣花酸、肉桂酸、丁香酚、木香烃内酯、去氢木香内酯、去氢二异丁香酚等6种成分的含量,并验证该方法在蒙药吉如合-6质量控制研究中的可行性与科学性。方法 采用一测多评法;供试品采用75%甲醇回流提取;以丁香酚为内标物,测定其他5种成分相对校正因子(?_k/m);采用一测多评法与外标法进行含量计算、比对。结果 所测定的鞣花酸、肉桂酸、丁香酚、木香烃内酯、去氢木香内酯、去氢二异丁香酚等6种成分分别在其各自范围内有良好的线性关系(即r>0.999 9),平均加样回收率为94.80%～98.85%,RSD<2.0%,外标法与一测多评法所测得结果之间相对误差<2%。结论 一测多评法操作简便、准确可行、重复性好,可用于蒙药吉如合-6的质量控制。     

KAP surveys and malaria control in Vietnam: findings and cautions about community research

The malaria disease burden is increasing in many countries despite the existence of effective preventative strategies and antimalarial drugs. An understanding of community perspectives and practices is one of the essential components of a successful malaria control program. This paper reports on a KAP (Knowledge, Attitudes and Practices) survey among the Raglai ethnic minority population in Ninh Thuan Province, Vietnam, which in 2003 had one of the country's highest confirmed rates of malaria. We found high levels of correct knowledge about malaria's transmission and symptoms, and self-reports of adequate bed net usage and appropriate health-seeking behavior. While the survey generated useful findings, an initial, qualitative investigation (eg, observation and focus group discussions) to explore the large numbers of potential influences on behavior and exposure risk would have provided a more robust underpinning for the design of survey questions. This would have strengthened its validity and generated additional information. The adoption of rigorous, multi-disciplinary research methods offers the best chance of contributing to the development of successful malaria control programs and effective policies.     

蒙药材蓝盆花指纹图谱及一测多评含量测定方法研究

目的： 建立蒙药材蓝盆花的HPLC指纹图谱及一测多评法同时测定绿原酸、木犀草苷、异绿原酸A及异绿原酸C 4个成分的含量,评价药材质量。方法： 采用Kromasil 100-5-C₁₈色谱柱（250 mm×4.6 mm,5 μm）,以乙腈-0.2%磷酸溶液为流动相,梯度洗脱,流速1.0 mL·min^-1,检测波长分别为326 nm（含量测定）和350 nm（指纹图谱）,柱温30℃。以17批样品建立指纹图谱共有模式。以异绿原酸A为内参物,建立绿原酸、木犀草苷、异绿原酸C与内参物的相对校正因子,计算含量,并与外标法计算结果进行比较。结果： 建立了蓝盆花药材的HPLC指纹图谱,标示了10个共有峰,并指认其中的7个色谱峰,分别为绿原酸、木犀草苷、异绿原酸A、大波斯菊苷、异绿原酸C、木犀草素、芹菜素。相对校正因子重现性良好,以异绿原酸A为内参物采用校正因子计算的含量值与实测值之间无显著差异。结论： 采用指纹图谱与多指标检测模式可为评价蒙药材蓝盆花的质量提供有效方法。     

Human disorders of cortical development: from past to present

Epilepsy and mental retardation, originally of unknown cause, are now known to result from many defects including cortical malformations, neuronal circuitry disorders and perturbations of neuronal communication and synapse function. Genetic approaches in combination with MRI and related imaging techniques continually allow a re-evaluation and better classification of these disorders. Here we review our current understanding of some of the primary defects involved, with insight from recent molecular biology advances, the study of mouse models and the results of neuropathology analyses. Through these studies the molecular determinants involved in the control of neuron number, neuronal migration, generation of cortical laminations and convolutions, integrity of the basement membrane at the pial surface, and the establishment of neuronal circuitry are being elucidated. We have attempted to integrate these results with the available data concerning, in particular, human brain development, and to emphasize the limitations in some cases of extrapolating from rodent models. Taking such species differences into account is clearly critical for understanding the pathophysiological mechanisms associated with these disorders.     

Functional Outcomes After Limb-Salvage Surgery and Endoprosthetic Reconstruction With an Expandable Prosthesis: A Report of 4 Cases

Beebe K, Song KJ, Ross E, Tuy B, Patterson F, Benevenia J. Functional outcomes after limb-salvage surgery and endoprosthetic reconstruction with an expandable prosthesis: a report of 4 cases.

Objective

To determine the functional outcomes of skeletally immature patients after replacement of the femur and tibia performed by using noninvasive expandable endoprostheses.

Design

Case series.

Setting

A hospital-based ambulatory care center.

Participants

Pediatric patients (N=4) with primary bone tumors of the distal femur and proximal tibia who underwent surgical replacement performed by using the Repiphysis noninvasive expandable endoprosthesis (Wright Medical Technology, Memphis, TN).

Interventions

Wide resection of bone sarcoma and placement of expandable endoprosthesis.

Main Outcome Measures

Musculoskeletal Tumor Society (MSTS) scores were assessed at the beginning of the study and at each follow-up visit. Medical Outcomes Study 36-Item Short-Form Health Survey, Version 2 (SF-36); gait; sit-to-stand transition; and range of motion (ROM) were assessed at an average follow-up of 31.5 months.

Results

At an average of 31.5 months postoperative, the SF-36 physical component summary scores lagged behind the national mean, whereas the mental component summary scores were satisfactory. MSTS scores indicated low levels of pain and supports use with high emotional acceptance and walking ability but persisting difficulties with function and gait. Patients also showed altered patterns of sit-to-stand transition including decreased peak vertical force in the operated limb and increased center of mass momentum in a shorter amount of time. Parts of gait functioning were found to be decreased, including gait velocity, stride length, and cadence. Some patients displayed alternate weight-bearing strategies that accompanied increased double-limb support and stance phase during walking. ROM and strength were diminished at both the hip and knee joints in the operated limb and in the nonoperated limb.

Conclusions

Reconstruction with a noninvasive expandable endoprosthesis produces satisfactory functional outcomes in pediatric patients with primary tumors of the bone. Patients in our study displayed some persisting physical difficulties including decreased ROM and strength and altered gait and sit-to-stand patterns, yet they maintained high levels of emotional acceptance and coping.