Advanced glycosylation end-products in diabetic rats on peritoneal dialysis using various solutions.

OBJECTIVE: To evaluate and compare the effects of glucose-based solutions to those of icodextrin with respect to peritoneal transport characteristics and advanced glycosylation end-product (AGE) formation in the peritoneal membrane in a diabetic rat model of peritoneal dialysis (PD). DESIGN: Thirty-three male Sprague-Dawley rats weighing between 275-300 g were divided into five groups: group C (n = 6), control rats implanted with a catheter but not dialyzed; group D (n = 5), diabetic rats implanted with a catheter but not dialyzed; group G (n = 7), diabetic rats implanted with a catheter and dialyzed with standard 2.5% glucose solution for daytime exchanges and 4.25% glucose solution for overnight exchanges; group H (n = 8), diabetic rats implanted with a catheter and dialyzed with standard 2.5% glucose solution for daytime exchanges and 7.5% icodextrin solution for overnight exchanges; group I (n = 7), diabetic rats implanted with a catheter and dialyzed with 7.5% icodextrin solution for all exchanges. Dialysis exchanges (25 mL per exchange) were performed three times daily for a period of 12 weeks. Tissue sections were stained using a monoclonal anti-AGE antibody. One-hour peritoneal equilibration tests (PET) were performed every 4 weeks for comparison of transport characteristics. RESULTS: The level of immunostaining was lowest in group C and highest in group G. Significant differences in immunostaining were seen between group C and group G (p < 0.001), group C and group H (p = 0.001), and group C and group I (p < 0.05). Significant differences were also found between group G and group D (p < 0.05), and between group G and group I (p < 0.05). Over time, the ratio of glucose concentration after 1 hour to glucose concentration at instillation (D/D0) decreased and the dialysate-to-plasma ratio (D/P) of urea increased. Significant differences in D/D0 glucose and D/P urea were found between group C and group H (D/D0: 0.40 +/- 0.01 vs 0.35 +/- 0.01, p < 0.05; D/P urea: 0.87 +/- 0.03 vs 0.97 +/- 0.02, p < 0.05). CONCLUSIONS: These results suggest that AGE formation is lower with the use of peritoneal dialysis solution containing icodextrin than with glucose-based solution. We conclude that use of icodextrin may help to slow the deterioration of the peritoneal membrane, prolonging its use for dialysis.     

二羟丙氧甲基乌嘌呤抗单纯疱疹病毒Ⅰ型的实验研究

二羟丙氧甲基鸟嘌岭(DHPG),在组织培养中对单纯疱疹病毒Ⅰ型(HSV-1)KOS株抑制50%空斑形成的浓度(IC_(50))为0.1μg/ml。DHPG与环胞苷联合应用的抗HSV活性呈协同作用;DHPG分别与无环鸟苷、酞丁安合用有相加作用。0.1和0.05%DHPG溶液滴眼对家兔实验性浅层单纯疱疹病毒角膜炎有显著治疗作用,浓度降低至0.025和0.0l%无明显疗效。对实质层型单疱角膜炎,0.1%DHPG溶液滴眼治疗有效。     

Peritonitis in continuous ambulatory peritoneal dialysis: analysis of an 8-year experience

Experiences with peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) program at a single center over 8 years were reviewed. Home-acquired peritonitis rates have been less than 1 episode per patient year since 1982. Gram-positive organisms continue to account for most episodes in a similar proportion. Actual known contamination could be pinpointed in only 7.4% of cases, but was strongly suspected in 35.8% of episodes. Exit site and/or tunnel infections were thought to have caused 20% of the cases. Intrinsic peritonitis probably accounted for 10.5%. Recurrence of peritonitis with the same organisms following cessation of antibiotics represented only 2.1% of cases.     

Diagnostic dilemma of an unsuspected hyperfunctioning accessory parathyroid gland after total parathyroidectomy with autotransplantation in a peritoneal dialysis patient

Persistent or recurrent hyperparathyroidism in patients with chronic renal failure may be a frustrating problem. We report a case history of a peritoneal dialysis patient who underwent total parathyroidectomy with autotransplantation for secondary hyperparathyroidism, developed tertiary hyperparathyroidism, and in an attempt to control hypercalcemia underwent seven partial resections of the autotransplant. Subsequently, a total excision of the parathyroid autograft was performed, but the patient continued to have hyperparathyroidism and unexpectedly was found to have a hyperplastic fifth parathyroid gland identified by thallium-technetium subtraction scan. The fifth gland was removed, and a part was implanted in the right forearm; however, the autoimplant had to be completely removed because of rapidly developing hypercalcemia. Hypercalcemia was controlled, but elevated levels of parathormone persisted. Remaining parathyroid tissue could not be found.     

纳洛酮催瘾试验2例

0　引言　阿片类依赖一般根据 DSM- 3- R标准诊断并不困难 .但有时患者不愿意承认暗中使用阿片类药物 ,而医生需迅速作出有否依赖的判断 ,则需使用纳洛酮催瘾试验 .我们应用此方法催瘾 2例的情况及有关注意事项介绍如下 :1　病例报告　患者 2例 ,男性 ,年龄 2 5和 31岁 ,因卖毒品被公安部门当场抓捕 ,为尽快初步验证其是否吸食毒品 ,随来求证 .催瘾诊断时 ,分别给两人 im 0 .4mg盐酸纳洛酮 ,1例 15min内出现心慌、烦躁不安、打哈欠、流泪、流涕等轻度戒断反应 .另 1例 30 min内无反应 ,随追加 im 0 .4mg. 5 min后即出现明显的戒断症状 .收…     

骨髓间充质干细胞移植入脑缺血大鼠侧脑室后的迁移及分化:免疫荧光标记

目的:骨髓间充质干细胞可以分化成神经细胞替代受损组织,并可分泌生长因子和营养因子来促进其体内细胞的存活和分化。实验将体外扩增和Hoechst33342标记的骨髓间充质干细胞移植入缺血性大鼠侧脑室内,观察干细胞在大鼠脑内的生存、迁移、分化情况及对神经功能恢复的影响。方法:实验于2004-12/2007-06在南京大学医学院附属鼓楼医院科研部完成。①取体质量120～160g的SD大鼠用于制备移植细胞;另取80只体质量250～300g的SD大鼠用于制作大脑中动脉闭塞模型。实验方法符合动物伦理学要求。②应用直接贴壁法分离纯化及扩增大鼠骨髓间充质干细胞,荧光染料Hoechst33342标记。③将造模成功的75只大脑中动脉闭塞大鼠按随机数字表法分为3组:模型对照组15只;磷酸缓冲液组30只;骨髓间充质干细胞移植组30只,将骨髓间充质干细胞立体定向移植到大鼠缺血侧脑室中。④术后1,3,6,12,24d测定大鼠神经功能损害评分,荧光显微镜下观察Hoechst33342标记的骨髓间充质干细胞在脑内的生存和迁移情况,采用免疫荧光法检测胶质原纤维酸性蛋白和微管相关蛋白2的表达。结果:①细胞移植后6d,12d骨髓间充质干细胞移植组大鼠的神经功能评分均显著低于磷酸缓冲液组(P<0.05)。②移植的骨髓间充质干细胞可在大鼠脑组织中存活,并向缺血区域迁移。③移植第24天Hoechst33342/微管相关蛋白2、Hoechst33342/胶质原纤维酸性蛋白双阳性细胞占Hoechst33342阳性细胞的百分率为(10.45±1.35)%,(8.73±1.38)%。结论:骨髓间充质干细胞可以在动脉闭塞局灶性脑缺血模型大鼠脑中存活,并向缺血区域附近迁移,在一定条件下可分化为神经元和星形胶质细胞,同时能促进局灶性脑缺血大鼠的神经功能恢复。