多聚（ADP-核糖）聚合酶抑制剂对大鼠缺血再灌注肾脏损伤的保护作用

目的探讨多聚（ADP-核糖）聚合酶（PARP）抑制剂3-氨基苯甲酰胺（3-AB）在大鼠-肾脏缺血再灌注损伤中的保护作用及对肾组织血管内皮生长因子A（VEGF-A）和中性粒细胞明胶酶相关脂质运载蛋白（NGAL）mRNA表达的影响。方法将54只大鼠随机分为假手术组（S组）、再灌注后模型组（M组）和PARP抑制剂组（P组）,每组8只。比较各组大鼠右侧肾动脉缺血再灌注后2、6、12h后的血肌酐和尿素氮水平、肾脏组织病理学变化、肾组织PARP蛋白表达及肾组织VEGF-A和NGAI．mRNA表达。结果（1）M组各时间点的血肌酐、尿素氮水平均高于S组,P组各时间点血肌酐、尿素氮明显低于M组,差异均有统计学意义（P〈0．01）;（2）P组肾组织病理学表现较M组改善;（3）P组各时间点肾组织PARP表达明显低于M组,差异有统计学意义（P〈0．05）;（4）与M组相比,P组肾组织的VEGF-AmRNA的表达升高,NGALmRNA表达降低,有统计学差异（P〈0．05）。结论PARP抑制剂3AB对大鼠肾脏缺血再灌注损伤具有保护作用,可下调NGAL及上调VEGF-AmRNA表达。     

预防和治疗抗生素相关性腹泻的药学体会

目的:促进抗生素相关性腹泻的有效预防和治疗。方法:选用临床实例对以益生菌酸奶、活菌制剂及益生元等多种微生态制剂预防和治疗抗生素相关性腹泻的结果进行分析和总结。结果:实例表明,有抗生素相关性腹泻危险因素的患者给予益生菌酸奶和益生元后,能有效预防抗生素相关性腹泻的发生;已发生抗生素相关性腹泻的患者,应用微生态制剂后取得显著疗效。结论:合理应用微生态制剂能预防和治疗抗生素相关性腹泻。     

大连市乙肝疫苗查漏补种情况调查

[目的]了解大连市乙肝疫苗漏种的情况及其影响因素。[方法]2006年10月至2007年5月开展了大连市2002年7月1日至2006年9月3013出生儿童的乙肝疫苗查漏补种工作,对于在补种过程中新发现的漏种儿童,按照“随时发现,随时补种”的原则进行补种。[结果]本次“查漏补种”工作共摸底调查263727名儿童,查出漏种儿童2017人,漏种率为0．76％,应补种针次4198针次;实补种1933人,补种率为95．84％。大连市乙肝疫苗近5年平均接种率为99．9％,漏种率较低;流动儿童较本地常住儿童漏种率高（P〈0.05）,补种率低（P〈0．05）。[结论]流动儿童中仍存在免疫空白现象。     

Respiratory symptoms in preterm infants: burden of disease in the first year of life

Objective

While respiratory symptoms in the first year of life are relatively well described for term infants, data for preterm infants are scarce. We aimed to describe the burden of respiratory disease in a group of preterm infants with and without bronchopulmonary dysplasia (BPD) and to assess the association of respiratory symptoms with perinatal, genetic and environmental risk factors.

Methods

Single centre birth cohort study: prospective recording of perinatal risk factors and retrospective assessment of respiratory symptoms during the first year of life by standardised questionnaires. Main outcome measures: Cough and wheeze (common symptoms), re-hospitalisation and need for inhalation therapy (severe outcomes). Patients: 126 preterms (median gestational age 28.7 weeks; 78 with, 48 without BPD) hospitalised at the University Children''s Hospital of Bern, Switzerland 1999-2006.

Results

Cough occurred in 80%, wheeze in 44%, rehospitalisation in 25% and long term inhalation therapy in wheezers in 13% of the preterm infants. Using logistic regression, the main risk factor for common symptoms was frequent contact with other children. Severe outcomes were associated with maximal peak inspiratory pressure, arterial cord blood pH, APGAR and CRIB-Score.

Conclusions

Cough in preterm infants is as common as in term infants, whereas wheeze, inhalation therapy and re-hospitalisations occur more often. Severe outcomes are associated with perinatal risk factors. Preterm infants who did not qualify for BPD according to latest guidelines also showed a significant burden of respiratory disease in the first year of life.     

通过基因芯片筛选创伤修复差异表达基因

目的通过基因芯片筛选同真皮间充质干细胞相关的创伤修复差异表达基因。方法利用贴壁生长的特性分离大鼠真皮间充质干细胞，用Hpure提取伤口液刺激前后dMSCs和创伤前后大鼠皮肤组织中总RNA。PCR扩增已构建抑制消减杂交差异表达文库中485个克隆的插入片断，送北京博奥制作基因芯片。提取的RNA反转录后分别同芯片杂交，找出在细胞水平和组织水平同时高表达的克隆。将这些克隆测序，进行生物信息学分析。结果分离的大鼠真皮间充质干细胞呈纺锤形，在体外显示多向分化潜能。抽提伤口液刺激前后dMSCs和创伤前后大鼠皮肤组织中总RNA，反转录后和基因芯片杂交，发现可能同创伤愈合相关的13条基因，其中热休克蛋白70（HSP70），基质金属蛋白酶3（MMP3），白细胞蛋白酶抑制因子（SLPI）等可能在创伤愈合中有重要意义。结论抑制消减杂交和基因芯片结合是筛选差异表达基因的一种有效方法。伤口液刺激前后dMSCs中差异表达基因的发现能为从基因水平探讨dMSCs参与创伤愈合的分子机制提供新的研究靶点。     

The routine use of Rh-negative reagent red cells for the identification of anti-D and the detection of non-D red cell antibodies

BACKGROUND: Before 1987, fewer than 50 patients per year at the authors' laboratory had a positive antibody detection test due to antepartum Rhesus immunoprophylaxis. However, after 1987, a marked increase was observed in the number of patients who had received Rh immune globulin (RhIG) during pregnancy as part of routine antepartum Rh immunoprophylaxis. In anticipation that an increased use of RhIG during pregnancy would increase the number of patients in whom anti-D was detected by this laboratory, a protocol was developed to abbreviate the process required to identify anti-D. Although this protocol was adopted primarily to address an anticipated increase in antenatal RhIG usage in women, it was also applied to alloimmunized Rh-negative males. STUDY DESIGN AND METHODS: When an Rh-negative patient (male or female) had a reactive screening test for unexpected antibodies and met certain other criteria, the patient's serum was tested with a three-vial set of Rh-negative reagent red cells (Rh-negative screening RBCs), instead of with panels of typed RBCs (panel RBCs), for the identification of anti- D or the detection of non-D antibodies. If the serum under test did not agglutinate or hemolyze Rh-negative screening RBCs, anti-D was identified and no further testing was performed. If the serum agglutinated or hemolyzed Rh-negative screening RBCs, conventional testing with panel RBCs was done to determine the antibody specificity. RESULTS: Rh-negative patients (n = 1174) who had reactive screening tests for unexpected antibodies were tested with Rh-negative screening RBCs; 1079 were found to have anti-D as a single antibody. Seven of these patients subsequently developed a non-D alloantibody, after transfusion or pregnancy, and one patient had anti-C that escaped detection at the time of initial testing with Rh-negative RBCs (a false- negative result). Ninety-two patients had anti-D in combination with a non-D antibody, and three patients had a non-D antibody but not anti-D. Use of the anti-D identification protocol actually reduced the laboratory workload by 176 College of American Pathologists workload units per month, in spite of a marked increase in the number of patients in whom anti-D was detected. No hemolytic transfusion reaction was attributed to the abbreviation of anti-D identification. CONCLUSION: The identification of anti-D may be abbreviated without jeopardizing patient safety. Such a protocol can reduce laboratory workload and might be particularly appealing to health care facilities that perform antibody detection testing on large numbers of Rh-negative pregnant women, especially if antepartum RhIG is administered routinely.     

Survey on pretransfusion testing

BACKGROUND: Hospitals and blood centers throughout the United States use a variety of reagents and methods to perform pretransfusion testing. A survey was developed to determine the reagents and methods in use and their relative prevalence in different work settings. STUDY DESIGN AND METHODS: A national survey on pretransfusion testing was conducted. Surveys were distributed to state and regional blood bank associations, which then distributed them to hospitals and blood centers within their region. In most instances, the blood centers distributed the survey to the local hospitals. Completed surveys were returned to the authors for review, and all information was entered into a database for analysis. RESULTS: Analysis of the data shows that the majority of blood banks use monoclonal reagents for ABO testing and monoclonal-polyclonal blended reagents for Rh testing. The data show that anti-IgG and polyclonal antihuman globulin reagents are used almost equally for antibody screening (detection) tests and that most blood banks use a three-cell antibody-screening test. Slightly more than 50 percent of hospitals use an immediate-spin crossmatch in the absence of unexpected antibodies. CONCLUSION: A number of approved reagents and methods are used by blood bank laboratories for pretransfusion testing. Facility size (number of beds) and type tend to influence the choice of methods and reagents employed. This survey provides an opportunity for blood bank laboratories to compare their current practices with those of their peers.