间歇性红外线加热对人成纤维细胞三维立体培养的影响

目的　观察红外线加热对人成纤维细胞三维立体培养的影响。方法　在人成纤维三维立体培养模型基础上 ,用红外线加热装置间歇性加热 ,共设 42℃组 (A组 )、3 8℃组 (B组 )和 3 3℃组对照组 (C组 ) ,观察第 0、2、3、5和 7d凝胶收缩状况及纤维细胞计数。结果　第 3天 ,A组的胶原凝胶收缩 (5 4.7% )明显大于B组 (4 8.5 % )和C组 (3 4.8% ) (P <0 .0 0 1)。第 7天 ,A、B、C三组的胶原凝胶收缩分别为 67%、5 5 .8%和49 .47% (P <0 .0 0 1) ,同时发现 ,各组间成纤维细胞生长状况与胶原凝胶收缩呈正相关关系。结论　间歇性红外线加热可通过促进成纤维细胞增殖而使胶原凝胶收缩 ,对慢性伤口的愈合可能有促进作用     

Evaluation of a centrifugal blood cell processor for washing platelet concentrates

A semiautomated saline wash procedure using a blood cell processor was evaluated as a technique for removing plasma from platelet concentrates. In vitro studies demonstrated 92 to 99.6 percent (mean, 96%) removal of total plasma protein (n = 30) with 84 to 97 percent (mean, 90.8%) platelet recovery (n = 28) in post-wash units. Post-wash pH values changed by +0.2 to -0.86 (mean, -0.47) (n = 30); the level of recovery from hypotonic shock was 69 to 97 percent (mean, 86%) (n = 11) of pre-wash units; weighted morphology scores decreased from a mean of 248 to 223 (n = 9). Aggregation response to arachidonic acid, collagen, and adenosine diphosphate plus epinephrine showed essentially no change following the wash procedure, and electron microscopy demonstrated slight morphologic alteration. Autologous platelets labeled with indium-111 demonstrated 43 +/- 20 percent recovery (n = 11) for washed units, compared to 41 +/- 10 percent for control unwashed units (n = 5); mean survivals were 140 +/- 41 hours (n = 11) for washed platelets and 185 +/- 28 hours for unwashed units (n = 5). Thirteen alloimmunized patients receiving 55 washed platelet concentrates demonstrated a mean 1- to 4-hour corrected count increment of 3.99 X 10(3) per microliter, compared to 3.02 X 10(3) per microliter for 77 unwashed platelet units given to the same patients. This study documents that platelet concentrates maintain viability and efficacy following a semiautomated saline wash method using the Cobe 2991 Blood Cell Processor, a technique that may be helpful for patients who require plasma-depleted platelet transfusions.     

牛心包衍生材料引导成骨效应的X射线和骨密度评估

目的:应用X射线和骨密度值评价碳化二亚胺交联处理的脱细胞牛心包的引导成骨作用。方法:实验于2004-09/2005-01在中南大学湘雅二医院中心实验室及湘雅二医院动物部完成。健康雄性成年新西兰白兔20只,在新西兰白兔双侧下颌体各制备7mm×7mm大小的骨缺损,一侧骨缺损上方紧贴骨面覆盖碳化二亚胺交联脱细胞牛心包,作为实验组;另一侧不作处理,作为对照组。每组又分4,8,12,16周4个时间点,每个时间点为5只。术后4,8,12,16周行X射线观察和双能X射线吸收仪测量骨密度,评价骨缺损修复情况。结果:纳入新西兰兔20只,均进入结果分析。①术后骨缺损区大体观察:术后12,16周时实验组骨缺损区创面平坦;对照组骨缺损区凸凹不平,中央有结缔组织长入,16周时仍有直径2mm以上的缺损,呈纤维性愈合。②两组兔术后骨缺损区X射线观察:自8周起,实验组骨缺损区密度均高于对照组。③兔骨密度变化:术后4,8,12,16周实验组骨密度均高于对照组,差异均有显著性意义[分别为(0.337±0.035),(0.304±0.027)g/cm2;(0.373±0.022),(0.354±0.025)g/cm2;(0.365±0.032),(0.341±0.031)g/cm2;(0.347±0.023),(0.311±0.028)g/cm2,P<0.05]。结论:X射线和骨密度评估结果均显示碳化二亚胺交联脱细胞牛心包有良好的引导骨组织再生作用。     

仰卧和俯卧位心脏对煤尘肺患者肺组织体积与功能的影响

目的:观察仰卧位和俯卧位心脏对煤尘肺患者肺组织体积和肺功能的影响,为临床应用俯卧位治疗成人呼吸窘迫综合征等肺部疾病提供依据。方法:2006-08/2007-01河南鹤煤集团公司总医院放射科对10例煤尘肺患者行仰、俯卧位高分辨螺旋CT扫描,分别测量位于心脏下方肺组织的体积,测量仰、俯卧位状态下肺功能,用配对t检验进行统计学分析。结果:10例患者均进入结果分析。①CT扫描心脏压迫下的肺组织体积:俯卧位时均小于仰卧位[左肺:(7.74±9.55),(242.60±72.11)mm3;右肺:(12.21±11.41),(156.49±76.54)mm3,P均<0.01]。②肺功能测量结果:仰卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.14±0.58)L、(1.62±0.79)L、(89.80±29.26)、(3.42±1.98)L/s;俯卧位时,患者的用力肺活量、第1秒用力呼气容积、第1秒用力呼气容积预计值百分率、最大呼气量,分别为(2.36±20.79)L、(1.80±0.77)L、(100.10±22.46)、(4.30±2.37)L/s。俯卧位时肺功能明显优于仰卧位(P<0.05)。结论:俯卧位时位于心脏下方的肺组织明显减少,可显著改善人体的肺换气功能。     

Production of auto-anti-idiotypic antibody during the normal immune response to TNP-ficoll. I. Occurrence in AKR/J and BALB/c mice of hapten-augmentable, anti-TNP plaque-forming cells and their accelerated appearance in recipients of immune spleen cells

Attempts were made to elucidate the cause of the downward regulation of the splenic plaque-forming cell (PFC) response in AKR/J and BALB/c mice between days 4 and 7 after a single intravenous injection of 2,4,6,trinitrophenyl- lys-Ficoll(TNP-F). AKR/J spleen cells, taken 7 d after injection of TNP-F, were transferred, together with TNP-F, into normal AKR/J mice. The day-3 or – 4 PFC response of the recipients was much lower than that of recipients of normal cells. However, the suppression was only apparent because the presence of 10(-8)-10(-7) M 2,4,6-trinitrophenyl-ε-amino-n-caproic acid (TNP- EACA) (or 10(-7)-10(-6) M 2,4,-dinitrophenyl-ε-amino-n-caproic acid) in the PFC assay caused a dramatic increase in observed PFC, averaging 298 percent on day 3 and 122 percent on day 4. Recipients of normal cells showed no such hapten-augmentable PFC. T-depleted immune spleen cells did not cause any apparent suppression of the response to TNP-F, but hapten-augmentable PFC in recipient spleens were again prevalent. Suppression of the PFC response, as well as hapten-augmentable PFC, were seen after transfer of immune serum. It was postulated that hapten augmentation of PFC was caused by displacement of auto-anti-idiotypic antibody from the surface of blocked antibody- synthesizing cells. Further studies showed that such hapten-augmentable PFC occurred in the spleens of a large percentage of both AKR/J and BALB/c mice examined after day 4 of the primary response to TNP-F. Thus, it was hypothesized that the downward regulation of the magnitude and, possibly, also of the heterogeneity of the splenic-PFC response was due to an auto-antibody response to one or more major idiotypes of the anti-TNP response.     

A snapshot of the organization and provision of primary care in Turkey

Background  

This WHO study aimed to support Turkey in its efforts to strengthen the primary care (PC) system by implementing the WHO Primary Care Evaluation Tool (PCET). This article provides an overview of the organization and provision of primary care in Turkey.     

Non-clinical efficacy and safety of HyVac4:IC31 vaccine administered in a BCG prime–boost regimen

Despite the extensive success with the introduction of M. bovis Bacille Calmette-Guérin (BCG), tuberculosis (TB) remains a major global epidemic infecting between 8 and 9 million people annually with an estimated 1.7 million deaths each year. However, because of its demonstrated effectiveness against some of the most severe forms of childhood TB, it is now realized that BCG vaccination of newborns is unlikely to be replaced. Therefore, BCG or an improved BCG will continue to be used as a prime TB vaccine and there is a need to develop effective boost vaccines that would enhance and prolong the protective immunity induced by BCG prime immunization. We report on a heterologous booster approach using two highly immunogenic TB antigens comprising Ag85B and TB10.4 (HyVac4) delivered as a fusion molecule and formulated in the proprietary adjuvant IC31. This vaccine was found to be immunogenic and demonstrated greater protection in the more stringent guinea pig model of pulmonary tuberculosis than BCG alone when used in a prime/boost regimen. Significant difference in lung involvement was observed for all animals in the HyVac4 boosted group compared to BCG alone regardless of time to death or sacrifice. A vaccine toxicology study of the HyVac4:IC31 regimen was performed and it was judged safe to advance the vaccine into clinical trials. Therefore, all non-clinical data supports the suitability of HyVac4 as a safe, immunogenic, and effective vaccination in a prime–boost regimen with BCG.     

Intracranial Artery Calcium Burden Predicts Recurrent Cerebrovascular Events in Transient Ischaemic Attack Patients

Background: Patients with initial transient ischaemic attack (TIA) subsequently have a higher risk of recurrent TIA or acute ischemic stroke (AIS). The role of scoring intracranial arterial calcification (IAC) in predicting the prevalence of stroke remains unclear. We aim to evaluate if radiological CT calcium score measuring IAC burden could predict future ischemic events in a cohort of TIA patients. Methods: We studied consecutive patients from July 2014 to December 2015 who presented with first episode of TIA. All patients had noncontrasted CT or CT-angiogram of the brain on admission. CT calcium score (cm3) was quantified by measuring calcium deposition in the bilateral internal carotid arteries, middle cerebral arteries, and vertebrobasilar system. Patients were followed up for 2 years and ischemic events for either recurrent TIA or AIS were recorded. We compared patients in terms of clinical profile at presentation and CT calcium score using appropriate univariate and multivariable analyses. Results: Of 156 TIA patients studied, 22% (n = 35) had recurrent TIA or AIS within 2 years of follow-up. On univariate analyses, recurrent TIA/AIS was associated with gender (OR 0.61; 95%CI 0.40-0.95; P = .038), hypertension (mean difference 2.49; 95%CI 1.08-5.75; P = .030) and higher CT calcium score (mean difference 0.84 95%CI 0.16-1.52 P = .016). On multivariable logistic regression, a higher CT calcium score was significantly associated with recurrent TIA/AIS (adjusted OR 1.25 95%CI 1.01-1.55 P = .042). Conclusions: In TIA patients, higher IAC burden by measurement of a quantitative CT calcium score may be associated with recurrent ischemic events.     

Development after prenatal exposure to cocaine, heroin and methadone

In Amsterdam a longitudinal, prospective and multidisciplinary study on the development of infants of drug-dependent mothers (IDDM) was started in 1983: 35 IDDM and 35 reference infants were originally enrolled. The drug-dependent women had used combinations of methadone, heroin, cocaine and other drugs during pregnancy. Of the IDDM, 80% had to be treated pharmaceutically for neonatal abstinence symptoms (NAS). Physical, neurological, cognitive and the socio–emotional development of the children were studied regularly from birth until 5.5 years of age. Differences between the reference group and the IDDM were found most clearly in cognitive development. The IDDM also had more behavioural problems at some of the ages studied. No group differences were seen in motor development. So far the results of the study show that IDDM and their caregivers need extra support in order to improve early communication and the children's cognitive development.