Body weight and comorbidity predict mortality in COPD patients treated with oxygen therapy.

The aim of this study was to investigate the association between clinical variables and all-cause and respiratory mortality in patients with chronic obstructive pulmonary disease (COPD) undergoing long-term oxygen therapy (LTOT). The authors retrospectively studied a historic cohort of 128 patients with COPD (126 males, mean age+/-SD 68.9+/-9.7 yrs, body mass index (BMI) 25.1+/-4.5 kg.m-2, and forced expiratory volume in one second 25.4+/-8.8% predicted), who were being treated with long-term oxygen therapy in a tertiary teaching hospital between 1992 and 1999. Comorbidity, assessed with the Charlson Index, was present in 38% of the patients. Vital status and cause of death were assessed through the population death registry. A total of 78 patients (61%) had died by the end of follow-up. Three-year survival was 55%. Death was due to respiratory causes in 77% of cases. On Cox analysis, BMI<25 kg.m-2, comorbid conditions, age>or=70 yrs and cor pulmonale were associated with all-cause mortality. The BMI and comorbidity were the only significant predictive factors when the analysis was restricted to respiratory mortality. In conclusion, body mass index<25 kg.m-2 and comorbidity were predictors of all-cause and respiratory mortality in a cohort of chronic obstructive pulmonary disease patients treated with long-term oxygen therapy. These factors should be taken into account when considering the management and prognosis of these patients.     

CT定位下经皮穿刺射频消融治疗肺肿瘤疗效分析

目的探讨CT引导下集束电极射频治疗肺恶性肿瘤的疗效。方法对1999年以来在cT定位引导下。采用WE7568集束电极射频肿瘤消融仪。用集束电极经皮穿刺到肺内肿瘤进行射频消融治疗，每针次温度75～95℃左右维持10min或15min．结果78例病人经CT引导行射频消融80例次，绝大多数病灶（77．4％）复查CT均有不同程度缩小或CT值下降30～37，疼痛等症状明显缓解。无严重并发症，无围手术期死亡。结论CT定位下经皮集束电极射频消融对肺恶性肿瘤的近期疗效明显，对晚期肺癌、多发性肺转移瘤及不能耐受手术者，可作为综合治疗的方法之一。     

传统信息模式下的药品采购分析

目的:分析传统模式下医院药品供应情况,试图建立快速、高效的药品采购模式。方法:以华西医院4周的药品计划和入库记录为基础信息,对基础信息中的各类相关数据进行比较分析。结果:在目前传统的信息传递和交流的模式下,医院药品供应有集中性和延迟性的特点。结论:传统的药品采购模式已不能适应医院需求,基于电子商务模式的网上药品采购,是实现药品供应快速、高效的切实之路。     

Evidence that the Receptor for Soluble CD14:LPS Complexes may not be the Putative Signal-Transducing Molecule Associated with Membrane-Bound CD14

Membrane-bound CD14 acts as a receptor for lipopolysaccharide (LPS) on monocytes/macrophages and neutrophils. Studies have suggested that the activation of monocytes/macrophages by the binding of LPS to membrane-bound CD14 may require the association of a signal-transducing molecule with membrane-bound CD14. The observation that non-CD14 expressing cells, such as endothelial cells, can nevertheless be activated by a complex of LPS and a soluble form of CD14 (sCD14) suggests that the receptor for this complex may be identical to the signal transducing molecule associated with membrane-bound CD14. The studies described show that two CD14-specific MoAb are able to block the LPS-induced activation of endothelial cells but do not affect the response of monocytes to LPS. This suggests that the interaction of the sCD14:LPS complex with endothelial cells is distinct from the interaction of membrane-bound CD14 with its putative signal-transducing molecule.     

Plasmid DNA encoding transforming growth factor-beta1 suppresses chronic disease in a streptococcal cell wall-induced arthritis model.

Transforming growth factor beta is a potent immunomodulator with both pro- and antiinflammatory activities. Based on its immunosuppressive actions, exogenous TGF-beta has been shown to inhibit autoimmune and chronic inflammatory diseases. To further explore the potential therapeutic role of TGF-beta, we administered a plasmid DNA encoding human TGF-beta1 intramuscularly to rats with streptococcal cell wall-induced arthritis. A single dose of 300 microg plasmid DNA encoding TGF-beta1, but not vector DNA, administered at the peak of the acute phase profoundly suppressed the subsequent evolution of chronic erosive disease typified by disabling joint swelling and deformity (articular index = 8.17+/-0. 17 vs. 1.25+/-0.76, n = 6, day 26, P < 0.01). Moreover, delivery of the TGF-beta1 DNA even as the chronic phase commenced virtually eliminated subsequent inflammation and arthritis. Both radiologic and histopathologic as well as molecular evidence supported the marked inhibitory effect of TGF-beta1 DNA on synovial pathology, with decreases in the inflammatory cell infiltration, pannus formation, cartilage and bone destruction, and the expression of proinflammatory cytokines that characterize this model. Increases in TGF-beta1 protein were detected in the circulation of TGF-beta1 DNA-treated animals, consistent with the observed therapeutic effects being TGF-beta1 dependent. These observations provide the first evidence that gene transfer of plasmid DNA encoding TGF-beta1 provides a mechanism to deliver this potent cytokine that effectively suppresses ongoing inflammatory pathology in arthritis.     

糖耐量试验对评价肝癌患者肝脏储备功能的价值

绝大多数肝细胞性肝癌患者合并肝硬变，为预测其对肝切除的耐受性，给正确选择切肝患者提供依据，作者对６２例切肝者和４９例未切肝者手术前后的糖耐量试验（ＯＧＴＴ）和肝组织病理学进行了对比研究。结果：术前ＯＧＴＴ曲地Ｐ型者切肝后恢复顺利；Ｌ型者对肝切的耐受性差，术后易发生肝功能衰竭等并发症，其肝硬化和蔼多为ＣⅢ或ＣⅣ级，曲线形态界于Ｐ和Ｌ型之间的Ｉ型患者２９例用肝门区域血管阻断法切肝，并在阻断血管前使用预     

High-resolution loading tests in the study of genetic heterogeneity in gangliosidosis fibroblasts

Summary GM₁- and GM₂-gangliosides were isolated from brain and radio-labelled. The labelled moieties were localized by hydrolysis with lysosomal enzymes, followed by thin-layer chromatography of the products. High-resolution loading tests with labelled gangliosides were developed and found to differentiate infantile and juvenile forms of GM₁- and GM₂-gangliosidoses as well as the identification of B, O and AB types of GM₂-gangliosidosis.     

Prior immunologic experience potentiates the subsequent antibody response when Salmonella strains are used as vaccine carriers.

Prior immunologic experience with homologous and heterologous serotype Salmonella strains potentiated the subsequent antibody response when the same strains were used as vaccine carriers of foreign antigens. This potentiation was positively correlated with the appearance of antibody directed against the lipopolysaccharide of the carrier strain. Both serum and mucosal antibody responses against the foreign antigen increased over time. Antibody responses in sera of animals primed with either the homologous or heterologous serotype strain were not statistically significantly different, while animals primed with the homologous serotype strain developed significantly better mucosal antibody responses against the foreign antigen.     

丙型肝炎病毒H株包膜蛋白在昆虫细胞中的表达及意义

目的　获得丙型肝炎病毒 (HCV) H株包膜糖蛋白的重组杆状病毒 ,在昆虫细胞中稳定表达包膜糖蛋白 E1和 E2 ,并初步应用于丙型肝炎患者血清抗体的检测。方法　用 PCR方法自 HCV H株扩增出包膜蛋白 E基因 ,构建重组杆状病毒 ,并在昆虫细胞中稳定表达包膜糖蛋白 E1和 E2。免疫荧光及 Western blot方法鉴定表达产物。用表达的 E1和 E2蛋白与 35例丙型肝炎患者血清反应。结果　昆虫细胞中表达的 E蛋白呈现 3种分子大小 ,E1的相对分子量为 2 1× 10 3和 33× 10 3 ,E2的相对分子量为 6 0× 10 3。在 35份感染者血清中 ,有 4例 E1抗体阳性 ,其中 1例检出 E2抗体。在 9例 PCR检测 HCV RNA阳性而抗 HCV检测阴性的血清中 ,有 3例血清与表达的 E蛋白反应。结论　 HCV E蛋白基因可在昆虫细胞中稳定表达 ,表达的 E1和 E2蛋白可用于 HCV患者的血清学诊断