Plasma TBARS,blood GSH concentrations,and erythrocyte antioxidant enzyme activities in regularly menstruating women with ovulatory and anovulatory menstrual cycles

BACKGROUND: Vigorous physical activity and subsequent depressed ovarian hormone secretion resulting in anovulatory menstrual cycles can affect erythrocyte antioxidant system in premenopausal women and contribute to attenuated protection against oxidative stress. METHODS: A total of 17 regularly menstruating women participated in the study. Prospective subjects monitored their basal body temperature (BBT) for 3 months prior to the study. Plasma progesterone concentration was assayed between the 7th and 9th day and again between the 22nd and 25th day of the menstrual cycle and made possible the classification of participants as either ovulating or non-ovulating. Plasma 17-beta-estradiol concentration was determined on the same menstrual cycle days as progesterone. Plasma thiobarbituric acid-reacting substances (TBARS) served as an index of plasma lipid peroxidation. Whole blood-reduced glutathione (GSH) concentration and glutathione peroxidase (GSH-PX) activity and erythrocyte catalase (CAT), superoxide dismutase and glutathione reductase (GSH-RX) represented red cells antioxidants. RESULTS: In non-ovulating women, the lack of progesterone peak between the 22nd and 25th day of the menstrual cycle was demonstrated. In addition, markedly lower (P<0.008) plasma 17-beta-estradiol concentrations in non-ovulating females than in ovulating ones in the follicular phase was noted. In the luteal phase, plasma 17-beta-estradiol levels in non-ovulating subjects tended to be lower (P<0.06) than in ovulating counterparts. Mean concentrations of plasma thiobarbituric-reacting substances and blood-reduced glutathione and mean activities of glutathione reductase, glutathione peroxidase and catalase did not differ significantly in ovulating and non-ovulating women. In non-ovulating women, both between the 7th and 9th day and the 22nd and 25th day of the menstrual cycle, erythrocyte superoxide dismutase (SOD) activity was higher (P<0.02) than in their ovulating counterparts. In ovulating subjects, significant and inverse correlation was demonstrated between circulating estradiol and SOD activity in collected data from both follicular and luteal phases. CONCLUSIONS: Current results indicate that persistent ovarian hormone disturbances in regularly menstruating women, and resultant anovulation did not affect plasma lipid peroxidation and GSH-dependent erythrocyte antioxidant defense. However, lower plasma estradiol concentrations resulted in attenuated erythrocyte SOD inhibition and elevated enzyme activity. The mechanism of inhibitory estradiol action on erythrocyte SOD activity as well as the importance of this effect for antioxidant protection merits further studies.     

长期骨髓细胞培养净化白血病细胞与临床疗效关系的研究

应用Dexter长期培养体系进行了17急性非淋巴细胞白血病例(ANLL)骨髓的长期培养,按照培养4周后基质细胞CFU-ANLL和CFU-GM的生长情况,将其分为3型:Ⅰ型(11/17例)为培养净化有效型;Ⅱ型(3/17例)为部分净化有效或需4周以上培养观察其净化效果的类型;Ⅲ型基质细胞缺陷。体外培养中各种类型细胞均同步死亡。Ⅰ型病人化疗有效率较Ⅱ、Ⅲ型高。该结果提示临床应用Dexter体系净化进行自体骨髓移植(ABMT)时,应按其体外生长类型选择病人。比分类与所处临床状态无关,其净化作用可能与临床化疗之间无选择性交叉抗肿瘤关系。     

Cytokine dysregulation in the post-Q-fever fatigue syndrome

The post-Q-fever fatigue syndrome (QFS) (inappropriate fatigue, myalgia and arthralgia, night sweats, changes in mood and sleep patterns) follows about 20% of laboratory-proven, acute primary Q-fever cases. Cytokine dysregulation resulting from chronic immune stimulation and modulation by persistence of Coxiella burnetii cells or their antigens is hypothesized. We studied cytokine release patterns of peripheral blood mononuclear cells (PBMC) stimulated with various ligands in short- term culture, from 18 patients with active QFS, and 27 controls: six with resolving QFS, five who had had acute primary Q-fever without subsequent QFS, eight healthy Q-fever vaccinees and eight healthy subjects without Q-fever antibody. Conditioned media (CM) from PBMC stimulated in short-term culture with Q-fever antigens, PHA or measles antigen (as an unrelated antigen) were assayed for IL-2, IL-4, IL-5, IL- 6, IL-10 and IFN gamma by AgEIA, and for IL-1 and TNF alpha/beta by bioassay. Aberrant cytokine release patterns were observed with PBMC from QFS patients when stimulated with Q-fever antigens: an accentuated release of IL-6 which was significantly [p = 0.01, non-parametric one- way analysis of variance (ANOVA)] in excess of medians for all four control groups. With IL-2, the number of responders in the active QFS group was decreased relative to control groups (Fisher's exact test, p = 0.01) whereas the number of IFN gamma responders was increased (Fisher's exact test, p = 0.0008). Significant correlations were observed between concentrations of IL-6 in CM, total symptom scores, and scores for other key symptoms.      

生长激素治疗烧伤的随机对照试验的系统评价

目的评价生长激素治疗烧伤的有效性和安全性.方法检索中国生物医学文摘数据库、MEDLINE、EMBASE和Cochrane图书馆,收集所有相关随机对照试验,对其逐个进行质量评价,并进行Meta-分析.结果纳入9个高质量研究,共治疗732例患者.①有助于烧伤创面的愈合[WMD-11.25,95%CI(-14.84,-7.66),P＜0.000 01];②有助于供皮区创面的愈合[WMD-1.87,95%CI(-2.28,-1.47),P＜0.000 01];③有助于缩短住院时间[WMD-8.10,95%CI(-10.40,-5.79),P＜0.000 01];④使用生长激素后,患者静息能量消耗有降低的趋势但尚无统计学意义[WMD-0.04,95%CI(-0.08,0.00),P=0.06];⑤生长激素会引起血糖升高[SMD 0.98,95%CI(0.54,1.42),P＜0.000 01],和血胰岛素升高[SMD 0.86,95% CI(0.43,1.30),P=0.000 1];病死率[OR 1.15,95%CI(0.15,8.53),P=0.9]和脓毒血症的发生方面无差异[OR 1.08,95% CI(0.50,2.34),P=0.8]及呼吸机需求方面无差异[OR1.51,95%CI(0.72,3.16),P=0.3].结论目前资料表明烧伤患者在监测和控制好血糖水平的条件下运用生长激素是安全、有效的.     

湖北省2006—2015年接受艾滋病HAART患者生存时间及影响因素

目的探讨湖北省艾滋病高效抗逆转录病毒治疗(HAART)患者接受治疗后的生存状况,并研究影响生存时间的因素。方法回顾性分析湖北省开始接受HAART时间在2006年1月1日—2015年12月31日的艾滋病患者,年龄≥15岁,有完整的基线及随访信息。通过寿命表法计算患者的生存率、死亡率、累积生存率;通过Log-Rank检验比较不同组别间的生存时间差异并做单因素分析,采用Cox比例风险模型分析接受HAART后患者的生存时间影响因素。结果共计10 065例,其中男性7 449例(74.01%),女性2 616例(25.99%)。在观察期内有1 048例(10.41%)患者死亡,因艾滋病相关疾病死亡的有646例(61.64%),治疗开始后6个月内死亡的有471例(72.91%),治疗第1年死亡的有497例(76.93%);累积生存率从第1年的95.03%下降到第10年的86.97%;家政及服务业(HR=1.33,95%CI=1.09~1.62)死亡风险大,高中/中专(HR=3.26,95%CI=1.72~6.18)的死亡风险较初中及以下大。基线机会性感染数越多(≥3个HR=0.73,95%CI=0.58~0.93)、WHO临床分期越高(HR=0.59,95%CI=0.49~0.70)、基线CD4+T淋巴细胞计数(≥351个/μL HR=5.83,95%CI=1.84~18.54)、开始治疗时年龄越大(≥50岁HR=0.70,95%CI=0.58~0.85)的艾滋病患者接受HAART后死亡风险大。结论湖北省2006—2015年接受艾滋病HAART的患者治疗后累积生存率较高;基线机会性感染数越多、WHO临床分期越高、基线CD4+T淋巴细胞计数越低、开始治疗时年龄越大者接受HAART后生存时间短。     

中国汉族人群中KIR分布规律及其在HLA相合亲缘造血干细胞移植中的作用

目的探讨杀伤细胞免疫球蛋白样受体（KIR）在中国汉族人群中的分布规律及其对人类白细胞抗原（HLA）相合亲缘移植预后的影响。方法采用PCR序列特异性引物（SSP）分型技术检测HLA及KIR基因型。检测了150例汉族人群中KIR的基因型分布、74例异基因造血干细胞移植供受者对KIR及HLA基因型,并对45例接受HLA相合亲缘移植、非去除T细胞异基因造血干细胞移植（allo—HSCT）的恶性血液病患者病例资料进行回顾性分析。结果KIR2DL1的基因分布频率为100％,KIR2DL2为20％,KIR2DL3为100％,KIR3DL1为95％。96％的供者携带与allo-HSCT关系密切的3组KIR受体。45例HLA相合亲缘供者中,36例患者KIR不合,占总人数的80％,其中35例患者KIR2DL1不合,1例KIR2DL2／2DL3不合,31例KIR3DL1不合。HLA相合亲缘供者移植患者中KIR2DL1不合组的急性移植物抗宿主细胞病（aGVHD）发生率（31％）明显低于KIR相合组（70％）,差异有统计学意义（P=0．029）。急性髓性白血病中KIR及KIR2DL1不合组的aGVHD发生率（18％）明显低于KIR相合组（75％）,差异有统计学意义（P=0．03）,淋巴系统疾病中差异无统计学意义。结论绝大多数中国北方汉族人群携带与allo—HSCT关系密切的3组KIR受体,HLA相合亲缘供者HSCT后供受者间KIR不合组aGVHD发生率明显下降。     

运动中ST段下移程度不同的心肌梗死后患者的心血管反应

目的：对运动中ST段下移程度不同的心梗后患者（PMIP）的心血管反应进行探讨。方法：46名男性PMIP在跑台上进行递增负荷运动实验．其间测量每级负荷时的血压、心率并连续监测12导联心电图（ECG）。根据跑台第Ⅱ级负荷时的ST段下移程度将其分为两组．第一组ST段下移〈1．0mm．第二组ST段下移〉1．0mm。结果：定量负荷工作时ST段下移程度大的患者其心率-血压乘积（RPP）也高。结论：当不便进行ECG监测时．RPP可能是评价患者对运动的临床反应的特效指标。     

非亲缘HLA相合骨髓移植治疗一例骨髓增生异常综合征

为了探讨非亲缘HLA相合供者骨髓移植 (UD BMT)治疗骨髓增生异常综合征 (MDS)的可行治疗方案和疗效 ,采用HLA配型相合的非亲缘骨髓移植治疗 1例骨髓增生异常综合征 难治性血细胞减少伴多系病态造血(MDS RCMD)男性患者 ,31岁。预处理方案为马利兰、环磷酰胺、阿糖胞苷、甲基环己亚硝脲和抗胸腺细胞球蛋白。以霉酚酸酯、环孢菌素A加短疗程的甲氨喋呤预防移植物抗宿主病 (GVHD)。结果显示 ,移植后 10天中性粒细胞 (0 .5× 10 9 L ,2 0天血小板升至 5 8× 10 9 L ,3个月血红蛋白升至 114g L ,无GVHD发生 ;移植后无病存活时间已达 9个月。结论 :非血缘HLA相合骨髓移植治疗骨髓增生异常综合征是可行而且有效的。