贞芪扶正颗粒和复方阿胶浆干预再生障碍性贫血模型小鼠外周血及骨髓象的变化

目的:观察贞芪扶正颗粒和复方阿胶浆对苯油溶液致小鼠再生障碍性贫血模型的疗效。方法:实验于2005-06/09在河南中医学院药理实验室完成。①选用昆明种成年雄性小鼠90只。按随机数字表法将小鼠分为9组,每组10只:大、中、小剂量贞芪扶正颗粒组:按15,10,5g/kg剂量灌服贞芪扶正颗粒混悬液(主要成分:黄芪、女贞子;甘肃扶正药业科技股份有限公司生产;批号040803,15g/袋)。大、中、小剂量复方阿胶浆组:分别按10,20,30mL/kg剂量灌胃复方阿胶浆(主要成分:阿胶、熟地黄、党参、山楂、人参、蔗糖;山东东阿阿胶股份有限公司生产,批号050446,250mL/瓶),司坦唑醇组:按4mg/kg剂量灌胃司坦唑醇混悬液(司坦唑醇片,广西南宁百会药业集团有限公司生产,批号050306,30mg/片)。空白组和模型组:灌胃同体积的生理盐水(20mL/kg)。每天给药1次,连续给药14d。除空白组外,其余组小鼠皮下注射体积分数0.25苯的玉米油溶液4mL/kg复制苯油溶液致小鼠再生障碍性贫血模型,空白组皮下注射同体积玉米油。②各组小鼠分别于末次给药后24h,进行血常规检测。取右侧股骨,冲出骨髓细胞,采用BI-2000医学图像分析仪计数骨髓有核细胞数。③计量资料符合正态分布、方差齐者用t检验;方差不齐者用t’检验。结果:小鼠90只均进入结果分析。①血细胞测定结果比较:模型组小鼠血红细胞、白细胞、血小板计数和血红蛋白水平明显低于空白组(t=3.39～11.89,P<0.01)。司坦唑醇组3项血细胞计数和血红蛋白水平明显高于模型组(t=4.94～6.73,P<0.01)。大、中剂量贞芪扶正颗粒组和各剂量复方阿胶浆组血白细胞计数明显高于模型组(t=2.32～3.03,P<0.05￣0.01)。中剂量贞芪扶正颗粒组和各剂量复方阿胶浆组小鼠血红细胞计数明显高于模型组(t=2.15～4.84,P<0.05￣0.01)。大、中剂量贞芪扶正颗粒组和各剂量复方阿胶浆组血红蛋白水平明显高于模型组(t=2.33～4.45,P<0.05￣0.01)。大、中剂量贞芪扶正颗粒组和各剂量复方阿胶浆组血小板计数明显高于模型组(t=4.06～6.24,P<0.01)。②骨髓有核细胞数:模型组明显低于空白组(t=8.99,P<0.01)。司坦唑醇组、中剂量贞芪扶正颗粒组和小剂量复方阿胶浆组明显高于模型组(t=2.39～2.82,P<0.05)。结论:贞芪扶正颗粒、复方阿胶浆对皮下注射苯所致小鼠再生障碍性贫血模型血细胞状况及骨髓象均有较好的改善作用,以贞芪扶正颗粒有较为明显的剂量依赖关系。     

Drug-induced hypothyroidism: the thyroid as a target organ in hypersensitivity reactions to anticonvulsants and sulfonamides.

Inherited defects in detoxification of reactive metabolites of drugs predispose patients to "hypersensitivity" reactions. Covalent interaction of metabolites with cell macromolecules leads to cytotoxic and immunologic outcomes, manifested clinically by multisystem syndromes with variable organ involvement. Hypothyroidism developed in 5 of 202 patients (age range, 1 to 81 years) we investigated for hypersensitivity reactions to anticonvulsants or sulfonamides shortly after their reaction. None had previous personal or family histories of autoimmune disease. All had low thyroxine levels, elevated levels of thyroid stimulating hormone, and autoantibodies including antimicrosomal antibodies. Patients were 2 to 18 years of age at presentation, and two were male. All returned to a euthyroid state within a year of presentation, and all remain well. The demographics, clinical presentation, and course of the patients is atypical of idiopathic lymphocytic thyroiditis. We investigated the pathogenesis of thyroid toxicity using the hydroxylamine metabolite of sulfamethoxazole as a model. The hydroxyalmine was toxic to thyroid cells in vitro, which did or did not express thyroid peroxidase activity, whereas the parent sulfonamide was toxic only to cells with active thyroid peroxidase. The purified enzyme converted sulfamethoxazole to the hydroxylamine. Formation of reactive drug metabolites by thyroid peroxidase in a host who is genetically unable to detoxify the metabolites may lead directly to cytotoxicity. Covalent binding to macromolecules, including thyroid peroxidase, also may lead to expression of neoantigens and formation of autoantibodies. Patients who have sustained hypersensitivity reactions to drugs should be investigated for possible involvement of the thyroid.     

Effects of whey isolate, creatine, and resistance training on muscle hypertrophy

PURPOSE: Studies that have attributed gains in lean body mass to dietary supplementation during resistance exercise (RE) training have not reported these changes alongside adaptations at the cellular and subcellular levels. Therefore, the purpose of this study was to examine the effects of two popular supplements--whey protein (WP) and creatine monohydrate (CrM) (both separately and in combination)--on body composition, muscle strength, fiber-specific hypertrophy (i.e., type I, IIa, IIx), and contractile protein accrual during RE training. METHODS: In a double-blind randomized protocol, resistance-trained males were matched for strength and placed into one of four groups: creatine/carbohydrate (CrCHO), creatine/whey protein (CrWP), WP only, or carbohydrate only (CHO) (1.5 g x kg(-1) body weight per day). All assessments were completed the week before and after an 11-wk structured, supervised RE program. Assessments included strength (1RM, three exercises), body composition (DEXA), and vastus lateralis muscle biopsies for determination of muscle fiber type (I, IIa, IIx), cross-sectional area (CSA), contractile protein, and creatine (Cr) content. RESULTS: Supplementation with CrCHO, WP, and CrWP resulted in significantly greater (P < 0.05) 1RM strength improvements (three of three assessments) and muscle hypertrophy compared with CHO. Up to 76% of the strength improvements in the squat could be attributed to hypertrophy of muscle involved in this exercise. However, the hypertrophy responses within these groups varied at the three levels assessed (i.e., changes in lean mass, fiber-specific hypertrophy, and contractile protein content). CONCLUSIONS: Although WP and/or CrM seem to promote greater strength gains and muscle morphology during RE training, the hypertrophy responses within the groups varied. These differences in skeletal muscle morphology may have important implications for various populations and, therefore, warrant further investigation.     

Physical activity in a multiethnic population of third graders in four states.

OBJECTIVES: This research assessed the amount of daily physical activity in a multiethnic sample of US third-grade students. METHODS: Physical activity interviews were conducted with 2410 third graders from 96 schools in four states. Blood pressure, cholesterol, body mass index, timed run for distance, physical-activity self-efficacy, and perceived support for physical activity were also assessed. RESULTS: Students reported a daily average of 89.9 minutes of moderate to vigorous physical activity, 34.7 minutes of vigorous activity, and 120.4 minutes of sedentary behavior; however, 36.6% obtained less than 60 minutes of moderate to vigorous physical activity daily, and 12.8% reported less than 30 minutes. Boys reported more physical and sedentary activity than girls; White children reported more activity than Black or Hispanic children; California children reported the most activity and Louisiana children the least. Geographic location, male gender, lower cholesterol, higher perceived efficacy in physical activity, and higher social support were associated with more physical activity. CONCLUSIONS: Average reported activity met the Year 2000 objectives; however, many students reported less than recommended amounts of activity. These findings support the need for health promotion programs that increase the number of physically active children.     

小鼠颅神经嵴细胞的培养和特征

目的：在体外原代培养Balb/c小鼠胚胎的颅神经嵴细胞。为颅面部各种组织细胞的发育研究提供细胞来源。方法：采用胰酶消化法分离小鼠胚胎第8.5天的颅神经管，从小鼠颅神经管中游离出来的细胞即为颅神经嵴细胞，用免疫组织化学方法鉴定细胞的来源，并测定细胞的生长曲线。结果：成功地培养出小鼠的颅神经嵴细胞，其形态类似成纤维样细胞，免疫组化检测结果表明，神经特异性烯醇化酶（NSE）抗体染色结果阳性。细胞的群体倍增时间为43.65h。结论：原代培养的小鼠颅神经嵴细胞生长稳定，来源明确，是颅面部各种细胞的发育和分化研究中一种有用的工具。     

Changing values for nursing and health promotion: exploring the policy context of professional ethics

In this article we illustrate, and argue for, the importance of researching the social context of health professionals' ethical agendas and concerns. We draw upon qualitative interview data from 20 nurses working in two occupational health sites, and our discussion focuses mainly upon aspects of the shifting 'ethical context' for those nurses with a health promotion remit who are working in the British National Health Service. Within this discussion we also raise a number of potentially substantive issues, including the risks of colluding in 'double standards', and the tensions between the practitioner and managerial roles in nursing. Overall, we hope to pose questions about the best ways to understand the ethical agency and responsibilities of health professionals.     

Treatment of progressive Hodgkin's disease with intensive chemoradiotherapy and autologous bone marrow transplantation

Twenty-six patients with progressive Hodgkin's disease after conventional chemotherapy received intensive chemoradiotherapy and autologous bone marrow transplantation (ABMT); 19 also received additional involved-field radiotherapy. Twenty-one patients [81%, 95% confidence intervals (CI) 61% to 94%] attained complete (n = 18) or partial responses. Ten patients (38%, 95% CI 20% to 59%) are disease- free a median of 4.5 years later (range 3.5 to 7.0 years), including seven patients with continuous complete responses. The likelihood of overall response was not significantly influenced by any clinical or treatment variable examined. However, there was a trend favoring patients with higher Karnofsky scores, and higher scores were associated with attainment of complete responses (P = .06 and P = .02, respectively, Mann-Whitney U test). Both higher Karnofsky scores and shorter durations of disease before transplantation were associated with improved survival in a stepwise Cox multivariate analysis. The chief cause of failure was progression at sites previously involved with Hodgkin's disease. No patient relapsed in the marrow, and two of three patients with a history of marrow involvement with Hodgkin's disease achieved durable complete responses after transplantation. These data suggest that inadequate pretransplant conditioning, and not the reinoculation of occult tumor cells in the autologous marrow, caused most relapses. Fatal treatment-related toxicity occurred in six patients. Three patients died of idiopathic interstitial pneumonitis; each had previously received local mediastinal irradiation before intensive chemoradiotherapy. Intensive chemoradiotherapy and ABMT produces durable responses in some patients with Hodgkin's disease incurable with conventional therapy. Use of such therapies at the first sign of failure with conventional chemotherapy and development of more effective conditioning regimens should further improve results.     

A comparison of the colorectal surgical research across Europe, USA and Australasia

Aim The annual scientific meetings of the Association of Coloproctology of Great Britain and Ireland (ACPGBI), the American Society of Colon and Rectal Surgeons (ASCRS), the European Society of Coloproctology (ESCP) and the Royal Australasian College of Surgeons (RACS) are the major fora for presentation of colorectal surgical research. Thus, their content could be a proxy of the content and quality of colorectal surgical research worldwide. We aimed to critically appraise the quantity, quality and topics of colorectal surgical research over the previous 5 years for the above meetings. Method All published abstracts from the ACPGBI, ASCRS, ESCP and the colorectal‐specific component of the RACS from 2006 to 2010 were appraised. Abstracts were coded by predefined categories pertaining to study type and topic. Results Level 1 evidence (systematic reviews/meta‐analyses) and level 2 evidence (randomized controlled trials) comprised 3% (95% CI 1–9%) and 5% (95% CI 2–11%), respectively, of research presented at the meetings. There was a predominance of level 4 evidence (retrospective studies) across all years (mean 54%, 95% CI 44–68%). Operative management was most commonly studied (mean 43%, 95% CI 36–49%). There was minimal research in perioperative care (mean 6%, 95% CI 2–13%) and basic surgical science (mean 6%, 95% CI 2–11%). Research related to perioperative care was significantly higher at the ACPGBI and RACS meetings than the ASCRS and ESCP meetings (P < 0.01). Conclusion The research at these meetings consists largely of retrospective reviews exploring operative management with minimal high quality scientific content. Active steps need to be taken to increase the quantity of high level evidence especially in topics other than operative management.