垂体催乳素瘤的诊断和治疗指南

2005年6月,在San Diego举行了第九届国际垂体研究大会.大会邀请在催乳素瘤治疗领域被认可的国际知名专家,包括内分泌专家和神经外科专家,特定召开专业委员会,对催乳素瘤的诊断和治疗进行探讨,并形成该指南.指南发表在2006年8月的临床内分泌学杂志上(Clinical Endocrinology, 2006, 65: 265-273).     

Effect of blood donation on the establishment of normal ranges of lymphocyte subsets

BACKGROUND: Absolute counts of CD4+ T-lymphocytes are used in the management of patients with human immunodeficiency virus infection. Low absolute counts of CD3+CD4+ cells have also been observed in healthy people–a phenomenon called idiopathic CD4 lymphocytopenia. It is common practice for normal ranges for lymphocyte subsets to be derived from samples taken from blood donors. STUDY DESIGN AND METHODS: A sample of EDTA blood was taken through the donation line tubing, after donation from 565 blood donors in Sydney, Australia, who were selected from a range of age groups. An additional 12 donors provided a predonation sample as well as a postdonation sample. Hematologic assays were performed on two analyzers. Samples were stained for CD3, CD4, CD8, CD19, and CD56 and analyzed on a flow cytometer. RESULTS: Three donors were found to have absolute CD3+CD4+ counts < 300 cells per microL. The percentage of CD3+CD4+ cells was found to increase with age. Both the percentage and the absolute count of CD3+CD8+ cells decreased with age, which resulted in an increased CD4:CD8 ratio with age. Men had consistently higher absolute counts of CD3-CD56+ cells than women. The 12 additional donors all had greater percentages of CD3+CD4+ cells and lower absolute counts for CD3+, CD3+CD4+, CD3+CD8+, CD19+ and CD3-CD56+ cells after donation than they had before donation (p < 0.001). CONCLUSION: It is not satisfactory to base normal ranges for lymphocyte subsets on donor blood, from which the blood sample has been obtained after donation.     

鹿瓜多肽注射剂质量评价与标准优化

通过探索性研究对鹿瓜多肽注射剂质量现状及存在问题进行评价,并对现行质量标准进行优化。首先,对影响终产品新鲜度的因素进行考察。建立丹磺酰氯柱前衍生-HPLC 法测定鹿瓜多肽注射剂中 8 种生物胺的含量,结果显示个别企业的样品中检出较高浓度的尸胺；采用免疫亲和柱净化-柱后光化学衍生-HPLC -FLD 法测定鹿瓜多肽注射剂及中间提取液中黄曲霉毒素 B₁、B₂、G₁ 和 G₂ 的含量,并采用自动电位滴定法测定甜瓜子原料的酸价和过氧化值,结果表明部分企业生产原料甜瓜子存在霉变、酸败等问题,应在新鲜度方面给予重视。其次,优化了鹿瓜多肽注射剂质量标准中高分子量物质和多肽含量测定的方法。采用 Tricine-SDS-PAGE 电泳法代替凝胶色谱法测定高分子量物质,提高了测定的准确性；采用试剂盒法代替福林酚法测定多肽含量,该法操作简便、专属性更强,适用于大批量样品的快速测定。最后,对鹿瓜多肽注射剂质量标准中缺失的溶血与凝聚、生物学活性测定项目进行研究。建立直接观察法结合酶标仪测定法考察溶血与凝聚反应,结果各企业样品均无溶血与凝聚现象；采用 CCK-8 法考察鹿瓜多肽注射剂对 THP-1 细胞增殖的抑制作用,以此评价其抗炎活性,结果显示鹿瓜多肽注射剂对 THP-1 细胞具有增殖抑制作用,各企业样品的体外抗炎效果具有一定差异。探索性研究结果显示,鹿瓜多肽注射剂原材料、中间产品及终产品的安全性均存在一定隐患,表明本品的整体质量水平一般,且现行质量标准存在缺陷,亟待提高。     

New insights suggesting a possible role of a heat shock protein 70-kD family-related protein in antigen processing/presentation phenomenon in humans

A possible role of the peptide binding protein (PBP) 72/74 in antigen processing and presentation has been recently suggested in mice. In order to evaluate a possible analogous role of a PBP72/74-related protein in humans, immunoelectron microscope investigations, functional studies, and immunofluorescence analyses were performed on normal human peripheral antigen-presenting cells. We demonstrated that the determinant recognized by antiheat shock protein (HSP) 72/73 monoclonal antibody (MoAb) is constitutively expressed on the cell surface of monocytes as well as of B cells. Moreover, the capability of monocytes to present a recall antigen to T cells was significantly decreased when preincubated with an anti-HSP72/73 MoAb. These data add further strength to a potential role of a protein related to human PBP72/74 homologue in antigen processing and/or presentation. Finally, the capability of anti-HSP72/73 MoAb to impair the ability of fixed monocytes to present a synthetic peptide demonstrates that cell surface- localized PBP72/74-related protein could play a role in antigen presentation.     

Influence of Rh phenotype on the antigen density of C, c, and D: flow cytometric study using a frozen standard red cell

BACKGROUND: Flow cytometry is increasingly being used for the comparison of antigen density. Indirect immune fluorescence is more sensitive than direct immune fluorescence and thus allows the study of red cells (RBCs) with a weak D antigen. STUDY DESIGN AND METHODS: In indirect immune fluorescence, when the fluorescence is standardized by the use of aliquoted frozen standard RBCs, the coefficient of variation in fluorescence intensity was less than 5 percent, which allows accurate determination of minor variations of Rh antigen density. RESULTS: For D antigen, the well-known suppressive effect of C, and the low antigen density of the weak D phenotype, was demonstrated. Use of epitope-specific monoclonal antibodies yielded similar results and allowed the identification of a D category IV heterozygote; the relative antigen density measured with a monoclonal antibody that reacted with D(IV) was twice that measured with a monoclonal antibody that did not react with D(IV). RBCs from C and c homozygotes had significantly more antigen than those from heterozygotes. There was significant variation in antigen density, depending on Rh phenotype: for example, D+ RBCs had less C antigen than D- RBCs, and Rh:1,2,-3,4,5 (CcDee) RBCs had more c antigen than Rh:1,2,3,4,5 (CcDEe) RBCs. There was no difference in D, C, and c antigen density in neonatal and adult RBCs. CONCLUSION: Flow cytometry is an excellent tool for the demonstration of minor differences in antigen density.     

尼群地平片剂生物利用度的研究

为提高国产尼群地平片剂的生物利用度,采用球磨混合粉碎法工艺进行处方设计,试制出新处方片剂,与西德Bayer公司片剂进行了体外溶出、体内生物利用度的比较。体内血浆药浓用GC-MS法测定,体内数据按零级溶出、一级吸收口服单室模型,经计算机用Gauss-Newton-Damping法处理求得药动学参数。本文研制的尼群地平新处方片剂生物利用度已超过西德Bayer公司片剂。     

美托洛尔酒石酸盐胃内滞留漂浮型控释片的制备及药代动力学研究

本文根据水动力学平衡药物控释系统的设计原理制备了美托洛尔胃内滞留漂浮型控释片剂(简称M-HBS)。实验表明,本品的体外溶出符合一级动力学过程(K′r=0.1651 h^-1);贮存期为两年;人体胃内γ-闪烁照相结果表明,本品在胃内滞留时间(5～6 h)明显比普通片剂(1.0～1.5 h)长;体内动力学过程符合表观一级吸收与一级消除的单室模型;ⅳ美托洛尔体内为双室模型;体内数据经NONLIN计算机程序处理,求得各项参数:Ka=0.1944 h^-1,K=0.1867 h^-1,Vd=2.813,t_max=5.247 h,C_max=125.1 ng/ml。本品的体内外数据具有显著的相关性(P<0.01)。     

An open study comparing manual therapy with the use of cold packs in the treatment of post-traumatic headache

One year after head trauma, 23 patients with post-traumatic headache entered a prospective clinical controlled trial to find out if specific manual therapy on the neck could reduce the headache. The study was completed by 19 patients (83%). Ten patients were treated twice with manual therapy and nine patients were treated twice with cold packs on the neck. The pain index was calculated blindly. Two weeks after the last treatment the mean pain index was significantly reduced to 43% in the group treated with manual therapy compared with the pretreatment level. At follow-up five weeks later, the pain index was still lower in this group compared with the group treated with cold packs, but this difference was not statistically significant. The pain index for all 19 patients was significantly correlated to the use of analgesics as well as to the frequency of associated symptoms (number of days per week with dizziness, visual disturbances and ear symptoms). It is concluded that the type of manual therapy used in this study seems to have a specific effect in reducing post-traumatic headache. The result supports the hypothesis of a cervical mechanism causing post-traumatic headache and suggests that post-traumatic dizziness, visual disturbances and ear symptoms could be part of a cervical syndrome.