钥孔戚血蓝蛋白诱导Balb/C小鼠脾细胞Th1/Th2失衡

背景:建立具有一定特征的、稳定的、可重复性强的Th1/Th2失衡动物模型是研究Th1/Th2失衡机制的重要基础.目的:分析钥孔戚血蓝蛋白诱导Balb/C小鼠脾细胞Th1/Th2失衡的特点.设计:随机对照探索性实验.单位:河北医科大学基础医学院河北省法医学实验室.材料:实验于2005-09/2007-02在河北医科大学基础医学院河北省法医学实验室完成.实验选用Balb/c小鼠,对动物处置方法符合动物伦理学要求.方法:①以钥孔戚血蓝蛋白 完全弗氏佐剂免疫Balb/C小鼠,分离脾细胞,细胞因子分泌高峰点测定实验分为3组,分别为钥孔戚血蓝蛋白6.25,12.5,25 mg/kg组:不同免疫剂量和免疫次数实验分为7组.分别为钥孔戚血蓝蛋白6.25,12.5,25 me/kg组,6.25,12.5,25 mg/kg二次免疫组及对照组.主要观察指标:以酶联免疫吸附法检测小鼠脾细胞培养上清中Th1型细胞因子γ-干扰素、白细胞介素2、白细胞介素12 p40及Th2型细胞因子白细胞介素4、白细胞介素5的分泌量及血清中Th1型抗体IgG2a和Th2型抗体IgG1水平.结果:①钥孔戚血蓝蛋白免疫使小鼠出现脾肿大,脾细胞计数增高.②体外同种抗原再刺激使免疫小鼠脾细胞培养上清中4种细胞因子浓度增高,其中白细胞介素2分泌量于24h即明显增高,48 h达高峰:白细胞介素4、γ-干扰素和白细胞介素5在24 h轻度增高,以后逐渐上升,96 h达高峰.各时间点培养上清中白细胞介素12p40含量均较低,与对照组无明显差异.③不同剂量单次或二次免疫均可致4种细胞因子不同程度增高,白细胞介素4/γ-干扰素比值增高,其中12.5 mg/kg钥孔戚血蓝蛋白二次免疫组细胞因子分泌量明显高于其他各组(P＜0.01).④钥孔戚血蓝蛋白免疫小鼠血清IgG1,IgG2a水平发生不同程度增高,其中IgG1增高更为明显.结论:钥孔戚血蓝蛋白加完全弗氏佐剂可诱导Balb/C小鼠脾细胞发生Th2型优势反应.     

组织多普勒技术对糖尿病妊娠胎儿心功能的评价

目的 通过组织多普勒技术测量胎儿二、三尖瓣环的运动速度来评价胎儿的心肌收缩与舒张功能，以此评估妊娠糖尿病胎儿心脏功能的损害程度。方法 妊娠糖尿病22例，正常对照组30例，使用组织多普勒测量胎儿心脏二尖瓣及三尖瓣环处的运动速度，并使用M型超声测量左右心的射血分数EF。结果 两组胎儿心肌舒张功能随孕周增长而增加，收缩功能与孕周无关。妊娠糖尿病胎儿心肌的舒张及收缩功能均比正常妊娠降低，射血分数高于正常。结论 组织多普勒技术是一项评价病理妊娠状态下胎心功能的新技术。     

Pharmacological inhibition of heparin-binding EGF-like growth factor promotes peritoneal angiogenesis in a peritoneal dialysis rat model

Background

Molecular mechanisms of peritoneal dialysis (PD) ultrafiltration failure, peritoneal neo-angiogenesis, and fibrosis remain to be determined. We aimed to determine the role of heparin-binding EGF-like growth factor (HB-EGF) inhibition on angiogenesis of peritoneal membrane in a PD rat model.

Methods

32 male Wistar rats were assigned into (1) control group; (2) uremic non-PD group: subtotal nephrectomy-induced uremic rats without PD; (3) uremic rats subjected to PD: uremic rats that were dialyzed with Dianeal^® for 4 weeks; (4) CRM 197 group: dialyzed uremic rats were supplemented with CRM197, a specific HB-EGF inhibitor. Peritoneal transport function was examined by peritoneal equilibration test. Expression of HB-EGF and EGFR in peritoneal samples were examined by real-time PCR, immunohistochemical staining, and western blot.

Results

Progressive angiogenesis and fibrosis were observed in uremic PD rats, and there were associated with decreased net ultrafiltration (nUF), increased permeability of peritoneal membrane, and reduced expression of HB-EGF and EGFR protein and mRNA in uremic PD rats compared to uremic non-PD or control groups (both p < 0.05). CRM197 significantly induced peritoneal membrane permeability, decreased nUF, increased higher vessel density, and reduced pericyte count compared to that of uremic PD rats. The levels of HB-EGF and EGFR expression negatively correlated with vessel density in peritoneal membrane (both p < 0.001).

Conclusion

PD therapy was associated with peritoneal angiogenesis, functional deterioration, and downregulation of HB-EGF/EGFR. Pharmacological inhibition of HB-EGF promoted PD-induced peritoneal angiogenesis and fibrosis and ultrafiltration decline, suggesting that HB-EGF downregulation contributes to peritoneal functional deterioration in the uremic PD rat model.

     

不同相对分子质量玻璃酸钠对膝关节镜术后关节功能恢复的作用比较

目的:观察关节腔内留置不同相对分子质量玻璃酸钠对膝关节镜术后早期疼痛及功能恢复的影响。方法:于2005-11/2006-05选择北京大学人民医院骨关节科收治的行膝关节镜手术患者60例。关节镜手术中根据不同诊断分别行半月板成形术、游离体取出术以及软骨成形术。60例患者按随机数字表法分为3个实验组,分别为Mr1.5×106～2.5×106玻璃酸钠组,Mr3×106玻璃酸钠组,Mr6×106玻璃酸钠组。术后关节腔内注入不同相对分子质量玻璃酸钠2.0～2.5mL,并被动屈伸膝关节20次,使玻璃酸钠均匀分布于关节内。术后第1天开始股四头肌力量锻炼,坐在床边屈膝活动,并可下床。术后1周拆除缝线,术后6周门诊复查。分别于术前、术后1,2,3d,1,6周采用同一评分量表进行自觉疼痛程度、日常生活活动能力、膝关节屈曲角度测评,评分越高,功能恢复越好。结果:纳入患者60例,均进入结果分析。①自觉疼痛程度测定:术后6周Mr1.5×106～2.5×106,3×106,6×106玻璃酸钠组自觉疼痛程度评分均高于术前[分别为(8.5±1.3),(7.3±2.2)分;(8.5±1.3),(7.3±2.2)分;(8.5±1.3),(7.3±2.2)分]。②日常生活活动能力测定:术后6周Mr1.5×106～2.5×106,3×106,6×106玻璃酸钠组日常生活活动能力评分均高于术前[分别为(60.5±8.4),(59.3±7.0)分;(63.4±8.2),(59.4±8.3)分;(66.9±3.8),(53.8±19.0)分]。③膝关节屈曲角度评分:术后6周Mr1.5×106～2.5×106,3×106,6×106玻璃酸钠组膝关节屈曲角度评分均高于术前[分别为(9.1±1.4),(5.8±2.7)分;(8.1±3.1),(7.2±3.5)分;(6.3±3.8),(5.5±3.1)分]。④综合评分:术后6周Mr1.5×106～2.5×106,3×106,6×106玻璃酸钠组综合评分均高于术前[分别为(88.1±7.7),(79.8±11.1)分;(91.4±6.8),(84.9±13.7)分;(91.2±10.7),(73.5±23.7)分]。关节腔内留置3种不同相对分子质量玻璃酸钠在膝关节镜术后近期各项评分差异均无显著性意义(P>0.05)。结论:关节腔内留置不同相对分子质量玻璃酸钠在膝关节镜术后近期康复中具有相似的效果。     

Genistein对去卵巢后大鼠基底前脑神经元一氧化氮合酶表达及认知功能的影响

目的:观察去卵巢大鼠植物雌激素替代治疗后基底前脑一氧化氮合酶阳性神经元的表达和其认知功能在去卵巢后的时程变化。方法:实验于2004-07/2005-07在南通大学基础医学院人体解剖学教研室完成。3月龄雌性大鼠48只随机抽签法分为假手术组、去势组、Genistein替代组和雌激素替代组,每组12只。卵巢切除前,各组大鼠行避暗回避实验行为学检测。各组大鼠的处理:①去势组:切除双侧卵巢。②Genistein替代组:切除双侧卵巢后进行Genistein替代,剂量100μg(溶于200μLDMSO)。③雌激素替代组:切除双侧卵巢后进行雌激素替代,皮下注射苯甲酸雌二醇,剂量10μg(溶于100μL无菌芝麻油)。④假手术组:只切开双侧腰肌不触及卵巢,随即缝合伤口,相同条件下存活4周。药物注射隔日1次,时间固定,持续4周,分别于最后1次注射24h后进行灌注固定。各组大鼠在灌注前1周进行避暗回避实验。脑切片用NADPH-d组织化学方法染色,观察基底前脑内侧隔核、斜角带核垂直支脑区一氧化氮合酶阳性神经元的分布,并进行计数和统计分析。结果:实验过程中无动物死亡,全部进入结果分析。①去势前各组大鼠避暗回避实验的探索次数和滞留时间差异无显著性(P均>0.05);去势后行替代治疗1,2周后,各组大鼠避暗回避实验的探索次数和滞留时间差异无显著性(P均>0.05);替代治疗4周后,Genistein替代组和雌激素替代组大鼠的探索次数比去势组明显减少,滞留时间比去势组明显延长(P<0.05)。②大鼠基底前脑一氧化氮合酶阳性神经元染色为深蓝色,胞体边界清晰,突起明显,为双极或多极细胞。内侧隔核的一氧化氮合酶阳性细胞主要分布于中线两侧,呈倒“V”字形排列,体积较小,胞体多呈梭形,各组大鼠的神经元数目在术后各时间点的差异不明显。在斜角带核垂直支则呈“人”字形排列,胞体较内侧隔核大,多呈锥形或椭圆形,多为多极神经元。各组大鼠神经元的数目呈动态变化,Genistein或雌激素替代组一氧化氮合酶阳性神经元数目上升,而去势组减少,替代治疗后1,2周内,Genistein或雌激素替代组与去势组之间差异无显著性(P>0.05);第4周时Genistein或雌激素替代组一氧化氮合酶阳性神经元的数目接近于假手术组水平,与去势组间差异有显著性(P<0.01)。结论:去卵巢后行替代治疗能增加大鼠基底前脑一氧化氮合酶阳性神经元的表达,改善大鼠认知功能,可能对中枢神经系统退行性病变起保护作用。     

Estimation of the cortical functional connectivity with the multimodal integration of high-resolution EEG and fMRI data by directed transfer function

Nowadays, several types of brain imaging device are available to provide images of the functional activity of the cerebral cortex based on hemodynamic, metabolic, or electromagnetic measurements. However, static images of brain regions activated during particular tasks do not convey the information of how these regions communicate with each other. In this study, advanced methods for the estimation of cortical connectivity from combined high-resolution electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) data are presented. These methods include a subject's multicompartment head model (scalp, skull, dura mater, cortex) constructed from individual magnetic resonance images, multidipole source model, and regularized linear inverse source estimates of cortical current density. Determination of the priors in the resolution of the linear inverse problem was performed with the use of information from the hemodynamic responses of the cortical areas as revealed by block-designed (strength of activated voxels) fMRI. We estimate functional cortical connectivity by computing the directed transfer function (DTF) on the estimated cortical current density waveforms in regions of interest (ROIs) on the modeled cortical mantle. The proposed method was able to unveil the direction of the information flow between the cortical regions of interest, as it is directional in nature. Furthermore, this method allows to detect changes in the time course of information flow between cortical regions in different frequency bands. The reliability of these techniques was further demonstrated by elaboration of high-resolution EEG and fMRI signals collected during visually triggered finger movements in four healthy subjects. Connectivity patterns estimated for this task reveal an involvement of right parietal and bilateral premotor and prefrontal cortical areas. This cortical region involvement resembles that revealed in previous studies where visually triggered finger movements were analyzed with the use of separate EEG or fMRI measurements.     

图片展示沟通技巧的临床应用

目的运用图片展示与暂时性失语患者进行沟通.方法通过对50例因疾病、上呼吸机或因手术治疗行气管切开但意识清醒的暂时性失语患者给予三方面支持,即情感支持、信息支持及医疗补偿性支持.结果通过应用图片展示辅以手势、体语来完成护患沟通,满足暂时性失语后患者的身心需求.结论本方法行之有效,对提高患者生活质量,增强护患关系有着十分重要的意义.