Clinical validation of a nutritional risk index

This research assessed the clinical validity of a nutritional risk index (NRI). Subjects were 377 male veterans, aged 55+, attending general medicine and geriatric outpatient clinics. Data were collected by personal interviews, anthropometric measurements, laboratory assay of nutritional parameters, three-day food records, and medical record reviews. Although the results showed that the NRI correlated significantly with only two nutritional measures (body mass index, total energy intake), critical values or threshold levels of NRI were identified that significantly discriminated low risk from high risk patients on four nutritional parameters (body mass index, total energy intake, laboratory risk, and medications risk). It was concluded that the NRI is a valid measure of health status and contains a nutritional dimension.John M. Prendergast, MD, MPH is Medical Director, Program on Aging, Mercy Hospital, Pittsburgh, PA 15219; Rodney M. Coe, PhD is Professor, Department of Community Medicine, St. Louis University School of Medicine and Education Coordinator, Geriatric Research, Education and Clinical Center (GRECC), VA Medical Center, St. Louis, MO 63104; M. Noel Chavez, PhD, RD is Assistant Professor, Department of Community Health Sciences, School of Public Health, University of Illinois, Chicago, IL 60612; James C. Romeis, PhD is Associate Professor, Center for Health Services, Education and Research, St. Louis University and Coordinator, Health Services Research and Development, VA Medical Center, St. Louis, MO 63104; Douglas K. Miller, MD is Assistant Professor, Department of Internal Medicine, St. Louis University School of Medicine, St. Louis, MO 63104; Fredric D. Wolinsky, PhD is Professor, Department of Sociology, Texas A&M University, College Station, TX 77843.This project was supported in part by grant #84-017 from the Veterans Administration and by K07-AG-00302 and K04-AG00328 from the National Institute on Aging.     

A comparison of polymerase chain reaction and an infectivity assay for human immunodeficiency virus type 1 titration during virus inactivation of blood components

Three examples of human plasma-derived concentrates, intermediate- purity factors VIII and IX, and fibrinogen were spiked with tissue culture-grown human immunodeficiency virus type 1 (HIV-1) strain RF. All examples were freeze-dried and heated at 80 degrees C for 72 hours by using validated production process models. HIV-1 infectivity was measured by a syncytial infectivity assay in C8166 cells and then compared with levels determined by nested HIV polymerase chain reaction (PCR). The infectivity assay demonstrated a reduction index of at least 4.5 log10, while PCR showed an average 1.7 log10. Large amounts of HIV- 1 RNA (10(5)) were still detectable by PCR in samples in which infectivity assays failed to detect any HIV-1. These data suggest that HIV-1 PCR levels do not parallel HIV-1 infectivity levels during virus- inactivation procedures involved in coagulation factor concentrate production. PCR was able to detect the RNA associated with inactivated HIV-1 particles in the factor concentrates, which allows the conclusion that PCR is not a useful test with which to monitor virus-inactivation procedures such as heating at 80 degrees C for 72 hours. This judgment contrasts with the more definite and sensitive role of PCR in diagnosing HIV-1 infection in patients in whom a positive HIV-1 PCR result correlates with active HIV-1 infection and with PCR's usefulness in monitoring virus removal.     

In vitro susceptibility of Mycobacterium marinum to eight antimicrobial agents.

The in vitro susceptibilities of 16 Mycobacterium marinum strains to eight antimicrobial agents were determined by the agar dilution technique. The most active drugs were amikacin and kanamycin. Tetracycline, doxycycline, and minocycline were inhibitory, predominantly at concentrations slightly below the expected blood and tissue levels. Trimethoprim-sulfamethoxazole and erythromycin demonstrated activity only at concentrations greater than those usually attained in serum and tissues. Gentamicin was relatively inactive.     

Lack of strong immune selection pressure by the immunodominant, HLA-A*0201-restricted cytotoxic T lymphocyte response in chronic human immunodeficiency virus-1 infection.

Despite detailed analysis of the HIV-1-specific cytotoxic T lymphocyte response by various groups, its relation to viral load and viral sequence variation remains controversial. We analyzed HLA-A*0201 restricted cytotoxic T lymphocyte responses in 17 HIV-1-infected individuals with viral loads ranging from < 400 to 221,000 HIV RNA molecules per milliliter of plasma. In 13 out of 17 infected subjects, CTL responses against the SLYNTVATL epitope (p17 Gag; aa 77-85) were detectable, whereas two other HLA-A*0201 restricted epitopes (ILKEPVHGV, IV9; and VIYQYMDDL, VL9) were only recognized by six and five individuals out of 17 individuals tested, respectively. Naturally occurring variants of the SL9 epitope were tested for binding to HLA-A*0201 and for recognition by specific T cell clones generated from five individuals. Although these variants were widely recognized, they differed by up to 10,000-fold in terms of variant peptide concentrations required for lysis of target cells. A comparison of viral sequences derived from 10 HLA-A*0201-positive individuals to sequences obtained from 11 HLA-A*0201-negative individuals demonstrated only weak evidence for immune selective pressure and thus question the in vivo efficacy of immunodominant CTL responses present during chronic HIV-1 infection.     

Collagen deposition in HIV-1 infected lymphatic tissues and T cell homeostasis

Lymphatic tissues (LTs) are structurally organized to promote interaction between antigens, chemokines, growth factors, and lymphocytes to generate an immunologic response and maintain normal-sized populations of CD4(+) and CD8(+) T cells. Inflammation and tissue remodeling that accompany local innate and adaptive immune responses to HIV-1 replication cause damage to the LT architecture. As a result, normal populations of CD4(+) and CD8(+) T cells cannot be supported and antigen-lymphocyte interactions are impaired. This conclusion is supported herein following LT sampling before and during anti-HIV therapy in persons with acute, chronic, and late-stage HIV-1 infection. Among seven individuals treated with anti-retroviral therapy (ART) and four individuals deferring therapy we found evidence of significant paracortical T cell zone damage associated with deposition of collagen, the extent of which was inversely correlated with both the size of the LT CD4(+) T cell population and the change in peripheral CD4(+) T cell count with anti-HIV therapy. The HIV-1-associated inflammatory changes and scarring in LT both limit the ability of the tissue to support and reestablish normal-sized populations of CD4(+) T cells and suggest a novel mechanism of T cell depletion that may explain the failure of ART to significantly increase CD4(+) T cell populations in some HIV-1-infected persons.     

Hematopoietic cell transplantation for Crohn’s disease;is it time?

INTRODUCTION Crohn’s disease (CD) is a chronic inflammatory disease of the gastrointestinal tract which commonly affects young adults. It follows a relapsing and remitting course and there is no known cure. However, approximately 10% to 15% have chronic …     

高迁移率族蛋白B1诱导巨噬细胞Janus激酶/信号转导及转录激活子通路活化的研究

目的 初步探讨高迁移率族蛋白B1(HMGB1)致炎效应的信号转导机制。方法 清洁级雄性Wistar大鼠，取其腹腔巨噬细胞，培养3d后以10mg／L HMGB1刺激。刺激完毕后直接在培养瓶中裂解细胞，分别采用免疫沉淀、免疫印迹法和凝胶阻滞分析等技术观察不同时间点Janus激酶2(JAK2)、信号转导及转录激活子—1(STAT1)以及STAT3的活化情况。结果 HMGB1可诱导大鼠腹腔巨噬细胞STAT1、STAT3在短时间内(2h)活化，其中STAT3活化最为迅速，10min即可达到活化高峰。但HMGB1不能在短时间内(2h)诱导JAK2活化。结论 JAK／STAT途径可能参与了HMGB1致炎效应的信号转导机制。     

国人全膝关节假体置换胫骨近端截骨面至腘血管距离的测量及意义

目的:测量国人全膝关节假体置换术胫骨近端截骨面后缘至腘窝血管之间的距离,以期为临床全膝关节置换术中避免损伤腘窝血管提供参考数据。方法:选择2006-06/12于解放军第二军医大学长征医院体检的50名正常成人(53膝),男29名(31膝),女21名(22膝)。所有观察对象均知情同意,且得到医院伦理道德委员会批准。对所有膝关节进行MRI扫描,在胫骨外侧平台以下10mm水平横断面上辨认腘动静脉,并测量胫骨近端截骨面后缘至腘窝动静脉的距离。结果:53膝全部进入结果分析,无脱落。①男性胫骨近端截骨面后缘至腘动脉、腘静脉平均距离为(6.7±2.5,7.3±2.3)mm,95%可信区间分别为5.8～7.6mm,6.5～8.1mm。②女性胫骨近端截骨面后缘至腘动脉、腘静脉平均距离为(6.6±1.9,7.1±2.7)mm,95%可信区间分别为:5.8～7.4mm,5.9～8.3mm。③不同性别观察对象胫骨近端截骨面后缘至腘血管的距离差异无显著性意义(P>0.05)。结论:腘窝血管紧邻全膝关节假体置换术胫骨近端截骨面后缘,不同性别间无明显差异。全膝关节假体置换术中进行胫骨近端截骨,特别是后方操作时需特别谨慎,以避免损伤腘窝血管。     

Effects of Androgen Treatment on the Male Rat Aorta

Androgen was given to male rats to determine if it exerted effects on the aortic wall distinct from those of estrogen deficit. Although a general anabolic effect was avoided, significant vascular effects were observed. The amounts of mural fibrous proteins, elastin and collagen, were significantly increased in treated animals; noncollagenous, alkali-soluble protein, thought to reflect the cellular component, was unchanged with treatment. These effects were not detectable on microscopic examination and measurement of the vessel wall despite attempts to duplicate closely in vivo wall dimensions before study. These findings of distinct and marked effects of androgen on vascular metabolism extend the growing evidence for an important role of sex hormones in vessel wall structure and function.