Treatment of psoriasis with fumaric acid esters: results of a prospective multicentre study

Systemic treatment of psoriasis with fumaric acid esters (FAE) has been found effective by empirical means. In recent years clinical studies have confirmed the antipsoriatic activity of a defined mixture of different FAE. The aim of the present prospective multicentre study was to investigate further the efficacy and safety of FAE therapy in a large number of patients with severe psoriasis vulgaris. From 101 patients included in the study 70 completed the treatment period of 4 months. Discontinuation was due to adverse events in seven, lack of efficacy in two, and other reasons, such as non-attendance for scheduled visits, in 22 patients. Evaluation of overall efficacy showed a decrease in psoriasis area and severity index of 80% after 4 months of FAE therapy. Laboratory investigations revealed a slight overall decrease of lymphocytes during the treatment period which was more than 50% below baseline in 10 patients. During weeks 4 and 8 mean eosinophil counts were above the normal range. At the end of FAE therapy elevated eosinophil counts had returned to normal values. None of the patients showed changes in renal function parameters throughout the study. Adverse events were reported in 69% of the patients mainly consisting of gastrointestinal complaints (56%) and flushing (31%). In five patients gastrointestinal complaints and in two patients flushing led to withdrawal from the study. Taken together the results of this multicentre study showed in a large number of patients that systemic FAE treatment is effective in severe psoriasis vulgaris. Transient eosinophilia seems to be a characteristic feature of FAE therapy, while lymphocytopenia is usually mild. Adverse effects are dose-related and consist mainly of gastrointestinal complaints and flushing.     

恶性淋巴瘤贫血发生率调查分析

目的：研究恶性淋巴瘤患者的贫血发生情况及其影响因素。方法：对我院2007—05-04—2012-09—30住院的1474例恶性淋巴瘤患者（初治1145例,复治329例）进行回顾性分析,统计其贫血发生率,并根据初治或复治、不同．病理类型、性别、年龄、临床分期或是否有B症状进行分组分析。结果：初治患者的贫血发生率为23．3％（267／1145）,复治患者的贫血发生率为41．9％（138／329）,明显升高,χ2=44．5,P〈0．001。不同病理类型初治患者贫血发生率由高至低依次为淋巴浆细胞淋巴瘤75．0％,血管免疫母T细胞淋巴瘤40．0％,套细胞淋巴瘤32．6％,外周T细胞淋巴瘤（非特指型）29．4％,弥漫大B细胞淋巴瘤25．3％,霍奇金淋巴瘤24．8％,边缘区B细胞淋巴瘤24．7％,NK／T细胞淋巴瘤21．4％,Burkitt淋巴瘤16．7％,问变大T细胞淋巴瘤14．3％,淋巴母细胞淋巴瘤11．3％,滤泡性淋巴瘤10．7％,蕈样霉菌病10％,弥漫小B细胞淋巴瘤8．3％。单因素分析发现,病理类型（χ2=32．4,P=0．002）、年龄（χ2=8．0,P=0．005）、分期（χ2=60．7,P〈0．001）和B症状（χ2=127．8,P〈0．001）是初治淋巴瘤贫血的危险因素。初治的贫血患者中侵犯食管、胃和肠等部位的患者比例较高,为35．2％（94／267）。结论：恶性淋巴瘤患者有较高的贫血发生率,复治患者贫血发生率明显高于初治患者,初治患者贫血的发生与病理类型、年龄、分期和B症状有密切关系。年龄〉60岁、Ⅲ～Ⅳ期、胃肠道侵犯、有B症状患者更易发生贫血。     

地塞米松对家兔失血性休克-再灌注损伤的防治作用

目的：探讨地塞米松对失血性休克－再灌注损伤的防治作用。方法：制备家兔失血性休克模型,随机分为地塞米松保护组（Ⅱ组）和未用地塞米松对照组（Ⅰ组）,检测血浆和组织一氧化氮代谢产物（NOP）、丙二醛（MDA）含量及平均动脉压（MAP）。结果：休克前2组动物NOP、MDA及MAP间均无统计学差异。休克90分钟时2组动物NOP、MDA均明显升高,MAP均显著下降,再灌注后,Ⅱ组NOP及MDA均逐渐下降,再灌注3小时后接近休克前水平,但明显低于休克90分钟和Ⅰ组同时间点水平;Ⅱ组MAP逐渐上升,再灌注3小时后接近休克前水平,但明显高于休克90分钟和Ⅰ组同时间点水平。此外,Ⅱ组心、肺、肝、肾、肠道组织NOP及MDA含量均明显低于Ⅰ组。结论：地塞米松可降低一氧化氮及氧自由基水平,减轻脂质过氧化反应,对休克－再灌注损伤起良好的防护作用。     

Reduction of immunosuppression for transplant-associated skin cancer: expert consensus survey

BACKGROUND: Reduction of immunosuppression is considered a reasonable adjuvant therapeutic strategy in solid-organ transplant recipients experiencing multiple or high-risk skin cancers. However, the literature provides no guidance about what threshold of cancer development would warrant initiation of reduction of immunosuppression. OBJECTIVES: To develop expert consensus guidelines for initiation of reduction of transplant-associated immunosuppression for solid-organ transplant recipients with severe skin cancer. METHODS: An expert consensus panel was convened by the International Transplant Skin Cancer Collaborative and Skin Care for Organ Transplant Patients Europe Reduction of Immunosuppression Task Force. Thirteen hypothetical patient scenarios with graduated morbidity and mortality risks were presented and mean and mode expert opinions about appropriate level of reduction of systemic immunosuppression (mild, moderate, severe) were generated. RESULTS: Mild reduction of transplant-associated immunosuppression was considered warranted once multiple skin cancers per year developed or with individual high-risk skin cancers. Moderate reduction was considered appropriate when patients experienced > 25 skin cancers per year or for skin cancers with a 10% 3-year risk of mortality. Severe reduction was considered warranted only for life-threatening skin cancers. CONCLUSIONS: Reduction of immunosuppression is considered a reasonable adjuvant management strategy for transplant recipients with numerous or life-threatening skin cancers. Proposed guidelines are presented for the graduated reduction of immunosuppression coincident with the increasing skin cancer risks.     

阿克他利对Ⅱ型胶原性关节炎小鼠的治疗作用及部分机制研究

 目的 研究阿克他利(Acta)对小鼠Ⅱ型胶原性关节炎(CIA)的治疗作用。方法 采用Ⅱ型胶原(CⅡ)乳剂皮内注射诱导的小鼠CIA模型。在此基础上,检测小鼠足肿胀、免疫功能的改变,以及对CⅡ的迟发性变态反应(DTH)和血清中抗CⅡ抗体的测定,同时进行了病理组织学的检查。结果 Acta(10,30,90 mg·kg^-1)ig对CⅡ诱导的小鼠足肿胀有明显的抑制作用;体外研究发现,Acta(10,30,90 mg·kg^-1)能使CIA小鼠过高的ConA增殖反应和IL-2的产生恢复至接近正常,同时对CIA小鼠过高的IL-1产生有明显的抑制作用;Acta(10,30,90 mg·kg^-1)ig可以明显减轻CⅡ诱发迟发性变态反应(DTH),但Acta对CIA小鼠体内的抗体的产生无显著影响。病理学检查表明,Acta(10,30,90 mg·kg^-1)ig可以减轻CIA小鼠的骨膜增生和软骨破坏。结论 Acta对CIA小鼠具有治疗作用,该作用可能是通过细胞免疫调节实现的。     

电脉冲介导基因转移效率的实验研究

目的　研究电脉冲介导的基因转移效率及其最佳的基因转移的电脉冲参数。方法　用微量注射器将pcD2/LacZ质粒10μg,在昆明小鼠的股四头肌注射,1～2min内在注射部位给予不同参数的电脉冲刺激(不同的电脉冲参数每组10只小鼠),然后进行β-半乳糖苷酶活性的测定或酶组织化学染色。同时设空白对照组及单纯注射组。结果　电脉冲可明显增加LacZ基因的表达,电脉冲组的β-半乳糖苷酶活性（131.6U/mg±86.5U/mg蛋白）是单纯注射组（4.9U/mg±1.0U/mg蛋白）的30倍（P<0.05）。组织化学染色结果表明电脉冲组肌肉组织中β-半乳糖苷酶蓝色颗粒的数目和染色的程度均明显高于单纯肌肉注射组。当电脉冲参数电压200V/cm,波宽40ms,脉冲次数6次和频率1Hz时,可获得最高的基因表达效率。结论　在最佳的电脉冲参数条件下,电脉冲介导的基因转移可获得较高的基因表达。     

不同产地牡丹皮饮片质量评价

目的对不同产地牡丹皮饮片进行质量评价。方法采用化学及仪器分析的方法测定3种不同产地牡丹皮饮片的水分、灰分、浸出物、丹皮酚、丹皮总苷及丹皮多糖含量。结果不同产地牡丹皮饮片有效成分含量有显著差异。结论3种不同产地的牡丹皮饮片样品中,安徽铜陵牡丹皮饮片质量最优。     

Home-Delivered Meal Programs for Homebound People with HIV/Aids

In major cities within the past decade, 17 community-based, home-delivered meal programs have emerged to meet the specialized nutrition needs of homebound people living with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (HIV/AIDS). This review includes specifics about these meal programs: funding, eligibility criteria, establishing and following nutrition and food safety standards, creating a network of volunteers for delivery of meals, providing nutrition counseling, and conducting periodic program evaluation. People living with HIV/AIDS may need the services of home-delivered meal programs throughout the course of HIV disease. Clinical dietitians and public health nutritionists should become familiar with existing programs and refer clients to services as needed. J Am Diet Assoc. 1995; 95:476–481.