细胞因子激活骨髓免疫细胞的实验研究

目的：通过对骨髓单个核细胞在体外与不同细胞因子培养,了解不同细胞因子对骨髓淋巴细胞的激活能力和对骨髓干祖细胞的损伤情况。方法：将IL-1、IL-2、γ-IFN、CD3单抗进行不同组合后,在体外与骨髓单个核细胞分成对照组、IL-2组、CD3-AK、CIK组进行培养。培养过程中观察细胞形态和数量的变化,并在培养后检测免疫活性细胞的细胞毒性和造血干细胞的保存情况。结果：培养过程中对照组细胞数量减少;IL-2组细胞数量变化不明显;CD3-AK组、CIK组细胞数量显著增多,并出现较多的集聚成簇的淋巴样细胞,培养后其细胞毒性明显强于对照组及IL-2组,但细胞数量增加和细胞毒性无明性差异,培养后各组造血干细胞保存情况约16%～87%。结论：IL-2、CD3单抗在体外与骨髓单个核细胞培养后,即能激活免疫细胞增殖,又能保留足够的造血干细胞。     

Representative dynamic ranges of spinal alignment during gait in patients with mild and severe adult spinal deformities

BACKGROUND CONTEXTSurgical correction strategies for adult spinal deformity (ASD) relies heavily on radiographic alignment goals, however, there is often debate regarding degree of correction and how static alignment translates to physical ability in daily life. Kinematic analysis has the potential to improve the concept of ideal spinal alignment by providing clinically meaningful estimates of dynamic changes in spinal alignment during activities of daily life.PURPOSEEstimate representative dynamic ranges of spinal alignment during gait among ASD patients using 3D motion tracking; compare dynamic alignment between mild and severe deformity patients and to healthy adults.STUDY DESIGN/SETTINGRetrospective review at a single institution.PATIENT SAMPLEFifty-two ASD patients and 46 healthy adults.OUTCOME MEASURESRadiographic alignment, kinematic spine motion, spatiotemporal gait measures, patient reported outcomes (VAS pain, ODI, SRS-22r).METHODSSpinal alignment was assessed radiographically and during standing and overground walking tests. Dynamic alignment was initialized by linking radiographic alignment to kinematic alignment during standing and at initial heel contact during gait. Dynamic changes in maximums and minimums during gait were made relative to initial heel contact for each gait cycle. Total range-of-motion (RoM) was measured for both ASD and healthy subjects. Dynamic alignment measures included coronal and sagittal vertical axes (CVA, SVA), T1 pelvic angle (TPA), lumbar lordosis (LL), and pelvic tilt (PT). ASD patient's deformities were classified as either Mild or Severe based on the SRS-Schwab ASD classification.RESULTSSevere ASD patients had significantly larger dynamic maximum and minimums for SVA, TPA, LL, and PT (all p<.05) compared with Mild ASD patients. ASD patients exhibited little difference in dynamic alignment compared with healthy subjects. Only PT had a significant difference in dynamic RoM compared with healthy (p<.001).CONCLUSIONSMild and Severe ASD patients exhibited similar global dynamic alignment measures during gait and had comparable RoM to healthy subjects except with greater PT and reduced spatiotemporal performance which may be key compensatory mechanisms for dynamic stabilization.     

胰弹力蛋白酶I和核糖核酸酶检测的临床价值

目的　探讨人胰弹力蛋白酶Ⅰ (Humanpancreaticelastase 1 ,HPE1 )放射免疫测定 (Radioimmunoassay ,RIA)和核糖核酸酶(Ribonuclease ,RNase)活性检测的临床价值。方法　参照Satake等建立的改良HPE1RIA和Thomas等的改良酸溶性产物法检测 82例正常成年人和 2 2 2例各类患者血清并分析结果。结果　 82例健康成人HPE1值为 2 3.8( 3.4ng L) ,RNase活性为 5 7.0 3( 1 2 .1 6 μ ml) ;急性胰腺炎和胰腺癌HPE1 值明显高于其他疾病 (P <0 .0 1 )。联合检测HPE1 、RNase活性可提高胰腺癌的检出率 ( 92 .47% )。结论　HPE1 RIA对急性胰腺炎有诊断价值 ,联合检测HPE1 、RNase活性检测对胰腺癌诊断有一定的临床价值     

口服莫沙必利治疗功能性消化不良的随机对照试验

目的　观察新型促胃肠动力药莫沙必利 (胃 5 HT4受体促进剂 )对功能性消化不良 (FD)的随机对照试验。方法　FD患者 42例 ,随机分为试验组 (2 1例 ,服枸橼酸莫沙必利片 )和对照组 (2 1例 ,服吗叮啉片 )。采用GCP标准 ,双盲法观察 ,在实验开始前、服药第 1 4、2 8天记录症状变化及副作用发生情况。随机抽取部分患者于实验开始前和结束时做99MTc胃排空试验。结果　莫沙必利对FD症状的疗效与吗叮啉组相当 (P >0 .0 5 )。99MTc胃排空测定发现莫沙必利组治疗后的半排时间 (45 .0 5± 1 2 .2 1 )min缩短 ,1 2 0min残留率 (2 9.73%± 8.5 1 % )减少 (P <0 .0 5 ) ,两组病例未发现毒副反应。结论　莫沙必利对于FD疗效良好 ,对胃排空延迟有良好疗效 ,安全度高。     

关于建立非隶属关系附属医院的实践与思考

本文从医学人才培养的高度,论述高校与附属医院建立非隶属关系的附属医院的过程、体会和思考,指出目前存在的问题和解决途径.对进一步深化临床教育教学改革具有重要意义.     

Decorin and suramin inhibit ocular fibroblast collagen production

Background: The process of ocular wound healing with respect to glaucomatous filtering procedures is of current interest. Delaying this response in patients could possibly lead to more favorable surgical results. So far, only highly toxic antimetabolites have come into frequent clinical use. The possible efficacy of other groups of substances such as growth factor inhibitors has not yet been examined in vitro. Methods: We exposed Tenon's capsule fibroblasts in tissue culture to various concentrations of decorin and suramin. The dose responses of type I and type III collagen to these inhibitors were measured using an ELISA-type dot blot assay. Total cellular protein production was assayed by measuring the incorporation of tritiated leucine. Results: At a concentration of 10 g/ml, suramin reduced the collagen production by more than 80%. Decorin, at a concentration of 100 g/ml, reduced type I collagen production by about 50% while type III collagen was reduced by 80%. At these concentrations, the total cellular protein production was not inhibited. Conclusions: Both suramin and decorin, which specifically inhibit the action of growth factors on target cells, reduce the production of collagen synthesis by Tenon's capsule fibroblasts. This is a specific effect, because total protein production is not influenced. This sets these substances apart from antimetabolites. Decorin and suramin may have clinical relevance in that they appear to interfere with ocular wound healing more specifically than the substances so far frequently used.     

Bacterial resistance in the '90s

The lesson of the antibiotic era is, the microbe always wins. Pediatricians need to understand why, to take the threat seriously, and to mobilize to fight back.     

Response from lieberman and colleagues

Respond on comments on Lieberman's article: Cyclosiloxanes Produce Fatal Liver and Lung Damage in Mice. Environ Health Perspect 107:161-165