A combined approach for purging multidrug-resistant leukemic cell lines in bone marrow using a monoclonal antibody and chemotherapy.

Selective removal of malignant cells (purging) from bone marrow (BM) is a concern in autologous BM transplantation (ABMT). Use of vincristine, etoposide, or doxorubicin for purging could be rendered ineffective by the presence of multidrug-resistant (MDR) tumor cells. To circumvent this particular problem, we investigated whether 17F9, a monoclonal IgG2b antibody directed against the cell surface product of the MDR gene, P-glycoprotein, is effective in selective removal of MDR cells from BM when used with rabbit complement (C'). Using two different cell lines we have demonstrated that 17F9 + C' selectively lyses MDR-positive cells. Three rounds of antibody + C' resulted in 96.4% +/- 3.6% kill of K562/DOX and 100% +/- 0% of CEM/VLB cells. Mixtures of malignant cells and normal BM resulted in 99.85% removal of K562/DOX and 99.91% removal of CEM/VLB clonogenic cells. This treatment did not affect normal committed precursors compared with C' alone. The addition of the cytotoxic agent etoposide (VP-16) following antibody purging results in a 4.6 log reduction of malignant cells. Furthermore, this antibody was effective when used against patients' leukemic blasts. These results suggest the use of 17F9 + C' is effective and selective for removal of MDR cells from BM before ABMT and the addition of VP-16 enhances the purging efficacy.     

从北京入境的中国籍旅行者死亡案例分析

目的 国际旅行者的健康和在旅行目的 地死亡原因应予以极大关注.通过对中国籍旅行者死亡原因的分析、致死危险性因素的评估,以便有针对性地对国际旅行者提供卫生保健咨询.方法 本文分析了1998年到2002年期间经北京口岸入境的在国外死亡的中国籍旅行者.对每例死亡的地理分布、死亡原因等进行统计.结果 1998年到2002年期间经北京口岸入境的在国外死亡的中国籍旅行者共64例.死亡发生在利比亚、阿拉伯联合酋长国、巴基斯坦、新加坡和巴林等36个国家和地区.心血管疾病、交通事故、工伤致死及意外伤害为主要的死亡原因.结论 根据旅行目的地国家不同、旅行目的 不同,针对心血管疾病、工伤、意外伤害及传染病等危险性提供旅行卫生保健咨询.     

老年2型糖尿病患者胰岛素抵抗相关指标的检测和意义

目的:探讨老年2型糖尿病胰岛素抵抗(IR)及其相关性,为老年2型糖尿病的合理防治提供临床依据。方法:选择120例老年2型糖尿病患者,按胰岛素敏感指数(HOMA)胰岛素抵抗(HOMA-IR)50百分位点将患者分为两组:胰岛素相对敏感组(HOMA-IR<3.56)和胰岛素相对抵抗组(HOMA-IR≥3.56),比较体重指数(BMI)、腰/臀比(WHR)、血压、血生化学检查等指标。用年龄>40岁,<60岁的2型糖尿病患者做对照组。结果:两组老年患者在年龄、性别、舒张压、空腹血糖、胆固醇、高密度脂蛋白、糖化血红蛋白、HOMA胰岛β细胞功能方面无差异;但BMI、WHR、收缩压、甘油三脂、空腹胰岛素、HOMA-IR差异具有显著性。多线性回归分析后,只有腰/臀比、收缩压、甘油三脂、HOMA-IR存在统计学差异。老年患者与对照组相比,IR发生率明显增加,且两者腰/臀比、收缩压、甘油三脂方面也差异显著。结论:IR与老年2型糖尿病密切相关,是临床防治糖尿病的重要靶点。     

膀胱癌组织P-gp,GST-π和TOPO-Ⅱ表达评估灌注化疗

目的：探讨膀胱癌的多药耐药性(MDR)，指导灌注化疗用药。方法：采用免疫组化法检测44例膀胱癌病理标本中P-糖蛋白(P-gp)、谷胱肽S转移酶(GST-π)和拓扑异构酶(TOPO—Ⅱ)的表达，评估肿瘤耐药谱。结果：①P-gp检测显示，54．5％的病例对阿毒索、丝裂毒索、长春新碱等抗生索类和生物碱类抗癌药高耐药。②GST-π检测显示仅34．1％的病例对顺铂、环磷酰胺等高耐药，而反有56．8％的病例对该类药无耐药或低度耐药。③TOPO-Ⅱ检测显示对阿霉索、柔红毒索、VP16等TOPO-Ⅱ抑制剂类抗癌药，仅13．6％的病例高度耐药，29．5％中度耐药。56．8％低度耐药。结论：检测膀胱癌MDR，了解多药耐药谱，可指导灌注化疗用药。     

生物衍生骨复合骨髓基质干细胞修复山羊胫骨缺损的血管化研究

目的研究生物衍生骨与骨髓基质干细胞(marrow stromal stem cells, MSCs)复合修复山羊胫骨缺损的血管化过程,了解其修复长段管状负重骨缺损的血管化情况. 方法制备生物衍生骨作为支架材料,培养、诱导MSCs作为种子细胞,二者在体外复合构建组织工程骨.20只山羊双侧胫骨中段制备成20 mm长的骨-骨膜缺损模型,采取自身左右侧对照,实验侧(右侧)缺损处植入组织工程骨,对照侧(左侧)植入单纯支架材料,采用钢板内固定.术后2、4、6及8周用墨汁灌注透明标本及血管面积图像分析方法观察血管化过程,组织学观察血管形成及成骨情况. 结果术后2、4周,实验侧血管形成较对照侧少(P<0.05);术后8周,两侧均完全血管化,差异无统计学意义(P>0.05).实验侧于术后6、8周新骨形成逐渐增加,材料降解吸收较对照组快;对照侧术后8周材料孔隙内仍无明显新骨形成. 结论生物衍生骨作为骨组织工程的支架材料,能够较快发生血管化;组织工程骨成骨能力较单纯支架材料强.     

Osteoclastogenesis in the nonadherent cell population of human bone marrow is inhibited by rhBMP-2 alone or together with rhVEGF.

During bone development and repair, angiogenesis, osteogenesis, and bone remodeling are closely associated processes that share some common mediators. In the present study nonadherent human bone marrow mononuclear cells under the induction of sRANKL and M-CSF, differentiated into osteoclasts with TRAP-positive staining, VNR expression, and Ca-P resorptive activity. The effects of various combinations of rhBMP-2 (0, 3, 30, and 300 ng/mL) and rhVEGF (0 and 25 ng/mL) on osteoclastogenesis potentials were examined in this experimental system. The percentages of TRAP-positive multiple nucleated cells represent osteoclast differentiation potential, and the percentages of resorptive areas in the Ca-P coated plates resemble osteoclast resorption capability. The presence of rhBMP-2 at 30 and 300 ng/mL showed inhibitory effects on osteoclast differentiation and their resorptive capability in the human osteoclast culture system. rhVEGF (25 ng/mL) enhanced the resorptive function of osteoclast whenever it was used alone or combined with 3 ng/mL rhBMP-2. However, rhVEGF-induced resorptive function was inhibited by 30 ng/mL and 300 ng/mL rhBMP-2 in a dose-dependent manner. Statistical analysis demonstrated that an interactive effect exists between rhBMP-2 and rhVEGF on human osteoclastogenesis. These findings suggested that an interactive regulation may exist between BMPs and VEGF signaling pathways during osteoclastogenesis; exact mechanisms are yet to be elucidated.     

调节T细胞与感染

近年来调节T细胞（Treg细胞）成为免疫学研究的热点问题。这些研究大部分集中于自身免疫病、移植免疫及抗肿瘤免疫领域，对于调节T细胞在针对抗感染免疫反应中作用的认识仍然有限。本文总结了目前在各种类型感染性疾病研究中对Treg的认识，并讨论了其在感染过程中可能发挥的作用。     

大中学生预防艾滋病生活技能需求

目的了解我国学生对学校预防艾滋病教育中生活技能的需求情况,为今后开展以生活技能为基础的预防艾滋病教育提供依据。方法对北京市5所初中3、所高中和2所大学的1207名学生进行问卷调查。结果无论初中、高中还是大学生,多数学生都认为这些生活技能要素在开展预防艾滋病教育中能够起到重要的作用。不同学段学生对9类技能的认知重要程度不同,初中生认为认识和解决问题能力最重要,高中生认为创造性思维能力最重要,大学生认为批判性思维能力最重要。结论根据学生年龄有所侧重地开展以生活技能为基础的学校预防艾滋病教育十分重要。     

CT features of presacral mass: an unusual focus of extramedullary hematopoiesis

A case of beta-thalassemia with an unusual focus of extramedullary hematopoiesis is reported. The presacral area was involved producing a significant mass effect on the rectum.     

改良去带盲结肠可控膀胱术

目的：评价改良去带盲结肠可控膀胱术的临床价值。方法：对8例膀胱癌患者施行全膀胱切除和改良去带盲结肠可控膀胱术。结果：随访3－41个月，均获得良好的疗效。贮尿囊容量为260－700ml，贮尿囊内最大压力为0.981-2.940kPa，每3－6h导尿1次，血清电解质和肾功能正常。结论：本术式可以获得大容量、低内压的贮尿囊，具有可控效果好、操作简单和并发症少等优点。