Recombinant rat stem cell factor synergizes with recombinant human granulocyte colony-stimulating factor in vivo in mice to mobilize peripheral blood progenitor cells that have enhanced repopulating potential

Splenectomized mice treated for 7 days with pegylated recombinant rat stem cell factor (rrSCF-PEG) showed a dose-dependent increase in peripheral blood progenitor cells (PBPC) that have enhanced in vivo repopulating potential. A dose of rrSCF-PEG at 25 micrograms/kg/d for 7 days produced no significant increase in PBPC. However, when this dose of rrSCF-PEG was combined with an optimal dose of recombinant human granulocyte colony-stimulating factor (rhG-CSF; 200 micrograms/kg/d), a synergistic increase in PBPC was observed. Compared with treatment with rhG-CSF alone, the combination of rrSCF-PEG plus rhG-CSF resulted in a synergistic increase in peripheral white blood cells, in the incidence and absolute numbers of PBPC, and in the incidence and absolute numbers of circulating cells with in vivo repopulating potential. These data suggest that low doses of SCF, which would have minimal, if any, effects in vivo, can synergize with optimal doses of rhG-CSF to enhance the mobilization of PBPC stimulated by rhG-CSF alone.     

组织工程化人形下颌骨髁状突的实验研究

目的　评价采用组织工程技术构建人下颌骨髁状突软骨复合组织的可行性。方法　以可降解生物材料聚羟基乙酸 (polyglycolicacid ,PGA) /聚乳酸 (polylacticacid ,PLA)预制人下颌骨髁状突模型 ,体外培养扩增牛骨膜成骨细胞和牛关节表面软骨。实验分 3组 :第 1组 ,模型内仅注入 1.5 %藻酸钙和 30 %氧化乙丙烯 ;第 2组 ,模型内分别注入成骨细胞和软骨细胞悬液 ,浓度为 5× 10 7/ml;第 3组 ,模型内接种成骨细胞藻酸钙悬液 ,同时在模型关节表面涂敷软骨细胞 PluronicF12 7悬液 ,浓度为 5× 10 7/ml。分别植入裸鼠皮下 ,12周后取材 ,作大体和组织学观察。结果　第 1组无骨和软骨形成 ,模型支架明显缩小 ,形态不规则 ;第 2组仅留残缺不全的组织结构 ,标本体积缩小变形 ;第 3组形态结构与原植入模型支架相同 ,组织学观察有骨和软骨组织结构 ,两者界面连接有序 ,骨组织内有大量新生骨板。结论　以人工合成生物材料预制人下颌骨髁状突支架 ,采用组织工程技术 ,可以在裸鼠体内构建具有骨软骨复合结构的正常形态的人形下颌骨髁状突 ,从而为进一步临床应用提供了理论依据     

应用组织工程化皮肤修复皮肤全层缺损

目的本研究旨在评价组织工程技术修复皮肤缺损的可行性。方法采用Ｙｏｒｋｓｈｉｒｅ猪,在其背部脊柱两侧做６个直径４ｃｍ的圆形全厚皮肤缺损,随机分为３组。第１组为空白对照,第２组仅置无细胞的ｐｌｕｒｏｎｉｃ;第３组分别用角朊细胞－ｐｌｕｒｏｎｉｃ、成纤维细胞－ｐｌｕｒｏｎｉｃ复合物置于创面上。第４、６周时取材,进行大体,组织学和透射电镜观察。结果４－６周时表皮和真皮间界面明显被上皮嵴和真皮乳头所分隔。对     

脑卒中患者对负性情绪及心理治疗认知状况的调查

目的:调查甘肃省脑卒中患者对负性情绪是否影响肢体功能以及心理治疗的认知.方法:采用问卷调查方式,对甘肃省10家不同级别的省市县级医院神经内、外科2010年收治的脑卒中住院患者1 100例进行调查.结果:负性情绪对肢体功能恢复的影响占69.80%,脑卒中后心理治疗的需要占76.99%.结论:负性情绪对脑卒中患者肢体功能恢复有影响,并且非常需要心理治疗.     

Angiotensin II desensitization and Ca++ and Na+ fluxes in cultured intestinal smooth muscle cells

The effects of angiotensin II (ANG) on Na+ and Ca++ fluxes in cultured intestinal smooth muscle cells from the guinea pig ileum were studied and correlated with the contraction and desensitization observed in whole muscles. The effects of ANG were compared with those of acetylcholine (ACh), an agonist that acts at muscarinic receptors in the intestinal smooth muscle and which does not induce desensitization. Both ANG and ACh stimulated 24Na+ influx upon addition to the cells, and this stimulation persisted for at least 30 min. Both agonists also stimulated 45Ca++ uptake but ANG's effect was transient, whereas that of ACh was persistent. Short-term (30 min) treatment with PMA (phorbol-12-myristate-13-acetate) caused a fade of the tonic response of the whole muscle to ANG, and also blocked this hormone's stimulating effect on 45Ca++, but not on 24Na+ influx. Long-term (7 hr) treatment with PMA, which suppresses protein kinase C activity, restored ANG's ability to stimulate 45Ca++ influx. The stimulating effects of ACh on 24Na+ and 45Ca++ influxes were not affected by short- or long-term treatment of the cells with PMA. Our results suggest that ANG desensitization involves protein kinase C inhibition of a step in the stimulus-response chain that is subsequent to phospholipase C-activation.     

Thromboelastometry and organ failure in trauma patients: a prospective cohort study

Introduction

Data on the incidence of a hypercoagulable state in trauma, as measured by thromboelastometry (ROTEM), is limited and the prognostic value of hypercoagulability after trauma on outcome is unclear. We aimed to determine the incidence of hypercoagulability after trauma, and to assess whether early hypercoagulability has prognostic value on the occurrence of multiple organ failure (MOF) and mortality.

Methods

This was a prospective observational cohort study in trauma patients who met the highest trauma level team activation. Hypercoagulability was defined as a G value of ≥11.7 dynes/cm² and hypocoagulability as a G value of <5.0 dynes/cm². ROTEM was performed on admission and 24 hours later.

Results

A total of 1,010 patients were enrolled and 948 patients were analyzed. Median age was 38 (interquartile range (IQR) 26 to 53), 77% were male and median injury severity score was 13 (IQR 8 to 25). On admission, 7% of the patients were hypercoagulable and 8% were hypocoagulable. Altogether, 10% of patients showed hypercoagulability within the first 24 hours of trauma. Hypocoagulability, but not hypercoagulability, was associated with higher sequential organ failure assessment scores, indicating more severe MOF. Mortality in patients with hypercoagulability was 0%, compared to 7% in normocoagulable and 24% in hypocoagulable patients (P <0.001). EXTEM CT, alpha and G were predictors for occurrence of MOF and mortality.

Conclusions

The incidence of a hypercoagulable state after trauma is 10% up to 24 hours after admission, which is broadly comparable to the rate of hypocoagulability. Further work in larger studies should define the clinical consequences of identifying hypercoagulability and a possible role for very early, targeted use of anticoagulants.

Electronic supplementary material

The online version of this article (doi:10.1186/s13054-014-0687-6) contains supplementary material, which is available to authorized users.     

Autologous bone marrow transplantation for acute myeloid leukemia using busulfan plus etoposide as a preparative regimen

We have studied the use of a new preparative regimen for the treatment of patients in remission of acute myeloid leukemia (AML) with autologous bone marrow transplantation. Chemotherapy consisted of busulfan 1 mg/kg every 6 hours for 4 days (total dose, 16 mg/kg) on days -7 through -4 followed by an intravenous infusion over 6 to 10 hours of etoposide 60 mg/kg on day -3. Autologous bone marrow, treated in vitro with 100 micrograms/mL of 4-hydroperoxycyclophosphamide, was infused on day 0. We have treated 58 patients up to the age of 60 years, 32 in first remission, 21 in second or third remission, and 5 with primary refractory AML unresponsive to high-dose Ara-C, but achieving remission with aggressive salvage regimens. Of the first remission patients, there has been 1 treatment related death and 5 relapses. With median follow-up of 22 months, the actuarial relapse rate is 22% +/- 9% and disease-free survival is 76% +/- 9% at 3 years. Patients with favorable French-American-British (FAB) subtypes (M3 or M4 EO) did especially well, with no relapses seen in 15 patients observed for a median of 30 months. Actuarial relapse rate at 3 years was 48% for first remission patients with less favorable FAB subtypes. Of patients in second or third remission, there were 5 treatment related deaths and 4 relapses. With median follow-up of 22 months, the actuarial relapse rate is 25% +/- 11% and disease-free survival is 56% +/- 11% at 3 years. Four of five primary refractory patients died during treatment and 1 remains in remission with short follow-up. These preliminary data are very encouraging and, if confirmed, support the use of autologous purged bone marrow transplantation using aggressive preparative regimens as one approach to improve the outcome of adults with AML.     

Rapid prenatal diagnosis of beta thalassemia using DNA amplification and nonradioactive probes

We used in vitro DNA amplification by the polymerase chain reaction and nonradioactive probes for prenatal diagnosis of beta thalassemia in Chinese from the Guangdong province. Exact molecular diagnoses were made in all 20 fetuses studied over a 6-month period. We conclude that this method of prenatal diagnosis for beta thalassemia is a viable approach in many parts of the world where this disease is common.