黄芪对脂多糖活化小鼠巨噬细胞产生一氧化氮的影响

目的研究黄芪经水提醇沉所得提取物及黄芪甲苷对脂多糖(LPS)活化小鼠巨噬细胞RAW 264.7细胞产生一氧化氮(NO)的影响作用,并测定提取物中黄芪甲苷的含量。方法小鼠三磷腺苷荧光试剂盒(ATPliteTM)测定黄芪提取物及黄芪甲苷对RAW 264.7细胞的毒性作用,Griss法测定样品对LPS活化RAW 264.7细胞后细胞培养液中亚硝酸盐(NO2-)的含量间接反映NO生成量,姜黄素为阳性对照。液相色谱仪测定提取物中黄芪甲苷的含量。结果黄芪提取物在200~400μg·mL-1、黄芪甲苷在10~20μg·mL-1的剂量范围内均表现出显著抑制NO生成的作用(P0.05)。每1 mg提取物中含6.1μg黄芪甲苷,400μg·mL-1提取物的抑制作用(其中含黄芪甲苷2.4μg·mL-1)与20μg·mL-1的黄芪甲苷相比,差异无统计学意义(P0.05)。结论黄芪具有抑制LPS活化小鼠巨噬细胞产生NO的作用,黄芪甲苷为其效应成分之一。     

Periprosthetic knee joint infection caused by Sneathia sanguinegens

Sneathia sanguinegens is a fastidious, Gram-negative, rod-shape organism rarely isolated from human specimens. In the present report, we describe a case of periprosthetic knee joint infection due to the organism, which occurred in a female patient receiving immunosuppressants for underlying lupus nephritis. The causative organism was isolated from the synovial fluid in the affected knee joint through inoculating the material on chocolate agar and incubation for 15 days under 5% CO₂. Moreover, the organism was capable to be subcultured on chocolate agar with incubation for a few days under 5% CO₂, demonstrating that this uncommon organism, although generally considered as a strict anaerobe, is culturable in aerobic condition if appropriate media and a sufficient incubation time are given. The patient was treated with intravenous cefepime, an antibiotic highly active to the isolated organism in an in vitro study, in addition to intraarticular debridement and exchanging a polyethylene insert in the affected joint. The antimicrobial therapy with cefepime was given for 19 days and, thereafter, changed with oral levofloxacin. Although the patient showed full recovery after administration of levofloxacin for 100 days, an in vitro study conducted later revealed that levofloxacin was inactive to the isolated organism.     

Staphylococcus pettenkoferi bacteremia in a tertiary care hospital in Japan: Report of three cases

Staphylococcus pettenkoferi is a coagulase-negative staphylococci (CoNS) species first isolated in 2002. Human infections caused by S. pettenkoferi are rare. We herein report three cases of S. pettenkoferi bacteremia in a tertiary care hospital in Japan. Staphylococcus pettenkoferi can be a causative pathogen of catheter related blood stream infection including complicated infection, and unknown source of bacteremia. All of the patients presented with fever and shaking chills, and good clinical outcome. Further research is needed to determine the role of this organism as a pathogen and frequency.     

2型糖尿病发生冠心病相关危险因素的研究

目的探讨2型糖尿病患者发生冠心病的相关危险因素。方法选择2型糖尿病患者150例,根据是否合并冠心病分为2组,单纯2型糖尿病患者组(A组)82例和2型糖尿病合并冠心病患者组(B组)68例。另选择同期健康体检者60例作为对照组,测定各组的同型半胱氨酸、高敏C反应蛋白、凝血酶原时间、活化部分凝血酶时间、纤维蛋白原和D-二聚体。结果与对照组比较,A组和B组患者同型半胱氨酸、高敏C反应蛋白和D-二聚体差异有统计学意义(P<0.05);与A组比较,B组同型半胱氨酸、高敏C反应蛋白和D-二聚体差异有统计学意义(P<0.05)。多因素logistic回归分析显示,同型半胱氨酸、高敏C反应蛋白和D-二聚体均为冠心病的危险因素。3组凝血酶原时间、活化部分凝血酶时间、纤维蛋白原比较差异无统计学意义(P>0.05)。结论同型半胱氨酸、高敏C反应蛋白和D-二聚体均是2型糖尿病患者发生冠心病的高风险因素。     

颈椎术后邻近节段退变性疾病患者矢状位平衡变化的研究进展

目前对颈椎矢状面平衡参数的研究已取得重大进展,且有许多学者已致力于对其与邻近节段退变性疾病(ASD)关系的研究,初步结果令人满意。发生ASD的患者常存在颈椎矢状位失衡,不同参数的变化各不相同,但各参数之间存在极强的相关性。同时,患者术前的年龄、颈椎退行性改变程度、手术方式及手术节段的选择对ASD的发生同样有显著影响。     

杞金方药细胞毒性及早期铅干预对小儿神经发育影响的研究

目的我们在研究杞金方药毒理学及安全性的基础上,观察以杞金方药（由枸杞子、鸡内金、焦山楂、木瓜等药物组成）对地鼠肾细胞生长及早期铅干预对新生儿神经行为的影响,研究其对细胞生长及早期铅干预对新生儿神经行为的发育。方法将生长状态良好的地鼠肾细胞用Versence-胰酶混合液消化后制成4×10^5浓度的细胞悬液接种24孔细胞培养板,每孔lmL,37℃二氧化碳培养。称取杞金方药颗粒剂10g放入100mL配液瓶中,加入50mL细胞培养液,121℃高压20min,4℃冰箱放置24h。不断搅拌,并使未溶解部分沉淀。同时将苯酚按同样方法处理做为毒性对照组。长成单层的地鼠肾细胞抽出生长液,将制备好的浸提液用细胞培养液1：2～1-32稀释后加入各孔,每稀释度接种2孔,同时设细胞对照和毒性对照。次日开始观察细胞生长状态。连续观察5d。受试产妇40例,受试纽每d1剂,煎汤分3-5次服,10d为1疗程。该方药是由鸡内金10～15份、构杞子10-15份、焦山楂5-10份、木瓜5～10份组成。将乳汁铅水平≥0．24μmol／L和〈0．24μmol／L设为高铅组和低铅组。受试前后两组间乳汁铅水平进行比较,在3个月龄时对研究对象用蓓蕾（Bayley）婴儿发育量表进行发育评价3个月±1周婴儿精神发育指数（MDI）和心理运动发育指数（PDI）。石墨炉原子吸收光谱法测定初乳铅含量。结果杞金方药制备的颗粒按不同稀释倍数接种于生长良好的地鼠肾细胞观察其对细胞生长的影响,经36℃连续观察5d未见细胞固缩、肿胀、脱落等细胞毒性反应,证实杞金方药不会引起对细胞的毒性反应。受试组和对照组服药前后进行乳铅水平比较,受试组乳铅水平明显低于对照组,两者比较差异有显著性。40例婴儿3个月龄时MDI、PD／与杞金方药合剂干预的相关回归分析结果表明,两发育指标和杞金方药合剂早期铅干预间存在有统计学意义的负相关。结论供试液按不同稀释倍数接种于生长良好的单层地鼠肾细胞,观察其对细胞生长的影响,单层地鼠肾细胞生长良好,与对照组比较细胞生长无差异,对地鼠肾细胞生长无不良影响。用该方药合剂早期干预初乳铅水平,对新生儿神经发育有一定影响。     

早期慢性肾脏病患者维生素D缺乏和贫血的相关性研究

目的探讨早期慢性肾脏病患者中维生素D缺乏与贫血间的关系。方法采用横断面调查研究的方法。分别用放射免疫检测法及全自动生化分析仪检测我院195例早期慢性肾脏病患者血清25羟基维生素D和1,25二羟基维生素D及血红蛋白水平,并比较不同维生素D水平组间的平均血红蛋白浓度及贫血患病率。结果受试对象平均血红蛋白浓度与25羟基维生素D(r=0.2146,P<0.01)及1,25二羟基维生素D(r=0.2479,P<0.01)浓度呈正相关。25羟基维生素D和1,25二羟基维生素D缺乏组与正常组相比,贫血的患病率增高。分层研究发现重度维生素D缺乏组贫血程度及血红蛋白水平降低更为明显。结论维生素D轴(1,25二羟基维生素D及25羟基维生素D)缺乏与低血红蛋白水平及贫血患病率相关。     

Vitamin D Deficiency in Mycosis Fungoides and Sézary Syndrome Patients Is Similar to Other Cancer Patients

BackgroundThe purpose of this study was to determine the prevalence of vitamin D deficiency in CTCL patients and whether supplementation corrects vitamin D deficiency or treatment outcome.Patients and MethodsThree hundred eleven CTCL patients including 27/311 (8.7%) with Sézary syndrome (SS), 169 cancer controls, and 69 normal controls from the M.D. Anderson clinics had 25(OH)D3 levels determined and categorized as deficient (< 20 ng/mL), insufficient (20-29 ng/mL), or sufficient (≥ 30 ng/mL). Clinical response was determined according to a change in percent body surface area involvement.ResultsLow 25(OH)D3 (< 30 ng/mL) levels were present in 76.9% of mycosis fungoides/SS patients, 75.2% of cancer controls, and 66.7% of healthy controls (P = .05, .07) and in 30% to 39% of historical normal controls. Correction of deficiency was successful in 35% or 55 of 156 patients who were given dealer's choice of either vitamin D2 at 50,000 IU orally (p.o.) biweekly or D3 1000 IU p.o. daily. Correction of vitamin D levels was noted in 27 of 100 (27%) patients given D3 and 28 of 56 (50%) given D2. Responses to standard CTCL therapy was similar among patients with corrected and persistently low levels (P = .51).ConclusionTo our knowledge, this is the first study of vitamin D status in CTCL patients. Vitamin D deficiency was present in CTCL and other cancer patients compared with normal and historical controls. Correction of vitamin D deficiency and type of vitamin D supplementation used did not affect the overall clinical disease response.     

氟达拉滨联合中剂量阿糖胞苷治疗复发难治性急性髓系白血病效果观察

目的 比较氟达拉滨（FLud）联合中剂量阿糖胞苷（Ara-C）（改良FLAG方案）与CAG 预激方案治疗复发难治性急性髓系白血病（AML）的疗效及患者不良反应.方法 49例复发难治性AML 患者,随机分为两种治疗方案组,改良FLAG治疗方案组：粒细胞集落刺激因子（G-CSF）每天200 μg/m2,第0天至第5天,Flud每天30 mg/m2,第1天至第5天;Ara-C每天1 g/m2,第1天至第5天.CAG预激治疗方案为：G-CSF每天200 μg/m2,第1天至第14天,阿柔比星20 mg/d,第1天至第4天,Ara-C 10 mg/m2,1次/12h,第1天至第14天.结果 改良FLAG组完全缓解（CR）率43 ％（10/23）,部分缓解（PR）率21％（5/23）,有效率64 ％;CAG预激组CR率23％（6/26）,PR率19％（5/26）,有效率42％,两组间比较差异有统计学意义（P＜0.05）;主要不良反应为骨髓抑制、感染,改良FLAG组感染发生率70％（16/23）,CAG组感染发生率为54％（14/26）,两组间比较差异无统计学意义（P＞0.05）.结论 改良FLAG方案可有效治疗复发难治性AML患者,加强感染防控措施,缩短骨髓抑制时间.CAG方案不良反应小,可分层个体化治疗复发难治性AML患者.