A computer model for the clearance of insoluble particles from the tracheobronchial tree of the human lung

A multi-compartment model for the clearance of insoluble particles from the tracheobronchial tree of the human lung was created. As a significant innovation, the model considers specific mass transfer paths that may play an important role for slow bronchial clearance. These include the accumulation of particulate mass in the periciliary sol layer, an uptake of stored particles by airway macrophages, and the endocytosis of deposited mass by epithelial cells. Besides the gel layer representing fast mucociliary clearance, all cellular and extracellular units involved into the slow clearance process are described by respective compartments which are connected by specific transfer paths. The gastrointestinal tract (GIT), lymph nodes (LN), and blood capillaries are included into the model as final accumulation compartments, to which mass is transferred via the airway route and the transepithelial path. Besides a basic version of the model describing the whole tracheobronchial region by one set of compartments, also an advanced approach is introduced which, in accordance with the International Commission on Radiation Protection (ICRP), subdivides the conducting airways into a bronchial (BB) and bronchiolar (bb) part. Preliminary results were generated with MS-Excel from deposition data of 1-mummass median aerodynamic diameter (MMAD) particles, calculating local slow clearance fractions according to mathematical procedures introduced in previous publications. While mucociliary clearance is completely finished within 24h after exposure, slow clearance takes place in distinct phases and needs several days to weeks. This multi-stage event is also reflected in the respective retention curves which correspond well to previously published graphs.     

Urinary excretion of platinum (Pt) following skin and respiratory exposure to soluble Pt at South African precious metals refineries

Adverse respiratory and skin health effects have been associated with occupational exposure to soluble platinum (Pt). However, the relationship between skin exposure and urinary Pt excretion has not yet been investigated. In this study we examined the relationship between skin and respiratory exposure to soluble Pt and urinary Pt excretion at two South African precious metals refineries.The skin and respiratory exposure to soluble Pt as well as the urinary Pt excretion of forty precious metals refinery workers was assessed simultaneously using Ghostwipes?, Methods for the Determination of Hazardous Substances method 46/2 and spot urine tests, respectively.The geometric mean for skin exposure to soluble Pt on four anatomical positions (palm, wrist, neck and forehead) was 0.008?μg/cm² [95% confidence interval (CI): 0.005-0.013?μg/cm²], while the geometric mean for respiratory exposure was 0.301?μg/m³ (95%CI: 0.151-0.601?μg/m³) and the geometric mean for urinary Pt excretion was 0.212?μg/g creatinine (95%CI: 0.169-0.265?μg/g creatinine). Partial correlations identified significant positive correlations between skin exposure, respiratory exposure and urinary Pt excretion (r?=?0.580 to 0.754).Skin and respiratory exposures to soluble Pt were both positively correlated with urinary Pt excretion, and both exposure routes should be considered when investigating occupational exposure to soluble Pt.     

A young male adolescent with feminine appearance: diagnosis of 46, XX syndrome neglected for 4 years with gynaecomastia presentation

Gynaecomastia is common in infancy and adolescent boys, but other inciting causes should be kept in mind and necessitate further evaluation should be conducted to determine any underlying conditions. A 22‐year‐old unmarried male adolescent visited our endocrinology clinic for feminine appearance despite operations for bilateral gynaecomastia 4 years ago. Physical examination showed inverted triangular distribution of pubic hair, sparse beard, small‐sized testes, flaccid short penis and surgical scar of the chest wall. Serum hormones study revealed primary hypergonadotropic hypogonadism, and cytogenetic study disclosed female complement (46, XX). The authors recommend that sexual chromosome abnormality should be considered in patients with hypogonadism to avert androgen deficiency‐related complications early and that long‐term team care should be provided to improve the patient's health‐related quality of life.     

Complement and human T cell metabolism: Location,location, location

The complement system represents one of the evolutionary oldest arms of our immune system and is commonly recognized as a liver-derived and serum-active system critical for providing protection against invading pathogens. Recent unexpected findings, however, have defined novel and rather “uncommon” locations and activities of complement. Specifically, the discovery of an intracellularly active complement system—the complosome—and its key role in the regulation of cell metabolic pathways that underly normal human T cell responses have taught us that there is still much to be discovered about this system. Here, we summarize the current knowledge about the emerging functions of the complosome in T cell metabolism. We further place complosome activities among the non-canonical roles of other intracellular innate danger sensing systems and argue that a “location-centric” view of complement evolution could logically justify its close connection with the regulation of basic cell physiology.     

膜辅助蛋白CD46 rs1970530遗传变异对肝癌发病风险的影响

背景与目的：膜辅助蛋白CD46可保护宿主细胞免受补体依赖的细胞毒性作用,研究表明,CD46可能作为肝细胞癌（hepatocellular carcinoma,HCC）患者的潜在生物标志物。探讨CD46基因表达及启动子区遗传变异与HCC发病风险的关系。方法：通过基因表达谱交互分析（gene expression profiling interactive analysis,GEPIA）在线网站分析HCC组织和正常肝组织CD46表达的差异;2011—2015年在华北理工大学附属唐山市工人医院和华北理工大学附属唐山市人民医院经病理学检查确诊且未经放化疗的240例HCC患者作为病例组,对照组为同时期入院体检的500名健康人群。采用聚合酶链反应-限制性片段长度多态性分析（polymerase chain reaction-restriction fragment length polymorphism,PCR-RFLP）法进行基因分型,检测两组基因型频率和等位基因频率,评估CD46 rs1970530遗传变异与HCC发病风险的关系。结果：CD46在HCC组织与正常组织中的表达差异有统计学意义（P<0.05）。经非条件logistic回归分析发现,CD46 rs1970530至少携带一个G等位基因型在病例组及对照组之间差异有统计学意义（OR=0.666,95% CI：0.448~0.990,P<0.05）;两组间等位基因G频率差异有统计学意义（OR=0.689,95% CI：0.478~0.994,P<0.05）。分层分析结果显示,至少携带一个G等位基因者可降低高年龄组（>60岁）（P=0.048）和男性（P=0.023）人群的HCC发病风险,在女性和低年龄组（≤60岁）中差异无统计学意义（P>0.05）。按吸烟状态进行分层分析,rs1970530变异与HCC易感性无明显关联（P>0.05）。结论：HCC中CD46基因高表达及CD46 rs1970530遗传变异影响HCC发病风险。     

血浆置换在儿童重症噬血细胞综合征中应用的疗效分析：前瞻性随机对照研究

目的探讨血m46;置换在辅助救治儿童重症噬血细胞综合征（hemophagocytic syndrome，HPS）中的疗效和应用价值。方法采用前瞻性随机对照研究方法，选取2018年10月至2020年10月在湖南省儿童医院儿童重症监护室（pediatric intensive care unit，PICU）接受救治的重症HPS患儿40例为研究对象，将患儿随机分为置换组和常规组（n=20），常规组患儿进行病因和对症常规支持治疗，置换组在常规治疗的基础上加以血m46;置换辅助治疗。对两组患儿的基本情况、治疗前后的临床症状体征、主要实验室检查指标、疗效和预后情况进行比较分析。结果两组患儿治疗前在性别、年龄、入院前病程、病因构成、小儿危重病例评分、器官或系统功能累及情况等指标上比较差异均无统计学意义（P>0.05），在实验室指标的比较上差异亦均无统计学意义（P>0.05）。两组患儿治疗7 d后，临床症状体征均有所缓解和改善。治疗后置换组C反应蛋白、降钙素原、血清铁蛋白、丙氨酸氨基转移酶、总胆红素水平均低于常规组（P<0.05）。置换组的PICU住院时间较常规组明显缩短，总有效率较常规组明显提高（P<0.05），O46;两组总的住院时间和3个月病死率比较差异无统计学意义（P>0.05）。结论血m46;置换在辅助治疗儿童重症HPS上的疗效优于常规治疗，能改善患儿的临床症状体征和部分实验室指标，缩短PICU住院时间，可能成为治疗儿童重症HPS的一项有效辅助治疗方法。     

艾滋病生存质量量表（HIV/AIDSQOL-46）的测评研究

1993年在日内瓦召开的世界卫生组织生存质量研讨会上将生存质量的定义界定为：不同文化和价值体系中的个体对与他们的目标、期望、标准以及所关心的事情有关的生存状况的体验。     

富血小板血浆治疗兔跟腱病的实验研究

目的探讨富血小板血m46;（platelet-rich plasma，PRP）治疗兔跟腱病的效果，为 PRP 治疗跟腱病的临床应用提供实验依据。方法取成年新西兰大白兔 48 只，体质量 2.5～3.0 kg，雌雄不限，随机分为模型组（A 组）、模型对照组（B 组）、模型+治疗对照组（C 组）、模型+治疗组（D 组），每组 12 只。A、C、D 组注射Ⅰ型胶原酶制备兔跟腱病模型，B 组注射等剂量生理盐水。D 组取自体耳中心动脉血，采用二次离心法制备 PRP，血小板计数提示 PRP 血小板达全血的 3～5 倍。模型制备后，C、D 组于造模部位分别注射生理盐水、自体 PRP，每468; 1 次，每次 0.8 mL，连续 4 468;。于 PRP 注射结束后 1 468;，采用超声弹性定量成像检测技术评价各组跟腱相对硬度，以 HRD%（硬度百分比）表示；万能电子拉力试验机测定跟腱最大断裂负荷；ELISA 法测定Ⅰ、Ⅲ型胶原蛋白含量；HE 染色和 Masson 染色观察跟腱胶原纤维形态。结果各组动物均存活至实验完成。超声弹性定量成像检测及力学试验示，A 组跟腱硬度评价指标 HRD% 及最大断裂负荷显著小于 B 组（P<0.05），C 组显著小于 D 组（P<0.05）。ELISA 检测示，A 组Ⅰ型胶原蛋白含量显著低于 B 组、C 组显著低于 D 组，A 组Ⅲ型胶原蛋白含量显著高于 B 组、D 组显著高于 C 组，差异均有统计学意义（P<0.05）。HE 染色和 Masson 染色示，A 组跟腱胶原纤维呈不规则卷曲，结构严重破坏；B 组呈平行有序排列、结构完整；C 组呈不规则卷曲，结构紊乱；D 组呈轻微卷曲，结构较为完整。 结论Ⅰ型胶原酶注射可成功构建兔跟腱病模型，PRP 治疗可增加跟腱硬度和最大断裂负荷，上调Ⅰ、Ⅲ型胶原蛋白表达水平，改善跟腱胶原纤维结构和形态，促进兔跟腱病的恢复。