Complement depletion during haemofiltration with polyacrilonitrile membranes

BACKGROUND: Polyacrylonitrile (PAN, AN69^®) dialysis membranes have beenshown to improve the outcome of critically ill patients. FactorD is an essential enzyme of the alternative pathway of complementand is increased during renal failure. On the other hand thecontact of blood with biomaterials activates the complementcascade through the alternative pathway. PAN filters adsorbfactor D which looses its enzymatic activity whilst bound tothe membrane [1] the complement alternative pathway functionof serum exposed to PAN filters is greatly diminished and restoredafter addition of purified factor D [1]. The aim of our studywas to measure the time course of factor D adsorption and itsblood concentration during CVVH in critically ill patients withacute renal failure. METHODS: We studied seven critically ill patients with ARF before, duringand after continuous veno-venous haemofiltration (CVVH) withAN69. RESULTS: There was a rapid decrease of factor D levels to 62(±6%)of the pre-CVVH value during the first 2 h, which continuedto 51(±7.3%) after 12 h; at 24 h there was a slight riseto 62±12%. Sequential use of Polyacrylonitrile (AN69^®)filters lowered factor D levels below the normal plasma concentrationin three patients, thus producing a state of factor D depletion. CONCLUSIONS: The significant reduction of factor D levels during CVVH withPAN filters suggests that frequent changes of PAN filters mayreduce alternative pathway function by lowering factor D levels.CVVH (as opposed to intermittent dialysis) with PAN membranesmay further improve the outcome of critically ill patients.     

聚丙烯腈基碳纤维的组织结构演变过程研究

用丙烯腈（AN）、衣糠酸（IA）、丙烯酸甲酯（MA）进行三元自由基溶液共聚合，经湿法纺丝制得聚丙烯腈（PAN）原丝，然后进行预氧化和碳化处理，并用SEM和TEM等分析方法跟踪过程中纤维微观结构的变化。结果表明：碳纤维的微观组织结构与原丝的微观组织结构密切相关，高强度、高取向度、结构均匀和弥散性好的原丝是获得高强度和高模量碳纤维的前提。     

nephrin及WT-1在嘌呤霉素大鼠肾病模型足细胞中的表达及意义

目的应用嘌呤霉素氨基核苷（PAN）模型,研究足细胞相关蛋白nephrin和肿瘤蛋白-1（WT-1）在足细胞中的表达及在肾小球硬化进展过程中的意义。方法单次尾静脉注射嘌呤霉素氨基核苷制作PAN模型,在4、14及20周处死大鼠,取其肾脏,切片,nephrin及WT-1免疫组化染色,半定量分析后进行统计学分析。结果对照组免疫组化染色nephrin沿肾小球毛细血管襻呈较为均匀的黄褐色粗颗粒样的线状分布,4周时与对照组比较PAN组nephrin略有分布不均,部分区域染色减弱或消失（均值为10．23±1．256和8．23±0．88,P〈0．05）,14周时在有节段性硬化的区域nephrin无表达（均值为7．58±0．71和10．23±1．26,P〈0．05）,而在20周时硬化的区域基本无表达（均值为7．88．±0．92和6．08±1．34,P〉0．05）,与对照组比较均有明显减少。4周时WT-1在足细胞核表达,呈深棕黄色粗大颗粒,与对照组比较无统计学意义（均值为10．14±2．02和10．11±1．56,P〉0．05）;14周时PAN组WT-1表达较对照组有所减少（均值为9．02±1．73和6．8±1．89,P〈0．05）;20周时与对照组比较PAN组WT-1明显减少（均值为7．34±1．22和4．43±1．01,P〈0．05）,足细胞数量随着时间的延长依次递减。结论Nephrin的表达在肾小球硬化过程中进行性减少,甚至消失;WT-1的表达随着肾小球硬化的进展逐渐减少。Nephrin和W-1表达的降低均反映足细胞的结构破坏和数量的减少,因此两者表达可反映足细胞损伤和肾小球硬化的关系。     

潘智敏教授治疗积证的学术经验

潘智敏教授系第四批全国名老中医药学术经验继承指导老师,博士研究生导师,临证30余年,学验俱丰,其在治疗积证方面积累了丰富的学术经验。潘智敏教授在继承前人积证学说的基础上,结合时代、地域特点和长期的临床经验,拓展了积证的范畴,提出了现代积证的病因病机特点,总结了新五积说,研制了治疗各种积证的基本方:五积方。并运用五积方加减治疗各种积证,取得了较好的临床疗效。     

潘智敏教授理瘀的学术经验

潘智敏教授系第四批全国名老中医药学术经验继承指导老师,博士生导师,得著名中医临床学家杨继荪教授的真传,临证30余年,学验俱丰,其对瘀证的研究,造诣较深。潘智敏教授在继承前人瘀证学说的基础上,总结了瘀证10型,提出了理瘀的对策和经验用药。     

嘌呤霉素肾病模型肾组织微小RNA的差异性表达及雷至胶囊的干预作用

目的:观察嘌呤霉素氨基核苷(puromycin aminonucleoside,PAN)肾病模型鼠肾组织微小RNA(microRNAs,miR-NAs)差异性表达的特征及其与足细胞裂隙膜(slid diaphragm,SD)关键结构分子nephrin,podocin和骨架蛋白synaptopodin表达的关系;阐明雷至胶囊(Leizhi capsule,LZC)在体内通过调控模型鼠肾组织miRNAs差异性表达而改善足细胞nephrin,podocin,synaptopodin表达,减少蛋白尿的机制.方法:将50只雄性Wistar大鼠随机分为空白组(A)、模型组(B)、雷至胶囊组(C,5 mL·kg-1·d-1)、雷公藤多苷组(D,10mL·kg-1 ·d-1)和缬沙坦(E,7.5 mL· kg-1·d-1)组.除A组外,其余各组大鼠一次性经颈静脉注射PAN(100 mg·kg-1)而建立PAN肾病模型.造模后第2天灌胃给药,A,B组大鼠用生理盐水干预,共10 d.造模前及造模后第3,9天称量各组大鼠体重,并检测24h尿蛋白排泄量(urinary protein ration,Upro).造模后第11天,处死全部大鼠,采集血液和肾组织,观察血清生化指标血清白蛋白(albumin,Alb),血清肌酐(serum creatinine,Scr),血清尿素氮(blood urea nitrogen,BUN),肾小球超微结构(足细胞足突形态)以及肾组织dicer酶,nephrin,podocin,synaptopodin表达;同时,借助生物芯片(biochip)技术,分析肾皮质miRNAs差异性表达的特征,并且,借助荧光实时定量聚合酶链反应(Real-time PCR)验证mo-miR-23a,rno-miR-300-3p,rno-miR-24,rno-miR-30c等的差异性表达量.结果:在PAN诱导下,模型鼠出现蛋白尿、肾功能减退、低白蛋白血症、足细胞足突融合;在模型鼠肾组织中,dicer酶影响足细胞nephrin,podocin,synaptopodin表达;上调rno-miR-23a,mo-miR-300-3p表达,下调mo-miR-24,rno-miR-30c表达;差异性表达的miRNAs包括rno-miR-24,rno-miR-30c,rno-miR-23a,rno-miR-300-3p等.雷至胶囊能改善PAN肾病模型鼠的一般情况、蛋白尿、血清BUN、足细胞足突融合;还能减少模型鼠肾组织dicer酶表达,增加足细胞nephrin,podocin和synaptopodin表达;减弱在模型鼠肾组织中上调的rno-miR-23a,rno-miR-300-3p,增强在模型鼠肾组织中下调的rno-miR-24,rno-miR-30c等.结论:PAN在体内通过dicer酶/miRNAs差异性表达途径而影响模型鼠肾组织miRNAs表达,干预足细胞nephrin,podocin,synaptopodin表达,破坏足细胞结构和功能,产生蛋白尿;雷至胶囊可以减少PAN肾病模型鼠蛋白尿,其机制可能是干预dicer酶/miRNAs差异性表达途径,调控足细胞nephrin,podocin,synaptopodin表达,改善足细胞的结构与功能.     

Immunologic Analysis of HIV-Uninfected Taiwanese Children with BCG-Induced Disease

Objectives  The aim of this study was to evaluate immunity in HIV-uninfected children with bacille Calmette–Guerin-induced disease (BCG-ID) over an 8-year period, with particular emphasis on underlying diseases. Methods  Patient afflicted with BCG-ID proven by clinical courses, dermatologic features, pathology, specific polymerase chain reaction, and/or spoligotyping were enrolled between 2000 and 2007. Lymphocyte proliferation, polymorphonuclear function, interleukin (IL)-12/23–interferons (IFN)-γ circuit, and Toll-like receptor 2-associated signaling were investigated. Results  Of the 271,618 total live births who received the BCG vaccine, eight patients (seven males) with BCG-ID were enrolled during an 8-year period and presented as three disseminated, two distant, and three regional BCG-ID. Their age at onset ranged from 1 to 28 months. All had a vaccine-injection scar except for one with lower CD3 and natural killer cells, compatible with severe combined immunodeficiency (SCID) identified by IL-2 receptor common gamma chain (IL2RG) mutation (Arg226Lys). The other SCID patient with de novo IL2RG mutation (Trp74Gly) had more recurrent infections. The third patient with primary autoimmune neutropenia had disseminated BCG-ID extending to abdominal wall. The fourth patient with chronic mucocutaneous candidiasis had regional BCG-ID and impaired lymphocyte proliferation to Candida and BCG antigens. No defective evidence of polymorphonuclear functions, IL-12/23–IFN-γ circuit, and Toll-like receptor 2-associated signaling was detected in the remaining four patients. Conclusion  Immunologic analysis in HIV-uninfected patients with BCG-ID reveals primary immunodeficiency diseases, especially in those with deficiencies in T-cell and neutrophil functions observed in our cohort, including primary autoimmune neutropenia and chronic mucocutaneous candidiasis.     

碳纳米管/聚丙烯腈原液的制备及可纺性

通过原位聚合的方法制备了碳纳米管／聚丙烯腈复合材料原液，并采用湿纺成型工艺制得碳纳米管／聚丙烯腈复合材料纤维。与共混工艺相比较，采用该方法制得的碳纳米管／聚丙烯腈复合材料碳纳米管在聚丙烯腈基中分散均匀，具有较好的可纺性。