高通量透析可改善维持性血液透析患者肾性贫血

目的 探讨高通量透析对维持性血液透析患者肾性贫血的防治作用及其机制。方法 55例患者随机分为高通量透析组(HPD组)与常规血液透析组(CHD组)，HPD组患者使用聚砜膜F60高通量透析器，CHD组患者使用低通量F6透析器治疗，检测首次透析前后两组患者血尿素氮(BUN)、肌酐(Cr)、K^ 、Na^ 、Cl^-、Ca^2 、P^3-、甲状旁腺素(PTH)，以及透析前后血浆细胞因子(IL-1β、IL-6、IL-8、TNF-α)和透析开始20min后透析废液中上述细胞因子含量，动态观察并记录患者主诉，动态检测透析前后血红蛋白、红细胞压积，透析治疗1年后，复测并比较两组患者临床生化指标。结果 ①HPD组对PTH、P清除高于CHD组(P＜0．05)，透析1年后，HPD组血浆PTH、P水平明显低于CHD组(P＜0．05)。②透析后即刻HPD组透析废液中细胞因子含量显著高于CHD组(P＜0．05)；透析治疗1年后HPD组血浆细胞因子水平呈下降趋势，但与治疗前比较，无统计学意义(P＞05)。③透析后即刻，HPD组与CHD组血红蛋白、红细胞压积水平与透析前比较均呈上升趋势，但无统计学意义(P＞0．05)，两组间比较差异不显著；透析1年后，HPD组血红蛋白、红细胞压积水平较透析前水平变化差异显著(P＜0．05)，两组间比较显著升高(P＜0．05)。结论 HPD可改善维持性血液透析患者的肾性贫血，其机制与HPD能清除一些不易被CHD透析清除、且对红细胞生成和成熟有抑制作用的蛋白类大中分子物质，主要是PTH、精胺、聚胺、细胞因子等有关。     

Adhesion polypeptides are useful for the prevention of peritoneal dissemination of gastric cancer

We examined the effect of adhesion polypeptides on the adhesion and invasiveness of gastric cancer cell lines. We previously reported the establishment of an extensively peritoneal-seeding cell line, OCUM-2MD3, from a poorly seeding human scirrhous gastric carcinoma cell line, OCUM-2M. Both 21 and 31 integrin expression was markedly increased on OCUM-2MD3 cells compared with OCUM-2M cells, and the ability of OCUM-2MD3 cells to bind to the extracellular matrix (ECM) was also significantly higher than that of OCUM-2M cells. The adhesion polypeptides, YIGSR and RGD, and two RGD derivatives significantly inhibited the adhesion of OCUM-2MD3 cells to the submesothelial ECM, while not inhibiting the adhesiveness of OCUM-2M cells and two well differentiated human gastric cell lines, MKN-28 and MKN-74. The YIGSR and RGD peptides also significantly inhibited the invasiveness of OCUM-2MD3 cells. The survival of nude mice with peritoneal dissemination given YIGSR sequenc e intraperitoneally was obviously longer than that of untreated mice. The survival of mice treated with RGD was also improved, and this effect was increased using the RGD derivatives, poly(CEMA-RGDS) and CM-chitin RGDS. These polypeptides appear to block the binding of integrins, which are expressed on OCUM-2MD3 cells, to the submesothelial ECM, and consequently inhibit peritoneal implantation. The peritoneal injection of adhe-sion polypeptides may be a new therapy against the dissemination of scirrhous gastric cancer, and may be useful for the prevention of dissemination in high-risk patients. © Rapid Science Ltd.     

Hepatitis B virus transmission in Brazilian hemodialysis units: serological and molecular follow-up

A serological and molecular study of hepatitis B virus (HBV) infection was carried out in dialysis units in Central Brazil. Between 1995 and 1999, serum samples from all HBsAg-positive hemodialysis patients (n = 43) were tested for HBeAg/anti-HBe and subtyping by monoclonal ELISA. HBV DNA was detected by PCR and positive samples were genotyped by restriction fragment polymorphism pattern (RFLP) methodology. TheHBsAg prevalence declined in this population during the survey period (12-5.8%). HBeAg and anti-HBe were detected in 23 (53.5%) and 18 (41.9%) sera, respectively. Thirty-six samples could be HBsAg subtyped: 21 were subtype ayw(3), 14 belonged to adw(2) and one was identified as adw(4). HBV DNA was present in 30 serum samples. Of these, 20 (66.7%) were genotype D, 9 (30%) genotype A, and 1 (3.3%) genotype F. In addition, the RFLP pattern could be determined in samples from 18/20 genotype D patients: D3 (10 strains), D7 (7 strains) and D4 (1 strain); from 8/9 genotype A patients: A1 (6 strains) and A3 (2 strains); and from the patient infected with genotype F: F1. Patterns D3 and D7 were associated closely with HBV infection in the two largest hemodialysis units studied. These findings confirm the value of the RFLP method as an effective molecular epidemiological tool for elucidating HBV transmission in hemodialysis units.     

Cellular basis for the age-associated increase in autoimmune reactions

The mechanisms that lead to the increased expression of autoantibodies with age are poorly understood. We have studied the number, size, and density of spleen and peritoneal cells from young and old BALB/c and C57BL/6 mice as well as the frequency of clonal precursors for antibodies to mouse erythrocytes, thyroglobulin, and IgG in these lymphoid preparations. Old mice have a 6-fold increase in the number of resident peritoneal cells and a 2-fold increase in the absolute number of Ly1-bearing B cells in this population. Furthermore, old mice have twice as many large, low density splenic B cells as young mice. The frequencies of B cell clonal precursors for anti-BrMRBC and anti-thyroglobulin antibody-forming cells in old mice were 3-10 times greater than in young mice. In the same cultures, however, no increase in the frequencies of B cell clonal precursors for anti-IgG or anti-DNA antibody forming cells was detected in old compared to young mice. These findings and other data suggest that there are at least two families of B cell autoantibody precursors, one including anti-BrMRBC and anti-thyroglobulin autoantibodies, the other including anti-IgG and anti-DNA antibodies. Studies of the differential regulation of these two families of autoantibody precursors might contribute to a greater understanding of autoimmune phenomena in age and disease.     

Adrenal release of catecholamines and Met-enkephalin before and after stress as measured by a novel in vivo dialysis method in the rat

A dialysis tubing was implanted in the adrenal gland of rats. Adrenomedullary secretion products were dialysed into Ringer solution in the awake animal. Catecholamines (CAs) and methionine-enkephalin (Met-Enk) were measurable under resting conditions. Epinephrine, norepinephrine and Met-Enk-like immunoreactive material increased following application of an immobilization stress for 5 min. The results demonstrate that adrenomedullary CAs and peptides are coreleased. They also demonstrate that Met-Enk-like immunoreactive material is released under stress.     

A new method for assaying adhesion of cancer cells to the greater omentum and its application for evaluating anti-adhesion activities of chemically synthesized oligosaccharides

A new ex vivo method for assaying adhesion of cancer cells to the greater omentum has been developed using mouse greater omentum and [³H]labelled human gastric and mouse colorectal cancer cells. Since the adhesion rates were found to increase up to 18 h and labelled cells seemed to be stable during the period, the present method could be useful for investigating adhesion of cancer cells to the greater omentum, which must occur at the first step of the peritoneal dissemination. The adhesion of cancer cells to the greater omentum was inhibited by a series of chemically synthesized oligosaccharides and Galβ1,3[3OMeGalβ1,4GlcNAcβ1,6]αBn was found to be the best inhibitor. The anti-tumor effect of this novel tetrasaccharide in vivo was shown in preliminary experiments using Balb/c mice and colon26 cells.     

小白鼠腹腔渗出细胞吞噬功能的研究

本实验比较糖元、鸡红细胞及两者复合使用对小鼠腹腔渗出细胞的影响,结果表明鸡红细胞和糖元一样能激活巨噬系和组织嗜碱系细胞,影响巨噬系细胞分化,鸡红细胞较糖元快;而影响组织嗜碱系细胞分化,糖元较鸡红细胞快。由于腹腔渗出细胞中存在原、幼巨噬细胞,按照血细胞发育是不可逆回的理论,推测腹腔巨噬细胞不是来源于血液循环中的单核细胞,而是来自血循环中的定向干细胞。本实验在腹腔渗出细胞中,首次发现组织嗜碱系细胞并描写其形态特征。     

Erythropoietin concentrations are elevated in the peritoneal fluid of women with endometriosis

Erythropoietin (Epo) is an important regulator of erythropoiesis and stimulates the proliferation of early erythroid precursors as well as the differentiation of late erythroid precursors of the erythroid lineage. However, recent studies have indicated that Epo also has angiogenic properties and plays an important role in the oestrogen-dependent cyclical angiogenesis within the mouse uterus. It was therefore postulated that Epo may be an important angiogenic factor in endometriosis. In order to address this hypothesis the concentration of Epo in peritoneal fluid (PF) was determined in patients with or without endometriosis. PF was collected from patients with endometriosis (n = 42) or without endometriosis (n = 18). Detectable concentrations of Epo were found in all PF samples analysed. The concentration of Epo in PF from patients with endometriosis was significantly higher than that in the control group (13.1 +/- 1.2 mIU/ml versus 7.2 +/- 0.7 mIU/ml, mean +/- SE respectively, P < 0.01). Furthermore, in patients with endometriosis the Epo concentrations in PF from patients with stage I disease (n = 17, 16.6 +/- 3.0 mIU/ml) were significantly higher than those with stage II (n = 8, 10.7 +/- 1.2 mIU/ml, P < 0.03), III (n = 13, 8.4 +/- 1.0 mIU/ml, P < 0.01), IV disease (n = 7, 7.5 +/- 1.0 mIU/ml, P < 0.01). These data suggest that Epo may play a role in the pathogenesis of endometriosis particularly in the initiation of the disease.     

Ability of rosetting or non-rosetting individual control and inflammatory macrophages to kill Escherichia coli X43 intracellularly

An autoradiographic method combined with a rosette technique was used to assess the bactericidal activity of individual control and inflammatory peritoneal macrophages (PM phi) in the presence or absence of expression of Fc receptor for IgG (FcR). There was a lack of FcR reactivity in a certain percentage of both categories of PM phi exposed to E. coli X43, a bacterium which is readily phagocytosed in the presence of specific antibody. Both rosetting and non-rosetting PM phi were capable of phagocytosing E. coli X43, but inflammatory PM phi showed a marked reduction in their capacity to ingest these bacteria compared with control PM phi. Once ingested the E. coli X43 were killed equally well by non-rosetting and rosetting control and inflammatory PM phi.     

腹膜透析病人的焦虑和抑郁水平与其病情变化的相关分析

目的:探讨腹膜透析病人情绪障碍,即焦虑症状和抑郁症状的发生情况,以及与透析相关因素的关系.方法:88例腹膜透析病人,使用Hamilton焦虑量表和Hamilton抑郁量表评估其情绪状况,同时测定其营养状况、残余肾功能和透析充分性、以及炎症水平,记录心脑血管事件发生情况等.结果:本组腹膜透析病人焦虑症状的发生率为44.3%,抑郁症状的发生率为56.8%.具有糖尿病和心脑血管病史者的Hamilton焦虑评分和抑郁评分高于无此类病史者(P<0.05).SGA评分较高的病人Hamilton焦虑评分和抑郁评分也较高;焦虑评分和抑郁评分较高的病人,其血清白蛋白水平、蛋白质摄入水平、体重指数、上臂中段肌肉面积和脂肪面积均较低(r=0.22～0.60,P<0.05或P<0.01).结论:腹膜透析病人焦虑症状和抑郁症状的发生率较高,焦虑症状和抑郁症状与心脑血管系统疾病和糖尿病相关,并可能与营养不良的发生存在一定的关系.