Complement inhibition for prevention of antibody-mediated rejection in immunologically high-risk heart allograft recipients

Allosensitization represents a major barrier to heart transplantation (HTx). We assessed the efficacy and safety of complement inhibition at transplant in highly sensitized heart transplant recipients. We performed a single-center, single-arm, open-label trial (NCT02013037). Patients with panel reactive antibodies (PRA) ≥70% and pre–formed donor-specific antibodies (DSA) were eligible. In addition to standard of care, patients received nine infusions of eculizumab during the first 2 months posttransplant. The primary composite endpoint was antibody-mediated rejection (AMR) ≥pAMR2 and/or left ventricular dysfunction during the first year. Secondary endpoints included hemodynamic compromise, allograft rejection, and patient survival. Twenty patients were included. Median cPRA and mean fluorescence intensity of immunodominant DSA were 95% (90%–97%) and 6250 (5000–10 000), respectively. Retrospective B cell and T cell flow crossmatches were positive in 14 and 11 patients, respectively. The primary endpoint occurred in four patients (20%). Survival at 1 year was 90% with no deaths resulting from AMR. In a prespecified analysis comparing treated patients to matched control patients, we observed a dramatic reduction in the risk of biopsy-proven AMR in patients treated with eculizumab (HR = 0.36, 95% CI = 0.14–0.95, p = .032). Our findings support the prophylactic use of complement inhibition for heart transplantation at high immunological risk. ClinincalTrials.gov, NCT02013037.     

Caspase inhibitor Z-VAD-FMK potentiates heat shock-induced apoptosis and HSP70 synthesis in macrophages

Caspase inhibitor Z-VAD-FMK potentiated heat shock-induced apoptosis in macrophages. Z-VAD-FMK did not activate HSP70 synthesis, but significantly increased the intensity of this process during heat shock. It cannot be excluded that caspases abolish HSP70 accumulation under these conditions. The HSP70 synthesis inhibitor quercetin potentiated DNA fragmentation in macrophages cocultured with Z-VAD-FMK after heat shock. HSP70 play an important role in the protection of macrophages from caspase-independent apoptosis.Translated from Byulleten Eksperimentalnoi Biologii i Meditsiny, Vol. 138, No. 9, pp. 261–263, September, 2004     

Exposure to formaldehyde and phenol during an anatomy dissecting course: sensitizing potency of formaldehyde in medical students

BACKGROUND: The sensitizing potency of formaldehyde and phenol during anatomy dissecting was investigated. The objective was to determine whether exposure induces specific IgE or IgG against formaldehyde-albumin or phenol-albumin. METHODS: In 27 medical students, specific IgE against formaldehyde-albumin by RAST plus ELISA and specific IgE against phenol-albumin by ELISA were assessed. In addition, specific IgG against formaldehyde-albumin was assessed in 23 students. Symptoms before and during dissecting were assessed, and indoor formaldehyde and phenol were measured. RESULTS: Mean indoor formaldehyde was 0.265 +/- 0.07 mg/m3, and mean indoor phenol was 4.65 +/- 2.96 mg/m3. Specific IgE/IgG against formaldehyde-albumin was not found at the beginning. Four students developed specific IgE against formaldehyde-albumin (RAST classes of > or =2.0), and all four also had specific IgE in the ELISA, but IgG against formaldehyde-albumin was not found. Specific IgE against phenol-albumin was not seen. Itch and paresthesia of the hands (P<0.00001), dizziness (P<0.008), burning eyes (P<0.01), headache, sneezing, epistaxis, gingival bleeding, oral or pharyngeal itch, and shortness of breath were experienced. CONCLUSIONS: Formaldehyde exposure during dissecting may induce specific IgE, but not IgG, against formaldehyde-albumin. Sensitization did not correlate with symptoms.     

鲜中药治疗急性白血病76例

目的 中药治疗急性白血病可以提高其疗效及患的生活质量。方法 针对急性白血病阴液亏虚、热毒炽盛的主要病机,选用大剂量甘寒养阴鲜中药为主组方,随证加减,辨证论治。结果 鲜中药治疗难治性白血病76例,完全缓解37例（48.7%),部分缓解14例（18.4%),未缓解25例（32．9％）,总缓解率达67．1％,获缓解的病例中,服药时间最短30天,最长180天,平均60．7天。结论 养阴清热鲜中药为主治疗急性白血病,辨证与辨病相结合。可提高缓解率,延长存活期,减轻化疗毒副作用,提高生活质量。     

Immunogenicity and tumor-inhibiting effects of HSP-antigen peptide complex in melanoma B16 cells in mice

目的 :黑色素瘤 B1 6细胞热休克蛋白 -抗原肽复合物 (HACs)及其粗提物 (HAC- CEs)的制备 ,以及它们的免疫原性和抑瘤效应的研究。方法 :应用 Sephacryl S- 2 0 0凝胶过滤制备HAC- CEs,应用亲和层析纯化 HACs,并测其免疫功能和抑瘤效应。结果 :应用凝胶过滤制备的HAC- CE3、HAC- CE4、HAC- CE5和应用亲和层析纯化的 HAC60 ,HAC75和 HAC97均不同程度地降低肿瘤发生率、延迟肿瘤发生时间和减少移植黑色素瘤 C57BL/6J小鼠死亡率 ;同时 ,伴有小鼠脾细胞 IFN-γ和 IL- 2分泌活性及 CTL杀伤率的增加。结论 :分子量为 60 0 0 0～ 970 0 0的 HACs具有免疫原性和抑瘤效应 ,本研究为制备肿瘤疫苗提供重要的实验依据。     

热休克预处理诱导HSP70蛋白表达减轻神经细胞的缺血损伤

目的 :研究热休克预处理对脑缺血再灌后热休克蛋白 70 (HSP70 )的表达影响及对缺血神经细胞损伤的保护作用。方法 :采用沙鼠短暂前脑缺血再灌损伤模型 ,光镜观察缺血再灌后神经细胞损伤情况 ,免疫组化方法检测脑缺血后不同时期额叶HSP70蛋白表达。结果 :沙鼠脑缺血后HSP70蛋白仅在再灌后 1d有少量表达 (P <0 .0 1) ;缺血神经细胞在再灌后第 7d大多出现损伤改变 ;热休克预处理能增加沙鼠脑缺血再灌后各期HSP70蛋白表达 (P <0 .0 1) ,明显减轻缺血神经细胞损伤 (P <0 .0 1)。结论 :热休克预处理能通过增加HSP70蛋白表达 ,减少缺血神经细胞损伤。     

半导体激光穴位照射的镇痛作用及其机制初探

目的　探讨半导体激光穴位照射镇痛效应及其镇痛的机制。方法　大鼠随机分成照射组、模拟照射组和纳洛酮预处理组。采用半导体激光照射大鼠“足三里”穴位 ,用电刺激鼠尾 -嘶叫法测定激光照射前后的痛阈。结果　照射后大鼠的痛阈明显提高 ,这种镇痛作用可被纳洛酮预处理所翻转。结论　半导体激光穴位照射产生镇痛效应机制可能与激光照射促进内源性阿片物质释放有关。     

张锡纯热病善后调理诸法探析

张锡纯一生善治伤寒、温病与各类急证 ,所著《医学衷中参西录》尤精于热病的善后调理 ,究其辨证立法的本质内涵而言 ,仍不离辨证施治的主旨。所论调理措施主要有药物调理、饮食调理、精神调理 3个方面     

Role of p38 protein kinase in heat-induced Raw cells apoptosis

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自动变温热交换水箱的研制

通过对变温热交换水箱的智能化设计（硬件和软件）,实现了循环水温的自动化控制,从而达到对热交换水箱中逆向运动的血液温度按临床需要自动进行温度调节。