Continuous intraventricular infusion of pentosan polysulfate: Clinical trial against prion diseases

Prion diseases are progressive neurological disorders due to abnormal prion protein (PrP^Sc) deposition in the central nervous system. At present, there is no effective treatment available for any form of prion disease. Pentosan polysulfate (PPS) has been shown to prolong significantly the incubation period in mice with PrP^Sc infection when administered to the cerebral ventricles in preclinical trials. In human studies conducted in European countries and Japan, intraventricular PPS was administered to patients with different forms of prion disease and was well tolerated. We report 11 patients with prion disease treated with intraventricular PPS at Fukuoka University from 2004. Cases included three familial CJD (two with V180I mutation, one GSS with P102L mutation), two iatrogenic CJD, and six sporadic CJD cases. At present, average survival period after treatment was 24.2 months (range, 4–49). Seven cases died of sepsis and pneumonia. Subdural effusion with various degrees was seen on CT scan in most cases. Except for these, adverse effects did not occur in the treatment period. Although our preliminary study of the new treatment with PPS by continuous intraventricular infusion showed no apparent improvement of clinical features in patients with prion disease, the possibility of extended survival in some patients receiving long‐term PPS was suggested.     

猪苓多糖通过Toll样受体4对小鼠骨髓来源树突状细胞作用研究

目的研究猪苓多糖(Polyporus umbellatus polysaccharides,PPS)活化小鼠骨髓来源树突状细胞(bone marrow dendritic cells,BMDC)功能调节的作用机制,进一步阐明PPS的免疫学活性机制。方法以3H-TdR掺入法、ELISA及流式细胞术检测BMDC表型和功能的各项指标。结果 PPS刺激小鼠BMDC表达CD11c、CD86及白细胞介素-12、-10(IL-12、IL-10)产生,并且具有剂量依赖效应。另外,较阴性对照组,经PPS诱导成熟的BMDC其活化初始T细胞的能力显著提高而吞噬能力显著下降。抗小鼠Toll样受体4(TLR4)单抗可抑制PPS刺激BMDC产生IL-12 p40及阻断荧光标记猪苓多糖(fluorescence-labeled PPS,f-PPS)与BMDC的结合,而抗TLR2及补体受体3(CR3)单抗却无此效应。结论 PPS可经TLR4活化小鼠BMDC发挥免疫调节活性。     

Repetitive transcranial magnetic stimulation in treatment of post polio syndrome

Background

Post polio syndrome is a rare disease that occurs decades after polio virus infection. Repetitive transcranial magnetic stimulation (rTMS) is a treatment option with proved effectiveness in drug resistant depression. Possibly it can be helpful in therapy of other neurological diseases including post polio syndrome.

紫菜多糖对小鼠免疫功能影响的研究

[目的]观察紫菜多糖对正常小鼠免疫功能的影响。[方法]分别经口给予实验小鼠500、1000、2000mg/kg.bw3个剂量的紫菜多糖。30d后,测定小鼠脏器/体重比值、细胞免疫功能、体液免疫功能、单核-巨噬细胞功能、NK细胞活性和白介素-2的值。[结果]各剂量组对小鼠胸腺/体重比值、腹腔巨噬细胞吞噬鸡红细胞的能力、小鼠NK细胞活力和小鼠血清溶血素水平均无影响;500和2000mg/kg.bw剂量组能升高小鼠脾/体重比值;2000mg/kg.bw剂量组的紫菜多糖能明显增强DNFB诱导的小鼠迟发型变态反应、增强ConA诱导的脾淋巴细胞增殖能力、能促进抗体生成细胞的生成,并能促进体液细胞白介素2数值的增加;1000、2000mg/kg.bw剂量组使碳廓清能力增强。[结论]紫菜多糖具有增强小鼠免疫功能作用。     

单眼老年性白内障手术单病种平均成本的构建与分析

根据眼科1年的成本、收入及患者住院费用，试构建单眼老年性白内障手术的单病种平均成本。在合理诊疗的前提下，控制住院过程的每个诊疗环节，可以降低单病种的平均成本，增加科室收益。药品和材料消耗是住院费用的主要部分，合理地降低药费和材料比例是控制医疗费用的关键。按病种付费和适合我国国情的按疾病诊断分类定额预付制是我们应该积极探索的付费方式。     

The palliative performance scale: examining its inter-rater reliability in an outpatient palliative radiation oncology clinic

Introduction  The Palliative Performance Scale (PPS) was developed by the Victoria Hospice Society in 1996 to modernize the Karnofsky Performance Scale. Currently, it is being used to measure palliative patient performance status in a variety of settings. Despite its widespread use, only one study has examined the inter-rater reliability of the PPS. Purpose  To examine the inter-rater reliability of the PPS in measuring performance status in patients seen in an outpatient palliative radiation oncology clinic Methods  Performance status for 102 consecutive patients was assessed by an oncologist (MD), a radiation therapist (RT), and a research assistant (RA) in the Rapid Response Radiotherapy Program at the Odette Cancer Centre in Toronto, Ontario, Canada. Raters’ scores were analyzed for correlation and compared to evaluate the inter-rater reliability of the PPS tool. Results  Excellent correlation was found between the scores rated by the MD and RA (r = 0.86); good correlation was observed between scores rated by the MD and RT (r = 0.69) and the RT and RA (r = 0.77). Scores between all three raters, as well as between rater pairs, were also found to have good reliability as measured by the Chronbach’s alpha coefficient. Significant results were obtained for the range of PPS scores in which the majority of our patients fell: 40–80%. Conclusion  PPS was shown to have good overall inter-rater reliability in an outpatient palliative setting, but more research is needed to establish the validity and reliability of the tool in a variety of different palliative settings.     

Phylogenetic analysis of the putative phosphorylation domain in the pyruvate kinase of Bacillus stearothermophilus

All sequenced phosphoenolpyruvate synthases (PPS), pyruvate:phosphate dikinases (PPDK) and enzymes I (EI) of the phosphoenolpyruvate:sugar phosphotransferase system comprise the PEP family. Linked to the C terminus of the sequenced pyruvate kinase from Bacillus stearothermophilus (PKBst) is a domain that is homologous to the putative phosphorylation domains of PEP family enzymes. We report sequence and phylogenetic analyses that lead to the following conclusions: (1) the phosphorylation domain of PKBst was derived from a PPS, late in the evolutionary process, after the divergence of PPSs from PPDKs and EIs; (2) this domain is probably functional in phosphoryl transfer; (3) the C-terminal phosphorylation domain in PKBst probably defines a compact domain in all PEP family proteins that is linked to other domains in these proteins via flexible linkers.