小儿支气管肺炎患者中性粒细胞吞噬及细胞内杀菌功能与脂质过氧化关系的探讨

目的：探讨了小儿支气管肺炎患者血液中性粒细胞吞噬及细胞内杀菌功能与脂质过氧化的关系。方法：采用普通酵母菌对62例患者及35例正常人进行中性粒细胞吞噬和细胞内杀菌功能试验和化学比色法测定血浆丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH—PX）含量，放免法测超氧化物歧化酶（SOD），并与35名正常健康人作比较。结果：小儿支气管肺炎患儿在治疗前中性粒细胞吞噬及细胞内杀菌功能均明显低于正常人（P〈0．01），S01）、GSH-PX低于正常人组（P〈0．01），而MDA显著地高于正常人组（P〈0．01），相关分析显示，中性粒细胞吞噬及细胞内杀菌功能与MDA呈显著负相关（r=-0．3118，-0．3024，P〈0．05），经10d治疗后则与正常人比较无显著性差异（P〉0．05）。结论：检测小儿支气管肺炎患儿血液中性粒细胞吞噬及细胞内杀菌功能与脂质过氧化的关系对临床诊断、治疗和预后观察有重要的临床价值。     

胸大肌肌间沟切开补充清除淋巴结在乳腺癌简化根治术中的应用

目的:探讨经胸大肌肌间沟切开辅助淋巴结清扫在乳腺癌简化根治术中的临床意义及应用价值.方法:在简化乳腺癌的根治术完成标本切除后,沿胸大肌的胸、锁部界线的肌间沟进路,补充清扫胸小肌前后及其内侧的淋巴结,即尖群淋巴结及部分肌间组淋巴结.结果:总共61例,经胸大肌肌间沟切开辅助淋巴结清扫,清理残留阳性淋巴结(LN )率6.6%(4/61);在简化根治标本LN( )的病例中,补充清除(LN )17.7%(3/17).结论:肌间沟进路补充淋巴结清扫术,能有效地清理简化根治术中残留阳性淋巴结,尤其是腋窝淋巴结阳性的病例,保障简化乳腺癌的根治术的疗效.     

中小学教师职业倦怠研究

目的调查中小学教师职业倦怠的现状。方法用MBI对250名中小学采师进行调查。结果①中小学教师的职业倦怠整体上比较严重；②第7阶段教师（16年及以上教龄）的情感衰竭、玩世不恭和职业倦怠程度最高；③是否重点、是否班主任、是否公办对情感衰竭存在显著影响；④重点学校教师职业倦怠程度高于普通学校教师。结论中小学教师的职业倦怠整体上比较严重，一些因素对职业倦怠存在重要影响。     

2型糖尿病肾病患者红细胞免疫功能与脂质过氧化的关系

目的：探讨了2型糖尿病肾病患者红细胞免疫功能的变化及其与脂质过氧化的关系。方法：应用红细胞酵母花环法对34例2型糖尿病肾病患者进行了红细胞免疫功能和化学比色法测定血清丙二醛（MDA）、超过氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-PX）含量,并与35名正常健康人作比较。结果：2型糖尿病患者红细胞免疫复合物（RBC-IC）花环率和MDA水平明显升高（P〈0.05～0.01）,而红细胞C3b受体（RBCc3b-RR）、SOD、GSH-PX水平显著低于正常（P〈0.01）。相关分析显示：RBCc3b花环与MDA呈显著负相关（r=-0.4012,P〈0.05）,RBC-ICR与MDA呈显著正相关（r=0.5928,P〈0.01）。结论：2型糖尿病患者红细胞免疫功能降低与活性氧代谢紊乱密切相关。     

药房工作人员职业倦怠状况分析

目的探讨药房工作人员的职业倦怠情况。方法采用职业倦怠量表对236名药房工作人员进行调查。结果药房工作人员的职业倦怠平均分为2.47;女性药房工作人员在个人成就感低上的得分明显低于男性(t=-2.479,P0.05);本科及以上学历的药房工作人员在情绪疲惫(t=3.563,P0.05)、去个性化(t=2.149,P0.05)和个人成就感低(t=3.083,P0.05)上的得分明显高于本科以下学历的药房工作人员;工作时间在10年以上的药房工作人员在个人成就感低上的得分明显低于10年以下(F=3.526,P0.05)。结论药房工作人员的职业倦怠水平较低,性别、学历和工作年限在不同程度上影响他们的职业倦怠状况。     

Long-Term Outcomes of Alemtuzumab-Based Reduced-Intensity Conditioned Hematopoietic Stem Cell Transplantation for Myelodysplastic Syndrome and Acute Myelogenous Leukemia Secondary to Myelodysplastic Syndrome

Allogeneic hematopoietic stem cell transplantation (HSCT) with reduced-intensity conditioning (RIC) offers a potential cure for patients with myelodysplastic syndrome (MDS) who are ineligible for standard-intensity regimens. Previously published data from our institution suggest excellent outcomes at 1 yr using a uniform fludarabine, busulfan, and alemtuzumab-based regimen. Here we report long-term follow-up of 192 patients with MDS and acute myelogenous leukemia (AML) secondary to MDS (MDS-AML) transplanted with this protocol, using sibling (n = 45) or matched unrelated (n = 147) donors. The median age of the cohort was 57 yr (range, 21 to 72 yr), and median follow-up was 4.5 yr (range, 0.1 to 10.6 yr). The 5-yr overall survival (OS), event-free survival, and nonrelapse mortality were 44%, 33%, and 26% respectively. The incidence of de novo chronic graft-versus-host disease (GVHD) was low at 19%, illustrating the efficacy of alemtuzumab for GVHD prophylaxis. Conversely, the 5-yr relapse rate was 51%. For younger patients (age <50 yr), the 5-yr OS and relapse rates were 58% and 39%, respectively. On multivariate analysis, advanced age predicted significantly worse outcomes, with patients age >60 yr having a 5-yr OS of 15% and relapse rate of 66%. Patients receiving preemptive donor lymphocyte infusions had an impressive 5-yr OS of 67%, suggesting that this protocol may lend itself to the incorporation of immunotherapeutic strategies. Overall, these data demonstrate good 5-yr OS for patients with MDS and MDS-AML undergoing alemtuzumab-based RIC-HSCT. The low rate of chronic GVHD is encouraging, and comparative studies with other RIC protocols are warranted.     

几种反应性氧代谢物逆转剂免疫佐剂作用的比较

目的 分析比较硫普罗宁(TIP)、还原型谷胱甘肽(GSH)、二氢氯组胺(DHT)3种反应性氧代谢物(ROM)逆转剂抗白血病细胞免疫治疗中的增效作用.方法 在K562细胞、NK细胞的混合培养系中分别加入单核细胞和白细胞介素-2,然后分别加入TIP、GSH、DHT,观察ROM水平及K562细胞抑制率(KIR)的变化.结果 加入E/MO=10/2、10/5、10/10三种浓度的MO,ROM水平分别为(389.79±43.83)U/L,(456.74±42.77)U/L,(601.42±21.92)U/L,KIR分别为82.36%,81.36%,48.09%:加入TIP、GSH或DHT后,当E/MO=10/2时,ROM水平从(389.79±43.83)U/L,分别减至(-1.20±60.70)U/L、(-3.58±9.49)U/L和(50.21 4-22.4)U/L(P＜0.05),随着TIP、GSH或DHT浓度的增加ROM水平逐渐减少,KIR从82.53%分别升至96.09%、96.39%和94.64%(P＜0.05).结论 TIP、GSH逆转ROM的效应强于DHT,提高NK细胞对K562的抑制率,其效应强度与DHT相似,但毒副作用轻微,两者均可能成为更理想的抗白血病的免疫佐剂.     

还原型谷胱甘肽对缺氧/复氧心肌细胞的保护作用

目的探讨还原型谷胱甘肽（GSH）对缺氧／复氧（A／R）心肌细胞的保护作用及机制。方法建立大鼠心肌细胞A／R损伤模型，随机分为5组：A组为正常对照组；B组为A／R组，缺氧2h。复氧1h；C、D、E组为处理组，加入GSH分别使其终浓度为40、80、160mg／L后A／R。用黄嘌呤氧化酶法测定超氧化物歧化酶活性，硫代巴比妥酸显色法测定丙二醛含量，荧光法测定细胞内钙离子浓度变化，采用RT-PCR检测白介素-1βmRNA和肿瘤坏死因子-αmRNA表达变化。结果与A组相比，B组心肌细胞内钙离子浓度明显升高，差异有非常显著性（P〈0．01）；心肌细胞培养液中超氧化物歧化酶活性下降、丙二醛含量升高，差异有非常显著性（P〈0．01）；白介素-1βmRNA和肿瘤坏死因子-αmRNA表达迅速增强，差异有非常显著性（P〈0．01）。与B组比，D、E组上述变化明显减轻，差异有非常显著性（P〈0．01）。结论GSH对A／R心肌细胞有保护作用，其作用在一定范围内呈剂量依赖关系。     

Nitric oxide donors offer protection to RBC from storage lesion

BackgroundRed blood cell (RBC), which is the most commonly transfused blood component, due to its ability to save a life in absence of any other blood components, can be stored up to maximum 6 weeks by following standard preservation procedure. During storage, RBC undergoes various biophysical and biochemical changes (commonly known as storage lesion) for which blood transfusion with “old RBC” shows a lot of clinical problems especially relevant to critically ill patients. Recent research on S-nitrosylation of haemoglobin to improve oxygen delivery of banked blood revealed the important role of nitric oxide (NO) in protecting storage lesion.Materials and methodsIn the present study, we used various “NO donating” chemicals with different NO release dynamics and chemistries in RBC storage cocktails to test the effects of NO on storage lesion. Changes in different storage markers were evaluated after 7 days storage of pre-treated RBC.ResultsAll the NO donors have shown protection against hemolysis. However, S-nitroso glutathione (GSNO) ranks first in shielding RBCs from storage lesion and additionally, it helps in elevating the value of 2, 3-di phosphoglycerate (2, 3-DPG), improving the RBC membrane fluidity and decreasing the adhesion towards endothelial monolayer.DiscussionPresent study reveals that NO released from NO donors confers protection against storage lesions of the RBC. Further, the study confirms that pre-treatment with GSNO, a NO donor and a nitrosylating agent, ensures the best protection to RBC during low temperature storage, when compared to other NO donor treatments.