Distal Proctocolitis and n-3 Polyunsaturated Fatty Acids (n-3 PUFAs): The Mucosal Effect In Situ

It has been postulated that patients with ulcerative colitis (UC) have altered reactivity of gut-associated lymphoid tissue. In such cases there is intense infiltration of the mucosa with immune competent cells and associated tissue damage. We have shown previously that the dietary supplementation with the n-3 polyunsaturated fatty acids (n-3 PUFAs), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) results in significant systemic immune suppression. The aim of this study, therefore, was to evaluate the in situ effect of n-3 PUFAs on distal proctocolitis. Each patient received either fish oil extract (EPA 3.2 g, DHA 2.4 g) (n = 9) or sunflower oil (n = 9) daily in a double blind manner for six months. Monthly assessment included: (1) disease activity using clinical, sigmoidoscopic, and histological scores and (2) immunohistochemical analysis (immunoglobulins, CD profiles) of rectal biopsy specimens (before and after six months supplementation) using monoclonal antibodies and quantitative computer-assisted video image analysis. Prior to receiving supplementation, patients with proctocolitis (n = 18) showed significantly higher numbers of cells expressing CD3 (pan T cells) and HLA-DR and IgM containing cells compared with non-colitic controls (n = 8). Six months supplementation with n-3 PUFAs resulted in significant reduction in the number of cells expressing CD3 and HLA and the percentage of cells containing IgM. There was no significant change in the CD20 nor the percentage of IgG or IgA containing cells in either group of patients with procto-colitis. In patients receiving n-3 PUFA supplementation, there was improvement in the disease activity and histological scores, compared with pretreatment evaluation. This study has demonstrated both evidence of suppression of in situ immune reactivity and concurrent reduction in disease activity in patients with proctocolitis receiving n-3 PUFA supplementation. This may have important implication for therapy in patients with ulcerative colitis.     

1-取代吡唑烷酮类抗惊构效关系的研究

1-正癸基吡唑烷-3-酮(Ⅱ结构式见表1)是欧洲专利报道的一种新型减肥剂。White等报道该化合物可通过血脑屏障,并对γ-氨基丁酸氨基转移酶(GABA-T)有强烈的抑制活性,但对谷氨酸脱羧酶的抑制作用较弱,因此可引起脑内γ-氨基丁酸(GABA)水平的升高,故我们相信应有抗惊活性。经我们合成后,发现Ⅱ确有良好的抗癲痫活性,抗小鼠最大电     

原发性胆汁性肝硬化自身抗体谱研究进展

原发性胆汁性肝硬化(primary biliary cirrhosis, PBC)是一种慢性渐进性胆汁淤积性肝脏疾病, 以小胆管破坏为主要组织学特征的非化脓性炎症,并以血清中出现特征性自身抗体为主要标志．自身抗体对该病发病机制、诊断、治疗及预后均有重要意义．我们就PBC自身抗体谱研究进展作简要综述．     

大学生信任感及其相关因素

目的:探讨当代大学生的信任感情况,为维护大学生的心理健康提供参考。方法:采用信任量表、简易应对方式问卷、领悟社会支持量表为调查工具,通过分层整群抽样,于2006-06对河北师范大学1250名大学本科学生进行调查分析。其中信任感量表有18题。由3个因子构成。该量表得分越高,信任感越强。领悟社会支持量表包含12题,分家内支持和家外支持2个因子。得分越高,得到的社会支持程度越高。简易应对方式问卷共20题。由积极应对和消极应对2个因子组成。因子得分为因子条目平均分。结果:共发放问卷1250份,收回有效问卷1196份。①大学生的信任感为(77.80±10.87)处于中等偏上水平。在信任总分上,女生高于男生(78.40±11.04,76.67±10.44,P<0.01)。一、四年级学生高于二、三年级学生(77.92±10.86和81.16±10.51,75.46±11.17和76.72±10.01,P<0.01)。文科生高于理科生(79.65±10.48,75.97±10.93,P<0.01)。恋爱学生高于未恋爱学生(79.48±11.34,76.70±10.40,P<0.01)。城市学生高于农村学生(79.59±10.85,77.12±10.80,P<0.01)。②在可依靠因子上,性别和是否独生之间存在交互作用(F=8.469,P=0.004)。③大学生的信任感与领悟社会支持、应对方式有显著性相关。家外支持、积极应对、消极应对、家内支持依次进入信任感回归方程。结论:性别、年级、专业、是否恋爱、是否独生、城乡来源等因素都会影响大学生的信任感。家内家外支持、积极应对与消极应对是影响大学生信任感的个体内部心理因素。     

混合造血干细胞移植后输注供者淋巴细胞和白细胞介素2对急性髓性白血病疗效的影响

目的:观察急性髓性白血病经混合造血干细胞移植后,应用供者淋巴细胞输注 白细胞介素2治疗的效果,并与移植后未经特殊治疗的效果进行比较。方法:①选取2000-01/2004-07解放军兰州军区兰州总医院全军血液病中心收治的19例急性髓性白血病患者,实验经医院伦理委员会批准,患者均知情同意。随机数字表法分为两组:观察组8例,年龄17～40岁,M2a 4例,M4 1例,M5a 3例;对照组11例,年龄19～39岁,M2a 2例,M3a 2例,M4 3例,M5a 4例。②两组患者采用化疗联合重组人粒细胞集落刺激因子的方法动员自体外周血造血干细胞,采集后液氮中保存5d备用。③术前采用直线加速器对患者全身及肺部照射,预处理完毕后实施混合造血干细胞移植。首先回输自体单个核细胞中位数为4×108/kg,CD34 细胞中位数为6.2×106/kg,粒-巨噬祖细胞集落形成单位中位数为5.8×104/kg。间隔1～6h后,采集人类白细胞抗原半相合异体骨髓,按回输自体单个核细胞数的1/6～1/10输注给患者。④两组患者移植期间均住无菌层流病房,给予相应并发症的防治及支持治疗。在粒细胞降至0时注射重组人粒细胞集落刺激因子150μg/12h,促进造血恢复。观察组给予供者淋巴细胞输注 白细胞介素2治疗,每次采集的供者淋巴细胞中,CD3 淋巴细胞中位数为1.43×108/kg,CD4 细胞中位数为0.97×108/kg,CD8 细胞中位数为0.41×108/kg,中位治疗次数4(1～7)次,回输后即开始应用100wu/d重组人白细胞介素2,共10d。对照组混合造血干细胞移植后未给予特殊治疗。结果:19例急性髓性白血病患者均进入结果分析。①造血恢复:两组患者均获得造血重建,术后4～9d粒细胞均降至0,12～17d粒细胞达0.5×109L-1,16～21d白细胞达4.0×108 L-1,19～23 d血小板达20×108 L-1。16～21 d骨髓检查示恢复期骨髓象。②术后并发症:两组患者不同程度地出现口腔溃疡,随着造血恢复,7～10d溃疡消失。观察组1例患者出现出血性膀胱炎,两组各2例患者出现发热。无肝静脉闭塞病和移植物抗宿主病发生。③嵌合体形成:观察组中1例M4患者形成嵌合体,对照组中2例M4患者与1例M5患者形成嵌合体,嵌合体持续存在3～12个月。④供者淋巴细胞输注 白细胞介素2疗效:观察组中有1例M2a患者在接受2次特殊治疗后7个月复发死亡;1例M2a患者接受2次特殊治疗后1年出现骨髓增生异常综合征,脑出血死亡,1例M5a患者应用特殊治疗1次后出现不明原因高热、抽搐,死于癫痫持续状态,其余5例患者随访2年均健康存活,长期生存率为62.5%(5/8)。对照组有2例M2a患者、2例M4患者、1例M5患者于移植后1～7个月复发死亡,1例M3患者于移植后25d死于脑出血,其余2例M3患者、2例M4患者、1例M5患者随访2年均健康存活,长期生存率为45.4%(5/11)。结论:混合造血干细胞移植后应用供者淋巴细胞输注 白细胞介素2治疗,急性髓性白血病患者均获得造血重建且无移植物抗宿主病发生,其长期生存率有效提高。     

颅内动脉瘤栓塞后并发脑缺血的原因分析

1 临床资料我们总结2004-02/2004-06在第四军医大学唐都医院神经外科住院行栓塞治疗颅内动脉瘤患者27(男12,女15)例,年龄32～72岁.     

Clinical and familial study of arrhythmogenic right ventricular cardiomyopathy

Objective　To explore the characteristics of arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods　Seven patients with arrhythmogenic right ventricular cardiomyopathy and 34 members of three families were studied. All patients and family members underwent history collection, clinical examination, electrocardiogram (ECG), two-dimensional echocardiography (2-DE) and a signal averaging electrocardiogram. Programmed ventricular stimulation was performed in five patients. Results　All patients and family members had normal morphologic characteristics and normal function of the left ventricular by 2-DE. Fourteen persons had abnormal findings indicating ARVC. Five had enlargement of the right ventricular with diffused hypocontractility, eight had thin and systolic bulging in the focal anterior wall with hypokinesia and one had bulging of the inferior wall. Twenty-five persons (seven patients and 18 family members) had abnormal findings in ECG. Positive ventricular late potential was recorded in 13 persons (six patients). Two to three monomorphic ventricular tachycardia (VT) with left bundle branch block (LBBB) configurations were induced in five patients. Ventricular fibrillation was induced in two patients during the electrophysiologic study (EPS). Five patients had very high pacing threshold and/or ineffective pacing in one or many regions of the right ventricle. Two members of one family died suddenly. One member was a dwarf with ARVC. Spontaneous VT with a left bundle branch block (LBBB) configuration was recorded in five patients, polymorphic VT with extremely short coupling interval in one, and premature ventricular complexes with LBBB configuration in 12 (six patients). Conclusion　Our familial study strongly suggests that ARVC may be a hereditary disease and it is helpful in the diagnosis and detection of ARVC. The most common manifestations were abnormal structure and function of the right ventricle and abnormal ECG of repolarization and ventricular arrhythmia which originates from the right ventricle.     

6-(4-酰基-1-哌嗪乙酰氨基)-3,4-二氢-2(1H)-喹啉酮类化合物的合成及正肌力活性初探

目的 :寻找具有正性肌力活性的化合物。方法 :根据文献报道的二氢喹啉酮类正性肌力药物的结构特点 ,设计、合成了其类似物。以苯胺为起始原料经多步合成 ,对所得化合物用离体豚鼠心脏与主动脉观察了心肌收缩力、扩血管作用及心率。结果 :合成了 1 0个 6 ( 4 酰基 1 哌嗪乙酰氨基 ) 3 ,4 二氢 2 ( 1H) 喹啉酮类化合物 ( 4a～ 4j) ,均为未见文献报道的化合物。结论 :初步药理试验表明 ,化合物 ( 4h)显示了正性肌力及扩血管活性。     

Coronary computed tomography angiography in a patient with atrial fibrillation, case report

Atrial fibrillation (AF) is the most common persistent arrhythmia. It is associated with wide range of cardiac clinical conditions. Because of variable duration of cardiac cycle resulting in reduced image quality, AF has been considered relative contraindication for performing coronary computed tomography angiography (CCTA). However, recent reports have suggested that newer dual source scanner with higher temporal resolution can be used in patients with AF ( [Oncel et al., 2007] , [Wolak et al., 2008] and [Rist et al., 2009] ). Image quality can be maintained if heart rate is lowered to less than 70 beats per minute. However, high heart rate can still be challenging. Mapping systolic phase with the use of absolute delay reconstruction algorithm has been shown to provide better image quality. In this article, we present a case of patient with chronic AF and in whom coronary examination was required before going to repair of aortic root dissection. CCTA, with the use of absolute delay reconstruction algorithm, provided diagnostic image quality of the coronary arteries.