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.     

Associations between both genetic and environmental biomarkers and lung cancer: evidence of a greater risk of lung cancer in women smokers

This molecular epidemiologic case-control study of lung cancer incorporated three complementary biomarkers: the glutathione S- transferase M1 (GSTM1) null genotype, a potential marker of susceptibility, and polycyclic aromatic hydrocarbon-DNA adducts (PAH- DNA) and sister chromatid exchanges (SCE), both indicators of environmentally induced genetic damage. Associations between biomarkers and lung cancer were investigated, as were possible gene-environment interactions between the GSTM1 null genotype and tobacco smoke exposure. Subjects included 136 primary non-small cell lung cancer surgical patients and 115 controls at the Columbia Presbyterian Medical Center. Questionnaire and Tumor Registry data, pre-treatment blood samples and biomarker measurements on blood were obtained. Overall, GSTM1 null genotype was significantly associated with lung cancer [odds ratio (OR) = 2.04, 95% confidence interval (CI) = 1.13-3.68]. ORs for GSTM1 and lung cancer were significant in females (2.50, 1.09-5.72) and smokers (2.25, 1.11-4.54) and not significant in males (1.4, 0.58-3.38) and non-smokers (0.88, 0.18-4.33). However, ORs for males versus females and smokers versus non-smokers did not differ significantly. The OR for GSTM1 and lung cancer in female smokers was 3.03 (1.09- 8.40), compared with 1.42 (0.53-4.06) in male smokers. In contrast to PAH-DNA adducts in leukocytes, SCE did not differ between cases and controls. Neither biomarker differed significantly between the two GSTM1 genotypes. The combined effect of elevated PAH-DNA adducts and GSTM1 genotype on case-control status (16.19, 1.2-115) appeared multiplicative. Results suggest that the effect of the GSTM1 null genotype is greatest in female smokers, which is consistent with other evidence that indicates that women are at higher risk of lung cancer than males, given equal smoking. Persons with both the GSTM1 deletion and elevated PAH-DNA adducts may represent a sensitive subpopulation with respect to carcinogens in tobacco smoke and other environmental media.      

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．     

CD4+CD25+调节性T细胞与炎症性肠病研究进展

CD4 CD25 调节性T细胞是维持机体自身免疫耐受的调节性T细胞亚群,主要来源于胸腺, 与自身免疫性疾病的发生、发展密切相关．炎症性肠病(IBD)是一种病因未明侵犯胃肠道的自身免疫性疾病,免疫耐受异常是导致其发病主要因素之一．CD4 CD25 调节性T细胞的异常表达可能与IBD的发病有关．     

彩色多普勒超声图像评估电烧伤血管损伤的应用价值

目的:探讨彩色多普勒超声图像对电烧伤血管损伤评估的临床应用价值。方法:选择2001-03/2006-02广西医科大学第一附属医院收治的17例上肢高压电烧伤患者的20条尺、桡动脉作为烧伤组,术前应用彩色多普勒超声观察患肢腕部创面及创面近心端8,15cm处尺、桡动脉的管壁厚度、管腔内径、收缩期峰值流速以及血栓形成等情况,并以该病例组正常上肢为对照。术中观察动脉大体改变,出现栓塞或管壁坏死者予以切除并进行组织病理学检查。结果:17例全部进入结果分析。①彩色多普勒超声显示烧伤组18条尺动脉和15条桡动脉出现不同程度的异常,表现为血管内膜水肿,管壁增厚,管腔狭窄或串珠样改变,血流缓慢,甚至血栓形成。②术中所见及组织病理学检查结果与彩色多普勒超声诊断相符。③桡动脉烧伤侧创伤处以及创缘近心端8cm处血管管壁厚度大于对照侧[(0.71±0.02),(0.41±0.08)mm;(0.70±0.02),(0.48±0.12)mm;P=0.000];创缘近心端8,15cm处收缩期峰值流速小于对照侧[(48.363±5.327),(55.304±7.401)cm/s,P=0.003;(52.053±4.797),(63.356±11.237)cm/s;P=0.000]。④尺动脉烧伤侧创伤处以及创缘近心端8cm处血管管壁厚度大于对照侧[(0.68±0.03),(0.40±0.06)mm;(0.59±0.01),(0.48±0.09)mm;P=0.000];创伤处、创缘近心端8,15cm处收缩期峰值流速小于对照侧(P<0.01)。结论:彩色多普勒超声检测技术具有无创性的特点,图像能够准确显示血管的形态学及血液动力学的改变,可为电烧伤患者血管损伤检测中一种理想的检测手段之一。     

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.     

青翘和老翘中连翘苷的含量测定

目的：测定青翘与老翘中连翘苷含量。方法：。双波和薄层扫描法。结果：表翘中连翘苷含量为０．０７６％;老翘中仅占０．０１２％,与报道的青翘中连翘酯苷含量高于老翘的实验结果相同,结论;本文结果与文献报道的就抗菌效价而言青翘优于老翘的结论吻合,目前市售药材青老翘混杂,有必要进行深入研究,确定合理的采收期。     

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。