胎儿宫内发育迟缓模型孕鼠血浆TXA_2／PGI_2的比值及青心酮、山莨菪碱的效

健康Ｓｐｒａｇｕｅ－Ｄａｗｌｅｙ种妊娠大鼠１０２只，均于妊娠第４天～第２０天仿Ｙｏｕｎｏｓｚａｉ法制备胎儿宫内发育迟缓模型．随机分成对照组、模型组、氨基酸组、青心酮组和山莨菪碱组，各组按规定给药，观察有关指标．结果表明：模型组胎仔发育明显迟缓，血红蛋白和红细胞压积水平升高，血栓素Ｂ_２／６－酮基－ＰＧＦ_（１α）（ＴＸＢ_２／６－ｋｅｔｏ－ＰＧＦ_（１α））比值明显高于对照组．以上指标在青心酮组和山莨菪碱组得到明显改善，收到一定疗效．     

Influence of glucose and inhibitors of glycolysis on release of total proteins and enzymes from human leukocytes

We studied the influence of substrates and glycolysis inhibitors on the release of proteins and enzymes from human leukocytes. We show the relationship between metabolic level and percentage of enzyme release.Leukocyte kept alive in a nutrient-free bicarbonate medium liberate enzymes even though their metabolic state is satisfactory. The addition of glucose to the medium significantly decreases this phenomenon without affecting the energy level. Addition of glycolysis inhibitors increases it, reduces the energy level, and interferes with other metabolic pathways.The results are discussed and compared to those obtained by other authors using various cell models.     

Early adrenalectomy stimulates subsequent growth and development of the rat brain

Rats were adrenalectomized (ADX) or sham-operated (SHAM) on the 11th day of life and subsequent brain development (cerebrum and cerebellum) studied in terms of tissue weight and biochemical composition. Measured at about 65 days of age, early ADX subjects had significantly heavier brains (in terms of both wet and dry weights) than SHAMs, despite being lighter in overall body weight. Brain protein and DNA contents were elevated, as was the activity of 2′,3′-cyclic nucleotide 3′-phosphodiesterase (CNP), a myelin marker enzyme. Glycerol-3-phosphate dehydrogenase (GPDH), a glucocorticoid-regulated enzyme, was reduced in activity. Although both the cerebrum and cerebellum showed the growth-enhancing effects of early adrenalectomy, the DNA and CNP changes were most pronounced in the cerebrum. Finally, the effect of adrenal removal on myelinogenesis was confirmed by subcellular fractionation experiments demonstrating that more myelin could be recovered from the brains of ADX than from SHAM animals. These results are significant in terms of the influence of adrenal secretions on normal brain development and the role of GPDH in myelin lipid biosynthesis.     

DHAP in combination with rituximab vs DHAP alone as salvage treatment for patients with relapsed or refractory diffuse large B-cell lymphoma: a matched-pair analysis

The addition of rituximab to chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL) has been shown to improve outcome in first-line therapy. However, in patients with relapsed or refractory disease, the value of adding rituximab to salvage chemotherapy is less clearly defined. This study performed a matched-pair analysis of patients with relapsed or refractory DLBCL by comparing the combination of dexamethasone, high-dose cytarabine and cisplatin (DHAP) with rituximab to DHAP alone. Sixty-seven patients with relapsed or refractory DLBCL were collected from two prospective phase II trials from Germany and Italy. Twenty-three patient pairs treated with either DHAP in combination with rituximab or DHAP alone could be analysed after matching for important prognostic factors. The addition of rituximab to the DHAP regimen led to higher complete and similar overall remission rates. However, differences with regard to complete remission rates failed to reach statistical significance, thereby necessitating further evaluation of the role of combined immunochemotherapy in this patient population.     

Cd20 Expression and Effects on Outcome of Relapsed/Refractory Diffuse Large B Cell Lymphoma after Treatment with Rituximab

Introduction: Down regulation of CD20 expression has been reported in diffuse large B cell lymphoma (DLBCL)).Therefore, it is important to determine whether chemotherapy with rituximab induces CD20 down regulation and effectssurvival. Objectives: To determine the incidence of down regulation of CD20 expression in relapsed DLBCL aftertreatment with rituximab and to compare outcomes and assess pattern of relapse between CD20 negative and CD20positive cases. Methodology: We retrospectively reviewed patients with relapsed DLBCL who received rituximab inthe first line setting at Aga Khan University Hospital between January 2007 and December 2014. Data were recordedon predesigned questionnaires, with variables including demographics, details regarding date of diagnosis and relapse,histology, staging, international prognostic index, treatment and outcomes at initial diagnosis and at relapse. The Chisquare test was applied to determine statistical significance between categorical variables. Survival curves were generatedby the Kaplan–Meier method. Results: A total of 54 patients with relapsed DLBCL were included in our study, 38 (70%) males and 16(30%) females. Some 23 (43%) patients were at stage IV at the time of diagnosis and 34 (63%) had Bsymptoms. The most frequent R-IPI at diagnosis was II in 24 (44%) patients. Only 6 (11%) did not show CD20 expressionon re-biopsy for relapsed/refractory disease, 2 with CD20 negative DLBCL responding to second line chemotherapy.A complete response after salvage chemotherapy was noted in 16 (29.6%) cases with relapsed/refractory DLBCL.Seven (13%) patients underwent an autologous bone marrow transplant as consolidation after second line treatment.Median overall survival was 18 months in CD20 positive vs. 13 months in CD20 negative patients. Conclusion: Thisstudy demonstrated that a small percentage of patients treated with rituximab lose their CD20 expression at the timeof relapse. However, it is unclear whether this is associated with an inferior outcome.     

青心酮对肺动脉内皮细胞及红细胞生物力学特性的影响

目的 观察青心酮对红细胞及肺血管内皮细胞生物力学特性的影响。方法 体外培养肺动脉内皮细胞，分对照组及青心酮大，中，小剂量处理内皮细胞，用微管吸吮技术观察细胞的变形过程。结果 与未用药组比较，在加用青心酮30min后，中，大剂量组内皮细胞弹性系数K1和K2增大，粘性系数μ变化不大；红细胞表观变形指数和最大变形值也明显增加。结论 青心酮可以增加肺血管内皮弹性，并使红细胞变形能力明显增强，这可能是青心酮改善血液循环的生物力学机制。     

青心酮联合St.ThomasⅡ停跳液对心肌保护的研究

目的：研究青心酮（DHAP）联合St.ThomasⅡ停跳液对离体大鼠心脏缺血再灌注后心肌功能的影响。方法：以离体大鼠工作心脏模型,对比青心酮联合St.ThomasⅡ停跳液与单纯St.ThomasⅡ停跳液,心肌缺血再灌前后左室压（LVP）、左室舒张末期压（LVDEP）、左心室内压上升及下降最大速率（±dp/dt max）、主动脉压（AP）、冠脉流量（CF）、主动脉流量（AF）、每搏心输出量（SV）和测定冠脉流出液乳酸脱氢酶（LDH）,心肌三磷酸腺苷（ATP）含量、超氧化物歧化酶（SOD）活性、脂质过氧化物（LPO）含量。结果：青心酮联合St.ThomasⅡ停跳液产生较好的心肌保护作用,明显促进心肌缺血再灌后心肌功能的恢复,增进心脏的收缩功能、心肌ATP含量和SOD活性的恢复,减少LDH的漏出。结论：青心酮联合St.ThomasⅡ停跳液对心脏模拟体外循环的缺血再灌损伤具有保护作用,该方法有临床应用价值。     

Successful mobilization of peripheral blood stem cells with the DHAP regimen (dexamethasone, cytarabine, cisplatinum) plus granulocyte colony-stimulating factor in patients with relapsed Hodgkin's disease

High-dose chemotherapy followed by autologous stem cell transplantation can improve the outcome of relapsed and refractory Hodgkin's disease (HD) patients. The objective of the trial was to determine the mobilizing potential of the DHAP salvage regimen (dexamethasone, cytarabine, cisplatin) for the collection of peripheral blood stem cells (PBSC) in patients with relapsed HD. The target yield of harvesting CD34 + cells was ≥ 2 × 10⁶/kg in order to support the subsequent myeloablative chemotherapy. Most of the 105 patients included were intensively pre-treated with different combination chemotherapy regimens prior to mobilization. The use of DHAP followed by granulocyte colony-stimulating factor (G-CSF; 10 μg/kg) resulted in the successful collection of adequate numbers of PBSC in 97.1% of patients (102 of 105) with a median harvest of CD34 + cells of 13 × 10⁶/kg (range 2.6 - 85.1). More than 2.0 × 10⁶ CD34 + cells/kg were achieved in 65 of 103 (63%) patients after 1 apheresis, the maximum number of aphereses for all patients was 3. It was found that the optimal time of PBSC harvest was at days 13 - 16 after initiating the mobilization regimen.

These results demonstrate that the salvage chemotherapy regimen, such as DHAP combined with G-CSF, can be successfully used to mobilize PBSC in HD patients.     

DHAP方案治疗复发或难治性非霍奇金淋巴瘤疗效观察

目的为了观察DHAP方案治疗复发难治性非霍奇金淋巴瘤（non—Hodgkin’s lymphoma,NHL）的临床疗效和不良反应。方法选择复发难治性NHL患者16例,采用DHAP方案化疗：DDP 85mg／m^2,静脉滴入,d1;Ara—c2g／m^2,静脉滴注,d2,每1次／12h;DXM 40mg／d,静脉推注,d1～d4。21-28d为1周期,共完成2～6个周期。结果16例患者CR6例（37．5％）,PR5例（31．2％）,SD3例（18．8％）,PD2例（12．5％）,总有效率为68．7％（11／16）。主要毒副反应为血细胞下降和消化道反应,均可耐受。结论初步研究结果显示,DHAP方案是治疗复发难治性NHL的有效解救化疗方案,缓解率高,不良反应可以耐受,值得临床进一步观察。     

Some aspects of platelet glucose metabolism in thrombocytosis due to myeloproliferative disorders

Some aspects of the glucose metabolism were investigated in platelets of 11 healthy donors and 11 patients suffering from thrombocytosis due to myeloproliferative disorders. Out of all the glycolytic compounds measured in resting platelets, dihydroxyacetonephosphate and fructose 1,6 bisphosphate were significantly higher in cells of subjects with thrombocytosis. No difference was observed in the basic net flux of glucose through the hexose monophosphate shunt. Addition of arachidonic acid to platelets of patients with thrombocytosis had a very poor effect in stimulation of the hexose monophosphate shunt, whereas high values of activation were obtained in control platelets. Lactate production determined by collagen was found significantly higher in all patients. These data observed in platelets of patients could be explained by a decreased pool of metabolic adenine nucleotides.