• 【表面上健康的男性和女性的组织因子血清水平和未来冠状动脉疾病的风险: EPIC-Norfolk前瞻性人群研究。】 复制标题 收藏 收藏
    DOI:10.1111/j.1538-7836.2006.02190.x 复制DOI
    作者列表:Keller TT,Choi D,Nagel C,Te Velthuis H,Gerdes VE,Wareham NJ,Bingham SA,Luben R,Hack CE,Reitsma PH,Levi M,Khaw KT,Boekholdt SM
    BACKGROUND & AIMS: INTRODUCTION:Tissue factor (TF) has been implicated in coronary artery disease (CAD). High levels of circulating TF are found in patients with acute atherothrombotic events. Whether high serum TF levels predict risk of future CAD independent of known risk factors remains unknown. METHODS:We conducted a prospective case-control study nested in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. Cases (n=1037) were apparently healthy men and women, aged 45-79 years, who developed fatal or non-fatal CAD during follow-up. Controls (n=2005) were matched by age, sex, and enrolment time. Serum TF levels were measured using high-affinity antibodies. RESULTS:In men, median TF levels were not significant higher in cases than in controls (59.0 pg mL-1, range: 16.7-370.4 vs. 54.9 pg mL-1, range: 16.2-452.4). In women, median TF levels were not significant higher in controls than in cases (73.4 pg mL-1, range: 16.7-492.3 vs. 50.5 pg mL-1, range: 16.5-376.7). The incidence of smoking was about double in the lowest compared with the highest TF quartile. Correcting for sex, age, body mass index, smoking, diabetes, systolic blood pressure, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol and C-reactive protein levels, the risk of future CAD was 1.05 (95% CI: 0.81-1.36) for people in the highest TF quartile, compared with those in the lowest (P-value for linearity=0.8). CONCLUSION:High levels of serum TF were not independently associated with an increased risk of future CAD in apparently healthy individuals.
    背景与目标:
  • 【免疫复合物介导的血管炎小鼠模型中血管损伤的部位和CD18的相关性。】 复制标题 收藏 收藏
    DOI:10.1038/sj.jid.5700563 复制DOI
    作者列表:Sindrilaru A,Seeliger S,Ehrchen JM,Peters T,Roth J,Scharffetter-Kochanek K,Sunderkötter CH
    BACKGROUND & AIMS: :How neutrophils (polymorphonuclear neutrophils, PMNs) damage vessels in leukocytoclastic vasculitis (LcV) mediated by immune complexes (ICs) is unclear. If degradative enzymes and oxygen radicals are released from PMNs while adhering to the inner side of the vessel wall, they could be washed away by the blood stream or neutralized by serum protease inhibitors. We investigated if in LcV PMNs could damage vessels from the tissue side after transmigration. We used CD18-deficient (CD18-/-) mice because the absence of CD18 excludes transmigration of PMNs. When eliciting the Arthus reaction in ears of CD18-/- mice, deposition of ICs was not sufficient to recruit PMNs or to induce IC-mediated LcV. Injection of PMNs intradermally in CD18-/- mice allowed us to investigate if bypassing diapedesis and placing PMNs exclusively on the abluminal side leads to vascular destruction. We found that injected PMNs gathered around perivascular ICs, but did not cause vessel damage. Only intravenous injection of wild-type PMNs could re-establish the Arthus reaction in CD18-/- mice. Thus, PMNs cause vessel damage during diapedesis from the luminal side, but not from the perivascular space. We suggest that in order to shield the cytotoxic products from the blood stream, ICs induce particularly tight interactions between them, PMNs and endothelial cells.
    背景与目标: : 中性粒细胞 (多形核中性粒细胞,PMNs) 如何损害由免疫复合物 (ICs) 介导的白细胞碎裂血管炎 (LcV) 中的血管尚不清楚。如果降解酶和氧自由基从pmn中释放出来,同时粘附在血管壁的内侧,则它们可能会被血流冲走或被血清蛋白酶抑制剂中和。我们调查了在LcV中,pmn是否会在迁移后从组织侧损坏血管。我们使用CD18-deficient (CD18-/-) 小鼠,因为缺少CD18排除了pmn的迁移。当在CD18-/-小鼠的耳朵中引起Arthus反应时,ICs的沉积不足以募集pmn或诱导IC介导的LcV。在CD18-/-小鼠中皮内注射pmn使我们能够研究是否绕过血管造影并仅将pmn放置在管腔侧会导致血管破坏。我们发现注射的pmn聚集在血管周围ICs周围,但不会引起血管损伤。只有静脉注射野生型PMNs才能在CD18-/-小鼠中重新建立Arthus反应。因此,pmn在从管腔侧 (而不是从血管周围空间) 进行的排尿过程中会引起血管损伤。我们建议,为了从血流中屏蔽细胞毒性产物,ICs在它们,pmn和内皮细胞之间诱导特别紧密的相互作用。
  • 【肝或外周血中端粒酶表达的动态变化及其对肝细胞癌的诊断意义。】 复制标题 收藏 收藏
    DOI:10.3748/wjg.v12.i31.4966 复制DOI
    作者列表:Yao DF,Wu W,Yao M,Qiu LW,Wu XH,Su XQ,Zou L,Yao DB,Meng XY
    BACKGROUND & AIMS: AIM:To investigate the dynamic alteration of telomerase expression during development of hepatocellular carcinoma (HCC) and its diagnostic implications in liver tissues or peripheral blood mononuclear cells for HCC. METHODS:Dynamic expressions of liver telomerase during malignant transformation of hepatocytes were observed in Sprague-Dawly (SD) rats fed with 0.05% of 2-fluoenyacetamide (2-FAA). Total RNA and telomerase were extracted from rat or human liver tissues. The telomerase activities in livers and in circulating blood were detected by a telomeric repeat amplification protocol-enzyme-linked immunosorbent assay (TRAP-ELISA), and its diagnostic value was investigated in patients with benign or malignant liver diseases. RESULTS:The hepatoma model displayed the dynamic expression of hepatic telomerase during HCC development. The telomerase activities were consistent with liver total RNA levels (r = 0.83, P<0.01) at the stages of degeneration, precancerosis, and cancerization of hepatocytes. In HCC patients, the telomerase levels in HCC tissues were significantly higher than in their adjacent non-cancerous tissues, but liver total RNA levels were lower in the former than in the latter. Although the circulating telomerase of HCC patients was abnormally expressed among patients with chronic liver diseases, the telomerase activity was a non-specific marker for HCC diagnosis, because the incidence was 15.7% in normal control, 25% in chronic hepatitis, 45.9% in liver cirrhosis, and 85.2% in HCC, respectively when absorbance value of telomerase activity was more than 0.2. If the value was over 0.6, the incidence was 60% in HCC group and 0% in any of the others (P<0.01) except in two cases with liver cirrhosis. However, the combination of circulating telomerase with serum alpha-fetoprotein level could increase the positive rate and the accuracy (92.6%, 125 of 135) of HCC diagnosis. CONCLUSION:The overexpression of telomerase is associated with HCC development, and its abnormality in liver tissues or in peripheral blood could be a useful marker for diagnosis and prognosis of HCC.
    背景与目标:
  • 【人髌骨血流变化的无创连续估计。】 复制标题 收藏 收藏
    DOI:10.1007/s11517-006-0070-0 复制DOI
    作者列表:Näslund J,Pettersson J,Lundeberg T,Linnarsson D,Lindberg LG
    BACKGROUND & AIMS: :A photoplethysmographic (PPG) technique to assess blood flow in bone tissue has been developed and tested. The signal detected by the PPG consists of a constant-level (DC) component-which is related to the relative vascularization of the tissue-and a pulsatile (AC) component-which is synchronous with the pumping action of the heart. The PPG probe was applied on the skin over the patella. The probe uses near-infrared (804 nm) and green (560 nm) light sources and the AC component of the PPG signals of the two wavelengths was used to monitor pulsatile blood flow in the patellar bone and the overlying skin, respectively. Twenty healthy subjects were studied and arterial occlusion resulted in elimination of PPG signals at both wavelengths, whereas occlusion of skin blood flow by local surface pressure eliminated only the PPG signal at 560 nm. In a parallel study on a physical model with a rigid tube we showed that the AC component of the PPG signal originates from pulsations of blood flow in a rigid structure and not necessarily from volume pulsations. We conclude that pulsatile blood flow in the patellar bone can be assessed with the present PPG technique.
    背景与目标: : 已经开发并测试了一种用于评估骨组织血流的光电容积描记 (PPG) 技术。PPG检测到的信号由恒定水平 (DC) 分量 (与组织的相对血管化有关) 和脉动 (AC) 分量组成,该分量与心脏的泵送动作同步。将PPG探针涂在髌骨上的皮肤上。探针使用近红外 (804 nm) 和绿色 (560 nm) 光源,并且两个波长的PPG信号的AC分量分别用于监测髌骨和上覆皮肤中的脉动血流。研究了20名健康受试者,动脉闭塞导致消除了两个波长处的PPG信号,而局部表面压力对皮肤血流的闭塞仅消除了560 nm处的PPG信号。在对具有刚性管的物理模型的并行研究中,我们表明PPG信号的AC分量来自刚性结构中的血流脉动,而不一定来自体积脉动。我们得出的结论是,可以使用目前的PPG技术评估pa骨中的脉动血流。
  • 【使用源自人脐带血的干细胞的潜在临床应用。】 复制标题 收藏 收藏
    DOI:10.1016/s1472-6483(10)60646-3 复制DOI
    作者列表:Ghen MJ,Roshan R,Roshan RO,Blyweiss DJ,Corso N,Khalili B,Zenga WT
    BACKGROUND & AIMS: :There is an abundance of clinical applications using human umbilical cord blood (HUCB) as a source for stem cell populations. Other than haematopoietic progenitors, there are mesenchymal, endothelial stem cells and neuronal precursors, in varying quantities, that are found in human umbilical cord blood. These may be useful in diseases such as immune deficiency and autoimmune disorders. Considering issues of safety, availability, transplant methodology, rejection and side effects, it is contended that a therapeutic stem cell transplant, utilizing stem cells from HUCB, provides a reliable repository of early precursor cells that can be useful in a great number of diverse conditions. Drawbacks of relatively smaller quantities of mononucleated cells in one unit of cord blood can be mitigated by in-vitro expansion procedures, improved in-vivo signalling, and augmentation of the cellular milieu, while simultaneously choosing the appropriate transplantation site and technique for introduction of the stem cell graft.
    背景与目标: : 使用人脐带血 (HUCB) 作为干细胞种群的来源有很多临床应用。除造血祖细胞外,在人脐带血中还发现了各种数量的间充质,内皮干细胞和神经元前体。这些可能在诸如免疫缺陷和自身免疫性疾病等疾病中有用。考虑到安全性,可用性,移植方法,排斥反应和副作用等问题,有人认为,利用HUCB干细胞的治疗性干细胞移植提供了可靠的早期前体细胞储存库,可用于多种多样的条件。可以通过体外扩增程序,改善体内信号传导和增加细胞环境,同时选择合适的移植部位和技术来引入脐带血,减轻脐带血中相对较少数量的单核细胞的缺点。干细胞移植物。
  • 【太空飞行期间便携式临床血液分析仪的评估。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Smith SM,Davis-Street JE,Fontenot TB,Lane HW
    BACKGROUND & AIMS: This study was designed to validate the utility of a commercial portable clinical blood analyzer (PCBA) in ground-based studies and on the space shuttle. Ionized calcium, pH, electrolytes, glucose, and hematocrit were determined. Results agreed well with those from traditional laboratory methods, and the PCBA demonstrated good between-day precision for all analytes. In-flight analysis of control samples revealed differences in one analyte (sodium). There were few changes in crew members' results during flight, and these were expected. Potassium increased in flight compared with before flight, and potassium, pH, and hematocrit decreased after flight. Ionized calcium was decreased in flight and on landing day. Changes during flight were likely related to sample collection technique. Postflight changes likely reflected the fluid redistribution that occurs after exposure to weightlessness. These data confirm that the PCBA is a reliable instrument for most analytes, and can provide important medical data in remote locations, such as orbiting spacecraft.

    背景与目标: 这项研究旨在验证商用便携式临床血液分析仪 (PCBA) 在地面研究和航天飞机上的实用性。测定了离子钙,pH,电解质,葡萄糖和血细胞比容。结果与传统实验室方法的结果非常吻合,并且PCBA对所有分析物均显示出良好的日间精度。对照样品的飞行分析显示一种分析物 (钠) 存在差异。在飞行过程中,机组人员的结果几乎没有变化,这是可以预料的。与飞行前相比,飞行中钾增加,飞行后钾,pH和血细胞比容降低。在飞行中和着陆日,离子钙减少。飞行过程中的变化可能与样品收集技术有关。飞行后的变化可能反映了失重后发生的流体重新分布。这些数据证实了PCBA对于大多数分析物来说是一种可靠的仪器,并且可以在偏远的地方提供重要的医学数据,例如绕行航天器。
  • 【艾滋病患者的更昔洛韦耐药巨细胞病毒 (CMV) 视网膜炎病例: CMV病毒载量和血液区室病毒突变的纵向分子分析。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:1997-06-01
    来源期刊:AIDS
    DOI:10.1097/00002030-199707000-00005 复制DOI
    作者列表:Boivin G,Gilbert C,Morissette M,Handfield J,Goyette N,Bergeron MG
    BACKGROUND & AIMS: OBJECTIVE:To study the temporal relationships between cytomegalovirus (CMV) viral load and specific UL97 mutations in polymorphonuclear leukocytes (PMNL) and plasma samples from a patient with AIDS who developed ganciclovir-resistant CMV retinitis.

    METHODS:Sequential PMNL and plasma samples were analysed for determination of the CMV viral load using non-molecular methods and a quantitative polymerase chain reaction (PCR) assay. Screening of the same samples for the most common mutations conferring ganciclovir resistance was performed using nested PCR and restriction enzyme analysis.

    RESULTS:At the time of progression of CMV retinitis (after 6 months of ganciclovir), a rapid increase in the CMV DNA load was found in both PMNL and plasma samples. This increase paralleled the emergence of a specific mutation (V594) in the same samples and recovery of ganciclovir-resistant blood isolates. In this patient, however, the only tests that substantially predicted the progression of CMV disease were the quantitative PCR assay using PMNL and to a lesser extent the pp65 antigenemia assay.

    CONCLUSIONS:Quantitative evaluation of the CMV viral load in PMNL using sensitive assays such as PCR appears to be a promising approach for monitoring antiviral therapy in subjects with AIDS. In addition, common mutations conferring ganciclovir resistance can be detected directly in PMNL and plasma samples.

    背景与目标: 目标 : 研究巨细胞病毒 (CMV) 病毒载量与多形核白细胞 (PMNL) 和血浆样本中特定UL97突变之间的时间关系,该患者患有更昔洛韦耐药的CMV视网膜炎。
    方法 : 使用非分子方法和定量聚合酶链反应 (PCR) 分析方法分析了连续的PMNL和血浆样品,以确定CMV病毒载量。使用巢式PCR和限制性内切酶分析对相同样品进行了更昔洛韦抗性最常见突变的筛选。
    结果 : 在CMV视网膜炎进展时 (更昔洛韦6个月后),在PMNL和血浆样品中发现CMV DNA载量迅速增加。这种增加与同一样品中出现特定突变 (V594) 和更昔洛韦耐药血液分离株的回收平行。但是,在该患者中,唯一可以基本预测CMV疾病进展的测试是使用PMNL的定量PCR测定,以及在较小程度上使用pp65抗原血症测定。
    结论 : 使用敏感的检测方法 (例如PCR) 定量评估PMNL中的CMV病毒载量似乎是监测艾滋病患者抗病毒治疗的有希望的方法。此外,可以直接在PMNL和血浆样品中检测到赋予更昔洛韦抗性的常见突变。
  • 【MRI引导的阿尔茨海默病内侧颞叶血流的SPECT测量。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Julin P,Lindqvist J,Svensson L,Slomka P,Wahlund LO
    BACKGROUND & AIMS: UNLABELLED:In this study, we assessed the accuracy and reliability of MRI-guided SPECT measurements of medial temporal lobe blood flow in Alzheimer's disease (AD).

    METHODS:Interactively aligned three-dimensional MP-RAGE MRI and 99mTc-HMPAO SPECT images were used for MRI-guided measurement of medial temporal lobe CBF in eight control subjects and eight patients with probable AD. Intraoperator reliability was assessed by repeated alignment and measurement by one experienced operator. Accuracy was assessed by examining two subjects with fiducial markers.

    RESULTS:The alignment error was less than 1 SPECT pixel size (3.5 mm) and the coefficient of variation in repeated measures of medial temporal-to-cerebellar CBF ratios was 3.2%. The difference in mean medial temporal-to-cerebellar CBF ratios between eight control subjects and eight AD patients was 12%. Also by using three-dimensional seed-grow defined healthy brain reference regions, there were significant differences between control subjects and AD patients in medial temporal blood flow. Furthermore, the volumes of the MRI-defined medial temporal ROIs were smaller in the AD patients. The best separation between AD patients and control subjects was achieved by combining MRI measurements of atrophy and SPECT measurements of CBF.

    CONCLUSION:These data show that the accuracy and reliability of MRI-guided SPECT measurements of medial temporal CBF clearly allow the detection of changes in AD. Also, a direct comparison of structural and functional changes is possible by this methodology, which might improve the early diagnosis of AD.

    背景与目标: 未标记 : 在这项研究中,我们评估了MRI引导的SPECT测量阿尔茨海默氏病 (AD) 内侧颞叶血流的准确性和可靠性。
    方法 : 交互式对齐的三维MP-RAGE MRI和99mTc-HMPAO SPECT图像用于MRI引导的8名对照受试者和8名可能患有AD的患者的内侧颞叶CBF测量。一位经验丰富的操作员通过重复对准和测量来评估操作员内部的可靠性。通过检查两个具有基准标记的受试者来评估准确性。
    结果 : 对齐误差小于1 SPECT像素大小 (3.5毫米),并且重复测量的变异系数内侧颞-小脑CBF比3.2%。12% 了八名对照受试者和八名AD患者之间平均内侧颞与小脑CBF比率的差异。同样,通过使用三维种子生长定义的健康大脑参考区域,对照组和AD患者在内侧颞血流方面存在显着差异。此外,在AD患者中,MRI定义的内侧颞roi的体积较小。通过结合萎缩的MRI测量和CBF的SPECT测量,可以实现AD患者与对照组之间的最佳分离。
    结论 : 这些数据表明,MRI引导的内侧颞CBF SPECT测量的准确性和可靠性显然可以检测AD的变化。此外,通过这种方法可以直接比较结构和功能变化,这可能会改善AD的早期诊断。
  • 【囊性纤维化患者在呼气正压和振荡呼气正压胸部理疗期间血气紧张的即时变化。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Lagerkvist AL,Sten GM,Redfors SB,Lindblad AG,Hjalmarson O
    BACKGROUND & AIMS: OBJECTIVE:To assess and compare immediate effects of chest physiotherapy with positive expiratory pressure (PEP) versus oscillating PEP on transcutaneously measured blood-gas tensions in patients with cystic fibrosis. METHODS:Fifteen patients (mean age 12.5 y, range 6.9-21.5 y) participated. The treatments were randomized and performed on 2 separate occasions, 8 weeks apart. Spirometry was conducted before and after each treatment. We transcutaneously measured oxygen tension (P(tO2). RESULTS:There were no changes in spirometry values. During PEP, different trends in blood-gas tension were seen, and there were no consistent changes. During oscillating PEP, P(tO2) increased and P(tCO2) decreased. During oscillating PEP, P(tCO2) was lower and the intra-individual change in P(tCO2) was more pronounced than during PEP. The results obtained immediately after oscillating PEP showed a higher P(tO2) and a lower P(tCO2) than with PEP. CONCLUSION:PEP and oscillating PEP can both cause transitory effects on blood gases in patients with cystic fibrosis. However, oscillating PEP alters blood-gas tensions more than does PEP, and hyperventilation during oscillating PEP may reduce treatment time.
    背景与目标:
  • 【冠状动脉患者预后评估: 通用严重度指标的性能和定制。】 复制标题 收藏 收藏
    DOI:10.1378/chest.111.6.1666 复制DOI
    作者列表:Sarmiento X,Rué M,Guardiola JJ,Toboso JM,Soler M,Artigas A
    BACKGROUND & AIMS: STUDY OBJECTIVE:To assess the prognostic performance of general severity systems (APACHE II [acute physiology and chronic health evaluation], simplified acute physiology score [SAPS II], and mortality probability models [MPM II]) in coronary patients and to derive new customized indexes for coronary patients using a reduced number of variables.

    DESIGN:Inception cohort.

    SETTING:Adult medical and surgical ICUs in 17 hospitals in Catalonia and the Balearic Islands.

    PATIENTS:Four hundred fifty-six patients with acute myocardial infarction.

    MEASUREMENTS AND RESULTS:The APACHE II, SAPS II, and MPM II variables and survival status at hospital discharge have been collected. Performance of the severity systems was assessed by evaluating calibration and discrimination. Logistic regression was used to customize the MPM II(24) and SAPS II indexes. Discrimination was high enough for all of the models. However, calibration of the MPM II(24) was not as satisfactory as for the other models. The MPM II(24) and SAPS II were both reduced to five variables (MPM II(24 cor:) age, PaO2, continuous vasoactive drugs, urinary output, and mechanical ventilation; SAPS II(cor:) age, PaO2/FI(O2) ratio, systolic BP, Glasgow coma score, and urinary output). Both models showed better calibration and discrimination than the original ones.

    CONCLUSIONS:Prognostic indexes developed for multidisciplinary patients show good performance when applied to patients with acute myocardial infarction, but customization can reduce the number of variables necessary to compute them without a loss of, and a possible improvement in, prognostic accuracy.

    背景与目标: 研究目标 : 评估一般严重程度系统 (APACHE II [急性生理学和慢性健康评估],简化的急性生理学评分 [SAPS II],和冠心病患者的死亡率概率模型 [MPM II]),并使用减少的变量数量为冠心病患者推导新的定制指标。
    设计 : 初始队列。
    设置 : 加泰罗尼亚和巴利阿里群岛17家医院的成人医疗和外科重症监护医师。
    患者 : 456例急性心肌梗死患者。
    测量和结果 : 已收集APACHE II,SAPS II和MPM II变量以及出院时的生存状态。通过评估校准和判别来评估严重性系统的性能。Logistic回归用于定制MPM II(24) 和SAPS II指数。歧视对于所有模型来说都足够高。但是,MPM II(24) 的校准不如其他模型令人满意。MPM II(24) 和SAPS II均降低为五个变量 (MPM II(24 cor :) 年龄,PaO2,持续血管活性药物,尿量和机械通气; SAPS II(cor :) 年龄,PaO2/FI(O2) 比,收缩压,格拉斯哥昏迷评分,和尿量)。两种模型均显示出比原始模型更好的校准和区分度。
    结论 : 为多学科患者开发的预后指标在应用于急性心肌梗死患者时显示出良好的表现,但是,自定义可以减少计算它们所需的变量数量,而不会损失预后准确性,并可能提高预后准确性。
  • 【通过微孔过滤测量的外周血中性粒细胞流变学很好地反映了白塞氏病的活动。】 复制标题 收藏 收藏
    DOI:10.1016/s0923-1811(97)00599-9 复制DOI
    作者列表:Iijima S,Otsuka F
    BACKGROUND & AIMS: Activated neutrophils take a long time to pass through a narrow lumen like a micropore, and are supposed to play a deteriorating effect on microcirculation. Although the activation of neutrophils has been demonstrated in Behçet's disease, nobody analyzes the clinical activity of the disease by means of the rheological measure of neutrophils activity. Using a micropore (pore diameter 5 microns) filtration technique, we measured the filtration time of peripheral blood neutrophils, as a rheological measure of their activity, in order to determine the clinical activity of Behçet's disease. Twenty-one patients with Behçet's disease and 14 healthy control individuals were enrolled in the study. Symptoms and signs exhibited in the patients led us to distinguish the Behçet's disease into inactive and active cases. The latter were further differentiated into cases with absent symptoms and with present symptoms. Neutrophil filtration times were 11.5 +/- 4.8 s in the active cases with present symptoms, which were significantly (P < 0.05) larger than those (7.4 +/- 1.9 s) in the active cases with absent symptoms. The latter filtration times were further significantly (P < 0.001) larger than values (3.7 +/- 1.3 s) in the inactive cases and also those (4.8 +/- 1.2 s) in control subjects. Furthermore, increases in the filtration time obtained immediately after the exposure of cells to the chemotactic peptide formyl-methionyl-leucyl-phenylalanine (FMLP10 nM) were significantly (P < 0.01) larger in the active cases with present symptoms than those in the active cases with absent symptoms. The latter were also larger, but not significantly, than those in the inactive cases, and were significantly (P < 0.01) larger than those in control subjects. The present results demonstrate that the micropore filtration method reflects well the rheological activity of neutrophils as well as the clinical status of Behçet's disease. This method is much better than the measurement of O2 production to differentiate between active cases with absent symptoms and inactive patients or even control individuals. Furthermore, it is more sensitive and useful than laboratory data like the CRP value or the number of peripheral blood neutrophils.

    背景与目标: 活化的中性粒细胞需要很长时间才能通过像微孔一样的狭窄管腔,并且应该对微循环起到恶化的作用。尽管在beh ç et病中已经证明了中性粒细胞的激活,但没有人通过中性粒细胞活性的流变学测量来分析该疾病的临床活性。使用微孔 (孔径5微米) 过滤技术,我们测量了外周血中性粒细胞的过滤时间,作为其活性的流变学指标,以确定白塞氏病的临床活性。21名beh ç et病患者和14名健康对照者参加了这项研究。患者表现出的症状和体征使我们将白塞氏病区分为不活跃和活跃的病例。后者进一步分为无症状和现有症状的病例。有症状的活动病例的中性粒细胞过滤时间为11.5 +/- 4.8 s,显著 (P < 0.05) 大于无症状的活动病例的中性粒细胞过滤时间 (7.4 +/- 1.9 s)。后者的过滤时间进一步显著 (P < 0.001) 大于非活性情况下的值 (3.7 +/- 1.3 s),也大于对照受试者中的值 (4.8 +/- 1.2 s)。此外,在细胞暴露于趋化肽甲酰基-甲硫酰基-亮氨酸-苯丙氨酸 (fmlp10nm) 后立即获得的过滤时间的增加在存在症状的活动病例中比在不存在症状的活动病例中显着 (P < 0.01) 大。后者也比不活跃的情况更大,但不显著,并且显著 (P < 0.01) 大于对照组。目前的结果表明,微孔过滤方法很好地反映了嗜中性粒细胞的流变活性以及白塞病的临床状况。此方法比O2产生的测量要好得多,可以区分无症状的活跃病例和不活跃的患者甚至对照组。此外,它比CRP值或外周血中性粒细胞数量等实验室数据更敏感和有用。
  • 【雌二醇通过上调Fas和Fas配体的表达来增加人冠状动脉内皮细胞的凋亡。】 复制标题 收藏 收藏
    DOI:10.1210/jc.2006-1225 复制DOI
    作者列表:Seli E,Guzeloglu-Kayisli O,Cakmak H,Kayisli UA,Selam B,Arici A
    BACKGROUND & AIMS: CONTEXT:In animal models, estrogen inhibits atherogenesis by inhibiting many of the early steps of atherosclerotic plaque formation. However, the lack of cardioprotective effect by postmenopausal hormone replacement therapy and possible increase in cardiovascular events observed during the first year after the initiation of hormone replacement therapy may suggest that once the plaque is formed, estrogen may have additional effects that may counteract its beneficial outcomes. Indeed, the effect of estrogen on plaque stability has not been identified. OBJECTIVE:We hypothesized that 17beta-estradiol (E2) may cause increased apoptosis in human coronary artery endothelial cells (HCAECs). This effect would explain an adverse effect on plaque stability in vivo. INTERVENTION(S) AND MAIN OUTCOME MEASURE(S):The effect of E2 on apoptosis, cell proliferation, and expression of proapoptotic molecules Fas and Fas ligand (FasL) in cultured HCAECs was evaluated. RESULTS:HCAECs in culture treated with E2 showed an increase in DNA strand breaks and nuclear fragmentation indicative of apoptosis. E2 treatment also induced a significant concentration-dependent increase in Fas mRNA and protein expressions in HCAECs. Moreover, the expression of FasL mRNA and secretion of FasL protein by HCAECs were enhanced in response to E2 treatments. CONCLUSIONS:E2 increases the apoptosis in cultured HCAECs. Enhanced Fas and FasL expressions in response to E2 suggest that activation of the Fas/FasL pathway may be a mediator of the proapoptotic effects of E2 in these cells.
    背景与目标:
  • 【全髋关节置换术中血液稀释与其他血液回输技术。】 复制标题 收藏 收藏
    DOI:10.1097/00003086-199706000-00018 复制DOI
    作者列表:Oishi CS,D'Lima DD,Morris BA,Hardwick ME,Berkowitz SD,Colwell CW Jr
    BACKGROUND & AIMS: Acute normovolemic hemodilution has been reported to result in blood savings varying from 18% to 90%. Very few of these are randomized prospective studies. This study attempts to determine the blood transfusion savings if acute normovolemic hemodilution is used in combination with autologous predonated blood and cell saver. Thirty-three patients undergoing total hip arthroplasty were assigned randomly to one of two groups (control, n = 16; hemodilution, n = 17). Patients in both groups entered an autologous predonation program if cleared medically and were placed on Cell Saver intraoperatively and in the postanesthesia care unit. In addition, the hemodilution group underwent acute normovolemic hemodilution preoperatively. Only 41% of the patients in the hemodilution group required any autologous blood transfusion as compared with 75% of the control group. In addition, the hemodilution group required a mean lower quantity of autologous blood transfusion (41% of the estimated blood loss) as compared with the control group (71%). The net anesthesia time increased by an average of 11.4 minutes in the hemodilution group. Acute normovolemic hemodilution is a safe procedure even in an older patient population. Hemodilution resulted in fewer patients needing autologous predonated blood transfusions. The major benefit of hemodilution was seen when predonation was not possible.

    背景与目标: 据报道,急性等容量血液稀释会导致血液节约从18% 到90% 不等。其中很少是随机前瞻性研究。这项研究试图确定如果将急性等容量血液稀释与自体预献血和细胞保护剂结合使用,则可以节省输血。将接受全髋关节置换术的33例患者随机分为两组之一 (对照组,n = 16; 血液稀释,n = 17)。如果经过医学批准,两组患者都进入了自体预捐赠计划,并在术中和麻醉后护理病房中放置在Cell Saver上。此外,血液稀释组术前进行了急性等容量血液稀释。与对照组的75% 相比,血液稀释组中只有41% 的患者需要任何自体输血。此外,与对照组 (71%) 相比,血液稀释组需要平均较低量的自体血回输 (41% 估计的失血量)。血液稀释组的净麻醉时间平均增加11.4分钟。即使在老年患者中,急性等容积量血液稀释也是一种安全的方法。血液稀释导致需要自体预输血的患者减少。当无法进行预捐赠时,可以看到血液稀释的主要好处。
  • 【通过血管内超声记录不稳定型心绞痛和急性心肌梗死中冠状动脉小动脉粥样硬化斑块上的血栓。】 复制标题 收藏 收藏
    DOI:10.1016/s0002-9149(97)00199-9 复制DOI
    作者列表:Birnbaum Y,Luo H,Fishbein MC,Samuels B,Siegel RJ
    BACKGROUND & AIMS: Rupture of atheromatous plaques leading to acute coronary syndromes usually occur in lipid-reach and well-developed coronary lesions. We describe 2 unusual patients with acute coronary syndromes in whom there was angiographic and intravascular ultrasound evidence of an intraluminal thrombus overlying a small, nonocclusive plaque in an enlarged coronary artery.

    背景与目标: 导致急性冠状动脉综合征的动脉粥样硬化斑块破裂通常发生在脂质到达和发达的冠状动脉病变中。我们描述了2例不寻常的急性冠状动脉综合征患者,其中有血管造影和血管内超声证据表明腔内血栓覆盖了扩大的冠状动脉中的一个小的非闭塞斑块。
  • 【正常成年大鼠血脑屏障缺陷区的丰富免疫环境。】 复制标题 收藏 收藏
    DOI:10.1016/s0165-5728(97)00038-6 复制DOI
    作者列表:Pedersen EB,McNulty JA,Castro AJ,Fox LM,Zimmer J,Finsen B
    BACKGROUND & AIMS: The circumventricular organs (CVOs) in the brain are without a blood-brain barrier (BBB) and as such directly exposed to blood plasma constituents and blood-borne pathogens. In light of previous studies showing discrepancies regarding the immunocompetence of these organs, we initiated the present study to provide a comprehensive immunohistochemical analysis of the cellular expression of immune-associated antigens within the pineal gland, area postrema and the subfornical organ. In all CVOs, subpopulations of cells morphologically similar to complement receptor type 3 immunoreactive microglial/macrophage cells expressed major histocompatibility complex (MHC) class II antigen, leucocyte common antigen (LCA/CD45), as well as CD4 and ED1 antigen. Based on morphological criteria the MHC class II antigen expressing cells could be grouped into a major population of classical parenchymal and perivascular ramified microglial cells and a minor population presenting itself as scattered or small groups of rounded macrophage-like cells. CD4 and ED1 antigen were expressed by both cell types. CD45 was preferentially expressed by macrophage-like cells. MHC class I antigen was expressed by the vascular endothelium in both BBB-protected and BBB-deficient areas and was additionally present as a lattice-like network throughout the BBB-deficient parenchyma in all CVOs. The results suggest that the BBB-free areas of the brain besides being constantly surveyed by blood-borne macrophages, possess an intrinsic immune surveillance system based on resting and activated microglial cells, which may function as a non-endothelial, cellular barrier against blood-borne pathogens.

    背景与目标: 大脑中的心室器官 (CVOs) 没有血脑屏障 (BBB),因此直接暴露于血浆成分和血液传播的病原体。鉴于先前的研究显示这些器官的免疫能力存在差异,我们启动了本研究,以提供松果体,后区域和下器官内免疫相关抗原的细胞表达的全面免疫组织化学分析。在所有cvo中,形态上与补体受体3型免疫反应性小胶质细胞/巨噬细胞相似的细胞亚群表达主要组织相容性复合物 (MHC) II类抗原,白细胞共同抗原 (LCA/CD45) 以及CD4和ED1抗原。根据形态学标准,可以将MHC II类抗原表达细胞分为主要的经典实质和血管周围分支的小胶质细胞群,以及少量的呈分散或小群的圆形巨噬细胞样细胞群。两种细胞类型均表达CD4和ED1抗原。CD45优先由巨噬细胞样细胞表达。MHC I类抗原在BBB保护和BBB缺陷区域均由血管内皮表达,并且在所有cvo的BBB缺陷实质中还以晶格状网络的形式存在。结果表明,大脑的无BBB区域除了不断受到血源性巨噬细胞的调查外,还具有基于静息和活化的小胶质细胞的内在免疫监视系统,该系统可能是针对血源性病原体的非内皮细胞屏障。

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