糖尿病患者体内某些物质的变化

糖尿病是一种常见的复杂性疾病,发病原因既有遗传因素又有环境因素,属于多遗传基因。目前人类根据对糖尿病患者体内某些物质的变化进行了研究,发现了诸如下丘脑神经肽、c肽联合胰岛素、肿瘤坏死因子、瘦素等物质。在糖尿病患者体内这些物质的含量有的提高,而有的却发生了相应的下降．主要是对这几种物质进行介绍,以使人们能更加准确地了解糖尿病的发病机制,从而研制出能更加行之有效的治疗方法。     

Resistance towards calcium induced bilirubin dependent hemolysis in porcine erythrocytes

Hemolysis of erythrocytes from human and porcine blood was studied at different calcium chloride (CaCl₂) concentrations (0.04–1.83 mM) and at a constant bilirubin concentration (72 mM). Although, human erythrocytes showed significant hemolysis (64%) at the highest CaCl₂ concentration (1.83 mM) used in this study, remarkable resistance to this phenomenon was observed with porcine erythrocytes as only 11% hemolysis was observed. A similar pattern in the behavior of both human and porcine erythrocytes was observed when parameter such as bilirubin concentration or time of incubation with bilirubin was varied. Other divalent cations such as Mn²⁺, Ba²⁺ and Mg²⁺ were either least effective or ineffective in inducing hemolysis in presence of bilirubin. Serum albumin played a protective role in this phenomenon in a concentration dependent manner, as no hemolysis was observed at a bilirubin/albumin molar ratio of 1:1 or less. Differences in the structural make-up of proteins and lipids in the erythrocyte membranes of the two species may account for their different behavior.     

Influence of blood specimen collection method on various preanalytical sample quality indicators

Preanalytical errors contribute to a large proportion of total laboratory errors. In order to achieve continuous laboratory improvement, it is important to focus on all phases of patient specimen testing i.e. preanalytical, analytical and post-analytical. With large variations in the way venous blood specimens are collected using diverse devices in the country, the effect of such practices on specimen quality is not known. The purpose of this study was to monitor fourteen specimen preanalytical quality indicators in order to compare the usage of evacuated blood collection devices with needle and syringe open collection using either disposable tubes or re-washed glass vials. The study involved 26638 patient specimens assessed over a period of 6 months. The results demonstrated that evacuated closed blood collection resulted in an approximate 100-fold reduction in the incidence of hemolysis in samples. Similarly, there was a 200-fold reduction in incidence of insufficient specimen quantity while using evacuated collection system. It was also found that incidence of specimen contamination, improper volume of sample collected, and specimen spillage was also lower when the evacuated collection system was used. Further, it was also observed that the facility with a laboratory information system demonstrated much lower specimen identification and related errors. The observed results clearly demonstrate that the usage of the evacuated blood collection system resulted in improvement of preanalytical specimen quality as compared to needle and syringe usage.     

Infliximab treatment in two Chinese patients with psoriatic arthritis

Psoriatic arthritis (PsA) is a rheumatoid factor (RF)-seronegative systemic inflammatory disorder associated with psoriasis. Current treatment for PsA in China is still focused on disease modifying anti-rheumatic drugs (DMARDs). In this paper, we report two Chinese patients with active longstanding PsA treated with infliximab, a human-mouse chimeric monoclonal antibody against tumor necrosis factor alpha (TNF-α). The results show that infliximab acted quickly and effectively in relieving peripheral and axial symptoms and refractory skin lesions, even in recombinant human TNF-α receptor (rhTNFR)-resistant case. The take-home message from our cases is that infliximab is a useful therapeutic option for refractory PsA, especially when a patient has a combination of psoriasis and psoriatic arthritis. Further local evidence and experience must be accumulated in order to make anti-TNF-α therapy more accessible to PsA patients in China.     

Lack of Circadian Pattern of Serum TNF-α and IL-6 in Patients with Fibromyalgia Syndrome

The present study was designed to test the hypothesis of a circadian variation in circulating levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in women with fibromyalgia syndrome (FMS). Serum levels of IL-6 and TNF-α were measured at 4 h intervals of the day in 50 women with FMS satisfying American College of Rheumatology criteria for FMS (age 36.68 ± 9.89) as well as 50 healthy control women (age 32.82 ± 10.53). Serum TNF-α levels were substantially increased in patients with FMS but showed no circadian variation. In contrast, no difference in the levels of IL-6 was found. Moreover, there was also no circadian variation in both the groups of patients and controls. We conclude that no circadian pattern exists in the circulating levels of serum IL-6 and TNF-α in patients with FMS, although TNF-α levels are found raised in patients with FMS.     

小儿分泌性中耳炎与肿瘤坏死因子及免疫球蛋白的关系

为探讨儿童分泌性中耳炎与肿瘤坏死因子及免疫球蛋白的关系,采用ＥＬＩＳＡ双抗体夹心法及免疫扩散试验,对３０例健康儿童和３７例分泌性中耳炎患儿进行肿瘤坏死因子和免疫球蛋白的测定。结果分泌性中耳炎ＴＮＦ－α明显增高,ＩｇＡ明显降低,ＩｇＧ、ＩｇＭ无明显差异。推测在分泌性中耳炎的发病过程中,免疫机制可起重要作用。     

溃疡性结肠炎模型的构建及其炎症反应机制研究

目的：构建2,4,6-三硝基苯磺酸（2,4,6-trinitrobenzene sulfonic acid,TNBS）以及恶唑酮（oxazolone,OXZ）诱导的小鼠溃疡性结肠炎（ulcerative colitis,UC）模型。方法：120只昆明小鼠（）随机分为4组（n=30）。Ⅰ组、Ⅱ组参照Morris及Walter的方法制备小鼠TNBS模型：Ⅰ组（TNBS溶剂对照组）,50%乙醇0.1 m L灌肠;Ⅱ组（TNBS模型组）,0.6%TNBS溶液0.1 m L灌肠;两组灌肠给药一次后在d 1、d 2、d 3、d 5、d 7每组处死6只。Ⅲ组、Ⅳ组参照Heller方法制备小鼠OXZ模型：Ⅲ组（OXZ溶剂对照组）,皮肤涂抹100%乙醇0.1 m L,每天一次,连续2 d,d 7以50%乙醇0.1 m L灌肠;Ⅳ组（OXZ模型组）,皮肤涂抹1%OXZ溶液（100%乙醇溶解）0.1 m L每天一次,连续2 d（致敏）,d 7以0.5%OXZ（50%乙醇溶解）0.1 m L灌肠;两组灌肠给药一次后在d 1~d 5每天处死6只小鼠。观察Ⅰ~Ⅳ组小鼠疾病活动指数（disease activity index,DAI）、结肠组织大体损伤指数（colon macroscopic damage index,CMDI）和病理组织学评分（histopathological score,HPS）,并检测小鼠结肠组织中髓过氧化物酶（myeloperoxidase,MPO）、白细胞介素-4（interleukin-4,IL-4）、肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）的水平。结果：两种模型组小鼠DAI,CMDI和HPS均较对照组有明显改变;TNBS和OXZ诱导的结肠炎均可导致MPO明显上升,TNBS结肠炎TNF-α明显上升,OXZ结肠炎IL-4明显下降。结论：TNBS及OXZ均能诱导小鼠溃疡性结肠炎模型。两种模型各有特点,其中TNBS诱导的小鼠溃疡性结肠炎以辅助性T1（helper1,Th1）型炎症反应为主,OXZ诱导的小鼠溃疡性结肠炎以辅助性T2（helper2,Th2）型炎症反应为主。     

骨形态发生蛋白-2治疗股骨头坏死研究进展

随着细胞组织工程学的发展,骨形态发生蛋白(bone morphogenetic protein,BMP)越来越多的应用在骨科领域,而骨形态发生蛋白-2(bone morphogenetic protein,BMP-2)在治疗骨缺损,骨不愈合等方面的效果已经在基础实验和临床实践上均得到了证实[1-3],其作用机制可能是BMP-2可诱导间充质干细胞向软骨方向分化,并通过Smad通路及MAPK通路传导,并对骨组织的形成、生长和损伤的修复具有促进作用[4]。基于这一作用机制,越来越多的学者把研究重点放在治疗股骨头坏死领域,文章就近年来BMP-2治疗股骨头坏死研究进展。     

Effect of Oxidized Phosphatidylcholine on Biomarkers of Oxidative Stress in Rats

In this study it was planned to investigate the effect of oxidized phosphatidylcholine (derived from egg) feeding on lipid peroxidation of different tissues in rats. Male Wistar albino rats were fed oxidized and unoxidized phosphatidylcholine for 2 and 4 weeks, respectively. During the period of study food intake and body weights of animals increased gradually. Animals fed oxidized phosphatidylcholine for 2 and 4 weeks showed 33 and 15% spontaneous hemolysis of red blood cells in vitro. Under identical experimental conditions animals given unoxidized phosphatidylcholine showed 14.5 and 13.4% hemolysis for 2 and 4 week’s period, respectively. Thiobarbituric acid reactive substances (TBARS) level in thymus, spleen, kidney, heart, liver and lung significantly increased in rats given oxidized phosphatidylcholine as compared to unoxidized group. Furthermore, in oxidized phosphatidylcholine group TBARS values in kidney, liver and lungs continued to rise for 4 weeks of treatment while TBARS level in heart, spleen and thymus was found to be decreased at the end of 4 weeks of oxidized phosphatidylcholine feeding. Plasma triacylglycerol and cholesterol was found to increase in rats who had received oxidized phosphatidylcholine for 2 weeks. These findings suggest that excess and persistent intake of oxidized phosphatidylcholine can cause significant damage to organs.     

行动学习法在股骨头坏死临床教学中的应用

传统教学模式以教师课堂讲授为主,无法激发学生探究知识的热情,难以取得令人满意的教学效果。“行动学习法”是克服传统教学模式弊端的重要方式,是现代教学方法改革的新趋势。将以“行动学习法”为中心的教学模式应用到股骨头坏死临床实践教学中,可以激发规培生对骨科的兴趣,提高他们在骨科规培时的实践能力。