脐血间充质干细胞治疗严重性系统性红斑狼疮的临床疗效初探

目的探讨脐血间充质干细胞对严重性系统性红斑狼疮（SLE）的治疗效果。方法从健康产妇足月分娩的脐带血（UCB）中分离单个核细胞、培养制备间充质干细胞（MSCs）。MSCs培养到第三代时,取样UCB-MSCs,用流式细胞术进行性质鉴定显示：UCB-MSCs高表达CD29,CD90;不表达CD34和CD45。收集生长良好的第三代UCBMSCs。（5.0-6.0）×10^7个细胞加入100ml含1﹪人血白蛋白的生理盐水中,静脉滴注;每天1次,6-10d,一疗程;3-6个月后再用第2疗程。结果通过UCB-MSCs输注,使现有方法治疗无效的2例严重性系统性红斑狼疮患者的症状完全恢复。第1例SLE伴严重狼疮肾,狼疮脑10年,双下肢水肿,皮肤坏疽,溃疡深达骨面,剧痛难眠1年。经治医生动员她截肢保命。UCB-MSCs治疗后10d,病情明显好转,双下肢水肿几乎全部消退。治疗6个月后,11处坏疽、溃疡的疮面10个疮面基本愈合。10个月后患者的坏疽,溃疡的疮面全部愈合,能自由活动,进入正常生活。第2例SLE伴狼疮肾,狼疮脑4年,一年来贫血严重,靠每周输血维持生命。UCB-MSCs治疗二个疗程后,咳嗽,呕吐症状明显好转,浮肿和双侧胸腔积液消失,各项检查指标基本正常,不需要输血治疗。恢复休学多年的学习生活。二者均随访8年,病情稳定,没发现复发症状。结论 UCB-MSCs治疗2例严重性红斑狼疮,取得一定的疗效;这种新的技术可望成为治疗严重性系统性红斑狼疮的辅助疗法。     

Effect of carboxymethyl-chitin-glucan on cyclophosphamide induced mutagenicity

The effect of high molecular carboxymethyl-chitin-glucan (CMCG), administered either intraperitoneally, intravenously or orally prior to cyclophosphamide injection, on the frequency of micronucleated reticulocytes was evaluated in peripheral blood of female ICR mice. Both intraperitoneal and intravenous administration of CMCG decreased the clastogenic effect of cyclophosphamide. The protective effect of CMCG was concentration dependent, with a higher decrease achieved by 100 mg/kg than by 50 mg/kg body weight. On the other hand, not even five peroral pretreatments with CMCG in the dose of 200 mg/kg body weight during the week prior to simultaneous administration of CMCG and cyclophosphamide induced a decrease of micronucleated reticulocytes in peripheral blood. It is therefore conceivable that CMCG failed to pass through the gastrointestinal tract, probably due to its high molecular weight. The antimutagenic effect of CMCG against cyclophosphamide was manifested by its intraperitoneal and intravenous administration to female ICR mice.     

Ultrasound-guided fetal intravenous transfusion for severe rhesus haemolytic disease.

Intrauterine, intraperitoneal transfusion is associated with a poor survival rate in fetuses with hydrops and low gestational age. A method of direct fetal intravenous transfusion was used in two fetuses. One fetus with severe rhesus haemolytic disease was given transfusions in the 29th and 30th weeks of gestation, using an ultrasound-guided needle through the hepatic part of the umbilical vein without fetoscopy. In another fetus, an experimental cannulation of the umbilical vein succeeded in the 23rd week of gestation. Ultrasound-guided fetal intravenous transfusion avoids the use of fetoscopy, which has limitations, and may improve the prognosis for rhesus-sensitised fetuses.     

The efficacy of Klebsiella pneumoniae bacteriophage in the therapy of experimental Klebsiella infection

The effectiveness of specific phage therapy was studied on Klebsiella experimental sepsis in noninbred white mice, caused by the intraperitoneal injection of K. pneumoniae highly virulent strain K2 5055 into the animals. For treatment, Klebsiella polyvalent bacteriophage administered on day 2 after the infection of the animals with Klebsiella was used. The study revealed that bacteriophage could be detected in the blood and internal organs of the animals within 24 hours irrespective of the route of its administration: intraperitoneal, intravenous or intranasal. The bacteriophage preparation, introduced intraperitoneally, was shown to be effective in the treatment of generalized Klebsiella infection. One daily intraperitoneal injection of Klebsiella bacteriophage for 15-20 days proved to be the optimum scheme of treatment. In contrast to chemotherapeutic preparations, bacteriophages had no effect on normal microflora and did not aggravate dysbiotic disturbances. For this reason, bacteriophages may become one of alternative antimicrobial remedies, selectively affecting infective agents.     

The risk of infecting premature newborn infants with the HB virus in transfusions with plasma HBsAg-negative by counterimmunoelectrophoresis

The prospective dynamic study of 229 premature infants with the use of highly sensitive methods, such as the passive hemagglutination test and the enzyme immunoassay, for the detection of HBsAg and anti-HBs antibodies. Of these, 182 infants received plasma (blood) transfusions in the first days of their life. Plasma (blood) used for transfusions was known to contain no HBsAg in accordance with the results of countercurrent immunoelectrophoresis. 47 infants had no plasma (blood) transfusions. In the group of 182 plasma recipients the presence of hepatitis B virus infection was detected in 17.0% of infants, the ratio of icteric, nonicteric and inapparent forms being 1:4.2:2. In the group of 47 infants no case of hepatitis B virus infection was observed.     

Ibuprofen reduces ethchlorvynol lung injury: possible role of blood flow distribution.

The role of cyclooxygenase products in acute lung injury was determined by pretreatment of dogs with ibuprofen before injury with intravenous ethchlovynol (ECV). In animals given ECV only, lung injury resulted in extravascular lung water of 18.9 ml/kg after 2 h, which was significantly higher than the 14.8 ml/kg in the group pretreated with ibuprofen. The comparison of gravimetric and indicator-dilution measurements of edema fluid indicates that edema fluid could not be reliably detected after treatment with ibuprofen because of diversion of flow from injured areas. Venous admixture increased from 6% at baseline to 32% 120 min after ECV in the vehicle-pretreated group compared with an increase from 4% at baseline to 7% in the ibuprofen-pretreated group. The regression analysis of the relationship between venous admixture and extravascular lung water indicated that, at any level of edema, venous admixture was significantly less in the group treated with ibuprofen than in the untreated group. Measurement of plasma and bronchoalveolar lavage fluid indicated that ibuprofen inhibited cyclooxygenase activity without affecting lipoxygenase activity. These results suggest that in intact dogs ibuprofen has a protective effect on both pulmonary gas transfer and pulmonary edema formation in ECV-injured lungs, which is consistent with limiting blood flow to injured segments of the lung.     

Group A Streptococcal L Forms I. Persistence Among Inoculated Mice

L forms induced from two strains of group A Streptococcus were inoculated intraperitoneally and intravenously into conventional and germ-free mice. After intravenous injection, streptococcal L forms disappeared very quickly from the blood, whereas, after intraperitoneal injection, it was possible to isolate them as long as 25 days after inoculation. Observations suggest that a certain degree of reversion to a bacterial form may occur spontaneously in animals.     

Enhancement of the pressor response to norepinephrine by angiotensin in the conscious rabbit

The pressor interactions between angiotensin II and norepinephrine were investigated in conscious New Zealand white rabbits receiving a low sodium diet. Angiotensin II was administered continuously by intraperitoneal osmotic pumps in a subpressor dose so as to avoid the potentially confounding effects of experimentally-induced hypertension. Norepinephrine challenges were given as a series of graded intravenous boluses. During the 3 days of study the baseline blood pressure in the angiotensin-treated rabbits (n=10) did not differ from that in controls (n=10) whose intraperitoneal pumps contained only diluent. After 24 hours the systolic and diastolic blood pressure responses to norepinephrine in the angiotensin-treated group were, on average, 45% and 30% higher than in the controls; after 72 hours, they were 46% and 34% higher. Although the pressor amplitudes were increased by angiotensin II, they were not prolonged. Thus, facilitation by the subpressor angiotensin II of the blood pressure responses to norepinephrine did not seem dependent upon alterations in endogenous sympathetic mechanisms or the uptake of norepinephrine; nor could it be explained by sodium retention. It is possible that angiotensin II exhibits its effect by enhancing contractile responsiveness to norepinephrine at the postreceptor level.     

Correlation of blood rheology with vascular resistance in critically ill patients.

Blood rheologic measurements together with peripheral resistance determinations in vivo were made in 27 critically ill patients. Eighteen of these patients (group I) suffered from violent trauma or operative injury and the other 9 (group II) were patients with generalized sepsis. As a result of fluid therapy all patients underwent hemodilution, resulting in a decrease in blood viscosity. This drop in blood viscosity was counteracted to some extent by an increased plasma viscosity due to elevated fibrinogen levels and a decreased red cell deformability associated with massive transfusions of stored blood. The correlation of vivo hemodynamics with blood rheological data made it possible to separate the relative roles of vascular dimensions and blood viscosity in affecting the total peripheral resistance. This approach permitted us to distinguish varying degrees of vasoconstriction in nonseptic patients in low flow states (group I) and varying degrees of vasodilation in septic patients (group II). This type of analysis serves to elucidate the pathophysiology of hemodynamic alterations in disease and provides a rational basis for devising an effective therapeutic program.     

静脉联合腹腔热灌注化疗对老年复发卵巢癌的临床效果

目的:对比分析静脉联合腹腔热灌注化疗与全身静脉化疗治疗老年复发卵巢癌的临床效果。方法:以2010年1月至2010年12月我院收治的80例老年复发卵巢癌患者为研究对象,行随机数字表法均分为观察组和对照组。观察组(n=40)行静脉联合腹腔热灌注化疗对照组(n=40)仅行全身静脉化疗。持续四个周期后统计疗效、不良反应,治疗前后CD3~+、CD4~+、CD4~+/CD8~+;持续随访,统计1年生存率、2年生存率、3年生存率、平均生存时间。结果觌察组总有效率(75.0%vs 52.5%)显著高于对照组;不良反应发生率(22.5%vs 80.0%)明显低于对照组;CD3~+、CD4~+、CD4~+/CD8~+均显著高于对照组;1年生存率(72.5%vs 55.0%)、2年生存率(27.5%vs 7.5%)均显著高于对照组;平均生存时间(16.8±2.1)月vs(13.8±1.8)月显著长于对照组。结论:静脉联合腹腔热灌注化疗治疗老年复发卵巢癌疗效显著,值得推广。     

AIDS and HIV-1 Infection: Clinical Entities in Geriatric Dentistry1

The number of AIDS cases in individuals 50 years of age or older in the United States is reported to exceed 9000. Contaminated blood and blood transfusions are major contributors to HIV-1 infection in this age group. Sexual transmission and infection through intravenous drug abuse are also potential avenues of HIV-1 transmission in the older population. AIDS presents with a variety of clinical manifestations, including dementia, frequently seen in non-HIV-1-infected older people. Neurological deficiencies associated with AIDS are very common and may lead to misdiagnosis in the elderly. The observed incubation period of HIV-1 infection is longer than previously estimated, increasing the risk of older individuals exposed to HIV-1 in the past to develop AIDS. Oral manifestations may present as one of the early clinical signs of AIDS. Little is known concerning AIDS in the geriatric population. It demands consideration by dental professionals treating older individuals belonging to one of the exposure categories of the disease.     

Differences in the Pharmacokinetics of Cocaine in Naive and Cocaine-Experienced Rats

Enhanced cocaine concentrations in brain and blood observed after an intraperitoneal challenge dose in rats exposed to cocaine for 10 days by subcutaneous administration are traced to a change in the absorption process from the site of an intraperitoneal injection to general circulation. This conclusion is reached by three sets of corroborating results: (a) Adipose tissue of rats treated for 10 days with repeat subcutaneous injections of cocaine did not reveal a buildup of cocaine in sufficient concentrations to account for the twofold increase in brain and blood concentrations seen during intraperitoneal administration; (b) administration of the drug by an intravenous route after 10-day cocaine treatment did not show a significant difference between treatment and control groups; (c) nonlinear regression on the intravenous and intraperitoneal data sets using a two-compartment open model indicated a difference in the absorption process but not in the metabolic and blood-brain transfer processes.     

Analysis of the pharmacokinetics of ethanol injected intraperitoneally and intravenously in rats with different levels of initial alcohol motivation

Ethanol pharmacokinetics was studied after its intraperitoneal and intravenous administration in rats with different initial level of alcohol motivation using gas chromatography. It was shown that in general pharmacokinetic pattern studied upon both intraperitoneal and intravenous ethanol administration (with respect to resorption and/or distribution), the rate of ethanol elimination including a number of processes leading to a decreased drug content may be an important criterion for the selection of animals with distinct initial levels of alcohol motivation.     

Staphylococcal footpad infection in mice.

Local footpad infection in mouse was investigated with 55 clinically isolated strains of Staphylococcus aureus. When 10(7) viable cells were inoculated into the footpad, local swelling and bacterial growth resulted after 24 hr. With a dose of 10(6) cells, moderate swelling was observed after a few hours but the reaction had almost disappeared after 24 hr. About 75% of the staphylococcal strains tested caused footpad edema in mice at doses of 10(7) cells. A statistical comparison of the virulence of the organisms on intravenous and intraperitoneal injection with that in inducing footpad swelling is also reported.     

Pulmonary circulation in experimental pulmonary edema during diverse artificial respiration regimes

In acute experiments on cats with closed chest by ultrasonic method the authors studied the blood flow in low-lobar pulmonary artery and the vein, the blood pressure in pulmonary artery, lung vessels resistance in experimental pulmonary edema caused by intravenous infusion of mixture fatty acids at artificial ventilation of increased frequencies or volumes, at was shown, that artificial ventilation of increased frequencies in pulmonary edema reduces the pressure increase in pulmonary artery, lung vessels resistance and increases the blood flow in pulmonary artery and vein. Artificial ventilation of increased volumes produces more intense pressure increase in pulmonary artery and lung vessels resistance than in initial ventilation but the blood flow was slightly changed. The authors assume that artificial ventilation of increased frequencies or volumes in pulmonary edema due to pulmonary circulation change reduces the pulmonary edema intensity at the beginning.     

Trypanosoma gambiense: immunosuppression and polyclonal B-cell activation in mice

The relationship between the suppression of antibody response and polyclonal B-cell activation was studied in mice treated with a cell homogenate of Trypanosoma gambiense. The cell homogenate injection in mice caused a progressive increase in splenic background plaque-forming cell response to sheep erythrocyte. In the mice with markedly increased background plaque-forming cell response, the different reactivity in the primary antibody response to sheep erythrocytes was observed between the intraperitoneal and intravenous immunization with sheep erythrocytes. The intraperitoneal immunization of mice with sheep erythrocytes strongly suppressed the antibody response, while the intravenous immunization with sheep erythrocytes led to an enhancement of the antibody response. The intraperitoneal injection of silica particles, a toxic agent to macrophages, 30 min before intraperitoneal immunization with sheep erythrocytes abolished the suppression of the antibody response completely. In addition, restoration of the suppressed antibody response was found in mice immunized intraperitoneally with a high dose of sheep erythrocytes. It appears that the suppression of antibody response is not attributable to polyclonal B-cell activation, and is associated with the elevation of the phagocytic activity of peritoneal macrophages.     

Pulmonary circulation in experimental toxic edema of the lungs

By means of ultrasonic method used in acute experiments on cats with open chest under artificial lung ventilation the authors studied the blood flow in low-lobar pulmonary artery and the vein, the blood pressure in pulmonary artery as well as the balance between output of right and left ventricles in experimental pulmonary edemas caused by intravenous infusion of mixture fatty acids. It was shown, that acute injury of lungs vessels produces redistribution of blood flow to the lesser circulation, increases the pressure in pulmonary artery. The pattern of pulsating blood flow in lobar artery and vein changes. The authors assume that in situation, when lung vessels permeability is already deranged redistribution of the blood to the lesser circulation aggravates the degree of edema.     

The effect of adrenalectomy upon the absorption,distribution and metabolism of ethanol in the rat

There was an increase in blood ethanol levels following the intraperitoneal or intravenous administration of ethanol to rats 8 days after adrenalectomy, compared to control animals. This was due to a 20% decrease in total body water and an increased rate of absorption following intraperitoneal administration. There was no change in the rate of ethanol metabolism.