去蛋白血液透析物促进创伤愈合的研究进展

去蛋白血液透析物促进创伤愈合的研究进展上海医科大学附属华山医院运动医学科（２０００４０）白玉龙，综述许胜文审校“爱维治”（Ａｃｔｏｖｅｇｉｎ）是用超滤法从小牛血液中提取的去蛋白血液透析物（Ｄｅｐｒｏｔｅｉｎｉｚｅｄｈｅｍｏｄｉａｌｙｓａｔａ）的商品名...

肝细胞质液透析物生物学特性的实验研究

肝刺激物质(Hepatic Stimulator Substa-nce,HSS)能刺激活体及体外培养肝细胞DNA合成,并能显著提高D-氨基半乳糖所致的急性肝衰竭大鼠的存活率,是一种很有希望治疗肝病尤其是重症肝炎的新型生化药物。但其提取工艺复杂,所需设备昂贵,不适合于大生产。我们大胆改革生产工艺,采用简便易行的透析工艺成功地从乳猪新鲜肝脏提取到能显著刺激大鼠原代肝细胞DNA合成的物质、并对某一些生物学特性作了初步研究。

猪脾浸液透析物(PS—DLE)对肿瘤患者红细胞C_3b受体活性的影响

用酵母菌花环试验,检测健康成人和肿瘤患者红细胞C_3b受体免疫粘附活性.结果发现PS—DLE对26例健康成人红细胞C_3b受体活性具有激活作用(P<0.01),检测17例肿瘤患者红细胞C_3b受体酵母菌花环率与健康人相比,明显偏低(P<0.01),经PS—DLE(4单位/日)治疗1周后,其红细胞C_3b受体活性明显提高,与治疗前比较相差非常显著(P<0.01).本实验结果表明,肿瘤患者的红细胞免疫功能是处于抑制状态,而PS—DLE可以提高红细胞的免疫功能.

Pegylated-interferon alpha 2a treatment for chronic hepatitis C in patients on chronic haemodialysis

AIM： To evaluate the response to pegylated-interferon alpha 2a in chronic hepatitis C patients on chronic haemodialysis. METHODS： Ten patients with chronic C hepatitis were enrolled in this study. All had increased aminotransferases for more than 6 too, positive antiHCV antibodies and positive PCR HCV-RNA. We administrated Peg-Interferon alpha 2a 180 μg/wk for 48 wk. After 12 wk of treatment we evaluated the biochemical and early virological response （EVR）. At the end of the treatment we evaluated the biochemical response and 24 wk after the end of the treatment we evaluated the sustained virological response （SVR）. We monitored the sideeffects during the treatment. RESULTS： Two patients dropped out in the first 12 wk of treatment and 2 after the first 12 wk of treatment. After 12 wk of treatment, 7 out of 8 patients had biochemical response and EVR and 1 had biochemical response but persistent viremia. We had to reduce the dose of pegylated-interferon to 135 μg/wk in 2 cases. Three out of 6 （50%） patients had SVR 24 wk after the end of the treatment. Intention-to-treat analysis showed that 3 out of 10 patients （30%） had SVR. Side-effects occurred in most of the patients （flu-like syndrome, thrombocytopenia or leucopoenia）, but they did not impose the discontinuation of treatment. CONCLUSION： After 12 wk of treatment with Peg-Interferon alpha 2a （40 ku） in patients on chronic haemodialysis with chronic C hepatitis, EVR was obtained in 87.5% （7/8） of the cases. SVR was achieved in 50% of the cases （3/6 patients） that finished the 48 wk of treatment.

NEUTROPHILIC TRANSIENT ACIDIFICATION AND SUPEROXIDE PRODUCTION IN PERITONEAL DIALYSATE

Aim. To elucidate whether an inhibited superoxide production(O 2 ) of neutrophils induced by commercial lactate based peritoneal dialysates(PDS) could be corrected after a transient intracellular acidosis. Methods. The intracellular pH([pHi]) of human neutrophils incubatd in PDS was monitored with a spectrofluorometer with a pH sensitive dye (BCECF AM). Neutrophilic O 2 stimulated by zymosan was determined in PDS with the superoxide dismutase inhibitable ferricytochrome c reduction, using a spectrophotometer. Results. The severe intracellular acidosis induced within 5 min by PDS at an extracellular pH of 5.2 could be promptly and completely recovered by a neutralization of the pH of media. However, O 2 by neutrophils exposed to the PDS for as little as 5 min was drastically and persistently inhibited, even the acidic [pHi] of cells had been fully returned for 1h. Conclusions. The intracellular acidification of cells in the initial phase could be transient and reversible, but impaired cell functions, at least in part including O 2 generating system, might be consistent and irreversible in the early stage of the cellular acidosis in the peritoneal cavity of CAPD patients. The findings above may be of particular importance in both clinic and cell biology.

Pharmacokinetics of paclitaxel in a hemodialysis patient with advanced gastric cancer: A case report

We report for the first time the possibility of weekly paclitaxel chemotherapy for a patient with advanced, nonresectable gastric cancer undergoing hemodialysis. A 50-year-old man with chronic renal failure due to bilateral polycystic kidneys, who had undergone hemodialysis three times a week for 5 years, presented with hematemesis in December 2004. Based on the diagnosis of gastric cancer with lymph node metastases, surgery was performed. On the 15th postoperative day, the patient was treated with chemotherapy using paclitaxel. Paclitaxel was administered at a dose of 60 mg/m^2 as a 1 h iv infusion in 250 mL of saline. Hemodialysis was started 1 h after the completion of the paclitaxel infusion and was performed for 3 h. Paclitaxel was administered weekly on d 1, 8, and 15 on a 28-d cycle. The maximum plasma concentration of paclitaxel was 1390 μg/L. The area under the curve of paclitaxel was 4398.6 μg·h/L. Grade 2 leukopenia was encountered during the first cycle. The plasma concentrations of paclitaxel from 6 to over 24 h after the infusion were 0.01 to 0.1 μmol/L in our patient, and these concentrations have been shown to be effective on inhibiting the growth of gastric cancer cells without producing adverse side effects in the patient. The plasma concentration of paclitaxel was not influenced by hemodialysis. We conclude that the pharmacokinetics of paclitaxel is not altered in a patient with renal failure, and that weekly paclitaxel is a suitable treatment regimen for hemodialysis patients with advanced gastric cancer.

Nitrogen Forms of Maillard Polymers Derived from Xylose and ^(15)N-Labelled Glycine

Water-soluble, nondialyzable Maillard polymers were prepared by reacting D-xylose with 15N-glycine (and/or glycine) at 68 ℃ and pH 8.0 at equimolar concentrations of 1, 0.5 and 0.1 mol L-1, respectively,for 13 days and partitioned into acid-insoluble (MHA) and acid-soluble (MFA) fractions. The nitrogen forms in these polymers were studied by using the 15N cross polarization-magic angle spinning nuclear magnetic resonance (CPMAS NMR) technique in combination with chemical methods. The 15N nuclear magnetic resonance (NMR) data showed that while the yield, especially the MHA/MFA ratio, varied considerably with the concentrations of the reactants, the nitrogen distribution patterns of these polymers were quite similar.From 65% to 70% of nitrogen in them was in the secondary amide and/or indole form with 24%~25% present as aliphatic and/or aromatic ammes and 5% to 11% as pyrrole and/or pyrrole-like nitrogen. More than half (50%~77%) of the N in these polymers were nonhydrolyzable. The role of Maillard reaction in the formation of nonhydrolyzable nitrogen in soil organic matter is discussed.

Determination of Creatinine in PETs and Laboratory Calculations of the Peritoneal Dialysis Adequacy

Since our Department for Dialysis performs the Peritoneal Equilibration Test （PET） to monitor peritoneal dialysis adequacy, our Laboratory has been asked to collaborate on calculating clearances and transport characteristics of patients. This collaboration is ongoing since 2003, despite the Baxter-PD Adequest software having appeared. Our aim is to emphasize the importance of the laboratory in the selection of formulas and specifically in solving the problem of determining creatinine concentration in PETs, and to recommend the cooperation between the laboratory and the dialysis department. Since creatinine determination is encumbered by recommendations for correcting elevated creatinine levels because of the influence of glucose in PETs, we compared results of dialysates determined as serum and as urine. Until now we had 86 patients on continuous ambulatory peritoneal dialysis （CAPD）. Method for determining patients＇ creatinine remains Jaffe kinetic uncompesated although the analyzers and the corresponding reagenses were changed in the laboratory. We have achieved the complete cooperation and confidence in the result, and with the PET test performed strictly according to the protocol, increasingly better results for clearences, Kt/V and transport characteristics. All this helps with treatment planning and analyzing patients＇ quality of life.

Effect of a novel three-step aging on strength, stress corrosion cracking and microstructure of AA7085

The influence of a novel three-step aging on strength, stress corrosion cracking(SCC) and microstructure of AA7085 was investigated by tensile testing and slow strain rate testing combined with transmission electron microscopy(TEM). The results indicate that with the increase of second-step aging time of two-step aging, the mechanical properties increase first and then decrease, while the SCC resistance increases. Compared with two-step aging, three-step aging treatment improves SCC resistance and the strength increases by about 5%. The effects of novel three-step aging on strength and SCC resistance are explained by the role of matrix precipitates and grain boundary precipitates, respectively.

Effects of precipitates on fatigue crack growth rate of AA 7055 aluminum alloy

The effects of precipitates on the fatigue crack growth rate of AA 7055 Al alloy subjected to different ageing treatments were investigated using transmission electron microscope and fatigue crack growth testing.The results show that the T77 treated samples exhibit the lowest crack growth rate,while the crack growth rate of over-aged samples is the highest.In terms of the model based on the reversibility of dislocation motion within the plastic zone close to the crack tip,the improved crack growth resistance is attributed to many precipitates that are coherent with Al matrix in the under-aged and T77 treated samples.When the precipitate is coherent with the Al matrix,the larger the precipitate is,the slower the fatigue crack grows.The effects of grain boundary precipitates and precipitate free zone on the fatigue crack growth resistance are less significant than those of precipitates within grains of the alloy.

A functional PES membrane for hemodialysis-Preparation,characterization and biocompatibility

In this work, we evaluate the properties of solution casted polysulfone （PSf）/sulfonated polyethersulfone （SPES） blend membranes prepared by non-solvent induced phase inversion technique. The morphologies of these blend membranes, observed using scanning electron microscopy （SEM） and atomic force microscopy （AFM） imaging, indicated a smoother skin layer and an increased number of highly interconnected pores in the sub layer. The efficacy of the prepared membranes was evaluated in terms of porosity, ultrafiltration rate （UFR）, molecular weight cut-off （MWCO） and mean pore size. The hydrophilicity of these membranes was in consonance with contact angle values. It was observed that the selectivity and the UFR of the blend membranes were higher when compared to pristine membranes. Furthermore, these blend membranes demonstrated an increase in biocompatibility - prolonged blood clotting time, suppressed platelet adhesion, reduced protein adsorption and lower complement activation. These membranes were also investigated for uremic solute removal. Diffusive permeability of middle molecular weight cytochrome-c revealed an increase from 8 × 10 ^-4 cm·s ^-1 to 18 × 10^-4 cm· s^- and illustrates the possibility that these sulfonated PES/PSf blend membranes can be used to prepare membrane modules for hemodialysis applications.

Proteomic study provides new clues for complications of hemodialysis caused by dialysis membrane

The complications of hemodialysis accompanied the hemodialysis and threaten the patients’life.Besides the loss of nutrient substance,such as amino acid and vitamin,we found new clues that the adsorbed proteins on common-used polysulfone-based dialysis membrane might be the reason according to the qualitative proteomic study by ionic liquid assisted sample preparation method.Our results indicated that the adsorbed proteins on the membrane were related with complement activation,blood coagulation,and leukocyte-related biological process.The quantitative proteome further demonstrated some significant changes of signal proteins in the post-dialysis plasma after the hemodialysis,such as beta-2-microglobulin and platelet factor-4,which would further verify these new clues.