PAF levels in saliva are regulated by inflammatory cells

Platelet activating factor (PAF), a powerful inflammatory phospholipid mediator, has been detected in normal human saliva and found to be increased in periodontitis. The cellular source of PAF in saliva is controversial although several data suggest an origin related to the presence of inflammatory cells. PAF levels in biological fluids are regulated by PAF-producing cells and by the PAF-degrading acetylhydrolase. Although in normal human saliva acetylhydrolase activity is very low, no information is available on the levels of this enzyme in inflammatory conditions of the mouth. The aim of our study was to assess the contribution of inflammatory cells to the levels of PAF in saliva in normal subjects and in patients with periodontitis. PAF was measured by radioimmunoassay (RIA) in mixed uncentrifuged saliva and in cell-free saliva from healthy subjects, before and after tooth brushing, and in patients with periodontitis. In healthy subjects PAF levels were significantly higher in whole saliva than in centifuged saliva (1.51 ± 0.22 vs. 0.92 ± 0.04 ng/ml, p<0.0039). A significant increase in the amount of PAF was detected in whole saliva, but not in centifuged saliva, 2 h after tooth brushing. In patients with periodontitis PAF levels were not different from those of healthy individuals when using centrifuged saliva but were significantly higher when using whole, uncentrifuged saliva. Exogenous radiolabelled PAF was degraded much more rapidly by the saliva of periodontitis patients than by that of normal subjects. In conclusion, our study shows that inflammatory cells regulate the levels of PAF in saliva contributing to its production and degradation. The differential degradation of PAF in normal and inflammatory saliva highlights the absolute need of a series of methodological precautions when performing studies on salivary PAF.     

Levels of gingival tissue platelet activating factor after conventional and regenerative periodontal surgery

The hypothesis, a relationship between gingival tissue platelet activating factor (PAF) levels and healing after periodontal surgery, was tested by measuring PAF levels in gingival tissues collected from sites that had undergone flap surgery and guided tissue regeneration (GTR) or flap surgery alone. Using a split-mouth design, 20 intrabony defects were randomly assigned to treatment with flap surgery and GTR (group 1) or with flap surgery alone (group 2). Gingival tissue samples were obtained at surgery (baseline) and at 6-month follow-up evaluation visit. One half of each sample was used for analysis of PAF levels by high-performance liquid chromatography, and the other half of the sample was used for histomorphometric analysis that included measurements of number and diameter of blood vessels. PAF levels and diameter of blood vessels were significantly decreased (p < 0.01), and the number of blood vessels was significantly increased (p < 0.05) in both groups after 6 months compared to the baseline values. Postoperative number of blood vessels were significantly higher in group 1 (p < 0.05), whereas there was no significant difference in postoperative PAF levels between the two groups (p > 0.05). Based on the reported results, it is suggested that a decrease in gingival PAF levels might be found after conventional and regenerative periodontal surgery.     

羊水栓塞患者sPLA2、PAF及凝血功能动态检测及临床意义

目的探讨羊水栓塞患者动态检测凝血功能及血小板活化功能的临床意义。方法选取羊水栓塞患者31例,检测栓塞前、栓塞后1 h及2 h凝血功能及血清血小板活化因子（PAF）及血清分泌型磷脂酶A2（sPLA2）水平,比较不同时间点及不同预后（死亡,存活）患者凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）、抗血酶Ⅲ（ATⅢ）、蛋白C（PC）、蛋白S（PS）、血小板活化因子（PAF）及血清分泌型磷脂酶A2（sPLA2）水平。结果羊水栓塞患者栓塞前、栓塞后1 h、2 h凝血功能、血小板活化功能各指标差异均有统计学意义（P<0.05）,FIB、ATⅢ、PC、PS低于栓塞前（P<0.05)。不同预后羊水栓塞患者凝血功能、血小板活化功能各指标组间差异、时间差异及交互作用均有统计学意义（P<0.05),FIB、ATⅢ、PC、PS低于存活患者(P<0.05),PAF及sPLA2高于存活患者(P<0.05)。时间因素对两组患者凝血功能、血小板活化功能各指标的单独效应均差异有统计学意义（P<0.05）,各组内两两时间点各指标差异均有统计学意义（P<0.05）。结论羊水栓塞患者随着病情进展,凝血功能障碍及血小板功紊乱持续加重,并与预后有关,动态监测凝血功能及血小板活化功能有助于评估病情及预后。     

翁维良教授治疗缓慢性心律失常动态诊疗方案可视化分析方法研究

起搏器植入作为缓慢性心律失常有创性介入治疗手段,尚无法满足所有的临床需要,急需在中医药领域寻找新的有效方药,为患者提供可替代的临床选择。本文系统分析翁维良教授应用温阳理气活血的方法治疗缓慢性心律失常长时医案3例,运用描述性统计的方法,通过逐条总结每个病案疗效变化影响因素,归纳长时病案诊疗波动原因及治疗策略,探索缓慢性心律失常等心血管疑难重症长时动态治疗方案分析策略,建立个体化医疗及中医药经验传承的有效方法。     

王居祥治疗胃癌经验

王居祥教授认为,胃癌的病机关键在于阳虚气结,其发病以脾胃虚寒为本,气机郁结为标,痰湿瘀血为病理产物,亦为促进病情发展的病理因素。治疗应扶正兼顾祛邪,扶正重在温补脾胃,益气养血,祛邪重视疏肝理气和胃,结合化痰软坚、清热解毒、活血化瘀等治法,扶正不留邪,祛邪不伤正。坚持中西医综合治疗结合个体化治疗的原则,强调长期调治。     

清热降浊、益气活血法治疗慢性肾小球肾炎的临床疗效

目的：探究清热降浊、益气活血中药方剂联合阿托伐他汀钙片治疗慢性肾小球肾炎（CGN）患者的临床疗效。方法：选取2017年5月至2018年5月六安市中医院收治的CGN患者90例作为研究对象,按照随机数字表法分为对照组和观察组,每组45例。对照组患者给予饮食指导,并口服阿托伐他汀钙片治疗。观察组在对照组治疗的基础上给予清热降浊、益气活血中药治疗。2组CGN患者均治疗50 d,观察并记录2组患者的疗效、血脂指标和肾功能指标。结果：与治疗前比较,2组CGN患者的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、血清尿素氮（BUN）、血肌酐（Scr）和24 h尿蛋白定量均明显降低,差异有统计学意义（均P<0.05）,且观察组患者的TC、Scr、BUN和24 h尿蛋白定量水平比对照组降低更显著（均P<0.05）。观察组患者的总有效率为93.33%,对照组患者的总有效率为84.44%,差异有统计学意义（P<0.05）。结论：清热降浊、益气活血中药方剂联合阿托伐他汀钙片可以显著降低CGN患者的血清血脂水平,使之恢复正常,改善肾功能,具有较高的临床应用价值。     

基于MAPK通路探讨益气活血法防治糖尿病心肌病的研究进展

糖尿病心肌病是涉及心脏微血管病变和心肌代谢紊乱的一种病症,严重者可出现心肌广泛性坏死。糖尿病心肌病的发病机制十分复杂,涉及到心肌纤维化,心肌糖脂代谢障碍,氧化应激,细胞因子异常,胰岛素抵抗,以及多种信号通路等,其中MAPK信号通路参与了糖尿病心肌病最重要的氧化应激和炎症反应等病理过程。中医药防治糖尿病的历史已有数千年,在治疗糖尿病心肌病这类复杂疾病中独具优势。     

理气活血类中成药治疗冠心病心绞痛的网状Meta分析

目的：系统评价理气活血类中成药治疗冠心病心绞痛的有效性。方法：检索国家知识基础设施数据库、中国学术期刊数据库、中文科技期刊数据库、PubMed、Cochrane Library,检索起止时间为建库至2020年7月。筛选出理气活血类中成药治疗冠心病心绞痛的随机对照试验,按照Jadad量表对文献进行质量评价,采用Stata 16和R3.5.1软件进行统计分析。结果：共纳入58个研究,总样本量7 467例,干预措施包括复方丹参片、复方丹参滴丸、速效救心丸、理气活血滴丸、冠心丹参滴丸、心可舒片、血府逐瘀胶囊、银丹心脑通软胶囊共8种理气活血类中成药。结果显示,心绞痛疗效方面,累积概率排序为：速效救心丸（0.815）＞复方丹参滴丸（0.804）＞银丹心脑通软胶囊（0.801）＞冠心丹参滴丸（0.447）＞心可舒片（0.444）＞血府逐瘀胶囊（0.378）＞理气活血滴丸（0.247）＞复方丹参片（0.063）。心电图疗效方面,累积概率排序为：速效救心丸（0.790）＞冠心丹参滴丸（0.784）＞血府逐瘀胶囊（0.734）＞理气活血滴丸（0.569）＞心可舒片（0.519）＞银丹心脑通软胶囊（0.362）＞复方丹参滴丸（0.242）＞复方丹参片（0.000）。综合2个结局指标,速效救心丸、冠心丹参滴丸、血府逐瘀胶囊疗效较佳。结论：气滞血瘀型心绞痛患者可优选速效救心丸,但受纳入研究质量所限,该结论仍需开展高质量研究进一步验证,并结合具体情况进行选择。     

Significance of platelet and monocyte activation for therapeutic immunoglobulin-induced thromboembolism

Objectives

Thromboembolic events (TEE) in patients receiving infusions of intravenous immunoglobulin (IVIG) products have recently been associated with contaminating factor XIa. We studied whether platelet and monocyte activation could also be involved.

Methods

Twenty IVIG samples from five manufacturers were tested for the induction of visible whole blood clot formation. A selection of TEE-associated and not associated lots was further analyzed for effects on thromboelastometry, platelet activation and adhesion, as well as monocyte tissue factor surface expression. Pure factor XIa was included for comparison. Western blotting was applied to analyze anti-CD154-reactive proteins in IVIG.

Results

In whole blood, IVIG enhanced macroscopic clotting additively with factor XIa. In monocytes, all IVIG products induced the FcγRII-dependent tissue factor expression to a similar extent, which was not affected by addition of factor XIa. Testing platelet aggregation, IVIG strengthened the ADP and TRAP-6-elicited response. Furthermore, IVIG increased platelet-monocyte adhesion and annexin V binding to platelet microvesicles, and promoted platelet adhesion to IVIG-coated surfaces. The strongest effects were observed with TEE-associated lots. CD154-related proteins were detected in all IVIG products. CD154-related high molecular weight complexes were particularly found in the TEE-associated IVIG. In platelet aggregation, recombinant soluble CD154 enhanced aggregate formation and stability.

Conclusion

Our data demonstrate that IVIG modulate platelet and monocyte activation and can thereby affect the hemostatic balance. These effects are either additive to or independent from factor XIa. CD154-related proteins are assumed to be involved in these interactions, the mechanism of which needs to be elucidated in further studies.     

血小板活化因子反相高效液相色谱法测定及其在老年性疾病中的应用

目的 建立血小板活化因子(PAF)的反相高效液相色谱(rHPLC)检测法,与生物学检测法比较,探讨其在老年脑梗死、高血压、冠心病等疾病中的意义。方法 采用rHPLC对100例健康对照者、23例脑梗死、28例高血压病、65例冠心痛患者血PAF进行分析。结果 rHPLC法与生物学法相关性较好,操作简便,重复性好,灵敏度高,干扰因素少。脑梗死、冠心痛患者血PAF值显著高于参考值（P＜0．01);高血压病组与对照组比较,无显著性差异(P＞0．05)。结论 rHPLC法测定PAF更具可靠性,更能正确地反映血中PAF水平;有助于进一步推动PAF的临床与基础研究。