接种四价脑膜炎球菌多糖疫苗引起过敏性紫癜1例报告

2011年3月22日,章丘市一儿童接种A、C、Y、W135群脑膜炎球菌多糖疫苗(以下简称四价流脑疫苗)后8小时,发生过敏性紫癜合并血管神经性水肿。报告如下。     

抗赭曲霉毒素A单克隆抗体的制备及其ELISA检测方法的建立

目的制备抗赭曲霉毒素A（OA）的单克隆抗体（McAb）并对其进行初步鉴定,在此基础上建立竞争抑制酶联免疫吸附试验（ELISA）用于OA的检测。方法采用小剂量长周期的免疫方案,以OA 牛血清白蛋白（BSA）偶联物免疫雌性BALB/c小鼠,采用细胞融合法获得分泌抗OA的McAb的杂交瘤细胞株,用竞争抑制ELISA法进一步检测McAb的特异性,腹水诱生法大量制备McAb,以OA为竞争抗原,建立检测OA的竞争抑制ELISA。结果OA BSA免疫的BALB/c小鼠血清效价为1:512?000,与BSA有强烈的交叉反应。细胞融合后,ELISA筛选抗体分泌阳性的杂交瘤细胞株,抗OA BSA的McAb与BSA的交叉反应率仅为3.5%,对分泌抗OA BSA特异的McAb的细胞株经3轮克隆化,抗体分泌阳性率达到100%,建立了1株能稳定分泌抗OA BSA McAb的杂交瘤细胞株,竞争抑制法进一步证明了该抗体是特异针对OA的,腹水诱生法制备了大量的McAb。竞争抑制ELISA线性范围为0.24～125?ng/mL,线性方程y=-0.113?2logx+0.901?6,相关系数r=0.98,最低检出浓度为0.24?ng/mL。样品的加标回收率为97.07%～107.83%。结论获得了分泌抗OA的McAb的杂交瘤细胞株,建立了OA检测的简单、灵敏、高效的ELISA检测方法。     

由脑膜炎奈瑟菌W135血清群引起的5例脑膜炎球菌病患儿的临床表现和转归

在法国由脑膜炎奈瑟菌W135血清群(N.m eningi-tidis W135)引起的脑膜炎球菌病正在增加,在儿童缺乏有关这些感染的临床及其转归的资料,作者对在2000年6月至2002年12月间住院的5例脑膜炎奈瑟菌W135血清群感染患儿进行了报道。其常有脑膜外脓毒性和(或)非脓毒性并发症,对1例迟发的脑膜炎球菌感染后综合征进行了报道。在脑膜炎奈瑟菌W135血清群感染患儿中需要对潜在的脑膜外并发症进行仔细的临床评估,并且需要对患儿进行长期随访。由脑膜炎奈瑟菌W135血清群引起的5例脑膜炎球菌病患儿的临床表现和转归@Faye A.$Serv.de Péediat.Gén., H…     

冻干A＋C群脑膜炎球菌多糖结合疫苗安全性观察

目的观察冻干A＋C群脑膜炎球菌多糖结合疫苗”沃儿康”的安全性,为更好地预防流行性脑脊髓膜炎提供依据。方法对接种冻干A＋C群脑膜炎球菌多糖结合疫苗的4335名6月龄～5岁的儿童分年龄组进行观察,电话回访有无不适症状;同时对接种A群脑膜炎球菌多糖疫苗的3527名儿童和接种A群C群脑膜炎球菌多糖疫苗的1083名儿童进行对照观察。结果接种冻干A＋C群脑膜炎球菌多糖结合疫苗的儿童不良反应发生率分别为〈12月龄组1.34％（34／2540）、1～岁组1.58％（12／761）、2～岁组2.38％（2／84）和3～岁组1.58％（15／950）,不良反应发生总人数为63例,不良反应发生率为1.45％（63／4335）;出现接种部位硬结、红肿、皮疹和瘙痒等局部反应0.83％（36／4335）,出现发热发热、变态反应、疲劳、乏力、厌食、呕吐和腹泻等全身反应1.22％（53／4335）,不良反应症状均自行消失或经对症治疗后2～3d内缓解并消失。接种A群脑膜炎球菌多糖疫苗的儿童不良反应发生率为1.16％（41／3535）,接种A＋C群流脑多糖疫苗的儿童不良反应发生率为1.75％（19／1083）。结论冻干A＋C群脑膜炎球菌多糖结合疫苗是安全的,可有效预防流行性脑脊髓膜炎。     

大观霉素酶联免疫吸附检测方法的建立

目的建立大观霉素直接竞争酶联免疫吸附（ELISA）分析方法。方法通过大观霉素与载体蛋白偶联,制备免疫原和检测抗原,用杂交瘤技术制备单克隆抗体（mAb）,鉴定mAb的特异性,并用于竞争ELISA检测。结果获得3株能稳定分泌抗大观霉素的单克隆抗体杂交瘤细胞株,大观霉素竞争ELISA检测的下限为1ng／mL。结论抗大观霉素的mAb具有抗原结合特异性,可用于大观霉素竞争ELISA免疫学检测。     

接种A＋C群脑膜炎球菌多糖疫苗致肝损伤1例报告

3周岁儿童按照国家免疫规划程序接种A＋C群脑膜炎球菌多糖疫苗，据报道接种A＋C群脑膜炎球菌多糖疫苗致肝损伤病例少见，就出现的1例进行报道。以引起广大接种医务工作者的重视。     

A、C群脑膜炎球菌-b型流感嗜血杆菌多糖结合疫苗免疫学效果观察

目的:对A、C群脑膜炎球菌-b型流感嗜血杆菌多糖结合疫苗(ACHib)免疫学原性进行观察。方法:选择300例3至12月龄健康婴幼儿作为研究对象,按照盲态观察法将所选婴幼儿分为3-6、7-12月龄2个年龄段,各有150例,参照组和探究组各75例。探究组仅注射ACHib疫苗,参照组同时注射Hib结合疫苗以及A、C群脑膜炎球菌多糖结合疫苗。结果:免疫后易感人群Hib以及A、C脑膜炎球菌血清抗体阳转率均超过90%,探究组与参照组阳转率差异不显著(P0.05),2组各年龄段以及非易感人群Hib以及A、C脑膜炎球菌血清抗体阳转率差异不具有统计学意义(P0.05)。结论:A、C群脑膜炎球菌-b型流感嗜血杆菌多糖结合疫苗免疫原性较好,能够发挥3种病原菌的预防作用。     

青海省海北州部分健康人群A群C群脑膜炎IgG抗体水平调查

目的 了解海北州部分健康人群A群C群脑膜炎IgG抗体水平,为预防流脑提供科学依据.方法 随机抽样2个县3-4岁70名儿童血清标本.应用ELSIA检测A群C群脑膜炎IgG抗体.结果 调查70名儿童抗体阳性率65.7%,接种A群C群脑膜炎球菌多糖疫苗预防控制流脑有重要意义,提高疫苗的有效接种率.     

抗脱氧雪腐镰刀茵烯醇单克隆抗体的制备及鉴定

目的 制备抗脱氧雪腐镰刀茵烯醇(DoN)单克隆抗体(McAb)并对其进行初步鉴定.方法 采用小剂量长周期的免疫方案,以DON-牛血清白蛋白(BSA)偶联物免疫雌性BALB/c小鼠,采用细胞融合的方法制备杂交瘤细胞株,酶联免疫吸附试验(ELISA)检测上清中McAb,对抗体分泌阳性的细胞株进行克隆化,直至抗体阳性率100%,用竞争抑制ELISA法进一步检测McAb的特异性,腹水诱生法制备大量McAb,并用饱和硫酸铵对其进行纯化,用抗体亚类鉴定试剂盒对该McAb亚类进行鉴定,BCA蛋白测定试剂盒测定蛋白含量,ELISA检测McAb的滴度、参考工作稀释度和亲和常数.结果 DON-BSA免疫的BALB/c小鼠血清效价为1∶256000,与BSA有强烈的交叉反应.细胞融合后,ELISA筛选抗体分泌阳性的杂交瘤细胞株,经3轮克隆化,建立了1株能稳定分泌抗DON-BSA McAb的杂交瘤细胞株3G5,腹水诱生法制备了大量的McAb.该McAb属IgG1,IgG含量为6.06 g/L,抗体滴度为1∶500000,参考工作稀释度为1∶64 000,抗体亲和常数为1.62×109.用间接竞争抑制ELISA测得校正曲线线性范围9.8～10 000 ng/mL,线性方程Y=-0.272 6X+0.225 9(r=0.930 9).结论 获得了分泌抗DON-McAb的杂交瘤细胞株,该单克隆抗体灵敏度高,特异性强,可用于制备高质量国产DON-ELISA检测试剂盒.     

特异性抗血清致敏葡萄球菌提纯A蛋白检测脑脊液中脑膜炎球菌A群抗原的研究

目前可用于检测脑脊液中脑膜炎球菌抗原的敏感而快速的早期诊断方法研究尚不多。近年来,Beuvery等用酶联免疫吸附法(ELISA)与对流免疫电泳法(CIE)对比,检测了细菌性脑膜炎患者脑脊液中的流感杆菌、肺炎球菌和脑膜炎球菌的多糖抗原,认为ELISA较CIE敏感;蒋小萍等用FLISA双抗体夹心法检测脑脊液中的脑膜炎球菌A群抗原,     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.