抗原优化与亚单位疫苗的研制

介绍了近年来为增强亚单位疫苗的免疫效果而采取的一些策略和方法，如抗原表位与免疫调节剂的融合、抗原的脂质化修饰、多抗原肽及颗粒化抗原的制备。提示新型亚单位疫苗的研制有赖于多学科理论和技术的发展。     

重组肿瘤相关抗原蛋白与肿瘤治疗性DNA疫苗静电耦合成为复合纳米颗粒的初步研究

目的:验证原核表达的重组肿瘤相关抗原蛋白SUR-IM与肿瘤治疗性DNA疫苗pVAX1-2PFcGB能够通过静电耦合形成复合纳米颗粒.方法:通过蛋白-DNA琼脂糖凝胶电泳阻滞实验、DNaseⅠ消化核酸的保护实验及原子力显微镜观察验证二者是否结合;此外,通过体外瞬时转染293T细胞研究蛋白质所结合的质粒是否能够在体外顺利表达.结果:证实二者确实能够通过静电耦合形成纳米级的颗粒,结合后蛋白质对DNA具有一定的保护作用,并且蛋白不会影响与之结合的质粒在细胞中的高效表达.结论:该复合纳米颗粒将蛋白质和核酸组分有机结合在一起,使肿瘤抗原、免疫佐剂及DNA肿瘤疫苗协同发挥作用,为日后进行抗肿瘤功能研究奠定了重要基础.     

结核病疫苗研究进展及挑战

卡介苗是目前唯一应用于预防人类结核病的疫苗，但其保护效果备受争议，研究新型高效的结核病疫苗尤为重要。从安全性、经济成本及保护效果等方面考虑，多阶段抗原亚单位疫苗或多表位疫苗具有较好的应用前景。随着对结核分枝杆菌致病机制的深入了解以及疫苗研发技术的不断更新，结核病疫苗会有重大突破。本文论述结核病疫苗的类型及其特性，并针对结核病新型疫苗研究中抗原选择、动物模型选择、疫苗效果评价指标及人群特异性存在的问题和挑战进行讨论，旨在为新型结核病疫苗的研究提供参考。     

肿瘤-睾丸抗原研究进展

肿瘤-睾丸抗原又称CT抗原,是一类在多种肿瘤组织中表达而在正常组织中除睾丸外不表达的抗原,因而是很有前途的肿瘤疫苗候选抗原.本文就目前肿瘤-睾丸抗原的定义、分类及其在肿瘤组织及正常组织中表达的特点和作为疫苗的临床研究进展作一综述.     

鼠疫耶尔森菌亚单位疫苗鼻腔免疫微球的制备与性质

目的：制备F1，V，F1-V3种鼠疫耶尔森菌亚单位疫苗鼻腔免疫微球，研究其体外释放性质、抗原活性等性质。方法：采用复乳溶剂挥发法制备鼠疫疫苗微球，以激光粒度测定仪测定微球的平均粒径，以BCA法及微量BCA法测定微球的疫苗含量及疫苗从微球的释放，以ELISA法考察从微球中释放出的鼠疫疫苗的活性。结果：鼠疫耶尔森菌亚单位疫苗微球粒径均匀，F1，V，F1-V疫苗微球平均粒径分别为4．2，4．6和5．9μm，包裹率分别为68．2％，61．3％和51．0％，载药量分别为9．7％，8．7％和6．2％，微球中包裹的疫苗与原溶液相比活性降低不明显。结论：采用复乳溶剂挥发法，通过控制一定的因素，可以得到具有较高包封率的鼠疫耶尔森菌亚单位疫苗微球。     

军事医学科学院研制出霍乱基因工程疫苗

霍乱是一种烈性传染病 ,世界上应用霍乱疫苗免疫已有 10 0多年的历史。但传统注射疫苗的方法由于副作用较大 ,效果不理想 ,已经被世界卫生组织宣布停止使用。军事医学科学院生物工程研究所在“86 3”计划基金资助下 ,自 1987年率先采用基因工程技术构建了高效分泌表达毒素Ｂ单位的工程大肠杆菌。该工程菌表达的ｒＢＳ其结构、理化活性、抗原性、免疫性与天然的ＢＳ完全相同。由它与杀死的霍乱弧菌抗原的Ｏ抗原及其他菌体抗原组构成ｒＢＳ ＷＣ疫苗 ,通过组构、工艺、动物免疫试验及生产工艺的研究 ,于 1989年先于国外被批准进行人体试验。先…     

基于蛋白芯片对不同方法预处理疫苗的抗原性评价

目的分别对4种疫苗（A群脑膜炎球菌多糖疫苗、吸附白喉破伤风联合疫苗、麻疹减毒活疫苗、炭疽芽孢杆菌疫苗株裂解液）进行不同的预处理,使其能作为抗原检测所诱导的抗体。方法分别用饱和碳酸钠溶液、重铬酸钾与稀盐酸混合液、80%乙醇处理A群脑膜炎球菌多糖疫苗,用饱和碳酸钠溶液、重铬酸钾与稀盐酸混合液处理吸附白破联合疫苗和麻疹减毒活疫苗,PAGE纯化炭疽杆菌疫苗株裂解液中的抗原,以蛋白芯片比较其抗原性。结果比较了不同方法预处理4种疫苗的效果,初步验证了所处理的疫苗具有良好的抗原性。结论运用恰当的处理方法对疫苗进行预处理,可使其在检测相应抗体时表现出良好的抗原性,为以疫苗作为抗原检测相应抗体打下了基础。     

树突状细胞疫苗设计策略的研究进展

近年来，树突状细胞（dendritic cells，DC）作为抗原提呈能力最强的、也是惟一能激活初始型T细胞的专职抗原提呈细胞（antigen presenting cell，APC），已成为肿瘤生物治疗领域备受关注的焦点之一。DC在体内含量甚微，仅占外周单个核细胞（peripheral blood mononudear cell，PBMC）的0．1％～0.5％，但其抗原提呈能力是巨噬细胞的10～100倍。DC强大的免疫刺激功能使其成为极具潜力的癌症及慢性感染性疾病的治疗性疫苗。迄今已有约60多项DC疫苗的临床Ⅰ、Ⅱ期研究正在进行中。尽管已取得显著进展，然而由于缺少临床疗效的客观证据，例如肿瘤消退的评价标准，DC疫苗还不能进入Ⅲ期临床实验。因此，优化DC疫苗的设计和制备策略，最大限度地发挥其免疫诱导潜能成为本领域研究亟须解决的问题之一。     

佐剂的研究进展

佐剂是一类与抗原合用并能增强和调节抗原免疫应签的物质，除传统用于疫苗的免疫佐剂和弗氏完全佐剂，铝盐，脂类物质外，新近用于疫苗的还有霍乱素Ｂ亚单位，生物降解微球体，抗原递呈细胞ＡＰＣ表面专一单克隆抗体以及细胞因子等。本文拟对佐剂的种类，作用机理以及它们的应用前景作扼要的介绍。     

幽门螺杆菌治疗性疫苗研究进展

幽门螺杆菌（Helicobacter pylori）被世界卫生组织定为一类致癌因子，由于化学疗法和预防性疫苗的局限性使得幽门螺杆菌的治疗性疫苗研究日益受到重视。目前幽门螺杆菌治疗性疫苗在小鼠动物模型实验中取得了一定疗效，但对灵长类和人类的治疗效果却令人失望。在治疗性疫苗研究中，保护性免疫机制的阐明、保护性抗原筛选和免疫佐剂研究备受关注。由于幽门螺杆菌在长期的进化过程中形成一套独特的机制来抵抗甚至抑制免疫系统，能否高效安全地从寄主体内清除幽门螺杆菌成为该研究的难点和重点，治疗性疫苗和抗生素的联合应用或许是解决这一问题的一个途径。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.