A prospective study of a serum-pooling strategy in screening blood donors for antibody to hepatitis C virus

BACKGROUND: To examine the feasibility and to perform a cost-benefit analysis of a pooling protocol of enzyme immunoassay (EIA) screening for antibody to hepatitis C virus (anti-HCV) under real conditions, a prospective study was carried out using sera from 1875 local blood donors. STUDY DESIGN AND METHODS: In the absence of knowledge of the anti-HCV reactions, the donor's sera were pooled into groups of five consecutive samples for testing by EIA. The dilution and final volume of the serum pool were adjusted to equal those recommended for single- serum EIA by the manufacturer of the test kit. The results obtained were compared with those of single-serum EIA to assess the feasibility of the pooling protocol. By applying probability theory, the percentage of reduction in the number of tests performed (L value) when the serum- pooling strategy was used was calculated for several anti-HCV seroprevalences and for varied sizes of pool. The calculations were performed on a computer using a program compiled by the authors. RESULTS: The results showed that seroprevalence was 2.24 percent (95% CI, 1.57-2.91%); the rate of false negativity was 0 (95% CI, 0–8.4%), the sensitivity of the pooling protocol was 100 percent (95% CI, 91.6- 100.0%), the rate of false positivity was 0.8 percent (95% CI, 0–1.8%), and the specificity of the pooling protocol was 99.2 percent (95% CI, 98.2-100.0%). Cost-benefit analysis showed that the pooling protocol could save 69.3 percent of the cost. A table of L values can be used conveniently by serologists to determine the optimum pool size if estimates of seroprevalence are available. CONCLUSION: The pool EIA did not perform worse than individual EIAs, and the pooling strategy was markedly less expansive. The pooling protocol was recommended for screening of anti-HCV-positive subjects from large populations with low seroprevalence.     

山莨菪碱和蝙蝠葛碱对白三烯和PAF诱导的牛脑前动脉平滑肌细胞DNA合成的影响(英文)

白三烯和血小板活化因子在低于nmol浓度时就能刺激培养的牛脑前动脉平滑肌细胞的DNA合成,在10^-7mol/L时达最大刺激。LTB₄,LTD₄和PAF在10^-7mol/L时对上述细胞DNA合成的刺激率分别为32%,29%和77%。山莨菪碱和蝙蝠葛碱在10^-7～10^-4mol/L范围内呈剂量依赖性地抑制白三烯和血小板活化因子的上述作用。     

血小板激活因子对大鼠脑血管通透性的影响及药物的保护作用

颈内动脉注射血小板激活因子(PAF),再给伊文思蓝,可见脑实质染色程度加深,而颈内动脉只注射伊文思蓝,脑实质未见染色。而我们合成的新药SZ-1可剂量依赖性地抑制PAF诱导的脑实质伊文思蓝染色程度的加深。在体外培养的脑微血管平滑肌细胞上,PAF能显著刺激~(14)-花生四烯酸的释放,而SZ-1能剂量依赖性地抑制这种释放,提示PAF在脑内产生的损害除与其他因素相关外,还与其刺激花生四烯酸释放有密切关系,SZ-1对PAF引起的脑部损害有保护作用。     

丝瓜叶化学成分的研究

从丝瓜(Luffa cylindrica Roem.)叶中分得一种新的五环三萜皂甙和芹菜素,用光谱和化学方法确定该皂甙的结构为21β-羟基齐墩果酸-28-O-β-D-吡喃葡萄糖甙,命名为丝瓜皂甙Q。     

白三烯拮抗剂ONO-1078对化学物质诱导大鼠皮肤微血管渗漏的抑制作用

大鼠皮内注射组胺、辣椒素和甲醛诱导皮肤微血管渗漏,白三烯拮抗剂ONO-1078剂量依赖性抑制这一反应,ID₅₀分别为1.98,1.78,2.23mg·kg^-1。与扑尔敏相比,对组胺的作用较弱,对辣椒素和甲醛的作用较强,地塞米松的作用强于ONOl078和扑尔敏。ONO-l078还抑制LTD4的作用,对大剂量组胺、缓激肽和P物质无明显作用。ONO-l078的作用可能与抑制感觉神经肽释放有关。     

Roles of attention, memory, and motor preparation in modulating human brain activity in a spatial working memory task

Neuronal activity of the human brain was studied with magnetoencephalography (MEG) in a spatial working memory task similar to those commonly used with nonhuman primates. The subject was required to remember target positions for 3 s and make a same-different judgement with a finger lift comparing the position of the probed target with the probe or to execute a memory-guided saccade to the probed target. In this type of task single-unit studies have shown attention- and memory-related activities independent of movement type during the retention interval in a large number of cortical areas of the primates, including the parietal and prefrontal areas. Consistent with these results, there were strong stimulus-driven transient and sustained responses and modulations of oscillatory activity during the retention period. Although we did not determine the source locations, coarse estimates of the currents responsible for the MEG signals showed activity over a wide area of the cortex, most prominently over the Rolandic, parietal and occipital areas, but also over the frontal area. Some of the activities in these cortical areas reflect processes that may be identified with attention and memory, while others were related to preparation of the overt movements.      

内固定基础上应用骨形态发生蛋白人工骨与自体髂骨植骨治疗骨质疏松性髋骨折的效果比较

目的:比较采用骨形态发生蛋白人工骨植骨加骨折内固定与自体髂骨植入加骨折内固定治疗骨质疏松性转子间骨折的效果。方法:选择2003-10/2005-10桂林医学院附属医院骨科收治的Ⅲ、Ⅳ、V型骨质疏松性转子间骨折患者51例,均知情同意。实验分组:随机将病例分为2组,骨形态发生蛋白人工骨植入组26例,自体髂骨植入组25例。实验干预:采用股骨上段外侧切口,DHS或加防旋钉内固定,骨形态发生蛋白人工骨由处理后的牛松质骨与成品重组人骨形态发生蛋白2按一定比例复合而成,骨折固定后在骨折缺损处、内侧及骨折周围植骨,骨形态发生蛋白人工骨组采用骨形态发生蛋白人工骨植入,自体髂骨组取自体髂骨植入。实验评估:术后定期随访,比较二组患者的基本情况、临床效果和影像学结果(骨折愈合情况和颈干角的变化)。随访时关节功能评定参照采用黄公怡等提出的标准,分为优、良、可、差4级。髋内翻分类标准为颈干角<100°。结果:术后随访1年,51例患者全部进入结果分析。①术后X射线片观察:骨形态发生蛋白人工骨组临床愈合时间短于自体髂骨组[(94.50±22.45),(116.96±15.90)d,P<0.01];骨形态发生蛋白人工骨组术后1年颈干角大于自体髂骨组[(127.19±3.23)°,(120.4±5.22)°,P<0.01]。②髋关节功能及不良事件和副反应:骨形态发生蛋白人工骨组术后以1年髋关节功能优良率优于自体髂骨组(P<0.05);骨形态发生蛋白人工骨组髋内翻、下肢短缩(>2cm)的发生率均低于自体髂骨组[髋内翻(n):4,7;下肢短缩(n):3,5,P均<0.01];钉退出二组差异均无显著性意义(P>0.05)。结论:伴有骨质疏松的转子间骨折患者,采用骨形态发生蛋白人工骨植骨优于自体髂骨植骨,可缩短骨折愈合期,减少髋内翻等并发症的发生率,提高术后髋关节功能优良率,提示骨形态发生蛋白人工骨能替代自体髂骨植骨治疗骨质疏松性转子间骨折。     

自体骨髓干细胞移植治疗神经系统损伤和变性疾病42例报告

目的:观察42例神经系统损伤和变性疾病患者经自体骨髓干细胞移植后,其神经系统症状与体征的改善。方法:①选取2005-06/2006-09解放军第四六三医院神经外科收治的神经系统损伤和变性疾病患者42例,对本试验均签署知情同意书。其中各种原因所致脊髓损伤30例,脑血管意外引起的偏瘫4例,老年痴呆2例,小脑疾患引起的共济失调2例,运动神经元变性疾病4例。患者入院后常规检查身体各项指标以评估是否适合行干细胞移植术。②术前患者均于皮下注射粒细胞集落刺激因子进行骨髓干细胞动员,5～12μg/(kg.d),连续4～5d。动员结束后患者在局麻状态下,于髂后上棘采集自体骨髓血约200mL,去除红细胞,密度梯度离心,分离出单个核细胞,再将收获的单个核细胞制成1.5mL细胞悬液(约1×108个细胞)备用。③通过手术或立体定向的方法将干细胞直接移植在神经损伤或变性部位,然后再根据病情经腰穿或静脉途径进行细胞移植,每次给予干细胞量按(2～3)×102个/kg计算,1次/周,共4周。④自体骨髓干细胞移植治疗过程中,为促进干细胞的生长和分化,根据患者病情及个人身体状况给予物理疗法、作业疗法等相应的康复功能锻炼,同时配以针灸、高压氧及药物营养神经和改善微循环治疗。结果:42例神经系统损伤和变性疾病患者均进入结果分析。自体骨髓干细胞移植治疗后1～3个月,17例脊髓损伤患者肢体症状明显改善,尤其是脑损伤后遗症引起的脊髓损伤其肢体症状改善更为显著;2例脑出血和1例脑血栓引起偏瘫的患者其肢体症状改善效果均较好;遗传性共济失调的2例患者疗效均不明显;1例老年痴呆患者其老年痴呆症状得到明显改善,并能在搀扶下行走,与旁人进行正常的交流;运动神经元变性病中1例患者肌萎缩性侧索硬化症改善效果较好,肌张力正常,颤抖减轻及至消失,多发性硬化中2例患者症状减轻。结论:干细胞移植配合功能锻炼等辅助手段对神经系统损伤和变性疾病的治疗效果肯定,有一定的临床应用价值。     

增强型绿色荧光蛋白标记技术示踪组织工程化骨形成

目的:观察以脂质体介导法转染的增强型绿色荧光蛋白质粒作为骨组织工程种子细胞示踪剂的可行性。方法:实验于2005-07/2006-11在南昌大学第二附属医院分子医学实验室完成。选取12个月龄中国青山羊2只作为骨髓基质干细胞供体。另取BACB/un裸鼠9只作为骨髓基质干细胞-珊瑚复合物受体。①将已转化pEGFP-N2大肠杆菌109菌种,进行质粒提取并经AvaⅡ酶切鉴定。②脂质体lipofectamine2000介导转染羊骨髓基质干细胞。分别于转染24h、6个月后计算荧光的转染效率。标记与未标记细胞经成骨诱导分化后,检测碱性磷酸酶活性和四环素钙结节染色,以未标记的同期细胞作对照。③将标记细胞接种于珊瑚支架,形成骨髓基质干细胞-珊瑚复合物,分别于体外培养4,7,14d后进行电镜扫描观察。④将体外培养7d的骨髓基质干细胞-珊瑚复合物移植于裸鼠皮下,8周后取出,荧光显微镜下进行示踪观察,苏木精-伊红染色观察组织结构。以未标记的骨髓基质干细胞-珊瑚复合物、单纯珊瑚作对照。结果:共纳入中国青山羊2只,BACB/un裸鼠9只,作为受体的9只裸鼠进入结果分析。①质粒经酶切后电泳,可见3条带,分别为445bp,1938bp,2354bp,确定所提质粒为pEGFP-N2。②转染24h后绿色荧光表达率35%;经G418筛选,转染6个月后绿色荧光表达率75%;与对照组相比,标记细胞碱性磷酸酶活性差异无统计学意义(P>0.05),均具有钙结节形成能力。③标记细胞与材料贴附生长良好,并分泌胶原纤维及钙盐结晶样基质。④组织学示新生骨样组织围绕材料孔隙生成;新生组织细胞内有绿色荧光表达,同时对照组未观察到绿色荧光。结论:脂质体介导法转染的pEGFP-N2标记骨髓基质干细胞,可用于裸鼠体内示踪,是一种理想的组织工程化骨组织的示踪方法。     

西山医院脊髓损伤功能量表内容介绍

目的:介绍一套新的脊髓损伤功能评价量表。方法:综合目前使用的各种常用脊髓功能量表,结合实际工作经验及脊髓损伤患者神经功能改善特点,制定了西山医院脊髓损伤功能量表。结果:西山医院脊髓损伤功能量表共分9大项16小项,采用4分制,正常为3分,最差为0分。总分0～48分,0～16分为重度残障,17～32分为中度残障;33～47分为轻度残障,48分正常。量表包括上肢运动功能(饮食、梳洗、书写)、下肢运动功能(站立、行走)、躯干运动功能(坐、翻身)、全身运动功能(床椅转移、穿脱衣服、洗澡)、括约肌功能(膀胱功能、直肠功能)、肌张力、泌汗、皮肤营养、疼痛、性功能。结论:西山医院脊髓损伤功能量表是一套专门应用于脊髓损伤患者功能评价量表。该量表能全面、精确评定患者功能,简便实用、费时短。应用这份功能量表,既能客观反映患者的功能变化,随访时又不增加患者负担,同时也能减轻医务工作者的负担。