抗人Ⅳ型胶原蛋白单克隆抗体的制备和鉴定

用人Ⅳ型胶原蛋白免疫ＢＡＬＢ／ｃ小鼠，克隆了一组分泌抗人Ⅳ型胶原蛋白的杂交瘤细胞株，并且对其中的Ａ２、Ａ４、Ａ５、Ｂ３和Ｅ２进行了鉴定。其抗体亚类分别为ＩｇＧ１、ＩｇＧ２、ＩｇＧ２ｂ、ＩｇＧ２和ＩｇＧ１。其亲和力常数Ｋａｆｆ＝６．６×１０８Ｍ（－１）～６．０×１０（１０）Ｍ（－１）。它们均能特异性地识别人Ⅳ型胶原蛋白。     

37℃凝血温度下正常人和哮喘患者血清ECP水平的测定

室温（２０℃）是广泛接受的血清ＥＣＰ测定凝血温度，但存在一些问题。设想体温３７℃可能是血清ＥＣＰ测定的有效凝血温度。为此，对６８例急性发作的哮喘患者在３７℃凝血温度下血清ＥＣＰ水平进行分析，比较凝血温度分别为２０℃和３７℃时同一患者血样本的ＥＣＰ水平变化，结果发现３７℃下哮喘患者血清ＥＣＰ水平（５０．９±３．１８μｇ／Ｌ）显著高于正常对照（１７．２７±１．３６μｇ／Ｌ，Ｐ＜０．０１）。在６８例病人中，３７℃凝血下有２８人血清ＥＣＰ水平高于正常值，而２０℃凝血下只有１７人血清ＥＣＰ水平高于正常值，两者间存在显著差异（Ｐ＜０．０５）。３７℃凝血温度下血清ＥＣＰ水平与哮喘症状计分显著相关（ｒ＝０．７７，Ｐ＜０．０１）。此外，尚测定了３７℃凝血温度下１０１位１０～５０岁的健康人血清ＥＣＰ水平，结果显示３７℃下正常人血清ＥＣＰ水平的几何均数是１７．８１μｇ／Ｌ，血清ＥＣＰ水平的正常值为７０μｇ／Ｌ以下（９５％的可信限）。本研究表明，在血清ＥＣＰ的测定中设凝血温度为３７℃不仅是有效、简化的方法，而且还可减少哮喘患者血清ＥＣＰ水平的假阴性。     

Rapid, accurate genotyping of the common -alpha(4.2) thalassaemia deletion based on the use of denaturing HPLC

AIMS: To develop an alternative assay for specific genotyping of the -alpha(4.2) thalassaemia deletion based on the DNA sequence features surrounding the breakpoint. METHODS: The 5' and 3' ends of the breakpoint regions of the -alpha(4.2) allele and the normal homologous segments were sequenced in Chinese individuals. A sequence haplotype composed of four single nucleotide variations within the X2/X1 box of the -alpha(4.2) breakpoint region was found in all of the 10 Chinese -alpha(4.2) thalassaemia alleles studied. Based on these findings, a novel polymerase chain reaction (PCR)/denaturing high performance liquid chromatography (DHPLC) assay was developed for rapid genotyping of the -alpha(4.2) allele instead of traditional Southern blotting or Gap-PCR. This method involves amplification of the alpha globin target sequence encompassing these four polymorphic sites, followed by a partially denaturing HPLC analysis using the transgenomic WAVE DNA fragment analysis system. RESULTS: The three major genotypes (-alpha4.2/alphaalpha, -alpha(4.2)/--SEA, and alphaalpha/alphaalpha) could be distinguished through the characteristic chromatograms generated by the WAVE system. The accuracy of this technique was evaluated blindly, and the results were 100% (40 of 40) concordant with the genotypes previously characterised by Southern blotting or Gap-PCR. CONCLUSIONS: This study validates the PCR/DHPLC approach as a simple, rapid, highly accurate, and cost effective method, potentially adaptable for use in epidemiological surveys, genetic screening, and diagnosis of silent alpha+ thalassaemia and Hb H disease.     

Primary papillary carcinoma arising in a thyroglossal duct cyst

We report a case of papillary carcinoma arising in a thyroglossal duct cyst, presenting with an anterior neck mass of a 31-year-old woman. The tumor was judged to be a primary lesion on the basis of intraoperative examination of the thyroid and pathologic findings of the mass. One year later, a small nodular mass in the left thyroid gland and lymph node enlargement of the right cervical lymph node were noted by follow-up imaging studies. Total thyroidectomy, right modified radical neck dissection and central neck dissection were performed. The thyroid gland revealed nodular hyperplasia without evidence of malignancy. On the other hand, the dissected neck lymph nodes revealed metastatic papillary carcinoma. Taken together, these findings suggested the tumor was a primary papillary carcinoma arising in the thyroglossal duct cyst.     

The Plasmodium circumsporozoite protein is involved in mosquito salivary gland invasion by sporozoites

Plasmodium sporozoites develop in oocysts on the midgut wall of the mosquito and are released into the hemocoel. Approximately 15-20% of oocyst sporozoites will successfully attach to and invade salivary glands, their target organ. We have previously shown that the major surface protein of sporozoites, the circumsporozoite (CS) protein, binds specifically to salivary glands and not to other mosquito organs exposed to circulating hemolymph. In addition, a peptide from the N-terminal portion of CS protein inhibits binding of the protein to the glands. In this study, we have extended these findings and show that both the protein and the peptide can inhibit sporozoite invasion of salivary glands.     

吗氯贝胺与米帕明治疗抑郁症多中心双盲对照试验

目的 :以经典抗抑郁药物米帕明为阳性对照药采用随机双盲双模拟方法对吗氯贝胺和米帕明治疗抑郁症的疗效和安全性进行研究。方法 :共纳入病人 2 0 0例 ,分别口服吗氯贝胺 3 0 0 -60 0mg d或米帕明75 -2 5 0mg d。结果 :两组病人Hamilton抑郁量表 (HAMD)以及Hamilton焦虑量表 (HAMA)总分在治疗结束时均显著下降 (P <0 0 0 1)。两组之间疗效无显著差异 (p >0 0 5 )。治疗结束时HAMD减分率分别为吗氯贝胺组 0 74± 0 2 4,米帕明组 0 74± 0 2 4(P >0 0 5 ) ;有效率吗氯贝胺组 79 4% ,米帕明组 85 4% (P >0 0 5 )。吗氯贝胺组有 10种不良反应发生频率显著低于米帕明组 ,主要是抗胆碱能、中枢神经系统及心血管系统不良反应。吗氯贝胺的疗效指数也显著高于米帕明组。结论 :吗氯贝胺是一种安全有效的抗抑郁药物     

Multiple imputation technique applied to appropriateness ratings in cataract surgery

Missing data such as appropriateness ratings in clinical research are a common problem and this often yields a biased result. This paper aims to introduce the multiple imputation method to handle missing data in clinical research and to suggest that the multiple imputation technique can give more accurate estimates than those of a complete-case analysis. The idea of multiple imputation is that each missing value is replaced with more than one plausible value. The appropriateness method was developed as a pragmatic solution to problem of trying to assess "appropriate" surgical and medical procedures for patients. Cataract surgery was selected as one of four procedures that were evaluated as a part of the Clinical Appropriateness Initiative. We created mild to high missing rates of 10%, 30% and 50% and compared the performance of logistic regression in cataract surgery. We treated the coefficients in the original data as true parameters and compared them with the other results. In the mild missing rate (10%), the deviation from the true coefficients was quite small and ignorable. After removing the missing data, the complete-case analysis did not reveal any serious bias. However, as the missing rate increased, the bias was not ignorable and it distorted the result. This simulation study suggests that a multiple imputation technique can give more accurate estimates than those of a complete-case analysis, especially for moderate to high missing rates (30 - 50%). In addition, the multiple imputation technique yields better accuracy than a single imputation technique. Therefore, multiple imputation is useful and efficient for a situation in clinical research where there is large amounts of missing data.