T-bet与Thl/Th2在乙型肝炎中的作用机制

T-bet是T-box家族的一种重要转录因子,在CD4+T细胞Thl型的分化中起重要作用,并抑制Th2细胞因子合成,可使完全分化的Th2逆转为Th1。目前已证实多种疾病的发生、发展和预后涉及Thl/Th2分化失衡。而T-bet对Thl/Th2分化调控作用在疾病中的作用机制有助于解释疾病的发展机制,为疾病的治疗提供依据。文中就T-bet在乙型肝炎中的作用机制作一综述。     

HIV-1-specific cytotoxic T lymphocyte (CTL) responses against immunodominant optimal epitopes slow the progression of AIDS in China

To assess the immunodominance patterns of HIV-1-specific cytotoxic T lymphocyte (CTL) responses and the contribution of these responses against the peptides scanning optimal epitopes in chronic infection, we test the HIV-1-specific CTL responses against a panel of 413 overlapping peptides spanning HIV-1 Asian B sequence, including 147 peptides corresponding to optimal clade B epitopes in 49 chronically HIV-1 infected individuals by interferon-gamma Elispot assay. A large variation in the recognition of peptides restricted by the same HLA class I allele is presented. Some epitopes are targeted frequently by individuals while other epitopes restricted by the same allele are rarely recognized in our research. HLA-B35 and HLA-A03 rather than other HLA alleles contribute greatly to total virus-specific CTL responses. Furthermore, there is a significant inverse correlation between the total contribution of HIV-1-specific CTL responses restricted by different HLA alleles to virus-specific immune responses and viral load in the individuals during advanced infection (P=0.002, r=-0.549). The peptides targeted by individuals have significantly lower entropy compared with those not targeted but restricted by the same HLA class I alleles (P<0.05) in 49 individuals infected by HIV-1, especially the advanced infection subgroup (P=0.044). These data demonstrate that the consistent immunodominance patterns of HIV-1-specific CTL responses of Chinese HIV-1 infected individuals and an inverse correlation between the relative contribution of responses restricted by HLA alleles and viral load, which indicates the important protective effect of optimal epitopes against slow disease progression even in advanced infection.     

扩散加权成像与传统磁共振成像联合诊断乳腺疾病

目的探讨扩散加权成像(DWI)与常规MRI征象联合诊断乳腺疾病的模式及诊断效能。资料与方法采用前瞻性研究,99例乳腺疾病患者共109个病变术前行3.0T乳腺MRI及DWI检查,经术后病理或长期随访确诊。乳腺良恶性病变的表观扩散系数(ADC)值进行同一观察者、不同观察者共3次测量,采用受试者操作特征曲线、串联并联诊断试验、机器学习探讨多参数联合对乳腺良恶性疾病的诊断效能。结果 ADC值的观察者内组内相关系数为0.950(95%CI 0.928~0.965);观察者间组内相关系数为0.937(95%CI 0.909~0.956);良性病变与恶性病变的ADC值分别为(1.447±0.377)×10-3 mm2/s、(1.054±0.255)×10-3 mm2/s,差异有统计学意义(P<0.05)。以ADC值1.125×10-3 mm2/s为阈值鉴别良恶性病变的敏感度和特异度分别为82.4%、74.1%,联合其他传统MRI征象可使敏感度、特异度高于单一ADC值诊断。结论 ADC值具有良好的可重复性和稳定性,ADC值与传统MRI征象联合应用可以更好地鉴别乳腺病灶的良恶性。     

AIDS的高效抗反转录病毒治疗指南解读

本文对高效抗反转录病毒治疗的时机选择、抗HIV药物种类、治疗方案的选择及治疗失败的判定等问题进行综述,以期更好地应用于临床实践。     

含人APOBEC3F启动子荧光素酶报告基因载体的构建

目的构建含人载脂蛋白BmRNA编辑酶催化多肽样蛋白3F（apolipoprotein B mRNA editing enzyme,catalytic polypeptide—like 3F,APOBEC3F）基因启动子的萤光素酶报告基因载体。方法应用5’cDNA末端快速扩增分析（5’rapidam—plification of cDNA ends．5’RACE）技术确定APOBEC3F转录起始位点,利用PCR技术扩增人APOBEC3F启动子序列,构建含人APOBEC3F启动子的萤光素酶报告基因载体,行双酶切及测序鉴定,并通过双萤光素酶报告基因系统检测启动子活性。结果APOBEC3F基因转录起始位点位于GenBank已公布的APOBEC3FcDNA起始位置上游13个核苷酸处,测序结果表明克隆获得的APOBEC3F基因启动子序列与GenBank报道一致。重组载体DGL3-A3F—Prom组F／R值（0．342082±0．023516）与空载体pGL3-basic组（0．007871±0．002357）相比,差异有统计学意义（P〈0．05）。结论成功构建了含人APOBEC3F基因启动子的萤光素酶报告基因载体,为更深入研究APOBEC3F基因转录调控机制奠定了基础。     

Fas/FasL途径在海水诱导大鼠肺组织细胞凋亡中的作用

目的通过观察和验证Fas/FasL信号途径对海水诱导大鼠肺组织细胞凋亡的影响,研究海水淹溺型肺损伤的致病机制。方法 24只大鼠随机分为正常对照组、2 h海水组和4 h海水组。2个海水处理组大鼠气管内注入4 ml/kg海水,分别作用2 h和4 h,测肺组织湿重/干重(W/D)比,采用HE染色观察肺组织病理形态改变,流式细胞仪检测肺组织细胞凋亡,蛋白质免疫印迹法(Western blotting)分析Fas、FasL及活化caspase-3的蛋白表达。结果与正常对照组相比,海水可导致典型的肺组织损伤,海水作用下肺组织细胞凋亡明显增加(P<0.01),Fas、FasL和活化caspase-3蛋白表达也显著上调(P<0.01)。结论海水可导致大鼠淹溺型肺损伤和肺组织细胞凋亡,Fas/FasL介导的死亡受体信号途径参与了凋亡的调控。     

Identification of HLA-A11-restricted HIV-1-specific cytotoxic T-lymphocyte epitopes in China

To fully define HLA-A11-restricted HIV-1-specific cytotoxic T-lymphocyte epitopes in China, a method combining the enzyme-linked immunospot (ELISPOT) assay with intracellular gamma interferon staining (ICS) of peripheral blood mononuclear cells (PBMC) was used to map the optimal epitopes targeted by ELISPOT and then to define the HLA restriction of epitopes by ICS. A novel HLA-A11-restricted CTL epitope and five other published HLA-A11-restricted epitopes previously identified by reverse immunogenetics or other methods were defined. The approach of integrating ELISPOT with ICS is both convenient and useful for the characterization of CTL responses to HIV-1 infection; this method is practical for defining novel epitopes and facilitates in developing new strategies for future vaccine design in China and other Asian countries.     

肿瘤干细胞研究现状

复发和转移是限制肿瘤临床治疗疗效的瓶颈。近些年,产生和发展了肿瘤干细胞理论,试图解释这种现象。本文就肿瘤干细胞研究的理论基础、现状及前景做一综述。     

军队医院低年资聘用护士一般自我效能感与幸福感现状及相关性研究

目的调查军队医院低年资聘用护士一般自我效能感与幸福感现状,并探讨其相关性。方法采用一般自我效能感量表和幸福感指数量表对某军队医院119名低年资聘用护士进行现场调查。结果军队医院低年资聘用护士一般自我效能感得分为(2.56±0.48)分,幸福感指数得分为(10.97±2.05)分,均低于常模(P<0.01),且二者呈正相关(P<0.05)。结论军队医院护理管理者应提高低年资聘用护士的一般自我效能感,进而提高幸福感,这对提升临床护理质量,从而更好完成医疗保障任务有重大意义。