A very high level of crossreactivity is an essential feature of the T-cell receptor

It is commonly accepted that a high level of antigen specificity is a feature of T-cell activation. However, here, Don Mason argues that a comprehensive response to foreign antigens requires that T cells are widely crossreactive, such that one cell reacts productively with approximately 10⁶ different MHC-associated minimal peptide epitopes.     

钾离子竞争性酸阻滞剂在酸相关疾病中的应用

酸相关疾病是一类消化系统中的常见慢性疾病.质子泵抑制剂现已成为治疗酸相关疾病的一线用药,然而临床应用中逐渐显现出一些局限性,如半衰期短、起效较慢、抑酸不充分、药理作用受CYP2C19基因多态性影响、夜间酸突破等,导致分酸相关疾病患者的症状不能获得充分缓解,以及难治、复发、直接的健康相关生活质量下降和经济负担增大.钾离子竞争性酸阻滞剂是一种新型抗分泌药,能够克服传统质子泵抑制剂的多种局限性,在临床应用中显示出更好的抑酸效应和安全性,可能成为解决酸相关疾病治疗中未满足的医疗需求的新策略,但也需要继续观察潜在的不良反应.本文综述了酸相关疾病治疗中面临的挑战,以及钾离子竞争性酸阻滞剂在酸相关疾病预防和治疗中的优势和前景.     

Effect of radioactive iodine therapy on salivary flow rates and oral Streptococcus mutans prevalence in patients with thyroid cancer

Unstimulated and stimulated salivary flow rates, Streptococcus mutans samples, and dental caries data were obtained from 50 patients with thyroid cancer who had received radioactive iodine, I¹³¹, from 0.3 to 20 years earlier. The salivary flow rates were compared with a healthy control group, and the S. mutans counts were compared to a group of patients with head and neck cancer who were sampled before radiotherapy. Flow rates were found to be significantly lower in the patients with thyroid cancer, and S. mutans levels were slightly but not significantly higher than the controls. Longitudinal flow rate data taken on four patients, who served as their own controls before and after I¹³¹ therapy, indicated a trend in saliva reduction.     

阿米替林对非酒精性脂肪性肝病细胞模型脂质沉积及生化代谢的影响

目的探讨阿米替林通过调节酸性鞘磷脂酶(ASM)/神经酰胺(CE)通路对非酒精性脂肪性肝病(NAFLD)细胞模型脂质及生化代谢的影响。方法体外培养HepG2和L02细胞构建NAFLD细胞模型,MTT比色法测定细胞增殖率,油红O染色观察细胞内脂滴变化。实验分组:正常对照组、模型组、Ami组、TNFα组、Ami+TNFα组。全自动生化分析仪检测细胞内TG、TC及细胞上清液ALT、AST水平,ELISA法检测细胞内总的CE、ASM水平,Western Blot检测细胞内ASM蛋白的表达;实时荧光定量PCR检测细胞内ASM mRNA水平的表达。计量资料多组间比较采用单因素方差分析,进一步两两比较采用Turkey检验。结果与正常对照组相比,NAFLD模型组ASM蛋白和mRNA表达量以及CE、TG、TC、ALT、AST水平明显升高(P值均<0.05);与模型组相比,Ami组ASM蛋白和mRNA表达量以及CE、TG、TC、ALT、AST水平明显降低(P值均<0.05),TNFα组ASM蛋白和mRNA表达量以及CE、TG、ALT、AST水平明显升高(P值均<0.05);与TNFα组比较,Ami+TNFα组ASM蛋白和mRNA表达量以及CE、TG、TC、ALT、AST水平明显降低(P值均<0.05)。结论ASM/CE通路促进脂质积聚、导致脂肪变,阿米替林可通过抑制该通路改善NAFLD肝细胞的脂质沉积。     

下肢功能不全穿通静脉的治疗进展

下肢功能不全穿通静脉（IPV）是下肢静脉性溃疡迁延不愈和下肢静脉曲张术后复发的重要原因之一,是临床上值得探讨的热点问题。笔者简要阐述下肢IPV的发病机制,对开放性穿通静脉离断手术、筋膜下经腔镜穿通静脉离断术（SEPS）和经皮穿通静脉闭合术（PAPS）的手术方式、优缺点做一描述,并提出微创化已成为IPV手术治疗的趋势,期望为临床上治疗IPV提供借鉴。      

布地奈德福莫特罗用于慢阻肺急性加重期观察

目的:观察布地奈德福莫特罗粉吸入剂治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效和安全性。方法:80例AECOPD患者随机分为观察组和对照组各40例,两组均采用常规治疗,观察组加用布地奈德福莫特罗粉吸入剂,比较两组临床疗效、症状明显缓解时间、不良反应。结果:观察组总有效率95.0%,对照组总有效率80.0%,观察组疗效优于对照组(P<0.05),观察组咳嗽、咳痰、气喘症状明显缓解时间较对照组显著缩短(P<0.05);两组均未见明显不良反应。结论:布地奈德福莫特罗粉吸入剂治疗AECOPD疗效确切,安全性好。     

冠心病心绞痛患者的中西医护理干预

[目的]探讨心绞痛患者中西医护理干预效果。[方法]选择2010年7月至2012年8月我院收治的冠心病心绞痛患者144例,随机按观察组74例及对照组70例划分,对照组行常规护理,观察组行中西医结合护理,回顾相关资料。[结果]两组护理前焦虑、抑郁评分无明显差异,护理后评分观察显著低于对照组,差异均有统计学意义(P<0.05)。观察组护理满意度为98.60%;对照组为85.70%,观察组显著高于对照组,差异有统计学意义(P<0.05)。[结论]冠心病心绞痛患者采用中西医结合护理,可提高护理满意度,降低焦虑、抑郁情绪,提高整体护理质量,加快了疾病康复进程。