按GB／T3359用随机样本检验数据判定医疗器械总体质量水平

计量抽样检验目前在中国医疗器械行业应用较少。本文结合两个国外医疗器械标准的实例对GB／T3359在医疗器械标准中的应用进行了解读,并通过与传统的计数抽样检验进行比较,得出医疗器械检验中采用GB／T3359进行计量抽样的优势所在。     

心脏大血管手术患方决策者健康素养对决策满意度的影响

目的 探究感知压力和不确定性忍受度在心脏大血管手术患方决策者健康素养与决策满意度间的中介效应,为提高心脏大血管手术决策满意度提供思路。方法 2021年10月—2022年5月,采用便利抽样法,抽取武汉市某三级甲等综合医院心脏大血管外科260名手术患方决策者作为调查对象,使用全面健康素养测量量表、感知压力量表、简版无法忍受不确定性量表、决策满意度量表进行调查。结果 最终回收有效问卷251份,有效问卷回收率为96.54%。心脏大血管手术患方决策者健康素养得分为（23.05±5.61）分,感知压力得分为（20.31±6.08）分,不确定性忍受度得分为（26.41±5.94）分,决策满意度得分为（43.86±10.54）分,4个变量均具有相关性（P<0.001）。中介模型显示,健康素养对决策满意的直接效应显著,同时,健康素养还通过3条路径间接影响决策满意,包括感知压力的独立中介作用（β=0.096,P<0.001）、不确定性忍受度的独立中介作用（β=0.093,P=0.001）、感知压力与不确定性忍受度的链式中介作用（β=0.076,P<0.001）,中介效应占总效应的49.1...     

基于营养风险筛查与耐受评估的护理干预对结直肠癌术后营养及胃肠功能恢复的影响

目的探讨基于营养风险筛查与耐受评估的护理干预对结直肠癌手术术后营养及胃肠功能恢复的影响。方法选取我院2017年5月至2018年5月收治的结直肠癌手术患者80例,随机将其等分为对照组与观察组,对照组给予常规早期肠内营养支持,观察组给予基于营养风险筛查与耐受评估的护理干预,比较两组术后营养状态及胃肠功能恢复。结果观察组体质量、前清蛋白、血红蛋白、血清白蛋白指标水平显著高于对照组(P<0.05);观察组首次排便、首次肛门排气及肠鸣音恢复时间均显著短于对照组(P<0.05)。结论基于营养风险筛查与耐受评估的护理干预应用于结直肠癌手术患者中,能改善其营养状态,促进胃肠功能恢复。     

Mycophenolic acid inhibits maturation and function of human dendritic cells and B cells

Mycophenolic acid (MPA) is considered an immunosuppressive compound mainly because of its inhibitory effects on lymphocyte proliferation. Here we studied specifically the effects of MPA on the ability of dendritic cells (DCs) to activate T cells via the indirect pathway and on the maturation and function of B-lineage cells. We demonstrated that DC cell-surface receptors, associated with antigen uptake and antigen processing and presentation (CD83 and CD205), were differentially downregulated in the presence of MPA, translating into a decreased uptake of alloantigens and reduced stimulation of T cells with decreased cytokine secretion (interleukin (IL)-1Ra and transforming growth factor (TGF)-α). Similarly, MPA significantly inhibited B-cell differentiation into memory and plasma cells in vitro and decreased secretion of TNF-α, IL-1Ra, and IL-10. We further demonstrated for the first time that not only the amount of antibody secretion was significantly lowered in the presence of MPA but also the total number of antibody-producing cells was reduced. Importantly, we provide direct evidence that HLA-specific antibody secretion was also affected using a newly developed HLA antibody-specific B-cell enzyme-linked immunospot assay. Our data indicate additional pathways by which MPA downregulates the immune system. This in turn may lead to improved conditions for allograft tolerance and control of allograft rejection.     

Role of Regulatory T Cells in Transferable Immunological Tolerance to Bone Marrow Donor in Murine Mixed Chimerism Model

Constructing a bone marrow chimera prior to graft transplantation can induce donor-specific immune tolerance. Mixed chimerism containing hematopoietic cells of both recipient- and donor-origin has advantages attributed from low dose of total body irradiation. In this study, we explored the mechanism of mixed chimerism supplemented with depletion of Natural Killer cells. Mixed chimerism with C57BL/6 bone marrow cells was induced in recipient BALB/c mice which were given 450 cGy of γ-ray irradiation (n = 16). As revealed by reduced proliferation and cytokine production in mixed leukocyte reaction and ELISpot assay (24.6 vs 265.5), the allo-immune response to bone marrow donor was reduced. Furthermore, the induction of transferable immunological tolerance was confirmed by adoptive transfer and subsequent acceptance of C57BL/6 skin graft (n = 4). CD4⁺FoxP3⁺ regulatory T cells were increased in the recipient compartment of the mixed chimera (19.2% → 33.8%). This suggests that regulatory T cells may be therapeutically used for the induction of graft-specific tolerance by mixed chimerism.     

Experimental immunotherapeutic approaches for atherosclerosis

Therapeutic options in atherosclerosis have largely been limited to the control of risk factors, such as hypercholesterolemia, hypertension, or diabetes. However, atherosclerosis is a chronic inflammatory disease in which dyslipidemia and inflammation are equally involved in disease pathogenesis. Moreover, abundant epidemiological and experimental evidence point to an important modulatory role of innate and adaptive immunity in atherogenesis, providing novel therapeutic targets for this disease. Indeed, there is now accumulating data in animal models demonstrating the potential for immunotherapeutic approaches to treat atherosclerosis. These include both general and antigen-specific ways of modulating immune functions, and they show great promise for the development of alternative and/or adjuvant therapies for atherosclerosis.     

冠心康颗粒药效学实验研究

目的:本次实验对冠心康颗粒(简称GG)药效学指标进行了考察。方法:1.用结扎冠状劝脉造成家兔急性心肌缺血模型,考察GG对家兔心肌梗塞面积和血清中乳酸脱氩酶的影响。2.小鼠常压耐缺氧试验.结果:GG高(4.65g/kg),中(3.10g/kg)剂量组明显降低心肌梗塞程度,明显抑制ST段抬高,明显降低乳酸脱氩酶的活性,与生理盐水组有非常显著差异(P值均<0.01)。GG具有明显延长小鼠耐缺氧时间,GG 16.5g/kg和11g/kg组小鼠生存延长分别为37.24%和24.27%,与生理盐水组有非常显著差异(P值均<0.01)。结论:冠心康颗粒具有延长小鼠耐缺氧时间,对实验性心肌缺血家兔具有抗心肌缺血、缩小心肌梗塞范围的作用.     

Adenoviral-mediated localized CTLA-4Ig gene expression induces long-term allograft pancreas survival and donor-specific immune tolerance in rats

T cell activation following alloantigen recognition plays a critical role in the development of the rejection in all solid organ, tissue and cell transplantation. A recombinant molecule, cytotoxic T lymphocyte antigen 4 antibody （CTLA-4Ig）, is known to induce to T-cell into ＂anergy＂ by blocking the costimulatory B7-CD28 interaction. Either systemic or localized administration of CTLA-Ig has been shown to prolong allograft survival and induce donor-specific tolerance in some transplant models. In this study, we characterized the expression and immunosuppressive effectiveness of adenoviral-mediated CTLA-4Ig gene transfer. We demonstrated transduction of the allografts with AdCTLA-4Ig resulted in localized expression, permanent graft survival and stable donor-specific tolerance. In addition, by performing simultaneous dual-organ through a local expression of CTLA-4Ig via adenoviral-mediated transplantation, we targeted on immunosuppression gene transfer into pancreatic allografts.     

肠内营养在溃疡性结肠炎治疗中的应用

目的:研究EN支持在溃疡性结肠炎(UC)治疗中的适应证、耐受性、不良反应和疗效.方法:回顾分析220例活动期UC病人,有85例应用EN支持.结果:应用EN支持者,全结肠型占(70.6%)明显多于左半结肠型(18.8%)、直肠乙状结肠型(9.4%)和直肠型(1.2%);重度(56.5%)多于中度(32.9%)及轻度(10.6%).EN组病人BMI<18 kg/m2比例明显高于对照组(P<0.05);ALB水平(28.91±6.64)g/L低于对照组(36.03±6.59)g/L.不同类型EN制剂增加至3 347 kJ/d时间无显著性差异(P>0.05).在不良反应中,腹泻的发生率为14.1%,占所有不良反应的57.1%;EN组与对照组比较,激素减量时间、手术率和缓解率无显著性差异(P>0.05).总蛋白、ALB、PA水平在EN支持后有显著提高(P<0.05).结论:①对病变范围广,中、重度的UC病人,应给予充足的EN;②对存在中、重度营养不良UC病人,应补充EN;③UC病人对不同类型营养制剂耐受性无差异,腹泻是最常见的不良反应;④EN可作为UC活动期的一种辅助治疗.