An HLA-B35-restricted epitope modified at an anchor residue results in an antagonist peptide

Peptides associated with HLA-B35 commonly have a proline or occasionally a serine residue in the P2 anchor position of the peptide, with a tyrosine at the C terminus. Based on this motif, we identified an octamer epitope from influenza A matrix protein which is presented by HLA-B35. The requirements for MHC binding and T cell receptor contact have been analyzed using analogs of this peptide with substitutions at positions 1, 2, 4, 7 and 8. The natural epitope contains a serine residue at P2 of the peptide. Substitution of this residue with proline (the favored amino acid in this position in B35-associated peptides) considerably enhances binding to HLA-B35 in the T2-B35 cell line, but the peptide is not recognized by the majority of CTL clones and can antagonize recognition of the index peptide. This suggests that a conservative substitution at the P2 anchor position results in a conformational change in the peptide-MHC surface exposed to the T cell receptor.     

流动渔船民血吸虫病防治措施的研究Ⅱ渔船民粪便管理为主的综合措施控制血吸虫病的效果

目的评价流动渔船民粪便管理为主的综合防治措施对控制血吸虫病的效果,为实施传染源控制策略提供有效防治措施。方法收集记录对策实施情况,采用现场调查的方法,每年对渔船民集散地采用系统抽样法进行螺情调查,并对渔船民进行病情调查,比较对策实施前后集散地螺情指标和渔船民病情指标变化趋势以及扬州市血吸虫病疫情变化。结果2006～2008年在扬州市53个渔船民集散地建造三格式无害化公厕103座,对22处集散地实施了安全用水,发放粪便收集容器1907只,发放防蚴霜8159支,开展集散地药物灭螺2316.74hm^2,渔船民查病9698人次,2006年淘汰处理耕牛91头。2005～2008年共捕获解剖钉螺40434只,发现感染性钉螺36只,各年查出感染性钉螺面积分别为55.11、9.00、9.00hm^2和2.00hm^2,钉螺感染率为0.133%、0.132%、0.052%和0.035%,4年共开展渔船民查病11680人次,查出粪检阳性15例,各年渔船民血吸虫感染率分别为0.36%、0.08%、0.14%和0。对策实施3年后,集散地感染性钉螺面积、钉螺感染率和渔船民血吸虫感染率分别下降了96.37%、73.77%和100%。全市感染性钉螺面积、钉螺感染率和居民血吸虫病患病率分别由110.03hm^2、0.111%和0.13%下降到4.00hm^2、0.012%和0.03%,分别下降了96.36%、89.19%和76.92%。结论在全面实施“以机代牛”的沿江地区,实施渔船民粪便管理为主的综合防治措施能够逐步控制血吸虫病流行。     

自制颈椎侧块锚钉在单开门颈椎管成形术中的应用

颈椎单开门椎管成形术（expansiveopen—doorlaminoplasty,ELAP）在临床被用于治疗脊髓型颈椎病、颈椎管狭窄、颈椎后纵韧带骨化症等疾病,由于减压彻底,被众多脊柱外科学者所推崇,但陔术式在广泛减压之余,仍存在一些弊端,不少患者。     

The Use of Anchors in Shoulder Surgery: A Shift From Metallic to Bioabsorbable Anchors

With major advances in arthroscopy, suture anchors became the primary devices used to assist in fixing soft tissues to bone. Metallic anchors were first produced and used in soft tissue fixation around the shoulder. However, their use resulted in some reported complications, including articular surface damage from migrating implants and distortion and artifact production in postoperative magnetic resonance imaging. Bioabsorbable anchors were developed to avoid these problems. Their newer versions were proven to have pulling-out strength equal to that of metallic anchors, with a reported lower complication rate. This had led to a major shift away from metallic anchors toward bioabsorbable anchors.     

关节镜下双排锚钉治疗肩关节前侧盂缘骨折的临床疗效观察

目的观察关节镜下双排锚钉修复肩关节前侧盂缘骨折的中长期临床疗效。方法自2011年5月至2014年2月,观察我院收治的19例肩关节盂前侧骨折患者,年龄在21~52岁,平均年龄34.9岁。所有患者采用双排锚钉缝合技术对移位的关节盂骨折进行复位,固定,采用视觉模拟评分法(Visual Analogue Scale,VAS)评分、Constant肩关节评分,ROWE肩关节功能评分,记录关节肩关节活动度,对比术前、术后随访数据评估其临床效果。结果平均随访时间为3.5年。VAS评分从术前7.3±1.4下降到1.4±0.7,明显缓解(t=6.332,<0.01),Constant评分由术前42.1±4.9,到术后89.8±5.4,有明显改善(t=5.827,P<0.01);ROWE评分由术前66.1±11.6,改善为91.7±3.6(t=8.305,P<0.01);关节活动度均有改善。结论关节镜下采用双排锚钉治疗关节盂前侧骨折,损伤小,解剖复位,固定牢靠,中长期效果满意。     

Which Clip? A Prospective Comparative Study of Retention Rates of Endoscopic Clips on Normal Mucosa and Ulcers in a Porcine Model

Background/Aim:

There are currently no data on the relative retention rates of the Instinct clip, Resolution clip, and QuickClip2Long. Also, it is unknown whether retention rate differs when clips are applied to ulcerated rather than normal mucosa. The aim of this study is to compare the retention rates of three commonly used endoscopic clips.

Materials and Methods:

Six pigs underwent upper endoscopy with placement of one of each of the three types of clips on normal mucosa in the gastric body. Three mucosal resections were also performed to create “ulcers”. Each ulcer was closed with placement of one of the three different clips. Repeat endoscopy was performed weekly for up to 4 weeks.

Results:

Only the Instinct and Resolution clips remained attached for the duration of the study (4 weeks). At each time point, a greater proportion of Instinct clips were retained on normal mucosa, followed by Resolution clips. QuickClip2Long had the lowest retention rate on normal mucosa. Similar retention rates of Instinct clips and Resolution clips were seen on simulated ulcers, although both were superior to QuickClip2Long. However, the difference did not reach statistical significance. All QuickClip2Long clips were dislodged at 4 weeks in both the groups.

Conclusions:

The Resolution and Instinct clips have comparable retention rates and both appeared to be better than the QuickClip2Long on normal mucosa-simulated ulcers; however this did not reach statistical significance. Both the Resolution clip and the Instinct clip may be preferred in clinical situations when long-term clip attachment is required, including marking of tumors for radiotherapy and anchoring feeding tubes or stents. Either of the currently available clips may be suitable for closure of iatrogenic mucosal defects without features of chronicity.     

微型骨锚及钢丝固定重建指伸肌腱中央束撕脱伤的比较研究

目的评价应用微型骨锚钉（mitek bone anchor）及钢丝固定重建指伸肌腱中央束撕脱伤的疗效。方法应用骨锚钉手术治疗忠者（锚钉组）18例，应用钢丝手术治疗（钢丝组）20例患者，疗效评价标准采用Dargan功能评定法进行评定。结果术后随访1～6年，患指功能锚钉组优16例，良2例。钢丝组优10例，良4例，可4例，差2例。结论应用微型骨锚钉重建指伸肌腱中央束止点比传统的钢丝固定技术更安全可靠。