淋巴细胞免疫疗法治疗复发性流产的疗效分析

目的：探讨不明原因复发性流产临床治疗中淋巴细胞主动免疫治疗的临床价值。方法选取2010～2012年我院诊治的复发性流产患者50例,随机分为两组,分别行无特殊处理和淋巴细胞主动免疫治疗,同时对主动免疫治疗患者封闭抗体阴性与阳性的妊娠结局进行统计。结果观察组患者流产率显著低于对照组（P＜0.05）。主动免疫治疗后封闭抗体阳性患者妊娠成功率为88.5%,阴性患者妊娠成功率为57.1%,阳性组显著高于阴性组（P＜0.05）。结论淋巴细胞主动免疫治疗能过有效治疗复发性流产,具有良好的临床效果,而封闭抗体检测能够对妊娠结局有积极的预测作用。     

颌骨大型牙源性囊性病变的微创治疗

目的探讨袋成形术联合应用阻塞器治疗颌骨大型牙源性囊性病变的临床效果。方法颌骨大型牙源性囊性病变患者36例,采用袋成形术联合应用阻塞器治疗,术后3、6、12个月复诊,行临床检查及拍摄X线曲面断层片,记录囊腔影像面积变化,术后6~12个月对仍存留的囊肿行Ⅱ期囊肿刮切术。结果 36例患者术后3~6个月面部膨隆畸形均基本消失或完全消失,无1例患者出现伤口感染;10例患者囊腔体积缩小大于90%,24例囊腔体积缩小率达到80%~90%,2例囊腔体积缩小在60%以上;Ⅱ期囊肿刮切术后继续随访1年囊肿无复发,形态功能均恢复良好。结论袋成形术联合应用阻塞器治疗颌骨大型囊性病变,可改善患者颌骨膨隆畸形,最大程度保留颌骨解剖结构及生理功能,疗效肯定。     

孕中不同时期联合免疫对HBV母婴传播的阻断效果

目的：探讨不同时期注射乙肝疫苗联合乙肝免疫球蛋对乙型肝炎病毒母婴传播的阻断作用。方法以HBsAg阳性孕妇及其婴儿为研究对象，A组105例于孕20周、24周、28周注射乙肝免疫球蛋白200 IU。B组106例孕妇于28周、32周、36周同法注射。两组新生儿出生后半小时内进行乙肝疫苗10μg、乙肝免疫球蛋白200 IU肌肉注射。结果 A组和B组新生儿出生时脐带静脉血、12月、24月外周静脉血HBsAg阳性率、HBsAb阳性率比较经χ2检验均有显著性差异（P〈0.05）。结论对HBsAg阳性孕妇孕20周、24周、28周及新生儿联合使用乙肝疫苗、乙肝免疫球蛋白可以有效减低HBV感染率。     

Ⅲ类环境中单层医用皱纹纸阻菌效果研究

目的评价单层医用皱纹纸的阻菌效果。方法在不同的气候条件下,曾进行了2次试验,每次试验将180个用单层医用皱纹纸包装的无菌试验包随机分3组,分别保存于不同的病房治疗室环境中（Ⅲ类环境）,分别于灭菌当天及存放7、14、30、60、90 d进行无菌试验。结果两次试验全部采用单层医用皱纹纸包装的共360个试验包,在病房治疗室最长存放90 d,均无细菌生长,无菌试验全部合格。结论单层医用皱纹纸用于无菌物品包装的阻菌效果是可靠的。     

A type-specific blocking ELISA for the detection of infectious bronchitis virus antibody

Infectious bronchitis virus (IBV) infection has been a major threat to the poultry industry worldwide. Current commercially available ELISA kits detect group-specific antibodies; however, to understand the status of field infection, a monoclonal antibody (mAb) blocking ELISA (b-ELISA) against local IBVs was developed. The selected mAb showed specificity to Taiwan IBV strains but had no cross-reactivity with the vaccine strain H120. Using the hemagglutination inhibition (HI) test as a standard, the cut-off value, sensitivity, and specificity of a b-ELISA using this mAb were evaluated in 390 field samples. The type-specificity of detection was validated using a panel of chicken hyperimmune sera. The results showed that the b-ELISA demonstrated high sensitivity (98.0%) and specificity (97.2%) of detection. The agreement between the results of the b-ELISA and the HI test was statistically significant (Kappa = 0.95), and there was no significant difference between these two methods (McNemar p = 0.72). The b-ELISA specifically detected Taiwan IBV serotypes but not three non-Taiwan IBV serotypes nor sera against other avian pathogens. This b-ELISA provides type-specific antibody detection of local IBV strains. It has the potential to serve as a rapid and reliable diagnostic method for IBV clinical infections in the field in Taiwan.     

Immune recognition of BoNTs A and B: How anti-toxin antibodies that bind to the heavy chain obstruct toxin action

We localized the BoNT regions that bind blocking Abs from 28 BoNT/A- and 30 BoNT/B-treated dystonia patients who became unresponsive to, and whose sera protected mice against LD100 of, the correlate BoNT. We analyzed Ab binding to BoNT/A- and BoNT/B-peptide panels, each of which consisted of 60, 19-residue peptides that overlapped consecutively by 5 residues and covered the entire H chain of the correlate toxin. Abs bound to a limited set of peptides but levels varied with patient, consistent with responses to each epitope being under separate MHC control. BoNT/B-treated patients had higher anti-toxin Ab levels and bound more H regions (at least 11) than BoNT/A-treated patients (5 regions). The epitopes were on surface areas that did not correlate with surface electrostatic potential, hydrophilicity, hydrophobicity, or temperature factor. Some epitopes within the two toxins display substantial homology and occupy equivalent 3-D locations, occasionally showing a small shift relative to one another, consistent with recognition adjustments accommodating structural differences between the two BoNTs. Blocking Abs bound to BoNT/A at sites that coincided or overlapped with those involved in synaptosome-binding, thus preventing its binding and blocking its entry into the neuron. On BoNT/B, Ab-binding regions overlapped with the sites that bind to mouse and rat synaptotagmin II or to ganglioside, thereby explaining Ab blocking of BoNT/B action.     

针灸刀与封闭治疗屈指肌腱狭窄性腱鞘炎疗效对照观察

目的:比较针灸刀与封闭治疗屈指肌腱狭窄性腱鞘炎的疗效差异,探寻较优疗法.方法:将304例患者随机分为针灸刀组(164例)和封闭组(140例).于患指压痛点和硬结处,针灸刀组应用任氏钩型针灸刀行勾割治疗,封闭组行常规封闭治疗.治疗1～2次后观察两组疗效以及治疗后6个月的复发情况.结果:针灸刀组治愈率为98.2％(161/164),优于封闭组的65.7％(92/140);针灸刀组复发率为1.9％(3/161),低于封闭组的37.0％(34/92),组间差异均有统计学意义(均P＜0.01).结论:针灸刀治疗屈指肌腱狭窄性腱鞘炎疗效优于封闭治疗,且复发率低.     

硝苯地平治疗慢性阻塞性肺病和原发性肺动脉高压远期效应临床研究

目的 观察硝苯地平对慢性阻塞性肺病(COPD)和原发性肺动脉高压(PPH)远期疗效.方法 用随机双盲、有安慰剂对照的设计方法,观察了硝苯地平对COPD和PPH患者[肺动脉压(PAP)和肺循环阻力(PVR)下降幅值;临床症状呼吸困难与运动量改善程度以及长期服用后对病人生存期的影响]的2年疗效.在148例患者中,治疗组100例(硝苯地平10mg,每月3次),安慰剂组48例(1片,每日3次).在长期治疗中,硝苯地平剂量根据患者的反应进行调整,剂量通常随治疗时间每2个月增加1次,每次增加5mg/d,并观察其疗效,用右心导管法和超声心动图检查法对治疗组患者进行三尖瓣跨瓣压(△P)和心排出量(CO).随访期间每6个月用超声心动图检查法复查上述指标1次.结果 COPD和PPH患者长期用硝苯地平治疗后,△P由(84.1±24.1)mmHg(1mmHg=0.133kPa)降至62.7±18.27mmHg(P＜0.01),CO由(4.00±1.22)L/min升至(4.70±1.22)L/min(P＜0.02),△P/CO由22.8±9.4降至14.9±6.5(P＜0.01).结论 长期口服硝苯地平治疗COPD和PPH,可使患者右心室压力逐渐降低,CO增加,临床症状与运动量改善,并可延长患者生命.     

OCCURRENCE,PROPERTIES, AND FUNCTION OF ASYMMETRIC IgG MOLECULES ISOLATED FROM NON-IMMUNE SERA

We have previously demonstrated that 10–20% of the IgG isolated from non-immune sera is asymmetrically glycosylated, in such a way that it fails to trigger immune effector mechanisms. As a result, a major portion of the non-immune asymmetric IgG molecules of the host could be self-specific, acting as auto-protective antibodies. In order to test this hypothesis, we investigated whether asymmetric IgG molecules are capable of recognizing self-antigens. About 40% of F(ab′)₂ fragment from normal rat IgG was able to react specifically with autologous rat cells. Moreover, upon being purified from normal rat sera, 78% of the asymmetric IgG sub-population showed self-reactivity. We demonstrated that about 14% of rat asymmetric IgG-F(ab′)₂ fragments was able to react with bacteria isolated from the intestine of uninfected rats. Lastly, in order to test whether there is a correlation between the decline of immune responses during ageing and asymmetric antibody production, we assayed IgG isolated from sera of young and old rats. There was an increase in the asymmetric:symmetric IgG ratio with ageing. We therefore suggest that asymmetric antibodies may exert a beneficial action by protecting self-antigens as well as normal intestinal flora from a deleterious immune response.