血浆置换在ABO血型不相容的亲属活体肾移植中应用效果评价

目的观察血浆置换在ABO血型不相容亲属活体肾移植中清除血型抗体的临床应用效果。方法回顾分析2017年7月~2019年1月本院54例行ABO血型不相容肾移植患者的临床特征及行血浆置换治疗后血型抗体效价变化情况,分析血浆置换治疗过程中不良反应发生情况。结果52/54例患者血型抗体(包括IgG和IgM)效价成功降至术前目标滴度,顺利进行肾移植手术;1例患者术后出现血型抗体反弹,移植肾失功;2例患者血型抗体效价未能降至目标水平,放弃肾移植手术,继续行肾脏替代治疗。血浆置换降低ABO血型不相容肾移植受者血型抗体的总有效率为94%。128次血浆置换过程中共发生了49次轻度不良反应。结论血浆置换是降低ABO非同型肾移植受者血型抗体(包括IgG和IgM)的有效方法,可与其他免疫抑制剂联合使用,缩短移植前血型抗体高滴度受者术前预处理时间。     

清肺口服液对腺病毒增殖影响的研究

目的:观察清肺口服液含药血清对腺病毒3I、7b型增殖的影响。方法:采用组织培养病毒滴度测定方法观察腺病毒3I、7b型滴度的变化。结果:清肺口服液含药血清不能影响腺病毒3I、7b型滴度。结论:清肺口服液含药血清不能直接影响腺病毒增殖。     

Approaching the sensitized lung patient: risk assessment for donor acceptance

The presence of HLA antibodies is widely recognized as a barrier to solid organ transplantation, and for lung transplant candidates, it has a significant negative impact on both waiting time and waiting list mortality. Although HLA antibodies have been associated with a broad spectrum of allograft damage, precise characterization of these antibodies in allosensitized candidates may enhance their accessibility to transplant. The introduction of Luminex-based single antigen bead (SAB) assays has significantly improved antibody detection sensitivity and specificity, but SAB alone is not sufficient for risk-stratification. Functional characterization of donor-specific antibodies (DSA) is paramount to increase donor accessibility for allosensitized lung candidates. We describe here our approach to evaluate sensitized lung transplant candidates. By employing state-of-the-art technologies to assess histocompatibility and determine physiological properties of circulating HLA antibodies, we can provide our Clinical Team a better risk assessment for lung transplant candidates and facilitate a “road map” to transplant. The cases presented in this paper illustrate the “individualized steps” taken to determine calculated panel reactive antibodies (cPRA), titer and complement-fixing properties of each HLA antibody present in circulation. When a donor is considered, we can better predict the risk associated with potentially crossing HLA antibodies, thereby allowing the Clinical Team to approach allosensitized lung patients with an individualized medicine approach. To facilitate safe access of sensitized lung transplant candidates to potential donors, a synergy between the histocompatibility laboratory and the Clinical Team is essential. Ultimately, donor acceptance is a decision based on several parameters, leading to a risk-stratification unique for each patient.     

血细胞参数RPR和P2/MS对乙型肝炎肝硬化的 预测价值

摘要:目的　验证血细胞参数RPR和P2/MS对乙型肝炎肝硬化的预测价值,并与其他一些指标比较。方法　选取乙型肝炎肝硬化患者304名（LC组）、慢性乙型肝炎患者212例（CHB组）,采用Sysmex XE-2100血细胞分析仪进行血常规检测;采用西门子Advia2400进行肝生化检测。根据公式RPR＝RDW（%）/PLT（109/L）和P2/MS＝［PLT（109/L）］2/［M（%）×S（%）］计算所有对象的RPR和P2/MS值,同时计算其AAR、APRI和FIB-4值。结果　LC组RPR中位数为0.22,显著高于CHB组的0.09;LC组P2/MS中位数为11.06,显著低于CHB组的73.02。ROC曲线分析显示,RPR和P2/MS诊断LC的曲线下面积（AUC）分别为0.883和0.879,差异无统计学意义（P＞0.05）。两者AUC与FIB-4（0.884）比较差异均无统计学意义;而均显著高于AAR（0.799）和APRI（0.681）。结论　RPR和P2/MS均对乙型肝炎肝硬化具有一定的预测价值,且诊断准确度相近。     

Anti-Obesity and Hypocholesterolemic Actions of Protamine-Derived Peptide RPR (Arg-Pro-Arg) and Protamine in High-Fat Diet-Induced C57BL/6J Mice

Dietary protamine can ameliorate hyperlipidemia; however, the protamine-derived active peptide and its hypolipidemic mechanism of action are unclear. Here, we report the discovery of a novel anti-obesity and hypocholesterolemic peptide, RPR (Arg-Pro-Arg), derived from protamine in mice fed a high-fat diet for 50 days. Serum cholesterol levels were significantly lower in the protamine and RPR groups than in the control group. White adipose tissue weight was significantly decreased in the protamine and RPR groups. The fecal excretion of cholesterol and bile acid was significantly higher in the protamine and RPR groups than in the control group. We also observed a significant decrease in the expression of hepatic SCD1, SREBP1, and adipocyte FAS mRNA, and significantly increased expression of hepatic PPARα and adipocyte PPARγ1 mRNA in the protamine group. These findings demonstrate that the anti-obesity effects of protamine are linked to the upregulation of adipocyte PPARγ1 and hepatic PPARα and the downregulation of hepatic SCD1 via SREBP1 and adipocyte FAS. RPR derived from protamine has a crucial role in the anti-obesity action of protamine by evaluating the effective dose of adipose tissue weight loss.     

Physical and infectious titers of helper-dependent adenoviral vectors: a method of direct comparison to the adenovirus reference material

Accurate measurements of the physical and infectious titers of adenoviral vectors are crucial for evaluating preclinical studies and for the safety and efficacy of clinical studies. Unfortunately, there are no standardized methods of measurement, consequently variable and unreliable values are the result. Furthermore, infectious titers of helper-dependent adenoviral vectors (HDAd) are difficult to measure because traditional cytopathic effect assays cannot be employed, thus hindering their potential clinical application. In response to this problem, a fully characterized Adenovirus Reference Material (ARM) has been developed to be used as a reference standard for clinical grade adenoviral vectors. However, no specific protocols for this purpose have been provided. To fulfill this important need, we have developed a simple assay involving co-infection of 293 cells with the adenoviral vector and the ARM to permit direct comparisons of their physical and infectious titers. We demonstrate, using a HDAd, that this co-infection assay is reliable, sensitive, and reproducible. Importantly, this assay is inherently unaffected by variables that plague other methods of determining vector titers. This assay is applicable to all human serotype 5 adenoviral vectors and will permit reliable comparisons within and between studies as well as meet an important prerequisite for clinical studies.     

Oral priming with Salmonella Typhi vaccine strain CVD 909 followed by parenteral boost with the S. Typhi Vi capsular polysaccharide vaccine induces CD27+IgD-S. Typhi-specific IgA and IgG B memory cells in humans

Attenuated live oral typhoid vaccine candidate CVD 909 constitutively expresses Salmonella Typhi capsular polysaccharide antigen (Vi). A randomized, double-blind, heterologous prime-boost clinical study was conducted to determine whether immunity to licensed parenteral Vi vaccine could be enhanced by priming with CVD 909. Priming with CVD 909 elicited higher and persistent, albeit not significant, anti-Vi IgG and IgA following immunization with Vi, than placebo-primed recipients. Vi-specific IgA B memory (B(M)) cells were significantly increased in CVD 909-primed subjects. S. Typhi-specific LPS and flagella IgA B(M) cells were observed in subjects immunized with CVD 909 or with the licensed Vi-negative oral typhoid vaccine Ty21a. CVD 909-induced B(M) cells exhibited a classical B(M) phenotype (i.e., CD3(-)CD19(+)IgD(-)CD27(+)). This is the first demonstration of classical B(M) cells specific for bacterial polysaccharide or protein antigens following typhoid immunization. The persistent IgA B(M) responses demonstrate the capacity of oral typhoid vaccines to prime mucosally relevant immune memory.     

自噬抑制剂3-MA抑制EV71病毒颗粒的产生与释放

目的 通过研究肠道病毒71型(Enterovirus 71,EV71)感染引起细胞的自噬及抑制自噬对病毒滴度的影响,为进一步明确EV71的致病机制提供基础.方法 利用Western Blot检测EV71感染后RD-A细胞内源性LC3的型别转换和P62的降解来指示细胞发生自噬的水平,通过测定染毒细胞培养上清中EV71病毒CCID50来观察抑制自噬后细胞释放EV71感染性病毒颗粒的变化.结果 EV71的感染促进了细胞LC3的型别转换和F62的降解,诱导了细胞发生自噬;3-MA抑制细胞自噬后,EV71染毒细胞产生的感染性EV71病毒颗粒数量减少.结论 EV71可以诱导细胞发生自噬,细胞自噬可能促进EV71感染性病毒颗粒的产生和释放.

Abstract：

Objective To determine whether or not enterovirus 71 ( enteroviurs 71, EV71) may induce autophagy and affect the production and release of EV71 after the treatment of autophagy inhibitor. Methods Western blots were performed to examine the conversion of LC3- Ⅰ to LC3-Ⅱ and the degradation of P62 after the RD-A cells were infected with EV71. CCID50 was determined by checking the virus titer in the supernatant of cells that treated with autophagy inhibitor 3-MA. Results EV71 infection enhances the type conversion of LC3 and degradation of P62. The infectious virus particles were decreased after the treatment of 3-MA. Conclusion EV71 infection could induce cell autophagy and the autophagy might contribute to the production and release of infectious EV71 particles.     

RPR、TP-ELISA和TPPA在无偿献血者梅毒筛查中的应用评价

评价快速血浆反应素环状卡片试验(RPR)、梅毒酶联免疫吸附试验(TP-ELISA)和梅毒螺旋体明胶凝集试验(TPPA)在无偿献血者梅毒筛查中的应用价值,选择适用于血站血液筛查梅毒的检测方法.选择无偿献血者20200份血液,采用RPR和TP-ELISA方法检测梅毒抗体,经初筛、复检阳性标本再以TPPA法确认.结果表明:R...