不同种类降压药对血压变异性的影响

目的通过比较6种不同种类降压药(吲达帕胺、依那普利、缬沙坦、氨氯地平、美托洛尔、特拉唑嗪)对患者血压的影响,总结不同种类降压药对血压变异性的影响。方法对85例18⁶5岁确诊为原发性高血压(EH)的患者,分4个阶段服用常见6大类降压药:吲达帕胺(利尿剂)、依那普利(ACEI)、缬沙坦(ARB)、氨氯地平(钙离子拮抗药)、美托洛尔(β1受体阻断药)、盐酸特拉唑嗪(α阻滞剂)。采用无创性便携式动态血压监测仪,24小时动态血压测量及分析系统(简称:ABPM测量装置)对患者血压进行监测,调节血压(6∶0065岁确诊为原发性高血压(EH)的患者,分4个阶段服用常见6大类降压药:吲达帕胺(利尿剂)、依那普利(ACEI)、缬沙坦(ARB)、氨氯地平(钙离子拮抗药)、美托洛尔(β1受体阻断药)、盐酸特拉唑嗪(α阻滞剂)。采用无创性便携式动态血压监测仪,24小时动态血压测量及分析系统(简称:ABPM测量装置)对患者血压进行监测,调节血压(6∶00²2∶00)每20分钟测量1次,晚上每30分钟测量1次的对比试验,根据实验数据分析这6种药物对于实验对象的影响及不同药物对血压BPV的影响。结果吲达帕胺、缬沙坦和氨氯地平有降低24 h血压BPV的作用;依那普利、特拉唑嗪和美托洛尔有升高24 h血压BPV的作用。缬沙坦组用药后,使24 h收缩压BPV降低了(1.72±4.43)mmHg,24 h舒张压BPV降低了(0.68±1.29)mmHg,其降低的幅度远远大于其他药物组。吲达帕胺组用药后使24 h收缩BPV降低了(1.63±2.79)mmHg、24 h舒张压BPV降低了(0.24±1.80)mmHg,其降低幅度比缬沙坦组略小。氨氯地平降低24 h舒张压,其降低值为(-1.3±0.23)mmHg,其降低幅度要比缬沙坦和吲达帕胺小。依那普利组、特拉唑嗪和美托洛尔组的24 h血压BPV有一定程度的升高。结论 6种降压药对血压变异性的影响存在差异性。     

用BPV转化灶做选择标记表达HBsAg的研究

作者构建了pBMTHBR2质粒,此质粒含有鼠MT启动子、完整的HBsAg基因(preS和S基因)、SV_(40)的拼接信号和完整的BPV基因组。用磷酸钙沉淀技术把此质粒导入鼠C_(127)细胞内,用BPV转化灶做标记,获得了转化细胞克隆。实验表明,57%的克隆细胞系均能分泌HBsAg。     

Safety and Feasibility of Melody Transcatheter Pulmonary Valve Replacement in the Native Right Ventricular Outflow Tract: A Multicenter Pediatric Heart Network Scholar Study

Objectives

This study sought to determine the safety and feasibility of transcatheter pulmonary valve replacement (TPVR) using the Melody valve in native (nonconduit) right ventricular outflow tracts (nRVOT), and to identify factors associated with successful TPVR.

家兔呼吸调节下血压即时变异与心率变异关系的研究

目的探讨家兔呼吸调节下血压即时变异（BPIV）与心率变异（HRV）的关系。方法30只家兔在麻醉下行呼吸机机械通气及颈动脉压力换能术,潮气量恒定10pJ／g,改变呼吸频率（40次／min50次／min60次／min）,记录并分析心电、血压和呼吸情况。结果在不同频率的呼吸调节下,R．R变化趋势、BP．BP变化趋势和呼吸波变化趋势完全同步。与呼吸频率50次／min比较,呼吸频率40次／min、60次／minRSP中心频率、HRV中心频率、BPIV中心频率差异有统计学意义（P〈0．01）。呼吸频率／心搏频率（RF／HR）与呼吸峰（RSP）、BPIV、HRV的中心频率呈正相关（分别r=0．996、r=0．994、r=0．996;均P〈0．001）。在40次／min、50次/min、60次／min的呼吸调节下,RSP、BPIV、HRV的中心频率功率谱相干（平均相干系数0．93±0．14）。结论血压即时变异符合呼吸性窦性心律不齐的生理机制,也符合呼吸性窦性心律不齐形成的心率变异机制,是R-R间期变化的二次效应。     

天麻钩藤饮对肝阳上亢型高血压患者血压变异性的影响

目的:观察天麻钩藤饮对肝阳上亢型高血压病患者血压变异性的影响。方法:将78例肝阳上亢型高血压患者随机分为治疗组40例与对照组38例。2组均给予苯磺酸氨氯地平口服,治疗组加用天麻钩藤饮治疗,疗程14天。在治疗前后分别行动态血压监测,观察血压变异性的变化。结果:2组治疗前24 h平均收缩压及舒张压比较,差异无显著性意义(P0.05)。治疗14天后,2组24 h平均收缩压及舒张压均有明显降低,其中治疗组治疗前后比较,差异有非常显著性意义(P0.01),对照组治疗前后比较,差异有显著性意义(P0.05)。治疗14天后,治疗组24 h平均收缩压及舒张压明显小于对照组(P0.05)。2组治疗前血压变异性指标比较,差异无显著性意义(P0.05)。对照组治疗前后比较,差异均有显著性或非常显著性意义(P0.05,P0.01),治疗组治疗前后比较,差异均有非常显著性意义(P0.01)。2组治疗后比较,差异也有显著性意义(P0.05)。结论:天麻钩藤饮能有效降低血压变异性。     

Oral administration of HPV-16 L2 displayed on Lactobacillus casei induces systematic and mucosal cross-neutralizing effects in Balb/c mice

The human papillomavirus (HPV) minor capsid protein, L2, is a good candidate for prophylactic vaccine development because L2-specific antibodies have cross-neutralizing activity against diverse HPV types. Here, we developed a HPV mucosal vaccine candidate using the poly-γ-glutamic acid synthetase A (pgsA) protein to display a partial HPV-16 L2 protein (N-terminal 1-224 amino acid) on the surface of Lactobacillus casei (L. casei). The oral immunization with L. casei-L2 induced productions of L2-specific serum IgG and vaginal IgG and IgA in Balb/c mice. To examine cross-neutralizing activity, we used a sensitive high-throughput neutralization assay based on HPV-16, -18, -45, -58, and bovine papillomavirus 1 (BPV1) pseudovirions. Our results revealed that mice vaccinated with L. casei-L2 not only generated neutralizing antibodies against HPV-16, but they also produced antibodies capable of cross-neutralizing the HPV-18, -45, and -58 pseudovirions. Consistent with previous reports, vaccination with HPV-16 L1 virus-like particles (VLPs) failed to show cross-neutralizing activity. Finally, we found that oral administration of L. casei-L2 induced significant neutralizing activities against genital infection by HPV-16, -18, -45, and -58 pseudovirions encoding a fluorescence reporter gene. These results collectively indicate that oral administration of L2 displayed on L. casei induces systemic and mucosal cross-neutralizing effects in mice.     

Concordance assessment between a multiplexed competitive Luminex immunoassay,a multiplexed IgG Luminex immunoassay,and a pseudovirion-based neutralization assay for detection of human papillomaviruse types 16 and 18

There are two approved vaccines against anogenital human papillomaviruses (HPV) and a nine-valent vaccine is currently under development. Although there are several assays available to measure antibodies elicited by HPV vaccines, there is currently no global standard for HPV antibody assays. In the current study, antibody responses to HPV16 and HPV18 among young men and women vaccinated with a quadrivalent HPV6/11/16/18 (qHPV) vaccine were assessed using three assays: a competitive Luminex immunoassay (cLIA-4) which measures antibodies directed against a single neutralizing epitope, an immunoglobulin G Luminex immunoassay (IgG-9) which measures both neutralizing and non-neutralizing antibodies, and a pseudovirion-based neutralization assay (PBNA) which functionally measures the full spectra of neutralizing antibodies. To assess HPV16 and HPV18 responses, 648 and 623 serum samples, respectively, were selected from three prior clinical trials of the qHPV vaccine. For each HPV type, the functional relationship between pairs of assay methods was estimated using a linear statistical relationship model and Pearson correlation coefficients. For both HPV16 and HPV18, the agreement between the PBNA and IgG-9 (correlation coefficients of 0.95 and 0.93, respectively) was comparable to the agreement between the cLIA-4 and IgG-9 (correlation coefficients of 0.92 and 0.92, respectively). Of 478 and 399 post-dose 3 samples that tested positive in the cLIA-4, 100% and 98% also tested positive in the IgG-9 and PBNA. The proportion of cLIA-4 seronegative post-dose 3 samples that tested positive in both the IgG-9 and PBNA was 68% (19/28) for HPV16 and 58% (71/122) for HPV18. The data demonstrate the three assays are highly correlated and reflect the measurement of neutralizing antibody. This further verifies that the IgG-9 assay, which is used to assess the immune response to an investigational nine-valent vaccine, is similarly sensitive to the PBNA for the detection of HPV16 and HPV18 neutralizing antibodies.     

在细胞球内BPV转化细胞抗凋亡的细胞间诱导研究

目的：（１） 建立“凋亡的细胞间诱导”的球体细胞培养实验系统，（２） 在该系统中研究ＢＰＶ 的致癌机制。方法：采用三维立体细胞培养技术，制作以转化细胞为核心，正常细胞为外壳的细胞球，模拟体内肿瘤细胞生长于正常细胞间的情形，观察癌基因ｓｒｃ、化学致癌剂甲基胆蒽及ＢＰＶ 转化细胞在细胞球中凋亡产生情况。结果：在球体细胞培养实验系统中，在ｓｒｃ 转化细胞产生凋亡的条件下，甲基胆蒽转化细胞同样能产生凋亡，而ＢＰＶ 转化细胞则抵抗了由周围正常细胞所致的凋亡。结论：（１）“凋亡的细胞间诱导”在球体细胞培养实验系统中，即在近似体内的条件下，不需要外源性ＴＧＦβ的参与同样可以产生，球体细胞培养实验系统是理想的研究近似体内条件下“凋亡的细胞间诱导”的模型，（２） 由于ＢＰＶ 转化细胞能抵抗“凋亡的细胞间诱导”，因此可以作为ＢＰＶ致癌机制一种解释，即ＢＰＶ不仅能诱导细胞转化，而且能保护已经转化的细胞不被“凋亡的细胞间诱导”所清除。     

Treatment of apogeotropic benign positional vertigo: comparison of therapeutic head-shaking and modified Semont maneuver

Several methods of physiotherapy have been advanced for apogeotropic type benign positional vertigo involving the horizontal semicircular canal (HC-BPV). The aim of this study was to determine the therapeutic efficacies of the proposed maneuvers in apogeotropic HC-BPV. Using a prospective randomized trial involving seven nationwide dizziness clinics in Korea, we compared the immediate efficacies of head-shaking and modified Semont maneuvers in 103 consecutive patients with apogeotropic HC-BPV. We also determined an additional therapeutic benefit of mastoid oscillation while the patients without response to both maneuvers were performing the Brandt–Daroff exercise. Successful treatment was defined as resolution of positional vertigo and nystagmus, or as transition into geotropic HC-BPV. Results showed that head shaking was more effective than the modified Semont maneuver (37.3 vs. 17.3%, P = 0.02). However, therapeutic efficacy did not differ between the maneuvers after the initial non-responders switched over to the other maneuver (23.3 vs. 25.0%, P = 0.861). Mastoid oscillation provided no additional benefit while the patients without response to both maneuvers were performing the Brandt–Daroff exercise. Most positional vertigos resolved within a week (89.4%) irrespective of the treatment modalities applied and all showed resolution within 28 days. The head-shaking maneuver described here proved more effective than the modified Semont maneuver in treating apogeotropic HC-BPV. Mastoid vibration conferred no additional benefit during the Brandt–Daroff exercise. S.-Y. Oh (Department of Neurology, School of Medicine, Chonbuk National University) conducted the statistical analyses.