人肠道病毒71型及柯萨奇病毒A组16型VP1蛋白的真核表达

目的：克隆人肠道病毒71型（EV71）及柯萨奇病毒A组16型（CA16）的VP1蛋白编码基因，构建相应真核表达质粒在体外进行重组表达，检测其细胞内定位，为EV71及CA16的疫苗研究提供基础。方法：通过PCR扩增分别获取EV71及CA16的VP1编码序列，插入pcFlag载体，分别构建EV71及CA16 VP1与FLAG标签融合的真核表达质粒；瞬时转染人胚肾293T细胞及横纹肌肉瘤RD细胞，Western blot法检测融合蛋白的表达，免疫荧光检测融合蛋白的细胞内定位情况。结果：测序表明两种来源VP1蛋白的重组表达质粒构建正确；分别转染两种不同的细胞后，均可通过Western blot检测到相应蛋白表达；免疫荧光检测显示两种毒株的VP1均表达在细胞质中。结论：外源融合表达EV71或CA16 VP1蛋白的真核表达质粒构建成功；所构建质粒分别转染细胞后，均可在细胞质内检测到VP1融合蛋白的表达。     

外源性神经节苷脂相关性吉兰—巴雷综合征的发病机制及诊治研究进展

吉兰―巴雷综合征（GBS）是一种以快速进行性四肢麻木无力为特点的急性炎性脱髓鞘性多发性多神经根神经病。随着外源性神经节苷脂在临床的广泛应用，该药引起的副作用也逐渐显现，外源性神经节苷脂相关性GBS是其最严重的并发症，临床上主要表现为轴索型GBS，以四肢弛缓性瘫痪为首发症状，表现为急性、严重且快速进展的周围神经受累，较其他轴索型GBS病情重，恢复时间长，预后差。目前发病机制尚不明确。静脉注射人免疫球蛋白是其具有循证医学证据的治疗方法，目前已取代血浆置换成为GBS首选治疗方法，推荐剂量为0.4 g/（kg·d），连续静滴5 d，大剂量激素治疗的效果还有待进一步探讨。早发现、早诊断、尽早停用外源性神经节苷脂、及时应用人血免疫球蛋白冲击治疗和康复治疗，可改善预后。     

外源性NGF对坐骨神经损伤后脊髓前角细胞CNTF表达的影响

目的　探讨坐骨神经损伤后脊髓前角细胞睫状神经营养因子 (CNTF)表达变化及外源性神经生长因子(NGF)与CNTF表达的关系。方法　采用大鼠坐骨神经损伤动物模型 ,分为给药组和对照组 ,每只大鼠又分为损伤侧组 (L组 )和健侧组 (R组 )两个亚组。用原位杂交、免疫组化技术检测CNTF的表达水平 ,观察各组在 1d、7d、1 4d、2 1d及 2 8d时的变化。用计算机图像自动处理系统进行定量分析研究。结果　给药组损伤侧脊髓前角细胞中CNTF表达水平除 1d、7d组外其余均多于对照组 (P <0 .0 5 ) ;而两组健侧脊髓前角细胞中CNTF表达水平无统计学意义 (P >0 .0 5 )。结论　①外源性NGF能促进坐骨神经损伤后损伤侧脊髓前角细胞中CNTF表达水平的增加 ;而对健侧CNTF表达水平无明显作用。②坐骨神经损伤后损伤侧脊髓前角细胞中CNTF表达水平在最初的 3周内逐渐下降 ,然后开始恢复 ,但至第 4周尚未恢复到开始时的水平 ;而两组健侧CNTF表达水平则无明显差异 (P >0 .0 5 )。     

卡托普利对.OH所致异常血流动力学的保护作用

．ＯＨ生成液０．０５ｍｌ．１００ｇ＾－１经胶静脉注入心脏，可使麻醉大鼠的左心室收缩压力、左心室压力与心率乘积、左心室压力上升最大速率和左心室压力下降最大速率明显下降。     

Coexisting Endogenous and Exogenous Llpold Pneumonia and Pulmonary Alveolar Proteinosis in a Patient with Neurodevelopmental Disease

We report a unique case of coexistingexogenous lipoid pneumonia, endogenous lipoid pneumonia (EU), and pulmonary alveolar proteinosis (PAP) in a 5-year-old patient with severe neurodevelop mental disease. The patient presented with gastroesophageal reflux and presumed chronic lung disease resulting from recurrent aspiration pneumonias and succumbed to respiratory failure. The autopsy showed lipid-laden macrophages and periodic acid-SchiJf9ositive granular matm'al i n alveolar spaces and multilamellated structures within both alveolar macrophages and extracellular debris.

These findings were similar to those in previous reports of coexisting E I P and PAP in the setting of gastroesophageal refux [I] . However, the present case diJfered by the presence of scattered large osmiophilic extracellular lipid vacuob. Besides strengthening the association between EIP and PAP and their relationship to gastroesophageal refux, this case suggests that t h q may arise together with exogenous lipoid pneumonia, through related mechanisms, in the setting of neurodevelopmental disease.     

Genotypic analysis of sequential genital herpes simplex virus type 1 (HSV-1) isolates of patients with recurrent HSV-1 associated genital herpes

Clinical recurrences of Herpes simplex virus type 1 (HSV-1)-associated genital herpes are thought to be caused by reactivation of latent endogenous HSV-1. However, the possibility of reinfection with exogenous HSV-1 cannot be excluded. This study aimed to determine the incidence of genital HSV-1 superinfection in patients by investigating the genotype of sequential HSV-1 isolates obtained from the same anatomical site of patients with clinical recurrences of genital HSV-1 recurrent genital herpes. Sequential genital HSV-1 isolates were genotyped by PCR amplification of the hypervariable regions located within the HSV-1 genes US1 and US12. Whereas the sequential HSV-1 isolates in 11 of the 13 patients studied had the same genotypes, the sequential isolates of 2 patients showed a different genotype. The data suggest that HSV-1-induced recurrent genital herpes can be associated with genital reinfection with an exogenous HSV-1 strain.     

皮肤涂抹雌三醇对裸鼠甲状腺功能和肿瘤影响的效果观察

目的研究经皮涂抹外源性雌三醇(E₃)对裸鼠甲状腺功能及甲状腺移植瘤的影响。方法使用123只4周龄裸鼠,按体质量采用随机数字表法分为9组:①对照组、②低E₃组、③高E₃组、④乳头状甲状腺癌组(PTC组)、⑤乳头状甲状腺癌+高E₃组(PTC+高E₃组)、⑥滤泡状甲状腺癌组(FTC组)、⑦滤泡状甲状腺癌+高E₃组(FTC+高E₃组)、⑧未分化型甲状腺癌组(ATC组)和⑨未分化型甲状腺癌+高E₃组(ATC+高E₃组),均正常饮食饮水。除对照组、PTC组、FTC组和ATC组外,其余5组每日给予皮肤涂抹雌三醇乳膏,低E₃浓度为市售化妆品人均每日使用量中雌三醇含量的25倍、高剂量为100倍。40天后,收集各组裸鼠的24h尿样;尿碘采用砷铈催化分光光度法测定,尿E₃、血清E₃、血清甲状腺激素[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)]和甲状腺抗体[甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TpoAb)],采用酶联免疫吸附实验[ELISA]测定。在接种肿瘤后的第4日起,每3 d测量肿瘤大小。结果①各组裸鼠血清E₃和尿E₃水平比较差异有统计学意义;其中FTC+高E₃组和ATC+高E₃组的血清E(310.22、14.18 pmol/L)和尿E(36.40、8.18 pmol/L)水平均分别显著低于FTC组和ATC组的血清E(326.52、22.80 pmol/L)和尿E(38.91、11.49 pmol/L)水平;而PTC+高E₃组仅血清E₃水平(12.17 pmol/L)显著低于PTC组(23.05 pmol/L);高E₃组的尿E₃水平显著低于低E₃组(6.92、8.94 pmol/L);低E₃组的尿E₃水平显著高于对照组(8.94、7.17 pmol/L),PTC组、FTC组和ATC组的血清E₃水平显著高于对照组和高E₃组(23.05、26.52、22.80比13.23、14.46 pmol/L)。②各组血清FT3水平比较差异没有统计学意义。各组血清FT4和TSH水平与对照组比较,差异均有统计学意义,其中各实验组的FT4水平均显著低于对照组,TSH水平均显著高于对照组,但PTC组与PTC组+高E₃组、FTC组与FTC+高E₃组、ATC组与ATC+高E₃组分别进行两两比较,FT4和TSH水平并差异无统计学意义。③各组裸鼠血清TgAb和TpoAb水平比较差异均有统计学意义。其中低E₃组、高E₃组、PTC+高E₃组、FTC组、ATC组和ATC+高E₃组的TgAb水平均显著高于对照组;各实验组的TpoAb水平均显著高于对照组。④各组裸鼠尿碘水平比较差异没有统计学意义。⑤各组裸鼠肿瘤体积大小比较差异均有统计学意义,PTC+高E₃组与PTC组比较,在接种肿瘤后的第7 d、16 d、25 d、28 d和37 d,肿瘤体积发生显著性差异(71.54、226.05、730.26、893.34、1242.12比49.87、325.50、551.28、664.38、967.78 mm³);FTC+高E₃组与FTC组比较,在接种肿瘤后的第25 d、28 d、37 d和40 d,肿瘤体积发生显著性差异(392.60、475.70、794.68、943.51比214.82、238.32、422.19、490.00 mm³);ATC+高E₃组与ATC组比较,在接种肿瘤后的第37 d和40 d,肿瘤体积发生显著性差异(217.53、432.10比577.19、1146.66 mm³)。结论外源性雌三醇能够诱导裸鼠发生甲状腺功能减退和抗体水平增高,同时对乳头状甲状腺癌和滤泡状甲状腺癌的生长有着促进作用,对未分化甲状腺癌的生长有抑制作用。     

Comparison of Ketogenic Diets with and without Ketone Salts versus a Low-Fat Diet: Liver Fat Responses in Overweight Adults

Ketogenic diets (KDs) often contain high levels of saturated fat, which may increase liver fat, but the lower carbohydrate intake may have the opposite effect. Using a controlled feeding design, we compared liver fat responses to a hypocaloric KD with a placebo (PL) versus an energy-matched low-fat diet (LFD) in overweight adults. We also examined the added effect of a ketone supplement (KS). Overweight adults were randomized to a 6-week KD (KD + PL) or a KD with KS (KD + KS); an LFD group was recruited separately. All diets were estimated to provide 75% of energy expenditure. Weight loss was similar between groups (p > 0.05). Liver fat assessed by magnetic resonance imaging decreased after 6 week (p = 0.004) with no group differences (p > 0.05). A subset with nonalcoholic fatty liver disease (NAFLD) (liver fat > 5%, n = 12) showed a greater reduction in liver fat, but no group differences. In KD participants with NAFLD, 92% of the variability in change in liver fat was explained by baseline liver fat (p < 0.001). A short-term hypocaloric KD high in saturated fat does not adversely impact liver health and is not impacted by exogenous ketones. Hypocaloric low-fat and KDs can both be used in the short-term to significantly reduce liver fat in individuals with NAFLD.     

《伤寒论》对多脏器功能障碍综合征治疗的启示

《伤寒论》以六经为纲,以证候为目,不仅叙述了外感伤寒热病的六经传变发病过程,也充分揭示了机体多系统疾病的发生、发展与结局的内在机制。认为伤寒热病的急性发病规律与六经中不同的传变机制,和现代医学多脏器功能障碍综合征(MODS)相似。其中的急下证、蓄血证、蓄血发黄证等,均与MODS不同的器官损伤密切相关。深入研究《伤寒论》辨治规律与MODS的相关性,对于拓宽MODS的临床治疗途径,具有重要意义。     

Attentional capture in schizophrenia: Failure to resist interference from motion signals

Cognitive neuropsychiatry occupies the comparatively neglected research region that lies between neurology, psychiatry, and cognitive psychology. Reasons for this neglect are discussed, together with arguments as to why it may be timely to focus on this intellectual no man's land.