卵巢癌抗抗独特型单克隆抗体3D12的制备及初步研究

目的:制备卵巢癌抗抗独特型单克隆抗体并进行初步鉴定,为深入研究卵巢癌疫苗的主动免疫机制奠定基础.方法:以卵巢癌抗独特型单克隆抗体6B11作为免疫原,采用杂交瘤技术制备抗抗独特型单克隆抗体3D12.经酶联免疫吸附实验(ELISA)、免疫组织化学、流式细胞学、免疫印迹杂交等检测其特异性结合抗原的性质;竞争抑制实验鉴定其特异性结合的抗原表位.结果:获得1株稳定分泌3D12的杂交瘤细胞,所分泌的3D12能够特异性结合6B11及卵巢癌初始抗原OC166-9,并能竞争抑制COC166-9(抗OC166-9的单克隆抗体Ab1)与OC166-9的结合.免疫印迹杂交显示,3D12与COC166-9免疫沉淀的蛋白的相对分子质量相同.该抗体为IgM,亲和力约为8.34×10⁷ L/mol.结论:卵巢癌抗抗独特型单克隆抗体3D12属Ab1样Ab3,间接证实6B11为抗原内影像型抗独特型抗体.     

卵巢癌6B11抗独特型微抗体诱导抗肿瘤免疫应答的体外实验

目的:研究6B11抗独特型微抗体在体外抗肿瘤免疫情况,探讨其作为卵巢癌疫苗的可能性.方法:分离人外周血单个核细胞,用6B11抗独特型微抗体刺激并培养.采用3HTdR参入法、51Cr细胞毒实验分别观察淋巴细胞增殖情况和细胞毒作用,ELISA方法测定用6B11微抗体刺激后培养上清液中IFN-γ水平的变化,流式细胞术检测微抗体刺激后淋巴细胞表型的改变.结果:6B11抗独特型微抗体可以刺激人外周血淋巴细胞的增殖,最佳刺激剂量为20 mg/L;并对OC166-9表达阳性的卵巢癌细胞系有细胞毒作用;用6B11微抗体刺激后培养上清液中IFN-γ水平升高;淋巴细胞的表型表现为,疫苗刺激后CD3 的细胞明显增高, CD4 的细胞也增加, CD8 的细胞增加不明显.CD4 /CD8 的比率明显增高,差异有统计学意义.结论:6B11抗独特型微抗体在体外可诱导机体产生特异体液免疫和细胞免疫反应,为抗独特型微抗体疫苗的临床应用提供了一定的实验依据.     

卵巢癌抗独特型微抗体主动免疫治疗卵巢癌动物实验

目的用模拟人卵巢癌抗原并有满意免疫原性的抗独特型微抗体进行临床前动物实验研究.方法将已构建的抗独特型微抗体融合基因在大肠杆菌进行表达,用Western blot、竞争抑制ELISA进行微抗体活性测定.20只人淋巴细胞免疫功能重建的荷卵巢癌腹腔瘤SCID小鼠分2组,10只用微抗体免疫后取血采用间接ELISA检测Ab3.观察小鼠腹腔积液生成时间、生存期,取脾做流式细胞分析CD4+、CD8+.结果在宿主大肠杆菌BL21(DE3)成功诱导表达出微抗体,Western blot结果表明微抗体可同时与COC166-9(6B11的一抗)及羊抗人的IgG1反应.竞争抑制ELISA表明微抗体可模拟原始抗原与一抗结合.微抗体免疫小鼠后可诱导产生Ab3,在末次免疫14 d时最高,持续6周降至对照组水平;CD4+/CD8+在末次免疫13 d达最高值.对照组和微抗体治疗组小鼠分别在(37.7±5.5)d和(48.6±14.3)d长出血性腹腔积液(P=0.04);两组小鼠生存期分别为(42.5±1.8)d和(59.4±16.8)d(P=0.011).结论微抗体保留了6B11scFv和人IgG的双重免疫学活性,达到了部分人源化的目的,并有满意的免疫原性,可诱导小鼠产生特异性体液免疫反应,抑制荷瘤小鼠腹腔积液的生成,延长生存期,或许将来可作为卵巢癌疫苗用于临床.     

间日疟原虫抗独特型抗体的制备和鉴定

利用低渗透析-Sephadex G200层析制备电泳纯、并具免疫活性的IgM型抗Pv红内期McAb(6H_6G_(11))免疫家兔,获得抗-6H_7G_(11)独特型抗体(Anti-6H_7G_(11)Id)。经免疫双扩散、ELISA以及竞争性免疫实验和动物实验表明,该Anti-6H_7G_(11) Id具有针对相应独特型决定簇的特异性,为半抗原抑制性Ab_2,并能模拟Pv抗原的作用,为交叉反应独特型。     

移植前诱导抗独特型抗体对小鼠皮肤排斥反应的抑制作用

目的　探讨抗独特型抗体诱导对异品系小鼠皮肤移植排斥反应的影响.方法　以C57BL/6小鼠脾细胞免疫BALB/c小鼠制备抗同种异品系抗体(Ab1).将Ab1与KLH交联后,免疫BALB/c小鼠诱导产生抗独特型多克隆抗体(Ab2),并以之为受体,观察Ab2对小鼠皮肤移植排斥反应的影响.结果　Ab1交联KLH加弗氏佐剂免疫可有效地诱导抗独特型抗体(Ab2)产生.与对照组相比较,Ab2诱导组小鼠移植物存活时间明显延长.结论　移植前在受体体内诱导产生以移植物抗原为模拟抗原的抗独特型抗体,可对移植排斥反应产生有效的抑制作用移植前诱导抗独特型抗体对小鼠皮肤排斥…     

卵巢癌抗独特型单链抗体诱导特异性体液免疫应答的动物实验研究

目的：用卵巢癌抗独特型单链抗体６Ｂ１１ｓｃＦｖ代替肿瘤抗原免疫动物，观察是否诱导动物产生特异性体液免疫反应。方法：将６Ｂ１１ｓｃＦｖ交联钥孔虫戚虫血蓝素，辅以弗氏佐剂反复免疫ＢＡＬＢ／ｃ小鼠，制备抗血清。采用间接法ＥＬＩＳＡ，竞争抑制ＥＬＩＳＡ及免疫流式细胞法分析抗血清特性。结果：经ＥＬＩＳＡ检测显示，由６Ｂ１１ｓｃＦｖ刺激产生的抗抗独特型单链抗体（Ａｂ３）能与６Ｂ１１ｓｃＦｖ和卵巢癌组织抗原ＯＣ１６６９特异性结合。竞争抑制ＥＬＩＳＡ表明，Ａｂ３能有效抑制卵巢癌单抗ＣＯＣ１６６９（Ａｂ１）与ＯＣ１６６９的特异性结合。免疫流式分析结果可见，Ａｂ３能与表达卵巢癌抗原的人卵巢癌细胞系ＯＶ１细胞表面结合而不能与无卵巢癌抗原表达的人宫颈癌细胞系ＨｅＬａ细胞表面结合。从以上结果可以证明Ａｂ３与Ａｂ１的抗原结合特性相同。结论：６Ｂ１１ｓｃＦｖ能代替卵巢癌抗原诱导动物产生特异性体液免疫反应，具有模拟抗原的作用，为６Ｂ１１ｓｃＦｖ作为卵巢癌抗独特型单链抗体疫苗的实际应用提供依据     

人源日本血吸虫Fab抗体库的构建及抗独特型抗体的筛选、鉴定

目的:构建人源日本血吸虫Fab抗体库,筛选出日本血吸虫抗独特型抗体并进行初步鉴定。方法:以3名晚期血吸虫患者切除的脾脏为源,构建人源日本血吸虫Fab抗体库。并以日本血吸虫可溶性虫卵抗原(SEA)及成虫抗原(SWAP)免疫鼠血清IgG包板进行筛选,经ELISA鉴定后,对阳性克隆进行可溶性表达。结果:构建了人源日本血吸虫Fab抗体库,库容为4.3×106,经核苷酸序列分析,证实插入片段为Fab基因片断。经过5轮筛选后,从富集的次级抗体库中随机挑取60个克隆,用ELISA法鉴定得到4个可与免疫鼠血清(Ab1)特异性结合,而不与SEA及SWAP结合的单克隆抗体(A3、B6、C4、C17),其中B6经SDS-PAGE电泳显示插入片断正确。结论:成功构建了人源日本血吸虫Fab抗体库,并从中获得人源日本血吸虫抗独特型抗体B6,为研制用于人体血吸虫病免疫预防的抗独特型抗体疫苗奠定了基础。     

Humoral immune responses induced by anti-idiotypic ntibody fusion protein of 6B11scFv/hGM-CSF in BALB/c mice

Background We have previously developed and characterized a monoclonal anti-idiotype antibody, designated 6B11, which mimics an ovarian carcinoma associated antigen OC166-9 and whose corresponding monoclonal antibody is COC166-9 (Ab1). In this study, we evaluate the humoral immune responses induced by the fusion protein 6B11 single-chain variable fragment ( scFv)/ human granulocyte macrophage colony-stimulating factor (hGM-CSF ) and 6B11scFv in BALB/c mice. Methods The fusion protein 6B11scFv/hGM-CSF was constructed by fusing a recombinant single-chain variable fragment of 6B11scFv to GM-CSF. BALB/c mice were administrated by 6B11scFv/hGM-CSF and 6B11scFv, respectively. Results The fusion protein 6B11scFv/hGM-CSF retained binding to the anti-mouse F(ab) 2 ’ and was also biologically active as measured by proliferation of human GM-CSF dependent cell TF1 in vitro . After immunization with the 6B11scFv/hGM-CSF and 6B11ScFv, BALB/c mice showed significantly enhanced Ab3 antibody responses to 6B11scFv/hGM-CSF compared with the 6B11scFv alone. The level of Ab3 was the highest after the first week and maintained for five weeks after the last immunization. Another booster was given when the Ab3 titer descended, and it would reach to the high level in a week. Conclusion The fusion protein 6B11scFv/hGM-CSF can induce humoral immunity against ovarian carcinoma in vivo . We also provide the theoretical foundation for the application of the fusion protein 6B11scFv/hGM-CSF for active immunotherapy of ovarian cancer. Chin Med J 2006; 119(2): 131-139     

抗独特型抗体的简易制备方法及其对双克隆骨髓瘤蛋白的检测

各种骨髓瘤患者的M蛋白均有个体基因型(Idiotype)抗原决定簇,可产生抗独特型抗体(Anti-idjotype antibody)。一个病人的体内可产生两种以上的M蛋白,且常有相同的独特型。有人报道用吸收过的抗Id抗体检测IgA骨髓瘤独特型B淋巴细胞。但他们是按照Abdou法。采用患者血清制备抗体操作烦琐复杂。我们首次利用两例双克隆骨髓瘤患者的肾脏受损而排出非选择性蛋白尿的特点,从尿巾收集骨髓瘤蛋白,免疫家兔制备抗独特型抗休成功,报道如下。     

卵巢肿瘤患者血清CP2及抗独特型mAb 6B11Ab2的检测意义

目的　探讨应用卵巢癌抗原 CP2 及卵巢癌抗独特型单克隆抗体 6 B1 1 Ab2 进行血清中相关抗体检测的可行性及临床应用价值 .方法　应用 EL ISA法对 95例恶性卵巢肿瘤、40例良性卵巢肿瘤及 9例子宫内膜异位症患者血清进行卵巢癌相关抗原及抗体的检测 ,并以 5 0例正常女性为对照 .结果　非粘液性卵巢上皮癌抗原阳性率为 10 0 % ,抗体阳性率为 6 6 .7% ,高于粘液性卵巢上皮癌、非上皮性卵巢恶性肿瘤及生殖系统其他恶性肿瘤 ,并且明显高于卵巢良性肿瘤 (P<0 .0 1) .结论　卵巢癌相关抗原及抗体的检测对临床诊断及辅助鉴别诊断有一定实用价值     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.