兵（学员）预防接种20 μg重组乙型肝炎疫苗（酿酒酵母）的免疫效果分析

目的:分析评价军队某部乙型肝炎表面抗体(Antibody to hepatitis B virus surface antigen,抗-HBs)阴性/ 弱阳性的新入伍人员,接种剂型为20 g/ ml 的酿酒酵母重组乙型肝炎疫苗(Recombinant hepatitis B vaccine derived Saccharomyces Cerevisiae Yest,HepB-SCY)后的免疫效果。方法:利用酶联免疫吸附法(Enzyme-linked immunosorbent assay,ELISA)和放射免疫法(Radioimmunoassay,RIA),筛选抗-HBs 为阴性的3 251 名和弱阳性的1 090 名新兵(学员)为实验观察对象,按照0、1 和6的接种程序,接种20 g/ ml 剂型的HepB-SCY,分别在每针接种后第28 天采血,用化学粒子发光免疫分析法(Chemilumines-cence immunoassay,CLIA)检测血清抗体的几何平均浓度(Geometric mean titer,GMT)。结果:观察对象全程免疫后,在弱阳性新兵(学员)中,第1、2 和3 针接种后阳转率分别为90.24%、97.82%和99.52%,第2 针免疫后的阳转率明显优于1 针免疫后阳转率(字2 =25.65,P<0.01),而第2 与3 针免疫后的阳转率之间无统计学差异(字2 =4.66,P>0.01);第1 和第2 针免疫后乙肝表面抗体的GMT 值分别为1 575.92 mU/ ml(374.94 ~4 606.45)和2 144.592 mU/ ml(757.078 ~6 089.4),二者的GMT 水平存在统计学差异(Z =-2.372,P<0.01)。在阴性人群中,第2 和第3 针接种后阳转率分别为86.13% 和98.72%,其中,高应答反应阳转率分别为56.43%和87.53%,第3 针免疫后的阳转率明显优于第2 针(字2 =118.5,P<0.05),第3 针免疫后的高应答反应率也明显高于第2 针(字2 = 231.07,P<0.05);第1、2 和3 针免疫后的GMT 值分别为101.352 mU/ ml(2.11 ~ 409.23)、155.812 mU/ ml(26.76 ~840.78)和747.312 mU/ ml(228.60 ~ 1893.6),第2 和3 针的GMT 水平之间差异存在统计学意义(Z =-23.042,P<0.01),第1 和2 针的GMT 水平之间差异也存在统计学意义(Z =-3.099,P<0.01)。结论:接种20 g/ ml 剂型的HepB-SCY 可激发机体产生较高水平的抗-HBs,并可有效提高群体的阳转率和高应答反应率。     

A novel stopped-flow method for measuring the affinity of actin for myosin head fragments using μg quantities of protein

Summary The dissociation constant for actin binding to myosin and its subfragments (S1 & HMM) is 1 m at physiological ionic strength. Many of the methods used to measure such affinities are unreliable for a K_d below 0.1 m. We show here that the use of phalloidin to stablise F-actin and fluorescently labelled proteins allows the affinity of actin for myosin S1 to be measured in a simple transient kinetic assay. The method can be used for K_d's as low as 10 nm and we demonstrate that the K_d's can be estimated using only g quantities of material. Furthermore we suggest how this method may be adapted for ng quantities of protein. This will allow the affinity of actin for myosin fragments to be estimated for proteins which are difficult to obtain in large quantities i.e. from biopsy material or from proteins expressed in baculovirus.     

Cefpodoxime 10 μg disc screening test for detection of Neisseria gonorrhoeae with mosaic PBP2 and decreased susceptibility to extended-spectrum cephalosporins for public health purposes

Antimicrobial resistance (AMR) in Neisseria gonorrhoeae remains a global public health problem. Susceptibility to first-line treatment extended-spectrum cephalosporins (ESCs) is decreasing worldwide resulting in therapeutic failures with oral ESCs. This study describes a cefpodoxime 10 μg disc test for screening for gonococci containing a penA mosaic allele encoding a mosaic penicillin-binding protein 2 (PBP2) and decreased ESC susceptibility. Selected clinical gonococcal isolates (n = 315), containing a high proportion of gonococci with decreased ESC susceptibility and high geographical, temporal and genetic diversity, were examined using agar dilution (n = 149; cefpodoxime and ceftriaxone) and Etest (n = 315; cefixime), and disc diffusion using a commercially available cefpodoxime 10 μg disc (n = 315). penA sequencing was performed on all isolates. The 2008 WHO gonococcal reference strains (n = 8) were included as quality controls. Using a ≤11 mm annular radius of growth inhibition as the breakpoint for the cefpodoxime 10 μg disc, all 78, with exception of one isolate (13 mm), mosaic PBP2-containing isolates, which also displayed decreased susceptibility to oral ESCs, were identified. In addition, 85 non-mosaic PBP2-containing isolates (44% of which contained a PBP2 A501 alteration) had annular radii ≤11 mm and raised minimal inhibitory concentrations to the ESCs. Screening for detection of mosaic PBP2-containing gonococci and decreased ESC susceptibility, most pronounced to oral ESCs, using a commercially available cefpodoxime 10 μg disc was rapid, inexpensive and sensitive. This test can be used in AMR surveillance programmes for public health purposes especially in less-resourced settings. Further studies to refine this disc testing-based approach are in progress.     

7500g巨大胎儿足月自然分娩1例

病例　患者 30岁 ,主因孕 5产 140 3 周破水半小时入院。查体 :体温 36℃ ,脉搏 80次 /分 ,血压 18/ 13ｋＰａ ,身高16 3ｃｍ ,体重 10 2ｋｇ ,宫底高 40ｃｍ ,腹围 12 0ｃｍ ,无宫缩 ,胎心140次 /分 ,血糖 8 19ｍｍｏｌ/Ｌ。Ｂ超示 :耻上胎头 ,双顶径9 4ｃｍ ,胎心活跃规律。羊水清晰 ,最大厚度 6 3ｃｍ ,前壁胎盘 ,Ⅱ级。提示 :宫内单活胎 ,头位 ,晚孕。入院诊断 :孕 5产140 3 周 ,ＬＯＡ ,胎膜早破 ,巨大胎儿 (估计体重小于 5 0 0 0 ｇ)。因患者曾顺产一 430 0 ｇ女婴 ,故本次入院后 ,静点催产素待其自然分娩。产程中 ,孕妇经会阴侧切…     

1109例孕妇50g葡萄糖负荷试验结果分析

目的通过50g葡萄糖负荷试验（GCT）对孕妇进行糖尿病筛查，了解妊娠期糖尿病（GDM）的发病情况，探讨其高危因素及合适的筛查时机。方法采用回顾性研究的方法，对2000年9月～2004年1月在江西省妇幼保健院产科门诊行GCT的1109例孕妇的临床资料进行分析。结果诊断为GDM者97例，发生率为：8、74％。筛查孕妇按年龄分成〈25岁、25～29岁、30～34岁、≥35岁4个年龄段，不同年龄段的平均空腹血糖、平均1h血糖、GCT异常率、GDM阳性率有显著差异，随着年龄的增加其阳性率升高。根据孕前体质指数（BIM）不同将孕妇分成〈25及≥25共2组，2组间平均空腹血糖、GCT异常率、GDM阳性率有显著差异，肥胖组阳性率高。按不同的筛查孕周分成6组，各组间空腹血糖、1h血糖、GCT异常率及GDM阳性率均无显著差异。结论GDM是一种常见的妊娠期并发症，有较高的发病率，年龄大、孕前肥胖是其独立的高危因素，妊娠各个时期的筛查阳性率相同，均可做GCT，但是妊娠早、中期筛查更利于早期诊断和治疗，妊娠晚期可再做补充或复查。     

Rearrangement and expression of the immunoglobulin μ-chain gene in human myeloid cells

Immunoglobulin （Ig）, a characteristic marker of B cells, has been reported to be expressed in epithelial cells, with a suggested role in their growth and survival. We have previously reported that IgG heavy chain is expressed in acute myeloid leukemia （AML）, but not in the monocytes or neutrophils from patients with non-hematopoietic neoplasms or healthy controls. In the present study, we assessed IgM heavy chain expression and repertoire in human myeloid cells. We detected VHIzDJHp- rearrangement and expression in 7/7 AML cell lines, 7/14 primary myeloblasts from AML patients, and interestingly, 8/20 monocytes and 3/20 neutrophils from patients with non-hematopoietic neoplasms and healthy individuals. We also found evidence of somatic hypermutation of the variable （V） gene segments in AML-derived IgM gene rearrangements but not in IgM from monocytes or neutrophils from patients with non-hematopoietic neoplasms and healthy individuals. Furthermore, IgM VH~DJH~ gene rearrangements in AML cell lines, primary myeloblasts, and monocytes and neutrophils from patients with non-hematopoietic neoplasms showed a restricted V usage and repertoire, whereas the VH~DJH~ gene rearrangements in monocytes and neutrophils from healthy individuals displayed more diversity. Anti-human IgM inhibited cell proliferation, but did not induce apoptosis in AML cell lines. Our findings suggest that AML-derived IgM might be a novel AML-related molecule that is involved in leukemogenesis and AML progression and might serve as a useful molecular marker for designing targeted therapy and monitoring minimal residual disease.     

Spinal motor actions of the μ-opioid receptor agonist DAMGO in the cat

For further evaluation of opioidergic spinal motor functions the action of the μ-opioid receptor agonist DAMGO was tested on transmission in different non-nociceptive and nociceptive spinal reflex pathways from flexor reflex afferents (FRA), and in non-FRA reflex pathways in spinal cats. The action of DAMGO was complex, not following a simple pattern with selective depression of nociceptive pathways compared to non-nociceptive ones. Monosynaptic reflexes of the flexor posterior biceps semitendinosus (PBSt) and transmission in nociceptive as well as non-nociceptive excitatory FRA pathways to PBSt were depressed, while the specific excitatory nociceptive non-FRA pathway from the central foot pad to foot extensors was mainly not depressed but rather facilitated by DAMGO. DAMGO caused a facilitation of monosynaptic reflexes to the extensor gastrocnemius soleus (GS) and partly a reversal of inhibitory to excitatory conditioning effects from cutaneous afferents to GS. FRA interneurones could show either an increase or a cessation of their spontaneous activity, but responsiveness to nociceptive and non-nociceptive afferent activation was blocked by DAMGO. The main DAMGO action is generated via interneuronal systems rather than on motoneurones themselves. The results indicate that opioidergic spinal functions are extensively involved in spinal motor control exceeding a mere suppression of nociceptive motor withdrawal reactions.     

802．11g无线局域网在PACS系统中的应用

目的测试PACS医学图像在802．11g无线局城网的实际传输情况，探讨无线局域周在建设医院PACS系统中的应用前景和存在的主要问题。方法使用NetIQ Chariot软件测试医生工作站和服务器之间的传输速率；结果利用医生工作站PACS客户稿软件从PACS服务器下载医学图像数据，测量下载时间。结论采用802．11g无线局域网和千兆以太网相结合的网络系统在传输速度、稳定性和安全性方面能满足医院PACS系统的需求。     

HIS系统数据库Oracle7.3到Oracle10g的升级

HIS系统在我院使用8年，运行相对稳定，只是随着实际情况的变化需要升级到更高的数据库提高效率，经过模拟试验和认真的查找有关文献我们制定了周密的计划和升级方案，最终升级结果良好。     

rBla g 2变应原的PEG修饰与免疫学特性分析

目的 研究化学修饰剂聚乙二醇(PEG)对德国小蠊(蟑螂)重组变应原rBla g 2变应原性的影响.方法 rBla g2在大肠肝菌中表达后,采用Ni+亲和层析纯化,然后甲氧基聚乙二醇2-N-羟基琥珀酰亚胺酯(mPEG2-NHS,Mr为10×103)修饰,经阳离子交换层析纯化,用SDS-PAGE、免疫印迹及ELISA分析其生物学特性.结果 rBla g 2纯化后的相对分子质量(Mr)约39×103;sDs-PAGE分析PEG-rBla g 2修饰产物,考马斯亮蓝染色可呈现5条带,而I2-KI染色则呈现7条带.对修饰产物的纯化表明阳离子交换层析可分离rBla g 2和PEG-rBla g 2;对修饰产物的免疫印迹分析显示Mr为100×103和130×103的修饰带可与蟑螂过敏患者血清特异性IgE结合,同时ELISA分析结果表明PEG-rBla g2复合物的体外免疫学反应性显著下降,仅为原来的42%.结论 PEG修饰可保持rB-la g 2与特异性抗体结合能力,却大大降低变应原的体外免疫学反应性,为重组低致敏原的研究提供了基础资料.     

乌鲁木齐市不同民族孕妇50g葡萄糖筛查结果比较分析

目的通过维吾尔族(以下简称维族)、汉族孕妇50g葡萄糖筛查试验(GCT)结果比较,探讨不同民族孕妇间用同一50g葡萄糖筛查标准是否适宜。方法选择2008年3月至2009年6月在我院行产前检查并接受50g葡萄糖筛查的妊娠中、晚期孕妇1865例,其中汉族1543例,维吾尔族322例,对筛查结果进行不同民族的不同年龄组、不同孕周组、不同体重指数(BM I)组的比较。结果与结论①汉族孕妇50g葡萄糖筛选异常率达35.4%,维族孕妇50g葡萄糖筛选异常率达31.4%。②总体上,汉族孕妇与维族孕妇50g葡萄糖筛查血糖异常率差异不显著。③不同年龄组以及不同孕周数组50g葡萄糖筛查试验结果民族间差异不显著。④不同体重指数组,当体重指数(BM I)大于25时50g葡萄糖筛查结果民族间差异显著。     

Opioid μ-receptors in the rostral medullary raphe modulate hypoxia-induced hyperpnea in unanesthetized rats

Aim: It has been suggested that the medullary raphe (MR) plays a key role in the physiological responses to hypoxia. As opioid μ‐receptors have been found in the MR, we studied the putative role of opioid μ‐receptors in the rostral MR (rMR) region on ventilation in normal and 7% hypoxic conditions. Methods: We measured pulmonary ventilation () and the body temperatures (Tb) of male Wistar rats before and after the selective opioid μ‐receptor antagonist CTAP (d ‐Phe‐Cys‐Tyr‐d ‐Trp‐Arg‐Thr‐Pen‐Thr‐NH2, cyclic, 0.1 μg per 0.1 μL) was microinjected into the rMR during normoxia or after 60 min of hypoxia. Results: The animals treated with intra‐rMR CTAP exhibited an attenuation of the ventilatory response to hypoxia (430 ± 86 mL kg^?1 min^?1) compared with the control group (790 ± 82 mL kg^?1 min^?1) (P < 0.05). No differences in the Tb were observed between groups during hypoxia. Conclusion: These data suggest that opioids acting on μ‐receptors in the rMR exert an excitatory modulation of hyperventilation induced by hypoxia.