我国医学原虫研究的现状与展望

医学原虫所引起的原虫病,仍为目前严重威胁人类健康的疾病。世界卫生组织重点防治的六大热带病,其中三种为原虫病(疟疾、利什曼病和锥虫病)。近年来又不断有新的原虫病发现。因此医学原虫的研究,仍为长期而又艰巨的任务。下面简要介绍近年来国内有关医学原虫生物学特性和免疫学诊断的研究。(一)医学原虫生物学特性的研究1.疟原虫我国疟疾发病率近年来虽有下降,但某些局部仍有回升和暴发性流行。为了防治疟疾,国内外开展了疟原虫各个时期的体外培养,并在培养的基础     

红内期疟疾疫苗的研究进展

目前发展疟疾疫苗仍然是防治和消灭疟疾感染的重要手段,红内期是疟原虫致病并引起临床症状的主要时期,发展有效的红内期疫苗不仅能减轻临床症状,还可降低血中配子体数量从而起到阻断传播作用.本文就目前红内期亚单位疫苗候选抗原及全虫疫苗的研究现状作一综述.     

一氧化氮对红内期约氏疟原虫感染的影响

目的：探讨的氏疟原虫感染早期一氧化氮（nitric oxide,NO)对红内期疟原虫的影响。方法：通过ELISA和Griess反应,观察疟原虫感染早期宿主体内细胞因子和NO对红内期虫体血症的影响及其效应。结果：疟原虫感染早期随着以IFN-γ分泌增加为主的Th1细胞免疫应答产生的过程,NO合成逐渐增加,红内期原虫血症受到抑制,一旦解除高水平NO的作用,虫体的增殖能力即可迅速得以恢复。结论：NO通过抑制裂殖子的侵袭力发挥抗红内期原虫感染的保护性免疫效应。     

疟疾疫苗进入临床试验

日前 ,我国自主研制的“重组疟疾疫苗”已获得国家药品监督管理局及世界卫生组织的批准 ,进入临床试验。这是我国第一个自主研制、进入临床试验的疟疾疫苗。该疫苗由第二军医大学基础部潘卫庆教授课题组和上海万兴生物制药有限公司共同合作开发 ,世界卫生组织作为申办方 ,将按国际 GCP标准主持该疫苗的临床试验。据潘卫庆教授介绍 ,疟疾目前仍然是严重威胁人类健康的疾病之一 ,现在全球每年有 3亿～ 5亿人患疟疾 ,其中约 30 0万人死亡。由于疟原虫抗药性的产生 ,研究有效的疫苗预防疟疾已受到全球的广泛关注。疟疾疫苗与艾滋病、结核疫苗…     

疟疾疫苗抗原研究进展

疟疾疫苗抗原研究进展人体寄生虫学教研室王星，徐大为关键词疟疾，疫苗抗原，抗原结构，基因结构疟疾目前仍是严重威胁热带地区和第三世界国家的寄生虫病，近年来因疟原虫抗药性和蚊媒耐药物的产生与蔓延，促使科学家们重新考虑研制安全有效的疫苗来控制乃至彻底消灭疟疾...     

疟疾的病原诊断

周围血涂片染色镜检疟原虫仍是当前确诊疟疾最可靠的方法。其中厚血膜用以检出疟原虫,薄血膜用于虫种的鉴定。目前常用的染剂为吉氏和瑞氏染剂。但由于若干因素的影响,可导致原虫的漏检,特别是对于低原虫血症,所以病原诊断一直是疟疾防治工作中实际存在和亟需加以研究的问题。本文谨就疟疾病原诊断的应用方面综述如下。常用血检方法申影响疟原虫检出的若干因素一、周围血液中疟原虫的密度一般认为,每立方毫米血液     

疟原虫复合多价疫苗研究进展

疟疾是流行于热带地区最严重的寄生虫病。据ＷＴＯ最新统计，疟疾分布于世界约１００个国家和地区，年发病人数３－５亿，死亡人数１５０－２７０万。大多数患者分布于非洲、亚洲、中美以及南美，我国也是疟疾流行区之一。近年来疟原虫、蚊虫耐药现象日益严重，这就更迫切需要尽快开展研制高效的抗疟疫苗[１］．由于疟原虫生活史复杂、抗原成份多、抗原变异等原因，单价疫苗免疫效果不理想。复合多价疫苗的问世是疟疾疫苗研制的一条新途径。多价疫苗包含子孢子、裂殖子、配子的有效保护性抗原表位（包括Ｔ细胞和Ｂ细胞表位），较单价疫苗更…     

疟疾红内期免疫调节机制

目的介绍疟原虫在宿主红细胞内的免疫调节机制其研究进展。方法查阅、归纳近几年来有关疟疾红内期免疫调节机制的部分文献、资料。结果疟原虫通过免疫逃避,诱导宿主免疫细胞凋亡及对免疫细胞的调节等手段得以在宿主体内存活。结论疟原虫对免疫系统调节机制的阐明将有利于疟疾疫苗及抗疟药的研究。     

载体介导的鼠疟原虫疫苗的研制现状

伯氏疟原虫、约氏疟原虫和夏氏疟原虫是3种常见的鼠疟原虫,在疟疾疫苗研究中具有重要地位。环子孢子蛋白(CSP)、裂殖子表面蛋白-1(MSP-1)和顶端膜抗原1(AMA1)等抗原是几种有效的鼠疟原虫疫苗候选分子,本文综述了鼠伤寒沙门氏菌、卡介苗、乳酸乳球菌、根癌农杆菌、酵母菌、腺病毒、杆状病毒、牛痘病毒、A型流感病毒、猪细小病毒、刚地弓形虫和豚鼠利什曼原虫等载体介导的鼠疟原虫CSP、MSP-1和AMA1疫苗的研制现状。     

基于基因组学和蛋白质组学的疟疾疫苗

疫苗学研究受益于新的生物信息学技术。疟原虫的完整基因组序列已经被破译,因此当前的疫苗研究可以指向传统疫苗研究未能发现的特异基因产物。疫苗发展的先进技术,诸如基因组序列分析、微阵列、蛋白质组学方法、高通量克隆、生物信息学数据库工具及计算疫苗学,可被用于开发包括疟疾在内的各种疾病的疫苗。疟疾基因组学、蛋白质组学和及免疫组学的新进展也将促进疟疾疫苗的成功研发。     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

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.