大肠癌噬菌体抗体库的构建及初步鉴定

目的 构建及初步鉴定大肠癌噬菌体抗体Fab呈现库.方法 分离大肠癌患者外周血淋巴细胞,提取淋巴细胞总RNA,逆转录成cDNA.用相应引物进行PCR,扩增出轻链和重链Fd段基因,经酶切后分别和噬粒载体pComb3连接,再经电穿孔转化大肠杆菌XLl-Blue菌株.将轻链和重链Fd基因先后克隆人pComb3中.结果 从分离出的淋巴细胞中提取到高质量RNA,RT-PCR分别扩增出约680 bp大小的κ、λ和Fd基因.PCR 产物和载体经纯化、双酶切后进行连接转化,成功地构建了人源性Fab抗体基因库,库容量达2.1×107,轻链K、κ、λ和重链Fd基因均插入pComb3的重组率为50%.结论 构建了大肠癌患者自然致敏抗体Fab段噬菌体呈现库,为筛选大肠癌相关抗体打下基础.     

人源性大肠癌自然致敏噬菌体抗体Fab呈现库的构建与筛选

目的构建大肠癌病人自然致敏淋巴结抗体 Fab 段噬菌体呈现库,初步筛选相关抗大肠癌抗体。方法取大肠癌病人转移淋巴结,提取淋巴结总 RNA,逆转录 PCR 扩增重链 Fd 和 k 轻链 cDNA。依次将 PCR 产物插入载体 pComb3的相应部位,构建人源性大肠癌噬菌体 Fab 基因库,并应用噬菌体表面呈现技术对该抗体库进行淘选及鉴定。结果所选2种 Ig 亚类的重链 Fd 片段、2种 k 轻链 cDNA 得到扩增。Fd 片段和 k 轻链均插入 pComb3的重组率为40%,Fab 噬菌体表达库容达1.48×10~6。经3轮淘选,抗体库得到约120倍的富集。3轮抗体库的点印记免疫染色均显示有 Fab 表达:酶联免疫吸附实验显示其与大肠癌抗原有结合活性。结论成功构建了大肠癌病人自然致敏淋巴结抗体 Fab 段噬菌体呈现库,利用噬菌体抗体库技术,可筛选相关抗大肠癌抗体。     

结肠癌患者淋巴结构建抗结肠癌噬菌体Fab抗体库

目的　构建 2个结肠癌患者自然致敏淋巴结抗体Fab段噬菌体呈现库。方法　取 2个结肠癌患者转移淋巴结 ,提取淋巴结总RNA ,逆转录PCR扩增重链Fd和κ轻链cDNA。依次将PCR产物插入载体 pComb3的相应部位 ,噬菌体VCSM13辅助感染。以点印迹检测噬菌体表面Fab的表达。 结果　所选 2种Ig亚类的重链Fd片段、2种κ轻链cDNA得到扩增。Fd片段和κ轻链均插入 pComb3的重组率为 40 %,Fab噬菌体表达库容量达 1.48× 10 6。噬菌体悬液的点印迹免疫染色显示有Fab表达。结论　构建了 2个结肠癌患者自然致敏淋巴结抗体Fab段噬菌体呈现库 ,为筛选结肠癌相关抗体奠定了基础。     

人大肠癌淋巴结抗体Fab段基因的扩增

目的:从大肠癌病人淋巴结中扩增抗体Fab段重链(Fd)和轻链(k)基因。方法以一步法提取淋巴结总RNA,采用逆转录及PCR反应。反应产物以琼脂糖凝胶电泳观察。结果:扩增的Fd和k基因长度分别为850和700bP,相应肿瘤和正常切缘组织未见扩增。结论:Fab段重链(Fd)和连链(k)基因的成功扩增为大肠癌基因工程抗体的制备噬菌体抗体库的构建奠定丁基础。     

抗华支睾吸虫噬菌体抗体库的构建

目的　构建抗华支睾吸虫噬菌体抗体库 ,以期筛选出抗循环抗原的抗体组合。方法　应用噬菌体表面呈现技术 ,从感染华支睾吸虫病人淋巴细胞中提取总 RNA,逆转录成 c DNA后 ,用相应引物 PCR扩增出重链 Fd和轻链基因 ,经 Xho 和 Spel、Sac 和 Xba 双酶切 ,先后克隆入噬粒载体 p Comb3,再电转化大肠杆菌 XL1- blue菌株 ,辅助噬菌体 VCSM13超感染。结果　从感染华支睾吸虫病人淋巴细胞中扩增出约 70 0 bp重链 γ1 、γ3Fd段和轻链 κ、λ基因 ,分别和 p Com b3连接后成功导入 XL 1- blue,得到滴度为 7.5× 10 1 0 cfu/ ml,库容量为 5 .6× 10 6 噬菌体抗体库。结论　抗华支睾吸虫 Fab段噬菌体抗体库的构建 ,为进一步筛选抗华支睾吸虫循环抗原单克隆抗体奠定了基础。     

大肠癌转移淋巴结构建人源性抗大肠癌噬菌体Fab抗体库

目的 构建人源性抗大肠癌噬菌体Fab抗体库.方法 术中剥取老年大肠癌患者系膜内转移淋巴结,提取细胞总RNA,逆转录合成cDNA,进行PCR,克隆于pComb3 载体,再经电转化大肠杆菌XLI-Blue菌株,形成噬菌体抗体库,最后通过免疫印记法鉴定初级抗体库中噬菌体上有Fab段的表达.结果 从系膜内转移淋巴结中扩增出650 bp重链Fd和轻链基因产物,轻链基因产物插入测得转化菌数为4.7×10~6,鉴定插入率为70%;重链Fd基因产物测得转化菌数为3.5×10~6,插入率为60%;免疫印迹法鉴定成功建立噬菌体Fab抗体库,库容量达1.4×10~6.结论 筛选大肠癌特异性抗原和相应噬菌体抗体,对大肠癌发病机制的研究以及探讨早期诊断方法有重要意义.     

人天然Fab段噬菌体抗体库的构建

目的通过构建人天然F ab段噬菌体抗体库为恶性肿瘤的免疫治疗提供新方法。方法取4个健康献血员新鲜血液各200m l,分离淋巴细胞,提取总RNA,经逆转录合成cDNA,设计多对引物,以PCR扩增抗体轻链和重链Fd段cDNA。轻链PCR产物和质粒载体pCom b3经SacⅠ和X baⅠ酶切,由T 4 DNA连接酶连接,电穿孔转化感受态大肠杆菌XL 1-B lue,扩增后提取质粒,构建轻链库。轻链库和重链Fd段PCR产物经X hoⅠ和SpeⅠ酶切,同样方法连接转化XL 1-B lue,加入辅助噬菌体VCSM 13产生噬菌体抗体全库。酶切鉴定轻链库和全库有无插入片段。结果提取的淋巴细胞总RNA质量好,部分重链Fd片段、部分κ轻链和λ轻链cDNA得到扩增。F ab全库库容达5.4×106,酶切证实有插入片段。结论本研究构建的人天然F ab段噬菌体抗体库可为进一步筛选特异性抗体及从肿瘤组织中提取肿瘤抗原用于免疫治疗奠定基础。     

人源性抗日本血吸虫噬菌体抗体库的构建及初步鉴定

目的利用噬菌体抗体展示技术构建人源性抗日本血吸虫Fab段噬菌体抗体库并进行初步鉴定。方法RT-PCR从对血吸虫感染有一定抗性成年人外周血淋巴细胞中扩增出入IgG轻链和重链Fd段基因片段，将其克隆入PComb3中．构建人源性Fab段噬菌体抗体库。并用限制性内切酶酶切、序列分析、DOT-BLOT以及SDS-PAGE等方法对噬菌体抗体库进行初步鉴定。结果噬菌体抗体库的滴度为6．2×10^11／L。库容量为1．2×10^7。酶切鉴定结果显示噬菌体抗体库轻重链重组率达到66．6％，测序结果表明克隆入PComb3的是人免疫球蛋白轻链和重链基因,DOT-BLOT实验证明该抗体库表达了人源性的抗体，而SDS-PAGE证实了免疫球蛋白Fab段的可溶性表达。结论成功地构建了人源性抗日本血吸虫Fab段噬菌体抗体库，为筛选人源性抗日本血吸虫的抗体、研究这些抗体的特性和功能奠定了基础。     

人源抗EV71病毒中和表位SP70 的Fab抗体研制

目的构建人源抗EV71病毒Fab噬菌体抗体库,筛选具有中和活性的人源单克隆抗体,为EV71感染引起的手足口病临床诊断及治疗奠定基础。方法从成人志愿者抗凝血中分离外周淋巴细胞,提取总RNA并逆转录为cDNA。以cDNA为模板,用人源IgG Fab段基因引物扩增轻链及重链Fd区基因,分步克隆至pComb3载体,构建Fab噬菌体抗体库。以SP70为抗原对Fab噬菌体抗体库进行富集筛选,将获得的重组噬菌体感染XL1-Blue菌并诱导表达,用SP70对诱导表达的菌上清进行筛选。结果共获得3株轻、重链基因组合序列不同的克隆,且这3株Fab抗体可特异性结合SP70多肽。结论成功构建人源抗EV71病毒Fab噬菌体抗体库,并从中筛选出3株针对EV71病毒结构蛋白VP1上中和线性表位SP70的特异性人源Fab抗体,为研发新的手足口病诊断和治疗工具奠定基础。     

人源性阿尔茨海默病噬菌体单链抗体库的构建

目的构建人源性阿尔茨海默病(AD)噬菌体单链抗体(scFv)库,为筛选β淀粉样蛋白(Aβ1-42)的人源性特异性抗体奠定基础。方法采集18例AD患者的外周血40ml,提取总RNA,应用RT-PCR法得到人抗体可变区重链(VH)和可变区轻链(VL)基因。将VH和VL由连接肽连接得到scFv片段,将所得片段双酶切后,克隆至pCANTAB5E噬菌体载体,大肠埃希菌TG1感受态细胞经电击转化,辅助噬菌体M13K07拯救后构建scFv型噬菌体抗体库。结果总RNA经逆转录PCR扩增VH和VL可变区基因的凝胶电泳显示,PCR产物长度分别为360bp和300bp,其连接形成的scFv片段长度为750bp,最终构建了库容为2.4×109的scFv库。BstNⅠ酶切鉴定构建的scFv库,经凝胶电泳可见,酶切片段长度差异性大,显示scFv库具有良好的多样性。结论成功构建人源性AD噬菌体scFv库,为进一步筛选Aβ特异性抗体,继而为AD的治疗研究奠定基础。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

治疗高血压药物的经济学评价

重视高血压治疗中的经济学评价,对利用我国有限的卫生资源来遏制高血压对人民群众的危害有着重要的现实意义。药物经济学对于药物治疗的成本和治疗的结果给予同样的关注。因为治疗高血压的费用,不仅涉及药物价格,还包括患者的危险水平,降压疗效和对临床终点事件的影响,以及治疗的依从性和安全性。因此药物经济学更强调整体成本和价-效比。低危病人,若非药价低廉,治疗的价-效比不够理想。而在高危的患者,价-效比越小越经济而不是药费越便宜越好。