HLA-A2肽四聚体的构建及其在乙、丙型肝炎中的初步应用

目的　分别构建乙型肝炎病毒 (HBV)和丙型肝炎病毒 (HCV)特异的HLA A2肽四聚体 ,为检测乙、丙型肝炎患者体内特异性的细胞毒T细胞 (CTL)提供直接、有效的方法 ,指导临床用药。方法　分别构建含有HLA A2 BSP(含有 15个可供识别生物素化的氨基酸位点 )和 β2微球蛋白(β 2m)基因的原核表达载体 ,并进行表达、复性、鉴定及纯化。再分别将HBV和HCV特异性短肽与HLA A2 BSP和 β 2m蛋白在体外进行耦合 ,该复合物经纯化浓缩后进行生物素化。生物素化的产物经纯化浓缩后形成单体 ,此单体再与藻红蛋白标记的链霉亲和素按一定比例耦合构建成四聚体 ,最后进行流式细胞仪检测。结果　获得了高效、稳定的pBV2 2 0 HLA A2 BSP和 pBV2 2 0 β 2m原核表达载体 ,表达量分别占菌体的 4 6 %和 2 6 %左右 ;纯度达 90 %以上。构建的四聚体可成功的检测急、慢性乙型和丙型肝炎患者中特异性的CTL ,急性HBV感染时CTL占 1 84 % ,慢性HBV感染时CTL占0 0 2 %～ 0 6 8% ,慢性HCV感染的CTL占 0 0 2～ 0 72 %。结论　高效、稳定的pBV2 2 0 HLA A2 BSP和 pBV2 2 0 β 2m原核表达载体大量的表达可用于构建各种肽特异性的四聚体复合物 ;在体外构建的MHC Ⅰ类分子四聚体 ,为特异性细胞毒T细胞的检测提供有效的工具。     

抗人免疫缺陷病毒I型(HIV-1)外膜蛋白gp120单链抗体基因的构建及测序鉴定

目的　构建抗HIV 1gp120单链抗体基因,为进一步用于HIV 1感染的诊断和治疗奠定基础。方法　利用 RT PCR法,从抗HIV 1gp120单克隆抗体杂交瘤细胞扩增得到抗体轻链和重链的可变区基因,经重叠延伸反应, 在体外随机合成单链抗体基因(ScFv),并克隆到pGEM Easy T载体中,经测序及Blast同源性分析。结果　该 ScFV基因全长为666bp,为VH Linker VL结构,VH基因为396bp,编码132个氨基酸;Linker为(Gly4Ser)3短 肽;VL基因为270bp,编码90个氨基酸。VH基因与小鼠IgG2a重链可变区的同源性达95%,VL基因与小鼠免 疫球蛋白κ轻链可变区的同源性达98%。结论　成功构建了抗HIV 1gp120单链抗体基因。     

可溶性HLA-A*2402-pBRLF1复合物的体外折叠与四聚体化

目的 研究可溶性HLA—A＊2402-pBRLF1复合物的体外折叠与四聚体化。方法 将原核高效表达的可溶性HLA—A＊2402-BSP融合蛋白及β2微球蛋白（β2m）与HLA—A＊2402限制性抗原肽Epstein—Barr病毒（EBV）即刻早期BRLF1蛋白中的九肽NH2-DYNFVKQLF-COOH进行稀释复性折叠，形成HLA—A＊2402-pBRLF1复合物单体，并在BirA酶的作用下进行生物素化，使生物素结合到HLA—A＊2402-pBRLF1复合物中H链c端的BSP序列上形成生物素化的可溶性HLA—A＊2402-pBRLF1复合物单体。利用特异单抗（W6／32和兔抗人β2m抗体）及链霉亲合素进行ELISA和Western blot，检测稀释复性和生物素化的折叠产物。然后用此生物素化的单体分子进一步构建成HLA—A＊2402-pBRLF1四聚体来检测人工抗原提呈细胞（aAPCs）诱导的特异性细胞毒T淋巴细胞（CTL）。结果折叠复合物中，主要含有HLA-A＊2402-pBRLF1复合物单体及β2m两种成分，其中HLA—A＊2402-pBRLF1复合物单体可生物素化和四聚体化。应用HLA—A＊2402-pBRLF1四聚体对特异性CTL检测结果说明体外成功地构建了HLA—A＊2402-pBRLF1四聚体。结论HLA—A＊2402-pBRLF1四聚体构建成功。为特异性CTL的检测提供了有力的工具。     

抗人免疫缺陷病毒Ⅰ型（HIV-1）外膜蛋白gp120单链抗体基因的构建及测序鉴定

目的 构建抗HIV-1gp120单链抗体基因，为进一步用于HIV-1感染的诊断和治疗奠定基础。方法 利用RT-PCR法，从抗HIV-1gp120单克隆抗体杂交瘤细胞扩增得到抗体轻链和重链的可变区基因，经重叠延伸反应，在体外随机合成单链抗体基因(ScFv)，并克隆到pGEM-Easy-T载体中，经测序及Blast同源性分析。结果 该ScFV基因全长为666bp．为VH-Linker-VL结构，VH基因为396bp，编码132个氨基酸；Linker为(Gly4Ser)3短肽；VL基因为270bp，编码90个氨基酸。VH基因与小鼠IgG2a重链可变区的同源性达95％，VL基因与小鼠免疫球蛋白κ轻链可变区的同源性达98％。结论 成功构建了抗HIV-1gp120单链抗体基因。     

特异性抗鼠IgD单链抗体基因的构建及序列测定

获得特异性抗鼠ＩｇＤｍＡｂ４１４／ＤＦ的单链抗体基因,方法：在获得高亲和力抗鼠ＩｇＤ特异性ｍＡｂ重,轻链可变区基因的基础上,采用酶连法将二者拼成单链抗体基因。结果所构建的单链抗体基因为ＶＨ－Ｌｉｎｋｅｒ－ＶＬ结构,长７２９ｂｐ,其中包含重链可变区基因３５７ｂｐ,可编码１１９个氨基酸,连接肽基因４５ｂｐ,可编码     

重症肌无力抗乙酰胆碱受体单链抗体基因的构建

[目的 ]构建重症肌无力抗乙酰胆碱受体主要免疫原区单链抗体A 7基因 .[方法 ]应用PCR技术及基因克隆技术分两步完成重链和轻链可变区基因的克隆 ,再对构建的单链抗体A 7基因进行序列测定检测其核苷酸序列 .[结果 ]构建的重组质粒经序列分析 ,重链可变区基因长度为 36 9bp ,轻链可变区基因长度为 32 1bp ,单链抗体基因长度为 735bp ;单链抗体A 7基因正确地插入在载体质粒pHEN 2开放读码框架内 .[结论 ]成功地构建重症肌无力抗乙酰胆碱受体主要免疫原区单链抗体A 7基因 ,为进一步制备基因工程抗体奠定了基础 .     

抗人卵巢癌单链抗体基因的构建

构建抗人卵巢癌单抗ＣＯＣ１８３－Ｂ２单链抗体基因。方法，将通过ＰＣＲ方法体扩增并经测序验证的重链，轻链可变区基因先后重组入原核表达质粒ＰＴＨＡ９０相应的位点上，中间通过一连接肽（Ｇｌｙ４Ｓｅｒ）３基因连接构建成单链抗体基因。     

重症肌无力单链抗体基因的制备

[目的 ]构建抗人乙酰胆碱受体主要免疫原区单链抗体 .[方法 ]应用多聚酶链反应从抗人乙酰胆碱受体主要免疫原区抗原结合片段扩增重链和轻链可变区基因 ,并克隆到载体噬粒 pHEN2 .将含有单链抗体基因的重组噬粒转化大肠杆菌DH5α ,分离提纯重组噬粒后再经酶切、琼脂糖凝胶电泳检查以确认单链抗体基因的正确性 .[结果 ]电泳检查发现了大小分别为 3 78bp ,3 3 9bp和 762bp的重链可变区、轻链可变区和单链抗体基因 ,且位置正确 .[结论 ]已成功地构建了抗人乙酰胆碱受体主要免疫原区单链抗体基因     

抗鼻咽癌单克隆抗体BAC5单链抗体原核表达载体的构建和表达

[目的]构建抗鼻咽癌单克隆抗体BAC5单链抗体的原核表达载体并观察其表达,为开展抗鼻咽癌单链抗体的进一步研究奠定基础.[方法]应用RT-PCR技术,扩增出鼻咽癌单克隆抗体BAC5的轻链、重链可变区基因,通过一段编码肽的序列进行连接,构建BAC5单链抗体表达载体pET22b-scFv,导人BL21(DE3)表达菌,并进行诱导表达.SDS-PAGE凝胶电泳鉴定融合蛋白的表达.[结果]克隆基因序列符合小鼠轻、重链可变区基因特征;pET22b-scFv表达质粒拼接正确;表达产物以包涵体形式为主.[结论]成功构建了能表达BAC5单链抗体的原核表达载体.     

抗转铁蛋白受体单链抗体原核表达载体的构建和表达

目的 构建抗转铁蛋白受体(TfR)单链抗体原核表达载体，为进一步研究其效应奠定基础。方法 从抗TfR单克隆抗体重链和轻链可变区基因的克隆载体pGEM-T-VH和pGEM-T-VL中扩增重链可变区(VH)和轻链可变区(VL)基因，用重叠延伸PCR的方法，在VH和VL基因间引入连接短肽(Linker)，构建VH-Linker-VL的单链抗体(single chain Fv，scFv)基因。经NcoⅠ和NotⅠ酶切后亚克隆到原核分泌型表达载体pUCl9／119上，转化和筛选后，阳性细菌经IPTG诱导表达。间接免疫荧光法(IFA)及抗体封闭试验鉴定其抗体活性。结果 凝胶电泳可见重叠延伸PCR扩增产物约700bp条带，SDS-PAGE鉴定表达产物的分子量为27kD左右，与scFv的理论值一致，IFA及抗体封闭试验证明表达产物有抗人TfR的活性。结论 本研究成功地构建并表达了抗人TfR scFv，为抗人TfRscFv的应用奠定了基础。     

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.