弓形虫有效抗原表位的筛选及其对小鼠免疫保护性的研究

目的:利用噬菌体随机肽库技术筛选弓形虫抗原的有效表位，并探讨其免疫保护效果。方法：用纯化的弓形虫免疫兔血清IgC对噬菌体12肽库进行三轮筛选，对获得的日的噬菌体用间接ELISA和Dot—ELISA检测其特异性，并对其中的某些克隆进行Western—blot分析和序列测定；用混和噬菌体克隆及强阳性表位克隆免疫BABL／c小鼠．间接ELISA法测定其特异性抗体滴度，攻击感染后观察小鼠存活情况。结果：经三轮筛选，特异性噬菌体得到富集，随机挑取18个克隆经间接ELISA和Dot—ELISA鉴定，有16个克隆能与弓形虫免疫兔血清IgG呈特异性反应。Western—blot分析显示P2克隆能被免抗弓形虫血清所识别，具有类似于弓形虫抗原的免疫原性，其序列为5’-CTTCAGTTGGATCGGGCTCGGTTTTGGAAT CAGGGT-3’，与GenBank的弓形虫已知序列无一级结构的同源性；与原肽库对照组相比，P2实验组和P总实验组免疫小鼠均能诱导出较高滴度的IgG抗体，抗攻击感染后小鼠的存活率及存活时间也均高于对照组。结论：利用噬菌体随机肽库技术获得了弓形虫抗原的有效模拟睥位，这些表位能诱导对弓形虫的部分保护作用。     

用抗HCV多抗从随机12肽库中筛选抗原表位

目的：用丙型肝炎患者血清中抗丙型肝炎病毒（HCV）抗体从噬菌体随机12肽库中筛选HCV抗原表位。方法：将丙型肝炎患者血清混合,提取纯化的IgG作为固相配基筛选噬菌体随机12肽库,按吸附-洗脱-扩增的淘洗过程进行3轮筛选,随机挑取噬菌体克隆用ELISA法检测其特异性,对4个克隆进行测序。并用ELISA法检测噬菌体克隆的诊断价值。结果：3轮筛选的投入产出比逐轮升高,回收率从(4.6×10-4)%增加到(5.3×10-2)%,具有良好的富集效果。对从第3轮洗脱物中挑选出的18个克隆进行结合试验,发现所挑的克隆与丙型肝炎患者的多克隆抗体有较强的结合力。其中4个克隆测序显示为同一克隆（命名为C1）,其外源插入肽为GSMSPYVRWYTP。用C1检测20例丙型肝炎患者血清的检出率为85.0%。结论：成功地用噬菌体12肽库对丙型肝炎患者血清进行了模拟肽筛选,且得到的模拟肽分子C1具有一定的诊断价值。     

日本血吸虫成虫67kD抗原模拟表位的筛选及其免疫原性

目的：筛选日本血吸虫成虫67kD抗原的模拟表位，对其免疫学活性予以鉴定。方法：用粗提日本血吸虫成虫67kD抗原的抗体IgG作配体筛选噬菌体12肽库，随机挑取三轮筛选后的噬菌体克隆，Dot-ELISA检测其特异性：用混和阳性噬菌体克隆免疫小鼠3次，攻击感染后45d剖杀，计数虫荷。结果：经三轮筛选，特异噬菌体得到富集，挑取的11个噬菌体克隆经Dot-ELISA鉴定均与67kD抗原免疫血清呈阳性反应。混合噬菌体克隆的免疫血清可识别67kD抗原，并具有一定的抗血吸虫的免疫保护效果。结论：利用噬菌体随机肽库技术获得了日本血吸虫成虫67kD抗原的模拟表位，这些表位具有良好的免疫原性。     

噬菌体随机肽库筛选日本血吸虫22.6kDa蛋白有效抗原表位的初步研究

目的：从噬菌体随机12肽库中筛选出中国大陆株日本血吸虫22.6kDa蛋白（Sj22.6kDa抗原表达的短肽分子，探讨其抗血吸虫的交叉免疫保护效果。方法：以纯化的抗日本血吸虫22.6kDa的多克隆抗体IgG为配基，对噬菌体12肽库进行5轮亲和筛选，富集特异性噬菌体，挑取克隆，经序列分析，免疫识别和动物初筛后获得阳性克隆。结果：经过5轮筛选，特异性噬菌体得到有效富集。随机挑选的24个噬菌体克隆中获得4个有效抗原表位。结论：利用噬菌体随机肽库筛选可获得类似日本血吸虫22.6kDa有效抗原表位的短肽分子，这些短肽分子能诱导抗血肿虫的保护性免疫。     

丙型肝炎病毒包膜蛋白E2抗原模拟表位的筛选和鉴定

目的：筛选丙肝病毒（HCV）包膜蛋白（E2）特异性噬菌体模拟表位。方法：以抗－HCV E2的单克隆抗体作为固相筛选分子，对噬菌体同七肽库进行5轮“吸附－洗脱－扩增“的筛选过程，随机挑取50个克隆，经酶联免疫吸附法（ELISA）鉴定、交叉反应以及竞争抑制性实验，最后对所选克隆进行DNA序列分析，以确定HCV E2抗原的模拟表位。结果：经噬菌体富集后，得到12个阳性克隆，确定氨基酸序列XXPXYXW为HCV E2的模拟表位。结论：用噬菌体七肽库成功筛选得到HCV E2的模拟表位，为开展用HCV模拟表位探索HCV的防治研究创造了条件。     

抗大肠杆菌LPS多克隆抗体的制备与LPS模拟肽的筛选

目的获得抗大肠杆菌脂多糖(LPS)多克隆抗体与模拟LPS表位的线性噬菌体展示肽克隆。方法制备兔抗鼠大肠杆菌抗血清,鉴定抗血清效价。以亲和纯化的多克隆抗体为靶,筛选噬菌体随机线性十二肽库。双夹心ELISA和竞争抑制ELISA鉴定阳性噬菌体克隆。结果兔抗血清能与大肠杆菌LPS反应。用亲和层析纯化的多克隆抗体为靶分子进行三轮筛选,随机挑选17个克隆,其中6个克隆显示与多抗结合。大肠杆菌LPS可抑制阳性噬菌体克隆与多抗结合,所有克隆的IC50(达到50%抑制率的LPS浓度)为250ng/ml。结论获得能与大肠杆菌LPS反应兔多克隆抗体,筛选得到可模拟大肠杆菌LPS表位的噬菌体展示线性十二肽。     

从随机多肽库中筛选日本血吸虫抗原模拟表位诱导保护性免疫的研究

目的 从噬菌体随机肽库中筛选出能模拟日本血吸虫抗原表位的短肽分子，并测定其作为疫苗候选分子的潜能。方法 分别用正常及感染日本血吸虫的东方田鼠血清筛选在丝状噬菌体表面表达的随机十二肽库。经三轮亲和筛选后，随机挑取噬菌体克隆用ELISA检测其与日本血吸虫抗血清的反应。用混合噬菌体免疫小鼠并进行攻击感染。结果 随机挑取的12个克隆中，感染东方田鼠血清来源的噬菌体有10个克隆为阳性，正常血清来源的噬菌体有7个克隆为阳性。用感染东方田鼠血清筛到的噬菌体免疫小鼠诱导了部分保护作用（22．6％）及较高的肝卵减少率（68．9％）。然而，正常东方田鼠血清筛到的噬菌体没有保护效果。结论 感染及正常东方田鼠血清筛到的模拟表位具有免疫原性，提示随机肽库技术在日本血吸虫疫苗研制中有其潜在价值。     

应用噬菌体7肽库筛选泡球蚴Em18抗原模拟表位的初步研究

目的：从噬菌体7肽库中筛选泡球蚴Em18抗原模拟表位,为研究和开发新的包虫病诊断抗原提供实验依据.方法：用纯化后的rEm18-GST免疫新西兰白兔,获得抗rEm18-GST的多克隆抗体,进一步纯化,获得抗Em18多克隆抗体IgG,以之作为靶分子,免疫筛选噬菌体随机7肽库.经过5轮的淘筛过程,随机挑取9个蓝色噬菌斑扩增,核苷酸序列测定分析并与Em18进行同源性比较.结果：经5轮筛选后,阳性克隆得到富集,9个噬菌体克隆的氨基酸序列与Em18无同源性.结论：所得肽段可能是Em18抗原模拟表位.     

噬菌体7肽文库筛查类风湿关节炎相关抗体及分析

目的筛选和鉴定与类风湿关节炎(rheumatoid arthritis,RA)患者血清特异性结合的噬菌体7肽,并分析其实际意义。方法采用30例正常人混合血清和30例RA患者混合血清作为筛选配基对噬菌体随机7肽库进行亲和筛选、扩增,获得RA血清特异性结合的噬菌体克隆。用患者混合血清进行Dot-ELISA实验鉴定获得的噬菌体克隆,进一步用RA患者及正常人血清各12例筛选阳性噬菌体的混合克隆。对鉴定的噬菌体克隆进行测序,并分析其同源性。结果获得17个与RA患者混合血清特异性结合的阳性克隆。阳性噬菌体混合克隆与RA患者个体血清反应阳性率明显高于其与正常人血清的反应率。序列分析显示阳性噬菌体克隆的抗原表位之间无共有序列,但与杆菌、球菌等有一定的同源性。结论 RA患者血清中存在与病原体抗原表位结合的抗体成分,提示RA的发病可能与病原体感染有关。     

日本血吸虫尾蚴抗原模拟表位的筛选及其免疫保护性

目的 筛选日本血吸虫尾蚴抗原的模拟表位，探讨其对日本血吸虫的免疫保护性。方法 用粗提日本血吸虫尾蚴抗原的抗体IgC作配体筛选噬菌体12肽库，按“吸附－洗脱－扩增”的过程进行三轮筛选；随机挑取单个噬菌体克隆进行Dot-ELISA检测；用混和噬菌体克隆免疫小鼠3次，攻击感染45d后剖杀冲虫，计算虫数及肝卵数。结果 经三轮筛选，特异性噬菌体得到富集，挑取11个噬菌体克隆经Dot-ELISA鉴定，均与日本血吸虫尾蚴抗原免疫血清呈特异性反应。与对照组相比，混和噬体克隆免疫小鼠的减虫率为18.79%，减卵率为38.00%。结论 利用噬菌体随机肽库技术获得了日本血吸虫尾蚴抗原的模拟表位，这些表位能诱导对日本血吸虫的保护性免疫。     

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

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.