肺炎嗜衣原体菌体抗原的制备及应用

目的制备肺炎嗜衣原体（Chlamydophila pneumoniae,Cpn）菌体抗原,纯化后建立ELISA方法,用于血清Cpn抗体的检测。方法应用进口Cpn毒株感染Hep-2细胞,利用吖啶橙染色和直接免疫荧光染色判断Cpn感染细胞,制备Cpn抗原。用初步纯化的Cpn抗原建立ELISA方法检测人血清特异性抗体。结果吖啶橙染色和直接免疫荧光检测显示,Cpn成功感染Hep-2细胞。提取Cpn抗原,用ELISA检测84份病人血清特异抗体,阳性率为52.4%,ELISA试剂盒法的阳性率为51.2%,差异无统计学意义（P〉0.05）。用Cpn菌体抗原ELISA检测209份病人血清,阳性率59.3%（其中心血管疾病患者血清138份,阳性率58.0%;呼吸系统疾病患者血清71份,阳性率62.0%）;检测84份健康者血清,阳性率2.4%,差异有统计学意义（P〈0.05）。结论Cpn菌体抗原ELISA检测血清抗Cpn抗体可用于判断Cpn感染;病人血清Cpn抗体阳性表明,某些心血管和呼吸系统疾病患者的致病原因可能与肺炎嗜衣原体感染有关。     

新疆伊犁儿童肺炎衣原体、鹦鹉热衣原体及沙眼衣原体血清抗体调查

目的 调查新疆伊犁地区农村居住儿童肺炎衣原体、鹦鹉热衣原体及沙眼衣原体感染状况 。方法 采用WHO推荐的微量间接免疫荧光方法(mIFA)半定量分析儿童血清肺炎衣原体、鹦鹉热衣原体及沙眼衣原体IgG抗体,比较每种病原体在不同调查点及年龄组间阳性率差异。结果 肺炎衣原体、沙眼衣原体及鹦鹉热衣原体人群血清IgG抗体阳性率分别为39.5%、2.1% 及0。巩留县(40.8%)及昭苏县(44.4%)人群肺炎衣原体抗体阳性率明显高于伊宁市(32.4%)。性别、年龄及民族等差异无统计学意义。结论 新疆伊犁农村地区儿童存在较高的肺炎衣原体抗体阳性率,沙眼衣原体阳性率较低。本调查没有检测到鹦鹉热衣原体抗体。     

新疆伊犁儿童肺炎衣原体、鹦鹉热衣原体及沙眼衣原体血清抗体调查北大核心CSCD

目的调查新疆伊犁地区农村居住儿童肺炎衣原体、鹦鹉热衣原体及沙眼衣原体感染状况。方法采用WHO推荐的微量间接免疫荧光方法(mIFA)半定量分析儿童血清肺炎衣原体、鹦鹉热衣原体及沙眼衣原体IgG抗体,比较每种病原体在不同调查点及年龄组间阳性率差异。结果肺炎衣原体、沙眼衣原体及鹦鹉热衣原体人群血清IgG抗体阳性率分别为39.5%、2.1%及0。巩留县(40.8%)及昭苏县(44.4%)人群肺炎衣原体抗体阳性率明显高于伊宁市(32.4%)。性别、年龄及民族等差异无统计学意义。结论新疆伊犁农村地区儿童存在较高的肺炎衣原体抗体阳性率,沙眼衣原体阳性率较低。本调查没有检测到鹦鹉热衣原体抗体。     

免疫荧光法检测衣原体方法的改进

免疫荧光法检测衣原体是准确率高,便于普及的好方法,但在我们使用的过程中与患者临床症状相结合发现阳性检出率,不尽人意。经过反复实践,我们对原法进行了新改进,不仅使操作更简便,用时少,同时提高了阳性检出率,现介绍如下。1 原理 使用过氧化氢,氧化衣原体的细胞壁,暴露抗原,使之快速与荧光抗体染料亲和,缩短了染色时间,同时由于氧化剂的增染作用,增强了染色效果,提高了阳性检出率。2 试剂（1）军事医学科学院提供免疫荧光试剂盒。（2）3％的过氧化氢。     

毛细管聚合酶链反应快速诊断孕妇沙眼衣原体感染

毛细管聚合酶链反应快速诊断孕妇沙眼衣原体感染裘国强，杨懿霞，酆豫增沙眼衣原体（ＣＴ）感染的实验室诊断以往采用宫颈棉试子取材涂片，经姬姆萨染色查包涵体等方法，因敏感性差，已较少采用。近年来，国内外学者报道，采用直接荧光抗体法（ＤＦＡ）检测，酶免疫反应，...     

兔衣原体病病原体的分离及鉴定

本文报道一起暴发流行的兔繁殖障碍综合征,主要表现为子宫炎、流产、死胎、产弱仔和不孕等。经过鸡胚分离、感染McCoy细胞、特异性免疫荧光染色、姬姆萨染色观察包涵体、碘染色、磺胺抑制等试验,初步确认该病原为鹦鹉热衣原体。     

兔衣原体病病原体的分离及鉴定

本文报道一起暴发流行的兔繁殖障碍综合征,主要表现为子宫炎、流产、死胎、产弱仔和不孕等。经过鸡胚分离、感染ＭｃＣｏｙ细胞、特异性免疫荧光染色、姬姆萨染色观察包涵体、碘染色、磺胺抑制等试验,初步确认该病原为鹦鹉热衣原体。     

抗日本血吸虫抗独特型抗体的制备及初步鉴定和应用

本研究用1株针对日本血吸虫尾蚴和童虫表膜抗原的单克隆抗体(N15D9)免疫新西兰兔制备多克隆抗N15D9独特型抗体。结果表明,多克隆抗N15D9独特型抗体具有较高的抗体滴度,经用间接免疫荧光法和ELISA分析,该抗体显示较高的结合特异性,与具有相同靶抗原结合特异性的单克隆抗体有中度的交叉反应。当用抗N15D9独特型抗体作为诊断抗原检测日本血吸虫感染的病人血清时,其阳性检出率为39％。本研究结果初步揭示,抗N15D9独特型抗体具有一定的分子模拟作帮和诊断应用的潜能。     

免疫荧光法检测衣原体新改进

免疫荧光法检测衣原体是准确率高,便于普及的好方法,但在我们使用的过程中与患者临床症状相结合发现阳性检出率不尽人意。经过反复实践,我们对原法进行了新改进,不仅使操作更简便,用时少,同时提高了阳性检出率,现介绍如下。 原理 使用过氧化氢,氧化衣原体的细胞壁,暴露抗原,使之快速与荧光抗体染料亲和,缩短了染色时间,同时由于氧化剂的增染作用,增强了染色效果,提高了阳性检出率。 试剂（1）军事医学科学院提供免疫荧光试剂盒。（2）3％的过氧化氢。 操作 先在载玻片背面用记号笔划一圆形小区,将采取     

肺炎衣原体假定蛋白Cpn0146的定位及其生物信息学分析

目的：对肺炎衣原体假定蛋白Cpn0146进行定位与生物信息学分析。方法：使用PCR方法从肺炎衣原体菌株AR39基因组中扩增Cpn0146,并将其插入到pGEX-6P2构建表达质粒pGEX-6p2-Cpn0146并转化大肠杆菌XL-Blue,IPTG诱导其表达融合蛋白GST-Cpn0146。纯化后的融合蛋白免疫小鼠制备特异性抗体,并应用间接免疫荧光法对肺炎衣原体的Cpn0146进行定位分析,最后利用软件Expasy和antheprot5.0对Cpn0146进行生物信息学分析。结果：成功构建了表达载体pGEX-6p2-Cpn0146和制备了抗Cpn0146的多克隆抗体。间接免疫荧光实验显示Cpn0146位于肺炎衣原体的包涵体膜上。生物信息学分析显示Cpn0146具有较好的亲水性与抗原性。结论：肺炎衣原体假定蛋白Cpn0146为一包涵体膜蛋白,其抗原性和亲水性较好。     

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.     

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。     

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。     

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.     

Angiographic diagnosis of the degree of serosal invasion of carcinoma of the colon

Angiography using Prostaglandin El^® was performed on 38 patients with carcinoma of the colon in order to diagnose the degree of serosal cancer invasion. The findings at angiography were classified into four groups:1) AG-S3, abnormal change (irregularity and/or encasement) up to marginal vessels; 2) AG-S2, abnormality up to vasa recta; 3) AG-S1, abnormality of penetrating branches of vasa recta within the wall of the colon; and 4) AG-S0, no distinct findings of abovementioned vessels. These angiographic findings were compared with both macroscopic and microscopic serosal cancer invasion. Angiographic diagnosis is in accord with the macroscopic findings in 84.2 percent of cases. Angiographic diagnosis is in accord with the microscopic findings in 32.4 percent of cases. Macroscopic findings confirm the angiographic diagnosis precisely but the conflict with microscopic findings should not be overlooked. This may be the result of inflammatory change, adhesion, and fibrosis around carcinoma of the colon.