国境口岸突发疫情快速反应对策探讨

[目的]适应国际疫情变化，为国境口岸突发疫情快速反应提供对策依据。[方法]通过对3例输入性传染病病例的临床诊断、流行病学调查、卫生检疫措施的分析，探讨口岸突发疫情的快速反应对策。[结果]口岸卫生检疫应扩大适用范围，将常见、多发性传染病的控制列为重点之一，并根据风险程度，宏观上把握分类管理、分级预警；微观上实行分别应对、分工协作，建立起更加科学、规范的防止疾病国际传播的新机制；突发疫情处置应以传染源控制和管理为重点，辅以切断传播途径和保护易感人群措施．夕h籍传染病病人，宜经治疗病情稳定后监护出境；应加强与地方医疗卫生机构的横向协作，构建应对突发疫情的联动应急体系。[结论]调整国境口岸卫生检疫策略，建立“应对突发疫情快速反应体系，为防止疾病的国际传播提供保障”的新机制。     

静默疗法对肿瘤化疗病人恶心、呕吐的防治作用

目的探索静默疗法对肿瘤化疗副反应的作用。方法将300例进行化学治疗的肿瘤病人随机分为对照组和试验组,每组各150例病人。对照组进行治疗时,只用常规的恩丹西酮预防恶心、呕吐等副作用;而试验组除了用恩丹西酮外,在受过专门训练护理人员的指导下用静默疗法辅助治疗来预防恶心、呕吐等副作用。结果试验组胃肠道等副反应控制率为57%,与对照组(43%)比较,有显著性差异(P<0.05)。结论静默疗法有减轻或防止化疗药物引起的胃肠道反应等副反应的作用。     

间充质干细胞的培养特性及其相关细胞因子表达

目的:探讨体外培养间充质干细胞的方法及其生物学特性,并检测与其抑制T淋巴细胞增殖活性减轻GVHD机制的细胞因子的表达。方法:通过密度梯度离心及贴壁筛选法分离、纯化及培养间充质干细胞,观察其生物学特性,并进行免疫细胞化学染色观察间充质干细胞是否表达TGF-β1、HGF。结果:采用贴壁筛选法培养间充质干细胞原代经7天贴壁后变为梭形,经14~17天可长满瓶底,传代后3~4天即可长满,免疫分型示CD29+,CD44+,CD34-,CD45-,免疫细胞化学染色显示高度表达TGF-β1及HGF。结论:密度剃度离心结合贴壁筛选法培养间充质干细胞可获得纯度较高,生物学特性稳定的间充质干细胞;间充质干细胞可能通过TGF-β1与HGF两种细胞因子抑制T淋巴细胞增殖减轻移植后GVHD。     

A recombinant antibody-targeted plasminogen activator with high affinity for activated platelets increases thrombolytic potency in vitro and in vivo

To increase thrombolytic specificity of urokinase (uPA), we engineered a recombinant chimeric plasminogen activator SZ51Hu-scuPA, which consists of a humanized monoclonal antibody (SZ-51Hu) specifically against P-selectin on activated human platelet and a single-chain urokinase (scuPA). The cDNA, encoding scuPA amino acids 1-411, was inserted in 5' end to 3' end orientation immediately after the CH3 of SZ-51Hu heavy-chain sequence in the expression vector alphaLys30. The resulting construct alphaLys30-SZ51VH/Hu-scuPA was used to transfect into SP2/0 murine myeloma cell line, which was pretransfected with SZ51Hu light chain. The fusion protein SZ51Hu-scuPA was expressed at 5 mg/L in the supernatant of cell culture. The fusion protein purified by affinity chromatography had a molecular weight of 160 kDa with fibrinolytic activity of 39,000 IU/mg and its affinity to activated human platelet was 67% of the parent murine mAb SZ-51. The thrombolytic property of the fusion protein was first characterized in an in vitro system, which consists of a 125I-fibrin-labeled human plasma clot containing different concentrations of human platelets suspended in citrated human plasma. Fifty percent lysis was reached with SZ51Hu-scuPA in 1 hour at a concentration of 20 IU/mL or in 2 hours at a concentration of 10 IU/ mL, which was much faster than uPA at the same concentration. The maximal lysis of the clots by SZ51Hu-scuPA was 4.1 to 8.4 times more potent than that by uPA. The fusion protein was further characterized in the hamster pulmonary embolism model with clots prepared from fresh platelet-rich human plasma containing 125I-labeled fibrinogen. The thrombolytic activity of SZ51-scuPA was 3.9 times more potent than that of uPA at 2,000 IU/kg in this model. Almost no significant fibrinogen breakdown was observed either in vitro and in vivo.     

中西医结合治疗恶性胸腔积液30例观察

近年来，笔者采用静脉导管留置胸腔闭式引流并注入白介素-Ⅱ胸腔灌注联合中药化饮解毒汤，治疗恶性胸腔积液（胸水）30例，并与单用西医方法治疗的30例作对照观察，取得较好疗效。现总结如下。     

Circulating Epstein-Barr virus DNA in serum of patients with lymphoepithelioma-like carcinoma of the lung: a potential surrogate marker for monitoring disease.

PURPOSE: The purpose of this work was to study the sera of patients with lymphoepithelioma-like carcinoma (LELC) of the lung for circulating EBV DNA. EXPERIMENTAL DESIGN: Prospectively collected serum samples from five female patients with advanced, inoperable LELC of the lung were measured for free circulating EBV DNA using a quantitative PCR technique. EBV-encoded small RNA (EBER)-1 was assayed in serial serum samples of three of the five patients, either from the start or during the initial phase of chemotherapy/radiotherapy until their terminal event or last follow-up. There was only a single-point sample for analysis in the fourth and fifth patients. Six other patients with LELC of the lung were also retrospectively identified, and their sera were tested for EBER-1 at either the first visit plus the last follow-up visit (n = 2), the first visit only (n = 2), or the last follow-up visit only (n = 2). RESULTS: Prospectively collected serum samples from five patients and retrospectively collected serum samples from two patients who had clinical disease at initial serum measurement showed detectable levels of EBER-1. Retrospectively collected serum samples from four patients with no clinical disease had negative sera. There is consistent correlation between the clinical response to treatment and subsequent clinical course of LELC and serum EBER-1 levels in the three prospective patients with longitudinal serum monitoring. CONCLUSIONS: This study shows for the first time that free EBV DNA can be detected in the serum of patients with LELC of the lung and further suggests the feasibility of its use for monitoring response to therapy in advanced cases.     

启东肝癌组织p53过表达的免疫组化检测

目的　了解p5 3突变在启东地区的肝癌发生中所起的作用。方法　应用免疫组化 (IHC)的方法对 90例肝癌和 75例癌旁组织切片进行p5 3蛋白检测。结果　在 90例肝癌中 ,有 4 0例 (44 .4 % )在核中表达为强阳性 ,2 5例 (2 7.8% )在核中表达为弱阳性 ;在 75例癌旁中 ,没有细胞核强阳性表达 ,仅 1例 (1.3% )有核弱阳性表达 ;肝癌的p5 3核表达显著高于癌旁 (P =0 .0 0 0 )。另外 ,在肝癌中有 9例 (10 % )为细胞质p5 3表达阳性 ,在癌旁中有 17例 (2 2 .7% )为细胞质表达阳性 ,肝癌的胞质p5 3表达显著低于癌旁 (P =0 .0 2 6 )。结论　p5 3基因突变和p5 3的功能失活在启东的肝癌发展中有着重要意义。     

消风除湿胶囊治疗类风湿性关节炎48例临床观察

选择诊断明确的类风湿性关节炎(RA)患者70例,分成消风除湿胶囊治疗组和雷公藤多甙片对照组,观察其总体疗效及对休息痛、压痛、肿胀、关节功能的影响,并分析其毒副作用.同时观察外周血免疫指标,血液流变学指标的变化.结果表明治疗组与对照组的总体疗效相似,医生评价与患者评价总有效率达80%以上.治疗组对休息痛、关节压痛改善优于对照组,P＜0.05.对关节肿胀、关节功能改善及血清中TNFα、IL-1水平全血低切,中切,高切,血液粘度差异有非常显著性意义,P＜0.01.治疗组、对照组对血细胞、肝肾功能治疗对比无显著性差异,P＞0.05.表明消风除湿胶囊对RA患者能有效地缓解休息痛、关节压痛、肿胀与改善关节功能,安全性高,其治疗作用机理与降低血免疫指标,血液流变学指标,血沉水平,从而调节机体免疫因子网络有关.     

针刺配合耳穴贴压治疗失眠症的疗效观察

目的　观察针刺配合耳穴贴压治疗失眠症的疗效。方法　把失眠患者随机分成 3组 ,综合组采用针刺配合耳穴贴压 ,与单纯针刺及耳穴贴压比较。结果　 3组均能有效治疗失眠症 ,总有效率分别为 95 .5 6%、 84.3 8%和 77.14 % ,但综合组愈显率为 71.11% ,针刺组及耳穴组愈显率为 40 .63 %和 3 1.43 % ,差异有显著性意义 (P<0 .0 5 ) ,且综合组的疗程短于针刺组及耳穴组 ,差异有显著性意义 (P<0 .0 5 )。结论　针刺配合耳穴贴压治疗失眠症有较好的疗效     

组合型人工肾治疗尿毒症的效果分析

目的探讨组合型人工肾治疗尿毒症患者的疗效与安全性。方法维持性血液透析患者60例，随机分成血液灌流串联血液透析（HP／HD）联合治疗方法与常规血液透析（HD）方法两组。观察治疗前后检测血液尿素氮（BUN）、肌酐（CR）、红细胞（RBC）、白细胞（WBC）、血红蛋白（HGB）、血小板（PLT）、β2微球蛋白（β-MG）、全段甲状旁腺素iPTH及临床症状。结果组合型人工肾治疗血液透析患者能显著清除尿毒症患者体内的毒素，同时患者的睡眠、食欲、皮肤瘙痒有不同程度的改善。未发生其他任何不良事件和副作用。结论组合型人工肾对尿毒症患者并发症的防治安全有效，弥补了常规血液透析的不足。