A cyclic peptide–polymer probe for the detection of Clostridium botulinum neurotoxin serotype A

A Botulinum neurotoxin serotype A (BoNT/A) ELISA detection system was developed based upon an 11-mer cyclic peptide, termed C11-019, that was identified through peptide phage display technology. The assay employs a sandwich format using the C11-019 cyclic peptide attached to a PEMA (poly(ethylene maleic anhydride)) matrix as the capture phase and anti-BoNT/A polyclonal antibodies as the detection phase. Results reported demonstrate that the C11-019 peptide–polymer can specifically bind to BoNT/A with no cross-reactivity to other serotypes examined in assay buffers and a variety of body fluids and foodstuffs. When a highly sensitive chemiluminescent substrate was engaged, the detection of 1 pg/mL could be readily achieved within 3 h with a linear range of 0.1–1 ng/mL. These results demonstrate that an inexpensive peptide–polymer-based capture ELISA system can be used for rapid, sensitive and highly specific BoNT detection.     

Abdominal nontuberculous mycobacterial infection in a university hospital in Taiwan from 1997 to 2003.

BACKGROUND/PURPOSE: Abdominal nontuberculous mycobacterial infection is a rare condition. Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis is the most common manifestation of infection due to nontuberculous mycobacteria (NTM). There are limited data on the clinical manifestations of nontuberculous mycobacterial infection. This study investigated the diagnostic features, clinical presentation, mycobacteriology, treatment and outcome of all abdominal NTM infections treated over a 7-year period at a major teaching hospital in Taiwan. METHODS: The medical records of all patients with a diagnosis of abdominal NTM infection from January 1997 through to December 2003 were retrospectively reviewed. RESULTS: All 11 patients with abdominal NTM infections identified during the 7-year period were included. Among these patients, six were male and five were female, with a mean age of 64.5 years. The disease manifested as peritonitis (9 patients, 82%), splenic abscess (1, 9%), or perirenal abscess (1, 9%). Most patients (73%) had underlying malignancy, most often hepatoma (45%). Immunocompromised status (liver cirrhosis, malignancy, acquired immunodeficiency syndrome) was noted in 10 patients (91%). None of our patients who developed NTM peritonitis had received CAPD. The peritoneal fluid appearance varied considerably, with no particular predominance of clear, turbid, bloody, or chylous findings. Rapidly growing mycobacteria were the major etiology (46%) of abdominal NTM infection, and Mycobacterium abscessus played a major role (27%). Overall, eight patients died, and only one patient survived longer than 1 year. Seven patients (64%) died before diagnosis. CONCLUSION: Abdominal NTM infection is frequently overlooked because of its rarity and nonspecific symptoms, with consequent delays in diagnosis and treatment. In immunocompromised patients with ascites from any cause (liver cirrhosis, malignant ascites, etc.), NTM peritonitis should be considered early in the differential diagnosis of symptoms including fever, abdominal pain and weight loss. The poor prognosis of abdominal NTM infection appears to be related to the severity of underlying conditions, most often malignancy.     

类风湿病中左心室收缩功能障碍：一种未被认识的负荷？

目的:本研究旨在明确左心室收缩功能障碍在临床类风湿病(RD)患者中是否较正常人群中更常见,并评价脑利钠肽(BNP)的诊断价值。背景:RD患者罹患缺血性心脏病的风险增加,而采用超声心动图评估RD患者心功能不全的大型研究却少见。假定左心室收缩功能障碍在RD患者中较正常人群中更为     

手术结及打结方法的规范与进展

打结是手术的最基本技术之一，主要包括结扎打结（结扎血管、胆管、淋巴管等）、固定打结（固定引流管、引流条等）及缝合打结。手术不论大小都不能不做许多重复的打结动作，学习手术技术正是从学打结、练打结开始的。由于打结的操作太习以为常，许多手术医生对打结不够重视，对各种手术结并没有一个全面的了解和认识，甚至每日都在重复着不规范的打结操作。手术打结操作是否正确、熟练程度如何等不仅体现了手术医生的基本素质，而且直接关系到手术的效果，甚至关系到病人的安危。     

腹腔镜与开放性肾囊肿去顶术的临床对照分析

目的评价腹腔镜与开放性肾囊肿去顶术的临床疗效。方法回顾性分析采用经后腹腔镜和经腹腔镜行肾囊肿去顶术21例，其中经腹腔5例，经后腹腔16例，与开放性手术16例比较。结果手术时间，术中平均出血量，术后下床活动时间，术后住院天数，术后并发症腹腔镜组均优于开放手术组，住院费用腹腔镜组略高于开放性手术组。结论腹腔镜肾囊肿去顶术治疗单纯性肾囊肿安全、有效。应成为治疗单纯性肾囊肿的首选方法。     

北京农村居民健康状况及卫生服务需求调查

目的了解北京农村居民健康状况及卫生服务需求特点。方法从昌平区、顺义区、大兴区、房山区随机抽取25～64岁农民1605人进行统一问卷调查。结果农民高血压自报患病率为22．4％，超重和肥胖率为56．1％；现在吸烟率为34．4％，缺乏运动率为41．6％；家庭主要经济支出为学生上学(35．3％)，建房(25．4％)和疾病(21．2％)；54．9％家庭医疗费用支出占总收入的10％以上；最关心的健康问题主要是慢性疾病防治(70．2％)；最希望获得的健康知识是慢性病预防知识(72％)；希望获得健康知识的途径是广播和电视(81％)；家庭最希望获得的医疗保健服务是方便看病和获得药物(73．8％)。结论慢性病给农民带来沉重负担，并成为农民关心的主要健康问题。     

Poly-L-Lysine玻片在寡核苷酸芯片制备中的改进

目的 为了制得适合固定未修饰寡核苷酸的芯片，提高检测灵敏性，对Patrick Brown实验室的多聚左旋赖氨酸包被玻片的方法进行改进。方法 玻片经清洗后用缩水甘油-丙氧基三甲氧基硅烷进行硅烷化，然后应用Poly-L-Lysine在玻片表面形成聚合物涂层，经次亚苯基二异硫氰酸盐表面活化后可使寡核苷酸共价连接在芯片表面。设计了各种实验考察方法改进前后芯片表面的性能，并将改进后的玻片初步应用于SARS冠状病毒寡核苷酸芯片检测中。结果 方法改进后芯片表面性能优良：固定效率高、点的同一性好、杂交效率和热稳定性好、寡核苷酸结合牢固、芯片可以重复利用。结论 利用共价连接，方法改进后的芯片表面适合固定未修饰的寡核苷酸，解决了寡核苷酸与玻片之间物理结合不稳定、易剥离的缺陷，提高了芯片检测的灵敏性。     

Particle size and morphology of UHMWPE wear debris in failed total knee arthroplasties--a comparison between mobile bearing and fixed bearing knees.

Osteolysis induced by ultrahigh molecular weight polyethylene wear debris has been recognized as the major cause of long-term failure in total joint arthroplasties. In a previous study, the prevalence of intraoperatively identified osteolysis during primary revision surgery was much higher in mobile bearing knee replacements (47%) than in fixed bearing knee replacements (13%). We postulated that mobile bearing knee implants tend to produce smaller sized particles. In our current study, we compared the particle size and morphology of polyethylene wear debris between failed mobile bearing and fixed bearing knees. Tissue specimens from interfacial and lytic regions were extracted during revision surgery of 10 mobile bearing knees (all of the low contact stress (LCS) design) and 17 fixed bearing knees (10 of the porous-coated anatomic (PCA) and 7 of the Miller/Galante design). Polyethylene particles were isolated from the tissue specimens and examined using both scanning electron microscopy and light-scattering analyses. The LCS mobile bearing knees produced smaller particulate debris (mean equivalent spherical diameter: 0.58 microm in LCS, 1.17 microm in PCA and 5.23 microm in M/G) and more granular debris (mean value: 93% in LCS, 77% in PCA and 15% in M/G).     

左主干起源于右冠状动脉窦（附2例报告并文献复习）

目的:分析左主干起源于右冠状动脉窦的临床特征,提高对左主干起源于右冠状动脉窦的认识和诊断.方法:回顾分析2例左主干起源于右冠状动脉窦的临床病例并对文献进行回顾分析.结果:左主干起源于右冠状动脉窦是一种罕见的先天性冠脉畸形,这种畸形可分为良性或恶性,主要根据异常左冠状动脉与主动脉和肺动脉之间的关系.对于可能引起猝死或严重心肌缺血患者,应进行冠状动脉旁路移植术.2例患者左主干起源于右冠状动脉窦,其中1例左主干走行于主动脉与肺动脉之间,1例走行于主动脉前方,这2例未进行预防性外科手术,目前预后良好.结论:左主干起源于右冠状动脉窦是罕见的冠脉畸形,应注意鉴别是良性或是恶性,确定下一步治疗方案.