抗NMDAR脑炎血清抗NMDAR抗体阴性患者临床分析

目的 探讨血清抗N-甲基-D-天冬氨酸受体(NMDAR)抗体阴性的抗NMDAR脑炎患者的临床表现特征、治疗及其预后特点.方法 收集郑州大学第一附属医院2013-09—2019-12确诊为抗NMDAR脑炎的60例患者,根据其血清中抗NMDAR抗体的情况分为血清抗体阴性组和阳性组,分析2组临床表现特征、辅助检查、治疗及预后...     

Studies on the mechanism of complement-mediated inhibition of antibody binding to HIV gp41

We have previously demonstrated that HIV envelope gp41 binding to specific antibodies decreases after preincubation of fluid-phase gp41 in normal human serum. This inhibition is proven to be mediated by the classical complement pathway. In this study recombinant gp41 (rgp41) and/or synthetic peptides were preadsorbed to solid phase, and then complement (normal human serum heated human serum, purified Clq/heated Clq) and anti-gp41 antibodies were added either after each other or simultaneously, and the amounts of bound antibody, and deposited C3b, C4b and Clq were measured. Complement-dependent inhibition of antibody binding to solid-phase rgp41 was found, and Clq seems to be at least partially responsible for this phenomenon. Heating of Clq did not affect this process. Higher amounts of anti-gp41 antibodies significantly and dose-dependently enhanced C4b and C3b fixation to solid-phase rgp41. In the case of synthetic peptides corresponding to the immunodominant region of gp41, significant antibody binding to the solid-phase peptides was also detected, and pretreatment of peptides preadsorbed to solid phase with normal human serum almost totally abolished the antibody binding.     

Flt3L对COPD大鼠铜绿假单胞菌肺炎的防治研究

目的 建立铜绿假单胞菌(PA)肺部感染大鼠慢性阻塞性肺疾病(COPD)模型,研究Flt3L(Fms-like tyrosine kinase-3 ligand )对其炎症反应的防治作用.方法 将50只健康雄性清洁级Wistar大鼠随机分为对照组(NS组)、PA感染对照组(NPA组)、COPD大鼠组(COPD组)、COPD大鼠PA感染组(CPA组)和COPD大鼠PA感染Flt3L处理组(Flt3L组),每组动物各10只.用烟雾暴露法复制大鼠COPD模型,气管内滴入PA溶液复制肺部PA感染模型.COPD组、CPA组、Flt3L组大鼠分别在第1～60天以烟雾暴露法复制COPD模型,Flt3L组于第61～65天连续给予Flt3L(20g/kg)腹腔注射,每天1次,连续5d,第66天同时建立NPA组、CPA组和Flt3L组模型.24h后计算大鼠死亡率,对支气管肺泡灌洗液(BALF)、肺组织进行细菌学、细胞学、病理学等研究.无菌操作下取出大鼠脏器进行细菌培养、菌落计数及细菌鉴定.结果 Flt3L组大鼠存活率(87.5%)显著高于CPA组(50.0%)(P<0.01),Flt3L组大鼠支气管肺泡灌洗液中淋巴细胞数[(0.41～0.05)×109/L]与CPA组[(0.24～0.04)×109/L]比较显著增加(P<0.01),光镜下观察比较发现Flt3L组大鼠肺组织炎症反应较CPA组明显减轻,脏器细菌培养阳性率CPA组(37.5%)显著高于Flt3L组(12.5%)(P<0.01).结论 Flt3L能够增强COPD大鼠对PA肺部感染的抗病力.     

The design of the SAFE or SORRY? study: a cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events

Background  

Patients in hospitals and nursing homes are at risk of the development of, often preventable, adverse events (AEs), which threaten patient safety. Guidelines for prevention of many types of AEs are available, however, compliance with these guidelines appears to be lacking. Besides general barriers that inhibit implementation, this non-compliance is associated with the large number of guidelines competing for attention. As implementation of a guideline is time-consuming, it is difficult for organisations to implement all available guidelines. Another problem is lack of feedback about performance using quality indicators of guideline based care and lack of a recognisable, unambiguous system for implementation. A program that allows organisations to implement multiple guidelines simultaneously may facilitate guideline use and thus improve patient safety.     

Serum heparan sulfate levels are elevated in endotoxemia

Background

Increased vascular permeability is a characteristic feature of sepsis which, in the past, has been ascribed exclusively to a malfunction of endothelial cells. However, recently it has become evident that the endothelial glycocalyx is of considerable importance concerning various aspects of vascular physiology, e.g. the vascular barrier and inflammation. Heparan sulfate, one of its essential components is characteristically traceable in blood, in case the endothelial glycocalyx is damaged or destroyed.

Methods

In 15 pigs we investigated whether the administration of endotoxin from gram-negative bacteria (Escherichia coli) results in increased serum levels of heparan sulfate, signalizing a shedding of the glycocalyx. In addition, markers of inflammation (white blood cell count, platelet count, tumour necrosis factor-α and interleukin-6) were evaluated over an observation period of 6 hours.

Results

Serum heparan sulfate concentrations significantly increased over time in the endotoxin group and were significantly elevated in comparison to the control group 6 hours after administration of endotoxin (p < 0.001). In the endotoxin group all markers of inflammation significantly changed during the time course.

Conclusions

The administration of bacterial endotoxin induced a significant rise in degradation products of the endothelial glycocalyx.     

nm23-H1表达预测大肠癌转移的价值研究

 目的　大肠癌预后取决于是否存在肿瘤转移,目前尚无肯定的观测大肠癌细胞恶性潜能的生物学指标。本研究目的在于探讨nm23-H1作为预测大肠癌转移指标的潜在价值。方法　采用免疫组织化学链霉菌亲合物素蛋白—生物素酶标(SP)方法对58例存档大肠癌标本进行nm23-H1蛋白表达检测,用SSPS统计软件包对nm-H1表达与临床病理参数的关系进行分析。结果　正常大肠粘膜和大肠腺瘤nm23呈阳性表达,62.1%大肠癌组织阳性表达。nm23表达与肿瘤分级、淋巴结及肝转移负相关(P值分别为0.0100,0.2087,0.00376)。nm23阳性表达的大肠癌患者预后好(P=0.0002)。结论　nm23-H1是预测大肠癌细胞转移潜能和预后的敏感指标。