几种肠道原虫主要表面蛋白的研究进展

在溶组织内阿米巴、隐孢子虫和蓝氏贾第鞭毛虫的致病过程中,一些表面蛋白发挥着重要的作用,介导了原虫与宿主细胞的粘附以及侵入宿主细胞的过程,本文综述了其主要表面蛋白的研究进展以及在诊断和治疗中的应用。     

Transient but marked ST elevation in precordial leads caused by ischemia of the isolated right ventricular branch

The present case is a 64 year-old man in whom transient but marked ST elevation was confirmed in the contralateral precordial leads (V1-3) during percutaneous transluminal coronary angioplasty (PTCA) of the proximal right coronary artery, suggesting that the patient had anteroseptal ischemia. The ST elevation persisted even after the balloon was deflated, and no changes in the left coronary artery were detected. In addition, blood flow in the affected area of the right coronary artery was favorable and there was a transient delay only in the right ventricular branch. Once blood flow in the right ventricular branch improved, ST returned to baseline, and when the right ventricular branch was again occluded by the balloon, ST elevation occurred in a reproducible manner. Hence, the electrocardiographic changes in the precordial leads were caused by occlusion of the right ventricular branch. It is rare to observe ST elevation caused by isolated right ventricular branch ischemia.     

新的塑料袋微生物培养法(PEM)作为白色念珠菌和滴虫性阴道炎的辅助诊断的评价

白色念珠菌和阴道毛滴虫是阴道炎最常见的病原体,尤其是后者,可引起男性尿道炎,并可致严重的并发症。这两种病原体均可借助于分泌物生理盐水涂片或染色法等检出,培养法则可提高检出率。有必要寻找一种简便易行、敏感特异的方法,作者因此提出了塑料袋微生物培养法(PEM)。实验在妇科门诊病人中进行,选择16至40岁主诉有阴     

Cytochrome P450 oxidoreductase gene mutations and Antley-Bixler syndrome with abnormal genitalia and/or impaired steroidogenesis: molecular and clinical studies in 10 patients

We report on molecular and clinical findings in 10 Japanese patients (four males and six females) from eight families (two pairs of siblings and six isolated cases) with Antley-Bixler syndrome accompanied by abnormal genitalia and/or impaired steroidogenesis. Direct sequencing was performed for all the 15 exons of cytochrome P450 oxidoreductase gene (POR), showing two missense mutations (R457H and Y578C), a 24-bp deletion mutation resulting in loss of nine amino acids and creation of one amino acid (L612_W620delinsR), a single bp insertion mutation leading to frameshift (I444fsX449), and a silent mutation (G5G). R457H has previously been shown to be a pathologic mutation, and computerized modeling analyses indicated that the 15A>G for G5G could disturb an exonic splicing enhancer motif, and the remaining three mutations should affect protein conformations. Six patients were compound heterozygotes, and three patients were R457H homozygotes; no mutation was identified on one allele of the remaining one patient. Clinical findings included various degrees of skeletal features, such as brachycephaly, radiohumeral synostosis, and digital joint contractures in patients of both sexes, normal-to-poor masculinization during fetal and pubertal periods in male patients, virilization during fetal life and poor pubertal development without worsening of virilization in female patients, and relatively large height gain and delayed bone age from the pubertal period in patients of both sexes, together with maternal virilization during pregnancy. Blood cholesterol was grossly normal, and endocrine studies revealed defective CYP17A1 and CYP21A2 activities. The results suggest that Antley-Bixler syndrome with abnormal genitalia and/or impaired steroidogenesis is caused by POR mutations, and that clinical features are variable and primarily explained by impaired activities of POR-dependent CYP51A1, CYP17A1, CYP21A2, and CYP19A1.     

浙江地区散发新型布尼亚病毒感染患者的临床特点及其基因序列

目的 分析发热伴血小板减少综合征布尼亚病毒(SFTSV)感染患者的临床特征、流行病学以及SFTSV基因序列.方法 收集2011年5月至7月在温州医学院附属舟山医院感染性疾病科收治的5例重症发热伴血小板减少综合征(SFTS)患者,均经PCR检测SFTSV核酸确诊.采用流式细胞仪(FCM)检测CD3+ CD4+、CD3+ CD8+T淋巴细胞,分离的病毒株测序并与GenBank比对.结果 SFTS患者典型临床表现为持续高热、全身肌肉酸痛、浅表淋巴结肿大、腹痛、腹泻,可伴消化道出血,在急性期WBC、PLT、CD3+CD4+T淋巴细胞呈进行性下降,最低分别为(0.97～2.00)×109/L,(12～42)×109/L和7.52％～20.39％.2例患者血清中分离出病毒,其基因序列与GenBank中的SFTSV进行比对,依赖RNA的RNA聚合酶基因与BX-2010、L-WWG、LN3、JS4、SD4、HN6和AH12的同源性为96％,糖蛋白基因的同源性为94％,而N蛋白基因与JS4、SD4和LN4的同源性为95％;分离的2株病毒的上述三种基因序列的同源性为99％.结论 SFTSV在浙江省有散发流行,以本土疫源性可能大,起病急,病情重,伴多脏器功能损害.     

上海市徐汇区公共卫生从业人员弓形虫感染的血清学调查分析

随机抽取2010年12月~2011年3月上海市徐汇区公共卫生从业人员448名,采集静脉血,ELISA法检测血清弓形虫特异性IgG抗体,抽检的448名公共卫生从业人员中,弓形虫IgG阳性率为10.3%(46/448)。不同来源地(上海、安徽、江苏、河南和四川等)和性别人员之间感染率差异均无统计学意义(P>0.05)。≥30年龄组阳性率(14.9%,29/195)明显高于<30年龄组阳性率(6.7%,17/253)(P<0.05),30~39岁年龄组最高,为15.8%(16/101)。食品生产加工行业从业人员阳性率(12.6%,36/286)显著高于非食品生产加工行业从业人员阳性率(6.2%,10/162)(P<0.05)。     

Production of high-affinity human monoclonal antibody fab fragments to the 19-kilodalton C-terminal merozoite surface protein 1 of Plasmodium falciparum

A combinatorial immunoglobulin gene library was constructed from peripheral blood lymphocytes of eight patients infected with Plasmodium falciparum and was screened for the production of human monoclonal antibody Fab fragments to the C-terminal 19-kDa fragment of P. falciparum merozoite surface protein 1 (MSP-1(19)). Three Fab clones recognized recombinant MSP-1(19) under nonreducing conditions. Indirect immunofluorescence microscopy demonstrated that three Fab clones stained the surfaces of late trophozoites/schizonts and merozoites of the FCR3 and 3D7 strains, suggesting the Fabs' reactivities to a conserved epitope. Sequence analysis of the heavy-chain genes revealed that the closest germ line V segments were VH1-8 and VH7-81, with 91% to 98% homology. The closest germ line D segment was D3-10, and the closest germ line J segment was JH4 or JH5, with 90% to 97% homology. In the light-chain genes, the closest germ line V segment was A27 for the Jkappa2, Jkappa4, and Jkappa5 segments. The dissociation constants of these Fab fragments for recombinant MSP-1(19) ranged from 1.09 x 10(-9) to 2.66 x 10(-9) M. The binding of the three Fab fragments to MSP-1(19) was competitively inhibited by the anti-MSP-1(19) mouse monoclonal antibody 12.8, which inhibits erythrocyte invasion by merozoites. However, the human Fab fragment with the highest affinity did not inhibit in vitro growth of P. falciparum. This is the first report of gene analysis and bacterial expression of human monoclonal antibodies to P. falciparum MSP-1(19). The combinatorial immunoglobulin gene library derived from malaria patients provides a potential tool for producing high-affinity human antibodies specific for P. falciparum.     

Enhancement of ultrasound-induced apoptosis and cell lysis by echo-contrast agents

To determine the effects of echo-contrast agents (ECAs) on ultrasound (US)-induced apoptosis and cell lysis, human myelomonocytic lymphoma U937 cells in suspension were exposed to 1 MHz continuous waves US for 1 min at an intensity of 0.5, 1.0, 2.0 or 4.0 W/cm(2) with or without non-shell type ECA, Levovist (2 mg/ml), and shell type, Optison (1 microl/ml) or YM454 (1 microl/ml). Levovist minimally enhanced the US-induced apoptosis at 1.0 W/cm(2) while Optison and YM454 did at 2.0 and 4.0 W/cm(2), as detected by flow cytometry. Cell lysis was also augmented when Levovist was combined with US at 2.0 W/cm(2), and when Optison was combined with US at 2.0 and 4.0 W/cm(2). YM454 showed the highest rate of enhanced cell lysis at 1.0, 2.0 and 4.0 W/cm(2). Therefore, this study shows that Optison and YM454 are effective in augmenting the US-induced cell killing, but not Levovist. Another result indicates that cavitation plays a role in the augmented effects and that inertial cavitation appears necessary for Optison and YM454 to effect their actions. In addition, results show that the rate of apoptosis is lower in the presence of ECAs with higher free radical scavenging activity, suggesting a possible role for free radicals in apoptosis. These findings suggest that some ECAs have potential to be adjuncts in cases wherein augmented US-induced cell killing is needed, such as in cancer therapy with US.     

酶靶试验:用溶组织素的免疫酶显色检测肠道的溶组织内阿米巴感染

探索一种高度敏感和特异的检测肠道溶组织内阿米巴感染的方法——酶靶(ENZYMEBA)试验。该法是以溶组织素的免疫酶显色为基础的。首先制备抗溶组织素抗体,即以纯化的溶组织素(主要是半胱氨酸蛋白酶)对新西兰白兔进行免疫,50μg酶加入0.5ml PBS,加福氏完全佐剂使其乳化,作