应用经胸超声心动图评估快速左心耳起搏心房颤动模型心脏结构及功能的变化

目的:应用经胸超声心动图观察高频率左心耳起搏致猪慢性心房颤动模型心脏结构和功能的变化。方法:实验于2005-09/2006-08在南京医科大学第一附属医院江苏省实验动物中心完成。①12只苏钟种猪随机分为实验组及对照组各6只,所有动物均开胸,将起搏电极固定在左心耳根部,高频率脉冲发生器植入左侧胸部囊袋。实验组术后恢复1周后起搏器以500次/min的频率快速起搏左心耳8周;对照组始终不起搏。②术后心电图定期监测起搏、心房颤动的发生情况;于术前、起搏后1周、起搏后4,8周超声心动图观察实验动物左房内径、心室收缩及舒张末左房面积、左房和左室射血分数、左室舒张及收缩末内径、左心室短轴缩短率等变化。结果:①实验组5只完成了实验,术后2周复查心电图,1只动物发生房颤,起搏8周3只发生阵发性房颤,1只未发生房颤;对照组则未发生任何心律失常情况。②左心房相关指标:起搏后1周,实验组左房内径、收缩末期左心房面积和舒张末期左房容积均较起搏前增加[(2.70±0.12),(2.50±0.12)cm;(6.78±0.81),(6.21±0.93)cm2;(4.66±0.53),(3.78±0.57)mL;P均<0.05],左房射血分数较起搏前下降[(55.6±6.0)%,(63.8±4.0)%,P<0.01],至起搏4,8周,左房射血分数进一步降低,左房内径等指标则继续增大。③左心室相关指标:起搏后1周,实验组左室舒张、收缩末期内径较起搏前增加[(3.64±0.13),(3.46±0.15)cm;(2.48±0.08),(2.14±0.09)cm;P均<0.01],左心室短轴缩短率和左室射血分数较起搏前下降[(31.6±2.0)%,(37.8±3.0)%;(60.8±2.0)%,(69.2±4.0)%;P均<0.01];至起搏4,8周,左心室短轴缩短率和射血分数进一步降低,左室舒张、收缩末期内径则继续增大,与对照组比较也差异显著(P<0.05,0.001)。结论:①超声心动图是监测房颤模型建立过程中心房、心室结构和功能变化的有效手段。②高频起搏左心耳是建立猪心房颤动模型的有效方法,快速心房起搏可导致左心房左心室增大及心功能减退。     

Serologic evidence that Scianna null (Sc:-1,-2) red cells lack multiple high-frequency antigens

Sera from three unrelated persons whose red cells (RBC) had the common Scianna phenotype (Sc:1,-2) contained IgG alloantibodies directed against high-frequency RBC antigens. In each case, sera or eluates or both failed to react only with Scianna null (Sc:-1,-2) cells, although an eluate from one person was compatible with a sibling's Sc:1,-2 cells. Cross-testing cells with sera or eluates, or both, from the three persons revealed no mutual compatibility. These studies show the existence of three additional RBC antigens phenotypically related to the Scianna blood group system. Sc:-1,-2 cells lack these antigens, which indicates that Scianna null cells lack multiple high-frequency antigens.     

自主研制镍钛记忆合金左心耳封堵器封闭左心耳对实验动物左心功能的影响

目的:应用经胸彩色多普勒超声技术评价自主研制的镍钛记忆合金左心耳封堵器封闭左心耳对实验动物猪左心房、左心室功能的影响。方法:实验于2005-09/2006-08在南京医科大学第一附属医院江苏省实验动物中心完成。①实验分组:选用苏钟小型种猪17只,随机分为实验组12只和对照组5只。②实验干预:实验组12只苏钟小型种猪使用自主研制的左心耳封堵器(发明专利号码:200610037789.3,公开号CN1799521,由镍钛合金骨架、多聚四氟乙烯膜和传送连接部分等构成。其外观呈单盘状,封堵器的左心房面呈圆盘状,直接连接放入心耳内的圆柱体结构)行左心耳封堵,对照组5只手术步骤相同而不采用封堵器行左心耳封堵。③实验评估:两组动物分别于术前、术后1周、2周、4周采用经胸超声心动图检查观察心功能的改变,测量左心房内径、最大及最小容积、左房射血分数、左心房搏出量、血流分数等左房功能参数以及左室射血分数、左室短轴缩短率、Tei指数、E/A比值等指标。结果:①实验动物数量分析:在施行左心耳封堵后,1头猪于术中出血过多并出现室颤后死亡,1头猪因封堵器脱入左房,卡在二尖瓣口导致死亡。其余动物封堵效果良好。②两组动物术后1,2,4周左房功能指标各参数与术前比较无明显变化(P>0.05);与术前相比,实验组术后1周、2周左室射血分数、左心室短轴缩短率、E/A比值分别由术前的0.70±0.04、0.39±0.03、1.33±0.28降低至术后1周的0.59±0.05、0.31±0.03、0.95±0.11(P<均0.01)及术后2周的0.62±0.05、0.33±0.05、0.90±0.05(P<均0.01);Tei指数由术前的0.48±0.02增加至术后1周的0.59±0.03(P<0.01)及术后2周的0.58±0.04(P<0.01)。对照组手术前后左室功能指标差异无显著性。结论:自主研制左心耳封堵器可以有效的封堵左心耳;左心耳封堵后短期内对实验动物左房功能无明显影响;封堵后短期内对左心室功能具有短期的减弱,更长期的安全性有待于进一步研究。     

Column agglutination technology: the antiglobulin test

A new system for typing and screening blood, based on the sieving effect of glass bead microparticles, has been developed. The test is performed in a microcolumn in which the red cell agglutinates are trapped in the glass bead matrix during centrifugation, and unagglutinated cells form a pellet at the bottom of the column. Anti- human globulin reagents were incorporated in the diluent and the new test system, column agglutination technology, was compared to conventional tube tests and low-ionic-strength method. Sera and plasmas (228 samples) were screened for red cell antibodies with two anti-human globulin reagents: one containing only anti-IgG and the other containing both anti-IgG and anti-C3b, -C3d. After initial testing, there was 94-percent agreement between column agglutination technology and tube tests, and after repeat testing, there was 97-percent agreement. The column agglutination technology anti-human globulin test eliminates the need to wash red cells, which decreases the overall test time. The test is easy to perform, and the results are more objective than those with tube and microplate methods.     

Heterogeneity of Tumor and Immune Cell PD-L1 Expression and Lymphocyte Counts in Surgical NSCLC Samples

Background

Immune-checkpoint inhibitors against programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) have shown remarkable therapeutic activity in non–small-cell lung cancer (NSCLC). However, biomarker-based patient selection remains a challenge. Our aim was to assess the heterogeneity of various immune markers between different tumor areas of surgically resected NSCLC specimens.