天麻素对心肌缺血再灌注损伤大鼠血清内皮素-1水平的影响

目的探讨天麻素对心肌缺血再灌注损伤大鼠血清中内皮素-1(ET-1)水平的影响。方法 Wistar大鼠50只随机分为5组:假手术组、模型组、天麻素低剂量组、天麻素中剂量组、天麻素高剂量组,每组10只。假手术组大鼠开胸不结扎冠状动脉前降支;模型组大鼠开胸结扎前降支;天麻素低、中、高剂量组大鼠开胸结扎冠状动脉前降支,术前给予相应剂量的天麻素,经舌下静脉给药。放射免疫法测量ET-1血清学水平;反转录-聚合酶链反应、蛋白质免疫印迹法检测各组大鼠心肌组织中ET-1的表达情况。结果与假手术组比较,模型组及天麻素低、中、高剂量组大鼠血清ET-1水平、心肌组织ET-1 mRNA及蛋白水平显著升高(P<0.05);天麻素低、中、高剂量组大鼠血清ET-1水平、心肌组织ET-1 mRNA及蛋白水平均较模型组显著降低(P<0.05),且天麻素剂量越高其水平降低越明显(P<0.05)。结论天麻素进行干预后可有效降低心肌缺血再灌注损伤后内皮素-1表达。     

Rearrangement of both immunoglobulin and T-cell receptor genes in a prolymphocytic variant of hairy cell leukemia patient resistant to interferon-alpha [published erratum appears in Blood 1989 Feb;73(2):624]

We describe a patient with the so-called "prolymphocytic variant" form of hairy cell leukemia (HCL) resistant to treatment with interferon- alpha (IFN-alpha). Analysis of immunoglobulin (Ig) and T-cell receptor- beta (TCR beta) gene rearrangements from serial peripheral blood mononuclear cell specimens (MNCs) confirmed not only the B-cell nature of the disease, but also the subsequent emergence of a morphologically indistinguishable population of cells with a clonal TCR beta rearrangement in addition to the original Ig gene rearrangement. With the exception of a transient increase in peripheral blood T cells during treatment with deoxycoformycin (DCF), the MNCs remained essentially constant throughout therapy with no evidence of a co- existing T-cell clone to account for the TCR beta rearrangement. Although MNCs from this patient bound significantly less IFN-alpha than did MNCs from other HCL patients, the binding was of high affinity with a kd similar to that of control cells. The number of IFN-gamma receptors on our patient's MNCs was four times higher than the number of IFN-alpha receptors and was similar to the number of IFN-alpha receptors on MNCs from HCL patients responsive to IFN-alpha. While various treatments including IFN-alpha, DCF, chlorambucil, splenectomy, leukopheresis, and IFN-gamma were not able to change the clinical progression of the disease, they may have provided an opportunity for the divergent TCR beta rearranged clone to expand and displace the initially dominant clone.     

功能板影响错伴特发性髁突吸收正颌术后稳定性的初步研究

目的:探讨特发性髁突吸收（idiopathic condylar resorption, ICR）患者在关节功能板治疗结合正颌-正畸联合治疗后下颌骨及髁突位置的改变,为后期研究提供依据。方法:回顾分析2008—2012年收治的13例特发性髁突吸收患者的临床数据,所有患者均在正颌手术前接受关节功能板治疗7.5±1.5个月。对患者正颌术前(T0)、正颌术后即刻(T1)、正颌术后至少12个月(T2)的咬合、头颅侧位片、MRI检查结果进行测量,采用SPSS 22.0软件包对数据进行统计学分析,评价正颌术后髁突和下颌骨的位置变化。结果:正颌手术(T1)纠正了所有患者的骨性Ⅱ类错畸形,建立了正常的咬合关系、前伸运动及侧方斜导运动。正颌手术平均下颌骨前移量(Y Axis-B, T1-T0)为（5.05±3.54）mm。与T1相比,T2时颞下颌关节间隙参数无显著改变。下颌骨位置参数中, 仅Y轴到B点的距离（Y轴-B）在T2与T1间存在统计学差异,其改变量平均值为（-1.64±2.48）mm,其余参数均无显著差异。13例患者中,11例患者Y轴-B 改变值<2 mm（84.6%）,仅 2例患者出现>2 mm的后退（15.4%）。结论:关节功能板治疗可增加ICR患者正颌手术的稳定性,可能是关节功能板保守治疗能够稳定ICR患者髁突在关节窝内的位置。     

Risk of human immunodeficiency virus (HIV) transmission by blood transfusions before the implementation of HIV-1 antibody screening. The Transfusion Safety Study Group

Little information is available regarding the risk of human immunodeficiency virus type 1 (HIV-1) infection for patients transfused before routine anti-HIV-1 screening of blood donors was instituted in March 1985. A model was developed for estimating both the proportion and the number of transfusion recipients in the San Francisco Bay area who were infected by HIV-1 during each of the 7 years preceding routine donor screening for anti-HIV-1. The model is based on analysis of 1) donation histories of HIV-1-infected donors identified at the regional blood center; 2) HIV-1 seroprevalence estimates for homosexual and bisexual men in San Francisco; and 3) HIV-1 infection and survival rates for recipients traced by the Transfusion Safety Study and Irwin Memorial Blood Centers' Look Back Program. The incidence of transfusion-associated HIV-1 infection is estimated to have risen rapidly from the first occurrence in 1978 to a peak in late 1982 of approximately 1.1 percent per transfused unit. The decrease after 1982 coincided with the implementation of high-risk donor deferral measures. It is estimated that, overall, approximately 2135 transfusion recipients were infected with HIV-1 in the San Francisco region alone. This number suggests a higher prevalence of transfusion-associated HIV-1 infection than has been generally recognized and indicates the need for continued tracing of potentially exposed recipients. The data also strongly support the effectiveness of early donor education and self-exclusion measures and emphasize the importance of continued research and development in this area.     

Transfusion practices in human immunodeficiency virus-infected patients

BACKGROUND: The reported immunomodulatory effects of transfusion raise concern about the potential for virus activation and tumor growth in human immunodeficiency virus (HIV)-infected patients. In the absence of “standards” of transfusion practice for such patients, a survey of transfusion policies among institutions specializing in the care of HIV- infected patients was performed to delineate current practices. STUDY DESIGN AND METHODS: A survey developed by the Transfusion Practices Committee of the American Association of Blood Banks was sent to 47 AIDS clinical trial units and 14 regional hemophilia centers in North America. RESULTS: Forty-three percent of centers completed the survey. Most centers observed more than 200 HIV-infected patients each. The key findings were that 1) 81 percent of centers used identical red cell transfusion criteria for HIV-infected and noninfected patients; 2) 52 percent used recombinant human erythropoietin as initial treatment for zidovudine-induced anemia, while 46 percent used recombinant human erythropoietin for anemia not associated with zidovudine; 3) 35 percent of centers used white cell-reduced blood components in lieu of cytomegalovirus (CMV)-seronegative components when administering transfusion(s) to CMV-seronegative patients; 4) 27 percent gamma- radiated cellular components, but no case of graft-versus-host disease had been observed; 5) > 85 percent of centers used monoclonal factor VIII for pediatric and adult hemophiliacs infected with HIV; 6) approximately one-third of centers routinely white cell-reduced cellular components; and 7) the most common reasons for white cell reduction included reduction of febrile reactions and CMV risk, reduction of platelet alloimmunization, and delay of immunomodulatory consequences of transfusion. CONCLUSION: There is marked heterogeneity in transfusion practice for HIV-infected patients. Modification of cellular components to achieve different objectives is routine in many centers.     

磁共振诊断卵巢纤维卵泡膜细胞瘤一例

正病例:患者,女,74岁,因下腹部坠胀6天入院。查体:腹部膨隆,其余未见明显异常。妇科检查:子宫呈老年性萎缩,子宫前方触及一实性包块,直径约13 cm,表面光滑,活动度一般,压痛(+);附件触及不理想。糖类抗原125199.60 U/ml,血液及其他实验室检查无异常。本院彩超示盆腔内实性包块,大小约为102 mm×129 mm×89 mm。磁共振检查:盆腔及腹腔内见巨大包块,T1WI信号略低于子宫肌层,内见斑点状高信号影(图1A),T2WI呈高、低混杂信号(图1B),弥散加权     

传染病专业研究生培养过程中糖生物学教学的难点与对策

糖生物学是一门新兴的学科,目前我国多数医学院校尚未开设糖生物学课程。糖生物学也是一门与感染免疫密切相关的学科,如蛋白质的糖基化修饰与病毒组装,准种演化,免疫耐受,免疫识别以及免疫效应细胞的激活和分化乃至疫苗的研发都具有非常密切的关系。因此,对感染免疫专业的研究生进行系统的糖生物学教育,对培养高质量的医学人才至关重要。本文结合本院研究生培养的实际工作经验,对糖生物学教育的必要性,目前面临的问题以及可能的对策进行了初步分析,为未来规范的研究生糖生物学教学提供初步的思路。