Molecular subtyping of Vibrio cholerae O1 and O139 by pulsed-field gel electrophoresis in Hong Kong: correlation with epidemiological events from 1994 to 2002

Two hundred twenty isolates of Vibrio cholerae O1 and O139 collected from 1994 to 2002 in Hong Kong were analyzed by pulsed-field gel electrophoresis (PFGE). Chromosomal DNAs from all V. cholerae isolates in agarose plugs were digested with the restriction enzyme NotI, resulting in 20 to 27 bands. Sixty distinctive PFGE patterns in the range of 10 to 300 kb were noted among 213 isolates typeable by PFGE. By comparing the common PFGE patterns obtained from four well-defined outbreaks of V. cholerae O1 and O139 with those obtained from other, epidemiologically unrelated isolates during the study period, indistinguishable and similar PFGE patterns were identified, indicating their close relatedness, in agreement with the results of epidemiological investigations. Heterogeneous PFGE patterns (with four to six banding differences), however, were identified among strains that were imported from other parts of Asia, including Indonesia, India, and Pakistan. Correlations with epidemiological information further support the usefulness of PFGE as an epidemiological tool in laboratory investigations of suspected outbreaks. Standardization of PFGE methodology will allow international comparison of fingerprint patterns and will form the basis of a laboratory network for tracking V. cholerae.     

THE EXPLORATION ON APPLIED VALUE OF BA IN DIAGNOSIS OF TIA

目的:探讨脑电地形图在短暂性脑缺血发作诊断中的应用价值.方法:在68例短暂性脑缺血发作患者中,进行了脑电地形图检查.结果:在67(98.52%)例患者中脑电地形图是异常的.40(58.82%)的患者脑电地形图在θ或δ频段显示高功率阴影,在α频段显示低功率阴影.14(20.59%)例患者在α频段显示低功率阴影.12(17.65%)例患者在θ或δ频段显示高功率阴影.1(1.47%)例患者在β频段显示低功率阴影.1(1.47%)例患者正常.结论:脑电地形图在短暂性脑缺血发作的临床诊断中具有重要意义.     

登革3型病毒prM-E和NS1多基因重组质粒DNA免疫原性增强效果观察

目的　观察登革 3型病毒的prM E和NS1基因重组质粒DNA混合免疫对免疫原性的增强作用 ,为登革DNA疫苗混合免疫提供实验依据。方法　将登革 3型病毒的prM E和NS1基因重组质粒DNA分别混合及单独免疫BALB/c小鼠 ,采用中和试验及MTT法检测免疫小鼠血清中和抗体及脾细胞特异性CTL(cytotoxicT lymphocytes)杀伤率。结果　混合重组质粒DNA免疫组与单一prM E基因重组质粒DNA免疫组均在末次免疫后第 14天检测到中和抗体 ,在第 33天达到高峰 ,为 1∶32。在末次免疫后第 4 1天 ,当效靶比为 4 0∶1时 ,混合重组质粒DNA免疫组的特异性CTL杀伤率为 15 % ,而 2个单质粒DNA组分别为 10 .9%和 12 .4 %。结论　重组质粒DNA混合免疫可同时诱发小鼠产生体液免疫和细胞免疫 ,而且细胞免疫应答具有一定的增强作用 ,但没有出现特异性CTL杀伤率的协同增强效果。     

一起戊型肝炎暴发的血清抗体比较研究

目的评价戊型肝炎(戊肝)抗体E2-IgM(抗-HEV E2-IgM)酶联免疫试剂(捕获法)在反映戊肝流行特征和对戊肝早期诊断中的作用.方法在首发病例26 d后对某单位戊肝暴发人群和相邻单位对照人群进行血清抗-HEV E2-IgM、IgG检测;部分人群进行美国Genelabs抗-HEV IgM、IgG的平行检测.结果抗-HEV E2-IgM试剂捕获法在对照人群中仅检出1例阳性(0.11%),且阳性和阴性之间可明显区分,其特异度为99.89%;在暴发流行人群中检出145例阳性(8.66%),显著高于对照人群(P＜0.001);暴发人群中戊肝患者的血清学动态变化为抗-HEV E2-IgM在暴露时间为30～60d时保持较高吸光度(A值),随着时间的延长A值呈明显下降趋势;抗-HEV E2-IgM阳性在该组人群中与性别和年龄无关;在暴发人群抗-HEV E2-IgM(+)的115例患者中,Genelabs抗-HEV IgG检测出88份阳性,检出率为76.52%,漏检27例,漏检率为23.48%.对照人群随机抽样179例患者中有20例Genelabs抗-HEVI IgG(+),阳性率为11.17%.在110份抗-HEV E2-IgM(+)的血样中,Genelabs抗-HEVIgM只检测出76份,检出率为69.09%;有16例患者Genelabs抗-HEV IgG、IgM均未能检出;Genelabs抗-HEV IgG和IgM的不一致率为25.45%.结论抗-HEV E2-IgM具有99%左右的特异度,与在正常人群中检出较高阳性率的Genelabs抗-HEV IgG试剂相比,减少了假阳性;抗-HEV E2-IgM与Genelabs抗-HEV IgM、IgG相比,对急性戊肝感染诊断的灵敏度提高了25%～30%,减少了漏诊;抗-HEV E2-IgM试剂盒操作简单、快速,本底较好,不存在酶结合物不足的问题.     

CT抗原KM-HN-1 HLA-A * 0201限制性表位预测及其与HLA-A * 0201结合强度分析

目的通过对CT抗原（cancer-testis antigen）KM-HN-1进行HLA-A＊0201限制性表位预测，并对候选表位肽与HLA-A＊0201分子结合亲和力及复合物稳定性进行分析，为探索基于KM-HN-1的免疫治疗奠定基础。方法利用基于蛋白酶体剪切位点特异性的算法PAProc及基于肽MHC-I结合的算法BIMAS和SYFPEITHI对KM-HN-1进行HLA-A＊0201限制性表位预测．合成KM-HN-1相关候选表位肽KM-HN-I321-329（KLLPFRETV），KM-HN-I303-211，（FLPTAPPNV），KM-HN-I629-637。（TLLQIIETV），KM-HN-I87-95（ILNKSIIEV），KM-HN-I538-596。（QMMEALDQL）及阳性对照肽HBVcAg18-27（FLPSDFFPSV）；对这些合成肽与HIA-A＊0201分子结合亲和力及其复合物稳定性根据文献报道的方法进行分析。结果KM-HN-I321-329（KLLPERETV）结合亲和力最低，KM-HN—I203-211（FLPTAPPNV）结合亲和力最高，其余3条肽结合亲和力介于2者之间；稳定性实验（DC50）结果显示：KM-HN-I538—546（QMMEALDQL）DC50小于2h，KM—HN-I321-329（KLLPERETV）的DC50介于2～4h之间，KM-HN-I87-95。（ILNKSIIEV）的DC50介于6～8h之间，KM-HN-I233-211（HLPTAPPNV）及KM-HN-I629—633（TLLQIIETV）的DC50均大于8h。结论基于蛋白酶体剪切位点特异性的算法及基于肽MHC-I结合的算法对KM-HN-1进行HLA-A＊0201限制性表位预测，结合候选表位肽与HLA-A＊0201分子结合的亲和力与复合物稳定性实验分析，为该抗原HLA-A＊0201限制性表位的鉴定奠定了基础。     

Synthesis and function of Actinomyces naeslundii T14V type 1 fimbriae require the expression of additional fimbria-associated genes.

The nucleotide sequence of the chromosomal DNA flanking the Actinomyces naeslundii (formerly A. viscosus) T14V type 1 fimbrial structural subunit gene (fimP) was determined. Six open reading frames (ORFs), in the order 5' ORF3, ORF2, ORF1,fimP, ORF4, ORF5, ORF6 3', were identified. ORF1 encoded a protein of 408 amino acid residues (Mr = 39,270) and had significant sequence homology with the A. naeslundii T14V type 1 and A. naeslundii WVU45 type 2 fimbrial structural subunits. An in-frame fusion of ORF1 to the malE gene of the expression vector, pMAL-c2, yielded a protein that was immunostained with antibodies raised against the maltose binding protein and A. naeslundii T14V whole bacteria. Digestion of the fusion protein with factor Xa released a protein (apparent molecular mass of 34 kDa) that was immunostained only with the antibody directed against A. naeslundii T14V whole bacterial cells. Integration plasmids carrying a kanamycin resistance gene (kan) that was used to substitute for ORF1 or for DNA fragments internal to the coding region of the other five ORFs were used to transform A. naeslundii T14V. Neither type 1 fimbriae nor the 65-kDa fimbrial structural subunit was detected in mutants obtained by allelic replacement of ORF1 or ORF2. Mutants obtained by allelic replacement of ORF3 or ORF4 expressed only the 65-kDa fimbrial structural subunit. These mutants did not bind, in vitro, to proline-rich proteins that serve as the receptors for Actinomyces type 1 fimbriae. In contrast, a mutant in which the integration plasmid DNA had been inserted at a site close to the carboxyl terminus of ORF6 expressed type 1 fimbriae and had adherence properties similar to those observed in the wild-type strain. These results demonstrate the existence of additional genes near fimP that are likely to be involved in the synthesis and function of cell surface fimbriae of A. naeslundii T14V.     

人脐静脉内皮细胞清除补体攻膜复合物的机制

目的：探讨内皮细胞清除补体攻膜复合物（MAC）的途径及其清除动力学，方法：原代培养的人脐静脉内皮细胞以RH414荧光标记质膜双层，0℃组装亚溶剂量的MAC，37℃复苏后，LSCM实时监MAC沉积诱导的质膜囊泡化形成和胞吞，胞吐情况,流式细胞仪定量检测内皮细胞表面MAC抗原的清除情况，结果：MAC沉积后，内皮细胞有的质膜囊泡化形成，囊泡以胞吞和胞吐2种方式离开细胞，并以前者占优，37度条件下，内皮细胞清除表面MAC的半衰期约为5min。结论：内皮细胞可通过胞吞和胞吐2种机制清除细胞表面沉积的MAC，并以胞吞方式为主。     

The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group

BACKGROUND: Patients with hypertension and renal-artery stenosis are often treated with percutaneous transluminal renal angioplasty. However, the long-term effects of this procedure on blood pressure are not well understood. METHODS: We randomly assigned 106 patients with hypertension who had atherosclerotic renal-artery stenosis (defined as a decrease in luminal diameter of 50 percent or more) and a serum creatinine concentration of 2.3 mg per deciliter (200 micromol per liter) or less to undergo percutaneous transluminal renal angioplasty or to receive drug therapy. To be included, patients also had to have a diastolic blood pressure of 95 mm Hg or higher despite treatment with two antihypertensive drugs or an increase of at least 0.2 mg per deciliter (20 micromol per liter) in the serum creatinine concentration during treatment with an angiotensin-converting-enzyme inhibitor. Blood pressure, doses of antihypertensive drugs, and renal function were assessed at 3 and 12 months, and patency of the renal artery was assessed at 12 months. RESULTS: At base line, the mean (+/-SD) systolic and diastolic blood pressures were 179+/-25 and 104+/-10 mm Hg, respectively, in the angioplasty group and 180+/-23 and 103+/-8 mm Hg, respectively, in the drug-therapy group. At three months, the blood pressures were similar in the two groups (169+/-28 and 99+/-12 mm Hg, respectively, in the 56 patients in the angioplasty group and 176+/-31 and 101+/-14 mm Hg, respectively, in the 50 patients in the drug-therapy group; P=0.25 for the comparison of systolic pressure and P=0.36 for the comparison of diastolic pressure between the two groups); at the time, patients in the angioplasty group were taking 2.1+/-1.3 defined daily doses of medication and those in the drug-therapy group were taking 3.2+/-1.5 daily doses (P<0.001). In the drug-therapy group, 22 patients underwent balloon angioplasty after three months because of persistent hypertension despite treatment with three or more drugs or because of a deterioration in renal function. According to intention-to-treat analysis, at 12 months, there were no significant differences between the angioplasty and drug-therapy groups in systolic and diastolic blood pressures, daily drug doses, or renal function. CONCLUSIONS: In the treatment of patients with hypertension and renal-artery stenosis, angioplasty has little advantage over antihypertensive-drug therapy.     

军校研究生自我效能感和主观幸福感的关系研究

目的探讨军校研究生自我效能感与主观幸福感之间的关系。方法采用幸福感指数量表和自我效能感问卷对281名军校研究生进行调查。结果①军校研究生的自我效能感与正性情感、负性情感和总体幸福感存在显著的相关关系，与生活满意度相关不显著；②高自我效能感和低自我效能感组在正性情感、负性情感和总体幸福感上均存在着显著的差异；③自我效能感分别进入正性情感、负性情感和总体幸福感的回归方程，对其均有较好的预测作用，其中对正，巨情感的预测更佳。结论军校研究生的自我效能感与正性情感、负性情感和总体幸福感存在显著的相关关系，对其有较好的预测作用，其中自我效能感与正性情感成分联系更为密切，预测作用更佳。     

Invasive pulmonary aspergillosis: high incidence of disseminated intravascular coagulation in fatal cases.

BACKGROUND AND PURPOSE: Disseminated intravascular coagulation (DIC) is a rarely described finding in invasive pulmonary aspergillosis (IPA) with unclear impact on mortality. METHODS: This study included patients with positive cultures of Aspergillus spp. from respiratory specimens, serological evidence of aspergillosis, or lung biopsy findings supporting aspergillosis treated at National Taiwan University Hospital from January 1999 to June 2005. IPA was defined based on the consensus of the European Organization for Research and Treatment of Cancer, and the Mycosis Study Group of the National Institute of Allergy and Infectious Diseases. Univariate logistic regression analysis was used to evaluate the factors associated with mortality. RESULTS: Proven or probable IPA was diagnosed in 26 patients. Hematological malignancy was found in 11 patients (42%) and immunosuppressive agents had been administered to 17 patients (65%). Among 20 culture-proven infections (77%), the most frequently encountered fungi were Aspergillus fumigatus (46%) and Aspergillus flavus (23%). The overall mortality rate was 62%. Univariate and multivariate analyses revealed that DIC was the only factor that was significantly associated with death attributable to IPA (p<0.01). CONCLUSIONS: IPA is associated with a high mortality rate, particularly for patients with DIC.